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Arthritis in hip and spine

Posted , 4 users are following.

lisa04688
lisa04688

Good afternoon.

I am 49 year old, just been diagnosed with athritis in my left hip and lower back.

My mum was crippled with athritis and my grand mother also,

I feel really scared, signed up for physio last week and tomorrow i have my 1st appointment.

I work as a care assistant, and in the last couple of weeks have been unable to work, so i am letting my company down while being on the sick. I have been looking for a lighter job..... But no joy.

I am goinging to see mt GP tomorrow, and would like to know what type of questions do i ask??? Do i also ask for referral to the consultant aswell???

I am taking a concoction of pain relief..

Please Help

Lisa xx

 

2 likes, 25 replies

25 Replies

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  • Jan999
    Jan999 lisa04688

    Posted

    Hello lisa you have my sympathy because I know just how painful osteoarthritis is. I have it in several joints. I happened to initially see a Rheumatologist because my Rheumatoid Factor was slightly raised. After a lot of other tests it was confirmed I have osteoarthritis and not RA. I presume you've had X-rays to confirm your diagnosis. I also take a raft of pain medication but the one thing that has helped me considerably is Amitriptyline. I now take 50mgs on a night. It blocks the pain, helps me sleep and I don't wake in agony like I used to. I'm very stiff and a bit groggy when it's time to get up but that soon wears off. Amitriptyline is now used to block pain where as years ago it was given in much larger doses for depression. It's something worth discussing with your doctor because it's recommended by Arthritis Research. If you haven't had a recent X-ray ask for one. I also see a podiatrist because the way I positioned my feet when I walked caused pressure on my knees and feet. I wear insoles in some of my shoes (these were specially made for me) and it helps with the pain. Hope this helps lisa.
    • Jan999
      Jan999

      Posted

      Just to add lisa my sister in law has osteoarthritis in her hips and was told she would need a hip replacement very soon. She was also referred to a Podiatrist and she now wears her inserts every day. She walks a lot as well because she has a dog. Anyway the inserts have worked so well she can put surgery off for the time being. She has also cut down the number of pain killers she takes so ask your doctor for a referral.
    • lisa04688
      lisa04688 Jan999

      Posted

      Hello Matron,

      Thank you for your reply.

      I have started on  Amitriptyline taking 10mg at night, yes they rae helpful,and do help me sleep.

      I also take Naproxen and co codomol, My gp has said if i need to ican take higher dose of  Amitriptyline.

      Yes also have had x ray and started physio.

      Thank you for your comments.

      Hope your controlling your pain

      Regards 

      Lisa xxx

    • Jan999
      Jan999 lisa04688

      Posted

      It's good that you're already taking Amitriptyline. Arthritis Research states a patient can take up to 50mgs so hopefully it will help. It has helped me. Just Google "Arthritis Research", I think you'll find it informative.
  • bexnkev
    bexnkev lisa04688

    Posted

    Hi Lisa

    I have recently been diagnosed with chronic osteoarthritis in both knees so I totally understand how scary it feels at the moment.

    If I was in your shoes, I would firstly see how physio goes (I had physio in the beginning)... the physio will be able to give you an indication of what they can do and if they cannot help, they will then refer you to the orthopaedic department.

    I was previously a care assistants so I know what the job entails - I would just say do not go back before you know the extent of the problem otherwise you could damage yourself further and you are still only young!

    I wish I could give you advice that would make you feel better but sadly the only reasonable advice I can offer is listen to your body.

    I hope everything gets sorted for you and I am sure others may be able to offer so useful advice (I am still very new to this too).

    Wishing you all the best

    Bex ☺

    • lisa04688
      lisa04688 bexnkev

      Posted

      Hi bexnkev

      Thank you for your reply.

      Yes it is a scary thought and about the future.I will let you know about my physio and see what happens.

      I am off to Turkey in 2 weeks time with my husband, whome is very supportive.

      Hopefully swimming and nice hot sun will help. All the best to you

      Regards

      Lisa xxx

  • susan67756
    susan67756 lisa04688

    Posted

    Lisa, I don't want to raise false hope but I was diagnosed with hip OA in 2006 by a leading specialist. In 2012 a physiotherapist told me that I had bone on bone restriction, in her opinion (based on feel) no cartilage left and at most a year before I'd need hip replacement. Now I'm 100% symptom free.

    Here's some info / questions I'd raise with the doctor if I were you:

    Doctors don't know what causes OA. They don't know why it's painful. They don't know why it gets worse in some people and not others.

    They DO know that there is no correlation between symptoms and x-ray / mri findings. Some people have trashed joints and no symptoms - others have bad symptoms and no joint wear. Therefore, the current procedure does not require x-ray or mri to make a diagnosis of OA. If you are over 45, have been in pain for three months or more and there is unlikely to be another diagnosis then a working diagnosis of OA is made. They stop looking for other causes and they treat it as if it were OA.

    It is possible that your symptoms are, as in my case, due to something else. Something cureable. In your shoes I wouldn't be too willing to accept the diagnosis because once you accept it's OA the only treatment you're likely to get is pain killers and surgery. Now that would be positively criminal if you lived like that for the rest of your life if the real cause was something that could be cleared up completely.

    I will PM you a link to information on the Arthritis Research UK site where current procedures and advice to GP's on making a diagnosis is explained. This verifies what I'm telling you.  If I share that link here my post won't be displayed. I'd take that to your doctor and tell her that you know someone (me) that lived with OA for 8 years and it turned out to be a muscle imbalance.

    NHS physios aren't good with complex muscle imbalances - they aren't trained to detect and treat them. I doubt they'll be much help. What I had would cause pain in hip and low back. It would also wear joints abnormally in hip and low back. Ask your phsyio if they can detect twisting in your pelvis - a sacral torsion. That can cause hip and back pain that could be mistaken for OA. If so then let me know and I'll give you some information to take back to the physio so they can check to see if you've got what I had.

    I don't want to give you false hope, but honestly - I'm proof that they get this wrong. An OA diagnosis is NOT reliable simply because they never rule out soft tissue problems before making it. My dad had both hips replaced by the time he was 50 - they assumed genetic link with me. They were wrong.

    What you do now will affect the rest of your life. Please do make sure they rule out soft tissue problems / muscle imbalance before accepting it's OA.

    • lisa04688
      lisa04688 susan67756

      Posted

      Hello Susan.

      Thank you for your comments and concern.

      I will ask all that you have just said. i have actually printed off your reply to take with me tomorrow.

      Thank you so much.

      I really appreciate what you have told me.

      All the best to you

      Love

      Lisa xxxx

    • Jan999
      Jan999 susan67756

      Posted

      Susan Arthritis Research is the website I read for information. To say nobody knows what causes osteoarthritis is wrong. I'm a nurse and I know quite a lot about osteoarthritis and other conditions. It's simply wear and tear on the joints and is mainly diagnosed by scan and X-ray. I saw a Rheumatologist initially because of a raised Rheumatoid Factor so I've had blood tests, X-rays, scans, the works and I'm confident I have the correct diagnosis. Osteoarthritis is common amongst Nurses and Carers because of the joints we use day to day. I could be on my feet for almost 12 hours on a night shift so it's obvious how I got the damaged joints.

      to say physiotherapists aren't good is an insult to all the excellent physios in the NHS. I know and have worked with some excellent ones. I don't know how you can generalise like that. I am sure lisa will be in excellent hands when she starts her physiotherapy and she will benefit from it. We have an excellent NHS in this country, I know very well there are exceptions but on the whole skilled professionals (and I included myself as a skilled Senior Nurse) will help Lisa to lead as normal life as possible.

    • susan67756
      susan67756 Jan999

      Posted

      Matron, it's no longer considered to be wear and tear of the joints and it is no longer diagnosed by scan and x-ray. I've sent Lisa the link to the document (written in 2011) where it explains to GP's that they need to change how they think about OA. It also explains that x-rays and mri's are not useful in making an OA diagnosis and are no longer recommended. It's now known that there is no correlation between x-ray findings and symptoms. GP's are now advised to make the diagnosis without x-ray - unless they want an x-ray to rule out something else.

      I said physiotherapists aren't good at spotting complex muscle imbalances because it's not what they're trained to do. I first heard that from a physiotherapist and many have agreed with it since. Several physios treated me over the years and none spotted what my real problem was. This is because they are no good at spotting what was really wrong because it's not included in their training.

      From the Arthritis Research UK site:

      "Our understanding of osteoarthritis has moved forward considerably over recent years. "

      "OA is often described as ‘wear and tear’ but this is not an accurate reflection of the pathogenesis of OA"

      "The approach taken in this report is that OA should be diagnosed clinically and not on the basis of an x-ray."

      The article was written by Mark Porcheret who is responsible for GP training in relation to osteoarthritis.

       

    • susan67756
      susan67756

      Posted

      Here's what one of the physios who had treated me had to say about it when he found out it had really been a muscle imbalance:

      "I do agree with you about the training to a part but all I'd add is try to understand you are the minority of the type of patients diagnosed with that [a muscle imbalance mimicing OA] so putting more effort into training in one small specific part of the physiotherapy degree is probably deemed not worth it...that's my best guess at why anyway (remember musculoskeletal Physio only makes up about 1/5th of Physio training of a 4 year course, 3 years in England or 2 year masters). Harsh to say but most people are lazy and inactive and unwilling to put in enough effort to even begin to start addressing muscle imbalances of that severity. Doesn't make the diagnosis any less wrong but even if it was right to the majority it would make no difference. "

    • Jan999
      Jan999 susan67756

      Posted

      It all depends which articles you read. My husband subscribes to the BMJ and I have recently read articles regarding OA written by senior Orthopaedic Surgeons who recommended using X-ray as a tool towards diagnosis. There isn't a blood test that can confirm it. You can read something somewhere on the Internet that will agree with you. I tend to read professional journals and some excellent Orthopaedic doctors are our friends who do a lot of research in this area. I agree you need to take a clinical approach. I'm a trained nurse so I do that every day. Just to add in my area physiotherapists are trained in spotting complex imbalances because that is what our consultants expect of them and the are very good at their job. Again you cannot generalise.
    • susan67756
      susan67756 Jan999

      Posted

      As I said, this article was written by the man responsible for GP training in the UK. So he's hardly just 'someone on the internet'.

      Physiotherapy courses have a set curiculum - if something isn't taught it really doesn't matter what consultants expect. If the physios haven't been trained to do something they can't do it.

      Complex muscle imbalances are currently not recognised as an alternative diagnosis that must be ruled out before diagnosing OA. Therefore, it's not deemed necessary to train physiotherapists to spot them and treat them.

    • Jan999
      Jan999 susan67756

      Posted

      Well physiotherapists in my area are trained. Yes there's a set curriculum in university but this training is undertake post qualification and not as part of the university training. One of our friends lectures to medical students and he is extremely knowledgeable in OA as well. 
    • susan67756
      susan67756 Jan999

      Posted

      So if the physiotherapists in your area are trained to spot muscle imbalances that mimic OA then what are the charactersitics that they're trained to look for? Perhaps you could provide me with contact details as I'm currently researching this and would love to talk to them.

      As for whether x-rays are used for a diagnosis - here's what the NHS site has to say about it:

      "Further tests – such as X-rays or blood tests – are not usually necessary to confirm a diagnosis of osteoarthritis, although they may be used to rule out other possible causes of your symptoms, such as rheumatoid arthritis or a fractured bone.

      X-rays can also allow doctors to assess the level of damage to your joints, but this is rarely helpful as the extent of damage visible on an X-ray isn’t a good indicator of how severe your symptoms are."

    • Jan999
      Jan999 susan67756

      Posted

      In my area anyone who is displaying symptoms of arthritis (in that I included all forms) the recommendation is to X-ray. Regarding your research I would need to know more about you and what you are hoping to achieve before any consultant would give any information. Regarding your request for information about the characteristics physios look for, I can't answer that as I'm not a physiotherapist. I again would need to get that information for you. Obviously I can't pass information of this sort on this website. I don't disclose my personal information here and I'm sure you wouldn't want to either. You would have to PM me with your request and I can then pass it on to the appropriate people.
    • susan67756
      susan67756 Jan999

      Posted

      What I'm hoping  to achieve is to raise awareness of muscle imbalance as an alternative diagnosis for OA. My belief (based upon my research) is that very many people are being misdiagnosed simply because no one in the NHS is trained to identify and treat complex muscle imbalances that mimic OA.

      Part of the problem is that in evidence based practice things are only rolled out if research has been done to prove an approach to be effective. No such research has been done with regards to soft tissue causes of OA type symptoms. It's not even a blip on the radar amongst OA researchers.

      Yet in your area the physiotherapists have been trained in this. This is VERY interesting. Who trained them? What exactly were they trained to do? This is what I want to find out. If I know what area you're in - not your personal address but just the area - I'll be able to find this out for myself.

      It's also info that I know lots of others will be interested in. There are quite a few on here that believe their OA to really be a muscle imbalance. If you have physios in your area trained in identifying and treating this they could perhaps refer their physios to them for more information.

    • Jan999
      Jan999 susan67756

      Posted

      Sorry susan I will not disclose any personal information here even the area I live. It will have to be done through private messaging 
    • Jan999
      Jan999 susan67756

      Posted

      I need you to send me an outline of what you want and why. What your research is and basically who you are and are you doing this research on behalf of anyone else eg a company, university. I've been told you won't be given any information without that. Apparently the Trust has had their fingers burnt before. There was some adverse publicity because they gave information to someone who turned out to be a journalist. There's plenty of time because I won't be online for a few days now as I'm going away and may not have wifi
    • susan67756
      susan67756 Jan999

      Posted

      I'm not looking for information from you - I don't want you to act as go between as that'll just end up like chinese whispers. I'm looking to know what part of the country you're saying has physiotherapists trained to spot the type of muscle imbalances that mimic OA. That's all. The reason being that I know lots of people that believe their OA symptoms are caused by muscle imbalances and they're on the lookout for people with special knowledge of this subject.

      Just tell me the area. Not where you live. Just the hospital or authority that has this specialist knowledge. You don't need to be involved. And by all means send it by PM.

       

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