More info on mucle imbalances (For those who seek cure)

ITLSusan

I've shared my story on curing hip OA and am working hard to help others understand how they might achieve this too.

To pre-empt any confusion over what I meant by cure here's what Dictionary.com has to say:

Cure: 
1.a means of healing or restoring to health; remedy.
2.a method or course of remedial treatment, as for disease.
3.successful remedial treatment; restoration to health.
4.a means of correcting or relieving anything that is troublesome or detrimental:

I stress I am not trying to tell anyone that they SHOULD attempt this. You are all free agents and if you know it's not for you then I have no interest in convincing you otherwise.

This is for people that ARE interested in taking the same steps I took to help myself. I'm now symptom free. It *might* work out that way for others.

For moderators that aren't clear on what muscle imbalance is - it's simply, well .... like it says on the tin. Muscles get out of balance causing joint to track abnormally. The treatment isn't anything controversial. It's physical therapy. Recommended by NICE and all competent sources of info on OA self help. Including Arthritis Care.

Here's what a Doctor *** ******** has to say about it:

"There's a continuous process of ‘wear and repair’ happening in our joints. But some circumstances tip the balance more towards wear in the joint rather than repair. For example, injury or muscle weakness around the joint, which in turn leads to pain and the changes seen in the joint in osteoarthritis.

Addressing problems like muscle weakness or abnormal load passing through the joint can help to bring the balance back towards the repair process. In summary – for most people osteoarthritis isn’t an inevitably progressive thing and can be modified by looking for and addressing the problems that tip the balance from wear to repair in the joints."

http://www.arthritisresearchuk.org/arthritis-information/q-and-a/selfhelp-exercise-and-healthy-lifestyle/walking-and-arthritis.aspx

So, by correcting muscle imbalances and restoring good posture and movement we can bring the balance back towards the repair process.

Now, in my case I had a whole host of problems. Including:

• Hip OA (one symptomatic hip; both hips with degenerative changes)
• Stiff, painful neck (moderate to severe degenerative changes)
• Bone on bone shoulder impingement
• Bunions (toe OA)
• Chronic, uncontrollable pain (nerve pain)

ALL became symptom free when I corrected the muscle imbalance. A single muscle imbalance was responsible for all of these symptoms. It wasn't the random collection of symptoms that it seemed to be.

It's well publicized that the best treatment for oa is exercise and physical therapy. Unfortunately only generic plans are recommended and they tend to not get good results. Even with these simple plans research shows that patient compliance is poor. Stellar results from these generic plans is rare. I'm told (I don't know how much truth there is in it) that this isn't researched and offered as a personalised treatment plan simply because most people won't be willing to put in the work to get good results. It's essentially cost considerations getting in the way.

Fortunately, if you're willing to put in the work and do your homework there is plenty of information out there to help you to become your own expert. Outside the health service there's lots of expertise in this. To eliminate muscle imbalances isn't easy. You first need to accurately diagnose what's wrong. But it CAN be done.

I found the key was:

• Accurately diagnosing the precise nature of the muscle imbalance.
• Identifying which muscles are involved - throughout the body. (So not just targeting with generic corrective exercise plans)
• Using targeted trigger point therapy to get pain relief and restore mobility
• Working hard on appropriate corrective exercises.

Every case is different. My feeling is that hips will be the hardest - and that's perhaps why hip OA is most likely to progress to needing surgery. But I got my hip problem sorted - it CAN be done.

I don't know what state my actual joints are in now. I don't much care. They are symptom free so I'm now in the same boat as all the non-symptomatic people with xray evidence of joint wear. But from what researchers are telling us it is possible that now that my body and joints are functioning normally the repair process may well be reversing the degenerative changes in my joints.

I'm not allowed to share details - by instruction from the moderators.

But I can guide you towards Googling "muscle imbalance" "Trigger Point Therapy" "Myofacial Release" "shirley sahrmann " "postural dysfunction'.

This *may* throw up information that will help some. But don't assume you're not curable if you fall at the first hurdle. It took me 9 years to figure it out. On a more positive note the things I learnt kept me pain free enough to keep training hard for the most part.

Best of luck and I'm happy to answer whatever questions I can within the rules of these forums.

Edited by Moderator JK

dreamdaisy

Oh delicious! Mucle imbalances? Come on, you can do better than that for a title. Your confusion between 'lose' and 'loose' is understandable but this typo is most entertaining. At least you are beginning to acknowledge that your approach may not be appropriate for all.

ITLSusan

Moderator - can ask why you edited out the doctor's name from my post?

The doctor in question is the author of the article that I lifted the quote from. the article that I've linked to. Surely he should be credited ? Isn't it normal to credit the author when you quote directly from their work?

See here for more info on citing internet sources:

"Whenever you use a direct quote, acknowledge the quote by placing it inside quotation marks and then naming the author."

http://ikeepsafe.org/be-a-pro/ethics/how-do-i-correctly-cite-internet-sources/

Slosh

When referencing internet sources you should also cite details of the source article and the date on which you downloaded it. I presume it was blocked as anyone can claim to be a doctor, perhaps you remember "Dr" Gillian McKeith.

ITLSusan

I didn't download the article. I provided a direct link to it. The article is freely available on the Arthritis Research UK website. I'm sure the mod was just rushing and assumed I was quoting my GP and not a Arthritis Research UK article! No doubt she'll pop the name back in in due course

ITLSusan

A little background on muscle imbalances for those that don't understand what this phrase means:

QUOTE:

"What is Muscle Imbalance?

Your body has muscles (or groups of muscles) that are attached to either side of a joint and work against one another to control the movement of the joint. It’s a bit like the handlebars of your bike: you can ride with one hand, but two hands working against each other gives you much better control.

When one side of the opposing muscles is stronger than the other, you have a muscle imbalance. For instance, if you regularly use the muscles on one side a lot more than the other, they get stronger muscles – and shorter and tighter. On the other side, the muscles get weaker – and longer and looser. The shorter, stronger muscles pull that part of your body out of position, and your whole body will end up making adjustments to compensate."
http://www.weybridgephysio.co.uk/article/muscle-imbalance-and-postural-dysfunction

How does this impact on osteoarthritis and joints?

When parts of your body are pulled out of position your joints can't track normally. Abnormal wear can occur. A little like the way tyres on your car wear when the tracking is off.

In addition to joint wear (which may or may not be symptomatic) your muscles will come under great strain. Some are constantly overstretched and others are constantly under tension. This causes tight knots and bands to form in the muscles which can produce extreme pain and refer that pain to joints and other parts of the body.

Due to normal human mechanics, when one joint gets out of balance it will often throw out the whole system. There are set patterns to the way in which sections of the spine and the rest of the body moves in relation to each other (see fryettes laws). Prevent one link in the chain moving normally, and in order to preserve center of gravity, the whole system will move out of alignment. Over time strain, wear and ultimately pain and restricted range of motion can occur in many joints.

As researchers now know, osteoarthritis ISN'T a wear and tear condition but rather "wear and REPAIR". Much of the joint damage is caused by the body's attempt to lay down bone in order to stabilise the joint. This isn't necessarily a bad thing if it doesn't get out of control. Given half a chance the joints can start to repair themselves.

As the doctor explained in the Arthritis Research UK article I linked to above - if you can just make changes to push things over to a state where 'repair' starts winning out over 'wear' the body CAN heal itself. It's possible to turn the condition around and get better rather than worse.

Now, if ALL of your symptoms are down to the muscle imbalance it is of course possible to become 100% symptom free. Cured.

If some of your symptoms are caused by wear to the actual joint then it's less clear. Research is now showing that actual improvement in xray findings can and does occur. (See the NICE guidelines for more info). But certainly you can help stop things getting worse and eliminate the symptoms caused by the actual muscle imbalance.

The bad news is that muscle imbalances can be notoriously difficult to address. The little generic exercise plans you get given by your doc or charities like AC won't cut it in most cases. It's something you need to work hard and consistently at. You need to understand your specific imbalances and use targeted exercises to correct them.

That said, some simpler imbalances do just correct themselves through change of habits etc. I'm guessing this is why knee OA often improves with time but less so hip OA - simply because imbalances that tend to occur around hips are HUGELY complex and stubborn.

But of course, OA isn't a proper diagnosis. Not every case is the same. Some people truly will have things wrong with actual joints and the joint itself is creating the problem. However, just because of the way in which the human body works, if you have joint dysfunction you will also have muscle imbalances. Guaranteed. Addressing the muscle imbalances will only do good.

mig

Not a good way to join a forum ,if you want support don't preach.

ITLSusan

I don't need your support thank you. I'm 100% about sharing info that has helped me and that I think will help others. No time for bickering - sorry!

I said at the start of the thread:

"This is for people that ARE interested in taking the same steps I took to help myself. "

If the obvious hostility from some people surrounding this topic is putting anyone off asking questions then please don't hesitate to contact me privately. I'm very happy to share with anyone that's interested what I know about the topic and the approaches I used.

stickywicket

ITLSusan wrote:

Now, if ALL of your symptoms are down to the muscle imbalance it is of course possible to become 100% symptom free. Cured.

If some of your symptoms are caused by wear to the actual joint then it's less clear.

:?: :? I just don't get this. According to ARUK 'Osteoarthritis is a condition that affects your joints. The surfaces within your joints become damaged so the joint doesn’t move as smoothly as it should - See more at http://tiny.cc/ce033x

ie OA is a condition of the JOINTS, NOT MUSCLES.

It has long been known that walking awkwardly to 'spare' a painful part of the body will lead to pain and potential damage both in the muscles surrounding the affected joint and elsewhere and that the right kind of (non-stressful) exercise is good for OA. None of this is new.

The new bits are where you talk of 'cure' and tell us that mere exercises are not enough and that you are 'the approaches I used'. What are your medical qualifications for this?

We only seem 'hostile' because we look after each other on here. We understand pain and try to protect each other from any unnecessary pain. And we all know that false hopes give the greatest pain.

I am willing to believe that you have cured yourself of a muscle imbalance – but not of OA.

stickywicket

stickywicket wrote:

The new bits are where you talk of 'cure' and tell us that mere exercises are not enough and that you are 'the approaches I used'. What are your medical qualifications for this?

Sorry :oops: That should have read 'that you are willing t share 'the approaches I used'.

ITLSusan

The new bits are where you talk of 'cure' and tell us that mere exercises are not enough and that you are 'the approaches I used'. What are your medical qualifications for this?

I have no medical qualifications. If information (including links to respected sources of information) shared by people with no medical qualifications is not of interest to you then that's your cue to move along. There's nothing here for you. You have to understand that whilst you're complaining that I'm not qualified to share my approaches others complain that I haven't shared enough.

On these forums though, I'll stick to directing people towards where they can figure all this out for themselves. Anyone wanting details of my personal approaches to correcting complex muscle imbalances (bearing in mind that I have no medical background) can contact me privately. That should keep everyone happy. To those people I will also say that I'm working hard to get someone involved in research to help me formalize and verify my approaches. It's proving tricky as it seems it's no one's job to monitor cases of OA that fully recover and to establish how and why.

You've now been made aware of some discrepancies between information on Arthritis Research UK, views of doctors writing for Arthritis Research UK and the NICE guidelines. Go research it. See what you learn.

ITLSusan

A hint:

You'll notice that the NICE guidelines DO NOT say that OA can't be cured. They do point out that it's common for the condition to reverse/improve - including xray findings. As of yet they don't offer a cure to all but they know it happens.

You must remember that the NHS has to find cures that will be affordable and will work with the masses. This is difficult with physical therapy where even with very simple, short term treatments patient compliance rate is way below 50%. They're not going to work on finding more effective (but more complex and expensive) approaches to physical therapy when they can't even get people to comply with the very basic stuff.

But that doesn't stop those that want to from pursuing this themselves. There are no guarantees. It took me 9 years to figure it out (although once I figured out the theory the fix took about a year). Some people will think it's not worth the hassle.

ITLSusan

For what it's worth, here's the response from one of the physiotherapists that I worked with as to why the treatment wasn't given on the NHS. I suspected lack of training. Here's what he said:

"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 [I was determined to seek out cure] 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. "

Did I have OA? Was it really a misdiagnosed muscle imbalance? Who's to say. But as my case was described as classic then chances are very many people can get similar results to me. This is why I keep emphasizing the point that OA is not a true diagnosis. It is only diagnosed by exclusion. If muscle imbalance is considered a separate condition from OA then you MUST rule out muscle imbalance before you can reliably diagnose OA.

The problem they face here is that in order to identify a muscle imbalance you need to train staff to recognize it. That requires a fair bit of expertise. It's not worth putting money into training staff to identify something that you know you're not going to treat any differently from OA. If people won't work at corrective exercise then drugs and surgery is all that's left. Why spend money giving the muscle imbalance it's own label? It matters HUGELY to people like me that are determined to find cure, but from the NHS point of view I'm part of a minority group that doesn't matter in the big scheme of things. Harsh, but true. (I think that's short sighted on their part given the dire straights the NHS will be in in future years but that's another matter).

ITLSusan

Another 'for what it's worth':

One of the people I'm working with to resolve her own hip OA is a doctor. I got to know her on another forum. Doctors generally don't know much about OA other than things to rule out, pain relief etc.

The typical athlete has more bio-mechanics/corrective exercise knowledge than the typical GP. GP's only need to know enough to rule out serious conditions, refer out and prescribe pain meds. The info in the NICE guidelines is pretty much all they have to go by once all else is ruled out. It's not hard to build up significantly MORE knowledge than they have. If you ask your doctor about this they'll probably verify what I say. You CAN help yourself.

Jen

I think if people are pretty sure they can be cured by correcting a muscle imbalance, they would go to see a professionally / qualified therapist in the field. I know I would, and have in the past, as I suspect others have too.

Paying privately, that is. I am sure if a cure by rebalancing the muscles was possible, people would go to see someone privately and paying to see a specialised therapist in the field shouldn't take 9 years to cure as such a therapist could I am sure rebalance the body muscular and skeletal in a much shorter time than that.

If only it was just a question of muscle rebalance for each of us, we could all be cured, but the fact is, its not the case for everyone.

If you register your website with each search engine you will find anyone searching for a cure for arthritis, or muscle imbalance cures they would easily find your website. Perhaps set up a forum on or attached to your website for people who want to discuss this possibility with you and others who have worked in the field of muscle imbalance or trigger point therapy. I know of several free forums where you can set up linking to your website and vice versa. PM me if you want links.


Have a good day all.

ITLSusan

I went to lots of therapists. None of them got results. As the quote from one of my therapists says - they don't have the training in complex imbalances. That particular physiotherapist I worked with for months. He was great too - really pulled out all the stops to figure it out.

So people shouldn't give up at the first hurdle. It's a good starting point but not the end of the road if they physio just says "It's OA". Keep researching - it paid off for me. It might seem a chore at the time but I went from lots of pain and dysfunction to symptom free and that was worth fighting hard for. Especially if you've got half your life and 25 years of working life ahead of you! But it's very much an individual decision as to whether to go down these uncharted routes. I'm not trying to twist anyone's arm. Just providing the info for people to take and do what they will with.

I don't make money out of sharing this. It costs me in fact. I've given up work for 6 months to do it. The reason I'm happy to do it is because a) I'm fascinated by the whole topic, and b) I can't describe how rewarding it is when you do make contact with the people that are desperately searching for this info. I was in that place and I vowed if I figured it out I'd share.

It's a bit of a chore and an emotional drain getting past those that want to make their objections to you sharing the info clear. But that's life. I beat OA - the rest is trivial.

I'm getting together all the reports from physios, chiros etc I consulted. I'll share them on my website when they're available. They might be helpful to some people.

(Sadly SEO doesn't quite work the way you think - but thanks for the suggestions. The gesture is appreciated!).

stickywicket

It's clear you'd like me to go away but please bear with me. I'm only trying to get a clearer picture.

I am honestly trying to be fair to you. I can accept that sometimes people can be diagnosed with OA who don't actually have it. Diagnostics is not an exact science. But, as the general guidelines for OA are to eat a sensible diet, lose weight if necessary and exercise I can't see that that would cause any great problems to anyone. Nor can I see what more is necessary. You imply that there is some mystique about muscle imbalance which, apparently, you can help people through but, without medical qualifications, how? How can we know that we won't be doing more harm than good? The links you have given show (to my way of thinking) nothing new. The doc you quoted on ARUK simply advocates keeping active, exercises and consulting a physio. AC has been advocating that for years.

You have listed your own problems as:

Hip OA (one symptomatic hip; both hips with degenerative changes)
Stiff, painful neck (moderate to severe degenerative changes)
Bone on bone shoulder impingement
Bunions (toe OA)
Chronic, uncontrollable pain (nerve pain)


I'm still not sure whether you had x-rays on your hips and neck or who, if you did, interpreted them. 'Shoulder impingement' is caused by a muscle tendon – not OA - (http://tiny.cc/55d43x) so I don't see how it can be 'bone on bone'. Bunions have various causes, including autoimmune forms of arthritis, but not OA though a bunion itself might cause OA. (http://tiny.cc/6ae43x) Nerve pain isn't necessarily anything to do with arthritis.

You see where I'm coming from? I feel you have probably 'cured' yourself of something by dedication and hard work and hats off to you for that. But I don't think it was OA. Yet now you are trying to convince people who do really have OA that they can also cure themselves if only they weren't so 'lazy and inactive'.

You probably have no idea how demoralising it is to be told repeatedly, by different people, that all we need to do is this particular type of exercise, this particular type of diet etc. It's like our old school reports 'Could do better'. No, actually, we couldn't. If the amount of energy, determination, perseverance and effort that we put into ordinary daily living (including exercises) could be harnessed I'm sure we'd beat any fitness fanatic on those criteria. But we'd still have arthritis.

theresak

Hear, hear Sticky - well said.

Sharon2960

Very eloquently put, Sticky!

ITLSusan

I'm not trying to convince you or anyone else of anything stickywicket. Honestly, this isn't about you. The information is being shared for people that value this kind of thing.

However, to answer your questions:

• Yes, my hips were xrayed via the NHS and I was found to have degenerative changes in both. I also had a 'capsular pattern' of tightness that at the time was thought to be indicative of hip OA.
  
  
• My whole spine was later x-rayed by a chiropractor (who's judgement I wouldn't trust an inch) and I have those xrays. Numerous people have seen them and commented that I have quite bad degenerative changes in my neck and moderate in my back. But certainly they haven't been looked at by a trained radiographer.
  
  
• Bunions could be down to anything. Absolutely. Although chances are I do have degenerative changes in that joint simply because most people do by my age.
  
  
• Shoulder impingement does indeed occur when the gap between bones is reduced through misalignment and tendons rub. However, if that gap is reduced enough then not only is there lack of space for the tendon but the actual bones jam into each other. If bones have been jamming together for a while there's a good chance some degenerative changes will occur.

That's my story then. But here's the significant point:

According to NICE guidelines xrays should NOT be used when diagnosing osteoarthritis. Reason being that most people that have degenerative changes are asymptomatic - it's not possible to tell from xrays whether degenerative changes are in any way involved in your symptoms. They could be a complete red herring. [read the nice guidelines if you doubt this]. So even a diagnosis WITH xray findings doesn't mean that the xray findings were anything to do with the symptoms. It could still be muscle imbalance causing the symptoms - with the muscle imbalance addressed symptoms could well disappear.

In 2006 when I was first diagnosed xray evidence was part of the diagnostic criteria. Soon after that the guidelines changed and it was recommended that the diagnosis of OA was made clinically. Take a deep breath and think about what this means:

Pain in joints with morning stiffness lasting less than 30 mins is deemed to be OA according to current diagnostic guidelines.

Therefore, had I gone to the doctor with an existing diagnosis of hip OA and complained of shoulder, neck and toe pain it would most likely have been diagnosed as OA. Even if I did get xrays done (which SHOULDN'T happen nowadays) the chances are that degenerative changes would have shown up as most people do have asymptomatic degenerative changes at my age - especially in joints that aren't moving correctly.

I TOTALLY get where you're coming from. Did I really have OA? For 10 years I insisted I didn't. I was categorically assured that I did - that I was in denial.

You need to look again at how they define OA. The current diagnostic criteria define OA as "joint pain with morning stiffness lasting less than 30 mins". There is no requirement to rule out muscle imbalance causes of joint pain before diagnosing OA. In some cases you might get lucky and have a knowledgeable doctor that suspects something treatable but most GP's won't have the necessary skills. What if they did diagnose muscle imbalance - where will they send you? Physios are already struggling to keep up with referrals. Results from physio are poor due to patient non compliance (a fact supported by research) - it's simply not cost-effecive. If you're already being treated for OA why complicate things and waste money trying to diagnose a muscle imbalance that you have no procedures or resources to treat? In cases of complex imbalances even physios don't have the necessary training - several failed in my case - along with chiros, osteopaths.

The significant point is this:

Muscle imbalances, for the most part, will fall under the OA umbrella under current diagnostic guidelines.

So - how many cases of OA truly come from the joints and how many are really the result of complex muscle imbalances? No one can answer that question because they haven't looked into it. They don't even record or investigate cured cases like mine.

But many people WILL manage to untangle the mess if they're pointed in the right direction. There are lots of people out there (remember, we're talking a worldwide population) that are desperate to do whatever it takes to resolve their issues. Many are keen athletes. Many just ordinary people that would rather be fighting something. They are happy to invest huge amounts of time in physical therapy but they need to know HOW. I know this because a) I was one of those people and b) I'm in contact with many and I know there are many more out there.

I appreciate that many people don't think they can be helped by this info. I think most people can't be helped by this info! Honestly - it's not about them. It's about the people that are looking for exactly this info. But in order to get the info to the people that do desperately want it I have to share it. I'm trying to clearly label my threads so that those that don't want to hear about it can skip over them.

theresak

Thank you. I think we've all now got your message.

ITLSusan

stickywicket wrote:

You imply that there is some mystique about muscle imbalance which, apparently, you can help people through but, without medical qualifications, how?

It is true that muscle imbalances are poorly understood within the NHS. I wouldn't call it mystique - it's just not something that a lot of research goes into. In private practice things are better and there is lots of expertise out there - but without the research it won't be adopted by evidence based medicine. Shirley Sharhmann is probably one of the best examples. Even to skilled practitioners muscle imbalances are very complex things to treat. It takes a lot of time and it's not something that can be handed to someone on a plate. It requires an extremely proactive approach.

Medical qualifications aren't necessary for treating muscle imbalance. Most doctors have no knowledge whatsoever about it. It's the domain of physical thereapists but to be perfectly honest the pioneers are trainers and coaches that choose to specialize in this. There are some talented people out there and many freely share resources for those that want to take a self-help approach. Everything I learned to help myself came from them - not from NHS sources.

In figuring out my own case I came up with a model - an approach that I think will help others. I've tried to share it with health pros but they aren't interested.

I've not given up on getting researchers involved. The current situation is that it's been forwarded to two professors in physiotherapy research at Keele University (which is the main research uni for OA). Also it's been forwarded to someone else but I'm not sure what their job is. I'm told they will look into it and I'll get an update in late October. That's the best I can do on that front.

If the health pros won't act then there is no other option. I'll release all my findings in some shape or form. I'm taking legal advice on that.

But ultimately people don't need me. I'm just willing to share in order to help people along. The key thing is that I'm sharing info and giving a heads up. People can do their own research and make their own decision as to whether to pursue this.

I hope this answers all of your questions. If you're interested then research it for yourself and see where that takes you. If not - ignore it. It's that simple Anyone that is genuinely interested, proactive and wants more info from me on how to get started with research etc feel free to PM me or contact me via my website. I can provide lots of links and resources.

OliverT

I have to say - it does seem a lot like some folks here are having a grudge against people with less symptoms than them.

I get it that this mushy word arthritis means many things, and presents in many ways, and there is a huge spectrum of presentations and ways it affects people.

This is not to have a pop at anyone, but this forum is called Arthritis Care, not Just Our Form Of Arthritis Care. It has to be an inclusive forum, and that includes me, ITLSusan, and everyone else here.


While I'm on the topic, you dont need to be medically trained to work in the field of sport, whether that be sport theory, exercise, sport nutrition, etc. This is not about prescribing or giving treatment (for which you do need to medically trained) but about making information available. If this information is not for you, then fair enough. There are others here on this forum who will be able to make great use of it, and to try to disallow that or to negate that is doing a disservice to those people and to this forum.

stickywicket

I've said what I believe to be the case and nothing I've read has made me feel any differently so I'll bow out of this thread rather than banging the same drum incessantly.

OliverT, I have no grudge against anyone for having fewer symptoms than I do. Indeed, for most of my life the vast majority of the world's population has had fewer symptoms of arthritis than I. I am delighted that neither of my sons or grandsons have arthritis and that 3 out of 4 are sports fanatics.

I also think my own record, and that of most people on here, on welcoming newbies (yourself and ITLSusan included), will stand up to any scrutiny you care to give it.

ITLSusan

I've been musing over the question of whether the diagnosis or the prognosis was wrong in my case.

In the eyes of the law I don't think I was misdiagnosed.

I would have to prove that there was a breach in duty of care. To do that it's necessary to show that the doctor failed to meet the standard of a reasonable body of other practitioners also skilled in that field. This is known as the 'Bolam Test'.

According to diagnostic criteria back in 2006 when I was diagnosed AND current diagnostic critiera I without a doubt had osteoarthritis.

However, courts have stated that where a body of medical opinion is relied on to show that a particular doctor was not negligent it is also necessary to show that such medical opinion itself is logical and reasonable. In other words, it is not enough that there is a body of opinion supporting the doctor; the body of opinion itself must be reasonable.

In this case I would most definitely argue that the body of opinion is most definitely not reasonable. I think it is perhaps reasonable for them to label me with osteoarthritis - it is after all just a term for 'sore joints'. But the prognosis - that it can't be cured - was very wrong.

However, if you look at the current NICE guidelines (which I think are largely unchanged since 2008?) there is nowhere that it actually says osteoarthritis can't be cured. I've searched the document. They simply don't say it. In actual fact they state quite clearly that it can and does get better.

So perhaps in 'dumbing things down' for the poor dumb patients those guilty of negligence are the doctors and producers of patient information leaflets? They shouldn't be saying the condition is not curable?

I might just phone one of those 'no win no fee' numbers tomorrow just out of curiosity. To see what they conclude.

Jen

Arthritis flares, for some these can last weeks or months then pain free for weeks or months. Some may be lucky enough to go years between bad flares.

No one medically or other really can say OA can be cured because no one can guarantee it won't return.

Getting better, in remission, symptom free, is not necessarily a cure.

In addition not everyone experiences OA in exactly the same way, the medical profession know this, one patient may be mostly symptom free with several flares a year lasting a few weeks at a time and another severely affected most of the year. No one can say cure is possible applicable to all diagnosed patients, because this would be inaccurate likewise the frequency of patients being symptom free is not the same in all patients nor the frequency of flares.