Living With Arthritis and Related Conditions in Ireland

Arthritis is a painful disease that usually affects the joints of the human body. Actually, the word arthritis comes from two Greek words: arthro and itis.

Arthro means joint while itis means inflammation.

If you or a loved one have ever had an arthritis diagnosis, you'll know the severity levels are broad and pain levels varied. Many impediments to everyday activities and different courses of action depend on your specific diagnosis and the individual being treated.

In this article, we're going to look at the various types of arthritis, symptoms of arthritis, and how to cope with chronic arthritis pain and related conditions as part of a proactive pain management effort for a better, more comfortable way of life.

Types of Arthritis

There are many different types of arthritis and managing patients with rheumatic and musculoskeletal diseases is something many healthcare professionals here in Ireland are well-versed in. All follow up-to-date HSE guidelines (PDF) and recommendations regarding prescription drugs such as mycophenolate, methotrexate, acetaminophen and non-steroidal anti-inflammatory drug administration considerations for patients with rheumatic diseases.

According to the Centers for Disease Control and Prevention (CDC) in the US, arthritis is a term that is normally applied to at least 100 different conditions.

The most prevalent types of arthritis in Ireland include the following:

• Osteoarthritis
• Rheumatoid arthritis
• Gout
• Lupus
• Childhood arthritis or Juvenile idiopathic arthritis
• Fibromyalgia
• Psoriatic arthritis
• Ankylosing Spondylitis

Let's have a look at each of them and how they can limit physical activity and negatively impact the quality of life for people with arthritis.

Osteoarthritis

Of all the different types of arthritis, osteoarthritis is the most prevalent. It's caused by the wearing out of cartilage, the substance between the joints. When this happens, bones may rub against each other, producing a feeling of excruciating pain.

Among the various diseases that cause disability among the older demographic, osteoarthritis occupies the top spot. In fact, osteoarthritis is relatively rare for those who are aged below 40, which could be the reason it's commonly known as "wear and tear arthritis".

In one Irish study published in the European Journal of Public Health, the overall prevalence of Osteoarthritis in Ireland was found to be 12.9%.

This is somewhat lower than the global average for arthritis patients among the general population.

According to a study published by The Lancet, the average global prevalence rate for osteoarthritis stands at 16%.

The United States leads the world in the prevalence of osteoarthritis where three main comorbidities are related to this form of inflammatory arthritis as follows:

• Heart disease: 49% osteoarthritis prevalence.
• Diabetes: 47% osteoarthritis prevalence.
• Obesity: 30% osteoarthritis prevalence.

Let's now turn to the symptoms of osteoarthritis.

Symptoms of Osteoarthritis

These include:

• Joint pain: This extreme joint pain is pronounced when you're on the move and it's often accompanied by stiffness.
• Joint inflammation: The wearing down of the cartilage and the subsequent exposure of the soft tissue are thought to contribute to joint inflammation.
• Other symptoms include tenderness and inflexibility of the joint among others.

 Management of Osteoarthritis

Since there's no cure for osteoarthritis, management of arthritis symptoms is usually the main focus of treatment. And since the most distressing symptom is chronic pain, medications that relieve pain form the core focus of most Irish doctors' prescriptions.

Voltarol Gel is a particular pain relieving favourite among osteoarthritis patients.

It's applied on the painful joint twice a day—after every 12 hours.

For other pain-related conditions, relief normally comes within 24-48 hours. However, the National Health Service (NHS) in the UK cautions that for cases of osteoarthritis, you may need to use the gel for up to 7 days to feel the full effect.

I’d add a paragraph in about Bio-electric therapy – Nurokor to reduce pain and inflammation here

You can also use corticosteroids, platelet-rich plasma (these drugs use protein to relieve pain), antidepressants and anti-seizure drugs. We always advise speaking to your doctor to discuss which medications may best suit your needs.

Non-drug mediated osteoarthritis management includes exercise. According to Arthritis Ireland, and contrary to widely held notions, exercise is actually beneficial in osteoarthritis management.

Rheumatoid Arthritis (RA)

Rheumatoid arthritis is an auto-immune disease. This means that the immune system mistakes the body for an enemy and attacks it. In cases of RA, the focus of the immune system attack is usually the joints. The most commonly affected joints include the knees and the wrist.

It's not yet known why the immune system behaves this way—but genes, family history, and gender are thought to play a role.

Women are 2.5 times more likely to have this form of arthritis than men.

Smoking is also one of the most understood lifestyle risk factors among people with RA - as is weight.

Smokers are inordinately represented in Rheumatoid arthritis statistics. They get a more severe form of this disease, and they are also less likely to experience remission.

The World Life Expectancy Organisation keeps an impressive number of global health statistics and databases. Statistics appearing on its website show that as of 2018, RA is responsible for 0.25% deaths in Ireland - or 0.77 deaths per 100,000.

These statistics put Ireland 17th in the world for Rheumatoid arthritis deaths, making it an all-too-common concern for health professionals to try and overcome with their patients.

Symptoms of Rheumatoid Arthritis

The most common symptoms among RA patients include:

• Pain and stiffness: According to the Arthritis Foundation, the pain and joint stiffness that comes with RA should have been present for at least one and half months. Since this type of arthritis affects joints like elbows, wrists, ankles and knees, these joints are usually the pain points of this autoimmune disorder.
• Other joint symptoms include swelling, tenderness, warmth, or redness on the joints. Small joints usually get affected first.
• Fatigue and tiredness doing everyday tasks.
• Fever, body chills and loss of appetite.
• Inflammation of blood vessels which may affect the nerves and the skin—or other organs of the body.

Management of Rheumatoid Arthritis

Rheumatic diseases like Rheumatoid arthritis do not have a definitive cure. Generally an autoimmune disease is only managed, not treated. That's the reason this type of arthritis is classified as a chronic disease.

The management aims to lessen joint damage, damage to the connective tissue, joint pain and swelling, joint injury, among other symptoms.

To do this and to restore joint function, therapies generally aim to minimise joint inflammation.

Certain arthritis medications which are used to manage RA are collectively identified as Disease-modifying Antirheumatic drugs (DMARD's)

Ibuprofen, from the Nurofen range of products, is particularly useful and can help reduce or eliminate intense joint pain associated with this type of arthritis. Alternatively, for drug-free options to reduce inflammation and block pain, consider the Nurokor range.

Other medications that can help ease the pain of arthritis include:

• Steroids
• Biologic agents: These are genetically engineered drugs that mimic the immune response of natural proteins.

Non-pharmacological management may include joint replacement especially in a case of severe arthritis.

Joint fusion or tendon repair are other recommended surgical interventions.

Also, maintaining a healthy weight should form part of your management plan as, according to the Arthritis Foundation, certain medications may not be as effective where patients are obese or overweight.

Obesity also tends to worsen symptoms.

Physical exercise can help reduce the severe pain of this joint disease and improve your health outcomes.

However, treating arthritis may involve a combination of approaches and that's the reason qualified medical advice is recommended.

Gout

Gout is caused when there's too much uric acid in the blood.

But why would uric acid accumulate in your blood?

Several factors can influence such a build-up, including:

• Being overweight or not eating healthily as part of a balanced diet.
• Adopting a diet high in animal proteins. The United States Third National Health and Nutrition Examination Survey specifically singled out meat and seafood.
• Having Type 2 Diabetes. 
• Drinking excessive amounts of alcohol.
• Prolonged taking of diuretics: Diuretics are drugs which result in increased water discharge from the body.
• Kidney disease: In Ireland, 16.6% of those who have Chronic Kidney Disease have gout.

When there's too much uric acid in the blood, the acid crystals are likely to form in the joints making you develop arthritis of this specific type.

But how would you know that you have gout - the disease traditionally associated with kings and nobles?

Symptoms of Gout

Some common symptoms of gout include:

• Pain in the big toe: the uric acid crystals often move to the joints in your big toe where your body's immune system attacks them. This is usually the clearest and the most unmistakable indication of gout.
• Pain in other joints like knees and ankles.
• Pain which is more severe at night.
• Tissue or muscle pain.

The good news is that, unlike other types of arthritis, gout can be treated.

Effective Treatment and Management of Gout

Doctors usually apply a two-fold approach in treating gout.

The first is to manage symptoms of gout attack like pain and inflammation. This is where pain relief products such as Voltarol or Nurofen – both widely and internationally recognised for their pain relieving properties - come in.

The second is to give drugs that alleviate uric acid accumulation.

Patients are also advised to make necessary diet and lifestyle changes ideal for minimal uric acid accumulation and subsequent problems.

Managing Other Forms of Arthritis

• Lupus: Avoid common triggers like sunlight and overworking, be able to tell when a flare is coming, and be in constant touch with your medical doctor.
• Juvenile idiopathic arthritis (JIA): This category of diseases primarily affect children. Since they also affect joints, and induce pain, many people with juvenile arthritis experience relief after using pain-relieving medications like Nurofen and Panadol.
• Fibromyalgia (sometimes accompanied by inflammatory bowel disease): It can also be managed by Non-steroidal anti-inflammatory drugs (NSAID's) such as naproxen or ibuprofen. Antidepressants, taken in low doses, are also helpful. Always talk to your doctor about these medications.
• Psoriatic Arthritis: Between 0.3% - 1% of the Irish population have Psoriasis. About 1 in 3 of these may develop Psoriatic arthritis. Psoriatic arthritis can be a very distressing disease. Drugs used to manage it include Biologics, NSAID's such as ibuprofen (specifically for inflammation), Disease-Modifying Anti-Rheumatic Drugs (DMARDS), and corticosteroids. Physiotherapy is also advisable especially to improve muscle strength and range of movement.
• Ankylosing Spondylitis (AS): This form of arthritis is recognisable by a stiff, bent spine. Medications may help reduce pain but exercise and physical therapy such as cold therapies and heat therapies can also prove highly beneficial among AS sufferers.

Sports Injury Joint Pain

Sports injury due to factors like sprains, strains, and cramps can be both painful and costly. As a result, some people can experience time lost playing a sport, fees incurred on medical treatments and a negative impact on mental wellbeing if side-lined through injury for a prolonged period.

You may relate and sympathise with the experiences of many GAA players, who are reportedly six times more likely than the general population to suffer from arthritis-related pains and stiffness.

While serious injuries may involve major medical interventions including surgery, don't underestimate the potential of anti-inflammatory solutions like Voltarol Gel and Thermacare patches for inducing immediate pain relief. 

Conclusion

Whatever the case and cause of your pain, whether it's related to arthritis or sports injury, you should carefully evaluate your arthritis treatment options and consult a GP or specialist physical therapist.

If you’ve got a question for our pain specialists on the topic of arthritis and related conditions or any of the pain relief solutions or medications available in-store or on our website, please contact us today. We are here to help and support you as you make informed decisions when it comes to managing and coping with your specific form of arthritis. We will help you find the best course of action in line with your GP’s advice.