This is a category taken from the full feed of Musculoskeletal and Arthritis news provided by ARMA's members.
  • The Arthritis and Musculoskeletal Alliance (ARMA) is the umbrella body for the arthritis and musculoskeletal community in the UK, and our mission is to transform the quality of life of people with musculoskeletal conditions. We have 33 member organisations ranging from specialised support groups for rare diseases to major research charities and national professional bodies.

Patients

Health Education England e-Learning for Healthcare (HEE e-LfH) has worked with Public Health England and Sport England to launch a new physical activity e-learning programme to help healthcare professionals to champion physical activity with patients.

The e-learning programme, which is aimed at GPs, nurses and other healthcare professionals, will familiarise the learner with the UK Chief Medical Officers’ Physical Activity guidelines.

This e-learning course prepares GPs, nurses and other healthcare professionals to champion the benefits of physical activity with their patients and, in doing so, help prevent and manage a range of common physical and mental health conditions.

Among the course resources are a ‘how to’ video on “Motivational Interviewing” and a guide to “Promoting Physical Activity in Primary Care”. Satellite sessions explore people’s changing needs across the life course and the crucial impact of physical activity on children, young people and older adults. This programme also gives a comprehensive guide to the use of physical activity in the clinical management of long-term conditions including: cancer, cardiovascular conditions, diabetes, musculoskeletal health and mental health. 

The programme is available on the e-LfH Hub and via AICC links.
For more information about the programme, including access details, visit the e-lfh.org.uk website.

Arthritis Action has launched a new webpage featuring arthritis-friendly exercises using animated images (GIFs). These chair-based strength and conditioning exercises were developed in partnership with wellbeing organisation Oomph!,  mobilising different parts of the body.

The exercises were designed with the aim to recondition and build mobility and confidence in people who have not been keeping active. The can be viewed on the Arthritis Action website.

EULAR has published a new lay summary: EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis

EULAR is disseminating the lay versions of the recommendations to patient organisations and healthcare professionals to support patients and carers in managing their condition.

For more lay summaries of EULAR recommendations, go to the EULAR website.

Case study of improved mobility and independence

Listen to Regina’s story of how she overcame osteoarthritis and difficulties with mobility with the help of the ESCAPE-pain group at her local leisure centre.

The ESCAPE-pain Programme: Helping people with chronic joint paint to self-manage their condition and become more physically active

At 76 years old, Regina had been suffering with osteoarthritis for over ten years and it was having a big impact on her life physically and emotionally. “I was in a bad place; I was in a wheelchair to start with.”

Regina found walking very difficult and a journey that should take five minutes, would take her thirty minutes. “It came to a point where I wouldn’t dare to cross the traffic lights, and my daughter would have to drive me everywhere, because I was so scared. Of course, getting on a bus – that was way beyond me. The furthest I ever went was to church and going to church I had to have a carer because I didn’t have the confidence to go on my own.”

In 2018, Regina signed up to a programme being run by Mytime Active in a local leisure centre for chronic knee and hip pain, called ESCAPE-pain. “ESCAPE-pain has really given me my independence back, more than anything else it has given me my confidence.” From having been too scared to travel alone, Regina’s physical function improved so much so that she felt confident to be able to use buses again and travel independently.

Regina also described how crucial the group aspect of the ESCAPE-pain programme was for her. “They make you feel comfortable even before you go into the class, and once you are there you meet other people who are like you, and you know that you are all in this together and that is what works more than anything else. I have made loads of friends at ESCAPE-pain, and I even go shopping with some of them.”

The programme was also important in helping her to adopt a more physically active lifestyle. “Now, I go to gym classes, I go to Zumba (it’s a dance class), and I go to yoga. I would recommend ESCAPE-pain because it makes you be yourself, I would recommend it to anybody, no matter what your state at the moment is.”

Scale of the problem

Regina’s experience is not uncommon. Osteoarthritis has a major impact on individuals, healthcare services and society. The social and economic burden of osteoarthritis is substantial and results in decreased quality of life, loss of productivity, and increasing costs of healthcare. In 2016, an estimated 30.8 million working days were lost to musculoskeletal pain in the UK, accounting for 22.4% of all sickness absence1. It is estimated that one in three people with osteoarthritis retire early, give up work or reduce the hours they work because of their condition2.

People living with osteoarthritis often believe it is an inescapable consequence of ageing and worsening disability is inevitable. Too few people with osteoarthritis receive core advice and support in line with NICE guidelines for care and management of osteoarthritis (CG177)4, 5, such as increasing physical activity and maintaining a healthy weight.

What is ESCAPE-pain?

ESCAPE-pain is an evidence-based exercise-based group rehabilitation programme for people with chronic knee and/or hip pain, also known as osteoarthritis, designed to improve people’s function by integrating exercise, education, and self-management strategies to dispel inappropriate health beliefs, alter behaviour, and encourage regular physical activity.4,6,7,8

The ESCAPE-pain programme was developed by Professor Mike Hurley and is hosted by the Health Innovation Network and supported by NHS England and Versus Arthritis.

ESCAPE-pain is shown to:

  • Reduce pain, improve physical function and mental wellbeing, and improve health beliefs4.
  • Sustain benefits for up to two and a half years after completing the programme6.
  • Create an estimated £1.5 million total savings in health and social care for every 1,000 participants who undertake ESCAPE-pain6, 7.

Currently, over 170 sites are delivering ESCAPE-pain across the UK in both clinical and non-clinical community sites (e.g. community centres and leisure centres) with more than 11,000 people having successfully completing the programme. As ESCAPE-pain has spread into ‘real world’ settings on-going collection of outcome data from sites demonstrates that participants are benefiting from the programme.

How the programme works

Participants attend 12 sessions twice weekly for six weeks, which is led by a trained facilitator* (i.e. either a clinician or level 3-4 fitness instructor). Each session comprises a 15–20 minutes facilitated discussion on a specific topic relating to the self-management of osteoarthritis. This is followed by a 35–40 minutes individualised exercise regimen. Once participants complete the programme they are signposted to local opportunities to help them maintain their physical activity.

*All ESCAPE-pain facilitators completed an accredited 1-day training course to ensure the quality of the programme.

How to find a local class

The programme is being offered in a variety of venues from hospital physiotherapy departments to leisure centres and gyms, from church halls to community centres. To find a local class either visit the site map on the website or email your postcode to hello@escape-pain.org.

Support tools

We have designed some support tools to help people continue exercising safely in their homes once they have completed the face-to-face ESCAPE-pain programme.

See here for further information about the ESCAPE-pain app and the web-based version of the app, ESCAPE-pain Online. Both are free to access.

For more information email us at hello@escape-pain.org or visit the website escape-pain.org.

References

  1. Sickness absence in the labour market – Office for National Statistics [Internet]. Ons.gov.uk. 2017 [cited 1 May 2018]. Available from: https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/labourproductivity/articles/sicknessabsenceinthelabourmarket/2016
  2. State of Musculoskeletal Health 2018 | Arthritis Research UK [Internet]. Arthritisresearchuk.org. 2017 [cited 1 May 2018]. Available from: https://www.arthritisresearchuk.org/arthritis-information/data-and-statistics/state-of-musculoskeletal-health.aspx
  3. NHS England: CCG programme budgeting benchmarking tool. [Internet]. NHS England. 2014 [cited 1 May 2018]. Available from: https://www.england.nhs.uk/resources/resources–for–ccgs/prog–budgeting/
  4. Hurley M, Walsh N, Mitchell H, Pimm T, Patel A, Williamson E et al. Clinical effectiveness of a rehabilitation program integrating exercise, self-management, and active coping strategies for chronic knee pain: A cluster randomized trial. Arthritis & Rheumatism. 2007;57(7):1211-1219.
  5. National Institute for Health and Care Excellence. Osteoarthritis: care and management. Clinical guideline [CG177]. 2014.
  6. Hurley M, Walsh N, Mitchell H, Pimm T, Williamson E, Jones R et al. Economic evaluation of a rehabilitation program integrating exercise, self-management, and active coping strategies for chronic knee pain. Arthritis & Rheumatism. 2007;57(7):1220-1229.
  7. Jessep S, Walsh N, Ratcliffe J, Hurley M. Long-term clinical benefits and costs of an integrated rehabilitation programme compared with outpatient physiotherapy for chronic knee pain. Physiotherapy. 2009;95(2):94-102.
  8. Hurley M, Walsh N, Mitchell H, Nicholas J, Patel A. Long-term Outcomes and Costs of an Integrated Rehabilitation Program for Chronic Knee Pain: A Pragmatic, Cluster Randomized, Controlled Trial. Arthritis Care & Research. Vol. 64, No. 2, 2012, 238–247.

Arthur’s Place has created and launched “Project Mum” a support kit for young women with arthritis and related conditions, those who are considering becoming mothers in future, women who are currently pregnant and new mums. There will be advice for Dads-to-be and partners too, with or without arthritis.

Project Mum includes invaluable advice from health professionals, including consultant rheumatologists, nurse specialists, midwives, a physiotherapist, occupational therapist and three clinical psychologists. Arthur’s Place is also tremendously proud to include personal shared tips and advice from more experienced mums at Arthur’s Social: the Facebook community.

At the heart of Project Mum is a series of twelve short videos in which North East consultant rheumatologist Dr Martin Lee answers common questions that young women with arthritis have about conception, pregnancy, birth and early motherhood. Dr Lee covers fertility, medication considerations, symptoms during pregnancy, impact on labour, breastfeeding and more. We believe these videos are the first of their kind, and we hope our friends and HCP colleagues will signpost patients to them.

The hope is that Project Mum will reassure young women that motherhood is possible, and there is support available from others going through similar experiences. We also hope to inspire young women to think ahead about whether they would like children in future and discuss this with their doctor as early as possible in their treatment journey.

A new design and new features for Arthur’s Place

The launch of Project Mum is an opportunity to bring a fresh look to Arthur’s Place. The new design is as contemporary and visually striking as before, but the new layout will greatly improve the user experience on smart phones. Please do take a look.

As well as the new design, the blogs section has been relaunched to allow more young people with arthritis to contribute. It is now possible for everyone to share their story, and to contribute just a single written piece, photograph, piece of audio or short video. The goal is to create the richest and most diverse account of life with arthritis for people aged 18-35yrs, from around the world.

There is also Arthur’s Place TV, the YouTube channel devoted to curating the most relevant and trustworthy videos that we feel could be of benefit. This will also host the unique video content that A.P. plans to create, as and when funding allows.

Finally, the arthritis facts section has been updated to include the latest information and signposting to other services – in particular Versus Arthritis – plus launched a monthly newsletter. Arthur’s Place hopes you will subscribe to help spread the word about the fantastic community support and the range of content and tools available.

Harnessing the power of social media to promote public health

The Institute of Osteopathy (iO) has launched a new community Facebook page ‘Osteopathy for Health’ with the aim to provide the public with useful health advice and tips to support positive lifestyle behaviours.

The iO first launched ‘Osteopathy for Health’ as web-based information, supported by a series of advice leaflets that could be distributed by osteopaths and other healthcare practitioners. The project has now evolved to utilise the power of social media to spread health and lifestyle messages on exercise, diet, getting older, sleep, and mental health on a dedicated Facebook page ‘Osteopathy for Health’.

The iO team will be working on developing more advice and promoting these on social media in the coming weeks and months and encouraging osteopaths to promote these public health messages through their own online networks.

Osteopathy for Health advice for the public:

  • Online. General health advice to the public is available from the iO website. Topics range from healthy eating to information to persistent pain. In the next year we will be transforming these pages: www.iOsteopathy.org/osteopathy-for-health
  • Social Media. Scroll Facebook, Instagram and Twitter for posts using #OsteopathyforHealth. You can search using the hashtag. Don’t forget: if you like it, share it!
  • Advice leaflets. The leaflets are available from the iO. To purchase copies please email enquiries@iOsteopathy.org

For more information about the Institute of Osteopathy’s ‘Osteopathy for Health’ public health advice programme, please contact comms@iOsteopathy.org

By Jill Hamilton, Professional Engagement Manager, National Ankylosing Spondylitis Society

Exercise is the single most important thing that anyone with axial SpA (AS) can do to self-manage their condition. It’s not always possible though; if someone is experiencing a flare or has severe physical disability as a result of their condition then exercising on land can be pretty much impossible. Exercising in water however is a lot easier; the warmth and the buoyancy make stretches more effective, it’s less painful, it’s easier to stay upright because the effect of gravity is less, it requires less physical effort and afterwards you usually have a really good night’s sleep!

In my time working at NASS I have had the privilege to see first-hand the benefits that people with axial spondyloarthritis (axial SpA) including ankylosing spondylitis (AS) have from being able to exercise in a hydrotherapy pool. Through our network of branches and local NHS services, people with axial SpA (AS) have been well looked after over the years.

I recall visiting one of our branches a while back and a member walked in whilst I was giving an update on what was happening at NASS. He came in clearly in the middle of a massive flare and looked completely crushed when he saw that we were sitting around talking. ‘Is there no hydrotherapy tonight?’ he asked, barely able to walk as his joints had stiffened up and the pain had taken over his body. At this point I stopped talking and said, ‘OK that’s enough from me, time for hydrotherapy everyone’. I knew from looking at him he couldn’t wait a minute longer – medication was having no effect and hydrotherapy was the only thing that was going to help him, even for just a few hours.

It saddens me that in recent years, the closure of hydrotherapy pools has become more common in NHS settings. Too often they are seen as a waste of money and an easy way for the trust or CCG to save some cash. It is a misunderstood form of treatment – to those who don’t use hydrotherapy it is a luxury; for those who do use it, it is essential to keep mobile and minimise pain.

NASS recently funded some research conducted by Melanie Martin, Advanced Physiotherapy Practitioner at Guy’s Hospital in London and Claire Jeffries, Physiotherapy Manager and Clinical Specialist in Hydrotherapy and Rheumatology at Queen Alexandra Hospital in Portsmouth, which looked at attitudes towards hydrotherapy. On average, people gave 7.7 out of 10 for how much hydrotherapy complemented their care overall.

Some of the recent comments that have been published by NHS trusts have been incredibly short-sighted. It seems that their view is, if it isn’t a cure, it’s not a valid treatment. Surgery and pharmacological interventions just aren’t possible for everyone though and so finding alternative forms of treatment is vital.

For a person who lives with chronic pain, the benefits of any treatment are very important; having those few days where you can feel ‘normal’ and get on with your every-day tasks are priceless. Don’t we all deserve those moments?

NASS is joining forces with other organisations to campaign to save our hydrotherapy pools. If you know of a pool under threat or simply would like to learn more about how to advertise your pool and utilise it to the fullest, get in touch. The hydrotherapy pools that are the most successful and the most protected is where they are used by people with a range of conditions and needs. We need to get the message out there just how important this treatment is, and we need the support of ARMA members to do it.

NASS Voices are new community events for both NASS members and non-members, bringing together people with axial SpA (AS), their families and friends, local rheumatologists, nurses, physiotherapists and others interested in the condition.

NASS are holding four events in 2019:

Cardiff 12-13 April 2019 Book via this link
Southampton 10-11 May 2019 Book via this link
Leeds 6-7 September 2019 Booking opens soon
London 15-16 November 2019 Booking opens soon

Read more about the events and learn what services are available near you via the NASS community engagement events page.