Rediscover what makes you happy –see page 39
FEEL THE LOVE
Connecting with your friends and loved ones
LIFE HACKS The best gadgets for making living easier
SPARKLE and shine
Have you recently…
If so, you may need to make or update your will. And we can support you to take the next steps.
Life changes in many ways and it’s important that our wills change with us. An up-to date will helps us look after our loved ones and can give us comfort knowing the things we care about in life will live on. Sometimes it can feel difficult knowing where to start – or even knowing how to choose a solicitor. We’d like to make this as easy as possible for you.
We are members of the National Free Wills Network which means you can meet face to face with a solicitor in your area and have a basic will written for free or update an existing will. Some solicitors may also be able to visit you in your own home if you are unable to travel.
The service is completely confidential and details of your will won’t be shared. If you would like to have your will written for free:
1. Let us know using the details below and we will refer you to the Network.
2. You will receive a pack which includes a list of participating solicitors in your area.
3. When you are ready, you can contact your preferred solicitor and make an appointment for a time that suits you.
There is no obligation to leave Versus Arthritis a gift but, of course, we hope you choose to. Gifts in wills form the foundations of our work – in fact they fund a third of everything we do. Together, we can help more people to feel better and live better – and look forward to a life without so many limits. All gifts, no matter what size, make a real difference.
Welcome...
… to the winter edition of Inspire, the magazine for everyone with arthritis.
The festive season can be full of highs and lows, periods of stress and times to relax, with busy social times and quieter moments. This issue delves deeply into how it feels to live with arthritis. We hope you find both comfort in knowing you are not alone, and helpful ways to make small changes so you can live the life you choose.
Chronic joint pain affects physical health, but has it impacted your relationships too? We uncover how pain can affect relationships; from feeling supported by loved ones, to exploring ways to talk about your condition – and how to find comfort and connection. Read our feature on page 8.
One of the best things you can do to help with joint pain and inflammation is movement. But how do you maintain movement during a flare-up? On page 26, we look at exercises that can be beneficial. How does arthritis impact the life stages for women, from puberty to pregnancy and menopause? We find out on page 12.
Our contributors this issue
Claire Munnings is a freelance health and wellbeing journalist, and the former editor of Natural Health magazine
Plus, there is a plethora of aids and gadgets on the market designed to make life easier and more comfortable. Take a look at page 16 for some options to make day-today life a bit more comfortable.
So, grab a cuppa (or some mulled wine) and dive right in. We would love to hear from you if you have any comments about the content of Inspire – what you found useful, what we’re missing – so that we can make it relevant to your life. Email us at inspire@versusarthritis.org and, if you need further support with your arthritis, please visit versusarthritis.org or call our helpline on 0800 5200 520.
Warm wishes, Rachel Curtiss Individual Giving Manager, Versus Arthritis
Katy Sunnassee is the editor of Top Santé magazine and blogs about perimenopause on Instagram @thehealtheditor
Georgina Wintersgill is a freelance health journalist who lives with her two children and three cats
Design and production: CPL One
1 Cambridge Technopark, Newmarket Road
Cambridge CB5 8PB 01223 378000, cplone.co.uk
Editor: Tracey Lattimore inspire@versusarthritis.org 01223 378026
For Versus Arthritis: enquiries@versusarthritis.org 0300 790 0400
Arthritis helpline: 0800 5200 520
Registered charity nos: 207711, SC041156
Registered office: Copeman House, St Mary’s Court, St Mary’s Gate, Chesterfield S41 7TD ©Versus Arthritis 2024
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: Liz Gregg (page 18), iStock and Getty Images
Health update
Our roundup of research, news and tips Out of this world
In November, arthritis researchers held their breaths as human tissue samples were launched from the Kennedy Space Centre on a journey to the International Space Station. But what does outer space have to do with arthritis?
Well, the team of researchers at Oxford’s Space Innovation Lab want to understand how microgravity affects the ageing process. They want to see if conditions in orbit could speed up the study of ageing that takes much longer to observe on Earth.
The samples in space will be on their way home soon, where the scientists will compare markers of ageing with samples that stayed on solid ground.
Led by Versus Arthritis funded fellow, Dr Ghada Alsaleh, whose research aims to further understand the links between ageing and osteoarthritis, the research conducted in space could more quickly improve quality of life on Earth for people with arthritis.
It starts in the lab…
Researchers at the Biomechanics and Bioengineering Research Centre Versus Arthritis have created lab-grown cells that are very similar to osteocytes, a type of bone cell important in maintaining the health of our bone. They may help us to understand what’s happening in the joint, and changes in the bone. The researchers also looked at how these model bone cells reacted to inflammation and pressure. Studies such as this further prove that osteoarthritis is a complex disease, with mechanical pressure and inflammation having varying effects on many different types of cells in and around the joint, which may contribute to the symptoms of osteoarthritis. This is key when developing new treatments that might be able to stop pain and joint damage. There is still much to learn, but by successfully producing a laboratory model of osteocytes, more studies can be done to see how bone cells change in, and contribute
A research project at the University of Nottingham, part of the Advanced Pain Discovery Programme (funded by Versus Arthritis and other organisations),
Keeping strong
Researchers at the Versus Arthritis Centre for Musculoskeletal Ageing have shown that life-long protein restriction in mice leads to changes to the way the nerves control muscles. This may lead to muscle loss, which can reduce joint stability and impact movement. The researchers showed that lifelong protein restriction within the mice led to several biological changes that, in turn, caused muscle loss. They also showed that, without enough protein, muscle sarcopenia – natural muscle loss as we age – is accelerated and starts earlier in life. While human studies would be needed to make any definite conclusions, the research suggests that – along with exercise – consuming an adequate amount of protein is needed to reduce muscle loss.
Easy does it
New research at the MRC Versus Arthritis Centre for Musculoskeletal Health and Work has shown that intensive, high-impact exercise after a hip replacement can increase the risk for follow up surgery. This means clinicians can now say with more certainty that patients should avoid high-impact physical activity and stick to more gradual strength-building techniques.
The research stresses the importance of getting the right level of physical activity after joint replacement surgery, as rehabilitation is needed to restrengthen the muscles around joints. While some people may want to return to their usual –sometimes high – level of physical activity after surgery, doing this the wrong way will risk harming the replacement joint.
It is important to gradually build up activity, and it is also vital for clinicians to manage expectations for post-operative physical activity. Future research may determine what the ideal intensity of exercise is, particularly for those wanting to get back to a pre-operative level quickly.
home at 21°C if you have a health condition impacted by the cold. There are ways to reduce your bills, such as closing blinds at dusk and blocking draughts. If you are worried, get in touch with Citizens Advice directly for more support. Winter fuel allowance
Earlier this year, the government announced changes to the Winter Fuel Payment. There are new restrictions – you must have reached State Pension age, and it will now be means-tested in England and Wales.
Some people with arthritis find that their symptoms get worse in the winter, and you may be worried about turning your heating on this year. It is really important to still heat your home. Citizens Advice suggests keeping your
GET THAT loving feeling…
Chronic joint pain can affect our physical health, but it can impact relationships, too. Here’s how to restore that comfort and connection
BY HOLLY TREACY-WEST
Imagine this: you’re lying in bed, watching the clock tick past 2am. Your partner sleeps soundly beside you, but your knees throb with every beat of your pulse. The pain feels relentless, and it’s more than just a physical ache. It’s the unspoken tension that lingered at dinner when you had to cancel plans with friends – again. It’s the look of concern in your partner’s eyes when they see you struggling to stand. Chronic pain doesn’t only affect your body; it quietly seeps into your relationships, tugging at the bonds of connection, intimacy and routine.
According to Eimear O’Mahony, counsellor at First Psychology Scotland, the role and dynamic within a
romantic relationship, family or friendship can shift when someone is dealing with chronic pain, such as that caused by arthritis.
‘A relationship that may have been 50/50 before can move into the dynamic of the carer/ patient role,’ she says. ‘The person with chronic pain often feels as if they are a burden, especially when they are being supported by others or need to ask for help.’
In fact, research published in the journal Social Science & Medicine found that family support is associated with a decreased risk of acute pain persisting, whereas family stress increased it. O’Mahony, who has worked with many people living with rheumatoid arthritis, chronic pain and chronic fatigue syndrome,
Emily’s story
Emily first experienced symptoms aged four, and was checked for juvenile idiopathic arthritis. But it wasn’t until age 20, after a bout of food poisoning, that she was diagnosed with seronegative arthritis.
‘It was a pretty miserable time,’ she recalls. ‘I felt so isolated because I was so young, and everyone else at the hospital was much older. I didn’t speak to anyone about it for a long time.’
After hitting rock bottom with both her arthritis and mental health, Emily began exploring other ways to manage her condition, including diet.
She started tracking her symptoms anonymously online and was amazed by the response. ‘Loads of young people like me reached out, saying they could totally relate,’ she says.
One thing Emily doesn’t compromise on is her daily walk. ‘I always go for a walk, either with my mum, boyfriend or by myself, no matter the weather. It helps me disconnect from the online world and to
reconnect with nature and loved ones.’
Emily has faced challenges in relationships due to her arthritis, but her current partner, Shyam, has been incredibly supportive.
‘On a recent trip to New York, I had a flare up and felt upset that I couldn’t join friends for dinner,’ she says. ‘Shyam went out of his way to care for me. His kindness made all the difference.’
For Emily, communication and self-compassion are key. ‘You have to be honest with yourself and others about your limits. If people can’t accept that, they’re probably not meant to be in your life.
‘You’re the one living with your health every day, so it’s important to take control and be kind to yourself.’
Emily Johnson launched the Instagram page @arthritisfoodie in September 2018. Her book Eat Well With Arthritis is out now (£25, Yellow Kite). Read our full interview with Emily in the Spring 2024 issue of Inspire.
reveals that all of her clients expressed that the emotional and psychological toll was harder than the physical symptoms. ‘Most felt as if they were going through a grieving process of the life they could have lived,’ she recalls.
For O’Mahony, human connection is fundamental to feeling happy and healthy. ‘When our health is affected by chronic pain, connection is often removed from our lives,’ she says. ‘Anxiety, depression, loneliness, anger and isolation are often experienced during prolonged periods of chronic pain and there is often conflict, tension, stress, helplessness and powerlessness from others, until you find answers or alleviate symptoms.’
O’Mahony notes that some people with chronic pain will appear to be fully functioning – eating, sleeping, working –and this brings its own sense of grief. ‘It appears to the outside world that you are fit and healthy, but internally and silently you are struggling.’
Making the connection
So, how can we find comfort and connection when we feel a sense of disconnect in
‘Acknowledge where you are right now. This is the first step towards acceptance’
‘Family support is associated with a decreased risk of acute pain persisting’
our relationships? ‘Normalise that it is okay to not feel connected,’ says O’Mahony. ‘Acknowledge where you are right now. This is the first step towards acceptance.’
For O’Mahony, if we are struggling to connect with others, it often indicates we might be struggling to connect with ourselves. ‘If you are dealing with chronic pain, or if you have felt unsafe in your body for a long time, it will take time to reconnect with yourself and with others,’ she says. ‘Long-term illness, chronic pain and chronic symptoms affect your identity, self-esteem, self-confidence and independence.’
O’Mahony believes the most important way to find comfort and connection is to feel heard and understood. ‘If you feel judged or misunderstood, this can lead to loneliness, isolation and actually increase your symptoms,’ she explains. When it comes to support, O’Mahony suggests getting as much of it as possible from doctors and therapists to help you understand what your body and mind are going through. ‘Ask your family and friends to attend an appointment with you to help them to understand the severity of your condition,’ she recommends.
It’s also important to notice the narrative you tell yourself. If you have dealt with chronic pain for a long time, it is worth starting to think
about how it will feel to improve your symptoms and to feel safe in your body again. ‘Use movement to process and release stored emotions,’ advises O’Mahony. ‘Reading books and listening to podcasts on trauma, mind-body connection, somatic experiencing and healing can sometimes help.’ Try the free podcasts Body Stuff with Dr Jen Gunter and The Holistic Psychologist by Dr Nicole LePera, or books When the Body Says No: Exploring the Stress-Disease Connection by Gabor Maté (£12.99, Waterstones) and The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk (£12.99, Waterstones).
LIFE
BY LOUISE PARFITT
CYCLE
How might menstruation, pregnancy and menopause affect arthritis? We look at the impact of hormones on the body, and ways to manage symptoms during these life stages
There are many factors that affect arthritis, such as genetics, ethnicity, health and weight – and, it seems, sex.
Arthritis and other musculoskeletal conditions have different prevalence between men and women. The Versus Arthritis report, The State of Musculoskeletal Health 2024, found women are two to three times more likely to develop rheumatoid arthritis. They also have an increased rate of osteoarthritis.
‘We know that female hormones are related to the development of arthritis because women are more likely to be diagnosed with arthritis than men,’ Dr Deborah Lee from Dr Fox Online Pharmacy explains. ‘However, it is still not well understood.’
Dr Jonathan Rajan, pain management consultant at the OrthTeam Centre, agrees. ‘There is an association between sex hormones and arthritisrelated pain at various life stages, including post-menopause.’
Low oestrogen
A 2022 investigation of the impact of hormones on rheumatoid arthritis found that a diagnosis is most likely around the time of menopause, when oestrogen levels are low. The condition tends to improve in pregnancy when oestrogen levels are high, but flares again in the postpartum period when oestrogen levels fall.
‘Oestrogen can affect the connective tissue in your joints, so lower levels can increase pain and inflammation,’ explains Dr Shirin Lakhani, menopause, women’s health and intimate health expert. ‘This is why women – during menopause or around their period – can feel an impact on their arthritis. This drop in oestrogen can also cause a rise in the chance of osteoporosis or other bone and joint disorders.’
It is important to eat a healthy diet and stay as active as you can to manage your symptoms at any stage of life. ‘But if you feel as though you’re struggling because of hormone changes, speak to a healthcare professional about pain management and get your hormone levels tested,’ adds Dr Lakhani. ‘Don’t suffer in silence.’
‘Oestrogen can affect the connective tissue in your joints, so lower levels can increase pain and inflammation’
Nicky’s story
Prior to menopause, I managed my low-level arthritis symptoms and generally had them under control, allowing me to go about my daily activities without much trouble.
But about five years ago, during perimenopause, I noticed some significant changes in my arthritis. Initially, I experienced an increase in joint stiffness and discomfort, especially in the mornings. My pain levels fluctuated more, and I also noticed an increase in flare ups, particularly in the joints of my fingers.
I now take glucosamine and ibuprofen for inflammation. I also take HRT, which has helped to manage my general symptoms. I have been introducing various dietary changes to reduce inflammation in my fingers. I find a diet rich in fruits, vegetables, wholegrains and healthy fats [such as olive oil] makes a difference. Staying hydrated and managing stress through activities such as meditation, Pilates and yoga helps, too.
Managing your arthritis at key life stages
Menstruation: track symptoms to see if your arthritis pain is worse during your period. If so, take prescribed medicines regularly when menstruating. ‘If you don’t take NSAIDs [nonsteroidal anti-inflammatory drugs] regularly, it’s advisable to start taking these a day or so before your period is expected, but check with your doctor first,’ says Dr Lee. You can also try gentle stretches, warm baths, and hot or cold pads on the affected joints.
Pregnancy: Although many women find arthritis symptoms ease during pregnancy, weight gain and fluid retention can put increased pressure on your joints. It can be difficult to move as much as usual, but try to stay as active as you can – pregnancy yoga, swimming and short walks will help. Talk to your rheumatology team for support.
Postpartum: Flare ups can last weeks or months before settling down. ‘It’s hard thinking of your own needs when you have a baby to care for, but you need to be kind to yourself: rest when you can, do some gentle stretches, and apply hot or cold pads to the affected joint,’ says Dr Lee. ‘A rheumatologist can advise on medication to control inflammation.’ Ask friends and family for help, even for small tasks. It can make a big difference.
Perimenopause: Often joint pain can occur for the first time, or there might be a flare up of arthritis. Dr Lakhani advises speaking to your doctor about hormone replacement therapy (HRT). ‘This can replenish lost oestrogen and help with pain and inflammation,’ she says. ‘You can also take regular painkillers to help with pain relief, but do check with your doctor first.
Menopause: The drop in oestrogen levels can contribute to inflammation, which might exacerbate or trigger rheumatoid arthritis. It can also affect those with osteoarthritis, as the protective effect that oestrogen has on joint tissues is reduced. Try to remain as active as possible – even gentle exercise will help. You could also speak to your doctor about HRT.
OVER TO YOU
Here's your chance to have your say
Fighting fatigue
Since joining you, I have enjoyed the magazine so much. I am 78 years old and, due to arthritis and long waiting lists, I have had to self-fund having two hips, two knees and a shoulder replaced over the past few years. Unfortunately, my biggest problem is my spine, which, due to hypermobility, can’t take surgery.
I swim twice a week and follow a healthy and nutritious diet, and find it very beneficial.
The article in the autumn edition of Inspire about the ‘spoon’ method (‘Get back that va-va-voom’) is very interesting and one I shall follow, as fatigue is hard to cope with.
Dianne, via email
School days
I was inspired by Holly’s and William’s stories (Inspire autumn 2024) about living with JIA. My niece was diagnosed with JIA when she was eight. It resonated with us when William explained that, just because you can’t always see the arthritis, it doesn’t mean it is not there – and that includes the other symptoms, such as fatigue. We also appreciated their tips for managing during the school day. We have found that telling a group of trusted people – including teachers –on the days when my niece needs extra time or support has been really important in helping her adjust to secondary school. Thank you, Holly and William, for sharing your stories.
Paul, Stevenage
Driving issues
My arthritis has worsened in recent years and I now need to use a walking stick when out and about. I am thinking of applying for a disabled parking badge, but am not sure where to start. Jacqueline, Kent
The government has lots of information about Blue Badges –including who is eligible and how to apply – at gov.uk/transport/ blue-badges You can also contact your local council. There’s a different process in Northern Ireland: search at nidirect.gov.uk for more information.
Send your tips and letters to Inspire magazine, 1 Cambridge Technopark, Newmarket Road, Cambridge CB5 8PB, or email inspire@ versusarthritis.org
SUPPORT ACT
We explore the abundance of aids and gadgets on the market designed to make life with arthritis easier –and more comfortable
BY GEORGINA WINTERSGILL
1. Nail clipper, £5.99 shop.versusarthritis.org
A traditional clipper doesn’t cut it if you have limited dexterity. This table-top version nails it with a large, easy-grip handle and rubber feet for stability.
Washing Dressing
2. Long-handled sponge, from £7.99 manageathome.co.uk
This useful aid has (literally) got your back. The long wire handle bends to the shape you need to access all those hard-toreach areas.
3. Body lotion applicator, from £16.99
The Mobility Aids Centre
This long-handled applicator applies lotions to the bits you can’t reach, and massages them in. Simply insert the lotion into the removeable head.
‘A long-handled grabber is very useful for picking up things I’ve dropped. I’m waiting for a shoulder operation, and my problem is reaching, stretching
‘I use an inflatable wedge pillow in bed at night when my knee pain has flared up. I lie on my back with both legs on it. It helps ease the pain and makes my knee a bit more comfortable so I can get to sleep.’
4. Long-handled shoehorn, from £8.99 completecareshop.co.uk When bending down is a struggle, a long-handled shoehorn is a necessity. This one is spring-mounted for flexibility.
5. Button hook, from £15.92 manageathome.co.uk
Nicola Sutherland, 53, has osteoarthritis
Elevation pillow, £29.99, amazon.co.uk
Simply pass the hook through the button hole then draw the button back through.
6. Dressing aid stick,
If you need a hand getting dressed, this sturdy stick may do the job. It comes with three different end attachments so you can hook various items of clothing and manoeuvre them
7. Tipping kettle, £49.99
shop.versusarthritis.org
Time for tea? This stylish kettle’s circular design, combined with its rotating cradle base, means you tilt it rather than lift – making it easier and safer than a traditional kettle.
8. Jar opener, from £6.99
themobilityaidscentre.co.uk
Jam today and jam tomorrow. This simple, functional little aid provides a good grip and makes opening and closing jars a breeze.
9. Ninja Air Fryer, £199.99
robertdyas.co.uk
Small, light, easy to clean and sits on the worktop. This model’s two-drawer design means each drawer is lighter to lift, but you still have plenty of capacity. Now you’re cooking!
Cooking Gardening
‘I use the Revitive Medic [circulation booster device] to strengthen my leg muscles. I started off using it for 30 minutes a day and felt a change after about a week. Now I just use it once a week. It takes the edge off my pain so I can get on with my day.’
Alan Grieve, 72, has osteoarthritis in both knees
Revitive Medic Circulation Booster, £300, argos.co.uk
‘Using hot-water bottles and microwaveable heat packs on the joints that hurt helps relieve the pain. I find the heat packs best, because they stay warm for longer and you can shape them better to fit your body.’
Ellen Sagar, 17, has enteropathic arthritis
10. Garden tools,
shop.versusarthritis.org
Get all tooled up with our stainless steel fork, trowel and cultivator, all easy to hold thanks to their angled handles and
11. Garden Kneeler, £29.99
robertdyas.co.uk
This comfortable kneeler provides protection for your knees, has robust handles, turns over to make a seat, and folds up for easy carrying and storage.
12. Garden cart, £27.99
robertdyas.co.uk
If you struggle to kneel, this sturdy cart may help. Load it up with tools and tow around, then sit on
the house? Let us know by emailing Inspire@ versusarthritis.org
Neck and shoulder pad, from £20.75, healthandcare.co.uk
A creative outlet is important, says Katie Eldridge
BY KATY SUNNASSEE
'ART HELPS ME OVERCOME ARTHRITIS’
Katie Eldridge, 29, from Snodland in Kent, was diagnosed with juvenile idiopathic arthritis (JIA) at age five. She shares her story of managing her arthritis and inspiring others to do the same
When I was young, Mum noticed I didn’t want to be physical like other children. I would sit indoors doing art. For me, life was just normal; I didn’t know that being in pain wasn’t the norm. When my knee puffed up and was all red and swollen, my parents took me to a private doctor where, luckily, I was diagnosed quite early on. I was put to sleep and had an arthroscopy, where they inserted a camera into my right knee; they could see it was all inflamed even though nothing showed up in my blood work – I’m what’s called
“seronegative”. It wasn't until later in life that the arthritis manifested elsewhere in my body.
At school I would have to miss assemblies to have physio. And I could only manage some of the PE lessons, so would have to sit out or do something else. It was the same with sports days – I would be the helper rather than a participant. Kids don't understand, so they’d ask why I was different. Why wasn’t I joining in? Why was I allowed to wear trainers, not plimsolls? It made me feel different.
I was put on methotrexate and am still on it, although I’m reducing the dose.
I don’t remember this but, apparently, the first time I took it I was sick in the back of the car. I tried the injectable methotrexate a few years back, but that made me very unwell. I couldn’t function. Now I'm on a new biologic therapy, which I inject bi-weekly. I do so much better on it.
I did my first fitness challenge in my early 20s when I was in a period of remission.
It was before Covid and I was off all tablets. I really wanted to push myself, so I signed up to a boot camp with former UK Special Forces soldier and TV personality Ant Middleton. I was so chuffed I got through the whole course, which was made up of log runs, sandbag runs, a 1k run, and functional body weight moves. My arthritis was still OK after that, then it flared up, but I managed to settle it down.
Then I had a terrible flare up during Covid.
Before then I’d not been on any medication, as my symptoms had calmed down, but the stress was like opening the floodgates. My arthritis came back in my ankles, knees, finger joints and wrists. I can only describe it as like having little shards of glass in my joints. It got so bad that I had to have steroid injections into some finger joints.
Katie feels like she is heading into remission after her arthritis flared during Covid
I had to stop going to the gym as well as my art because I couldn't do anything with my hands – I couldn't even pick up a kettle to make a cup of tea. That’s when I got put on the new drug because I was so unwell.
I only rejoined the gym this May. I go two to three times a week, and also do yoga and Pilates classes as I get bored with just the gym. And now I work from home, I can go for walks at lunchtime. I recently started a new job, which is a lot less stressful than my previous officebased job and means I don’t have to commute, so can get more rest. All in all, I feel I'm heading back into remission.
Diet-wise, I cut out dairy and gluten for eight months, but it made little difference. I’ve stuck with reducing
wheat, as apparently that can aggravate arthritis, and I do limit dairy, although I'm not on a super-strict diet. I veer towards antiinflammatory foods and avoid anything greasy and fried, which flares me up completely, as will lots of sugar. It’s everything in moderation. I love Asian dishes – a salmon stir-fry is my go-to dish.
1
Keep talking to people Make sure you are constantly in conversation with at least one other person. Don’t isolate yourself.
2
Don't be embarrassed I used to hide my condition. Talk to others and ask for help. And don't be afraid to ask for adjustments at work.
3
Push to be seen Since Covid, things have been busy for doctors and it's easy to be lost in the system, but if you're in pain, push to get an appointment.
4
Do something to keep your mind off the pain Find something you really enjoy, onto which you can put all your focus. For me, that’s art classes. A creative outlet is important.
5
Try to maintain a positive mindset Arthritis is not a very nice condition and can completely overwhelm you, but having a positive mindset will help squash down the negativity. Difficult symptoms come and go, so hold onto the thought that things will improve.
Find out more about Katie on Instagram @Katie_eldridge_art and @Simply_life_drawing. Visit katieeldridgeart.com
'Art can bring happiness and fulfilment in many ways'
One way I take my mind off arthritis is through art. I've always loved it. At primary school I lacked so much confidence, but art was a confidence booster and an outlet for expressing myself. I was arty all through secondary school and was an art prefect. I didn't carry it on, although I wanted to. I wasn’t sure how likely it would be I’d get a job in art, so I went down the numbers route into accounts. Art became a sideline, but I’d love to do it full time one day.
A friend and I have set up life drawing classes to introduce a creative outlet to the local area. She runs the logistics and bookings, while I plan and teach the classes. It lets me use my creativity alongside work, because I was determined not to let it fall to the side again after being unable to draw and paint during my previous flare. I enjoy tutoring the life drawing classes because I've met so many great people and it's such a wonderful mindfulness activity to escape a hectic schedule.
Art can bring happiness and fulfilment in many ways, whether it's creating a feeling as something visual, capturing an important memory forever, portraying someone and their unique personality, or simply brightening up a dull room. For me, it is great mindfulness among a very chaotic world. I do portraiture commissions including pet portraits, and I’d love to have a little studio or just a room in my house where I could do art all day, every day. That’s the dream!
Untapped potential
AI, although notorious for being seen as a negative thing, could be beneficial for those waiting for an arthritis diagnosis
Barely a week goes by in my working world without mention of AI – artificial intelligence. It’s a concept that a lot of us, myself included, struggle to get our heads around. And, as we struggle, I don’t suppose we’re much helped by the competing narratives that portray it as a force for good or something quite sinister. Friends of mine who are trying to make a living out of being voiceover artists definitely place it in the mainly negative column, as work dries up in favour of something computer generated... and, doubtless, cheaper.
That said, I’ve just come across an arthritis-related story, in which AI has the potential to do some serious good. It’s been reported by the BBC that the Henley Business School, based at the University of Reading, has been given a grant of more than a million pounds to develop a machine learning system called RMD-Health. According to the researchers working on the project, the aim is to improve the early detection of diseases such as arthritis.
Professor Weizi Li, the project lead, said: ‘Unlike existing solutions, which often rely on the advice and guidance from already stretched rheumatology specialists, we’re introducing a machine learning-based system.’ Professor Li said
Julian
Worricker is a BBC TV and radio presenter and journalist.
He has psoriatic
arthritis
this would enable doctors to ‘refer patients more accurately and promptly, ultimately leading to quicker and more effective treatment’.
The machine is being developed using available patient referral data, which Dr Antoni Chan – project co-lead and a consultant rheumatologist – said had so far demonstrated ‘significantly higher accuracy’ compared with existing clinical criteria and clinicians’ assessments. That struck me as important... as did an emphasis on the collaborative nature of the project that also involves secondary care specialists, GPs, industry stakeholders, patients and the public. Call me a Luddite, but I’m more optimistic about technological advances when plenty of human beings are still involved.
It’s a three-year project, so watch this space.
Small differences
Away from the daunting world of scientific advancements, I was pleased last week to discover what a difference arthritis-friendly pens can make. My mother, who is 95, has debilitating arthritis in her hands. Quite apart from the pain it causes, it’s also had an impact on her handwriting, of which she was immensely proud. She was a schoolteacher, so I think it counted for a lot when she was marking homework. I made a speculative purchase of a few pens that are more bulbous than the fashionable slimline ones; they consequently demand less grip where it hurts most. The transformation in her handwriting is striking; it looks almost as stylish as it did when a pupil was getting a ‘can do better’.
As I’ve discovered with my own arthritis over the years, it’s sometimes the little things –the little adjustments – that just help life tick along a bit more comfortably.
Versus Arthritis has been conducting research into AI and detecting arthritis –scan this QR code to find out more
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 How can I cope with feeling down when my arthritis pain worsens during the cold months?
A It’s understandable to feel low at times. Here are tips to brighten your spirits and ease your discomfort:
•Keep moving. Gentle activity, such as walking or light stretching, can help keep your joints moving and lift your mood.
•Get some sunlight. Try to spend time outside during daylight. Even sitting by a sunny window may help.
•Stay warm. Baths, heating pads, or snuggling with a pet can soothe aches and provide comfort.
•Connect with friends and family. Make plans to meet up. Sharing your feelings can help you feel less alone and distract you from worries.
•Keep a daily routine. Planning your day with time for rest, activity and socialising helps create stability. If sadness or low mood linger, talk to your GP or nurse. Remember, you’re not alone, and support is available to help you through.
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 I have rheumatoid arthritis and my balance isn’t good. My friend broke her wrist slipping on ice and I’m terrified of doing the same. What can I do?
A It’s important to eat enough protein, which contains all the building blocks needed to make muscle. Guidelines recommend a daily intake of 0.75g protein per kg of body weight, but with age you may need up to 1.2g per kg.
Regular exercise is also crucial for building muscle strength to reduce your risk of falls. There are lots of exercises you can do indoors and even sitting down, using resistance bands, light weights, or tins of beans! Make sure you replace damaged feet on walking sticks or frames, and shoes with worn treads. Stock up on non-perishable foods so you don’t have to go out if the weather is bad, or arrange a supermarket delivery. And get your hearing and eyesight checked. You’re more likely to have a fall if you can’t see or hear hazards.
Helen joined Versus Arthrits as a helpline advisor after studying for a Health Sciences degree. She enjoys the combination of learning and helping people.
Q I have gout and I am experiencing a flare up. What can I do to help treat this?
A With gout, urate crystals can break free into joint spaces, irritating the joint capsule lining and causing pain and swelling from inflammation. Medications, including colchicine, steroids and non-steroidal antiinflammatory drugs such as Naproxen, may be prescribed by your doctor and you may be advised to take these at the first signs of an attack. Self-care measures during an attack include cooling the affected joint with ice packs, resting it on a cushion, and protecting the joint – as even light touch can increase pain. To prevent future attacks, you may be prescribed urate-lowering therapies, such as Allopurinol or Febuxostat. Other preventative measures include maintaining a healthy weight, keeping active and reducing consumption of food and drink higher in purines that can contribute to higher urate levels.
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.
BY CLAIRE MUNNINGS
HOW TO MAINTAIN movement DURING A flare up
Exercise may be the last thing on your mind when you’re in the middle of a flare up, but gentle, slow movement can help
Allowing your body to rest is essential when arthritis symptoms feel particularly intense, yet gently moving and continuing some form of activity is just as important.
‘Maintaining general movement is crucial for overall joint health and wellbeing,’ says Victoria Anderson, clinical exercise physiologist and founder of Longevity Health and Fitness (longevity healthandfitness.co.uk).
‘‘Physical activity has been shown to lessen the intensity of arthritis symptoms and lower inflammation levels, while improving strength, aerobic exercise capacity, sleep, fatigue and quality of life, compared with those who are sedentary.’
Of course, this is often easier said than done. During flare ups, many people face significant challenges when it comes to staying active – not only is it hard to physically move when you’re in pain, but it’s also difficult to feel motivated mentally. However, not moving can cause more issues in the long run.
‘When we’re in pain, we tend to want to do less, so flare ups will reduce our mobility and make us more inactive,’ says Tim Allardyce, an osteopath and physiotherapist at Surrey Physio (surreyphysio.co.uk).
‘This can also lead to a vicious cycle, with the less we do, the stiffer we get. Exercising with arthritis is generally recommended, although adaptations will need to be made.’
Have a look at the following tips to help ensure your body gets the movement it needs.
Try to keep moving
The general advice is to focus on slow and gentle movement during a flare up, rather than stopping altogether. While everyone’s situation is unique, some activity will usually be better than none, and this could be something as simple as completing some light stretching each morning.
Tim Allardyce adds that, for those really struggling with pain, even exercises completed while lying in bed can be useful. ‘For example, if you have a particularly sore knee or hip, just bending the hip or knee and using your hand to stretch the joint can provide improved mobility,’ he explains.
People with arthritis agree that it’s best to keep moving, with one advising to try ‘simple stretches for a few minutes, then rest and repeat until the body is able to do more’, and another recommending to ‘take things slower to start with until you get going’.
Prepare for exercise
Consider ways you can ease your body gently into exercising and support its recovery through the episode. This might mean applying a hot or cold compress before or after movement to soothe sore joints, timing your exercise around certain points of the day, or speaking to a physiotherapist about the best movements for you.
Depending on the activity you’re doing, make sure you’re wearing sensible clothing and footwear – and remember to warm up your muscles and joints before moving your body too much.
Lower the intensity
During a flare up, it’s important to be gentle to your body – so avoid intense or impactful movement that can jar joints or put pressure on specific areas.
‘Generally, high intensity, high impact or high volumes of exercise are most likely to aggravate symptoms,’ says Anderson. ‘Consider reducing the impact of your activities, by switching from 30-minute walks to 15-minute strolls.’
‘I recommend my patients choose exercises that help take the load off their joints during a flare up,’ adds Allardyce. ‘Gentle exercise helps
mobility, and that helps reduce inflammation. Swimming is a great example of an exercise that won’t tend to aggravate pain, as is gentle walking on flat surfaces.’ Simply walking in water is great, too, in case you are worried about getting your hair wet in the pool.
Be mindful of your pain
The key is to listen to your body and be aware of anything that worsens pain. Never force a movement if it causes pain in a certain area and, instead, consider alternative ways to move, or modifications you can make to the exercise. ‘If a
specific exercise significantly increases pain, it doesn’t necessarily mean you need to stop all together,’ adds Anderson. ‘Rather, consider how you could modify it. For example, resistance training is a vital component of structured movement for arthritis, but during a flare up, the amount of weight or number of repetitions may feel more uncomfortable.’ She advises first trying to reduce the load or weight for each movement, and then the number of sets. Remember, it’s important not to overdo any exercise during a flare up, as this can cause more pain.
Three easy moves to try today
Although the best exercises for you to try will depend on the type of arthritis you have and the location of the pain, Victoria Anderson says the three moves below can be useful in most situations.
Lumbar rotations
Helps to mobilise the lower back and hips
1. Lay on your back with your knees bent and feet together.
2. Now, rock your knees and hips gently to one side, towards the floor, and then bring them back to centre.
3. Repeat on the other side.
Single leg knee hug
Helps stretch the hip and knee and joint space
1. Lie on your back with your knees bent and both feet flat on the floor.
2. Gently pull one knee up into your chest, hold the stretch, then release.
3. Repeat on the other leg.
Hip abduction
Can be modified and performed when standing, seated or lying
1. Place a resistance band around one ankle and to an anchor point on your opposite side.
2. Move your leg outwards against the resistance band.
3. Slowly lower the leg down to the floor and repeat a certain number of times (eg. five), before doing the same on the other leg.
Get involved
Versus Arthritis works with and for people who have any type of arthritis, and we’re here to help you stay active, independent and connected
Raising the voices of people with arthritis
In October, five fantastic campaigners joined our CEO, Deborah Alsina, to hand in our open letter to Prime Minister Keir Starmer – along with 85,940 signatures calling on the government to take arthritis seriously. Just in time for World Arthritis Day on Saturday 12 October, a further 15,000 of you signed the letter, helping us hit the incredible milestone of 100,000 signatures. That’s more people than you’ll find at a Taylor Swift concert in Wembley Stadium!
Eleven-year-old Sfiyah, who has Juvenile Idiopathic Arthritis, handed the letter to 10 Downing Street. ‘I wanted to get involved because having a condition such as JIA has made me realise exactly how difficult it can be to get the right support,’ she said. ‘My parents always say that anyone can make a difference. I wanted to try and help so children like me can have the right support with their care, education and wellbeing.’
A huge thank you to everyone who signed and shared the letter – together, we showed just how powerful a community we are. Time and again we’ve shown the power we have when we come together and make our voices heard. So, while we wait for a response from the Prime Minister, we’ll keep going.
Our community can’t ignore the pain of arthritis. Together, we’re making sure the Government doesn’t either.
We have a winner!
In the Autumn 2024 edition, we held a photography competition asking: ‘What does a pain-free future look like to you?’ Well done to Kris, shown below. Here, he shares his experience of living with chronic pain.
‘I have ankylosing spondylitis and, about a year ago, I had the worst sciatica from a bulging disc. It hurt to walk, hold my child – everything except laying down. I went on a self-management course for living with chronic pain, got referred to the national exercise referral scheme and took up swimming.
‘It’s still painful now, but to manage it I swim two to three times a week, go to the gym, do Pilates, walk, and do gentle stretching. I also use a TENS machine and hot water bottle on my back.
‘If I look back at where I was 18 months ago, the difference in what I can do now, with much less pain, is a great reminder of the importance of exercise.’
Build your strength
Adding a resistance band to your workout can help strengthen bones and muscles, as well as improve your posture. We have launched three illustrated exercise sheets that focus on building strength in the legs, arms, shoulders and back. You’ll find the relevant downloadable sheet under each accompanying video at versusarthritis.org/about-arthritis/exercisingwith-arthritis/resistance-band-workout-sessions
Walk to World Arthritis Day
Thank you to everyone who took part in Walk to World Arthritis Day in October.
More than1,200 people took part, walking nearly 50
The season for giving
With just a few weeks to go before Christmas, take a look at our fantastic stock of Christmas cards at shop. versusarthritis.org. From wintery scenes to wholesome woodland animals and the nativity, there is something to suit all of your friends and family. At £3.99 for a pack of 10 cards, you can share joyful wishes to celebrate the season while also helping to fund life-changing research and vital support services for people with arthritis.
Easy shopping
In addition to our helpful products that can make life with arthritis easier to navigate – some of which you’ll see on page 16 – we have some new wellness products to help you get cosy this winter. For soothing warmth and comfort, try a heatable Hot-Pak neck wrap, which some people find can ease aching muscles after a long day. And we’re very excited to introduce Warmies luxury slippers and boots – simply warm them gently in the microwave and treat your feet to the warmth they deserve on those cold evenings. Visit shop.versusarthritis.org
million steps together, raising £52,000 to support people with arthritis. Vix, who took part, said: “I felt supported by the individuals who celebrate the wins, however small. The differing levels of ability and personal challenges empowered me to work within my own limitations with pride.”
braided belt, £37 thenauticalcompany.com
Suitable for both men and women, this contemporary belt is stretchy and easy to fasten thanks to its woven texture.
2. Laura Ashley beauty bag essentials, £18 next.co.uk
This beautiful set –featuring a floral quilted bag, hand and nail cream, and a nail file – ensures a touch of sophistication for travel or home.
3. Eye mask, £15 marksandspencer.com
Indulge yourself with this eye mask from the National Gallery collection. It’s crafted from pure silk for a gentle feel on your skin – a perfect treat for you or a friend!
THE SHOPPING EDIT
Bring the magic in with these gorgeous seasonal goodies
scarf, £40 thenauticalcompany.com
This 100% wool Breton scarf, in ecru with dark navy blue stripes –made in France – is sure to keep you warm and toasty this winter!
5. Figgy Pudding Christmas Gold multiwick candle, £36 st-eval.com
Meticulously handpoured and adorned with gold lustre for an extra touch of sparkle, this half-dipped pillar candle has a 90-hour burn time to light up your festive season.
6. Birds At Dusk Feathers scatter cushion, £35 wayfair.co.uk
This filled, square cushion has a beautiful design: perfect for a cosy living room.
Eating well means making choices about what you eat, how much and how often. The amount of information on food labels can be overwhelming, so knowing what to focus on makes it simpler to make the right choices, especially when you have arthritis and need to stay mindful of keeping a healthy weight for you.
You might be surprised to learn that the information on a food label is highly regulated, which is why it’s so cluttered. Here we explain what information to look for –and how to use it.
Traffic light icons
Let’s start with the front of the pack and the traffic light labelling – so called thanks to the green, amber and red colours. The colours indicate the amount of nutrients per
WHAT CAN your food label TELL YOU?
They might look complicated, but food labels can be really useful once you know how to read them
BY ANGIE JEFFERSON, REGISTERED DIETICIAN
100g/ml of food/drinks as ‘low’, ‘medium’ or ‘high’, compared with a reference intake percentage for an average adult, based on an averagesized woman doing an average amount of physical activity.
Traffic lights can help you to compare foods. For example, you might compare the sugar content of two breakfast cereals, the saturated fat content of meat products or the salt content of ready meals. Keep an eye on the serving size though, as this may vary between brands.
Green means this is a low and healthier choice. Amber means a moderate, more acceptable choice. Red means high, guiding you to eat that food less often and in smaller serving sizes.
Most labels contain a mixture of colours, but the more green you see, the better!
The nutrition information panel is found on the side or back of the packaging. It looks complicated, but can be useful, once you know what each section means.
Ingredients list
Ingredients in a food product are listed in order of their weight in the recipe, with the biggest first. Do the ingredients appear to be things you would use in your kitchen? If not, the product might be an ultraprocessed food, something we
should be limiting in our diets due to food additives and other ingredients you wouldn’t use at home. Examples of these foods are ham, sausages, ice cream and flavoured yoghurts.
Remember that scarysounding chemical names are often used. For example, vitamin C is often called ascorbic acid, and salt might be labelled as sodium chloride. The ingredients highlighted in bold are things that people are most commonly allergic to; there are 14 of these. If any of these are possibly present, but not deliberately added, they will be declared as a ‘may contain’ or ‘contains traces of’ warning, which means there’s a significant risk to an individual who has that allergy.
Some foods will say ‘no added sugar’ or ‘low sugar’, but certain sweeteners – such as maltitol, aspartame and sucralose – can still cause blood sugar spikes.
Nutrition panel
This lists the amount of eight main nutrients, including fat, carbohydrate and protein, in 100g or 100ml of the product, and also per serving. Some packets may compare this to the ‘recommended intake’ for an averagely active adult female (%RI). You may also see other nutrients where they occur in significant amounts, such as vitamins or minerals.
The nutrition panel is useful to check your serving size, especially for snacks and drinks, which are easy to overconsume. Pack size can influence your serving size too, as bigger packs can tempt you into bigger servings.
You can also compare nutrient content per 100g. This is useful, as serving sizes can vary between brands. Look for higher amounts of fibre and protein, and lower levels of saturated fat and sugars.
Use-by and best before
These sometimes confuse people, but it’s important to know the difference.
Use-by is a food safety date. Never eat food after the useby date, even if it looks and smells okay, as it could make you very ill. Use-by appears on foods that go off quickly, such as meat, milk, yoghurt or ready-to-eat salads.
Best before is linked to food quality and typically appears on frozen, tinned or dried foods. You can eat foods after their best before date; they will be perfectly safe, but may not be at their best.
Food labels contain a wealth of information that can help you to build your healthy balanced diet. Above all, try not to be overwhelmed by the sheer amount of information –pick and choose, and learn to become more label savvy!
Nutrition and health claims
Health claims stand out most on food packaging, as they are often in a flash or banner. They are the most complicated in terms of food law, but the words and pictures are tightly controlled to ensure that you, the consumer, are not misled.
Nutrition claim
A nutrition claim is a statement about the nutrition a food provides; for example ‘source of vitamin C’, ‘high in fibre’ or ‘low in fat’. The product has to meet strict guidelines as to the amount of a nutrient the food contains before these claims can be made.
Health claim
A health claim is a statement such as ‘lowers cholesterol’ or ‘fuels a healthy gut’. You can’t just make up a claim – only approved and permitted health claims can be made. These have been through a very thorough approval process.
General health claim
Statements, such as ‘good for you’ or ‘superfood’, suggest the food boosts wellbeing, and these are considered to be general health claims. These can only be used if the food can legitimately make one of the listed claims.
Five-a-day
Five-a-day flashes mean that the suggested portion includes at least 80g of fruit or vegetable; one of your recommended five daily portions.
Focus on... hands
We use our hands for most activities, so when arthritis pain strikes, how can you manage it?
BY VICTORIA GOLDMAN
To keep your hands mobile, you need to find a balance between movement and rest. ‘Little and often is my motto,’ says Abigail Harding, an occupational therapist (hand therapist), who has psoriatic arthritis. ‘I rest my hands if they’re painful, but it’s also important to maintain the full joint range.’
Heat pads and gloves may help to keep your hands moving and ease pain. ‘If you find your hands tend to be stiff in the mornings, putting them in a bowl or sink full of warm water can help,’ says Alison Edwards, consultant orthopaedic surgeon at Practice Plus Group Hospitals. Some people prefer to use cold therapy, such as ice packs and ice sprays. If you’re using ice packs, don’t put them on your bare skin or leave on for more than 20 minutes.
Joint support
Splints, braces and gloves may rest and support your joints during a flare up. ‘I use an adjustable finger splint to ensure my finger position is correct and to protect my finger from accidental knocks and movements,’ says Harding. Edwards stresses that you shouldn’t wear splints all the time. ‘This can lead to some weakness in muscles that normally move that joint, or to worsening stiffness,’ she says. Try the Versus Arthritis compression gloves to help reduce stiffness and swelling, £15.99 (find them online at shop.versusarthritis.org).
Pain relief
Pain relief* creams and gels work directly on your hands to ease pain and are less likely to cause side-effects than tablets. ‘Find out what works best for you,’ says Edwards. ‘Use whichever you prefer, alone or in combination, to help manage your symptoms.’
*Check with a pharmacist or doctor whether the products are suitable for you.
1
Take regular breaks from activities that involve a firm grip or repetitive movements
2
Use gadgets to make tasks easier – such as electric tin openers and tap turners. See page 16 for some ideas
3
Tools with chunky handles are usually the most comfortable to hold
4
Use both hands for certain activities, such as picking up heavy bags
5
When choosing clothes, avoid fiddly buttons or stiff zips
For more exercises, scan the QR code below: Top tips
Festive feasting
SETTLE DOWN for a feast with these SEASONAL STARS
Spiced apple frangipane tart
Serves 8
Ingredients
For the pastry:
160g plain flour
50g icing sugar
120g unsalted butter, cold and cubed
1 egg yolk
1 tbsp of cold water (more if needed)
For the frangipane:
130g unsalted butter, room temp
150g caster sugar
Pinch of smoked sea salt
2 eggs, plus 1 egg yolk
2 tsp vanilla extract
1 tsp ground cinnamon
½ tsp ground nutmeg
150g ground almonds
45g plain flour
2 large apples, cored and thinly sliced, with skin on
Icing sugar, to serve
Method
1 Preheat the oven to 180C. Put the flour and icing sugar into a food processor, add the butter and pulse until it resembles fine breadcrumbs. Add the egg yolk and cold water, and pulse again until the pastry starts to come together. If it looks a
little dry, add a splash more water.
2 Bring the pastry together with your hands and knead very gently. Wrap in clingfilm in a flat disc shape, and chill in the fridge for 30 mins.
3 Roll it out on a lightly floured surface into a 2cm thick circle, and drape over a 23cm fluted tart tin. Gently press in the corners and up the sides. Lightly prick the base of the tart with a fork, and chill for 30 mins.
4 Line the pastry with baking paper and baking beans, then bake for 15 mins. Remove the beans and paper and bake for 5 mins until the pastry is lightly golden. Remove from the oven and allow to cool slightly.
5 Make the frangipane. Using an electric whisk, place the softened butter, sugar and pinch of smoked salt in a large bowl and whisk for 2-3 mins until pale and fluffy. Then add the eggs, yolks and vanilla and whisk again. Finally, add the cinnamon, nutmeg, ground almonds and flour, and whisk until combined.
6 When the pastry case has cooled slightly, trim off excess. Spoon in the frangipane and smooth with a palette knife. Arrange the apple slices on top and lightly press into the filling.
7 Bake for 40-45 mins. Allow to cool before dusting with icing sugar.
Charred Brussels sprouts on toast (see image, right)
Serves 2
Ingredients
2 slices of sourdough bread
200g Brussels sprouts, halved
1 tbsp olive oil
100g ricotta
½ lemon, zested
30g blanched hazelnuts, toasted
50g parmesan, finely grated
Pinch of sea salt
Cracked black pepper
Method
1 Preheat the oven to 180C. Place the Brussels sprouts onto a large baking tray and drizzle with the olive oil, then season with sea salt and black pepper. Place into the oven and roast for 15-20 mins until partly charred. Toast the bread.
2 In a small bowl, mix together the ricotta and lemon zest and season. Spread the ricotta mixture on top of each piece of toast. Roughly chop the toasted hazelnuts.
3 Top each toast with the charred Brussels sprouts, a scattering of toasted hazelnuts and some grated parmesan cheese. Serve immediately.
Mushroom, squash and chestnut wreath (image below)
Serves 6
Ingredients
2 red onions, finely sliced
3 tbsp olive oil
1 knob of butter
Pinch sea salt
1tsp soft brown sugar
450g mixed mushrooms (eg. chestnut, shittake, oyster), torn into pieces
½ small butternut squash, peeled and diced into 2cm cubes
50g chestnuts, crumbled
Small handful sage leaves, shredded
A little grated nutmeg
30g dried cranberries
Pinch of sea salt
1x 320g sheet of puff pastry
Milk or egg to glaze
Method
1 Preheat the oven to 200C. Put 1tbsp of olive oil plus a knob of butter in a frying pan and melt. When foaming, add the sliced onions and a pinch of sea salt and fry on a low heat for 10 mins until soft. Add the brown sugar and cook for another 5 mins until the onions have caramelised. Set aside to cool.
2 Place the mushrooms onto a baking tray along with the diced butternut squash. Drizzle with the remaining olive oil and season. Roast for 25 mins until the squash is tender and the mushrooms are golden. Set aside to cool.
3 In a bowl, combine the caramelised onions, chestnuts, sage, nutmeg and dried cranberries.
4 Unroll the pastry onto a baking tray and pile the filling down the middle. Brush egg wash onto the edges of the pastry and roll over to seal, as though making a large sausage roll. Take the two open ends and join them together, sealing well. Egg wash the outside of the wreath and then place into the fridge for 30 mins.
5 Bake for 35-40 mins until golden and crisp. Cool slightly before serving.
Flaming old fashioned
Ingredients
2 tsp sugar syrup
2 dashes of bitters
Pinch of sea salt
60ml whiskey or bourbon
Orange
Soda water (optional)
Rosemary and cinnamon stick
Method
1 Soak the rosemary and cinnamon stick in some high proof spirit for a few minutes – this will be the flaming part of the cocktail.
2 Take a tumbler and add the sugar, bitters and salt, stirring as you go. Fill the glass with ice and add the whiskey or bourbon and stir again. At this stage, you can add a splash
of soda water if you like, along with a slice of orange.
3 Take the rosemary and cinnamon stick and, very carefully, balance this on the rim of the glass. Then use a lighter or matches to ignite it – the smell of the smoked rosemary and cinnamon will add lovely Christmassy notes to your cocktail.
REDISCOVERING YOUR BEST SELF
When you’re living with a chronic condition, it can be easy to lose your va-va-voom. Here, we look at what you can add to your life to bring you joy
BY GEORGINA WINTERSGILL
t can be difficult to adjust to the loss of your old life – times when health and mobility used to be better. There may be things you can no longer do. You may feel you’ve lost your sense of self. If you’re living with chronic pain, it may be a challenge to find the joy in life that you once took for granted.
Tamar Pincus, a professor of psychology at the University of Southampton, says: ‘You may be so busy trying to control your pain, you’re chasing the cure and forgetting to live.’
We asked Professor Pincus for advice on rediscovering your sense of self, and finding joy in the present.
Do things you love
The first step is to identify what you love doing, or would love to try.
Professor Pincus says: ‘For everyone, there’s something that will make them feel absolutely alive, despite living with arthritis. I like the activities that have the most components. For example, a dance class is physical, social, musical, and regular. Activities that tick a lot of boxes are more likely to be maintained and more likely to reactivate your sense of self.’
She advises writing a list of ideas and rating them in terms of how much you want to do them and how much effort they’ll take. Are they in your price range? Are they somewhere you can get to? If not, consider whether a few adjustments could help. For example, if you can’t get to an art class, perhaps you could find some tuition online. If you can’t do a standard yoga class, chair yoga (traditional yoga poses adapted to be performed while seated) might be ideal. If a favourite activity simply isn’t possible, be creative when thinking about
alternatives. Professor Pincus advises: ‘Think outside the box. If you can’t run marathons any more, maybe you could write a book about marathon running.’
If you’re struggling to think of ideas, or find the whole concept of new activities a bit overwhelming, ask a friend or family member for help. ‘We found that you lose your courage to try new things, and pain reduces your ability to problemsolve,’ says Professor Pincus. ‘Reach out to someone who knows you well and can come up with ideas.’ Why not accompany a friend to something they enjoy? You never know, you may enjoy it too, and the peer support may help to get you there.
Be mindful Consider mindfulness (a technique that involves paying attention to the present moment without judgement). A recent study found that 10 minutes a day improved wellbeing, reduced depression and anxiety, and inspired healthier lifestyle choices. Participants used a free mindfulness app (‘Medito’) for a month, with sessions including relaxation exercises, attention to breath, self-reflection and setting intentions. ‘Mindfulness doesn’t work for everyone,’ says Professor Pincus, ‘but for people for whom it works, it’s incredibly powerful.’
We’re here to help
You are not alone – you are part of a community of people who understand what it is like to live with arthritis. If you would like to speak to someone, you can call the Versus Arthritis helpline on 0800 5200 520 (call us free Monday to Friday, 9am-6pm), reach out on social media, or join our online community at community.versusarthritis.org.
Get outdoors
Spend time connecting with nature. Researchers have found that taking part in outdoor, nature-based activities led to improved mood and reduced anxiety. Gardening, outdoor exercise, conservation activities, and ‘forest bathing’ (spending time in nature and using all your senses to experience your surroundings) were all said to make people feel better. According to Professor Pincus, we need green spaces and a change of environment.
Engage with music
Music can be life-enhancing.
In a study involving people aged 50 to 80, three-quarters said that engaging with music (whether listening or
participating) helped them relax or relieve stress, and 65 per cent said it helped their mental health or mood. Combining music and social activity may be even more beneficial. In 2013, researchers interviewed people who sang alone and people who sang in a choir. Both groups reported high levels of wellbeing – but levels were higher among those who sang in a choir.
Have a good chat
Researchers recently found that one good-quality conversation per day with a friend increased wellbeing – and more than one increased it further! If getting out is difficult, schedule regular phone or video calls – or, better still, invite a friend over; the study found that in-person chats were most effective.
‘When we live with pain, we lose our joy in life’
Tamar Pincus (left) is a professor of psychology at the University of Southampton. Her research (funded by Versus Arthritis for the past four years, alongside the Medical Research Council) focuses on investigating psychological aspects of pain, especially chronic pain.
She says: ‘When you live with pain, it has an impact on all the things you are and do. Pain interrupts – so when you try to do things, it takes away your attention. Pain interferes – it’s hard to plan ahead, so it impacts your goals. Pain affects your identity – you think, “Who am I? I can’t recognise myself. I feel a burden.”’ As a way to deal with this loss of identity, Pincus uses principles from acceptance and commitment therapy (ACT). ‘It’s mindfulness – about living in the here and now,’ she explains. ‘When we live with pain, we lose our joy in life. Our research suggests that living well with pain is about trying to reintroduce joyful activities into life. It gives us an enormous amount of satisfaction and a sense of identity, and it’s a distraction from pain.’ Watch the video, ‘Pain and Me’ on YouTube –scan the QR code below.
How to
TRAVEL BETTER
Linda Tetley, 77, who lives in Mallorca, is queen of packing for airport travel
BY GEORGINA MARIC
‘Iwas diagnosed with rheumatoid arthritis
28 years ago and I also have osteoarthritis in different joints, but I’m as active as possible. I have good days and bad days. Weather conditions make a difference – I always feel like a weather cock when rain is about, and the damp does affect me. I don’t consider it an illness, but a condition that you have to cope with. It has got worse, so I’ve had several joint operations over the years.
It hasn’t stopped me travelling though; long stays, short stays, overnight – I’m very lucky to have the opportunities. I have my family living abroad, with some in Dubai, so I visit regularly.
The most important items to take are medication and face masks if you are in places with crowds, queuing up or waiting. I try to avoid people with colds so that I don’t have to cope with something else on top of the arthritis.
I take a change of clothes in my hand luggage, including underwear in case I get caught in a queue. I always have a pen in my bag to use digital machines as I have deformed fingers – it’s easier to use a pen rather than a finger to type out whatever you need to.
Always wear comfortable shoes. In airports, you might need to take them off, so it’s much easier to have shoes with Velcro rather than fastenings as they are easy to slip on and off.
Wherever I’m staying, in a house or hotel, I always work out the layout beforehand; you could call or email the hotel to ask questions. You don’t want to stay somewhere where you have to walk up a slope or use steps. And make sure there’s a working lift. I can’t use a bath, so a shower unit is perfect as I can walk in and out easily.
I also make sure there are extra pillows in my room – sometimes I use them to elevate my legs as well.
Take a light handbag with a shoulder strap so your hands are free to do other things. Make sure you have a light bag with wheels – just make sure you have the right size bag for the airline. In airports, I always take a foldaway walking stick. Depending on how you are feeling on the day, you can use it or just put it in your handbag. On a bad day, you might not be able to walk fast, so request wheelchair or buggy assistance. This will make travelling so much easier and save a lot of hassle.’
Travel tips
BE PREPARED
Call or email ahead to ask for a room on the ground floor or near to a lift so you don’t have to negotiate stairs
PARK IT
Ask if the hotel has a car park you can use, or if there’s a secure spot nearby
GRAB AND GO
Find out if there is an easyaccess shower and grab rails in the bathroom
SENSIBLE PACKING
Use a bum bag or crossbody bag for important items so they are close to hand without putting strain on your neck and shoulders
WHEELY GOOD IDEA
Choose a lightweight suitcase with wheels that you can manoeuvre easily
DOUBLE UP
Take light clothes and layer up, and shoes that you can wear in the day and evening
SMALL AND MIGHTY
Bring a pill sorter box to avoid taking numerous packages, and mini travel bottles for beauty essentials
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