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.

Treatments & Therapies

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.

New product the Keywing is opening the door for millions to use keys with ease, while restoring independence.

Winner of the Design Council Spark Award and a £65,000 investment from charity Versus Arthritis, the Keywing is being released on the 27 March 2019, helping millions with reduced dexterity to open doors and regain independence.

Retailing from £4.99, the Keywing is a simple, innovative and thoughtfully designed product that clips onto keys. Once in place, it creates a larger surface area and longer lever, making keys easier to hold, grasp and turn, and locks much easier to open.

The Keywing has been designed by Australian born, London-based designer Geoff Rolandsen. Geoff witnessed his father living with deteriorating dexterity in Australia and the challenges that it brings to his everyday life. Inspired when his father struggled to unlock his shed, and determined to make a difference to his life, Geoff set out to design a beautiful, desirable product that could help restore independence to his father and the 10 million people in the UK who live with arthritis and reduced dexterity.

“It was incredibly frustrating to know that a task as simple as opening the front door, is such a challenge to so many people” says Rolandsen.

The Keywing design has been tested and refined over the past 18 months with hands on testing undertaken by Versus Arthritis supporters across the UK. It is launching in March 2019 at www.theKeywing.com and on Amazon, and a full national retail launch is under discussion.

User testing responses have been incredible, with 90% of people saying it significantly helped them to use their keys with ease, and would make a welcomed difference to their day-to-day lives.

Sarah Odoi, IP development manager at Versus Arthritis, comments:

“There over 10 million people in the UK living with the pain and fatigue of arthritis. That’s one in six people. Many struggle with everyday activities that we take for granted, like getting dressed in the morning or turning the key in a lock. That’s why products, like the Keywing, are essential in helping people to stay in control of their own lives, without the fear that they can’t unlock the door to their home.

“As a charity we support innovative designers, like Geoff, to make everyday products that not only help people with arthritis to maintain their independence but that are appealing to eye – many people are put off from using clunky ‘aids’. It’s been fantastic to work with Geoff and the Design Council, and help the idea come to life.”

“I’ve been blown away by the feedback from users saying how this product has made such a difference to their lives,” Rolandsen adds. “Enabling them to leave their house with confidence that they won’t struggle to unlock their front door upon return is the biggest reward for me.”

Reduced hand dexterity has a vast range of causes and is impacting a growing portion of society with research from Versus Arthritis showing that nearly half (44%) of sufferers have difficulty moving around independently. Pain and difficulty undertaking daily tasks, such as locking and unlocking doors, is a key contributing factor to this alarming statistic.

Dr Anna Lowe, a chartered physiotherapist, believes The Keywing could play a key role in making these challenges easier to manage for people with reduced dexterity.

“As a physiotherapist I’ve worked with many people with reduced dexterity associated with conditions including arthritis and long-term neurological conditions where keys and locks present a particular challenge because of the manual dexterity and strength required.”

“The Keywing is a neat little device and could help to give individuals and their families and carers confidence and peace of mind and could make the difference between someone needing help to get in or out of their own home and being able to do it independently.”

It is not only arthritis sufferers who will benefit from the Keywing. Feedback shows that it can also make a positive impact for the 17 million people who live with a musculoskeletal condition in the UKref (around 28.9% of the population) and those with deteriorating hand strength caused by ageing.

Visit www.theKeywing.com to get your hands on the Keywing and keep informed of new innovative products being released in the future. Until May 1st, ARMA newsletter readers can receive 20% off any purchase using the code ARMA2019 at the checkout. The Keywing is also eligible for VAT relief to qualifying customers and charities.

by Sarah Duncan, Head of Clinical Policy, NHS England

An interview on the news recently about stem cell research into cartilage replacement for osteoarthritis, made me reflect on the phenomenal pace of change and progress in the relatively short time of my career. As a new physiotherapist in the mid-1980s we used short wave diathermy; long flexible heated tubes wrapped around a patient’s knees, to help with the pain of arthritis. Although patients really enjoyed the heat, it made little difference to their ongoing pain and mobility.

At that time, every orthopaedic ward housed patients on traction for spinal pain. Attached to heavy weights via tape stuck to their legs, patients were on bedrest for 6 weeks. It would be the physio’s job to get them standing up for the first time. Many people would nearly faint as their cardiovascular system tried to cope with being vertical again. I often thought the subsequent manoeuvres to get them flat again must have reversed the alleged benefits of the bedrest. This was a time when there were treatment regimes for everything and the main individualising factor was the surgeon’s preference.

I was working in Somerset when I came across a different approach to chronic pain management, led by Dr Alf Collins, now Personalised Care Group Clinical Director at NHS England. His approach for people living with persistent pain was to help them understand and come to terms with their pain, and adopt strategies which enabled them to lead as fulfilling and independent lives as possible. Physiotherapists ran education and exercise groups, which also enabled people to share their experiences with others who understood and could empathise. This approach really worked for many people, supporting both their mental and physical health, and they were empowered to take control of their condition. I learned that managing pain was less about giving a treatment to a passive recipient and more about collaborating and working with them.

Fast forward 30 years and I’m in a national clinical policy role, which includes the Musculoskeletal (MSK) Conditions programme. Digital technology, genomics, stem cell research, and advances in surgery are all enabling progress to be made, beyond anything imaginable in the ‘80s. This progress also includes the evidence-based personalised care approach that the membership organisations of ARMA have long supported and developed. In partnership with ARMA, NHS England has developed the MSK Knowledge Hub enabling the MSK community to debate innovative ideas, share learning and celebrate success. The NHS Long Term Plan published yesterday, has a whole chapter on personalised care building on the  Five Year Forward View, which recognised the need for better integration of services, and connection with the voluntary sector, to enable a more personalised approach.  The NHS Long Term Plan aspires to a fundamental shift in approach to deliver more person-centred care, including for musculoskeletal conditions.

We must continue to develop the focus on people as individuals amongst the high-tech treatment options, and ensure people are properly listened to. People with MSK conditions should have choice and control over the way their care is planned and delivered, based on what matters to them and not only on what’s the matter with them. I’m encouraged to see that the Long Term Plan for the NHS will build on the evidence and examples to show how personalised care could, and should be, business as usual across the health and care system.

More people, more active, more often: three perspectives on physical activity and musculoskeletal health

21 November 2018

Introduced by Sue Brown ARMA CEO and Liam O’Toole, CEO, Versus Arthritis, who partnered with ARMA for the flagship lecture, the three presenters delivered speeches that did not disappoint the rapt audience of health professionals, commissioners, patients, public and NHS health officials and, of course, parkrunners. The discussion about how to overcome the barriers to activity faced by people with musculoskeletal conditions ranged from big-picture societal issues to practical hows-to. 

Michael Brannan, Physical Activity Programme Manager, Public Health England said that strength, balance and co-ordination were often referred to as the ‘forgotten guidelines’ included in the Chief Medical Office Physical Activity Guidelines. While two-thirds of men and half of women achieve the cardiovascular elements of the CMO guidelines, a much smaller proportion meet the strengthening, balance and coordination elements of the CMO guidelines. 

Claire Harris, Physiotherapist from NASS, spoke of the general and specific barriers people face to activity, such as time, transport – especially for people in rural communities – fatigue, financial problems, family support, pain, stiffness, disability, low self-esteem, disability and co-morbidities and how to overcome these, for example, motivational interviewing. 

Nick Pearson, CEO of the popular weekly parkrun, was thought-provoking and unafraid to challenge the status quo. He said, “Many populations most at risk of life-impacting, disabling health conditions are the populations most likely to be inactive, doubling down on their risk levels and potentially creating a ‘health underclass’; these populations are exposed to the highest environment and social risk factors, cut adrift and deprived of the vast majority of health initiatives and interventions. Parkrun has been able to cut through some of these structural, political, and social challenges.”  

The panel then considered questions such as how some of the success of Parkrun could be imitated, followed by audience questions. 

In case you missed it, or want to see it again, the recording of the event is available here.

Twitter, with vlogs from attendees, was popular at the event, you can see the range of tweets and vlogs on #MSKactivity.

by Dr Hamish Reid, Consultant in Sport and Exercise Medicine, Moving Medicine design and development lead

Moving Medicine is an exciting new initiative by the Faculty of Sport and Exercise Medicine in partnership with Public Health England and Sport England. It is dedicated to spreading best practice, research and advice to clinicians and patients to create a healthier, happier and more active nation. On the 16th October 2018 the initiative was formally launched by the Honourable Matt Hancock, Secretary of State for Health and Social Care, headlining the flagship set of resources to support high quality conversations on physical activity across a broad range of chronic diseases including musculoskeletal pain.

Why is it important?

The UK is currently suffering epidemic levels of physical inactivity in keeping with global trends. This inactivity causes a heavy burden of morbidity and mortality. This burden, In contrast to communicable disease, can be prevented and effectively treated through moving more. In no areas is this more important that musculoskeletal conditions.

At the heart of intervention in healthcare lie conversations between healthcare professionals and members of the public. These conversations provide a unique opportunity to interact with the least active members of society, but many healthcare professionals currently lack the skills, knowledge and systems to deliver impactful conversations on physical activity.

How has it been developed?

The ‘prescribing movement’ resources have been developed by a large team of Sport and Exercise Medicine doctors in consultation with 300 medical specialists, general practitioners, researchers and patients. The foundations of the content lie in robust reviews of the literature on physical activity in specific diseases and differ from other resources summarising the evidence base on physical activity as the structure has been designed by clinicians for clinicians to use in practise. A knowledge into action framework, Delphi study and behavioural change framework have underpinned this iterative development process. The result enables the user to dig as deep as they want to into the evidence base, embedded in a time-based framework to support good quality conversations based on established behavioural change techniques and motivational interviewing theory.

What does this mean for musculoskeletal care?

The Moving Medicine musculoskeletal pain resource has been designed with experts in musculoskeletal care in partnership with many ARMA members. Due to the exceptional input from the ARMA network this resource has been developed to fulfil an unmet need in the excellent resources available. It is a practical resource to support and inform clinical staff in routine practice and has been designed to support conversations.

We encourage everyone to use and share the resources. If you are keen to find out more or contribute to the Moving Medicine to get in touch with us at contactus@movingmedicine.ac.uk, join our Facebook ambassador group or follow us on twitter @movingmedicine – we would love to hear from you.

Visit the website at www.movingmedicine.ac.uk.

Taking place on Wednesday 21 November 2018 at 6pm in London.

Hear and debate three perspectives on physical activity at the Annual ARMA Lecture, this year in partnership with Versus Arthritis. Three outstanding speakers, Nick Pearson, CEO parkrun, Michael Brennan, Physical Activity Programme Manager, Public Health England and Claire Harris, Physiotherapist speak to the theme: More people, more active, more often: three perspectives on physical activity and musculoskeletal health

Physical activity is good for promoting musculoskeletal health and helps alleviate the symptoms of musculoskeletal conditions. Yet nearly a quarter of adults in the UK are physically inactive. Getting people active is an obvious way to reduce the costs of MSK conditions to individuals, the NHS and the economy. If activity brings such benefits, why is this so difficult? How can we overcome the barriers people face in getting more active? And what additional barriers are faced by those who have an MSK condition? How can we harness the powers of statutory, voluntary, private sectors and communities to tackle this?

The evening will begin with a drinks reception and the lecture will conclude with a question and answer session, with questions taken from an audience of leading health and public health professionals, policy makers, commissioners, patients, and representatives of professional bodies.

Tickets are available here

The ARMA annual lecture will be on 21 November on the theme of physical activity. Three speakers will discuss three different perspectives on how to get more people, more active, more often. The event will discuss the roles of statutory, voluntary, private sectors and communities in addressing this important challenge.

  • the CEO of parkrun
  • the physical activity programme manager from Public Health England
  • a musculoskeletal specialist physiotherapist.

Look out for booking details coming soon.

Help us guide future research about problematic knee replacements

The British Association for Surgery of the Knee (BASK) is running a Priority Setting Partnership (PSP) in partnership with the James Lind Alliance (JLA). The aim of this process is to bring patients and carers together with a range of healthcare professionals. We want all groups to highlight uncertainties relating to the assessment, management and rehabilitation of ‘patients with a problematic knee replacement’. We will thereby identify future research questions and ultimately publish a list of ‘top 10 research priorities’. This will guide funders for future research.

What can you do to help?

If you have experience of problematic knee replacements as a patient, carer or professional: Tell us the top 3 questions you would like to see answered by future research at www.jlarevisionknee.com. The survey goes live on Monday 10 September 2018 and we are hoping to get as many responses within the first month as possible.

For any queries or please email jlarevisionknee@gmail.com