There are two types of arthritis (rheumatoid and osteo) and about eight million sufferers of the disease.
Rheumatoid arthritis is caused by inflammation in the lining of the joints and is a chronic progressive disease that causes swelling in the joints, resulting in deformity and immobility especially in the fingers, wrists, feet and ankles.
Osteoarthritisis affects the cartilage and bone, causing pain and stiffness. It usually occurs in weight-bearing joints such as the hips, knees, spine, back and neck, but can also affect finger joints, toe joints and the spine.
In the case of rheumatoid arthritis an early warning blood test may help sufferers in the future. Doctors have discovered a link in the blood of those likely to develop the disease – two kinds of anti-bodies – one to a substance called anti-cyclic citrullinated peptide and another called rheumatoid factors.
There is a drug which is able to block a chemical called tumour necrosis factor (TNF) which causes the swelling and tissue damage in rheumatoid arthritis. It is available on the NHS but expensive it costs about £10,000 a year but helps those who do not respond to any other treatment. – about ten per cent of people with the disease. Another is Enbrel is a twice-weekly injection for rheumatoid arthritis.
Recent discoveries that may help are:
Surgeons in Finland have managed to create new joints using tissue-engineering techniques and a specially designed mould or scaffold. In the operation, a small round scaffold full of tiny holes is fitted in the gap between the two pieces of bone at either side of what was the joint. Once in place, the job of the scaffold is to create and maintain a space between the bone ends.
The idea is that the surrounding tissue invades the mould through the tiny pores of the scaffold and fills the empty space, effectively creating a living, working joint. The Finnish surgeons who carried out the operations on 80 individual joints at the Medical University of Tampere said they found that during the first ten days, when the hand is in a splint, the cells migrated into the mould and almost filled it. As the cells grow, the mould itself starts to degenerate.
Almost two years after the first joint was implanted, doctors found that all patients had less pain and had a wider range of movements in their hands. The surgeons say that although this group of patients had very poor joints because of previous repeated operations, the results were at least as good as those reported for the best conventional implants.
More information on the treatment options available and advice can be obtained from the National Rheumatoid Arthritis Society Helpline, Mon-Fri 9.30am-5.30pm, 01628 670606. www.rheumatoid.org.uk
In cases of osteoporosis one of the most common treatments is the painkiller Inbrufen. Doctors have also discovered that some antibiotics may help to slow down the effects of osteoarthritis of the knee. Doctors who gave the antibiotic doxycycline to patients with the disease found it significantly reduced the loss of cartilage by 33% , as well as cutting pain levels. It is thought that the antibiotic works to relieve arthritic pain by inhibiting chemicals or enzymes that break down joint cartilage. It is thought that doxycycline can slow the progression of structural damage and help reduce pain.
There is a growing list of alternative therapies such as frankincense and myrrh made from the gum of two different trees – boswellia serrata (frankincense) and commiphora molmol (myrrh) has been found to be as successful at reducing pain and inflammation caused by arthritis as conventional painkillers.
An exotic fruit called Noni, a member of the citrus family from the south sea Pacific islands is attributed with relieving arthritis pain. The juice from the fruit found on the islands of Tahiti and Hawaii has anti-inflammatory chemicals and antibacterial compounds that work to block the causes of joint pain.
Cod liver oil has long reputed easing aching joints. Now scientists say it is so effective it should be hailed as a natural ‘wonder drug’. In the first clinical study of its kind, cod liver oil was found to be highly effective in slowing the destruction of joint cartilage – the ‘cushion’ between bones – in patients with arthritis. A daily capsule of fish oil could help delay arthritis from developing and people as young as 20 should start taking it to protect their joints. Fish oil cuts the risk of heart attacks and strokes by helping to thin the blood, and contains essential fatty acids – omega- 3s – which are crucial for maintaining brain power and may protect against Alzheimer’s.
A laboratory study has also shown that collagen, the most abundant protein in the body, can stimulate the growth of new cartilage tissue. Present in bones, joints, muscle and other connective tissue, scientists believe that in some people, particularly the elderly, its production slows down or stops.
Supplements seem to perform the same role as natural collagen in keeping the tissue in joints healthy and supple. The latter group showed significant reduction in pain and an improvement in joint mobility, with 93 per cent achieving positive results, some after only two weeks.
Glucosamine is a natural substance in the body which helps form new connective molecules that make vital links between cells and tissue. As people age, they lose the ability to manufacture sufficient levels of glucosamine. Cartilage then loses its gel-like nature and ability to act as a shock absorber. In Spain, Portugal and Italy, glucosamine is the preferred treatment for arthritis. Research shows glucosamine sulphate – a basic building block in cartilage tissue – can combat pain caused by the natural wear of joints that comes with increasing age. Top athletes take the food supplement in pill form to relieve the pain caused by the constant pressure on their joints, especially the knees.
People with joint pain and muscular tension are also getting relief from a skin patch which provides a steady supply of glucosamine. The glucosamine gel patch gives a sustained release through the skin. Glucosamine is combined with the cooling effect of menthol and anti- inflammatory properties of horse chestnut. The patch can be worn day or night on ‘mobile’ areas such as the elbow, knee, ankle or foot, as well as flat areas such as the back.