I don’t have a recent will because…
“We
don’t want to be spending a lot of money writing a new Will.”
“I can never get in during Free Wills Month, all the appointments go really quickly.”
“I need to write my Will; I just don’t know where to start.”
Having an up to date Will in place is important.
It’s the only way to ensure your loved ones are protected and your wishes will be carried out. It can also be reassuring for your family to know your affairs are in order. We understand getting started with writing your Will can be daunting and challenges like cost or not knowing where to start can get in the way. That’s why we’ve partnered with the National Free Wills Network to make writing or updating your Will as easy as possible.
Using our offer, you can receive a simple Will free of charge with the assurance of meeting and writing your Will with a trusted solicitor in your area. Some solicitors offer home visits and video appointments if you are unable to
“It’s been on my to-do list for ages, I just never seem to find the time.”
“I’m housebound and can’t get to a solicitor.”
travel. Your partner or spouse can also use the service to write their Will at the same time.
If you would like to use the service:
1. Contact the team on the details below – we will need your name and address. Or use the QR code to share your details.
2. You will receive a pack in the post that includes a list of participating solicitors in your area.
3. When you are ready, you make contact with your chosen solicitor and arrange an appointment for a time that suits you.
There’s no obligation to leave a gift in your Will to Versus Arthritis but of course, we hope you choose to. All gifts, no matter the size, can make a real difference.
I’D
LIKE TO USE THE NATIONAL FREE WILLS NETWORK AND HAVE MY WILL
WRITTEN FOR FREE.
Please contact Gill and Anna in our Gifts in Wills team to confirm your name and address and we will refer you to the Network. Tel: 0300 790 0406 Email: giftsinwills@versusarthritis.org Or scan the QR code to complete a simple form with your details.
Our experts this issue
Dr Sarah Jarvis
Sarah is a medical writer and broadcaster, and doctor to BBC’s The One Show and BBC Radio 2
Angie Jefferson
Angie is a registered dietitian who enjoys turning complex science into simple messages
Julian Worricker
Julian is a BBC TV and radio presenter, and has lived with psoriatic arthritis for many years
Dr Stephanie Barrett
Stephanie is a consultant rheumatologist with a passion for treating pain and fibromyalgia
Dr Nerina Ramlakhan
Nerina is a physiologist, sleep expert, author and speaker
Patricia Bisset
Patricia is a rheumatology specialist occupational therapist supporting people with arthritis
Dr Nora Ng
Nora is a consultant rheumatologist at The Lister Hospital, and Guy’s and St. Thomas’ Hospital
Jack March
Jack is a physiotherapist who specialises in rheumatology
Our team
Dr Lee David
Dr David is a GP and CBT therapist, author, and supports health professionals
Dr Lizzy Rosser
Dr Rosser is a research scientist interested in children and young people with arthritis
Joanna Hall
Joanna is a walking, fitness and wellbeing expert, and author of 14 books
Sarah Stannard
Sarah is a certified health and wellness coach
Jo Travers
Jo is a registered dietician and author who helps translate science into practical everyday advice
Jane is a Versus Arthritis Helpline Team Leader who also works to support the advisors
Design and production: CPL One
1 Cambridge Technopark, Newmarket Road
Cambridge CB5 8PB 01223 378000, cplone.co.uk
Editor: Tracey Lattimore
Art director: Chloe Bage inspire@versusarthritis.org
For Versus Arthritis: enquiries@versusarthritis.org 0300 790 0400
Arthritis helpline: 0800 5200 520
Registered charity nos: 207711, SC041156
Registered office: 120 Aldersgate, London, EC1A 4JQ. ©Versus Arthritis 2025
Views expressed in Inspire are not necessarily those of Versus Arthritis or Inspire (the Editor, the Editorial Advisory Board or the Executive Board). No responsibility or liability will be accepted, either for their contents or accuracy, or for any action taken as a result of anything contained in Inspire. Products, treatments and services in Inspire are not necessarily recommended by Versus Arthritis. Versus Arthritis is not equipped to test and approve products, treatments and services available to the general public. Please exercise your own judgement about whether or not the item or service advertised is likely to help you personally and, where appropriate, take professional advice from your doctor, nurse, physiotherapist or occupational therapist before buying or trying something.
Photography and illustration: Katie Donnelly (page 19), iStock and Getty Images
Welcome...
This is Inspire, the magazine for people with arthritis –welcome to our summer edition! We’re excited to share lots of ways to help you live the life you choose, with tips from experts, real-life experiences from people with arthritis, and updates about research progress.
This issue, we look at four ways to approach exercise this summer. From walking to swimming, hopefully you’ll find something that suits you on page 25.
Whether you’re a cat person or a dog lover, have chickens in the garden or a tortoise – or simply enjoy watching your goldfish in its tank – pets can bring a lot of joy. They are not without their challenges, though, especially when arthritis can bring mobility issues. Read about looking after your pet on page 40.
As you navigate your condition, you may be referred to an occupational therapist. But what do they actually do? Where do they fit into the care pathway alongside GPs, physiotherapists and rheumatologists, and how can they help you? Find out on page 14, as we speak to Melissa and Patricia, who explain their roles and how they support people with arthritis.
Our real-life feature comes from actress Kelly-Anne Lyons. She tells us how she balances her career, family and passions with JIA and Lyme disease – find out more on page 19
Sleep and nutrition are cornerstones of managing your condition and helping you to feel well, but these can also be a challenge. Check out our sleep-tricks article on page 10, as well as some interesting suggestions on page 28 about foods that are good for your gut.
Enjoy the issue, and remember, we are here for you!
Warm wishes, Rachel Curtiss Individual Giving Manager, Versus Arthritis
Where to find help and support
We are always here to support you, so get in touch if you have any questions
Our helpline
Call us
Call our free* helpline on 0800 5200 520 (MondayFriday, 9am-6pm) if you need to speak to someone. Please note: the helpline is closed from 12pm the last Friday of every month for training.
Email us
Drop us an email at helpline@versusarthritis.org
Write to us
Helpline, Versus Arthritis, Copeman House, St Mary’s Court, St Mary’s Gate, Chesterfield S41 7TD
Chat online
You can also chat to the helpline team and other people with arthritis, through our online community. Visit community.versusarthritis.org
What do we do?
You don’t need to face arthritis alone. Our advisers aim to bring all of the information and advice about arthritis into one place to provide tailored support for you.
We can help with more than 200 conditions, including osteoarthritis, rheumatoid arthritis, fibromyalgia, psoriatic arthritis and gout.
We aim to bring you the most up-to-date evidencebased information and developments on arthritis and rheumatology, based on the latest research and medical information.
Please note that our advisers aren’t medically trained and aren’t able to offer you individual medical advice. The service we provide is confidential – for more information, please read our Helpline Confidentiality Statement at versusarthritis.org
*Calls to our 0800 number are free when calling from within the UK, but charges will apply when calling from abroad. For more information, please contact your network provider.
OVER TO YOU
Here's your chance to have your say
Working it out
Thank you for the feature ‘Getting the balance right’ (Spring 2025) about managing arthritis at work. I struggled for many years because I did not tell people about my arthritis for fear of being judged or defined by it. As a result, I pushed on through, experiencing regular flares up and having to take time off as a result.
I was upfront about my arthritis with my current employer from the start, and immediately I was offered an occupational health assessment. It recommended a number of items to support me, including an ergonomic chair, which has made such a difference. Also, I am now very disciplined about getting up to move every hour.
To anyone who is struggling on in silence, please don’t! The support I have, both in terms of equipment and from my manager and colleagues, means that I can give my best to my role without compromising my health. It’s like a weight has been lifted from my shoulders.
Randeep, Birmingham
Supporting role
I had a knee replacement last year and it has transformed my life. I was so worried about it beforehand – including wondering if I was ‘too young’ (I am 45) – but the support from the Versus Arthritis community really helped me to prepare for and recover from it.
I am now back to full fitness and have booked a walking holiday in June with my best friend to celebrate!
Emma, Wrexham
Inspire says: To connect with our Versus Arthritis community, go to community.versusarthritis.org
A winning combination
As a recent subscriber to Inspire, I thought I would drop a line to the team. I am a former sports editor of three national newpapers, editor of a couple of lifestyle magazines and radio presenter for BBC Radio 5 Live, and I really appreciate excellent design and content. Inspire is truly outstanding in all respects. I notice you are recent award winners – very well deserved. Brian Alexander, via email
email inspire@ versusarthritis.org
Our roundup of research, news and tips
Take the plunge
Now the warmer weather is here, why not think about digging out your swimwear and taking a dip in your local pool? Swimming and exercising in water can be beneficial for people with arthritis because water helps to support the weight of your body, reducing strain on painful joints and easing stiffness and pain. It also provides a degree of resistance for you to work against, which can help to strengthen your muscles.
Versus Arthritis and Swim England have developed a factsheet on swimming and aquatic activity to help you plan your visit and find a pool: scan the QR code or visit swimming.org/justswim/musculoskeletal-conditions-swimming
Hormones and our immune system
B cells are white blood cells that play a crucial role in our immune system, as they identify and target toxins in the body. A study from University College London, funded by Versus Arthritis, found that, after puberty, cisgender women (a person whose gender identity corresponds to their sex assigned at birth) have an increase in ‘class-switched memory’ B cells compared with cisgender men. This is a specific type of B cell that help maintain long-term immune responses, and might contribute to inflammation.
Researchers also discovered that natal oestrogen in transgender men reduced B cell frequency, and gender affirming oestradiol treatment taken by transgender women did not increase B cell levels.
Post menopausal cisgender women also saw an increase in these B cells after taking hormone replacement therapy, compared with those who did not take it.
These findings show that oestrogen has the capacity to influence B cell biology. This research also indicates that sex hormones and sex chromosomes work together to influence immune responses.
By furthering our understanding of the body’s immune responses, this study could help predict disease outcomes in individuals, laying the foundation for personalised and targeted treatments in the future.
Interested in hearing more about B cells and our researchers’ hopes for the future? Listen to our 35-minute podcast with top arthritis researchers at versusarthritis.org/planb
Able compression gloves are designed to support anyone with arthritis. Available in five sizes, the gloves can ease pain, inflammation and swelling. Compression confuses the pain nerve signals to the brain and encourages the lymph system to move fluid away from swollen joints. The gloves also help support wrist and finger joints. Choose yours today at shop.versusarthritis.org
Call to rethink disability cuts
In March, the UK government announced possible future cuts to disability benefits as part of its plan to get more people back to work. Although none of these proposed changes will happen immediately (2026 at the earliest), this news will be worrying for many people with arthritis.
One in five people out of work lives with a musculoskeletal condition such as arthritis. Versus Arthritis supports the government’s plan to get more people back to work, but cutting disability benefits is not the answer.
Instead, people need treatment at the right time, work adjustments, and tailored recruitment support if they’re going to find and stay in the right job. And for people unable to work, we must demand a fair and compassionate benefits system.
The proposed changes include replacing the Work Capability Assessment with one new assessment for all disability-related benefits, restricting eligibility for Personal Independence Payment, restructuring Universal Credit, and reducing payments for people too unwell to work. Most of the proposed changes apply to the whole of the UK, but PIP only applies to England and Wales.
Deborah Alsina, CEO of Versus Arthritis, has signed Scope’s open letter to the UK Chancellor, Rachel Reeves, calling on her to rethink these cuts. The government must keep its manifesto promise to champion disabled people’s rights by fixing the system with them, not against them.
Unveiling our first research consortium
Versus Arthritis continues to invest in research, bringing together researchers from our Centres of Excellence, clinicians and people with lived experience of arthritis. Our recently awarded Epidemiology Consortium aims to improve quality of life for people with arthritis, focusing on five areas:
1. Inequalities and musculoskeletal health –Understanding why healthcare experiences vary across age, location and background, and how services can improve.
2. Reducing the impact of chronic pain – Exploring how symptoms that start in childhood develop into chronic pain, with the aim of early intervention.
3. Menopause – Addressing the overlooked impact of menopause on arthritis and clarifying guidance on hormone replacement therapy.
4. Safer medication management – Evaluating common pain relievers to balance benefits and risks in decision-making.
5. Safer monitoring of MSK –Assessing how often safety blood tests are needed, to reduce distress, especially in children.
Using NHS and study data, the findings hope to inform NHS practice, policy and public understanding, empowering people to make informed choices.
8 sleep tricks ACTUALLY WORTH TRYING
From counting sheep to bathing before bed, there are all sorts of sleep-inducing techniques to encourage better slumber. Some of these may also help you if you’re prone to waking at night, especially if you’re in pain. But which should you try? Here are our top tips for sleeping well this summer
BY CLAIRE MUNNINGS
1
Time your medication
Some medications prescribed for arthritis (such as prednisone and hydroxychloroquine) can impact your ability to sleep. To try to curb this effect, experts recommend taking certain types of medication in the morning, so the levels in your body are at their lowest come bedtime. Remember, though, that all medication is different and it’s always best to speak to your doctor about the best solution for your own needs.
2
Establish a good routine
How good is your sleep hygiene? Making sure your sleep routine is optimal is key to getting a good night’s rest and staying asleep once you do drop off. The first thing is to create a restful environment. Ditch distractions such as a TV and try to make sure your room is free from excess clutter. Try to ensure your mattress and bedding are comfortable. Make sure you turn off your devices, such as your mobile, at least one hour before bed, and use calming scents such
‘Do some relaxation exercises or light stretching if that helps your arthritis’
as lavender to create a restful haven. Maintain a consistent nightly routine, such as having 30 minutes of wind down before sleep, dimming your lights, and perhaps doing some relaxation exercises or light stretching if that helps your arthritis.
3
Focus on your breathing before bed
Mindful practices have long been celebrated for helping us feel more relaxed, and there’s a growing body of research to suggest that meditation can help improve sleep quality, too. By focusing on the present moment and becoming more aware of your breathing, you can encourage your body to release tension and prepare for bedtime.
‘Prolonging how long you’re breathing out for can make your vagus nerve [a long nerve that connects
‘If you sleep on your back, try propping a small pillow under your knees for extra support’
the brain to various organs, including the heart, lungs and digestive tract] send a signal to your brain to activate your “rest and digest” system, which can calm the body and mind and help us drift off,’ explains neurophysiologist and sleep expert Dr Nerina Ramlakhan, who works with Oak Tree Mobility.
You can find excellent meditation videos and whitenoise sounds on YouTube and the Spotify app – these can also if you wake up in the night with
4
Use a pillow as a prop Do you find it difficult to get comfortable at night? Sleep-posture expert James Leinhardt, founder of Levitex Foams, recommends using a pillow for extra support. ‘Side sleepers should try putting a pillow between their knees and ankles for more support, and, if you sleep on your back, try propping a small pillow under your knees,’ he advises. ‘These little tricks should, hopefully, support your body in a neutral position and reduce the amount of time spent in awful sleep postures.’
While a pillow between the knees can help reduce pain, some people with arthritis find it can disrupt sleep because they have to move the pillow during the night. One good tip is to use a silk pillowcase on your pillow, so it slides around in bed easier. You could also use a knee pillow with a strap that can be tied gently around your leg to stop it moving around too much.
5Make your fan work harder
Experts generally agree that the ideal bedroom temperature for optimum sleep is between 16°C and 18°C, but it can be hard to maintain this during the summer. When it’s really hot, using a
standard fan can help cool a room, and you can bolster its efficiency by placing a bowl of ice cubes in front of it (which works by chilling the air being distributed). If the noise of a fan keeps you awake, try putting it on an hour before bedtime to cool the room down, then turn it off when you turn in.
It’s still worth treating flareup areas with heat packs during the summer, however, as a cold room can stiffen you up more.
6
Try temporary blackout blinds
With the warmer weather also comes lighter mornings, which can make for an early wake-up call. Permanent blackout blinds can be expensive, but you can buy cheaper portable options – such as Velcro blackout blinds –that offer a convenient and temporary way of blocking out light during the summer nights. You can also hang ready-made blackout linings to your existing curtains.
7
Eat more oily fish
Most of us are aware that eating oily fish is good for brain health, but did you know it could also help us sleep? As Jo Travers, a nutritionist for Discover Great Veg, explains, fish such as salmon, mackerel, sardines and herring are rich in omega 3, and research has started to show that these fatty acids may benefit better slumber. This may be because omega 3s help regulate the function of the pineal gland in the brain, where the hormone melatonin is produced. This is
important because melatonin helps regulate our sleep-wake cycle and control our circadian rhythm. If you do add more fish to your diet, ensure it’s cooked, because raw fish is not recommended if you are taking certain arthritis medications.
8Have a glass of sour cherry juice
Studies have shown a glass of sour cherry juice might help you sleep. ‘Sour cherries are another food that contain melatonin, and several studies have shown that eating this type of cherry, or drinking the juice, can improve sleep, especially in older adults,’ says Jo. Although more research needs to be done to confirm these findings, it could be a trick worth trying Make sure you don’t drink too close to bedtime, however, to avoid waking in the night to go to the toilet. This not only disturbs your sleep, but may be tricky with stiff, painful joints.
helps me’
Naomi Tyrrell, 44, has psoriatic arthritis and often wakes up in the night in pain, unable to get back to sleep. Here’s what she finds useful
‘I use lavender oil in a warm bath before bed, as that can help me sleep more deeply, and a few drops on a tissue near my pillow also helps – probably because my mind associates it with relaxation. I have a heat pad that I can move around in the bed and I try not to get into a cold bed, because that makes my feet very sore.
‘I have also started doing “cognitive shuffling”. You choose a word and then have to think of as many words as you can that begin with each letter. So, if the word was lavender, you’d think of as many words as possible beginning with “l”, before then moving on to “a”. The idea is that you are asleep before the end of the word. It takes my mind in different directions, which is useful as a distraction from pain. I don’t think it would work if the pain was severe, but for mild pain it’s worth a try.’
What does an OCCUPATIONAL therapist do?
We speak to two occupational therapists to find out what they do and how they can support people living with arthritis
BY LOUISE PARFITT
‘It’s that feeling of knowing you have helped someone to reach a better place’
MELISSA CHIEZA PRIMARY CARE MENTAL HEALTH PRACTITIONER, EAST OF ENGLAND
I work alongside GP surgeries to support patients with their mental health. The people I see usually have two or three co-existing conditions, such as arthritis and diabetes, or arthritis and asthma. As well as offering support with their physical health, it’s important that the person’s mental
wellbeing is looked after, too.
I see a lot of people who were shielding during the Covid-19 pandemic who feel worried about going back into busier places, or who feel a bit forgotten now that life has returned to a more normal pace. Increasingly, I am seeing women who are perimenopausal: those symptoms combined with living with a condition such as arthritis can leave them feeling overwhelmed.
If you are struggling with your mental health, you can contact the Samaritans 24 hours a day: call 116 123 or email jo@samaritans.org
helping them access financial benefits, to techniques to manage anxiety. It can also be helping them prepare for medical appointments or to access other support, including talking therapies or adaptations to their home if their mobility is affecting their daily life.
I usually see people for six sessions. Our initial consultation lasts between 30 and 40 minutes, during which I find out exactly what they would like me to help them with. The support is so wideranging – from getting access to a gym and personal trainer if they wish to lose weight, and
I see my role as preventative –being there to support people before they need crisis services. I received an email the other day from someone I worked with at the beginning of the year who wasn’t in a good place. They have now been to talking therapy, and their medication has been adjusted and is now working well for them, so they wanted to thank me and the GP. It’s that feeling of knowing you have helped someone to reach a better place in their lives that makes my job so worthwhile.
‘It’s so varied – no day is the same!’
PATRICIA BISSET RHEUMATOLOGY SPECIALIST OCCUPATIONAL THERAPIST, GREATER GLASGOW AND CLYDE
Most of my referrals are through rheumatology consultants – if someone has highlighted that they have issues with daily activities, or with fatigue, or maybe they have a new diagnosis and aren’t sure how to cope. In a nutshell, I am here to support people to cope with their long-term arthritis. It involves looking at what’s important to them: what they want to be able to do and achieve. My role is to help them maximise their potential, but how I do that depends on each person’s needs and wishes.
People think of occupational therapists (OTs) as helping with equipment to aid daily living, such as raised toilet seats or hand rails, which we can do. But we also support people with managing fatigue, to make adjustments to enable them to carry on working, or adapting their golf clubs so they can continue their hobby.
We’re also trained to provide mental health support and we
signpost people to other forms of assistance. It’s so varied – no day is the same!
I absolutely love my job. People trust you with the most intimate aspects of their lives. Often, it is a big step for them to come forward to ask for that support, so it’s a huge privilege. One of my team received feedback from someone who had been referred to us for splints. She said her occupational therapist did so much more than provide splints; she helped to lift her out of the black hole that she was in – which, to me, sums up why I do my job.
Would I benefit from seeing an OT? An OT can help if you are struggling to manage your condition physically or emotionally.
How do I access one? OTs may work with a rheumatology consultant, a GP surgery or pain management clinic. They may be based in a clinic setting or in the community. Ask your GP or health or social services professional, and they will be able to assist.
Where can I find more information? Search “occupational therapy” at versusarthritis.org
experts ASK THE
Email your question to inspire@versusarthritis.org
Dr Sarah Jarvis is a medical writer and broadcaster. She has been the BBC Radio 2 doctor for many years and is doctor to the BBC’s The One Show
Q My husband had a couple of bouts of gout years ago, but they have become much more frequent since he has started having to take medication for heart failure. What can he do?
A Gout is a form of inflammatory arthritis – inflammation of the joints. It is more common in men, especially as they get older, and it can sometimes run in families.
But gout isn’t caused by an overactive immune system. It happens when levels of the natural chemical uric acid build up too much.
Everyone has uric acid in the bloodstream, but levels are usually kept within strict limits by excreting it from the body through the kidneys and gut. If your kidneys don’t remove it efficiently, or if your body is producing too much uric acid, levels can build up. At this stage, urate crystals are formed from the uric acid and these can get deposited in your joints. The most common joint affected is at the base of your big toe, and the results is severe pain, redness and swelling. Gout causes episodes of severe inflammation, stiffness, pain and damage, known as gout flares.
Living with obesity and drinking large quantities of alcohol (especially beer) can make you more prone to gout. Genetics plays a part, so a family history of gout makes it more likely that you’ll get it.
Along with chronic kidney disease, certain medicines can impair your kidneys’ ability to remove uric acid from your system. These include diuretics or water tablets (often used to treat heart failure) and low-dose aspirin (often given after a heart attack or stroke). ACE inhibitors and beta blockers, which are also used for heart conditions, can increase uric acid levels, too.
It’s important that your husband doesn’t stop any of his heart medication without medical advice. I suggest he explains to his doctor how difficult his gout is making his life. They may be able to find alternative treatments for him that don’t carry the same risk.
Dr Lee David is a GP and CBT therapist. She has written books on wellbeing, and supports health professionals struggling with mental and physical health
Q In summer months I feel drained and my arthritis can play up – how can I stop this affecting my mood?
A If symptoms get harder to manage, or your energy dips, there are ways to lift your mood. Pace your day, balancing activity with regular breaks, and give yourself permission to rest. Plan uplifting activities that don’t exhaust you, such as crafts, music or light gardening. Gentle movement, such as stretching or short walks at cooler times, can ease stiffness and lift your spirits. Stay connected to what matters – whether that’s time outdoors, seeing friends or simply taking space to unwind. Mindfulness or journalling can help with stress, and a gratitude journal can gently shift your focus towards what’s going well, even on harder days.
Above all, be kind to yourself. Adapting to your body’s needs and taking small steps to care for yourself can help you feel more balanced –emotionally and physically.
Jack March is a physiotherapist specialising in rheumatology and teaches healthcare providers about management of rheumatological conditions
Q Does hot or humid weather affect my arthritis?
A Most joints have their own ‘mini-environment’, kept stable by a joint lining that also gives it a local internal pressure, much like a balloon. Joints are susceptible to air pressure changes and this, typically, is what affects the symptoms experienced by someone with arthritis. Alterations in air pressure might cause increased symptoms in those with swelling, and a decrease in symptoms in those with stiffness.
The stress of keeping cool can also affect inflammation in the body and this can aggravate symptoms of arthritis, particularly for those with arthritis in the hands and feet.
Keeping comfortable and moving can help to alleviate any increases in symptoms. Cool-water baths for the hands and feet are particularly useful, and inflammation typically responds to movement. But if all of your symptoms are better in the heat, then make the most of it!
Jane is a Helpline Team Leader. She loves supporting the advisors and ensuring the helpline and its channels are a great place to reach out to
Q I’ve just been diagnosed with axial spondyloarthritis – what is it exactly?
A Axial spondyloarthritis is a type of arthritis that mainly affects your back. There are several types, but if changes to your spine are visible on an X-ray, it’s called ankylosing spondylitis. The condition can also affect the feet, hips, neck and shoulders.
You will probably be prescribed drugs to reduce the amount of inflammation in the body and you may be offered a steroid injection into a swollen joint as a short-term treatment. Sometimes with ankylosing spondylitis, you may get eye inflammation (uveitis), which can be treated with steroid eye drops. It is very important to keep active. A referral to a physiotherapist to maintain mobility in your spine and other joints will help you maintain good posture. Regular exercise will help with the range of movement in the back, stop your spine from stiffening and help your overall health.
The Versus Arthritis community is here for you. Our website is full of useful advice and stories about how to manage your arthritis, and you can also order free information booklets at shop.versusarthritis.org . Meet people in person at our local support groups, or chat to us online at community.versusarthritis.org or on the phone on 0800 5200 520.
A small step forward
New research funded by Versus Arthritis is looking positive for autoimmune diseases, explains Julian Worricker, but it’s early days
Every now and then, I can walk into the Radio 4 production office and quietly delight in an editorial decision that –hopefully – gives everyone reading this magazine a lift. This was true on The World Tonight a few weeks ago, when we covered an important development in a scientific trial under way in Newcastle. It related to the treatment of rheumatoid arthritis, and the possibility that the condition could be “switched off”. Not everyone on the production team knew of my own interest in the subject, so it was a good opportunity to shatter a few myths in casual conversation. I’m not sure I had to explicitly dismiss the “it’s just aches and pains for old people” suggestion – hopefully we’re smarter than that on Radio 4 –but it was an illustration of how arthritis continues to fall under the radar.
Pioneering research
The work in Newcastle, funded by Versus Arthritis and the European Commission, is focused on blood cells.
Professor John Isaacs, a Versus Arthritis trustee who has worked on the condition for 35 years and is leading the research, described it as pioneering. I defer to him to explain it, so here’s the relevant paragraph from the BBC website, starting
when given back to the patient, they command the soldiers to stop attacking the patient’s joints. In time, this treatment could provide significant benefits to people living with rheumatoid arthritis by “switching off” the disease.’
Early days
with the context: ‘There are different types of cells that come together, rather like an army of soldiers, to attack an infection or disease. These take instructions from the white blood cells known as dendritic cells – the “generals” of the immune system. When these generals sense danger they become excited and send out the attack signal, but when there is no danger detected they remain calm and instruct the army to ignore healthy tissues. When this goes wrong, it causes diseases like rheumatoid arthritis.’
Then came an explanation of the medical trial, which has emerged from an understanding of the way those cells are behaving: ‘Over the course of a week, the patient’s white blood cells are grown in the lab and trained to resemble the “calm” generals, so that,
I spoke to former nurse Carol Robson, who’d volunteered to take part in the trial. Since being injected with the retrained white blood cells she said she was in less pain, although it’s too early to draw definite conclusions. Before we started recording the interview, I told her about my arthritis, so we were able to compare notes on whether putting one’s hands in packets of frozen peas can provide relief on a bad day. It was one of her chosen methods. There’s still a long way to go. The first two trials are small – about 32 patients have been involved – and more research is needed. Even if the treatment is shown to reeducate the immune system, it may be another five to 10 years before patients can access it. But Professor Isaacs said it would make him and his team immensely proud to have developed the treatment. If it’s successful, the research could also have implications for other autoimmune diseases, such as diabetes or multiple sclerosis.
Julian Worricker is a BBC TV and radio presenter and journalist. He has psoriatic arthritis
BY IONA TULLOCH
‘MOVEMENT IS MEDICINE’
Actress and TV presenter Kelly-Anne Lyons has dealt with JIA and Lyme disease, but embraces life’s ups and downs with resilience and humour
Whether dazzling audiences on TV or navigating health challenges, Kelly-Anne Lyons approaches life with unwavering optimism and strength. An actress, television presenter, writer and model, she has graced our screens through roles in British comedy and hidden-camera sketch shows, including BBC’s Dick and Dom’s Funny Business, Fool Britannia and Richard Hammond’s Secret Service.
Beyond the bright lights of entertainment, KellyAnne has faced significant health challenges because of Lyme disease, juvenile idiopathic arthritis (JIA) and – more recently – restless leg syndrome. But thanks to her determination, positive outlook and commitment to healthy living, she balances the needs of her thriving family and demanding career
with her own physical and emotional wellbeing.
Kelly-Anne’s battle with arthritis began at the age of 13. Misdiagnosed for eight months with chronic fatigue and flu, her joints eventually swelled up and a school nurse finally realised the likely cause. Soon afterwards, Kelly-Anne was diagnosed with JIA, thought to be caused by Lyme disease.
‘Looking back, it’s surprising the doctors didn’t figure it out, as we lived in a wooded suburban area where deer and Lyme disease were prevalent,’ she says.
Adjusting to life
‘Living with arthritis as a teenager wasn’t easy. I had to miss school for medical appointments and was often exhausted. Where possible, and with the help of my amazing parents, I found ways to work around the impact of the pain, swelling and stiffness. For example, to avoid having to carry heavy bags of schoolbooks, I had one set at school and one at home.’
Managing symptoms and seeking remission were the ultimate goals, but there was no quick fix. ‘My drug regime impacted on my gastrointestinal health, which, in turn, had to be managed by medication,’ says Kelly-Anne. ‘But thanks to my supportive family and a great medical team, I was able to maintain an active lifestyle.’
Just before she started college, Kelly-Anne’s arthritis went into remission. While she has not experienced a fullblown flare-up in adulthood, occasional joint pain reminds her to remain highly tuned to what is going on in her body.
New beginnings
Today, Kelly-Anne lives in Paris with her husband, Simon, and six-year-old daughter, Bella.
‘After sitting out the pandemic in London, the chance to relocate to Paris with Simon’s work seemed too good to turn down,’ she says. ‘We were ready for an adventure, even if it came at a temporary cost to my acting career.’
Three has now become four, as Kelly-Anne gave birth to another daughter last month.
Anyone with inflammatory arthritis is likely to feel apprehensive about how pregnancy might affect their joints, says Kelly-Anne. ‘In my previous pregnancy, I experienced some back and pelvic girdle pain,’ she says. ‘This time round, I worked harder to prepare my body for pregnancy. As well as strengthening exercises, Pilates twice a week and daily walking have kept me fit, so my joints have felt strong throughout.’
Better still, Kelly-Anne was surprised when pregnancy played a vital role in a nagging health issue that she’d been living with for more than a year.
‘When out running, I tripped and fell, damaging my shoulder joint. Despite months of physiotherapy, it just wouldn’t recover,’ she says. ‘I was booked in to have a steroid injection, but fell pregnant. My doctor suggested I hold off, to see what impact the pregnancy would have on my body. Before long, the joint had fully recovered – an unexpected bonus!’
It hasn’t been all plain sailing, however, as both of Kelly Anne’s pregnancies have been impacted by restless
‘Living with arthritis as a teenager wasn’t easy. I had to miss school for medical appointments and was often exhausted’
Protective effect
There are changes to the immune system in pregnancy that help to protect the baby. These changes can have long-lasting positive effects for people with rheumatoid arthritis. Versus Arthritis is currently researching this to understand why these protective changes to the immune system occur in pregnant women.
leg syndrome (RLS). ‘When I was pregnant with Bella, RLS made sleep almost impossible, and nothing seemed to help,’ she says. ‘Thankfully, it resolved as soon as she was born.’
Affected again in her second pregnancy, Kelly-Anne was recommended magnesium supplements, which didn’t appear to help; nor did eating potassium-rich foods, stretching or massage. The insomnia that ensued would have brought most people down, but not Kelly-Anne.
‘I worked my way through the stack of books on my bedside table and told myself I was in training for when the baby is born,’ she laughs. ‘And I remained grateful that my RLS was pregnancy related and therefore temporary. My poor father has been affected for many years, and I don’t know how he does it long term.’
Kelly-Anne’s Pilates teacher read that iron supplements may be able to help RLS in some people. ‘Although my iron levels were within normal range, my doctor said they
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were edging down slightly and he was happy for me to give supplements a go. Three days later, it was like a switch flipped. I could finally sleep again.’
Health journey
Whether recovering from arthritis, pregnancy or injury, exercise has been a cornerstone of Kelly-Anne’s health journey. ‘I’ve learned that you can’t just wait to feel better – you have to actively do something about it,’ she recommends. ‘Movement is medicine.’
Kelly-Anne has developed a structured approach to getting back into shape after childbirth. ‘First, I set a clear fitness goal and create a manageable plan to allow me to achieve my goal,’ she says. ‘I find enjoyable activities that keep me motivated. Listening to my body and adjusting my
plan accordingly is essential, as is reducing any barriers. I get my work-out clothes ready the night before to make it super easy to exercise when I wake up. Or I’ll arrange to meet somebody to exercise with, so that even if I don’t want to exercise that day, I’ll show up for my friend. Motivational podcasts keep me inspired.’
Living in Paris has been enriching for Kelly-Anne and her growing family, and she’s taking time to document her experiences on Instagram. With her followers now in the tens of thousands, what started as a hobby has evolved into a career move. ‘My ultimate idea is a book, and this is part of my creative journey,’ she says.
With her 40th birthday approaching, Kelly-Anne is focused on enjoying this special time. ‘40 is a big milestone, but I don’t fear it. I feel stronger and more confident than ever. Every challenge has taught me something. If you approach difficulties with curiosity instead of fear, you come out stronger.’
Understanding Lyme disease
Lyme disease is a bacterial infection that can be spread to humans by infected ticks.
Ticks can be found in long grass, woodlands and moorlands. Not all ticks carry the bacteria that causes Lyme disease, but those that do are more common in southern and northern England, and the Scottish Highlands.
Symptoms include a circular or oval-shape rash appearing around a tick bite, usually within four weeks. The rash often has a lighter or darker area in the centre (a bit like a bullseye) and might gradually spread. Some people also get flu-like symptoms.
Most people with Lyme disease get better after antibiotic treatment. But if untreated, Lyme disease can lead to arthritis in up to 60% of people.
Top tips for prevention
•Wear long socks and sleeves while walking outdoors, and check for ticks after being outside in areas known for ticks.
•Stay on clear paths where possible, and wear light-coloured clothins so ticks are easier to spot.
•Should you find a tick, remove it using fine-tipped tweezers or a special tick-removal tool.
•If you notice a rash or become unwell, book an appointment with your GP.
Workplace adjustments
We are all too aware of the impact arthritis can have on work; data tells us that people with arthritis are 20 per cent less likely to be in work compared with those without arthritis. In our research on work and arthritis, respondents with the condition tell us that the lack of targeted advice and support can make work more challenging.
Working with volunteers with arthritis, and an occupational therapist, we developed a Work Adjustment Plan, specifically for people living with arthritis or musculoskeletal conditions. Our Work Adjustment Plan is designed to help you identify barriers you may face at work, guiding you to find solutions.
In addition to the plan, you can find key work-related information on the Work and Arthritis area of our website. You can download the plan at: versusarthritis.org/about-arthritis/work-andarthritis, or to receive a printed copy of the Work Adjustment Plan, email ProfessionalEngagement@ versusarthritis.org
A big tick
Versus Arthritis has been awarded the PIF TICK (Patient Information Forum Trusted Information Creator) – the UK’s only independently assessed quality mark for print and online health and care information. Our information underwent a thorough assessment, demonstrating it had met 10 key criteria. This means that the information you read, watch or listen to is evidence-based, understandable, jargon-free, up to date, and produced to the highest standards. Order our information booklets at shop.versusarthritis.org/ collections/free-informationbooklets
Accessing support
Community Appointment Days are events to help people discover ways to manage their MSK health in a holistic way. From a healthcare perspective, it’s a chance for patients referred to the MSK waiting list to discuss what matters to them with physiotherapy staff and partner organisations in a community setting. It’s about helping people feel reassured, and access care and support locally in one place, and empowers them to do more for themselves. There are no time constraints or queues, giving people time to have a conversation and be listened to. In the past year, Versus Arthritis teams have attended 37 events and supported more than 2,000 people.
Ask your GP about the next Community Appointment Day in your area.
and flexibility in a short period of time, not to mention the increased levels of confidence. Why not give it a go? Contact Lisa at l.carlisle@ versusarthritis.org to find out more. CHI ME UP!
Chi Me is a modified version of Tai Chi that helps improve posture, balance, breathing and flexibility, and Versus Arthritis is offering free, online sessions. Each session lasts
around 30 minutes and can be done seated or standing, from the comfort of your home. Chi Me is not strenuous and can really improve a person’s range of movement
4 WAYS to stay fit
THIS
SUMMER
Be inspired to try a new form of exercise to help your joints stay fluid and supple
BY KATY SUNNASSEE
WALKING
What it’s good for: Walking is a great way to stay fit. If you walk briskly, you’ll improve cardiovascular health, but without the strain of running. The continuous motion boosts circulation and lymphatic drainage.
What’s more, being out in nature also helps you destress. ‘Walking not only improves cardio benefits, but it also helps your brain, too, as you take in more oxygen when you stand up straight,’ says Joanna Hall, founder of WalkActive.
‘Your diaphragm is responsible for helping air come into and out of your body,’ she adds. ‘With good posture, the diaphragm moves about 10cm, but if you stoop or slouch, it can only move around 3-4cm, limiting your ease of breathing. And breathing deeply helps you feel more positive and upbeat.’
Tipping forward as you walk compromises posture, recruits the wrong muscles and triggers lower back discomfort. To avoid this, Hall advises lengthening your neck and imagining a string pulling you up from the crown of your head.
Also visualise peeling your back foot off the floor with each stride. ‘Imagine it like separating two pieces of strong Velcro. This helps your posture by improving the mobility of your feet and stimulating the posterior (back) muscles of your body to propel you forward, rather than pulling yourself forward, which encourages leaning forward,’ says Hall. How to get started: Try the Joanna Hall WalkActive app at walk-active.com to find out more. Or download the free NHS Active 10 walking app. What to wear: Be kind to your knee and hip joints with decent hiking trainers or walking boots. For summer, you could try trekking sandals.
CYCLING
What it’s good for: Cycling is a great low-impact activity – which means it’s easier on your joints – that increases your cardiovascular health and gets you outside. Pedalling around on two wheels with the wind in your hair is one of the most freeing feelings.
‘Many of us at Wiggle are cyclists ourselves, but we know from our customers that they value the mental benefits as much as the physical,’ says Nassrin Chamanian, content manager at cycling brand Wiggle. And if you’re new to cycling, summer is the perfect time to get started.
‘Riding during the summer gives you a few months of better weather and longer days to build your fitness,’ she says. ‘And if you can, it’s a good idea to ride into the wind at the start of your outing so you get a tailwind on your return,’ advises Chamanian, who also suggests stretching out and using a foam roller up and down your legs after a ride to avoid stiffness the next day.
‘Always look ahead, anticipate hazards and signal your movements clearly,’ she says. ‘Make sure your bike is roadworthy and fitted with working lights.’ How to get started: ‘Decide what type of cycling you want to do and buy the correct bike,’ advises Chamanian. Bike hire is available at various National Trust locations – see nationaltrust.org.uk for details. You can try using the Komoot app (komoot.com), which shows area highlights near you and helps you plan a route to suit your bike. If you have a road bike, for instance, it keeps you away from the muddy trails. What to wear: You needn’t squeeze yourself into racing Lycra. Try lightweight shorts or soft jogging bottoms, and a sweat-wicking top. And don’t forget your helmet!
SWIMMING
What it’s good for: Swimming is the ultimate lowimpact exercise that’s kind to your joints. The water keeps you buoyant, keeping strain off any achy hips or knees. ‘Swimming is great both physically and mentally – the latter of which isn’t really talked about often enough,’ says Sophia Hart, a swimming instructor in Colchester, Essex. ‘It really can help you feel positive and happy. Just a few lengths can leave you feeling calmer and more centred as you get into the rhythm. When I swim, it reminds me to practise deep breaths and helps clear my mind.’
It’s also great physically, especially for those with arthritis. ‘Swimming is non-weight-bearing, so the water keeps the weight off your joints, meaning you’ll feel more supple and stick at it for longer,’ says Sophia. But while it may not be weight-bearing, that doesn’t mean it’s easy. ‘The water provides resistance meaning it still works your muscles and provides a good cardio workout.’ Do avoid breaststroke legs, however, if you have hip arthritis.
If you want to avoid getting your hair wet, due to the physical strain of hair washing, you can simply walk in the pool instead of swimming – it’s still great exercise. How to get started: Contact your local pool for information about lessons if you’re new to swimming. Of course, there’s always the sea if you’re on holiday – just stay safe and stick to the shoreline, and check for any swim flags to warn of danger. What to wear: Swim shorts or a swimsuit. For women, there are plenty of stylish swimsuits around that offer a little more coverage. Try a tankini (strappy top and separate bottoms) if you don’t want to reveal your tummy, but want something different.
YOGA
What it’s good for: Some of yoga’s many benefits include improved flexibility, strength and body awareness, as well as reduced stress and anxiety. In fact, it’s great for improving flexibility and balance in adults aged 65 and older. ‘Yoga is a great practice to keep our joints flexible, and maintaining joint health enables the joints to move to their full range of motion. This, in turn, helps to keep the connective tissues and other joint structures strong and agile, all of which allows you to move more freely and with ease, preventing injury,’ says Sophia Drozd, yoga instructor and founder of the app Yoga 4 Pain (yogaforpainapp.com).
‘Yoga can really help those with arthritis, as it’s a gentle practice that promotes relaxation. It can help to build strength, improve flexibility and balance, as well as reducing pain and stress that can be exacerbated by living with a chronic health condition,’ she says.
How to get started: ‘Ease yourself in, start small, do short durations and listen to your body and limitations as you move,’ says Sophia. ‘Chair and bed yoga can be great supportive options for those in pain and with limited range of motion. Restorative and yin yoga are both relaxing supportive styles of yoga that can be great places to start, too.’
Try the Yoga 4 Pain app and find classes near you at yogahub.co.uk, and at better.org.uk – go to ‘yoga classes’. What to wear: Leggings, loose sweatpants or shorts and a loose top will do. You may need your own yoga mat, but these can be bought cheaply at large supermarkets or sports shops.
Do bacteria in our gut influence arthritis?
BY ANGIE JEFFERSON, REGISTERED DIETITIAN
EASY TO digest
We share a close relationship with bacteria that live on us and inside us. And, while we usually think of bacteria as harmful, there are countless different bacteria that help us. In fact, it is thought that more than half your body is not human, with the numbers of bacterial cells being approximately equal to the number of human cells. The largest amount of bacteria are living inside your gut, particularly in the colon, and these are called the gut flora or the gut microbiota.
Around 1,000 different types of bacteria can survive in the human gut, but typically we host between 100-150 of these at any point. Just like fingerprints, we all have a unique gut flora, and this changes all the time. There doesn’t seem to be a single combination that makes the optimal gut flora – what is right for one person will not be right for others. However, recent discoveries suggest there are patterns in gut bacteria that may be associated with arthritis at different stages of the disease.
How do gut bacteria help?
‘Just like fingerprints, we all have a unique gut flora’
Gut bacteria have a key role to play within digestion, where they break down dietary fibre (through fermentation) and help to neutralise harmful by-products of digestion. While fermenting fibre, the bacteria produce vitamins (B2, B12, folate and vitamin K), which can be absorbed by the body. They also produce substances called shortchain fatty acids (butyrate, acetate and propionate), which are incredibly useful, helping to protect against colon disorders, reduce inflammatory processes, and lower cholesterol and blood sugar levels. One less useful by-product is gas. Sudden changes in fibre intake can overstimulate gas-producing bacteria, causing bloating and flatulence, so gradual increases in fibre intake accompanied with plenty of fluids is the best approach.
How does this affect arthritis?
Dr Lizzy Rosser, an associate professor at University College London (UCL), explains, ‘In rheumatoid arthritis (RA), the body’s immune system becomes faulty and attacks the joints, causing inflammation and damage. Osteoarthritis and gout also involve inflammation of joints by different processes.
‘We’ve found that both humans and animals with arthritis have lower levels of bacteria that produce butyrate, and this may affect how inflammation is regulated by the body,’ she says. ‘Supplementing mice with butyrate reduces the severity of arthritis, and we are still trying to understand whether butyrate supplementation or a diet that increases the levels of butyrate in the body may be a promising treatment in the future.’
Bacteria may also be protecting the health of the gut wall and preventing damage. A healthy gut lining forms a protective barrier against bacteria and other unwanted substances passing into the blood stream and only allows nutrients, water, short chain fatty acids and other “good” substances through.
Researchers are also investigating whether supporting gut barrier function is a potential treatment target for arthritis.
Can you correct gut bacteria?
Currently there is no magic cure. Supplements containing live bacteria (probiotics) are problematic, as while some are good, many are poor quality and don’t contain the live bacteria that they claim.
Probiotics only contain a few specific bacteria types (remember the 100-150 different types inside us already), and while gut levels of these rise with regular use, levels tend to rapidly fall again once you stop. And you may be taking medications that affect how these gut bacteria thrive and survive – but it’s important not to stop taking them. The best thing you can do is eat a diet that supports a diverse community of gut bacteria. Bacteria love fibre, and soluble fermentable fibres may be particularly beneficial for butyrate producing bacteria. Start with the basics of eating at least five servings of different fruits and vegetable each day and choosing wholegrain breads, breakfast cereals and grains, such as wholegrain rice, wholemeal pasta and noodles, or quinoa, as often as you can. Then add foods containing fermentable fibres such as beans, pulses, barley and oats; fruits including apples, bananas and raspberries, and veg such as leeks, onions and garlic.
Meal ideas to boost good bacteria
Make a grain salad Mix a pouch of ready-cooked brown rice and quinoa with a can of chickpeas, diced peppers, chopped herbs (coriander and parsley work well) and add chilli if liked. Top with cooked salmon, mackerel or chicken.
Reduce your meat intake
Replace half the meat in a recipe, such as a casserole or bolognaise, with lentils or a can of beans.
Go for oats
Baked oats make a tasty breakfast or dessert. A simple recipe is to blitz 100g oats with 1tsp baking powder, a generous pinch of cinnamon, 1 chopped banana and 2 eggs. Stir in a handful of blueberries. Divide into four oiled ramekins and bake for 2025 mins at 180◦C or 8-10 mins in an air fryer. Cool slightly and enjoy.
About our testing
We fund a broad range of medical research, from research in laboratories to testing involving human volunteers. Where there are no alternatives, we fund medical studies that use animals, but do so adhering to the most rigorous guidelines.
Add some sunshine to your life with these simple summer recipes from Prue Leith
Asian noodle salad with peanut dressing
Serves 4
This salad relies on ginger, rather than chilli, to give it a reviving kick, and gets its sweet richness from the addition of honey
Ingredients
2 carrots, peeled and grated
½ small cucumber, cut into matchsticks
1 red pepper, deseeded and finely sliced
1 baby gem lettuce, finely sliced
1 pak choi, finely sliced
4 spring onions, finely sliced
A small handful of coriander, mint and Thai basil leaves, torn
Avocado, marinated feta and chorizo on toast
Serves 4
For the marinated feta
100g feta, broken into chunks
4 tbsp olive oil
Zest of 1 lemon
A pinch of chilli (red pepper) flakes
½ tsp fennel seeds
Salt and black pepper
For the chorizo
140g chorizo, sliced lengthways on the diagonal
To serve
2 ripe avocados, sliced
4 slices of sourdough, toasted
A few basil leaves (optional)
Method
1 To marinate the feta, combine the ingredients in a bowl and gently toss to mix. Cover and chill until needed.
2 For the chorizo, heat a dry frying pan on a medium heat. Add the chorizo and cook until crisp (about 3 minutes per side). Remove the chorizo from the pan and place it on a plate lined with kitchen paper to drain any excess oil.
3 To serve, divide the avocado between the toasts and top with equal amounts of the feta and chorizo, and a few basil leaves too, if you like.
2 tbsp roasted peanuts, chopped, to serve
For the peanut dressing
1 tbsp peanut butter
4 tbsp light soy sauce
2 tbsp rice vinegar
2 tbsp clear honey or maple syrup
2 tbsp sesame oil
1 garlic clove, crushed
1 tsp finely grated ginger
Method
1 In a salad bowl, first whisk all the dressing ingredients together, adjusting with warm water as necessary, until you have a coating consistency.
2 Add all the salad ingredients to the bowl with the dressing and turn them gently.
3 Top with the chopped peanuts.
Top tip
If you are making this in advance, let the halloumi cool before arranging the plate, as warm halloumi will wilt the rocket. If you want to serve the halloumi hot, just add it to the rest of the salad at the last minute
Summer watermelon and halloumi salad
Serves 4-6
Ingredients
3 tbsp plain flour
200g halloumi, sliced
Vegetable oil, for frying
200g watermelon, skin removed and cut into thin slices
30g rocket leaves
20g/2 tbsp pomegranate seeds
About 10 mint leaves, torn
For the pickled shallots
3 tbsp white wine vinegar
1 tbsp caster (superfine) sugar
½ tsp salt
2 shallots (or 1 small red onion), finely diced
For the dressing
2 tbsp extra-virgin olive oil
1 tbsp white balsamic vinegar
1 tsp clear honey
Salt and black pepper
Method
1 Make the pickled shallots. Tip the vinegar, sugar and salt into a small saucepan and add 3 tablespoons of water. Stir, then place on a medium-high heat and bring to a boil. Boil for 1 minute, then remove from the heat and add the shallots (or onion). Set aside to cool.
2 Whisk all the dressing ingredients
together in a small bowl and season with salt and pepper. Set aside.
3 Tip the flour into a shallow bowl and season with salt and pepper. Dip the halloumi slices into the flour to coat.
4 Heat a tablespoon of oil in a frying pan on a medium-high heat. Add the halloumi slices and fry on each side for a few minutes until golden and crisp. Leave to cool.
5 Arrange overlapping layers of halloumi, watermelon and rocket on a large serving plate.
6 Drain the shallots (or onion), and sprinkle them on top of the salad, along with the pomegranate seeds and mint leaves. Drizzle the dressing over or serve it on the side.
Recipes from Life’s Too Short To Stuff A Mushroom by Prue Leith (Carnival, £25)
journeys with this neck pillow. Perfect for car, train or plane, it’s lightweight and comfy.
2. Chappie hammam towel, £30 ebbflowcornwall.uk Beach lovers will adore this lightweight and stylish hammam towel, which folds up small to fit in your beach bag. You can also wrap it around you to
THE SHOPPING EDIT
4. Peta easi-grip trowel, £11.99 shop.versusarthritis.org
If you’re a keen gardener but find it awkward, this handy trowel helps keep your wrist at a natural, stress-free angle to help eliminate strains.
5. Blue wheely suitcase, £59.99 tkmaxx.com
Lightweight and easy to manoeuvre, this wheely case is perfect for your travels, especially if you find it hard to lift.
6. Baseball cap, £14 marksandspencer.com Style out sunny days with this breathable, pure-cotton cap. An adjustable strap at the back provides a secure fit, while Sun Smart UPF50+ technology helps to protect skin against harmful UV rays.
HOW to say no…
Listening to your body and creating boundaries is key for your mental and physical health. But it’s not always easy. Here’s how to approach it
BY CLAIRE MUNNINGS
We’ve long been encouraged to take a positive view of life and to not let our age, health conditions or anything else hinder the way we embrace it. But while feeling strong enough to say yes at times is crucial for our wellbeing, it’s just as important to be able to say no to the things that don’t feel right.
When you’re caught in the middle of an arthritis flare up, even something seemingly simple to everyone else – such as meeting up with friends or lending a hand at home –can feel impossible. Yet, the pressure to say yes is real. It can be hard to admit when you just don’t have it in you. But here’s the truth: saying no isn’t selfish, rude or unkind. It’s one of the most powerful ways to take care of yourself.
According to health and wellness coach Sarah Stannard,
pushing through discomfort to avoid disappointing others can often lead to worsened symptoms, prolonged flare-ups and increased stress.
‘Every task – whether socialising, helping family or running errands – requires a level of physical and emotional effort. Saying no to some things allows you to conserve energy for the things that truly matter – your health, your recovery, and the activities that bring you joy,’ she affirms.
How to set your own boundaries
If saying that one little word –‘no’ – feels uncomfortable or even downright impossible, you’re definitely not alone. The good news? There are some
simple, effective ways to make it a whole lot easier. Here are a few helpful tools and tips to get you started.
Help others understand: A lot of people don’t have first-hand experience of chronic pain and they might not realise just how much it can affect your daily life. That’s why opening up to loved ones about how you’re feeling, and why you need
to set certain boundaries, can help them understand where you’re coming from.
For more about spoon theory, read our article in the Autumn 2024 edition at versusarthritis. org/inspire/ autumn2024
‘A great way to explain chronic illness to friends and family is through the “spoon theory”, which likens daily energy to a set number of spoons,’ says Sarah. ‘Explain that each activity takes a spoonful and, once they’re gone, they’re gone. Sharing this perspective can help others understand why you need to be mindful of your commitments.’
Reframe what ‘no’ means: We often feel guilty when we say no to social invitations or requests for help, but, instead, try to consider the positives this little word can bring.
‘Remind yourself that setting limits isn’t selfish; it’s necessary for your health,’ says Sarah. ‘Think of it as creating space for healing, rather than letting others down.’
Use clear, compassionate communication: The act of declining an invitation or request can feel tricky, but there are phrases you can use to honestly and politely explain your position.
Sarah suggests trying one of the following:
• ‘I’d love to help, but I need to prioritise my health today’
•‘I can’t make it this time, but I’d love to plan something when I’m feeling better’
•‘I really appreciate the invite,
but I need to rest right now’. You could choose to offer alternative options, too, if you feel happy to do so. You might no longer be able to make dinner that evening, for example, but a short catch up over coffee the next day may be manageable.
Plan ahead: Although unexpected flare-ups can happen, there are probably some key triggers you can recognise and certain limitations you can foresee. Perhaps gardening one day makes you feel sore the next, or maybe you never sleep well the night after a meal out. By understanding how your symptoms tend to present themselves, you can try to block time in your diary to recoup and ensure you don’t overstretch. Having a plan such as this makes it easier to say no to the things that clash with restful time, because the reasoning behind it feels solid – and it can prevent you having to cancel plans last-minute.
‘Identify your nonnegotiables, whether that’s ensuring rest days between social activities or limiting physically demanding tasks,’ advises Sarah.
‘Learning to say no has been life changing’
Tamara Judge, 44, was diagnosed with rheumatoid arthritis nearly 20 years ago. She’s now a resilience coach and the founder of Keystone Coaching, and has found that setting boundaries has brought countless benefits
‘Setting limits isn’t selfish; it’s necessary for your health’
‘Learning to set healthy boundaries and say no was truly life changing. It has allowed me to protect my limited energy, reduce feelings of guilt and resentment, and make more space for the things and people that genuinely support my health and happiness.
‘Not everyone in my life understood straight away, and that was hard at first
because symptoms, such as pain, are often hidden –and some people can make assumptions. But through honest conversations, calmly explaining my needs (and working on my own thought traps), most of my friends and family came to appreciate that prioritising my health wasn’t selfish –it was essential for me to be able to show up fully when I could.
‘If you’re trying to set boundaries, my advice is to start small, be kind but firm, and remind yourself that saying no to others is really saying yes to your own wellbeing, time and energy.
‘You don’t need to justify yourself – respecting your limits is valid and necessary.’
BY EVE BOGGENPOEL
HOW TO HAVE A PET – andenjoyit
Love animals, but concerned your condition means owning a pet isn’t viable? You can still enjoy the company of a furry friend – it just takes a little planning
If you’ve ever had adoring eyes gaze up at you or seen a tail wag at lightning speed the moment you walk through the door, you’ll understand the joys of owning a pet. But the benefits go much deeper. Research has shown that sharing your home with a furry companion can help reduce stress, alleviate depression, lower cholesterol, and decrease the risk of cardiovascular issues. Pet ownership is also linked to
improved cognitive and brain health, and recent studies have shown that it may even have benefits for the perception of pain for people living with inflammatory arthritis. It’s also beneficial for your mental health and blood pressure.
Of course, caring for a pet while managing joint pain presents challenges, so it’s worth doing a little research before bringing one into your home.
‘The main areas to consider with dogs are exercising and feeding,’ says Lynne Hubble, former dog breeder and Crufts judge.
If long walks are difficult, consider hiring a dog walker or increasing your dog’s activity indoors.
‘Throwing a ball is about the best thing you can do,’ says Hubble. ‘Teach your dog to retrieve a ball in the garden or living room, or throw it from the ground floor up to the landing to give them a cardiovascular workout.’
When it comes to choosing a breed, smaller dogs are ideal: they are easier to lift, if you want to. ‘You can always
encourage them to jump onto the sofa first, which makes lifting easier,’ suggests Hubble. ‘Poodles are hard to beat –they don’t shed and need minimal grooming. Maltese and cockerpoos are great options, too.’ Some dogs need lots of exercise and mental stimulation, however, so bear this in mind.
As well as simple commands such as sit, lie down and fetch, some dogs can be trained to help with daily tasks. ‘Some can be taught to pull laundry from the washing machine, for example,’ Hubble says. ‘A Cavalier King Charles is a great option – they are eager to please and happy to help.’
Cats are often an easier choice. If you install a cat flap, they can go in and out of your house independently. Smaller pets, such as rabbits and guinea pigs, can be great companions, but will need regular cleaning out, so make sure you can manage before making the commitment.
Practical aids
If your symptoms are milder, or on days when you feel more mobile to get out for a walk, several aids can make caring for your pet easier.
‘You can get collars that slip over the head, so you don’t have to fiddle with buckles or tiny holes when preparing for a walk,’ says Hubble. There are also arthritis-friendly leads, including hands-free options worn around the waist.
Training your dog not to pull on the lead is a must – there are dog trainers nationwide if you need help.
Feeding can also pose
challenges, so try bowls with extendable handles or a wall-mounted stand. Water bowls connected to the mains are another helpful option, refilling automatically as your pet drinks.
Help at hand
Even with good planning, there may be times during flareups, hospital stays or recovery periods when extra support is needed. If you’re 65 or over and struggling to care for your pet, The Cinnamon Trust (cinnamon.org.uk) connects people with volunteers who can help with grooming, dog walking, cage cleaning or temporary foster care.
The vet charity PDSA (pdsa. org.uk) also offers free or low-cost treatments and medications to those in eligible areas receiving state pension or benefits such as Disability Living Allowance or Personal Independence Payment.
What’s the alternative?
If pet ownership doesn’t feel manageable, Borrow My Doggy (borrowmydoggy.com) lets you look after or spend time with dogs on walks, day visits or while owners are away. Basic membership is free and, for £12.99 per year, you can access privileges such as safety checks, insurance and a 24/7 vet helpline.
Alternatively, Pets as Therapy offers visits to care homes, day centres and mental health facilities with trained volunteers and their animals. Ask your organisation to register at petsastherapy.org. You could also volunteer at your local animal rescue centre.
Your tips for looking after a pet
We asked our Facebook community to share their tips on owning a pet
‘Having a dog can be the impetus to go out walking, which is beneficial for my arthritis. Grooming her can be difficult, so I have trained her to sit on a stool in front of me to be combed, so I don’t have to bend right down.’ – Val
‘I have raised food and water bowls, which are positioned by a wall that I can hold onto when I reach down to pick up and replace them. I have a can hook for the tins, plus a silicone grip to hold the base to protect my hands. I only buy 3kg bags of dry food, and I get the tins and dry food delivered.’ – Diana
‘It was agreed with my husband that, if we got a dog, he had to do everything, as I cannot. But getting her has made me get a mobility scooter and go out every day with them for walks. She sits on my chair with me and makes me feel better. She gets me up and out, and walks beautifully next to my scooter.’ – Kim
‘I have a feeding station with a long handle so I don’t need to bend down. I buy small bags of food and pouches that are easy to open. My dog is groomed short, so no need for much brushing and she doesn’t shed hair, so there’s less cleaning up. She is trained to walk with a mobility scooter.’ – Claire
BY GEORGINA WINTERSGILL
5 WAYS TO MAKE THE MOST OF your medical appointment
Make every minute count! We asked the experts for tips on how to make your consultation as effective as possible
Your appointment, for which you may have waited a long time, has finally come around. You might be feeling anxious or overwhelmed, which can make it difficult to communicate effectively. So how can you make the most of those precious minutes? We asked two rheumatologists for advice.
1Do your homework
A little prep goes a long way. Think about what you’re hoping to get out of the appointment and any questions you want to ask.
Dr Stephanie Barrett, a consultant physician and rheumatologist based in London, recommends making a list of symptoms with a timeline. ‘If you’ve got pain, include where it is, what it feels like, and how long you’ve had it. Are you worse in the mornings or do things get worse throughout the day?’
Bring a short list of questions and a list of current meds, including doses. Check your medication stock (if you get it from the hospital) and bring your latest bloodtest results if they are done elsewhere.
2Take notes
Go with a notebook and pen, or ask permission to record the conversation on your phone. Dr Nora Ng, consultant rheumatologist at The Lister Hospital, part of HCA Healthcare UK, says: ‘Some people bring a partner or friend as a second pair of ears or a scribe.’
3Check you’ve understood
Dr Ng says: ‘Usually at the end of the appointment there’s a verbal summary. We should summarise in a letter as well. Patients should say if they don’t
understand, especially if there’s a new diagnosis or medication.’
If you still have questions after your appointment, phone or email your healthcare team.
4Choose the right outfit
Dr Ng says: ‘Clothing is something to consider, as you may need to undress for a more global assessment.’ Choose an outfit that’s easy to get on and off.
5Allow extra time
Factor in plenty of time for your journey. Allow lots of time to park, or ask someone to drop you off. Allow plenty of time on arrival, too. ‘Think about navigating busy lifts at the hospital,’ says Dr Ng. Appointments may be running late, so pack snacks and a book, and keep your schedule flexible. Dr Ng says: ‘Allow extra time at the end for blood tests, X-rays, and picking up prescriptions.’
The Arthritis Tracker app allows you to rate your daily symptoms, which you can use when talking to health professionals. Search Arthritis Tracker on App Store or Google Play to download to your phone or tablet for free.
Shop with Versus Arthritis
Whether you are shopping for yourself or someone close to you, there are many products to help with daily tasks around the house, in the garden and for when you’re on the move. And with every purchase you’ll be helping to fund life-changing research and services that bring us closer to a future free from arthritis. shop.versusarthritis.org
