Joint care

Reduce stress on arthritic joints

• Keep to your ideal weight
• Pace your activities throughout the day - don't tackle hard physical jobs all at once
• Think about your movements - what makes things worse?
• Wear shoes with thick soft soles, which act as shock absorbers
• Consider using equipment or modifying your home and workplace to help you avoid stressful movements

Dealing with pain

As well as medication, there are simple ways in which you can treat your painful joints.

Warmth applied to the affected area can relieve pain and stiffness. Some people buy special heat lamps or creams that produce localised heat, but a hot water bottle can be just as effective. Make sure it's wrapped in something so it doesn't burn you.

An ice pack can bring relief to hot and inflamed joints, but you should seek advice from a physiotherapist first. Never apply ice directly to the skin - it can burn.

Stress and muscle tension can make arthritis seem much worse. Many people find that taking a long bath, listening to soothing music or using a relaxation tape can help. Your physiotherapist will be able to advise you on relaxation techniques.

Some people try and break the pain cycle by putting together a pain management plan. This might include:

• Notes on the best times to take medication
• Notes on when heat, cold and rest seem to help
• Plans on when to take different types of exercise
• Reminders of what helps you feel relaxed

Diet and arthritis

Your body needs a variety of nutrients to stay healthy, so make sure you get lots of fruit and vegetables, meat and/or fish, dairy foods, and bread, rice or pasta. This is what is meant by a balanced diet.

There are many theories about whether what you eat affects your arthritis. As yet there's little scientific evidence to suggest that it does, but some doctors feel special diets are worth trying as long as they don't mean missing out on vital nutrients.

If you're considering going on a special diet for your arthritis, it's important to discuss it with your doctor first.

Some people with arthritis find their condition improves when they give up certain foods. One theory is that this is because of a food allergy or food intolerance.

There are many tests for determining allergies or intolerances, but the only reliable way of identifying foods that could be making your arthritis worse is by systematically excluding them from your diet. This should be done with the knowledge of your doctor and the help of a qualified dietitian.

Helpful foods for arthritis

There are theories that certain foods and dietary supplements may help arthritis. Some have been tested more than others. For example, there's evidence that the essential fatty acids found in fish oil and plant seed oils, such as sunflower oil and evening primrose oil, may help some people with rheumatoid arthritis, taken at a dose of 3.5g daily for fish oils and up to 6g daily for EPO. Glucosamine sulphate (but not glucosamine hydrochloride), Chondroitin, and cod liver oil can help those with osteoarthritis.

Other supplements you may hear about include green-lipped mussels, selenium and garlic. However, there's little scientific evidence of these having positive effects for rheumatoid arthritis and only slightly for osteoarthritis.

You should discuss taking such supplements with your doctor, for example, glucosamine may interfere with medications for diabetes, fish oils can affect blood clotting so should not be taken with aspirin or warfarin, evening primrose oil may interact with anti-inflammatory medications and also anticoagulants.