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Learning to understand your arthritis
Probably the most important step in managing your arthritis is learning
more about the type of arthritis you have. We know from research and our
own experience caring for individuals with arthritis that most people will
benefit if they learn to understand their disease and how to manage some
of the problems themselves. Sometimes this means learning to know a little
about your joints and other parts of your body that may become involved as
a result of your arthritis (depending upon the type of arthritis you
have). If you have already been given a diagnosis you can find out more
about the type of arthritis you have by going to the Arthritis Research
Campaign’s website www.arc.org.uk
If you haven't seen a doctor about your
arthritis it might be helpful to do this so you know best how to manage
your problems.
The other reason for learning more about your condition is for you to know
more about how your arthritis should be treated and what advice you should
or should not listen to. Friends and relatives often form their own ideas
and opinions about arthritis. The most unhelpful advice you are likely to
hear is that 'there is nothing to be done for arthritis'. There is always
something that can be done. It is true that there may be no 'cure' for
your type of arthritis but there are many ways that you can learn to
manage your arthritis. Another important point is that unless you
understand your diagnosis you will always come across well wishers who may
provide you with the wrong information or you may just experience a
mixture of confusing and contradictory advice.
One of the most frustrating aspects of all types of arthritis is that you
cannot always predict when you are going to have a problem with your
joints, either from the pain or difficulties in movement. If you
understand your condition there are sometimes helpful clues that may help
you to be more aware and look for ways of helping yourself - for instance
adjusting your pain medications, taking more rest or plan your outings
more carefully. An increase in symptoms is often called a 'flare'. A
'flare' usually means that the pain in the joints increases (sometimes
with swelling of the joint) or that stiffness and sometimes this can be
accompanied by a feeling of being 'tired' and 'washed out' (especially
with some types of arthritis like: Rheumatoid Arthritis, Psoriatic
Arthritis or Ankylosing Spondylitis, Lupus).
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What
is a 'flare' or your arthritis?
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Joint stiffness may increase. If you see a doctor or nurse it will be
helpful if you can give them an idea of how long the stiffness in your
joints lasts. For example in Rheumatoid Arthritis joint stiffness is
usually worst in the morning and may last only 10 minutes on a good day
but last a few hours on a bad one. With Osteoarthritis the stiffness in
the joints will tend to be longer at times of inactivity - when you sit
down to rest it takes you longer to get moving again because of the
stiffness.
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Pain may increase. This may be in just to one or two joints (especially
if you have osteoarthritis) or quite a few joints. It is often accompanied
by tenderness of the joint (or joints) and swelling. If you joint pain is
accompanied by heat and redness to the skin, with swelling and pain around
the joint area, it is important that you see a doctor promptly. This is to
ensure that there is no infection in the joint (this is not common but
does need urgent treatment if this happens). Gout can sometimes look like
an infected joint. If you have gout and you have a 'flare' it is very
common for the joint to become red and extremely painful (even to the
touch sometimes) and for those getting used to their gout it can be
difficult to know if it is the gout that is causing the problem. It will
be easier to understand this if you have seen a doctor and have been given
information by your doctor or nurse. For information on specific advice
about how to manage pain see Managing Pain
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Fatigue is a common problem when you have a flare; particularly if you
are experiencing pain and difficulties in movement or have a condition
that is a systemic disease (some diseases are caused 'systemic diseases'
because they can affect other parts of your body, not just your joints).
You can also feel tired when you are anaemic (when you don’t have enough
iron in your blood) and some people with arthritis can be prone to
anaemia.
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If you are having regular blood tests it is sometimes possible to see a
change in the blood tests as a result of your 'flare'. With a flare of the
arthritis you might become more anaemic or the 'flare' may be as a result
of an infection. So understanding your blood tests and what the different
types of blood results mean can be very helpful. For information on
understanding blood tests see Assessment & Monitoring
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Flares can sometimes be as a result of an infection (for instance if
you have a nasty chest infection). It will help if you get the infection
treated promptly. However, not all infections can be treated by
antibiotics and flu is a virus that may makes you feel ill and may make
your joints ache but antibiotics will not help. Seek advice from your
doctor or nurse.
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Practical ways of coping
People who have had an illness or a long term (chronic) conditions for a
number of years know that they need to have some practical ways of helping
themselves when they are having problems managing their arthritis. However
good the care you receive is there will still be times when you will need
to find ways of managing your arthritis yourself. In order to help you
manage here are a few practical tips that might be of use. |
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Managing a 'flare of your arthritis'
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Try hard to think positively and work out the best way to manage over the
next few days. Usually flares will come and go. It may be difficult to
understand why you have a flare - at other times you can see that perhaps
you had been gradually less well or you had forgotten your medications for
a period of time, or had an infection that perhaps had started the flare
up of your arthritis. At other times there will be no reason at all. This
can be very frustrating and most of us look for a reason. However learning
to positively cope with the flare and deal with practical aspects is often
a very good start. If the flare of your condition continues for more than
a few days or you have identified a possible infection it might be helpful
to contact your doctor for a review of your arthritis. |
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Make sure you
review your pain medications. For further information see Managing Pain
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Review your daily
activities and plans or workload - try to find ways to manage your time
to allow for mental and physical rest – healthcare workers often call
this ‘pacing’.
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Many of the things
you can do are simple practical things and do not rely on medicines.
Practical tips such as hot baths (especially helpful in the morning if
early morning stiffness is a problem). See Managing Pain
for some other ways of coping with your flare or visit the arc website
which has an excellent leaflet on pain in arthritis. (www.arc.org.uk)
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If the flare is of
only one joint - for example the knee - it may be helpful to find ways
of helping or protecting that joint. For instance using a walking stick
will help the painful knee reducing the load it has to bear whilst in a
flare. Or wearing shoes with good arch support and cushioning (such as
trainers) If the joint pain persists over a few days and you try all the
practical tips it may be worth going to see your doctor or
nurse/physiotherapist who might be able to consider whether a joint
injection would help.
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Using your mind to
cope with your arthritis
There are a number of reasons why the mind if so powerful in helping you
to cope with your arthritis. We all hear stories of how people manage to
survive very difficult situations by determination and focussing on a
goal. Your mind is a powerful tool that you should use. If you can use
your mind to focus on positive ways of coping you can block out negative
messages. From time to time you may feel low and struggle to cope and that
is natural too - but if you can try to focus on positive aspects of
managing your arthritis it will help you identify problems and use
practical ways of dealing with them.
We know that: |
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How you feel about the arthritis
will affect how you cope. If you feel that the arthritis has 'control'
over you and there is nothing you can do, it may make you feel low and
out of control. It can make you feel powerless and that you just have to
take anything the arthritis 'throws at you'. It will stop you looking
for positive ways of dealing with your arthritis.
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Feeling 'low' and 'out of
control' might mean that you are more aware of the negative messages
from your body. You will quickly recognise the pain and respond with
negative thoughts about your pain and how you cannot reduce the
discomfort. So it might be that your pain will be felt more quickly and
you will become focussed on the pain sensations rather than ways of
distracting your mind from the pain. It might be helpful for you to look
at an article I have written on the National Rheumatoid Arthritis
Society Website on how pain works at
www.rheumatoid.org.uk/article.php?articleid= 300
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If you feel so 'out of control'
it can make you decide that the arthritis will be a problem - no matter
what you do. This can mean you;
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Don’t take any of the treatment
you have been given to help control your arthritis or manage the pain
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Or that you do not you seek help
when you need it. This can create a spiral of problems that can lead to;
depression, difficulties with coping with everyday activities and low
self esteem.
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How you feel or see yourself as a
result of your arthritis will have an affect on you. When you are given
a diagnosis it can be a shock - most people see themselves as 'healthy'
and well without illness. So being given a diagnosis that gives you a
diagnosis sometimes without a cure can make you see yourself
differently. How you adapt to the realisation that you have arthritis is
important - remember you can be more 'healthy' than many other members
of the public in many ways - you just happen to have a problem with one
aspect of your body.
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Try to find out about your
medications and treatments you are having - even if you are worried
about them sometimes understanding all the risks and benefits of the
treatment can help.
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The best way to help
yourself manage how you think about your conditions will be to take
opportunities to learn about your arthritis and how to manage some
problems yourself. The support of the healthcare professionals who can
teach and guide you is very important but this support isn’t always
available to everyone and cannot be there all the time. As so many people
say 'there wasn’t anybody around and available to help at 3 o'clock in the
morning when I had a problem with my joints and I didn’t know what to do'.
There are a number of opportunities to improve your knowledge about your
arthritis. There are group activities organised either by your local
hospital or by a patient organisation (Expert Patient Programme). One to
one sessions with a specialist practitioner who will tailor the
information specifically to your individual needs. Arthritis Care (www.arthritiscare.org.uk)
or National Rheumatoid Arthritis Society (www.rheumatoid.org.uk) are
organisations who provide a range of opportunities for you. If you are
unsure what your local hospital provides, phone the rheumatology
department to find out or contact your health centre and ask the nurse
practitioner if they have any information. |