ARTHRITIS PAIN: Questions answered

by Dr Mike Smith

Question 1

I am 69 and my arthritis is so bad that walking long distances is now virtually impossible for me. I live on my own and enjoy doing my own shopping, but sometimes the parking is so far away from the shop I want to visit that I cannot go. A disabled parking permit would make my life a lot easier, but I do not know how to go about getting one. Can you help ?

Answer

Certainly. If you phone your local council (you will find the address and number in your phone book) they will be able to arrange for you to be sent details of how to apply for a Disabled Parking Permit, usually known as the orange badge parking scheme. This "badge" allows a severely disabled or blind person, who is either a car driver or passenger, concessions to park that are not available to other drivers and passengers. People eligible to apply for such a badge will have permanent disabilities and, in the case of children, be over two years of age. Temporary disabilities due to broken limbs or recent operations, for example, will not qualify you for the scheme.

The badge usually allows holders to park free of charge and without time limit at parking meters, or at places where others may park for only a limited time. In general, a badge holder can park for up to three hours on single and double yellow lines, subject to certain rules and regulations. They are usually allowed to park free of charge in council car parks, pay and display parking areas, and in residential parking bays.

There is usually a charge of £2 for the badge which is valid for three years.

The form you will be asked to fill in also has a section which has to be completed by your medical practitioner in the case of disability. The part of the form that you must complete is quite straightforward and asks such questions as:

• what is the nature of your disability ?
• what is the maximum distance you can walk without stopping, severe discomfort, or help from another person ?

I am sure that you will find the benefits of an orange badge a real help.

Question 2

I have rheumatoid arthritis and my doctor suggested that I tried resting when I next had a particularly painful, acute, episode of it. I did, but it did not seem to lessen the pain, and a colleague at work said her doctor gave the opposite advice, saying that gentle exercise is best. Which is correct ?

Answer

Opinions vary, but much depends on the severity of the condition and the symptoms it causes. With rheumatoid arthritis, if the individual feels generally well and the joint symptoms, though constant, are not too severe, it is likely that professionally recommended exercises which both keep the joints moving and the muscles strong are likely to bring benefits, both in the short- and long-term.

Such exercises will prevent muscle wasting, and so their continuing muscular support for the joints can help to prevent joint stiffness and possible disfigurement that might otherwise follow.

But when rheumatoid arthritis makes the sufferer feel generally ill, possibly with a temperature, signifying that the condition is in a particularly active phase, then until that passes it is likely that a doctor will suggest that you take it easy. That is the least painful option for a start, and is likely to be far more comfortable generally. To exercise when the inflammatory condition is at its height could damage those acutely inflamed and swollen tissues more than resting them will, until the episode settles down.

Question 3

My mother takes a prescribed medication for her arthritis but she also takes a lot of other things claimed to help the condition, such as vitamin tablets, fish oils, and mineral supplements. It worries me that all these tablets will have an adverse effect upon each other, but I do not like to interfere. Do you think I should mention it to her GP ?

Answer

If I were you, I would discuss it with her and suggest that either she or you, or both, discuss the preparations that she is taking with her local pharmacist. Pharmacists are specialists in the use, side-effects, and dosages, of the medicines and supplements they dispense, particularly over-the-counter medicines as well as nutritional supplements such as vitamins, minerals, and fish oils. They will know the recommended daily allowances (RDAs) of your mother's supplements. And whenever taking such products, especially as they are often mixtures of several vitamins and minerals, it can be possible to overdose (on vitamins A, D, and B6 for example especially if they are used constantly.

Many people do feel the benefit of taking a regular recommended amount of, say, fish oil for the relief of symptoms of their arthritis and, if they can afford the small cost and feel it is bringing them benefits, taken in the right amount it will certainly not do any harm.

Regrettably it is not always successful, especially with the more severe symptoms of arthritis, though it can bring some benefits when taken together with the doctor's prescribed tablets.