Latest news with #VersusArthritis
Telegraph
26-04-2025
- Health
- Telegraph
How to look after arthritic knees
When it comes to osteoarthritis (OA), our knees are most vulnerable; the most complex joints in the body, constructed with four bones and an extensive network of ligaments and muscles, carrying our full body weight. An estimated 5.4 million people in the UK are living with knee OA, but we still don't know the cause. It's not a simple case of 'wear and tear'. Genetics play a role, as well as gender – it's more common and severe in women – and injuries, such as sports injuries earlier in life or hard physical labour. 'At its base level, OA is inflammation of a joint, a cycle of wear and failure of repair,' explains Mr Saket Tibrewal, a consultant trauma and orthopaedic surgeon at the Cromwell Hospital, who specialises in the knee. 'Any joint damage causes inflammation, then you get the release of fluid which carries enzymes which damage the cartilage itself.' Cartilage is the smooth, slippery tissue that cushions the end of our bones to allow them to move freely against each other. The more damaged it becomes, the greater the reaction to further damage – the more fluid, the more enzymes. 'Over time, these cycles get progressively worse.' How can we halt it? Anyone concerned by OA knee pain should first get a diagnosis to establish the state of the joint and, if it is OA, how much cartilage is left. When it comes to self-management, it won't be possible to reverse, but there are steps that might prevent further deterioration and certainly control symptoms. 'If you get it right, you might be able to get through all your active life with a little bit of pain but avoiding surgery,' says David Vaux, the head of therapies and exercise at Arthritis Action and author of Stronger. 'If you get it wrong, and especially if you do too much, you potentially accelerate your journey towards a knee replacement.' So what might help? The best supplements for knee pain Turmeric ' Turmeric is a natural anti-inflammatory,' says Tibrewal. 'I tell my patients to take it and for some, it really works.' Curcumin, one of its active components, has anti-inflammatory properties similar to that of non-steroidal anti-inflammatories and a BMJ review of studies of turmeric or curcumin on knee OA found that all recorded improvements in pain and function. Glucosamine 'This plays a role in building cartilage and might delay it's breakdown,' says Tibrewal. 'Again, not everybody is going to feel a benefit, but some do.' While some research has found that glucosamine reduces OA knee pain, other studies showed little improvement. Chondroitin 'This can nourish the joint and improve cartilage health,' Tibrewal explains. According to the charity Versus Arthritis, chondroitin has been tested in more than 20 randomised controlled trials and many have shown significant clinical benefits in pain reduction. Although, again, evidence is mixed. Vitamin D ' Vitamin D supplements are important for general bone health,' notes Tibrewal. It may also have anti-inflammatory effects and help maintain the immune system. Get the right footwear 'Your knee is affected by everything around it,' says Tibrewal. 'The ankles, hips, back and spine all feed into it. It's one whole chain and little imbalances anywhere can affect the knee. People who are flat-footed, or have an incorrect gait, for example will get good symptom relief by addressing that.' A doctor, occupational therapist, physiotherapist or podiatrist can all give advice here. For those with advanced knee arthritis, Nice guidelines recommend Apos, a foot worn device which looks like a trainer and redistributes pressure in order to reduce pain. (It's also available privately, often covered by medical insurance.) 'Insoles can make a big difference,' says Tibrewal. 'I also use a lot of knee bracing. For people who have a lot of wear in one part of the knee, special braces can push the leg straight and take away the pressure.' Finding the correct footwear is essential. Shoes should have thick soles, enough toe room, and good arch support. 'There should be enough cushioning to reduce the impact when you walk,' says Vaux. Listen to your knees 'Exercise is so important to strengthen the joint but if you feel pain doing something, it's a request for change,' says Vaux. 'Either you did it for too long or it's the wrong exercise for you. Anyone with OA needs to listen to their body and pace themselves far more than the person on the next treadmill or climbing the escalator in front of you who doesn't have OA. It's not fair but it's important to understand that. Exercise, like medicine, requires the correct dose and for that, you need a diagnosis first, and then a schedule where you 'train clever', not hard, doing less exercises but precise ones. We need a little bit of impact for strong bodies, but prolonged impact is detrimental.' How do you know if pain is 'healthy' post-exercise ache or a sign of damage? 'It's normal to have aches after training, but if the knee swells, if you're losing mobility, if it's pain that persists, you need to rest the knee,' Vaux continues. When it comes to training muscles around the knee, Vaux suggests twice a week is enough. 'But that's not a golden rule,' he adds. 'If you train on Monday and by Thursday, your knee is not feeling great, opt for something non-weight bearing, like cycling, or work on your core and upper body.' Lose weight 'Offloading the knee through weight reduction is first and foremost the most effective way to alleviate symptoms,' says Mr Rej Bhumbra, a consultant orthopaedic surgeon on the Knee Team at The London Orthopaedic Clinic. 'Four times our body weight goes through the knee joint, so even if a patient can lose 5kg, that means 20kg less on the knees. That slight change in weight makes a huge difference.' However, it isn't just about weight. 'It's the type of weight you have,' says Bhumbra. 'Is your body distribution more fat-based or muscle-based? Muscle bulk around the knee – good quads and hamstrings – offloads the knee.' Research by the Radiological Society of North America (RSNA) has shown that people with strong quads are less likely to need knee replacements. Sleep well and manage stress 'Sleep is when your body makes its repairs, so prioritise sleep and find ways to manage stress, whether it's breathing protocols or talking therapies or anything else,' says Vaux. Chronic stress and lack of sleep triggers inflammation and potentially exacerbates pain and the cycle of joint damage. 'If you're always in a state of arousal, our sympathetic nervous system keeps us on alert and the counterbalance, our parasympathetic nervous system, doesn't have a chance to help our body relax, recover and repair.' A review of 54 studies on the impact of chronic stress on arthritis, found that 41 showed it to be a risk factor for worsening pain and disease progression. Tailor your diet 'Eat your anti-inflammatories,' says Tibrewal. 'Get your omega-3 from oily fish.' The Mediterranean diet is anti-inflammatory while processed meats, sweets and sugary drinks are linked to higher inflammation. Protein is also important. 'As we age, our ability to absorb protein is reduced so we should be eating a little bit of protein with every meal,' says Vaux. 'The amino acids stored in our skeletal muscular tissue are the repository on which the body draws when recovering from injury and repairing. Stay flexible Synovial fluid, also known as joint fluid, is a thick, lubricating liquid found within the knee joint that reduces friction during movement and nourishes the cartilage and surrounding tissue. 'Joint health depends on a full range of motion in order to get synovial fluid feeding the surface of our articular cartilage,' says Vaux. 'If you lose 10 or 20 per cent of movement, you've lost 10 or 20 per cent of that nourishing fluid getting to those areas and that will accelerate wear and tear. Build in a simple night-time and morning stretch routine – you can do them when you're lying in bed.' These include: Knee rotations Lying on your back with your legs together and knees bent, slowly lower your knees to one side, staying within a comfortable range and not allowing your back to raise up. Bring your knees back to the middle, repeat to the opposite side. Doing so for 2 minutes, this should be slow and rhythmic. Crossover knee push Then cross your right ankle over your left knee. Using your right hand to gently press on your right knee, push your knee away from your body until you feel a slight stretch in your right hip and lower back. Then, gently pull your knee toward your belly button before pushing it away again. Continue this movement for one minute before swapping to the left side and repeat the movement. The best exercises for arthritic knees When it comes to exercise, low impact is important, such as swimming, cycling, cross-training, and rowing machines. 'If you really want to run, if you love to run, I'd recommend grass, not tarmac or treadmill and to limit it, mixing it up with other non-weight bearing cardio,' says Vaux. 'Brisk walking is excellent.' 'For strength training, you want to build all the muscles around your knees as a natural brace for that corseting effect, but you also want to strengthen the connective tissue, your ligaments, and tendons that stabilise the knee joint. Isometric exercises – which involve contracting muscles without moving the joint – are ideal for people with knee OA. They give you a really nice contraction without the impact that we want to avoid.' Static wall sit 'These are great for stabilising our knee joints,' says Vaux. 'Depending on your level, start with a slight bend in the knee leaning against the wall, then hold for 30 seconds. Over time, build up to a minute. When that becomes easier, bend your knees a further five degrees and so on. Build this habit into the dead times of your day, like waiting for the kettle or when you're on hold on your phone. Remember, if it hurts, go higher, or try another exercise.' Static hip bridge 'This is another great isometric exercise that builds tolerance in the muscle and ligaments of the knee,' says Vaux. 'It is also a good alternative if wall-sits make your knees sore.' Lie flat on the floorwith your legs bent. Drive through your heels to push your hips upwards as far as you can go. Slow motion sit down 'When you have got to sit down during the day, do it in slow motion every time to the count of 5 or 6,' says Vaux. 'This is an eccentric contraction and it's gold dust for building stability and preventing knee injuries and the kind of knee pain you experience when walking downstairs.' Alternate single leg box step-ups 'Build up to four sets of 10 on each leg and when that feels easy, put some bottled water into a pack on your back and build up to four sets of 10 again,' says Vaux. Using the staircase is also fine. Walking lunge 'Start with own body weight, building up to four lots of 10 lunges for each leg and when this is too easy, add some water bottles to your backpack and start again,' says Vaux. Single leg balance 'Balancing on one leg can be done anywhere, including waiting for a train or queuing at a check out,' says Vaux. 'Use a sink or table if you need a little more support.' Bouncing 'These are great for balance, muscle and bone health and without the knee impact of jumping,' says Vaux. Facing a desk, a table, kitchen top or sink, hold the surface in front of you with your hands shoulder width apart, bend your knees slightly, with feet shoulder width apart and gently bounce. Keep your back straight and looking up, letting your heels raise up but not letting your toes leave the floor. Start out with 20 bounces and build up to 50 bounces 3-4 times a week. Stronger:10 exercises for a longer healthier life by David Vaux is available now
Daily Mail
22-04-2025
- Health
- Daily Mail
Revealed: The miracle treatment that could ease your crippling knee pain and save you from surgery for years
Former Olympic athlete Allison Curbishley used to compete for Britain in the 400m, but by last year she was struggling to even walk a few feet because her right knee was so painful and stiff. Like millions in this country Allison, 48, was suffering with osteoarthritis, when cushioning cartilage in the joint wears away, and doctors were warning her a knee replacement may be her only option. But despite her finding even going down the stairs virtually impossible at times, Allison didn't feel ready to undergo this surgery. 'I knew if I had one [a replacement knee] that young, it would probably need replacing in about 20 years,' says Allison, now a BBC broadcaster who lives near Hexham, Northumberland, with partner Steve Cram, 64, the Olympic silver medallist and athletics commentator. 'But I didn't think I had many other options.' Yet Allison is now back to her former active lifestyle – after having an injection of a gel normally used to treat lame horses. Doctors hope it will delay younger patients needing a knee replacement by years. More than 100,000 people a year in the UK undergo knee replacement surgery. Although the average age for the procedure is 70, around one in six patients are under 60. An artificial joint usually lasts about 20 years. It's hoped the new gel, called Arthrosamid, could postpone when patients need their first knee replacement, potentially avoiding the need for a second one in later years. Called a hydrogel, it is made of water and a porous component called a polyacrylamide, a substance that's not degraded by our immune system so remains in the knee for years, where it calms down inflammation in the synovium, the soft membrane that lines and protects the knee joint. Once the gel is injected, which takes 15 minutes under a local anaesthetic, it gets absorbed by the synovial membrane. Data presented at the European Orthopaedic Research Society meeting in Denmark last year, involving 49 patients with an average age of 70, showed that four years after a single jab of the gel they still had reduced pain and stiffness and improved function of the knee. More than five million people in the UK have knee osteoarthritis, according to the charity Versus Arthritis. It causes cartilage – the tough fibrous material which acts as a shock absorber for our joints – to be worn down to the point where bones rub together. This is not only caused by wear and tear; it is now believed that gender (it's more common in women), obesity and injury to the joint also play a part. 'More people are exercising and active for longer,' says Andrew Pearse, a consultant orthopaedic surgeon at Worcestershire Acute Hospitals NHS Trust. 'Recreational sportspeople have higher rates of injury and therefore are more likely to end up with osteoarthritis.' Treatment usually revolves around controlling the pain and inflammation with drugs such as ibuprofen, or steroid injections into the knee to reduce the swelling. But tens of thousands each year need major surgery to have an artificial knee joint fitted. Allison was forced to retire from athletics after six operations (followed by a further three since retiring) to clean out damaged cartilage floating inside her knee. 'Unfortunately my knee problems have plagued me all through my athletics career,' says Allison. 'By the time I was into my mid-40s there was less and less I could do. I couldn't kneel because my right knee simply wouldn't bend enough to allow that and was too weak for me to ever balance one-legged on it. 'After a long drive I had to flex my knee because it was so stiff. I would wake up in the night as my knee hurt so much, and in the morning I had to warm it up with gentle bending movements.' Painkillers did little to help and in November 2022 her knee had deteriorated so much that her surgeon raised the subject of a joint replacement. 'By this time I was suffering big flare-ups when my knee would lock and leave me in agony,' Allison recalls. But then she heard about the new gel treatment via her physiotherapist. Arthrosamid was developed in Denmark and was first used in 2009 in the veterinary world to treat lameness in horses. Since proving safe for humans, about 15,000 patients across Europe have had the treatment. It's not available on the NHS and private treatment in the UK costs around £2,500. 'It has the potential to be a game-changer,' says Mr Pearse. Meanwhile, a five-year NHS trial was launched last year by Robert Jones and Agnes Hunt Orthopaedic Hospital and Keele University, involving 61 patients with knee osteoarthritis who were given Arthrosamid. Six months in, researchers reported 76 per cent had reduced pain and improved function. Allison had her injection in July last year and was almost immediately 'walking about without any pain and I had more flexion in my knee', she says. Earlier this year she did her first 5km Park Run in five years. 'At some point I might need a knee replacement but the gel has at least bought me more time before having it,' she says.
Yahoo
24-03-2025
- Health
- Yahoo
Teaching blood cells how to 'switch off' arthritis
Patients are taking part in a trial that scientists hope could ultimately lead to a cure for rheumatoid arthritis. The AuToDeCRA-2 study seeks to prove it is possible to train white blood cell commanders - dubbed the "generals" of the immune system - to order other "soldier" cells to stop attacking healthy tissues. Prof John Isaacs, who has worked on the condition for 35 years and is leading the research, believes this could make it possible to "switch off" rheumatoid arthritis. Trial participant Carol Robson, from Jarrow in South Tyneside, says the worst part of living with the disease is the pain, but if the research helps ease suffering "that would be wonderful". The study, funded by the charity Versus Arthritis and the European Commission, is being run by Newcastle University and Newcastle Hospitals. "It's pioneering," Prof Isaacs claims. "There are only one or two other groups around the world doing similar work." In this latest research, now in its second phase, certain cells are isolated from a patient's blood. Prof Isaacs explained there are different types of cells that come together, rather like an army of soldiers, to attack an infection or disease. These take instructions from the white blood cells known as dendritic cells, which he refers to as the "generals" of the immune system. When these generals sense danger they become excited and send out the attack signal, but when there is no danger detected they remain calm and instruct the army to ignore healthy tissues. When this goes wrong it causes diseases like rheumatoid arthritis. Over the course of a week the patient's white blood cells are grown in the lab and trained to resemble the "calm" generals so that, when given back to the patient, they command the soldiers to stop attacking the patient's joints. "In time, this treatment could provide significant benefits to people living with rheumatoid arthritis by 'switching off' the disease," Prof Isaacs explains. Among the estimated 450,000 people in England who live with the condition is 70-year-old former nurse Ms Robson. She wakes up every morning to pain. Before she was diagnosed she would put her hands in packets of frozen peas in an effort to find some relief. She now takes immunosuppressants, which she says help a bit, but since being injected with the retrained white blood cells she believes she is in less pain. "Is this just me hoping it is? But realistically I do think it is better," she says. "If this trial works to switch off rheumatoid arthritis that would be wonderful. "It's a privilege to be part of something that is actually quite a leap forward - if they get it right." The outcome of the Newcastle work is being widely monitored as it could have huge implications for the 18 million rheumatoid arthritis patients worldwide. Prof Isaacs said, if its successful, the research could also have implications for other autoimmune diseases such as diabetes or multiple sclerosis. "It's an area of research that we describe as re-education of the immune system. The first two trials are small - in total about 32 patients have been involved - and more research is needed, but if it shows signs of success another, larger trial will follow. Even if all goes to plan and the treatment is shown to re-educate the immune system, it may still be another five to 10 years before patients are able to access it. But Prof Isaacs, who has dedicated his career to the condition, said it would make him and his team immensely proud to have developed the treatment. Follow BBC North East on X, Facebook, Nextdoor and Instagram. AI researchers work on detecting arthritis earlier Newcastle Hospitals Professor John Isaacs Versus Arthritis
Yahoo
24-03-2025
- Health
- Yahoo
Teaching blood cells how to 'switch off' arthritis
Patients are taking part in a trial that scientists hope could ultimately lead to a cure for rheumatoid arthritis. The AuToDeCRA-2 study seeks to prove it is possible to train white blood cell commanders - dubbed the "generals" of the immune system - to order other "soldier" cells to stop attacking healthy tissues. Prof John Isaacs, who has worked on the condition for 35 years and is leading the research, believes this could make it possible to "switch off" rheumatoid arthritis. Trial participant Carol Robson, from Jarrow in South Tyneside, says the worst part of living with the disease is the pain, but if the research helps ease suffering "that would be wonderful". The study, funded by the charity Versus Arthritis and the European Commission, is being run by Newcastle University and Newcastle Hospitals. "It's pioneering," Prof Isaacs claims. "There are only one or two other groups around the world doing similar work." In this latest research, now in its second phase, certain cells are isolated from a patient's blood. Prof Isaacs explained there are different types of cells that come together, rather like an army of soldiers, to attack an infection or disease. These take instructions from the white blood cells known as dendritic cells, which he refers to as the "generals" of the immune system. When these generals sense danger they become excited and send out the attack signal, but when there is no danger detected they remain calm and instruct the army to ignore healthy tissues. When this goes wrong it causes diseases like rheumatoid arthritis. Over the course of a week the patient's white blood cells are grown in the lab and trained to resemble the "calm" generals so that, when given back to the patient, they command the soldiers to stop attacking the patient's joints. "In time, this treatment could provide significant benefits to people living with rheumatoid arthritis by 'switching off' the disease," Prof Isaacs explains. Among the estimated 450,000 people in England who live with the condition is 70-year-old former nurse Ms Robson. She wakes up every morning to pain. Before she was diagnosed she would put her hands in packets of frozen peas in an effort to find some relief. She now takes immunosuppressants, which she says help a bit, but since being injected with the retrained white blood cells she believes she is in less pain. "Is this just me hoping it is? But realistically I do think it is better," she says. "If this trial works to switch off rheumatoid arthritis that would be wonderful. "It's a privilege to be part of something that is actually quite a leap forward - if they get it right." The outcome of the Newcastle work is being widely monitored as it could have huge implications for the 18 million rheumatoid arthritis patients worldwide. Prof Isaacs said, if its successful, the research could also have implications for other autoimmune diseases such as diabetes or multiple sclerosis. "It's an area of research that we describe as re-education of the immune system. The first two trials are small - in total about 32 patients have been involved - and more research is needed, but if it shows signs of success another, larger trial will follow. Even if all goes to plan and the treatment is shown to re-educate the immune system, it may still be another five to 10 years before patients are able to access it. But Prof Isaacs, who has dedicated his career to the condition, said it would make him and his team immensely proud to have developed the treatment. Follow BBC North East on X, Facebook, Nextdoor and Instagram. AI researchers work on detecting arthritis earlier Newcastle Hospitals Professor John Isaacs Versus Arthritis
BBC News
24-03-2025
- Health
- BBC News
Newcastle arthritis study hopes to 'switch off' pain
Patients are taking part in a trial that scientists hope could ultimately lead to a cure for rheumatoid AuToDeCRA-2 study seeks to prove it is possible to train white blood cell commanders - dubbed the "generals" of the immune system - to order other "soldier" cells to stop attacking healthy John Isaacs, who has worked on the condition for 35 years and is leading the research, believes this could make it possible to "switch off" rheumatoid participant Carol Robson, from Jarrow in South Tyneside, says the worst part of living with the disease is the pain, but if the research helps ease suffering "that would be wonderful".The study, funded by the charity Versus Arthritis and the European Commission, is being run by Newcastle University and Newcastle Hospitals. "It's pioneering," Prof Isaacs claims. "There are only one or two other groups around the world doing similar work." Training the 'generals' to stay calm In this latest research, now in its second phase, certain cells are isolated from a patient's Isaacs explained there are different types of cells that come together, rather like an army of soldiers, to attack an infection or take instructions from the white blood cells known as dendritic cells, which he refers to as the "generals" of the immune these generals sense danger they become excited and send out the attack signal, but when there is no danger detected they remain calm and instruct the army to ignore healthy tissues. When this goes wrong it causes diseases like rheumatoid the course of a week the patient's white blood cells are grown in the lab and trained to resemble the "calm" generals so that, when given back to the patient, they command the soldiers to stop attacking the patient's joints."In time, this treatment could provide significant benefits to people living with rheumatoid arthritis by 'switching off' the disease," Prof Isaacs explains. Among the estimated 450,000 people in England who live with the condition is 70-year-old former nurse Ms Robson. She wakes up every morning to she was diagnosed she would put her hands in packets of frozen peas in an effort to find some now takes immunosuppressants, which she says help a bit, but since being injected with the retrained white blood cells she believes she is in less pain."Is this just me hoping it is? But realistically I do think it is better," she says."If this trial works to switch off rheumatoid arthritis that would be wonderful."It's a privilege to be part of something that is actually quite a leap forward - if they get it right." The outcome of the Newcastle work is being widely monitored as it could have huge implications for the 18 million rheumatoid arthritis patients Isaacs said, if its successful, the research could also have implications for other autoimmune diseases such as diabetes or multiple sclerosis. "It's an area of research that we describe as re-education of the immune first two trials are small - in total about 32 patients have been involved - and more research is needed, but if it shows signs of success another, larger trial will if all goes to plan and the treatment is shown to re-educate the immune system, it may still be another five to 10 years before patients are able to access Prof Isaacs, who has dedicated his career to the condition, said it would make him and his team immensely proud to have developed the treatment. Follow BBC North East on X, Facebook, Nextdoor and Instagram.
