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NHS treatment

I find GPs have been of no help. Each and every can only suggest physiotherapy and harmful pain killing drugs.

Are there any GPs who actually have osteoarthritis? I think that those who have may have a better understanding of what patients are trying to explain as well as current research. I am fed up with the terms "wear and tear" and "progressive untreatable condition",

It is duty for physicians to keep knowledge updated and continuous referrals to outdated medical text books are of no use. Research indicates that Osteoarthritis is an autoimmune condition, perhaps even systemic, and the inflammatory response is the cause of cartilage catabolism.

Will whole joint replacement be necessary if there is earlier physiological intervention to stop progression and even reverse the condition ?

In more than 3 years of non treatment or ineffective treatment I observe nothing knew in NHS treatment of osteoarthritis.

Time to rethink osteoarthritis?

Comments

  • Mike1Mike1 Posts: 606 ✭✭✭

    GPs are GENERAL Practitioners who know a bit about everything that is why there are SPECIALISTS so in the first instance a referral to a Pain Clinic should be sought as they are the experts in pain and can refer to other Specialists such as Neurosurgeons and so forth. Osteoarthritis is not an autoimmune disease, and although the exact causes are not known, multiple risk factors have been identified. In a healthy joint, cartilage provides cushioning and a smooth joint surface for motion. In an osteoarthritic joint, as cartilage is irreversibly destroyed and bone abnormalities develop, movement becomes painful and more difficult. As for stopping progression or reversing the condition this is merely a pipe dream that has no bearing on fact, regrettably once you have OA you have OA!

  • If folk would start using their GP practice with an element of respect then it might just be able to return similar. No matter how many times GP practices ask their patients not to request say, Paracetamol on prescription, because of costs, and they carry on demanding them for free it is not surprising that staff can be less caring than they could be, if they had far less time wasters to deal with.

    Well that’s my daily rant over, have a nice day guys. 😄

  • Mike1Mike1 Posts: 606 ✭✭✭

    I have tremendous respect for my GP, even though I may not like the way he deals with my conditions, and refer to him as “Sir” during the appointment. It takes 10 years to become a GP, a 5-year degree in medicine, recognised by the General Medical Council; a 2-year foundation course of general training; followed by a 3-year specialist training course in general practice. However, like every other qualification some people are better than others. In medical degrees there is no level of pass like in other degrees (i.e. 1.1, 2.1 etc) just either pass or fail; the surprising fact is that the pass mark is 50% and in other degrees generally 40%! 

    General practitioners (GPs) treat all common medical conditions and refer patients to hospitals and other medical services for urgent and specialist treatment. They focus on the health of the whole person combining physical, psychological and social aspects of care based on their knowledge and experience. Remember though that the average GP appointment is only 10 minutes and with the best will in the World they can only diagnose on the basis of what the patient tells them and what they can see or determine through examination, therefore it is important to get the salient points over to the GP during the 10 minute appointment. Writing down how you feel, what your pain levels are like, what if anything affects your pain and so forth can be very useful. It is quite possible that you may have omitted something or the GP may have overlooked something bearing in mind the length of the appointment and the workload he/she has, in such cases it is perfectly acceptable to politely ask for a second opinion or a referral. If you are uncomfortable challenging your GP there is nothing wrong in making an appointment with a different GP for the same problem.  For some services, such as Physio or Podiatry, it is also possible to self-refer so it is worth checking out your own Health Authority's website.

  • joomsjooms Posts: 29

    Research suggests that progression of osteoarthritis ie cartilage catabolism is immunopathogenic ie an immune response.. Although described as innate immune response the fact that it progresses to cartilage degradation suggests that the immune response is disregulated and has become an auto immune disease.

    The initial cause of joint damage is something else.

    Reversing osteoarthritis. Research shows that by removing senescent cells the remaining chondrocytes can produce the ingredients for cartilage repair.

    The focus on treatment should move away from the wear and tear explanations and mechanical replacements towards a physiological therapy that stops the inflammatory products progressing the damage.

  • Hi Jooms

    Thank you for your message. I am sorry you are feeling let down by your GPs. We agree that it is very important that patients and GPs work in partnership using the latest evidence-based information to help manage arthritis.

    It’s worth asking if there is a GP in the practice that takes an interest in arthritis and musculoskeletal (MSK) conditions.  We are keen to transform care for people with arthritis and any health care professional with an interest in improving MSK health can join our professional network. More than 5,000 GPs and primary care professionals have now participated in our core skills e-learning package.

    Thanks for the comments from Mike1 and Crookesey. You may find the information here on the causes, treatments and help self-options for managing osteoarthritis helpful. I have also included a link about other types of arthritis.

    Although there’s no cure for osteoarthritis yet, there are treatments that can provide relief from the symptoms and allow you to get on with your life. These include lifestyle changes, pain relief medications, physical therapies and supplements and complementary treatments.

    You are very welcome to call us on our freephone helpline: 0800 5200 520 so you can talk things through with one of our helpline team. 

    I hope this is helpful.

    Best wishes

    Mags

    Helpline Team


  • joomsjooms Posts: 29

    Thanks Mags for reply.

    But nothing new.

    I would be interested to know what Versus Arthritis thinks about the following.

    "Human osteoarthritis is a systemic musculoskeletal disorder involving activation of innate and adaptive immune systems accompanied by inflammation exemplified by the elevated production of pro-inflammatory cytokines which play a significant role in the progression of the disease. The future of novel therapies for osteoarthritis should consider developing drug development strategies designed to inhibit pro-inflammatory cytokine-induced signal transduction. These strategies have been successful in the development of drugs for the treatment of rheumatoid arthritis."

    Malemud CJ. Biologic basis of osteoarthritis: state of the evidence. Curr Opin Rheumatol. 2015;27(3):289-294.

    It seems to me that there may be a danger that any exercise that causes joint pain promotes inflammation and further degradation of cartilage of cartilage.

    There are several other research studies that explain the disease much better than the outdated "wear and tear" explanation.

    Possibly now is the time to consider the systemic and auto-immune effects of the disease ?

  • Hi Jooms

    I have passed your query on to our health information team. I will get back to you with a response as soon as possible. This may take a few days.

    Best wishes

    Mags

    Helpline Team

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