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 40 member organisations ranging from specialised support groups for rare diseases to major research charities and national professional bodies.


Pain Alliance Europe are asking for responses to the 2018 edition of the Survey on Chronic Pain, which highlights how pain can affect the work-life of pain patients.

The charities who are members of Pain Alliance Europe (PAE) are inviting people with chronic pain or their carers to fill in this short survey on the effect of their chronic pain on their quality of life, their work situation and about any financial help they receive. The survey starts with some basic questions.

This is the second survey that PAE has created on the theme of chronic pain, in a series of annual surveys on the impact of pain. With each survey, PAE will analyse a different aspect of the impact of pain on the quality of life of the chronic pain patients in Europe.

A report will be created at the end of this survey, comparing the pain patients’ experiences in different countries. This report will be publicised by Pain Alliance Europe in order to reinforce their actions and promotions in order to make politicians and policy makers more aware of the important issue of chronic pain.

You can also follow @pain_europe on Twitter and share the poster [PDF].


The HMSA are busy preparing for their ‘Taking Action 2018-2022’ launch, which aims to guide strategy for the next 5 years. Part of that process is ‘The Big Conversation’ Members Consultation survey.

You can read about this and more from the February edition of HMSA’s e-news.
Learn more about:

  • livestream chats from HMSA’s resident occupational therapist;
  • the HSD Ambassador and Youth Patron preparing for the Hypermobility Management Workshop;
  • a consultation on the Call 111 campaign;
  • the helpline;
  • and an update from the CEO, Donna Wicks.

NHS England is consulting on proposals that will stop routine prescribing in primary care of over the counter treatments for a number of conditions, including the maintenance use of vitamin D. Receiving adequate vitamin D intake is crucial for current and future bone health and NICE Public Health Guideline 562 (PH56) states that a licensed dose of vitamin D, for prevention of vitamin D deficiency, should be widely available to at-risk groups.

The consultation recognises that vitamin D should continue to be prescribed for patients who are deficient and that it can be prescribed in combination with calcium for osteoporosis. However, vitamin D for maintenance is subject to restrictions and there is a risk that at-risk patients, may not purchasing it themselves (due to cost, accessibility or lifestyle reasons) or purchase a product which is inappropriate for their needs (due to ingredients or dosing levels). If you are going to respond to this consultation, consider raising the issue of availability of a licenced dose of vitamin D on prescription among at-risk patients. Let us know if you are responding.

Guest blog by Alison Trewhela, Director of the Yoga for Healthy Lower Backs Institute

Evidence-based exercise for people restricted by back pain, fearful of movement, in considerable pain, or with other illnesses and injuries, ‘Yoga for Healthy Lower Backs’ (YHLB) is a gentle 12-week mind-body exercise programme offering a potentially life-long solution.

Public Health England has recently included YHLB as one of seven evidence-based MSK options in their PHE MSK ROI Return on Investment Interventions report and online tool. Healthcare and public sector commissioners and well-being providers are hereby more easily able to choose cost-effective innovative interventions. YHLB shows a £10 return on investment for every £1 spent.

The ‘Yoga for Healthy Lower Backs’ programme was born out of a large research collaboration of academics, health economists, yoga teachers and back pain specialists led by The University of York and funded by Arthritis Research UK. The 313-participant randomised control trial compared this yoga programme and usual GP care against usual GP care and evaluated back function at the end of the course as well as 12 months later.

The findings showed that YHLB was effective for chronic low back pain for the long-term (Annals of Int. Med., H. Tilbrook et al, Nov. 2011; Vol 15 No 9).

An economic evaluation showed that YHLB would be cost-effective within the NHS, was a dominant treatment for society, and that it reduced work absenteeism by 70% over the 12 months studied (Spine Journal, 15th Aug 2012, LH Chuang et al).

To share this research and knowledge, as the lead yoga research consultant and designer of the YHLB programme, I have trained over 400 experienced yoga teachers nationwide and, along with others, have set up a social enterprise and training Institute. Teaching teams and regional Hubs are being established to improve ease of access.

Our ‘best practice’ ‘Yoga for Healthy Lower Backs’ structured programme was designed to offer person-centred self-management support and advice. Uniquely, it is unparalleled in its strong evidence-base.

Attendees learn how to use strengthening, mobilising, stretching and pain-relieving poses, relaxation and breathing techniques and postural awareness exercises that aid a return to normal activity levels at work, home and leisure. They gain extra psychological support from group learning and benefit from positive ‘side-effects’, such as reduced time off work and improved mood.

Importantly, this is a specialised yoga course, designed for those with persistent, episodic or recurring back pain. However, it is equally true that if you have a lower back (!) and want it to be healthy, you can attend this gentle yoga course and learn how to help yourself to improved comfort, health and well-being for now and the future.

It is a ‘mind-body package of care’ that can easily be integrated into daily life. Offering a manual, relaxations CD, practice sheets and hand-outs, the 12 classes teach people to self-manage their back pain, whilst encouraging long-term changes in increased physical activity and improved well-being. A recent study showed that YHLB attendees had a 63% improvement in feeling able to manage their back pain by themselves.

Through ARMA, we have been able to connect with many organisations in the musculoskeletal field with which we share similar goals. Through these connections, we are continuing to make progress in taking the results of the research out to those that it would most benefit, i.e. those with back pain, but also health professionals and commissioners.

Amongst other regions, the YHLB programme is being successfully piloted by the NHS in Cornwall, as follows:

  • GP surgeries (n=5) subsidizing course costs
  • ‘Social prescribing’ scheme
  • Subsidised courses for Primary Care staff
  • Teaching Team and Regional Hub

The evidence from the research contributed significantly to the evidence NICE evaluated in their Guidance on low back pain and sciatica which mentions mind-body exercise, such as yoga, as a first step to managing low back pain.

In the light of the recent Government Paper Improving Lives, The Future of Work, Health and Disability, a social franchising model to take this successful and evidenced Yoga forward as an early intervention treatment option is being explored. The Government paper states “Early intervention and access to treatment and support were critical to preventing the progression of ill-health and preventing people falling out of work.”

One YHLB course attendee called it “a life-changing experience after years of frustration.”

As a specialist tutor for Yoga and Research at University of Exeter Medical School, I know how hard is has been in the past to find yoga programmes with strong evidence-base, so all this is fantastic news for those with back pain, referrers and commissioners.

Further information at or email

by Jane Green BSc. (HONS) Psych., PGCE, Av.Dip. Ed. Child Development, MA Ed.  (Leadership and Management / autism)

Why did I stop working in my professional career?

Two-and-a-half years ago I medically retired. This was after years of pain following full dislocations; half-dislocations; sprains; tears in joints, muscles, ligaments and tendons; and arthritis. I received my diagnosis of Ehlers-Danlos syndrome 3 (now hEDS) and associated conditions later that year.

As a child, I did have a few problems with joints and did ‘party tricks’. Whilst bringing up my sons, one with significant medical and neurodevelopmental difficulties, I was passionate about improving autism practice. The OU offered me opportunities without my needing previous qualifications. I won two awards. I had two knee operations in 2003 but was not offered any physio afterwards. It took me nearly a year before I could walk unsupported. In 2006 I was shortlisted for the EP doctorate and offered a place. Unfortunately my knees were unstable and deconditioned, so it made commuting to London impossible. My career then comprised of schools: I was special needs teacher at Young Epilepsy, Advisory teacher for the Local Authority, Lead Educationalist/consultant for the National Autistic Society and Autism Education Trust, Strategic Assistant Head teacher and DfE Autism Education Trust trainer for Ambitious about Autism.

Often, as key speaker at conferences, I would approach the rostrum wearing a microphone and all you could hear were bones crackling, snapping and occasionally popping. There would be a stunned silence. At first I tried to ignore this, but with experience I learned to announce the additional noises to the audience. Speaking at MDT meetings I had time to talk to smaller groups on their tables. I soon came to recognise the look on the face of some delegates (disbelief- face), knowing then to check if my arms or legs were out of place and adjust them, whilst asking the delegates if they were occupational therapists/physiotherapists – which they undoubtedly were! As I was the key speaker holding conferences together it put a great responsibility on my shoulders (excuse the pun) just to be there. So I continued, despite multiple injuries, increasing inflammation and pain.

Throughout my career I tried to stay working. EDS is a variable condition, but without management it became unmanageable. I received drugs for inflammation and referrals to MSK departments. By then I received a diagnosis of hypermobility and discharged. Unfortunately, it took five months to be seen by MSK after the initial event (which was a dislocated ankle with several other injuries).

This delay meant:

  1.  I was not believed
  2.  I couldn’t remember all the facts or what it looked like five months before
  3.  the amount of time escalated other injuries

I was then told categorically “we all have aches and pains at [my] age”. This brought about a defence mechanism in me: I knew that medical resources didn’t know what to do with me. When my shoulder dislocated with tendon tears, I continued working with an increasingly painful but useless shoulder and arm. All this time, I was also a carer. My GP said there was a pain management course. However, the advice given was impossible for me. When I asked what to do as I was hypermobile, I was told ‘this isn’t a course for you’.

I had often limped and used a walking stick at work. Once, over a period of two days, an older injury to ankle ligaments resurfaced in my other foot, so I swapped the walking stick to support that leg. Comments made to me in the office were:

Oops, did you forget you were limping on the other leg last time?”
and “My son dislocated his shoulder but it popped back in and he just got on with it.

I found it difficult to explain to them how much pain I was in because I didn’t understand it myself. There a was no pathway and to some extent I thought that maybe everyone suffered like me.

The hot-desking policy at work caused me stress so I asked for a set desk, a chair with arms, a foot pedestal and drawer of files placed nearby. After a health assessment I was given a set place for ‘reasonable needs’. This meant me getting on the floor to dig out my foot rest, finding a chair that moved multi-directionally with hand rests, and a subsequent hunt for suitable drawers after my two-and-a-half hour commute.

I get a lot of muscle spasms which are agony. I tried to use the quiet room to stretch but it was never available. I was sent to my organisation’s physiotherapist, usually used for students and staff. The physiotherapist tried, but I recognise the face of confusion and disbelief quickly now. I was told to go elsewhere. My last injury meant that I could not sit down for over a year.

As EDS UK Support volunteer Area Coordinator for Surrey/Sussex, I was asked to attend the Crawley ARMA event and NHS England conference as patient speaker. EDS UK Support is proud to be a member of ARMA. As a small charity, membership is a great way of keeping up-to-date with changes in government policy that affects our community and it gives us a voice as part of an alliance when EDS doesn’t have the resources to do that type of work directly.

The timely, effective and responsive assessment and management of patients using the Patient Advice and Information Lines (PAIL) leads to improved quality of care and patient experience.

Whilst a number of the Patient Advice and Information Line calls are related to clinical concerns, patients, family and carers often talk about other life events that may impact on their treatment and management plan. Clinical Nurse Specialists and Members of the Rheumatology Multidisciplinary team need to be responsive with a wealth of knowledge and experience; they must also be imaginative with a bit of Health Service/ Community Care “common sense” to support these patients through these life events.

Colin Beevor, Matron from Portsmouth Hospitals NHS Trust has used data from previous PAIL calls to develop the “Rheumatoid Arthritis – Game of Life” board game to equip all Clinical Nurse Specialists and members of the team necessary knowledge and skills to manage patients over the telephone.

In this fast-changing era of medicine, the board game offers the opportunity to increase knowledge and stimulate discussion and learning within teams.

Colin Beevor: “The board game has been developed with Lilly UK and was launched at the 2017 Nurse RESPONSE Forum in London on the 23rd December 2017. I had a lot of fun working through the scenarios, which act as practice development tools for those working with people living with Rheumatoid Arthritis. The game also has potential to be further utilised in the education of patients, family and carers and the wider community of primary care team members.”

Alison Kent, Chairperson at the Response Conference: “The community of Clinical Nurse Specialists and members of the multidisciplinary team are very skilled at managing patients, but often there are life events that mean we need to rethink patient management plans. During the three workshops at the conferences the board games were well received by the delegates, and many asked if the board game could be taken back to their own department as a teaching aid.”

Jenny Kynes, Head of Nursing, Musculoskeletal Service Centre, Portsmouth Hospitals NHS Trust: “We are always looking at new ways of providing nurses with education; whilst there may be insufficient evidence in the literature to either confirm or refute the use of such learning, it looks like the board game was received well by the delegates and achieved its main aims, at bringing fun, to increase knowledge and to stimulate discussion around supporting patients with Rheumatoid Arthritis.”

Flare Roller Coaster for People Living with Arthritis and Connective Tissue Diseases

The Next Rheumatology Flare Roller Coaster workshop will be held on Saturday 3rd February 2018, from 09:30 -13:00.
Venue: Fracture Clinic – C Level, Queen Alexandra Hospital, Cosham PO6 3LY

Places are limited so please register early.

To book your place or receive more information, email: or telephone 02392286935

For frequently asked questions about our Flare Rollercoaster workshop, please see our leaflet [PDF].

If you have arthritis or a connective tissue disease, the festive period can be tough. For starters, the months of December and January come at the coldest time of year, which can cause more problems, and although cold weather doesn’t cause arthritis or connective tissue diseases, it may increase joint pain and possible flares.

Colin Beevor, Matron: “Sometimes flare-ups can’t be avoided, no matter how hard you try. If you start to feel increased pain or joint stiffness, take action.”

There are many self-management treatments that can help reduce joint pain:-

  • Hot/warm packs and even warm baths can soothe painful joints and relieve stiffness;
  • Ice packs can relieve pain, reduce inflammation, and cool down joints during flare-ups. Remember: do not apply heat or ice packs directly to the skin or for more than 20 minutes at a time;
  • Topical cream or gel that contains the nonsteroidal anti-inflammatory drug NSAID. Ask your local pharmacist before using a topical treatment that contains NSAIDs particularly if you already take over-the-counter or prescription NSAID tablets.
  • TENS Machines – Transcutaneous electrical nerve stimulation machine administers mild electrical currents through the skin to the nerve fibers which can help to block or suppress pain messages.


Keeping Active

Although arthritis and connective tissue diseases and exercise may not seem like a natural match, staying active can definitely help your joint pain.

Getting out in the fresh air has proven benefits to your health, from strengthening your muscles to improving your blood pressure and helping with a good night’s sleep, spending time in the open is good for your health.

Swimming is a form of exercise suitable for all age groups. Even if you are not a strong swimmer or have non-swimmers in your family it is a great way of spending time together and getting fit whilst doing it. Swimming is a great low-impact activity that helps burn calories, strengthen muscle mass, and improve cardiac endurance.  The water allows your body to exercise without impacting too much on the joints; this makes it an ideal exercise for those with stiff joints, sore muscles. If you find going to the swimming pool very cold, a tip is to wrap your towel and clothing in a hot water bottle.

On 30th November 2017, the National Osteoporosis Society published new Osteoporosis Standards and Vertebral Fractures Guidance for Health Professionals. The guidelines help health professionals provide the possible care for people with osteoporosis.

Fizz Thompson, Clinical Director for the National Osteoporosis Society, said: “The National Osteoporosis Society plays a key role in driving positive change in healthcare provision for people affected by fractures and osteoporosis, and these new documents – developed with clinical experts over a two year period – demonstrate how the Charity is setting the agenda in this area.

“The new guidance will raise awareness of the clinical significance of fractures among all clinicians and managers, and highlights the importance of undertaking further investigation and starting treatment in a timely way.”

View the documents here on the NOS website.

Fourteen patients and their partners and staff from the Department of Rheumatology are about to complete their 6-week ballroom class. Over the weeks they will have taken an additional 12,000 steps and exercised for around extra 5.5 hours.

Claire Jeffries, Rheumatology Specialist, Physiotherapist and Hydrotherapy Manager, points out that there are many health benefits of dancing: “it’s great for people of all ages, shapes and sizes”.

Dancing offers a wide range of physical and mental benefits:

  • improved condition of your heart and lungs
  • increased muscular tone, strength, endurance and motor fitness
  • increased aerobic fitness
  • weight management
  • stronger bones and reduced risk of osteoporosis
  • better coordination, balance, agility and flexibility
  • increased physical confidence
  • improved mental functioning and psychological wellbeing
  • greater self-confidence and self-esteem

The Department of Rheumatology would encourage people living with Arthritis and connective tissue diseases to consider dance as a form of activity. To get started simply choose a style you enjoy, or would like to try, look for dance schools in your local area and join a class.

Colin Beevor, Matron, said: “There are many forms of dance, from ballroom to barn dancing and disco to Morris dancing. Ballroom dancing has been great for our dancing patient group; it’s been such an enjoyable way to be more physically active and help with overall fitness for people living with arthritis. We are so grateful for the support from P. Peskett from the PP Dancing Club; she had made it fun to get more active!”

See a photo of the PortsHosp ballroom dance group.

Remember: you can dance in a group, with a partner, or on your own. There are lots of different places where you can enjoy dancing, for example, at dance schools, social venues, community halls and in your own home. Dancing has become such a popular way to be active and keep fit that most fitness clubs now offer dance classes in their group exercise programs.

Join us for our fundraising tea dance on Saturday 9th December 2017 at St Colman’s Church hall, Cosham from 3:00-5:00pm.
Tickets are available at £5 from

Our next dance class will be Scottish Dancing. Join us for classes starting on Wednesday 14th February 2018 for 6 weeks at the Queen Alexandra Hospital, Cosham. Anyone who has ever been to Scottish country dancing knows just how much fun a Dashing White Sergeant can be. It is likely, too, that anyone who has attempted the Gay Gordons or Strip-the-willow also knows the physical effort needed for a full night of traditional Scottish dancing.

A fun-packed day for all

On Sunday 22nd October 2017, the Department of Rheumatology staff hosted more than fifteen tables for children’s games and crafts – f rom Dominos, colouring to ghostly table lights, and homemade first aid kits – whilst Dads and Mums living with arthritis and connective tissues attended a number of short presentations aimed at providing help and advice:

  • Strategies for coping with a diagnosis and moving forward
  • How to manage family life work and arthritis and connective tissue diseases
  • Incorporating the benefits for staying active and eating healthily

The DaM-it Arthritis project is funded through the Department of Rheumatology’s charitable funds and non-conditional educational grants, offering free events to support the community of Dads and Mums affected by Arthritis and Connective Tissue Diseases and their families.

We recognise that social and emotional peer support is as essential as medical care for people living with these long-term conditions.

The Department of Rheumatology at the Portsmouth Hospital NHS Trust aims to understand the needs of this group and will be hosting a variety of family-centred events in 2018, combining fun and games with an understanding of the conditions and the impact it has on the family. We aim to offer a variety of workshops, classes, groups and activities in a non-residential, home-like setting.

Read the DaM-it-Arthritis info-sheet here.

Jenny Kynes, Head of Nursing, MSK Services, said: “Dads and Mums affected by Arthritis and Connective Tissues diseases need a place where others understand what they are going through. I am so pleased to see and hear about the work of the Rheumatology Department where the Dads and Mums get the opportunity to discuss and question healthcare professionals about subjects important to them.

Alex Fletcher, DAWN coordinator, said: “I was humbled and amazed at listening to the dads and mums’ stories. It gave me a true understanding, in-depth, of the impact living with arthritis and connective tissue diseases has on their lives and the lives of their partners and children. Until then, I only knew of their names from updating the information systems, so meeting them was revealing, touching and often heartwarming. It reminds us to think of a person, not just a condition, and ask what matters most to them?”

The Department for Work and Pensions is looking to second people with a professional or lived experience of musculoskeletal conditions to work on an exciting, new project. The Community Partners Programme is a new initiative working with Jobcentre colleagues to enhance our service to customers with disabilities and health conditions.

We are looking to second a colleague from a local organisation to be a Musculoskeletal Community Partner to work across Bedfordshire and Hertfordshire. We are looking to arrange secondments with organisations who would like their colleagues to gain valuable experience in a government department, and to share their specialist skills and knowledge to enhance the supported to Jobcentre colleagues with disabilities and health conditions.

The role is initially for 12 months, but could be extended for a further 11 months.
If you would like more information, or to see a job description, please email Laura Cook or call 07384 248684.

The deadline for applications is Monday 11 December 2017.

NRAS have partnered with Daman, a Danish digital Healthcare company, to bring you RheumaBuddy.

The aim of the app is to create an overview of your Rheumatoid Arthritis (RA) and Juvenile Idiopathic Arthritis (JIA) on a daily basis by discovering patterns and ultimately gaining a greater control of the condition. As well as creating a great overview, RheumaBuddy allows you to log sleep, exercise and hours of work or school. It is also possible to chat with other patients and learn from their experiences.

It is available to download on both Android and Apple based mobile phones for FREE!
Visit the NRAS website to find out more and download the app.