By Dr Basil Almahdi, (MBBS, FRCA, FFPMRCA), Consultant in Pain Medicine and Prescriber at Integro Medical Clinics (www.integroclinics.com)
Arthritis is a very common condition which affects more than 10 mil- lion people of all ages, throughout the UK, though it is most common in older people. The condition causes pain and inflammation of the joints and can be debilitating if severe. There are several types of arthritis, but the most common forms are rheumatoid arthritis, which initially affects the
outer covering of the joints and osteoarthritis which first affects the smooth cartilage lining of the joints. Rarer forms of arthritis include pso- riatic arthritis, lupus and others. At colder and wetter times of the year, symptoms of arthritis can be exacerbated. At Integro Medical Clinics, we are experts in helping our patients to relieve the pain of their arthritis symptoms, using cannabis medicines as a treatment option.
Osteoarthritis is the most common type of arthritis and affects nearly 9 million people. It generally develops post mid-40’s or later. It affects the smooth cartilage lining of the joint and makes movement painful and feel stiff. Once the cartilage lining starts to roughen and thin out, the muscles, tendons and ligaments may have to work harder, causing further swelling, inflammation and pain around the joint. Severe loss of cartilage leads to bone rubbing on bone, which alters the shape of the joint and can change the shape of the joint. You normally find this type of arthritis in hands, hips, knees and spine.
Rheumatoid arthritis affects over 400,000 people in the UK, with women 3 times more likely to be affected than men. In this type of arthritis, the body’s immune system targets the affected joint, which leads to inflammation, pain and swelling. This can lead to the weakening of cartilage and then bone, and change the joint shape, sometimes
causing the direction of the fingers to drift sideways. Those who suffer rheumatoid arthritis can also develop problems with other tissues and organs. Cannabis medicines not only have an anti-inflammatory affect but in this form of arthritis they can actually rebalance the bodies endocannabinoid system and help manage the immune system response.
WHAT ARE THE SYMPTOMS OF ARTHRITIS?
The symptoms of arthritis can vary greatly, depending on the specific type of arthritis you have. This is why it is important to get an accurate diagnosis so that we can manage your symptoms you in the most appropriate and effective way possible. Some early symptoms can be recognised as the following:
• Warm, red skin over the affected joint area
• Joint pain, stiffness or tenderness
• Swollen joints
• Restricted movements of the joints
• Weakness or muscle wastage
• Generalised pain and an inability to move freely
COMMON TREATMENTS FOR ARTHRITIS
As there are several forms of arthritis, it is important to obtain an accurate diagnosis before undergoing any treatment for this condition. However, some of the commonly used arthritis medications (some of these medications can induce unpleasant side-effects) include the following:
• Nonsteroidal anti-inflammatory drugs
• Disease-modifying antirheumatic drugs
• Biologic response modifiers
Non-pharmacological interventions can be a very valuable addition to any symptom management regime for those living with arthritis.
Physiotherapists can help you create a programme of specific exercises to achieve and maintain as greater range of dexterity and movement in your joints for as long as possible. Movement is a key factor in managing arthritis pain.
Specially fitted splints will often be fitted by an occupational therapist or physiotherapist and can help support your joints, easing pain and inflammation. There are two different types of splints, resting and working. Resting splints are to help your joints rest whilst working splints designed to support your joints whilst you use them making certain tasks less painful.
Acupuncture seems to relieve pain by diverting or changing the painful sensations that are sent to your brain from damaged tissues and by stimulating your body’s own pain-relieving hormones (endorphins and encephalins). This pain relief may only last a short time when you begin treatment, but repeated treatment (usually weekly for six or eight sessions) can bring long-term benefit, often for several months. If the pain returns, then more acupuncture may help for another few months. CBT
Talking therapy called cognitive behavioural therapy (CBT) can actually improve arthritis pain. In CBT, therapist may help patient work toward restructuring his thoughts about pain to help him stop feeling helpless and catastrophizing about the symptoms and replacing those thoughts with healthier, more rational thoughts to help him cope.
CANNABIS MEDICINES AND ARTHRITIS SYMPTOMS
There is good evidence that cannabis medicines can reduce inflammation in the joints as well as providing effective relief from the pain associated with arthritis.
Cannabis Medicines can be effective in the management of arthritis symptoms, which can then enable people to feel more able to engage in long term management strategies such as physiotherapy that may have been avoided due to pain levels being unmanageable.
Combining pharmacological and non-interventional management strategies are often the best way of managing your arthritis symptoms. Working closely with your healthcare professionals with the goal of improving quality of life overall.