Ask an expert about arthritis (UCLH web chat) 

This one hour web chat will take place at:
2 - 3pm on Monday 13 October 2014.

Around 10 million people will seek help from their family doctor each year with arthritis or related conditions.  For our October web chat we have consultant rheumatologist Dr Jessica Manson available to answer your questions about all aspects of arthritis – from prevention to diagnosis, day-to-day management, treatment options and what’s new in terms of research. Dr Manson specialises in treating inflammatory arthritis at University College Hospital, and has extensive knowledge of all forms of the condition.  The subject of Dr Manson’s PhD was lupus nephritis (inflammation of the kidneys caused by lupus), and her current research is into rheumatoid arthritis.

Set your reminder in the window below and join us here on the day. Or click on the add to calendar button below to put the event directly into your calendar.

Read the transcript below.

1:27 UCLH: 
Good afternoon and welcome to our web chat. We will begin at 2pm but you can submit your questions now in preparation for the chat. Please note: your questions will not appear in the main chat window until after 2pm.

Dr Jessica Manson will be joining us to take your questions on ‘Arthritis’ and will try to answer as many questions as possible within the hour long web chat.
2:00 Dr Jessica Manson: 
Welcome to our web chat on the subject of Arthritis. My name is Jessica Manson, consultant rheumatologist at UCLH. I am ready and waiting to take your questions. I have already had a few questions sent in so I will try to answer them in chronological order.
2:00 [Comment From HelyHely: ] 
Dear Dr Mason, Could you please update me on the progress on terms of researching and treatment options on the various types of arthritis? Rheumatoid arthritis and other types? The NHS funding available for the cure? With thanks.
2:01 Dr Jessica Manson: 
Thanks for your question, Hely. Rheumatology is a very research heavy speciality. Many studies are dependent on the involvement of NHS patients, but most are funded by charities eg Arthritis Research UK and the Wellcome Trust. We are involved in multiple studies investigating the causes/ possible treatments for rheumatoid arthritis, and other diseases such as lupus and psoriatic arthritis, here at UCL/UCLH. You could have a look at the charity websites for an up to date list.
2:02 [Comment From JohnJohn: ] 
I have arthritis in my hands. I am a 78 year old male; but very fit (18-20 hours of vigorous exercise a week; resting pulse of 40bpm; recovery from 110 to 70 in 1 minute). My hands are 50% physically regressed; but only 10% functionally regressed. Arthritis is inconvenient for: gardening; housework; cycling; tennis; badminton etc etc My daily prevention routine is as follows: On waking: 30 squeezes of my foam ball; 3 minutes finger exercising; 3 minutes finger strength building. Throughout the day: as above. Plus within activity exercising e.g. when cycling; walking etc and activity exercising e.g. cutting bread etc. Before sleeping: massaging with oil (my partner). I also off-load heavy finger work to higher joints e.g. secateurs to hedge cutters for bush trimming. My questions are: 1. Can you recommend a more effective regime? If so, what is it? 2. To what extent over time can the regime under 1. above sustain my arthritic regression at its present level? 3. What would be the rate of additional regression over time? Of course, I understand that any responses are only best intelligent guesses; but they will be better than mine. Thanking you in advance, Best wishes,
2:02 Dr Jessica Manson: 
Thanks for your question, John. I think you are doing all you can, and I don’t think I have anything else to add. As you suggest in your question, people often have a fairly significant change in the appearance of their hands without too much impact on function. The main thing is to preserve muscle strength, which it sounds like you are doing very well.
2:02 [Comment From AntoniaAntonia: ] 
I have JIA, what are the chances of passing arthritis on to my children?
2:03 Dr Jessica Manson: 
Thanks for your question, Antonia. I am afraid we don’t really have the data to give you a clear answer (yet). We think there is a genetic contribution to risk but that this is probably small. We are doing some cohort studies here at UCL/UCLH to help to try to answer this kind of question (see the link to the Centre for Adolescent Rheumatology here: http://www.centre-for-adole...).
2:08 [Comment From Alan J.Alan J.: ] 
I’ve been experiencing persistent aching in my hands and feet over the last 2 years and am awaiting to see a consultant following blood tests that were positive for rheumatoid arthritis. I am 37 and a little concerned at this development. I find the aching in my feet particularly sore which affects my mood – especially when tired. I commute on my bike daily and think this may contribute to the pain, but I am reluctant to stop doing something I otherwise enjoy. I am in good health in general, am not overweight and have a healthy nutritious diet. Do you have any advice on how I manage this: how can I alleviate symptoms, cope with the pain, and prevent the condition worsening?
2:08 Dr Jessica Manson: 
Thanks for your question, Alan. Your symptoms, particularly in the context of a positive rheumatoid factor, may represent the beginning of an inflammatory arthritis. There are early arthritis clinics for patients like you here at UCLH, and at most other hospitals. It is important that you are seen quickly so the diagnosis can be confirmed or excluded. In the meantime, anti-inflammatories such as ibuprofen can help. I would encourage you to continue with low impact exercise such as riding your bike.
2:15 [Comment From PaulPaul: ] 
How many people in the UK have lupus nephritis and what does it cost the NHS in care?
2:17 Dr Jessica Manson: 
Lupus nephritis is very rare, and the incidence varies with ethnicity and gender - it is more common in women with Chinese or Afro-Caribbean origin. A recent study from the UK suggested that the overall prevalence of lupus nephritis proven on biopsy was 4.4 per 100,000. I do not know the answer to your question about cost. Sorry.
2:19 [Comment From John LongJohn Long: ] 
One question that I forgot.... is there a particular food regime that is supporting of arthritis? I have a balanced healthy diet; but maybe there are some additions that would help my arthritis.
2:20 [Comment From John LongJohn Long: ] 
Thanks for your comments. Did you get the chance to see the photos that I sent. If so, would a splint be helpful for my left index finger? Maybe kept on overnight or some-such.
2:20 Dr Jessica Manson: 
Thanks for your additional questions, John. I did see the photos, yes, and a splint from a hand therapist can help.
Regarding food, there are no data to suggest any particular food type can help, but a healthy balanced diet is a good idea for your general health. Some studies suggest that a chondroitin/glucosamine sulphate supplement can help. I would recommend a 6 week trial if you want to have a go.
2:22 [Comment From GuestGuest: ] 
Hi - my hands 'lock' into position when I curl them and are sometimes painful - it's very sporadic so I am not sure how serious it is - can you advise me?
2:22 Dr Jessica Manson: 
Hand “locking” is tricky without me seeing it. It can be a nerve problem, or a cramp. Locking of one finger (called triggering) can represent tendonitis. I would advise that you see your GP who can examine you.
2:23 [Comment From Renee HoskingRenee Hosking: ] 
I would be grateful for some dietary advice - what to avoid, etc. Thank you!
2:25 Dr Jessica Manson: 
Thanks Renee. I assume you mean you have osteoarthritis? If so, see my recent answer to John at 2.20.
2:28 [Comment From Renee HoskingRenee Hosking: ] 
It is osteoarthritis, and yes, I did see your answer to John. Glad I don't have to give up my glass of red wine with supper! Will try out your suggestion to John.
2:28 [Comment From MyaMya: ] 
Hi I get very sore joints - mainly knees - as the weather gets damp and colder, what should I do about this? I hate exercise! I am 52
2:29 Dr Jessica Manson: 
Thanks Renee, Glad I could help.
2:29 Dr Jessica Manson: 
Thanks for the question Mya. We think that joint pains get worse in the damp/cold weather because muscles go into spasm. I would recommend some simple stretching, and quads strengthening exercises (which you can do in front of the TV!). Arthritis Research UK has a good leaflet on knee pain (http://www.arthritisresearc...).
2:31 [Comment From LouLou: ] 
I am late 40s (49) and beginning to feel it! What exercise is best to combat the creaks and inevitable 'sighs' when I get up?
2:31 Dr Jessica Manson: 
Thanks for your question, Lou. A bit of stretching before you even get out of bed can be good. Also, low impact exercise to maintain muscle strength can really help – eg Pilates, swimming, bike riding.
2:33 [Comment From GuestGuest: ] 
I am moving house and trying to make the transition as smooth as possible. Is there any information that I should get from my old rheumatology department for the department at my new district general hospital?
2:33 Dr Jessica Manson: 
Thanks – moving is stressful especially when that means a change in your medical care too. The two hospitals should communicate for old letters/scans etc. But always good to take any old letters you have with you for your first appointment if you have them.
2:38 [Comment From IvettIvett: ] 
Why does arthritis occurs in early age in healthy,active adults?
2:39 Dr Jessica Manson: 
Thanks Ivett, yes arthritis can affect people at any age. It is true that osteoarthritis tends to affect people as they get older, but many forms of inflammatory arthritis affect young adults, and children.
2:43 [Comment From LesleyLesley: ] 
I have osteoarthritis Iin my back, knees, both hands, neck and though not yet diagnosed I suspect in my feet too. I am asthmatic and allergic To Antiinflammatories. I have been told by my go to just take pain killers and use ice/heat. Is there anything else you could recommend?
2:44 Dr Jessica Manson: 
Thanks Lesley, there are a variety of pain killers other than anti-inflammatories that can help. Paracetamol, and paracetamol with codeine, can be of use, particularly if you know you are going to do something that is usually painful. Exercise is good too, though can be hard to do if you are in pain. If there is one particular joint that hurts, you can have direct injections, and of course surgery if it is very bad. Have a look at the Arthritis Research UK website for good advice: (http://www.arthritisresearc...)
2:50 [Comment From BruceBruce: ] 
My mother has developed a very stooped over stance as she gotten older - and lots of joint pains - I don't know if they are linked - what exercise would you recommend to avoid this? Pilates has been suggested but seems like something women not middle age men do!!
2:51 Dr Jessica Manson: 
Thanks for your question, Bruce. They may not be linked. I wonder if she might have osteoporosis? Osteoporosis doesn’t hurt unless you have a fracture. To reduce the risk of osteoporosis it is important you don’t smoke, and have enough vitamin D/calcium. Weight bearing exercise is good too. If the pain is due to osteoarthritis, then yes, Pilates is the thing to do, or other forms of low impact exercise.
2:55 [Comment From Emma SEmma S: ] 
Dear Dr Manson, thank you very much for the really helpful advice given so far. Might I ask 2 questions please? (a) I assume regular exercise is still recommended as a valuable aid to managing/reducing symptoms of arthritis? If so, is daily exercise still to be the goal, or is exercise that is done slightly more sporadically (ie not every day) still of benefit? (b) If one has for many years suffered that has been atributed to long standing arthritis, is there a reliable way of then distinguishing from that some new pain which could be attributable to a more serious condition such as cancer? Thank you very much.
2:55 Dr Jessica Manson: 
Thanks for the feedback, Emma. In answer to your questions: regarding exercise, little and often is best if your arthritis is bad. Your second question is tricky. Pain can change both in type and intensity from one day to the next. If you have concerns, I would advise you see your GP.
2:58 [Comment From LeonardLeonard: ] 
I enjoy walking - hill walking but am finding it increasingly uncomfortable on my knees going downhill - this is a recent thing, I'm 58 - do I need to see a physio or get an appointment with a doctor in rheumatology? What would you suggest?
2:59 Dr Jessica Manson: 
Thanks Leonard. Going downhill puts a lot of pressure on the front of your knee, and you may be developing early osteoarthritis. You need to keep your quadriceps muscles very strong. I would think a GP appointment and possible physio referral would be a good start.
3:00 [Comment From MyaMya: ] 
Thanks - I can do something in front of the TV!
3:00 Dr Jessica Manson: 
Yes, you can! Good luck.
3:00 [Comment From BruceBruce: ] 
Hi - yes I think it might be osteoporosis as she has very bad diet and has smoked all her life - she is 70 plus now. Thanks I am keen to avoid! Will take advice, thank you
3:01 Dr Jessica Manson: 
Thanks Bruce, you are welcome. I assume your mother has seen the GP too?
3:01 [Comment From Emma SEmma S: ] 
Thank you very much indeed Dr Manson
3:02 Dr Jessica Manson: 
You are welcome, thanks for contributing to the webchat.
3:03 [Comment From BruceBruce: ] 
No she hasn't but I will advise her too.
3:03 Dr Jessica Manson: 
Thanks Bruce, please do.
3:03 Dr Jessica Manson: 
Here are some links you may find useful:

UCLH Rheumatology service -

Centre for adolescent rheumatology - http://www.centre-for-adole...

Arthritis Research UK - http://www.arthritisresearc...

Centre for Rheumatology (UCL) -

NHS Choices - arthritis -
3:03 Dr Jessica Manson: 
Thank you for joining us today in our live web chat. We hope you found the chat useful and some of your questions have been answered.

 Useful links