Animal Care

A CHANGE FOR THE BETTER?

Mark Newton-Clarke MAVetMB PhD MRCVS, Newton Clarke Veterinary Surgeons

VirtualShutter/Shutterstock

Iam sitting down to write this just after the shortest day has passed, a psychological milestone in the year that I always look forward to. That little feeling of optimism, drip-fed by weekly increases in daylight length, leading us into spring. How we all hope for similar weather to last year’s early months, maybe with a little more rain for the farmers and gardeners among us.

Last month I wrote about the growing pains of puppies with the emphasis on behaviour. You might be surprised (and horrified, I expect) to learn that one of the most common reasons for a young (usually) male dog to lose his life is by being euthanised due to unacceptable levels of aggression, usually towards humans. We shouldn’t forget sheep-worrying is also a capital offence. Many cases are due to the young buck exercising his dominance over the human members of the family, putting them in their places with a growl here and even a nip (or worse) there. This situation represents a failure of control, by humans who have inadvertently elevated the status of their dog above themselves. With training and by taking back control of the ‘critical resources’ that dogs hold most dear, the situation can be rescued but the path is complicated and uncertain.

As our puppies go through adolescence, many will start to push the boundaries of behaviour to unacceptable levels. Seeing what you can get away with is a strategy that dog owners and parents recognise all too well and it’s up to all members of the family to reinforce the rules. For our dogs, modifying hormones and therefore behaviour through surgery (neutering) is an option which has been practised for many years.

A question we are often asked is whether neutering will change canine behaviour for

the better. It really depends on the dog and the behaviour! Firstly, I do not recommend routine neutering of male dogs, unless there is evidence of one or more of the testosteronedriven undesirable behaviours (hypersexuality, roaming after females on heat, excessive urine marking and dominance aggression). Presence of such traits may well improve after castration. Inherently dog-specific behaviours like hunting, guarding territory and seeking affection are generally unaffected by neutering, as is obedience which must be taught from an early age. So there are potential benefits to castration in dogs but there are also possible adverse effects. There is some evidence that neutered male dogs are more prone to the progression of cognitive impairment. Cognitive impairment refers to the behavioural changes that occur in senior dogs as a result of disturbances of memory, learning, and the circadian rhythm (sleep-awake cycle). Pity that remaining ‘entire’ doesn’t guarantee immunity from mental senility, as many men of my age are starting to realise! There is an implant available for temporary (6 months or so) ‘chemical’ castration which we have used several times over that last few years. It can be a useful guide to the success or otherwise of surgical castration which, of course, is permanent. One last point here, a castrated male can be fertile for up to a month after the operation so if you have brother and sister in the house, count this into your timing for any planned surgery.

For females, neutering (spaying) involves removal of the uterus and ovaries, so the twiceyearly oestrus cycle (season) is abolished, preventing any possibility of pregnancy. For bitches who suffer from false pregnancy, a hormonally-driven crankiness that occurs about 2 months after a season, spaying is curative. It also reduces the risk of mammary cancer and prevents the common and serious condition called pyometra (an infection of the uterus). So if you are not planning to breed with your female dog, the balance lies in favour of neutering. What could be the down-side? Certainly weight gain is potentially a significant issue due to the change in hormones that occurs and regular weight checks are encouraged. Another issue is urinary incontinence, which occurs in a small percentage of spayed female dogs. This annoying complication is influenced by the timing of the operation and recent research suggests an increased risk in bitches spayed before their first season. Luckily there are simple and effective remedies for this form of passive incontinence. It is also important to avoid surgery until at least 3 months after the end of the previous season to allow sex hormones to settle down.

For those of you with plans to breed with your dogs, the first birthday is an important milestone. Hip and elbow scores can be measured on X-rays after 12 months of age and the best scores are achieved at a young age. There certainly are limitations to this method of predicting joint health but, at present, it’s the best we have. A much better scheme would be to test the progeny of a breeding pair of dogs as their puppies will be more likely to show the effects of ‘bad’ genes. However, the logistics of this are near-impossible and the first litter are already born! Why are there no genetic tests for hip dysplasia like other inherited disorders? The answer lies in the complexity of the genes that code for a complicated structure like a hip or elbow joint whereas a single genetic defect can be defined with relative ease.

The Kennel Club offers advice on genetic tests and many breeders use the results to plan their litters. The tests can be done on a simple cheek swab or a small sample of blood. When carriers of a particular gene are identified, breeding can be undertaken with a non-carrier dog, effectively eradicating the condition in a few generations. However, like many preventative health schemes, including vaccination, success requires compliance from a high proportion of the population.

I’ll leave that thought with you. As always, if you have any questions regarding neutering or breeding, call us at the surgery.

newtonclarkevet.com

A DAY IN THE LIFE OF A VET

EXPORTING OUR FOOD TO EUROPE

John Walsh BVSc Cert AVP DBR MRCVS, Friars Moor Vets

It has certainly been a strange year for everyone with Brexit and COVID. We have all had to get used to new ways of working and living our lives. Even at the practice we are not immune from the effects and we had to separate the two sides of business – the pet and livestock health sides. By doing this it enabled us to carry on working and looking after sick animals in the event of a positive coronavirus case in either side of the business. The practice is normally a very sociable and friendly place to work and I think this is the one thing that everyone misses the most about working at the vets. Hopefully, the vaccine rollout will enable everything to return to some sense of normality very soon.

I thought today I would highlight another side of my work that you may find surprising and which is going to be getting busier over the coming year. We have several vets at the practice who have the relevant government qualifications that enable us to sign certificates for exporting products of animal origin to overseas countries. Before Brexit, companies could export products to the EU without the need for these certificates. Products that we certify for export include cheese, milk, cream, whey, honey, live animals for breeding and even leather. These products made by farmers and producers are some of the highest quality in the world and that is why they are in high demand both in Europe and around the world. The reason we provide certificates is to ensure that the animal products come from animals that are both free from disease and have had the highest welfare standards. We also certify that there are processes in place in the factories to ensure products have received the correct treatments such as pasteurisation, that prevent other diseases being passed to the consumer at the destination.

Although the paperwork side of the process is not the most exhilarating work, it is very interesting working with the food-producing companies. It amazes me the thought and preparation these companies put into every stage of the production cycle to ensure the highest standards of food safety and, most importantly, to produce the best taste! I now have the privileged position of being involved in the whole production process; from the grass growing in the fields that feed the cows or sheep to the making and dispatch of the delicious end product around the world!

HEAD-TURNER

Sarah Hitch, The Sanctuary Beauty Rooms and The Margaret Balfour Beauty Centre

Dima Aslanian/Shutterstock

Resting just below that mask of yours is a largely forgotten and unloved part of you – your neck.

Even the most robust skin care routines typically ignore this area – we often neglect to take our facial skincare products down onto the neck or chest area and don’t protect it with SPFs.

Google searches on neck products and neck treatments are on the up, showing a growing awareness and concern. This can partly be attributed to the fact that we are up close and personal on Zoom calls and ‘keep in touch’ selfies where people can focus in, closely looking at every detail of people’s faces and skin. The long term underlying stress that we are currently coping with is another factor in our skins looking lack lustre and feeling prematurely aged.

The technology we are using, now more than ever, to work and communicate is causing us to look down at screens and use the neck repeatedly. Being in front of screens also exposes our skin to the damaging blue UV light radiation that screens emit, so don’t forget

to apply your high level SPF even when working from home. This trauma to the neck through our communication habits is being dubbed as ‘Tech Neck’ as we fold the skin and strain our neck as we look down at our devices, further damaging this delicate area.

Even if your face looks healthy, your neckline can tell a different story. That’s because neck skin is thinner and more vulnerable to sun damage, photosensitisation from fragrances, friction from clothes and skin strain from muscle movements. Lack of proper skincare can further exacerbate the premature ageing of this area. The skin also loses strength and flexibility with age as the overworked neck muscles and the supportive fascia tissue weaken underneath. These factors then exacerbate the appearance of lines, creases and sagging as the elasticity weakens and collagen production slows.

Using area-targeted skincare products designed to address the specific challenges and needs of this fragile prematurely ageing skin can be a game changer.

Products used regularly at home can tone and tighten the skin to achieve a more visibly lifted appearance. If the neck area is already a concern of yours then do seek out area-specific products from skincare companies. Peptides that increase collagen synthesis and strengthen the moisture barrier can have their effects further enhanced by specific massage movements to kick start this area into rejuvenation. If you have not noticed ageing in the neck area yet then do remember to include the area every time to treat your face - cleanse, exfoliate, moisturise and protect with high level SPF.

thesanctuarysherborne.co.uk

________________________________________ Wednesday 17th February 7pm and Thursday 25th February 10am Join Sarah for a virtual ProFirm@home group session focusing on the neck area. This will be a guided hands-on Dermalogica skin treatment that you can do on yourself at home!

Book in for the 45 minute session by emailing treatments@thesanctuarysherborne.co.uk and receive your home treatment kit ready for your chosen session. £15 booking fee is redeemable against Dermalogica purchases after the session.

Muntanya is an independent trekking and outdoors shop offering clothing and equipment from major suppliers. 7 Cheap St, Sherborne, Dorset DT9 3PT david@muntanya.co.uk 01935 389484 • 07875 465218 www.muntanya.co.uk

YogaSherborne

Classes and 1-1’s online

• Hatha Yoga • Relaxation and guided meditation Contact Dawn for more details 07817 624081 @yogasherborne hello@yogasherborne.co.uk Yoga Alliance qualified teacher

DORCHESTER PODIATRY AND WELLBEING

Podiatry Services HCPC registered • Routine nail cutting • Corn and callus removal • Ingrowing nails • Insoles and Gait analysis • Diabetic / arthritic foot care • Verrucae treatments • Nail surgery • Shockwave therapy • Fungal infections

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Branch and Root Therapy and Supervision

Explore the roots of your feelings and behaviour in order to grow and flourish

Qualified counsellor, based in Sherborne, offering phone and online consultations during lockdown. Specialising in working with young people but also experienced in working with adults. For more information visit www.branchandroot.co.uk or email karenbranchandroot@gmail.com

HOW TO STOP WORRYING

Kay Johnson, Local Author

Have you ever wished you could switch off the worries that may be buzzing round inside your head? Or, at the very least, transform them into something more manageable? Well, this pipe-dream can become a reality by unlocking the mystery of your mind.

When we are pre-occupied with our troubles and worries, we tend to assume that’s ‘just how it is’, and there’s nothing we can do to change the way we think about the problems we are facing. This is particularly true for those of us who have had a predisposition to worry all our lives. It originates from the belief that the extent to which we worry is determined by three factors: our genetic make-up, our upbringing and the experiences we have been through. These factors do indeed affect our tendency to worry, but there is a fourth factor, which is our ability to learn new ways of dealing with worrying situations, irrespective of what has gone before. The way forward lies in understanding a few key principles about how our mind works.

The starting point involves accepting that we often can’t change the situation in which we find ourselves.

Olga Strelnikova/Shutterstock

We also can’t change the way other people behave, only they can do that. Nothing is accomplished by railing against the unfairness or awfulness of a difficult situation, no matter how justifiable that may seem. Instead, we need to change the way we deal with the situation and how we respond to others, which is done by focusing on the things over which we have control, namely our thoughts, feelings and actions.

The real challenge lies in changing the way we think about the problems in our lives. Anyone who has ever tried to stop worrying will know how difficult this is. But with a bit of time and practice, it’s possible to ease the worries out of your mind.

There are a few techniques you can use. The first involves inoculating the worrying things you say to yourself with thoughts that are more constructive. For example, if you find yourself saying: I can’t cope or I don’t know what to do, try switching your internal dialogue to the polar opposite. So, you might say, calmly and confidently to yourself: I can do it or you might ask yourself: how can I solve this problem? As you switch your internal thoughts in this way, you may find that it doesn’t feel quite right. This is simply because your mind has got into the habit of thinking in a particular way. But the more you change what you say to yourself, you gradually start to believe that you can find a way of dealing with the problems in your life more effectively.

Worrying self-talk is often accompanied by bad news pictures that flash across the screen in your mind. You literally see inside your head vivid imagery of the things you fear. These images, like the words you say to yourself, also need to be inoculated with something more helpful. So, if you see yourself in your mind’s eye not being able to cope with something, gently replace it with an image of doing the very thing you believe you cannot do.

By changing what goes on inside your head, you not only start to believe that you can overcome the difficulties you’re facing, but you also fire up your subconscious to come up with solutions to resolve those problems. The subconscious is the powerhouse that operates beyond your conscious awareness and has a phenomenal capacity to come up with solutions to life’s difficulties. Its efforts just need to be channelled in the right direction, and this is accomplished by switching the thoughts in your conscious mind to something more constructive.

As you start to make these changes, you’re likely to feel more upbeat and able to deal effectively with your worries. Sometimes though, it can feel like hard work and as though you’re not making much progress. Perhaps you’re finding it difficult to change your internal dialogue and pictures, and hold them in your mind. Maybe, you still feel dragged down by all your concerns. This is often because your mind and body are pulling in different directions. You can’t be thinking one thing and feeling another. So, for instance, if you want to induce a sense of confidence, you need to adopt a confident posture by standing up tall, holding your head high and looking straight ahead. Alternatively, if you want to induce a sense of calm, you need to slow your breathing and relax the muscles in your face, neck and shoulders.

The more you can focus your thoughts and feelings on what you want (your ideal outcome) rather than what you don’t want (your concerns), the more likely you are to relieve the intensity of your worries. At the same time, new ideas tend to pop into your conscious mind that would previously have been filtered out. You become aware of all sorts of opportunities and choices you didn’t notice before. And most importantly, you start to realise you have the skills and qualities you need to manage the problems you’re facing. Together, these things create a new understanding of yourself, enabling you to deal more effectively with the difficulties in your life rather than being overwhelmed by doubts and fears.

At the same time, these changes also affect your behaviour, because you’re then motivated to take different sorts of action to resolve your troubles and worries. And when this happens, you start to see favourable change manifest itself in your external life, leading to more beneficial outcomes.

Sadly, there are some life situations that can’t be changed, such as the loss of a job, a serious health condition or the break-up of a relationship. And although these heart-breaking circumstances can’t be altered, they can be rendered more manageable by changing the way you think and feel about them, as well as taking different sorts of actions to help ameliorate their impact.

So, the key to smoothing away your worries is to change the way you respond. As you do this, you discover you can take life’s problems in your stride. You get better outcomes. And most importantly, you find relief in even the most stressful situations.

Kay Johnson is author of ‘How Can I Stop Worrying? The Definitive 5-Step Process to Help You Smooth Away Your Worries’.

THE BICYCLE WHEEL REVOLUTION

Mike Riley, Riley's Cycles

Every part of the modern bicycle has been refined since pedal-powered bikes were introduced and though they say you cannot reinvent the wheel, bicycle designers have had a good try.

Souplesse is a cycling term which describes a state of harmony and smoothness in the way a rider propels their bike and wheel and tyre producers make claims for their products’ contribution. This may seem aspirational for ordinary riders, but all can appreciate how a good set of hoops contribute to bike performance and taking care of your wheels contributes to cycling enjoyment.

I was encouraged to write this article after contributing advice to a cycling group and include riders’ experiences and experience from our workshop. To keep the article length down I have excluded carbon wheels.

Wheel Construction Bicycle wheels comprise rim and hub linked by spokes. Spokes attach to the rim by nipples and, at the hub, by the spoke head. Spoke patterns are known as lacing. The rim is surrounded by a tyre. Gear type affects hub width, this in turn affects spoke angle, which in turn affects rim spoke hole construction. All hubs include bearings and an axle and a means of attaching sprockets.

Materials used include plastic, steel, aluminium alloy, carbon fibre and even wood.

Rim Shapes The external shape of a rim is constrained by tyres and brakes. Tyres are generally tubular (tubs) or clincher style. Tubs rims have a flatter shape designed to glue tubs onto - these are a specialist choice. Most popular are clinchers where the rim clinches the tyre bead under pressure. A recent cycling development is tubeless tyres - subtle differences in internal rim shape allow the tyre to seal against the rim. It is essential for safety that tubeless tyres are only fitted on tubeless compatible rims.

Rims may be asymmetric in profile - number of spokes per side or spoke hole angle.

Spokes and Lacing Patterns Rim and disc brakes produce different forces. Disc brakes require stronger hubs. A subtle key difference is the lacing pattern – weight-saving patterns on rim brake wheels are not suitable for disc brakes.

The most common lacing pattern is 36 hole 3 cross - lightweight wheels may have as few as 12 radial spokes.

Spokes may be galvanised steel, stainless, alloy or carbon. They are measured by length and gauge and have different profiles and ends, these myriad permutations are a headache for a cycle shop. For general use the best spokes are butted stainless. Butted means diameter varies along the length - these are not

only lighter, but surprisingly less likely to break and improve ride quality.

Nipples are threaded inserts fed through rim holes to attach spokes. They can be brass, steel or aluminium. It is important to check spoke tension regularly as spokes may break or nipples unscrew. Alloy nipples used in wet conditions corrode and fail without warning - check them regularly and avoid if you are not a weight weenie.

The strongest rims have eyelets in the spoke holes and nipples may have washers to spread load.

Hubs I was amused by a post another bike mechanic sent about a rider who changed his rear hub to add a fixed sprocket and asked why his legs were being pushed round. He misunderstood that most hubs have a freewheel which allows pedals to stop when riding downhill or slowing down. Most hubs also include gears.

Friction is a cyclist’s enemy and bearings determine smoothness. Basic bearings have a hard surface built into the hub, loose metal ball bearings, cones mounted on an axle and seals to keep grease in and water out. If not serviced appropriately, bearing surfaces wear and the hub becomes scrap. Some hubs have cartridge bearings, their benefit is they can be replaced when worn.

Rim Construction Metal rims are extruded, curved and joined by welding or pinning. There is usually a hairline at the join covered with a manufacturer’s decal.

Anecdotally modern rims wear more quickly, however this may be because modern brakes are more powerful. Andy, one of our regular customers, covers a high mileage each year of well over 10000 miles and wears out rims in under two years.

A club member pointed out his best bike’s alloy Mavic rims have a ceramic coating and the pads and rims are barely worn. I had a wry thought that this effect may be because the bike is on the wall of his garage while he is riding his winter bike, but I am sure he is correct that coating the edge of a rim has benefit. Another rider experimented when he found his rim worn to less than 1mm thick and, inflated it to over 100psi pressure, the weakened rim deformed from the outward tyre pressure. Others took my advice that rims or hubs were worn out and replaced their wheels - they were delighted with the performance improvement.

Pre-Ride Checks Check for rim defects such as dents and that the rim runs true by spinning it while watching against a reference point. Ensure tyres are correctly inflated. Spokes may break or loosen - to check grasp a pair on the same side, squeeze lightly to feel the tension, work your way round noting any slack. If you find a damaged spoke, replace ASAP.

A simple wheel rim wear check is to run a fingertip over the rim feeling if it is concave, or use a straight edge and check by eye. Rim wear indicators take different forms - a continuous black groove or a small circle often opposite the valve hole, though beware of clogging by muck.

Caring for Wheels As well as general wear, excessively worn pads can score rims leading to premature failure. Particles stuck in the pad can have the same effect. Some pads are kinder to rims, e.g. Koolstop and Swisstop brands, and improve braking. Although costing more, they save expense from replacing wheels or rims. Pads must be matched to rim material.

Avoid thumping into pot holes and kerbs, but do not swerve in case a vehicle is about to pass. On mountain bikes it is possible to put a foam insert into the tyre to protect the rim at low pressures.

Post-ride rinse grit from rims and pads with watering can or hose. It is not appealing on a chilly day, but if completed while togged up from your ride you will not notice the cold as a virtuous glow warms you from inside. Periodically remove wheels to inspect pads, embedded particles can be hooked out with a sharp podger.

If rims wear, a new wheel may be the answer as hubs and spokes also deteriorate. Wheels can be rebuilt when cost effective with new rims and spokes and bearings serviced. Select the correct rim width and diameter to suit your tyres.

An option avoiding rim wear is a bike with disc brakes.

Servicing Servicing wheels annually is advisable, especially if ridden in winter. Thoroughly clean the wheel then inspect all components, check spoke tension and adjust as required, true the rim to remove buckles, clean bearings and regrease or check for roughness and wear depending on bearing type. This can extend wheel life significantly.

Stay safe!

FALL PREVENTION

Craig Hardaker BSc (Hons), Communifit

Image: Stuart Brill

Balance is a crucial survival skill, but it’s also perishable. The muscles we use to stand tall weaken ever so gradually after we reach 35 (yes, only 35). The length of our stride shortens, the pace of our steps slows, and vision — critical to coordination — becomes fuzzier.

Balance really is ‘use it or lose it’. You can maintain it if you stay active.

How well we keep our balance in midlife can protect us from what lies ahead - one in three adults over age 65 takes a serious tumble each year. Avoiding falls means a longer independent life, and good balance is key to achieving this. Working on our strength and body weight distribution improves our balance, making us more stable.

But an enhanced sense of stability doesn’t just help protect you from future falls. There are immediate health benefits — better mobility, fewer injuries, greater capacity to push yourself harder during workouts — which in turn increase overall fitness.

The problem is that people are often unaware that their coordination is slipping. While there are hallmarks of clumsiness, such as poor handwriting and constantly bruised shins and knees, these are often ignored. Even naturally agile people need to work to boost balance with age.

Balance is a separate system, just like strength or flexibility. You can improve it if you continue to challenge it. Here are some ways to improve your balance:

Stand on one leg* - Try to do this while you are washing the dishes. When you can hold the pose for 30 seconds on each side, stand on a less stable surface, such as a couch cushion. To increase the challenge even more, do it with your eyes closed.

Walk heel to toe* - The same sobriety field test policeman give drunk drivers also improves balance. Take 20 steps forward, heel to toe. Then walk backwards, with toe to heel, in a straight line.

Get a good night’s rest - Sleep more than 7 hours a night. Sleep deprivation slows reaction time, and studies show that it’s also directly related to falls. Researchers tracked nearly 3,000 older women and found that those who typically slept between 5 and 7 hours each night were 40% more likely to fall than those who slept longer.

Exercise regularly – Not just general exercise but specific, targeted exercise helping you fight all the negatives of the ageing process, not just balance.

Improving your balance really does need to be proactive not reactive. Do not wait until you fall to do something about it. *not suitable for everyone

TEN TIPS FOR TRAINING

(whether gyms are open or not)

Simon Partridge BSc (Sports Science), Personal Trainer, SPFit

Afew weeks ago, under the tier system, we were offering hybrid coaching sessions and classes, where some of our participants were in our gym whilst others were online, training from home. This was amazing. Now we are in full lockdown, here are ten tips for training, no matter where you are.

1. Prioritise compound exercises Compound exercises work multiple muscle groups because there is movement at two joints. They should be the cornerstone of any workout programme whether you are training for strength, building muscle or aiming to lose fat. Examples are the bench press, squats and deadlifts and all of these can be adapted whether you train in a gym or at home.

2. Have a clearly defined goal The classic new year’s resolution is to change our body shape. The best body transformation clients that I have worked with are women wanting to get into shape for their wedding. We need a clearly defined goal if we are actually going to achieve the results we truly want.

3. Go lighter with isolation exercises To grow muscle and ‘tone up’, isolating moves are where only one joint moves and most people use this when training their arms, for example. Lifting lighter and prioritising technique work the muscles far more effectively than just lifting heavy weights.

4. Maximising time under tension (TUT) This will make a huge difference to the effectiveness of your workouts. Pay particular attention to the lowering phase slowly if you want to tone up.

5. Spend more time on mobility Good mobility means good movement patterns. You can add more weight and achieve a better range of movement which is essential for maximising muscle gains and fat loss. It will also reduce your risk of injury.

6. Use the correct weight and repetition selection The final couple of reps should be very challenging. We want to train the most effective way to grow new muscle and burn fat.

7. Master the techniques Learning how a move is performed effectively, even if this means making the exercise easier or reducing the weight you lift, can help you progress.

8. Record your results Keep a training diary with not just your sets, reps and weights but how the session felt, energy levels and anything that will help you plan your future workouts to improve.

9. Stretch for strength Studies show that improving your flexibility not only reduces the risk of injury but can also stimulate muscle growth.

10. Follow a progressive plan for a specific period This does not mean lifting heavier every session. Progressive overload should be the goal of every plan. For example, start with muscular endurance or toning and muscle growth, then move to maximal strength, culminating with power training to encourage progress.

Good luck everyone, wherever you are able to train. Let’s make every workout as effective and fun as possible.

ARTHRITIS

PREVENTION AND TREATMENT

Dr Tim Robinson MB BS MSc MRCGP DRCOG MFHom GP & Complementary Practitioner

As we grow older our joints inevitably ‘wear and tear’, the condition known as osteoarthritis. The most common symptoms are pain in the affected joints, along with stiffness and reduced range of movement. Conventional treatment is with the painkiller, paracetamol, and anti-inflammatory, ibuprofen. Surgical joint replacement may be necessary if the pain and disability is not controlled with medication. However, besides these conventional treatments it is also worth considering complementary alternatives.

Omega 3 fish oil has been shown in studies to be beneficial as it has anti-inflammatory properties. Omega 3 is found in oily fish such as mackerel, sardines and salmon - two portions weekly are sufficient - or it could be taken as a supplement.

Glucosamine and chondroitin are naturally occurring compounds found in cartilage. They can be taken as a combined supplement as trials have shown them to have mild antiinflammatory effects. They also help build and restore damaged cartilage within arthritic joints. Try it for three months to see if it helps.

Homeopathic medicines can also help ease the pain and joint stiffness of osteoarthritic joints. Rhus tox, Ruta and Bryonia are the recommended medicines. Take one dose of the 30c strength twice daily over 4 weeks.

There are a number of herbal medicines that may also be helpful. Tumeric has been in the news a lot over the last few years. Others are ginger and bromelin, but always be cautious with taking herbal medicines as they can clash with conventional medicine and have serious consequences. Always read the instruction label or contact the supplier before you take them.

Besides supplements and medicines, conventional or complementary, it is important to maintain joint integrity by keeping as active as possible. Inactivity leads to tightening of the ligaments and tendons around joints, thus leading to further joint stiffness and reduction in the cushioning synovial joint fluid. Try to keep as active as possible with daily walks or swimming. Gentle stretching or supervised Pilates or yoga are all extremely beneficial. Assessment and manipulation by a physiotherapist, osteopath or chiropractor should also be considered. Acupuncture can also be helpful, particularly for chronic low back pain due to facet joint arthritis.

And so, in summary, I have listed quite a number of treatments and approaches that have all been found to be beneficial for arthritic pain and joint stiffness. But like everything, there is no ‘one size fits all’. I suggest experimenting with each in turn in order to find those that bring greatest relief – once you have found them you won’t want to give them up!

doctortwrobinson.com glencairnhouse.co.uk