Radcliffe aching to run

By Lisa Salmon

Think of a typical arthritis sufferer and you usually picture someone in old age, not an elite athlete like Paula Radcliffe.

But the marathon runner is walking proof that the condition blights younger people's lives too, as osteoarthritis forced the 38-year-old world record holder to pull out of the Olympics.

A recent report by the charity Arthritis Care found that while the average age of osteoarthritis (OA) diagnosis is 57, as many as one in five people under 45 are found to have the problem.

A major factor in Radcliffe's condition was clearly the repetitive foot stress caused by long-distance running, and she has described the joint in her left foot as "degenerative and badly damaged".

Consultant rheumatologist Professor Simon Bowman explains that athletes like Radcliffe develop OA for slightly different reasons than less athletic people.

"Although we call osteoarthritis wear-and-tear arthritis, for most people it isn't necessarily related to the activities they've done," he says.

"But athletes are putting so much stress on their joints, and someone like Paula Radcliffe would be more prone to arthritic problems because she's an elite athlete."

But as the Arthritis Care survey shows, you don't have to be an athlete or elderly to get OA, which is the most common form of arthritis, affecting around eight and a half million Britons.

The survey, OANation 2012, found that 71% of people with OA are in constant pain, and one in eight (more than a million people) say the pain's often "unbearable".

What is it?

Osteoarthritis occurs when the cartilage which covers joint surfaces and normally cushions movement is worn thin, leading to friction and pain.

It can occur in any joint, but is most common in the hips, knees and hands. While it's more common as people age, not everyone gets it.

Though many of the symptoms can be similar, OA shouldn't be confused with rheumatoid arthritis (RA), a chronic, inflammatory autoimmune disease (which occurs when the body's own immune system mistakenly attacks healthy cells), which is unrelated to age and can affect multiple joints and organs.

Pain and stiffness are the most common symptoms of OA, and sometimes extra bone can be formed round the joints, further restricting normal movement. There may also be secondary inflammation, causing swelling.

But OA is much more complex than just simple wear-and-tear, and has both environmental and genetic causes.

Arthritis Research UK estimates that about 50% of the risk of developing the condition is due to inherited genetic factors.

In fact, just last month a study funded by Arthritis Research UK identified eight new genetic regions linked to the disease, in areas involving cell maintenance, regulation of cartilage, bone development and body weight.

The study's principal investigator John Loughlin, professor of musculoskeletal research at Newcastle University, says: "We know that osteoarthritis runs in families and that this is due to the genes that people pass on, rather than their shared environment.

"We were able to say which genetic regions are the major risk factors for developing osteoarthritis: the first time that this has been possible for this common yet complex disease."

It's hoped the findings could eventually help researchers develop drugs to stop the disease.

Growing problem

Prof Bowman says OA is becoming more common, with the OANation survey predicting that cases are set to double to more than 17 million by 2030.

The huge expected rise is because two of the main risk factors for developing the disease - being overweight and over 50 - are expected to increase massively over the next 20 years. Population projections suggest that over half the population will be aged over 50 by 2030, and obesity in the UK is set to increase from 16 million people to 27 million over the same period.

"While there's nothing we can do about ageing, we can manage our diet and weight and minimise the stress on our joints," says Judith Brodie, chief executive of Arthritis Care.

She says keeping moving is also important, as it helps manage the pain.

The OANation report found that 52% of people with OA questioned had given up or reduced walking since being diagnosed, and 44% said they did no exercise at all.

Yet 87% of those who exercised said they felt the benefit.

"There's evidence that exercise delays the onset of osteoarthritis," stresses Brodie.

"That first step of movement if you're in pain can be really difficult, but it's worth it - if you get moving and keep moving, it can make a big difference."

How to cope

Current treatments only relieve OA symptoms, and medication is usually painkillers and anti-inflammatory tablets.

Physiotherapy, chiropractic and osteopathy can also help, says Prof Bowman, and joint replacement surgery is a last resort for the worst cases.

But lifestyle changes can make a huge difference both to the chances of developing the condition, and the suffering that occurs if it's already started.

So losing weight, taking more exercise and eating a healthy diet can really help.

For people worried about causing additional damage to joints, opting for low-impact exercise, such as swimming, walking and aqua aerobics, will still give you the benefits of a work-out without straining joints.

"If people make the right lifestyle changes you can certainly see stabilisation of the condition, and there is a little evidence that in some situations you can see healing of damage," says Prof Bowman.

"That should encourage people, particularly those with osteoarthritis in the knees which is related to obesity, to make big changes to their lifestyle so they can make a big difference to their outcome and need for surgery."

:: For more advice on arthritis, visit the Arthritis Care website www.arthritiscare.org.uk or call the Arthritis Care helpline on 0808 800 4050