"I've been diagnosed with wear and tear on my right hip. I've a constant nagging pain, but don't want to take the painkillers prescribed. Is there anything else I can do to help the pain?"
Dr Sarah Jarvis says: “ Osteoarthritis is often described as ‘wear and tear’. It’s the most common kind of arthritis (joint inflammation or problems) and affects about 8.5 million people in the UK. The most common joints affected are hips, knees, spine and finger joints. It gets more common with age, and at least half of people have at least some osteoarthritis by the age of 65. However, it can affect much younger people, especially in joints that have been damaged (eg by trauma or congenital deformity) or if you’re very overweight.
The most common symptoms of osteoarthritis are stiffness (often worse in the mornings), pain and sometimes swelling. Affected joints may look slightly larger, but they don’t tend to be hot, red and acutely swollen – this is seen in ‘inflammatory’ arthritis, such as rheumatoid arthritis. Pain is often worse when you’re moving around, and rest pain is a sign of more severe arthritis.
In inflammatory arthritis, treatment aims to modify the course of the disease and needs to be taken regularly. In osteoarthritis, tablets will only reduce pain in the short term, not change the long-term outcome. Painkilling tablets can cause side effects – codeine-based painkillers can be addictive, and can cause constipation and drowsiness. Non-steroidal anti-inflammatory tablets can cause indigestion or bleeding from the stomach, as well as damaging the kidneys in vulnerable patients (especially at high doses or if taken long-term).
There is no need to suffer needlessly, and I would not recommend that you avoid painkillers at all costs. However, lifestyle changes can help significantly with osteoarthritis. Keeping your weight down is key, since excess weight puts enormous pressure on weight-bearing joints. While exercising can make pain worse, keeping active plays a pivotal part in keeping joints mobile and reducing further deterioration.
The evidence over some complementary therapies is conflicting. While honey with cider vinegar has been used by many thousands over the years, there is no evidence it actually makes a difference. Many people swear by glucosamine and chondroitin, but there have been as many negative as positive studies. However, the rosehip extract GOPO does have promising evidence and may be worth trying.”
-Dr Sarah Jarvis