What is OA?

Airwave!
Airwave! Member Posts: 2,424
edited 11. May 2019, 11:41 in Living with arthritis
The Pain Clinic says that tissue damage (OA) should not hurt and that it can heal, the cause of the pain is neural plasty, or the brain sending out incorrect pain signals after receiving stress signals for too long and becoming oversensatised (in a nutshell). I should now be taking a slow but sure path to fitness.

I find it hard to come to terms with after forty years of being told I have arther on my back but if this is a dawning of the new age of medicine and this is correct then so be it.

What have others been told?

Comments

  • stellabean
    stellabean Member Posts: 307
    edited 30. Nov -1, 00:00
    I am afraid I not had a good experience with pain clinic myself. I was told that the pain in my 3 damaged discs in my neck ( pressing on the spinal cord) were causing me so much pain because I refused to talk about my 6 miscarriages. I think they should read some of the information on this site. I have also been told that some my symptoms were due to too many pain signals.
    Once the joint surface is damaged it does cause pain it doesn't always behave the way they say or would like the body to it can remodel a joint surface leaving it rough and deformed and that is painful to walk on my right knee has no cartilage left.
    I did find the physio at the pain clinic helpful and encouraging when the neurosurgeon was telling me to use a wheelchair, she encouraged me to keep mobile.
  • daffy2
    daffy2 Member Posts: 1,636
    edited 30. Nov -1, 00:00
    My own view is that not enough is known for the medical profession to be able to make pronouncements, but that doesn't stop them. OA is really only just beginning to be looked at with any real effort - having always been 'old age, and wear and tear' the realisation that there is more to it than that has been a long time coming(same as with osteoporosis which has been ignored until recent years as it was a 'disease of old women'). Pain is a complex area, and is always going to be complicated by the fact that as humans we don't react consistently. There is no doubt that the mental side of things, whether that be emotional, psychological or whatever, can be an important factor, but again, pigeonholing doesn't help, as the same set of circumstances can lead to completely different outcomes in different individuals.
    This lack of certainty and consistency is something that the medical profession as a body finds very hard to deal with, and that difficulty can lead to some very distressing outcomes and experiences for patients.
    When I was catapulted into this world(and it was sudden, certainly not the traditional model of disease progress) I was one of those who found that the pain and joint difficulty experienced bore no relation to what showed on the Xrays. I have accepted that situation and can cope with it at present, but it has made me very aware of what it must be like to be told, in effect, that there is no clinical reason for the pain a person is actually experiencing, even though their life may be severely affected by it.
    The fact that the NHS treats patients as separate conditions rather than as a whole person doesn't help with getting a solution. The fact that someone's joints 'shouldn't' be causing the level of pain that the patient claims means that the whole problem is dismissed, when one reason may be that it is muscles causing much of the pain as the body copes with an iffy joint - but that is a different department and a different problem, so won't be dealt with in that round of investigations - if at all.
  • stickywicket
    stickywicket Member Posts: 26,623
    edited 30. Nov -1, 00:00
    This just isn't right. For a start, tissue damage does hurt. Secondly, neuroplasty (not neural plasty) is any surgery to repair nerve tissue. I believe it's true that tissue damage can heal but, with arthritis, there is more than just tissue damage. See here https://www.versusarthritis.org/about-arthritis/conditions/osteoarthritis/

    I think it's also true that we can become oversensitised to pain when it has gone on for a long time and that nerve damage can actually cause changes so that neural pathways which would normally bring pleasure are changed to ones bringing pain. https://www.sciencedaily.com/releases/2017/06/170601151906.htm

    I don't know if this can be reversed but it might be worth asking the Pain Clinic people.
  • dreamdaisy
    dreamdaisy Member Posts: 31,552
    edited 30. Nov -1, 00:00
    Ah, the pain clinic, in my experience a place run for those who are in pain by those who are not. A place where you can sit and discuss pain thus making it worse. A place where pain becomes a competition as to who's in more or who is on the strongest stuff - yet still in pain. :roll:

    Anything which affects or stops the body working as it should will be a source of pain, ideally it is a warning signal that something is amiss but, for the likes of us, as what is amiss cannot be repaired it keeps signalling. Doncha ya lurve pain theory? Give the 'experts' ten minutes of our pain reality and they would be gasping for the morphine. Twerps.

    The cause of my OA is two-fold: I am alive and I have another form of arthritis. For those with solely OA the cause is life. It's no mystery, it damages joints, erodes cartilage, no wonder it hurts. :lol: DD
  • Airwave!
    Airwave! Member Posts: 2,424
    edited 30. Nov -1, 00:00
    Well you know whats happened to me over thd yezrs, I am firmly of the opinion tgat it bloody well hurts! It is often interesting to hear other peoples views and experiences though.

    I thought I was on course for two new shoilders and the Dr at the MSK Team changed jis kind and sent me to the Pain Clinic so I thiught I'd better go along with it rather than start refusing, jopefully this will eventually lead to a new joint or two. Thanks for uour replies, I spoke to my GP this morning whilst I was in there and the truth hasn't changed in the medical world its just how its being put across by the PC teams.
  • WelshSquirrel
    WelshSquirrel Member Posts: 17
    edited 30. Nov -1, 00:00
    Hi Airwave!
    I've had a similar experience to you at our local pain clinic. I'd been suffering from pain in multiple joints (lumbar spine, fingers and neck at that point) from my early thirties (I'm 50 now). Given that my mum, uncle, brother, etc, have all suffered from multiple joint OA starting at about the same age, and following the same pattern of spread through the joints, and given the lumps appearing on some of my joints, I thought that the diagnosis was fairly obvious.

    Unfortunately the impression the Pain Clinic staff gave - whether or not it was intended - was that I almost unconsciously wanted to follow in my mum's footsteps and so was imagining that ordinary everyday pains were something much worse. They based part of their insistence that there was nothing really wrong on a spinal x-ray that was almost 20 years old at that point. :shock:

    Like you, I was told my pain was down to faulty or habitual brain signals and that OA can heal - something a friend who was then a nurse in an orthopaedic clinic found ridiculous! They also told me that they believe it's better for patients' mental health not to give them a formal diagnosis if at all possible as this 'programmes' them to assume they are ill / disabled. Personally I find being disbelieved and uncertain about what's causing pain much more of a problem as both generate lots of stress in my experience! Maybe that's just me :?

    Since then further x rays have confirmed fairly advanced OA in my cervical and lumbar spine and fingers, and you can tell just by looking that it's changing the shape of my big toes.

    As others have said, it would help if these clinics were run by people with some understanding of what it means to live with chronic pain!

    I should maybe say that I've met and been helped by some wonderful physios and Occ Therapists - but not at the Pain Clinic! :lol: I'm sure there are some good pain clinics out there somewhere too!
  • Airwave!
    Airwave! Member Posts: 2,424
    edited 30. Nov -1, 00:00
    Thanks Welsh Squirrel, there does seem to be weight of annecdotal evidence about these Pain Clinics. Yes I can see the effect that telling a person that they are suffering a long term condition can be detrimental if they have a weak mental state, knowing and accepting is a part of life, isn't it? Fitness and a clear mental state do not necessarily go together.

    The combined effect of a set of professional health staff telling us over a number of weeks that we are not suffering pain from OA is at best unsettling and in my case puts me on my guard and makes me question their advice. I have found with the health service that you have to go through advised programs, with a grin painted on, if you want to get a positive outcome, at a later date i.e, tried that, what next?

    It was suggested to me that 40 years was a long time to bear the kniwledge of OA and that in this day I wouldn't get such a diagnosis which to me begs the question of what diagnosis would they give me? Even the MSK team acknowledged 'widespread OA', they said no OA in my spine which my GP said was incorrect looking at the x rays. Hey ho! There has been a downside to having OA but for me ghere has been an upside, no work, time with gc and oh, I get to please myself with my own agender in life etc etc which I think is a good mental state to be in.

    I suspect that all this will come out in the wash?
  • vickyp
    vickyp Member Posts: 27
    edited 30. Nov -1, 00:00
    After several years of 'presenting' myself to GP complaining of stiffness/pain and attending physio I have encountered quite literally the rolling of eyes from the GP who told me there was nothing wrong with me, to the physios who told me that my pain system had gone wrong. I was told this so often that I started to feel quite crazy. I started to worry that I was developing mental health problems.

    Eventually, x-rays showed OA but still the diagnosis of GP was pretty much the same regarding pain; insisting it was mainly in my mind/pain system gone wrong. I was told that I was making rather a fuss about the pain as it was really very mild. I do not know how pain is quantified. I was told that it take the body 3 months to heal from an injury so that anything after this was an oversensitive pain system that had gone wrong.

    My big toe was the first site were 'mild OA' was diagnosed. Within a year of being told that I had 'mild OA' my toe was pointing in a completely different direction and is a noticeable deformity. When I want to re-assure myself that I am not going mad I look at my toe. THIS IS REAL, NOT IN MY HEAD. I CAN SEE IT!!

    Now I have had x-rays show OA in both big toes, both hips, right ankle and in my neck. Still they roll their eyes and say that and that my pain is disproportionate (more eye rolling on part of the medics).

    So now when I am starting to feel insane I look at my toe and know it is all real and not in my head. The toe is easy, I can see the changes - the neck and hips not so easy to see the changes. It is insane that there is so little understanding or empathy for OA within the medical profession.
  • dreamdaisy
    dreamdaisy Member Posts: 31,552
    edited 30. Nov -1, 00:00
    My theory is that because OA is so common, and nothing can be done to remedy matters until things have deteriorated to such a pitch that surgery becomes an option, it is for many GPs a medical eye-rolling condition. OA has no urgency, it does not necessarily cause an early death so no dark glamour there, it merely spoils life for millions of people. Like all forms of arthritis it is a progressive, degenerative condition but, being as common as chips, it is of no import. DD
  • WelshSquirrel
    WelshSquirrel Member Posts: 17
    edited 30. Nov -1, 00:00
    Made me smile when I saw your comment, vickp, as though my toe isn't quite as deformed (yet!) as yours sounds, I too look at my lumpy and gradually sideways bending toe when I need a reminder that my joint problems aren't all in my imagination :D (I'm getting lumps on some of my fingers now just to back up my toe's opinion!)

    I think you're right, too dreamdaisy, about the reasons OA is overlooked or underestimated so often. A locum commented once that my pain killers seemed very strong for someone so young (i.e.49 at the time). I think that shows another reason eyes are often rolled at us - it's assumed that OA is a condition of old age mainly, and that younger people can't really have it badly enough for it to be debilitating. Oh yes we can!!

    Fortunately for me, at least so far, the days when I am in acute pain that severely or completely restricts my mobility are fairly few and far between - I get flare-ups like that only 4-5 times a year for
    a few days each time - but I've found that many medical staff underestimate how draining it can be to be in even moderate pain in a number of joints every day - almost every action and movement hurting somewhere or other!

Who's Online

1
1 Guest