Arthritis in Ireland-the painful truth
By Niall Hunter - Editor
Every year in Ireland, around 400,000 people consult their doctor with symptoms related to arthritis, according to Prof Barry Bresnihan, consultant rheumatologist and Chairman of Arthritis Ireland.
Prof Bresnihan, in a recent presentation to the Joint Oireachtas Committee on Health and Children, gave a stark picture of the incidence of arthritis in this country, its medical and social cost, and the shortage of staff and facilities to cope with the condition.
Prof Bresnihan said almost one-third of women and one-quarter of men will complain of arthritis or joint pain to their GP, and the condition is more common in older people.
Fifty-two per cent of those over 55 will develop arthritis; however, almost one in five of those under 55 will also present to the medical services with problems relating to arthritis.
Dr Bresnihan estimates that extrapolating from UK data, the cost of arthritis in lost working days in Ireland is approximately 1.6 billion euro per annum.
Arthritis accounts for the largest category of GP visits, with 30% of GP visits relating to musculoskeletal disorders.
Approximately 60% of people with arthritis will be treated within the primary healthcare system while the remainder will require specialist services to deal with arthritis in Ireland.
He stresses that there is a significant burden of ill-health due to disability that is directly attributable to arthritis. For example, there is a 40% increased of heart attack in patients with rheumatoid arthritis.
Dr Bresnihan,in his submission, points out that rheumatology services to deal with arthritis in Ireland are limited.
An inadequate rheumatology service, he points out, results in critical delays in the diagnosis of common, treatable diseases and the failure to prevent disability, co-morbidity and death.
It also, Dr Bresnihan says, places unnecessary strains on already overstretched primary care and emergency services.
Large areas of Ireland are completely devoid of rheumatology services, according to Dr Bresnihan.
There are 12 rheumatology centres in the Republic-one in Navan;five in Dublin;one in Waterford;two in Cork;one under development in Limerick;one in Galway and one in Manorhamilton, Co.Leitrim.
The British Society of Rheumatology recommends that an adequate rheumatology service should consist of one wholetime equivalent consultant per 85,000 population.
In the Republic, however,the rheumatology service is provided by one wholetime equivalent consultant per 400,000 of the population.
Prof Oliver Fitzgerald, consultant rheumatologist at St Vincent’s Hospital in Dublin, told the Committee that at St Vincent’s, the waiting time for a patient who needs an urgent first consultation is three to six months.
The waiting time at St Vincent’s for a routine first consultation is nine to 15 months while the waiting time for a routine return consultation ranges from five months to four years.
Dr Robert Coughlan, consultant at Merlin Park Hospital in Galway, said of 871 arthritis patients currently waiting to be seen at Merlin Park, 213 patients have waited longer than four years and 244 have waited between two and four years.
Dr Fitzgerald said rheumatologists have recently met with Health Minister Mary Harney and the HSE, and it has been agreed to engage with consultants to examine the emergency situations where there are gaps in services around the country and to develop a more long-term strategy for arthritis care.
Mary Healy, of the Mayo Branch of Arthritis Ireland, told the Committee there is a nationwide shortage of consultants, physiotherapists, occupational therapists and specialist rheumatology nurses.
She said many people with arthritis feel suicidal as they feel so badly about the fact that they must wait four to five years to be seen by a consultant for the first time for a condition that causes them so much pain.
For more, visit the Irishhealth.com Rheumatoid Arthritis Clinic.
it seems that allthough a large no of people suffer from arthritis they do not seem to be as vocal as other groups hence lack of services
My brother suffers from arthritis and I have looked at him suffer in silence for over twenty years (he is now 44). recently he had to take time off work through his arthritis and signed on sick, he was called up be inteviewed by a Doctor in SWD and had a visiter to his home twice. When he wasn't at home the second visit (note they do not inform you of a time or date of visit) his was left a note which stated he must state were he will be at all times. He decided to return to work as he felt like a prisoner. It was the first tme he had taken more that a week sick in over twenty years????
It is an absolute disgrace that patients have to wait 4 years to have arthritis treated. The FF backbenchers revolt against the proposal for Cafe Bars and get their way. They should be revolting against this type of failure in public health services. It just shows where our priorities are. John.
That's because so many of them are elderly and in so much pain. People with arthritis are not likely to be able to march on the Dail! Just because people don't have the strength anymore to demand what they are entitled to doesn't mean they should be ignored. I have arthritis and if you think you can wait and take action when it matters to you then you're sadly mistaken. You won't be able to do much about it, like the rest of us now. You need to plan for your future and prepare for the worst while hoping for the best.
I have arthritis since 1985 (RA)and nothing seems to have change much G P'S WILL NOT SEND THE PEOPLE RHEUMATOLOGIST they wait,Yes sometimes even years before they send people.In my case after 6 years and a long fight ,all's well that end well so see RHEUMATOLOGIST ASAP'
As i understand it there are different types of arthritis. Rheumatoid arthritis (sp) - often referred to as rheumatism and osteoarthritis - referred to as arthritis, which generally is from wear and tear (as distinct from arthritis resulting from and autoimmune problem). It's interestign tho' that in Southerm Europena countries there seems to be a far lower incidence of arthritis. I wonder is it to do with out specific enetic make up or the fact that they have a much healthier climate.
I would like to discuss Juv arthriti, my son has it he is now 12 and has suffered for the last year with no relief from any medication
It seems to me we can talk for a long time about arthritis but as a long term sufferer (Juv RA) I believe we also need to accept that at this time there is no cure for it. We have an individual responsibility to ourselves to learn to live with it, control it and take control of our lives with it. Thats not to say we should shut up and put up, just take positive action to achieve the best possible results in the knowledge that this may be a lifetime circumstance. Having said that I sense that there is a sort of dismissal of arthritis as a health issue in general terms, an apathy towards it. As for the long waiting lists ~ perhaps we should all make appointments for our children now in the same way as we put them on school waiting lists! That way they can get into 'the system' in plenty of time.
There is ecvidence to show that an altered diet as well as gold injections into te joints and parafin waxing has provided some relief
I've been told by my GP that exercise (stretching in particular) along with walking for fitness purposes can help enormously with light osteoarthritis (the wear and tear kind). Where can I get a list of these "stretching" exercises in particular?
My mother (56) has had severe RA for the past 20 years, she is completely crippled with it and has never had any period of remission, yet in the past year she has lost her medical card. There is no cure for arthritis and she faces a future of more joint replacement surgery and endless amounts of medication. It is an absolute disgrace that arthritis is not a listed disease for a medical card.
I am a remedial massage therapist and have spoken to people suffering with both osteoarthritis and rheumatiod arthritis who have found this therapy helpful. Remedial massage may ease pain and/or improve joint mobility but you should ensure that you see a qualified remedial massage therapist. Try The Northern Institue of Massage, Bury, UK www.nim.co.uk they have training centre in cork and belfast, to obtain details of qualified therapist. Another organisation people may find useful would be The Arthritic Association Eastbourne, UK www.arthriticassociation.org.uk a registered charity aimed at relieving suffering by natural methods. 01323 416550
Are there any remedial massage therapists in the republic, other than in Cork.
I would suggest emailing the Northern Institute via their website for details of qualified therapist in the republic, or alternatively try the LCSP Register of Remedial Masseurs and Manipulative Therapist who should also be able to supply you with details of trained therapist in your area. www.lcsp.uk.com
Having had persistent pain in the shoulders, neck, upper arms, and hips,etc.for some time, I was finally diagnosed with PMR(Polymyalgia Rheumatica). The medication -Prednisone, worked within 24 hours and gave me complete freedom from pain! I started on 20mg tapering off to 5mg now. I am told there are side effects from the Prednisone. How long can I stay on the 5mg without serious problems?
I am 29 year old female and recently have been diagnosed with Osteoarthritis, has anyone any tips on dealing with the pain, the tablets help but dont keep it at bay all day it is making my work difficult. All tips greatly appreciated.
i awake every morning with my fingers so swollen i am unable to clench my fist any remedy at all to ease the pain
My wife aged 45 was diagnosed with arthritis and prescribed SALAZOPYRINE EN please note if anyone is using this drug insist that you are given regular blood tests to check level of white blood cells as this drug is responsible or my wife now having a terminal lung desease this drug can have serious side efects, wich the dept of health seem to ignore and stillrefuse to answer questions on if in doubt just check on any serch engine and see the dangers of taking this drug
dear sir. or madam. i am 57 and i have pains in every part of my body. most in my hands. the last from minits to hours.
My mother is due to have a shoulder replacement in 3 weeks time. Has anybody had one? If so I would be grateful if you could let me have your experience. she is just having the ball replaced the socket is ok. thanks
Hi All Suffering From Arthritis You should try syn-flex its great for fibromyalgia and all kinds of arthritis and it is a natural product with no side affects costs just 35.00 and they have Syn-flex Power+Plus power stick it gives instant relief you can call 041-9836019 to make an order. My mum has been using it for 2 years now and cannot live without it she is off all other medication. Syn-flex has no side affects. Give it ago Brenda
i have arthritis i have been on tablets called salazopyrin for the last 3 years i was just wondering do they do any damage to your health i take 6 a day
I am 47 and suffered from osteoarthritis since I was 27, When I turned 42 my condition got worse after epidural. I now have a neuropathy and myopathy I have been admitted to hospital several times and had lots of tests the doctors cant explain why my condition is getting worse and I have lost all hope. My life has changed dramitically it is effecting my work because I am in pain all the time and I have lost all faith in the medical profession.. Can anyone advise me as I do not have any support.
Is there any Cork based organisation where sufferers can meet and just have a social life. If not is there anyone interested in starting a group.
I am looking for information on anti-tnf medication and also on an alternative to aulin (I cannot take Difene). I am currently taking Salazopyrin, Deltacortril, Diazepam, Methotrexate (25mg) and Aulin. As Aulin has now been taken of the market my inflammation is really bad. My rhuematologist has decided to start me on anti-tnf and as I have had problems with previous meds I would appreciate any information I can get, any help at all would be great.
dear ian it frighten me to hear about your wife as i take this drug but i have my bloods done every month,but i will be looking into this more,as i take 6 tablets a day,
My Consultant told me after a consultation in September that my second hip would be replaced before Xmas. After several letters, phone calls, I've heard nothing. My neighbour as a private patient like myself was waiting 18 months, with the same Consultant. If I was mobile, I wouldnt mind waiting, but I cannot plan anything, as some days, I can hardly move. In the meantime, could somebody recommend a drug to put me out of this daily pain. If it was just my hip, it wouldnt be so bad, but I have pain all over. Maybe I should add, after I was discovered with Haemochromotosis, that I developed general Arthritis. Your views would be very helpful Thanks.
I have just been put on methotrexate for RA. Could anyone tell me if I can have a drink on this medication?
I have some idea of what you are going through as I have arthritis, but not as bad as yours obviously. I have heard on many occasions that "hash" is wonderful for this pain but I haven't tried it however, it the pain was as bad as you describe maybe a doctor could prescribe it for you apparently it can be added to baking etc. I hope this is of some help to you.
Best wishes from a fellow sufferer.
Hello Anonymous, it is not actualy legal to perscribe the substanbce you mention here in Ireland.
Thank you for telling me I actually didn't know that I am not out there mixing, and I thought that a Doctor could prescribe certain drugs not all would you believe a certain postman offered it to me Ha! I am nieve.
Do you have any suggestions for arthritic pain that is what I was trying to do in the first instance.
Thanks in advance.
No, it has not been decriminalised for medical use here, altho' it has in the UK as far as I am aware. You're welcome. I'm sure your GP would have told you anyway.
Oh I would certainly believe that it is out and about there alright.
Two things my grandmother, many many years ago, found helpful was parrafin waxing. They coat the joints in a liquid parafin apparently and that is supposed to get relief. Another thing she had done was gold injections - where they inject tiny tiny amounts of gold into the joint - it is a bit severe of a procedure but it really helped her.
It depends I suppose on the type of arthritis. It is is auto-immune or from waer and tear. For the latter, I believe you can have synthetic synovial fluid injected into the joint to replace the fluid your losing. It's done in hospital as a day procedure and don't worry it;s not as bad as it sounds.
Hope this helps,
Thanks for that information although I don't think I will bother I am obviously not as bad as the person I was answering. I never used hash to tell you the truth I never had the nerve but I have often heard it is indeed good for different diseases but on the other hand if my pain became unmanageable I would take up the postman's offer believe me. The old remedies are always there but some people think they are too bothersome, if the pain is bad enough you will do anything.
Thanks for your advice Maria,
Funny, but I never tried it either. I did hear tho that it is being used with great effect foir relief in MS in the UK.
I never heard anything about old remedies for arthritis. Could you tell us more.
What I meant by old remedies was the one you mentioned paraffin wax but it entailed soaking cotton strips (a couple of yards of cotton) in the paraffin and wrapping it around the affected joints then wrapping hot towels around the area, I remember my mother doing it. Also I remember filling a basin with very hot water and adding powered mustard for her and she soaked the cotton strips and applied them to her hands and knee, it must have worked because I remember she did it quite often. We also used it if we had colds fill basin with hot water and mustard and soak feet in same it was supposed to draw the badness down, how true I don't know, but for what it is worth.
About ten/twelve years ago I had gold injections into my shoulder but for some reason or another it didn't work for me. I think maybe if I got more walking in to my day I would be better but I can't say I enjoy it, I used to.
Enough for now I am rambling.
That's a pity that the gold injections didn't work for you. Another remedy my grandmpother had, now this is not strictly legit but sure I'll post it anyway. It was to mix poteen (she knew someone who could give her a little strictly for external application for medicinal use) mix it with olive oil, heat it to just about the point where it was bearable, then after a hot bath (when the pores ar open I suppose) rub plenty of it well into the joint and wrap a hot towel around it. Secure it with a bandage and wear it in bed until morning.
She swore by it. Of course she also swore by drinking nettle soup every spring and taking boiled root ginger for a cold
We're a right pair me suggesting hash and you suggesting poteen (I don't think I spelt that correctly) even worse I did try that and given time I always have the postmans offer Ha! Maria the type of arthritis I have doesn't even ease in the heat. I remember a long time ago a friend of mine he was a well known Singer/artist well he relocated to Australia because of the pain he was in and the climate was wonderful for him whereas mine gets worse in a hot dry climate, so I have given up, I can't use anti-inflammatories because of another problem I have. I am fine Maria.
All the best Anne
Did anyone ever try laser treatment? My father has very bad arthritis in his ankle and has tried lots of remedies to no avail. He decided to go for laser treatment, was told it would take 20 sessions at €60 a session. He went for around half a dozen times and told the "specialist" that it was getting no better who promptly left the room. My fathers chart was on a monitor (or something similar) and he noticed the recommended dose changing from 20 to 60!!! At €60 a session this is a lot of money. There and then my father decided it was nothing but a scam and has not gone bac since. I do agree with him but then I do see his ankle or the pain that he is in and it saddens me. Poor man can no longer go out for a pint 2 nights a week like he used to. So I'm wondering if anyone has benefited from this laser treatment and if it's worthwhile for my father to try them again. Perhaps with a different therpaist? Any advise appreciated, thanks.
Oh gosh, maybe I shouldn't have suggsted the poitin (think I got the spelling right tht time) but it did work for my grandmother.
Actually believe it or not, as a joke I was goign to suggest you move to the heat .
With regard to the anti-inflammatories, I would seek a second opinion on that as I would be very surprised at a doctor tellign you you couldn't use any anti-inflamatory at all, even externally. Difene gel I have heard is very good. Take care of yourself.
Sorry Billy, I never heard of anyone using laser treatment for athritis.
The reason I can't take anti-D's is because I had a kidney removed in '92, it was called a staghorn, apparently urea had been building up for a long long time and it was beyond repair. now apart from arthritis I have the urea in my feet they call it gouty arthritis my large toes have now fused. Mr. Casey told me that when a woman presents with gouty arthritis he asks when had she been on diuretic tablets and I had because of my High BP. I probably haven't explained too well but it transpires that I can't have anti-inflamatories because of my kidney etc. I also have problem with my thyroid. Maria I am a sitting miracle Ha!
Oh no, you poor woman, that's awful. You sound like you've been through a lot. Two friends of mine also suffered with uric acid builds up on their foot joints - as yoiu say, gout. But they manage to finds the trigger for it - fizzy drinks in one and any type of offal based meat in the other case so thankfully they avoid those completely and they're fine now.
I wonter would an external non-steroidal anti-inflammatory be ok to use? Your doctor will know best of course.
Snap! I also have problem with my thyroid. It's called Maria hashimotos auto-immune disease. Basically its hypothyroidism where my body is producing anti-bodies to my own throid gland - treating it's a foreign object or an invader. The anti-bodies then attack the thyroid gland. I am lucky tho in that it is treatable and I'm reasonably ok.
Thanks Chris, I had never heard of it either before my da went to get it done and haven't seen anywhere else carrying out laser treatment for arthritis. I guess we can write it off as a scam and be thankful that my father saw sense after half a dozen sessions.
Re the Gouty Arthritis, Mr Casey told me with my family history and the fact that my kidney was lost to the build up of urea. I asked Dr. Kane in Tallaght for his opinion and he agreed, he told me that there is a tablet coming on the market due in January and he will put me on it because despite the meds I am on now Allopurinol AND Colchicine I am still producing urea, and this tablet won't affect my remaining kidney.
Now regarding the thyroid I am on a tablet called Mimpara, my "kidney Doctor" said it would also help me with my depression, yes I have had that for years too. I had xray and ultra sound done and it showed that I had one of the parahypothroydism , Maria this is where I am totally out of my debth, in my neck one of the ?something (there are four) is enlarged, sorry I can't explain it better maybe you know, anyway all I know is I am so so tired all the time but P.G. next month may be better.
All the best Anne
Best of luck wiht the new tablets Anne. Mimpara, I haven't heard of but I think the parathyroiud glands are different to the thyroid gland. Unless I am mistaken, the parathyroid glands are situated just above the kidneys and relate to the adrenals and the thyroid is in the neck. They're all related of course becuase they're part of the adrenal system. I think in your neck, you might be referrign to the lobes. There are four lobes of the thyroid - it's kind of butterfly shaped, if that makes sense to you. I'vre had an ultrasound on mine and a biopsy too. Before I was treated I was permenently exhausted and also feeling a bit depressed so I can indentify there certainly. Well the best of luck.
I am waiting for an appointment to visit a Consulant Orthopaedic Surgen. In the last three years I have had trouble walking and had to attend my g.p. She suspected a disc problem. It did not show in the xray in November 2006. Then in March 07 I put out a disc at work and my Dr. said if I had anymore problems I would need a M.R.I. scan. Than last Janurary I began to get pain in my legs and hips. So my Dr. thinks it could be degeneration of the discs inthe lower back. I am really fed up waiting for an appointment to see a consulant find out why I am still like this. Sometimes I feel like a 70 or 80 year old I am so stiff.
I have been recently diagnosed with RA, am currently considering going on Plaquinal. Would be intrested to hear from anyone who has taken this drug. Have been going for acupuncture for the pain which is very effective, but find that my hands and arms are getting weaker. Am also taking Mobic, which also helps with the pain.
I was diagnosed with osteoarthritis 3-4 years ago after the birth of my last child, firstly it was IBS then B 12 definciency Pernocious Anemia then osteoarthritis in both my thumbs (it is so painful especially with a child to take care of). I went to a specialist and the only suggestion was either steroid injections or surgery... I declined on both (2 years ago).. Now its got worse and also have been diagnosed with hypothyroid and blood pressure up to 7.3.... Does anybody know if there is a connection due to IBS...? Doctor recommends taking tablets for hypothyroid and I am scared to go back to her for tablets as I dont like tablets due to all other things going on in my body. Has anybody got any knowledge on any of these for me