Conditions

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Rheumatoid Arthritis

Rheumatoid arthritis is a condition that causes pain and swelling in the joints. Hands, feet and wrists are commonly affected, but it can also affect other parts of the body. Rheumatoid arthritis can make your joints feel stiff and can leave you feeling generally unwell and tired.

The condition is estimated to affect thousands of people in Ireland and occurs more frequently in women than men. It is most common between the ages of 40 and 70, but it can affect people of any age.

Rheumatoid arthritis is an autoimmune disease. This is when your immune system, which usually fights infection, attacks the cells that line your joints, making them swollen, stiff and painful. Over time (if not effectively treated), this can damage the joint itself, the cartilage and nearby bone.

The symptoms of rheumatoid arthritis usually vary over time. Sometimes, symptoms only cause mild discomfort. At other times, they can be very painful, making it difficult to move around and do everyday tasks.

When symptoms become worse, this is known as a flare-up or flare. A flare-up is impossible to predict, making rheumatoid arthritis difficult to live with.

Free app to download from Google Play googleplay or iOS App Store iosappstore - RAISE Rheumatoid Arthritis

www.arthritisireland.ie

www.versusarthritis.co.uk

www.nras.org.uk

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Fibromyalgia

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Fibromyalgia is a common illness. In fact it is more common than RA. People with mild to moderate cases of fibromyalgia are usually able to live life as normal.

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Useful links when pain is main concern:

Understanding pain in less than 5 minutes

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Tame the Beast – Lorimor Moseley

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When stiffness is main concern:

People often describe vague muscle aches as "stiffness," but when doctors talk about "stiffness," they mean that a joint doesn't move as easily as it should. Stiffness may be prominent even when joint pain is not. Joint stiffness can have considerable impact on your daily life and work.

Mild morning stiffness is common in osteoarthritis and often goes away after just a few minutes of activity. Sometimes people with osteoarthritis also notice the same type of stiffness during the day after resting the joint for an hour or so. In inflammatory arthritis, however, morning stiffness may not begin to improve for an hour or longer. Occasionally, prolonged joint stiffness in the morning is the first symptom of an inflammatory condition. Joints affected by inflammatory arthritis can feel very stiff, e.g. if your hands are affected, you may not be able to fully bend your fingers to form a fist. Like joint pain, the stiffness is often worse in the morning or after a period of inactivity.

Here are some things that you can try to help ease morning stiffness:

  1. Plan ahead; Discuss with your team about timing your anti-inflammatory medications.
  2. Exercise in bed; set your alarm for a few minutes earlier than you need to be up at. Stretch gently and do some gentle range of motion exercises. It helps to warm up your muscles and loosen your joints. Discuss with your physiotherapist what exercises are suitable for the joints that are affected.
  3. Have a warm shower; the heat causes the blood to move to the surface of the skin, warming the joints in the process.
  4. Warm your clothes on a radiator or briefly in the dryer. Heat can help.
  5. Use heat packs/hand warmers/warm clothing, especially on chilly days.
  6. Move your body every day: Inflammatory conditions can make exercise difficult. While it is important not to stress or strain a joint while it is in flare, you should still try to move all the other joints. When not in flare you should aim to build up to 20-30 minutes of activity every day (more if you are able to). Keeping your body fit and strong can reduce the amount of time it takes to relieve stiffness and get going in the morning.
  7. Don’t stress, ask for help: Mornings tend to be busy anyway, but when your joints are stiff and painful, things may be even more difficult. Don’t be afraid to ask for help, family and friends are usually happy to be of assistance.
  8. Be mindful; Take time for yourself every day. Managing stress can help you cope better with your condition.

Check out the Arthritis Ireland website, under “Get Help” click on “Take control with Exercise”.

arthritisireland.ie

versusarthritis.org

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Useful links when worry or anxiety is main concern:

The Struggle Switch – Russ Harris

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The Unwanted Party Guest – Joe Oliver

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Struggling With Internal Hijackers  

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90:10 What is the single most important thing you can do for your stress – Dr. Mike Evans

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Useful links when sleep disturbance is main concern:

Do you practice good sleep hygiene? Mayo Clinic Minute

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Sleep hygiene – How to Sleep Better!

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11 Sleep hygiene Tips by SleepZoo

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Additional useful links:

23 and ½ hours - Dr Mike Evans

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What’s the best diet: Healthy eating 101 – Dr. Mike Evans

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Are you sitting too much?

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Values vs Goals – Russ Harris

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The Sushi Train Metaphor – Russ Harris

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Patient Information Leaflets

  1. Understanding Pain
  2. Managing Activity
  3. Flare-ups and Pain
  4. Sleep and pain
  5. Setting Goals
  6. Exercise and Pain
  7. Persistent Pain Booklet
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Mindfulness Audio Tracks

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Other useful resources online:

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Spondyloarthritis

Axial Spondyloarthritis (axial SpA) is an inflammatory arthritis where the main symptom is usually back pain. Axial spondyloarthritis is an umbrella term and it includes:

  • Ankylosing Spondylitis (AS): Where changes to the sacroiliac joints or the spine can be seen on x-ray.
  • Non-radiographic axial spondyloarthritis: Where x-ray changes are not present but inflammation is visible on MRI or you have symptoms.

Typical symptoms of axial SpA (AS):

  • Slow, gradual onset of pain and stiffness in the back over weeks or months.
  • Early-morning stiffness and pain, which generally reduces during the day with movement or exercise.
  • Symptoms lasting for more than 3 months.
  • Feeling better after movement and worse after rest.
  • Fatigue or tiredness.

If left untreated it can be a painful, progressive form of inflammatory arthritis. It mainly affects the spine but can also affect other joints, tendons and ligaments. It can be associated with inflammatory bowel disease, inflammatory eye conditions and psoriasis.

Work: 
Symptoms can sometimes interfere with your ability to perform your duties at work. Pain and fatigue can have a significant impact on what you want and need to be able to do at work.

Work is good for your health – as well as improving financial security, it can boost health and happiness.

For more information, click on the links below:

Free apps to download from Google Play or iOS App Store:

Back to Action   iosappstore

MySPA googleplay  iosappstore

The Occupational Therapist (OT) can assist you by supporting you to stay in work, or get back to work. Ask for nurse or doctor for a referral to OT if this is something you need.

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Osteoarthritis

Osteoarthritis (OA) is the most common joint disorder. It is a clinical syndrome of joint pain accompanied by various degrees of functional limitation and reduced quality of life. While it generally affects the elderly population, it should not be considered a consequence of aging.

In OA, the bottom of the thumb, and the small joints of the fingers are often affected. This can cause pain, weakness and problems with your grip. You may find that some of your regular daily activities become difficult and painful. There are many different options that can help, including:

  • Strengthening the muscles that support the joints
  • Changing the way you do things, modifying your grip
  • Using equipment such as jar openers, and tools with larger handles
  • Using splints and gloves to support painful joints
  • Pain relief, such as anti-inflammatory gels and paracetamol

The knee is one of the most commonly affected joints. Osteoarthritis causes the cartilage in your knee joint to thin and the surfaces of the joint to become rougher, which means that the knee doesn’t move as smoothly as it should, and it usually feels painful and stiff. Osteoarthritis can affect anyone at any age, but it’s more common in women over 50. The genes we inherit from our parents can also increase the risk of the condition developing. Being overweight is also linked to osteoarthritis, as this causes extra strain on weight-bearing joints, such as your knees.

www.versusarthritis.org

www.escape-pain.org A rehabilitation programme for people with chronic joint pain of the knees or hips that integrates educational self-management and coping strategies with an exercise regimen. There is a free app that you can download (Android only).

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Foot Problems

Feet have a complex structure consisting of 26 bones, more than 30 small joints (where bones meet) and many muscles, tendons, ligaments and nerves.

Pain or problems in the foot and ankle are often, but not always, associated with arthritis.

Most feet have an arch shape that spreads the body's weight evenly over many bones and joints. The structure of the foot changes as we get older or if arthritis affects the foot joints, and many people will notice changes, particularly in the arch of the foot.

Even if you don't have any significant health conditions, you should still seek help if there is:

  • Ulceration of the skin (a break in the skin), or if it is infected.
  • Poor circulation/blood flow to the area.
  • Pain for more than three months.
  • A change whereby symptoms are noticeably worse.
  • A change in the colour of your skin, especially if it's dark blue or black.
  • Progressive changes in the shape of your foot.

You should also seek help from your GP if:

  • you suddenly develop foot problems,
  • you have increased swelling,
  • you're on drugs which suppress your immune system (including steroids or biologics), or if you have a history of poor skin healing.

Useful links:

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Useful resources from the UCD centre for Arthritis Research

UCD centre for Arthritis Research: A research group investigating rheumatic diseases.  Their Newsletter is co-produced by patients and researchers. It can be accessed here.

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