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Help for arthritic backs

If you are a fit young person but suffer from backache, talk to your doctor.

You may have Ankylosing Spondylitis, a type of arthritis which can strike relatively young people, mainly men, and is often not diagnosed for years.

That’s the bad news. The good news is a small team at Waikato Hospital are working together to diagnose and treat the disease.

Led by rheumatologist Dr Douglas White, and including physiotherapist Sarah Wales and clinical nurse specialist Trisha Holmes, all from the Rheumatology Department, the team are concerned many people are suffering in silence when help is available.

“We are seeing a third to a half of who we should be seeing,” says Dr White, who says data from overseas suggests AS affects about 1 per cent of the population.

“We are not seeing that and we could do a lot for these people.”

While this under-reporting is a concern it has risen sharply since a national advertising campaign last year which saw a 64 per cent jump in referrals from GPs

What is Ankylosing Spondylitis:
Inflammation of soft tissues around the spine, but also sometimes neck, knees and ankles Symptoms usually appear between the ages of 15 and 35 Affects 2-3 times more men than women, and symptoms usually more severe in men Strong tendency to run in families
When people with Ankylosing Spondylitis do get the right diagnosis they typically arrive at a Rheumatology Department’s outpatient clinic.

These are held twice a month, and provide information and support for patients. 

There is also a one-hour weekly exercise class at the clinic.

An extension of that is a three-month pilot course of hydrotherapy classes being run by physio Sarah at the hydrotherapy pool at Waterworld.

The pilot is being funded by a pharmaceutical company connected with the treatment of the condition.

While there is no cure, medication and exercise programmes can make a huge difference to the quality of people’s lives.

“The men really appreciate the group environment, with their strengthening and stretching.

The feedback has been very positive and the men say they can feel the benefits.”

Exercise and stretching help retain mobility and can stop the vertebrae fusing – the worst result of the disease.

In a worst-case scenario that fusion may mean a person can no longer drive and probably not work.

In a best-case outcome treatment will allow the person to lead a full, productive life.

DR Doug WhiteThis is why Dr White, pictured left, and his team want to get involved early in the process.

“This is a great team here,” said Dr White, whose research work in AS he hopes will help slash the diagnosis time down from the current seven years.  “That’s too long, and so much could be done in that time.”

Rheumatoid arthritis is usually diagnosed within months.

Physio Sarah agrees. “This is not as rare as people think and there are options for them.”

Nurse Trisha has done a lot of work supporting the clinics and patients, including creating a database to keep track of people’s progress. She too wants to see better and earlier outcomes for AS people.

“I lot of young guys blame sports injuries. But I see young fathers who can’t play with their babies – because of the back pain – so it has a huge impact on their quality of life.”



Lewis Bird works with Rheumatology Clinic physiotherapist Sarah Wales during a hydrotherapy session at Waterworld.

Lewis Bird is convinced trial hydrotherapy sessions for people with Ankylosing Spondylitis will get him back to work.

Lewis has battled the arthritic disease for 35 of his 46 years but kept on top of it until long hours at a desk and another health complication in 2006 forced him to give up fulltime IT work.

“But this is great,” he said during Waikato Hospital Rheumatology Clinic physiotherapist Sarah Wales’ weekly pool session.

There is no cure for AS but exercise is the key to keeping people mobile. Lewis also attends the weekly exercise clinics at the hospital but says land-based routines are “much harder”.

“It’s good to chat with other people here with AS too but that’s not a big thing for me. I like to get on with it.”

Lewis was just 11 when he was told he had AS, and thinks he was fortunate to get an early diagnosis. Many others put up with pain and deteriorating conditions for years before finding out the source. “So many people don’t know about it, they don’t know what they’ve actually got.

“There’s excellent support now, I wish that had been there all along,” he said referring to the Rheumatology Clinic’s AS programme.

“It’s been a battle but I’ve had a lot of support from doctors and my family.”

The Rheumatology Clinic’s one-hour weekly pool classes are a three-month pilot course being run by physio Sarah at the hydrotherapy pool at Waterworld in Te Rapa. The pilot is being funded by a pharmaceutical company connected with the treatment of the condition.

Lewis knows the benefits of exercise for AS suffers – and follows the “move it or lose it” line. He kept on top of it until the combination of longer hours, less sporting activities and hyperthyroidism made things too tough six years ago.

“Sitting at a desk and not doing exercise is not good for this condition.”

But he’s working hard at the clinic and pool. “I’m convinced it will get me back to work quicker.”




ENDS


Date: 27 November 2012

Contact:
Simon Brandon
Communications Consultant
Waikato District Health Board
021 712 663