Joint issues

[ZM1980]

Hi all, first post here. I have been experiencing ongoing, worsening joint symptoms - soreness, stiffness, grating and grinding sensations, weakness, mild pain in various joints - outer elbow, base of thumbs, wrists, neck and knees. I first saw a Rheumatologist in 2015 and was diagnosed with joint hypermobility, X-rays all normal, however, my symptoms have been gradually worsening over the years and last year following an MRI scan, I was diagnosed with cervical spondylosis (mild) and referred for physiotherapy. I was given neck exercises to do, but have not noticed any improvement in symptoms.

I was referred back to Rheumatology last year, but because of long waiting lists, was only seen in September this year (by one of those services the NHS outsources patient care to), who weren't very helpful, leading me to request a second opinion. They said inflammatory conditions have been ruled out, but diagnosed 'mechanical joint pain' and mild carpal tunnel syndrome (bilateral). I did mention my worsening symptoms in various joints and that I was concerned about possible osteoarthritis, but they dismissed this.

My symptoms are quite bad at the moment, especially the soreness and stiffness in the upper joints (outer elbow, wrists, thumb), to the degree that even carrying a slightly heavy shopping bag exacerbates things. When I spoke with my GP a few days ago, he said I'm 'too young to have widespread osteoarthritis' (I'm 42, but given my hypermobility and chronic symptoms, I'm thinking it's possible). I just want a diagnosis - an explanation for my symptoms - so I can look into appropriate treatments.

The only abnormalities in my blood tests are persistently higher than normal ESR and slightly high CRP (normal RA). I take vitamin D regularly and omega 3, 6, 9.

I would appreciate any advice on diagnosis and treatment - what type of scans/imaging would help in making a diagnosis and what treatments are available. Thanks in advance.

[DorsetLady]

Have a look at his site - very informative and helpful...

versusarthritis.org/about-a...

[ZM1980 in reply to DorsetLady]

Thank you for the link, will have a read through

[arthritis_action Partner]

Hi ZM1980 , thanks for sharing your experiences.

There are a variety of approaches and techniques to address both the physical and mental impact of arthritis. Arthritis affects people differently, so each individual can choose the techniques that help them live a fuller, more active, life whilst living with the condition.

Options to help manage your symptoms of arthritis include:

• Try to keep to a healthy weight. For every pound that you are above a healthy weight, an extra 4 or 5 pounds of weight goes through your hips knees and feet. This can increase the pain you feel in those joints

• Keep your muscles strong and do some exercises, to build the muscles that support and protect your painful joints. Exercises that increases muscle strength can really help support the joints and reduce the pain of arthritis

• Keep to a healthy diet. Eating healthily can help maintain muscle and bone strength, and help you keep to a healthy weight

• Try to relax to help manage the pain better. Distraction, meditation, reducing stress and trying to help your sleep can all help reduce pain

• Painkillers and anti-inflammatory medicines are often prescribed to help with the pain and stiffness of osteoarthritis. These can be taken when needed or before activity that you know can trigger the pain. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can be very effective for helping pain and stiffness, but they should be used in the lowest possible dose for the shortest possible time as they can increase the risk of irritation of the stomach including ulcers as well as cardiovascular disease such as heart attack and stroke

• Physical therapies such as physiotherapy, osteopathy and chiropractic treatment can all help. Therapists can give you exercises to help you manage your pain and improve your function

• Joint injections of a corticosteroid and local anaesthetic can sometimes help individual joints that are especially painful. The benefits can last for many months or even longer

More information can be found on the charity website arthritisaction.org.uk. Hope the above is helpful, let us know how you get on!

[ZM1980 in reply to arthritis_action]

Thank you for all the useful info. I was walking quite a bit (daily), but as my symptoms have flared up, I've reduced this and am a bit apprehensive about doing exercise, incase it worsens things. Im not taking any medication/painkillers, as I have chronic digestive issues (reflux, stomach issues), so can only really take paracetamol. Want to be certain this is osteoarthritis, but how do I go about getting a diagnosis? It seems that Rheumatology only deal with/treat inflammatory joint/autoimmune conditions

[arthritis_action Partner in reply to ZM1980]

Many people with arthritis worry that exercise can harm the joints, however this is not true. It is normal to sometimes feel a little sore or uncomfortable after exercise, especially if it is something you haven’t done for a while, but it is important to remember that this does not mean that you are harming your joints. In fact, regular exercise is essential as it helps to strengthen the muscles that protect and support the joints. Exercise has even been proven to help reduce the pain of arthritis and improve function.

Regarding getting a diagnosis, it would be best to speak to your GP or healthcare professional and ask for their advice based on your specific circumstances. We have a page on our website about speaking to your GP which may be helpful for this: arthritisaction.org.uk/wp-c...

[ZM1980 in reply to arthritis_action]

Thank you for the link. I plan to contact my GP again soon, especially as at the moment, certain movements seem to be exacerbating the symptoms in a lot of my joints! I was doing resistance band exercises up until June/July this year, but then stopped. Will have a look into what type of exercises are beneficial.

[piglette]

My mother had osteo arthritis at the age of 42 as well. My ESR and CRP are high around 42 and 31 respectively. I would love to know why. I used to be a trustee of Arthritus Care now Versus Arthritis and there were several people in their 40s with osteo.

[ZM1980 in reply to piglette]

That makes sense, I do think it's possible to develop early onset osteoarthritis. Sorry your mother experienced this too, how was she diagnosed? Your CRP levels seem quite raised, did your GP have any idea as to why? Mine are slightly high at 6.2/7 (5 being the upper limit), but ESR has been higher than normal for a while - highest was 47, then reduced to 36 - not sure what it is now.

[piglette in reply to ZM1980]

My mother was dusting and found she could not pick up the duster. Her doctor diagnosed it. In the end her hands were like claws. She had new hips later on. My CRP has gone over 100 a couple of times. My GP tested for cancer. He has now decided it is just me!

[ZM1980 in reply to piglette]

I'm glad no cancer was found - it must have been worrying with the blood results and having the tests. In the absence of physical symptoms, I suppose sometimes there really is no medical reason for blood results being at a higher range!

[piglette in reply to ZM1980]

It would be nice to know why. My brother did think that I may have been meant for another planet!

[Happyrosie]

I can’t add much to what other posters have to helpfully said other than to add that my mother had osteoarthritis in various joints by the time she was in her early forties. She loved knitting and had to give it up through pain in fingers.

I myself have generalised oestoarthritis. I use exercise, care for my diet and painkillers

[ZM1980 in reply to Happyrosie]

My hands tend to go a bit stiff when I hold a pen/write for a while, so my writing's not always at it's best! Sorry to hear how osteoarthritis affected your mother, with the knitting too. Hope you're managing well with your symptoms, what exercises do you find help best?

[Happyrosie in reply to ZM1980]

Exercise: almost every day I do between 8,00 and 10000 steps (I’ve got a Fitbit to check). This is mostly just moving around but I go for a 40 minute walk most days.

And almost every day I do ten minutes of Joe Wicks on Utube. His “exercises for seniors” are several ten or fifteen minute programs and are really excellent to follow, and of course free!

[Batty1]

Do you have psoriasis or family history of them? Have you had a DEXA scan yet? Take a look at this link for hyper flexibility joints, interesting.

rarediseases.info.nih.gov/d...

[ZM1980 in reply to Batty1]

Thank you for the info. I had been thinking about the possibility of Ehlers Danlos, as I have a lot of chronic digestive issues (mainly reflux, stomach issues), fatigue, as well as the joint symptoms. Not sure about a family history of psoriasis, but my mother, who also has joint issues (arthritis), has a small patch of dry, itchy skin, just on her wrist - I don't have dry skin, but sometimes feel an itchy, tender sensation over my sternum and other bones. I did ask MSK for a DEXA scan , only to be told they only refer if 'clinically indicated', so have been considering of going private for that (or might try asking GP)!

[kev60]

Hi and welcome i have been asked to add my tuppence worth as i have had various therapies, physio, neuro physio, hydrotherapy and osteopathy. osteopathy worked because its hands on the same with neuro physio. i seem to do better with hands on therapy but its hard to come by as the services at the moment prefer arm's length, i have had physiotherapy using an app and a paper sheet but find difficult to get into. but you need to try anything and everything you can get and find the one that works for you. my arthritis of the spine was down to carrying up to 9 tons per day of glass. but it took a while for a full diagnosis of AO of the spine as they found i had bone growths on my spine (and a lot of pain). As for pain killers i have GORD (reflux) and am restricted with what i can have, i have found Bunov pain patches have helped, and they go through the skin rather than stomach. i started on 5micrograms and went up to 35micrograms and settled on 30micrograms, it helps alleviate the worst of the pain but i still get bad days, good luck in the future. kevin

[ZM1980 in reply to kev60]

Hi, thanks for sharing. There seems to be quite a few different therapies available for joint issues/arthritis, good that you tried quite a few and found some that helped. I'm on the waiting list for physiotherapy (have had a bit for neck issues in the past), but will see what they suggest for the other joint issues. Will have to look into what else is available at the moment, but I'm thinking there's a lot less available now, though.I have GORD as well, so aspirin and ibuprofen exacerbate symptoms, but I can tolerate paracetamol. Your spine condition sounds painful - glad you finally got a diagnosis and found the Bunov patches work for you. I'm still trying to get a diagnosis, but going by my symptoms and hypermobility, I'm thinking osteoarthritis. Will see, anyway.

Best wishes

[Kneesandtoes]

Reading up on the Omega 3 Omega 6 balance might be a good idea. Most diets have too much omega 6 in relation to Omega 3 and that is inflammatory. You are supplementing with omega 6 which may be counterproductive.My swollen painful finger joints returned to normal after I replaced spreads, margarine and sunflower oil with butter and olive oil. Cutting out processed food and reducing sugar also reduces inflammation.

YouTube has lots of helpful videos with exercises, Bob and Brad are very good, but there are others who emphasise that you must strengthen the muscles round the joints not just walk. I have never liked taking pain killers, because they lower the body temperature which in my case is already low and one risks doing too much without being guided by the pain.

[ZM1980 in reply to Kneesandtoes]

Yes that's true about the omega 3 to omega 6 ratio - I haven't been taking it long, but it's a combined supplement, with the omega 3 at 260mg and omega 6 at 67mg - but you're right that maybe I don't need to be supplementing with the omega 6 at all. I use olive oil and olive oil spread. That's great the swelling in your fingers was alleviated by cutting out sunflower oil etc - sometimes it only takes a minor change to have an effect. Completely agree about painkillers masking symptoms too much - I try not to take them, only if absolutely necessary (prolonged pain/can't stand the pain). Will look into the YouTube videos, thank you for the recommendations!