Young with OA,what is the future?

[Jenny1]

Hi,
I have developed troublesome OA in the last five years. This occurred in my early 30s. I have pain in my spine,one knee,some fingers and my feet.I am also very prone to getting tendonitis.
I had to have surgery on my knee and spine due to this.
I was sent to rheumatolgy and was told I am just unlucky to have so much 'wear and tear' and it must run in the family.
I was told I could take paracetamol as I can't take anti-inflammatories and try to get a good night's sleep and that would sort me out and I was discharged. My bloods don't show inflammation and I don't have red hot joints but they do swell and are painful.
I keep fit and eat healthy .I exercise every day as I would get too stiff if I didn't although I often have worse pain the day after exercise.
There is no one person to look after OA.I go between the GP,Physio and Orthopaedic doctors to sort out the problems that keep happening.They only look at each joint problem as they occur but there is no co-ordination between them.
Are there any new regimes/thoughts out there?.J

[Arthritis Care]

Hi Jenny1

Thank you for your post, I’m sorry to hear about the pain your experiencing, it sounds as if you’ve had a pretty challenging time and you’re wondering what the future holds, which is completely understandable and may be at times quite difficult to manage.
I wonder if you would like to give us a ring on our Helpline where we can take the time to talk informally and in confidence, sometimes a listening and supportive ear can be quite helpful.

It’s great that you keep fit and eat healthily as they are the main components of the self-management of Osteoarthritis, as well as not carrying excess weight. You seem to be seeing the correct professionals for your arthritis, I wonder if on each consultation you could ask them to notify each of the others, so as to keep each of them up to date with their findings, (if this isn’t being done already).

Here is a link to our information on self-management which you may find of interest, in our ‘Managing pain’ publication you will find details about ways to manage pain aside from medications: https://www.arthritiscare.org.uk/what-i ... &location=

I hope this is helpful.

Best wishes
Lynda

Arthritis Care Helpline
0808 800 4050 10 am to 4 pm weekdays

[Dr Sandeep Bawa]

Jenny,

Sorry to hear about your issues.

Have you ever been offered a joint injection?

Have you ever been seen by a Rheumatologist?

I think you should discuss with your GP regarding the possibility of a Rheumatology referral - obviously I don't have all your details to hand but this maybe worth considering - also to rule out any systemic involvement as you are very young to have such damage simply due to OA

Hope this helps.

[pinkjude]

Hi Jenny, I suffered with severe pain in my leg, back, foot etc for years from about aged 35. My GP kept telling me I had pulled a muscle doing gardening etc and kept fobbing me off with painkillers. Eventually I asked for a second opinion from another GP in my surgery. She did some basic exercises and said I think its a problem with your hip/ pelvis. I had an xray then MRI which found that I had severe wear and tear caused by osteoarthritis. When I saw a consultant he said that my pelvis was twisted and I had probably been like it since birth and I had learned to walk etc in my own way to overcome it.
I ended up having a hip replacement but they made me wait until I was 50. He made my legs equal lengths which meant I struggled to walk properly after wards but after a lot of physio am finally feeling the benefit.
I can recommend pilates which is very gentle and really helps with your posture etc and a good practitioner tailors the exercises to you and gives you things to do at home, maybe worth considering.

I understand your frustration and worry but hopefully with the correct advice you can find the treatment that works best for you

[Jenny1]

Thanks Dr Bala and PinkJude
I did see rheumatology but it was not a good experience. The junior doctors I saw treated me like a joke,poked me so hard in the chest I was bruised and told me to go to bed ear lier. I later went to a consultant who thought I might have a connective tissue disorder but didn't know what and no clues in my bloods so was discharged also.
I do pilates and strength training to help my muscles stay strong. Lying in bed now with terrible pain in my knee because I sat for too long when out for a meal.

[wendygreen]

Hi Jenny1,

In addition to your exercise regime and the excellent advice you've already been offered, have you considered trying a supplement? Some people find relief from supplements like Indian frankincense, SAMe, sigesbeckia, glucosamine, chondroitin and turmeric - and since you can't take anti-inflammatories it's definitely worth a try.

Make sure you buy your supplement from a reputable company (preferably UK/US based) and preferably one that bears a THR (traditional herbal registration) stamp - which means the MHRA (Medicines & Healthcare products Regulatory Agency) is satisfied that it meets their quality standards.

You'd need to take your chosen supplement for at least 3 months to find out whether or not it can help your symptoms. To help you determine whether it's worth continuing with the supplement after that period, rate your pain and other symptoms out of 10 before starting with it and again at the end of the 3 months.

Just a few further thoughts .... you say that your joint pain is worse the day after you exercise, which makes me wonder if you're overdoing it? While exercise is great for arthritis sufferers for a whole host of reasons - including less pain and stiffness and better mobility - it's important not to overdo it, as it can make your symptoms worse. As well as considering moderating the amount of exercise you do, it may be worth trying something a little gentler - such as yoga or t'ai chi for stretching and walking or swimming for low-impact aerobic exercise?

I hope this helps.

Wendy

[Mr Adrian Wilson]

I think it would be a good start to get some plain X-rays including arthritis views and an MRI to quantify the amount of damage and see which part of the knee is affected as there are many new and exciting non surgical and surgical interventions now available for active people with osteo wear and tear arthritis.
Sadly the UK is a conservative place in terms of what is offered so its really important to go and see a specialist knee surgeon i.e. someone who only looks at knees..

[Lee Murphy]

Hi,
I have developed troublesome OA in the last five years. This occurred in my early 30s. I have pain in my spine,one knee,some fingers and my feet.I am also very prone to getting tendonitis.
I had to have surgery on my knee and spine due to this.
I was sent to rheumatolgy and was told I am just unlucky to have so much 'wear and tear' and it must run in the family.
I was told I could take paracetamol as I can't take anti-inflammatories and try to get a good night's sleep and that would sort me out and I was discharged. My bloods don't show inflammation and I don't have red hot joints but they do swell and are painful.
I keep fit and eat healthy .I exercise every day as I would get too stiff if I didn't although I often have worse pain the day after exercise.
There is no one person to look after OA.I go between the GP,Physio and Orthopaedic doctors to sort out the problems that keep happening.They only look at each joint problem as they occur but there is no co-ordination between them.
Are there any new regimes/thoughts out there?.J

Hello Jenny,
Given the diffuse nature of your arthritis and my speciality, I will only comment on your foot problems. The vast majority of patients with foot arthritis are treated successfully with non-surgical options. Using simple supportive or functional foot orthoses (specialised insoles) often helps along with the right shoes. There are lots of different and more stylish shoes available on the market that support your foot and put less pressure on painful joints. Targetted corticosteroid injections can also help individual joints affected by arthritis - these help reduce pain and inflammation but do not get rid of the arthritis in the joint so I rarely use them in isolation. Due to the fact that your feet have 28 bones and several small joints between these, I often perform the injections under image guidance to give patients the best chance of lasting relief. Ankle splints (eg. if you google 'Mueller the one') can be very helpful in reducing pain associated with arthritis of your ankle and joints in the back and middle of the foot. I often use these in combination with injections.
If the more friendly options do not work for you, surgery for foot arthritis is a reasonable option. There are many surgical options, but most of them can be broken down into the following four:
- cheilectomies (where the prominent pieces of extra bone that have grown as part of the arthritic process are removed to stop them rubbing on shoes or reduce pressure across the joint)
- osteotomies (where bones are cut and re-aligned to reduce pressure across the joint surface)
- arthroplasties (where pieces of bone are cut away from a joint to stop them rubbing together and causing pain - this can also be combined with joint replacements in your ankle or big toe joint for example)
- fusions (where the surfaces of the arthritic joint are removed and the two bones stuck together to reduce movement and pain)
As above, I would recommend seeing a specialist in the foot for your foot problem. Podiatric surgeons see and treat feet every day and arthritis is a very common condition that we successfully manage.

[Jenny1]

Thanks once again for being so kind to reply.
As regards exercise it is difficult to get the balance right. My physio is constantly on about keeping mobile but I can end up in pain because of my efforts.
I had my knee scoped a few years ago and was told I had no cartilage left behind my kneecap. I had a medial meniscus tear repaired at the same time. I had a fall earlier this year and further tore the medial and also tore the lateral meniscus.The surgeon I saw then said he couldn't do anything else and that if I was in absolute agony I could maybe get a steroid injection.
I have a great orthotics physio and I do feel they have helped but still have problems with my feet. I have peroneal tenosynovitis in one foot with a tendon tear.My foot occasionally rolls over to the ankle side nearly knocking me over.On the other foot I have a painful bunion and a huge ganglion under my third and fourth toes. This is growing because I am getting a tingling sensation with it.
My feet are getting wider all the time and so have a hard time getting (rather ugly ) shoes.
I guess it would make life easier if you had one doctor to oversee all these things not going from one specialist to another. OA is a very low priority in my experience.

[wendygreen]

Hi Jenny,

With regard to exercise - I realise it's hard to get the balance right, but I think it's worth experimenting with different types and amounts of activity to find out what gives you the most benefit without triggering more pain.

I hope you find some relief from your OA pain.

Wendy