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Covid-19 Update


Face Coverings

From 15 June 2020, visitors and outpatients coming into our hospitals will be asked to wear a face covering at all times, to help us reduce the spread of Covid-19.
 
A face covering can be as simple as a scarf or bandana that ties behind the head. It should cover your mouth and nose while allowing you to breathe comfortably.

New measures to increase services
Our staff have been working hard to respond to the coronavirus pandemic and ensure the safety and quality of our services for all patients.
 
Just like the rest of the NHS, our number one priority for the last few months has been ensuring that all those who need urgent care - not just those with coronavirus - have been able to get it when they need it.  Combined with the need to avoid unnecessary contact to reduce the spread of the virus, this has meant that some non-urgent appointments may have been postponed, and others delivered differently using technology.
 
We are now preparing to gradually increase some important face-to-face services, but only where this can be done safely - the virus is still circulating and we don’t want to put our patients, the public or our staff at greater risk.  Thank you for your patience and understanding during these difficult times.
 

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Condition directory

Shoulder Osteoarthritis

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What is shoulder osteoarthritis?

 

Osteoarthritis refers to collection of changes that occur at a joint that affects it health. These  changes include:

-Thining of the cartilage that covers the surfaces of the joint exposing the underlying bone

-Subsequent tear, flair and repair process causing bony irregularity across joint surfaces

-Tightening of soft tissues around the joint.

The shoulder is one of the less common places in the body for osteoarthritis to develop. In fact it is quite rare in people under the age of 60. It can cause varying degrees of pain and stiffness of the shoulder joint. For some people the symptoms are hardly noticeable, for others they can have a massive impact on the ability to use the arm.

There are some risk factors than can predispose you to developing the problem in your shoulder these are:

1. Age. It is very rare under the age of 60

2. Previous fracture or dislocation. Previous significant joint trauma is linked to subsequently developing arthritis

3. Heavy manual occupation. It is thought heavy repetatative work may be a factor in recurrent tear, flair and repair cycles

4. Genetics. Osteoarthritis can run in families

5. Obesity.  Having a higher than normal body mass index (BMI) is associated with osteoarthritis in the shoulder. This is thought to be due to the 'switching on' of inflammation by a group of chemical messengers called adipokines. These chemicals are secreted by fat tissue (which we tend to have more of in our jont soft tissues if we are overweight). 

6. Smoking. Smoking is linked to poor joint health.

What can i do about the problem

Osteoarthritis is a long term condition- it usually develops and evolves very slowly (there are some more aggressive types that tend to affect younger people where the osteoarthritis develops quickly, but these are the exceptions not the rule).

Just as with other long term conditions like asthma or diabetes there are steps that can be taken to manage existing symptoms, and lifestyle changes that can be made which will generally improve symptoms.

From time to time people with osteoarthritis can experience flair up of their symptoms and may require additional help or treatment at these times to setle things back down.

Managing existing symptoms

The main ways of managing existing symptoms are looking at medication useage, maintenance exercises, and activity pacing techniques.

The aim of medication in osteoarthritis is to minimise your experience of pain symptoms. For some people dipping in and out of pain relief as required is sufficient to do this, for others a more formal regime of taking medication regularly is required to acheive this aim. National guidance for the use of medication in osteoarthritis suggests that people should try and use paracetamol or a NSAID in the first instance. Because both sets of drugs are unsuitable for some people you should speak to your GP about which approach is right for you.

Maintenance exercises are designed to keep your shoulder moving well, the following exercises are likely to be useful.

 

 

 

Actvity pacing techniques are useful to consider if either:

you are not able to to complete activities you enjoy because of pain

or

 you can complete activities but you suffer for doing so for a few days afterwards.

Pacing involves breaking bigger activities down into smaller chunks  to acheive you goal. The short video below explains how to pace your activities.

 

Improving existing symptoms

Employing the above management strategies for your existing symptoms should have the net effect of improving your existing symptoms.

Symptoms may also be improved by thinking about lifestyle factors. The key areas where changing lifestyle can be beneficial to joint health are:

stopping smoking, loosing weight, and exercising regularly.

Exercising regularly has been shown to have a strong effect on peoples self reported ability to function with arthritis.

If you are overweight, using a calorie controlled diet t otry and reduce this has also been shown to reduce arthritis symptoms.

Smoking cessation improves not only joint health but will have a positive impact on almost every system in the body.

To find out more about the positive effect that managing your lifestyle can have on your pain visit our lifestyle page.

 

Managing flare ups

If you experience a flare of symptoms this is usually linked to an episode of inflammation within the joint. It is therefore usual for a flare up to last between 6 and 12 weeks. If you are struggling with a flare it is worth considering your medication based option for managing this. Your GP may prescribe you a short course of medication to help with the flare up or alternatively a corticosteroid injection into the joint can be helpful to settle things down. We are happy to see people on a one to one basis for consideration of an injection during a flare up period. Please speak to your GP to arrange an MSK referral.

 

I'm struggling to manage the problem what should i do?

You can ask your GP for a referral to the MSK service or you can refer yourself here.