Mental Health and arthritis: a complex relationship
In the latest issue of JointHealth™ insight, Arthritis Consumer Experts (ACE) reports on the important relationship between mental health and arthritis. People with inflammatory arthritis are more likely to experience mental health conditions such as depression, anxiety, and “brain fog” than the general population.
This issue of JointHealth™ insight will cover the following:
Relationships between depression, “brain fog” and inflammatory arthritis
Burden of depression
Recognizing and managing depression and anxiety
Prevent depression and anxiety
Love, sex, and arthritis*
*Please be advised that the content in this section contain graphics of “joint friendly” positions during sex and may not be appropriate for you or others in your household. The graphics are excerpted from the book, “Rheumatoid Arthritis: Plan to Win”, by Cheryl Koehn, Dr. John Esdaile and Taysha Palmer published by Oxford University Press, 2002.
In recent years, public and private health organizations in
Canada have invested in digital health technologies as a way to improve patient
experiences, outcomes and quality of care.
According to Valuing
Canadians’ Secure Access to Their Health Information and Digital Health e-Services,
a study commissioned by Canada
Health Infoway, there are four main types of digital health services:
Secure online platforms that allow citizens to access their personal health
– A patient e-service that allows patients and/or their caregivers the ability to
communicate with their healthcare team through secure e-mail or SMS messaging
visit – A patient e-service that allows patients and/or their caregivers the
ability to meet with their health care provider via a face-to-face virtual
encounter, through functions such as video calls
e-Rx Renew – A patient e-service that allows
patients and/or their caregivers to renew prescriptions
What are the benefits
of digital health?
Digital health is beneficial for health systems and
Canadians, particularly those living with arthritis. For example, digital
health services allow you to:
Avoid or reduce in-person visits to a healthcare provider’s office, helping you conserve energy and avoid prolonged periods of sitting in the car or public transit.
Increase productivity at work, as you are not taking time off work to see your healthcare provider.
Renew prescriptions online and see a history of past prescriptions.
Access care faster in rural and remote communities.
Access your digital health records, such as lab results. Many people with an inflammatory arthritis who are on a biologic or methotrexate get monthly blood tests. Monitoring these test results helps track disease activity and check that medications are not causing any issues.
In 2018, Canada Health Infoway conducted a national study on the value of digital health technology and found that Canadians collectively save $119 to $150 million every year from their use of virtual care and e-Services. Health systems save $106 to $134 million by reducing administration costs and helping Canadians avoid unnecessary in-person appointments, trips to the emergency room and medical errors.
How can I access
The Connecting Patients for Better Health: 2018 report provides the latest availability, use and citizen interest in accessing their health information online as well as digitally enabled health services (e-services). The report is based on the results of four public opinion surveys conducted between February and March 2014 – 2018. There is an increased demand for digital health services. The number of people surveyed who accessed medical records electronically doubled, from 7% in 2016 to 15% in 2018.
Canada Health Infoway, a non-profit agency sponsored by the federal government, is working towards improving access to digital health services in Canada. Many health care centres are also working independently to provide their patients with online services. Consider asking the receptionist to see if any e-services are available at your healthcare provider’s office. Here are some examples of digital health services currently available in Canada:
In some provinces, patients have access to their medical records and or lab results online:
Arthritis ID is an app for patients that provides information to help detect, treat and manage arthritis. There is an interactive arthritis screening tool and questionnaire that will help you determine indications of a type of arthritis.
JointHealth™ Medications Guide enables patients to have a meaningful conversation with their rheumatologist and pharmacist about available therapy options, side effects and route of administration.
JointHealth™ Education courses help people living with arthritis learn to have more meaningful, fact-based conversations with their rheumatologists, other health care team members, families, friends and employers.
The Biosim•Exchange is an information hub for consumers to get the latest biosimilars news to help patients learn more biosimilars and their place among inflammatory arthritis treatments.
Arthritis Research Canada’s ANSWER: Decision Aid for Patientsaim to help you decide if methotrexate is the right treatment option for you. You should use this tool only if you have rheumatoid arthritis and if your doctor has suggested methotrexate as a treatment option.
Much has been said and written about the importance of exercisefor our health and wellbeing. However, for people with arthritis, it also can help manage symptoms. While people with arthritis may be reluctant to exercise fearing joint damage, exercise is especially crucial for people living with all forms of arthritis disease. In fact, exercise is a vitally important part of a well-rounded arthritis treatment plan.
For people living with arthritis, pain, body weight, age and lack of knowledge about appropriate types of exercises may be hurdles to getting started on an exercise program. Another barrier is the lack of recommendation and referral for exercise by physicians. A Canadian study of osteoarthritis patients showed that only one third had been advised to exercise by their doctor. However, exercise has numerous physical and mental health benefits and there are no specific exercises that should be avoided by people with arthritis.
One of the most important benefits of exercise is weight management, which helps to improve body image and can improve the symptoms of arthritis, especially of osteoarthritis. If a person is heavier than their ideal body weight, even a small amount of weight loss can help reduce both the risk of developing certain types of osteoarthritis and the chances of osteoarthritis worsening with age.
For everyone, exercise helps to improve heart and lung function, but for people living with arthritis, a variety of types of exercise can help to reduce joint pain and control joint swelling. These include:
Range of motion exercises help to keep the joints mobile and are also useful for helping to prevent injuries.
Weight bearing exercises can decrease bone loss, keep weak joints stable, and reduce the risk of osteoporosis.
Aerobic exercises, such as walking, help with weight loss. As well, exercise can help make it easier to fall asleep and to sleep more soundly.
In addition to improved physical health, exercise has many psychological benefits. Pain can seem more pronounced when we are unhappy or upset and exercise can help reduce depression. Additionally, it can improve self-esteem and self-confidence, improve the ability to relax, improve mood and wellbeing, and promote a good body image. Exercise also provides a good outlet for dealing with stress and anxiety.
Research suggests that most types of physical activity do not cause or worsen arthritis. In contrast, a lack of physical activity is associated with increased muscle weakness, joint stiffness, reduced range of motion, fatigue and overall reduced physical fitness.
Once a regular pattern of exercise has been established, it is important to maintain this pattern.
In order to get the benefits of exercise, it is vital to stay active.
Research shows that in people with osteoarthritis, once exercise stops, the reduced pain and disability they were experiencing ends.
To ensure that you keep up with a routine of exercising, consider joining a group program or bringing a friend or family member along to motivate you.
Eight ways to get started exercising:
Try to choose a type of exercise, or an exercise program, that you enjoy. It will be much easier to stick to the program if you like what you are doing. Most types of activities are helpful for people living with arthritis, so feel free to do your favourite things such as walking, swimming, golfing, or gardening. Exercise doesn’t have to be strenuous or boring to be good for you.
Community centres can be a terrific resource. Flip through the lists of classes offered at your local community or aquatic centre to find activities that best suit your interests and physical abilities.
You may find that having a partner to exercise with will be more motivating. Research tells us that people are more likely to stick with exercises if they bring along a friend or family member.
Sometimes, having a detailed list of activities and realistic goals will help motivate you, so it may be useful to get a referral to a physical therapist to create an appropriate exercise regimen that suits you and your body. Also, keeping an exercise log can help you and your therapist monitor your progress.
For some, assistive devices such as splints or orthotics may be helpful for protecting your joints while you exercise. An occupational therapist can be a good resource.
Before beginning a new exercise program, it is a good idea to speak with your doctor or health care provider to determine the most appropriate exercise or activity for your needs and capabilities. Also, be aware that during flare-ups it is important not to over-stress and over-work joints, which may cause more pain. For this reason it is important to speak to your doctor about exercise and the types of exercises most suitable.
Try setting a firm goal and then rewarding yourself when you achieve it. For example, set a goal of swimming 5 laps. When you reach that goal, reward yourself, and then set a new goal of swimming 10 laps. Rewards can be anything that is meaningful to you: setting aside time for yourself, treating yourself to a massage or a good book, or going out for a meal with friends.
Acknowledge your effort. Be proud of yourself for taking an active role in your health care.
A time to give thanks, reflect on the past, and look forward to the future
“’Tis the season” when our thoughts turn to sharing, caring and remembering; a perfect time to thank all of Arthritis Consumer Experts’ members, subscribers, research partners and supporters for their ongoing engagement and support. Together, we remain committed to helping people living with arthritis across Canada through research-based information and education.
“When you help a person living with arthritis, you are passing on the message that “you are not alone, we are with you, don’t be afraid.” That message needs to be shared not just during the holidays, but throughout the year.
Today, arthritis is Canada’s most prevalent disease and it’s far more serious than most people realize. Approximately six million adults – one in five – have doctor-diagnosed arthritis. Two-thirds are under the age of 65. Arthritis and musculoskeletal conditions are the leading cause of work disability in Canada. In other words, we are a “big deal” to the health care system and to society.
In 2019, ACE will remain focussed on helping all Canadians living, playing, working and raising families with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, osteoarthritis and the many other forms of the disease. As it has for the past 20 years, our work will reflect your needs and aspirations. As Canada’s largest and longest running patient-led arthritis organization, we will continue to fight for the rights of people living with the disease; to work with healthcare professionals and governments to develop services and policies that reflect a world as seen through our eyes and experiences; to inform the implementation of models of care to better help patients like us in their disease journeys; and to volunteer and work side-by-side with Canada’s brightest arthritis researchers and knowledge translators.
Over the past two weeks, you’ve graciously shared your wishes as part of ACE’s #MyArthritisWishList social media campaign – sincerest thanks for your participation in this fun and inspiring campaign. Your wishes remind us that when you live with arthritis, that means “every day, all day.” For many of us there are days with no break from pain, stiffness, depression, relationship challenges; the list is long. Yet, despite it all, we rise above from a deep reservoir of resilience.
“The worldwide arthritis community is my hero.”
Every day, I’m constantly inspired by our arthritis community, made up of people who are brave, funny, brilliant, insightful, industrious, and so many other wonderful qualities. People trying to be all that they can be, while also trying to kick arthritis to the curb. The worldwide arthritis community is my hero.
On behalf of everyone at ACE, I wish you joy and peace this holiday season.
Sincerely Cheryl Koehn Person with rheumatoid arthritis Founder and President of Arthritis Consumer Experts
Arthritis Consumer Experts’ Year in Review
In 2018, Arthritis Consumer Experts (ACE) worked to improve the lives of people living with arthritis through education, empowerment and advocacy. With help from the arthritis patient community, healthcare professionals, researchers and partner organizations, ACE submitted patient inputs to CADTH and provincial drug plans, participated in conferences, workshops and webinars, launched JointHealth™ Education Advanced Therapies, provided updates from the American College of Rheumatology and European League Against Rheumatism annual meetings, and advocated on behalf of our community with public and private health policymakers.
Thank you to our members and subscribers for making 2018 one of the best years yet! Here are the monthly highlights from this year and some holiday tipsto get you through the rest of the year.
Do you want to travel pain-free? Do you wish there were more ways to help people living with arthritis? Share your wish list with us this holiday season!
For this year’s holiday campaign, Arthritis Consumer Experts (ACE) is asking you to share your arthritis wish list using our campaign hashtag #MyArthritisWishList. ACE will do the same, and hope that through continued community sharing, research and medical advances are possible. Here are a few wishes from last week:
“I wish my family doctor would make arthritis resources available in the waiting room.” – ACE Subscriber, #MyArthritisWishList
“My daughter lives with rheumatoid arthritis and buses to school every day. She gets dirty looks when she asks for a seat. I wish people understood that arthritis is an invisible disease.” – Concerned mother, #MyArthritisWishList
To participate in the #MyArthritisWishList campaign, please:
Send an email to firstname.lastname@example.org and tell us your arthritis wish or wishes
Share your wish on our Facebook or Twitter and include the hashtag #MyArthritisWishList
Share, like, and comment on #MyArthritisWishList posts
We will provide a #MyArthritisWishList summary on January 8, 2019, and promise to use it as ACE’s guiding light for our advocacy, research and information programming over the next year.
Here’s to speaking out and working together to make everyone’s arthritis wishes come true!
Do you have moderate to severe rheumatoid arthritis? We need your valuable input.
The Common Drug Review (CDR) is currently welcoming patients and their caregivers to provide input to patient organizations on the manufacturer’s submission for baricitinib (Olumiant®) for moderate to severe rheumatoid arthritis.
The CDR is part of the Canadian Agency for Drugs and Technologies in Health (CADTH). The CDR conducts objective, rigorous reviews of the clinical and cost effectiveness of drugs, and provides formulary listing recommendations to the publicly funded drug plans in Canada (except Quebec).
To help them make their recommendations, the CDR accepts input from patient organizations and groups, like Arthritis Consumer Experts (ACE). Because patient input is vitally important to government decision-making about medications, we would like to gather your views and share them with the CDR.
If you live with rheumatoid arthritis or care for someone with rheumatoid arthritis, please send us your input by Wednesday, January 16, 2019, so that we may make a submission by the January 18th deadline. Your input will be anonymous.
Please submit your input by completing the questionnaire below or contact us at email@example.com to provide your input or arrange for a phone interview at 604-974-1366.
Arthritis is the most common cause of work disability in Canada, resulting in both poor quality of life and workplace limitations. ACE members have told us about the challenge of managing workplace responsibilities while managing their disease, including symptoms such as pain, fatigue, and stiffness, often with a gradual loss of physical function.
According to Statistics Canada, the estimated annual cost of workplace disability from arthritis and musculoskeletal conditions is $13.6 billion. Studies have also shown that many people diagnosed with rheumatoid arthritis (RA) are forced to leave the workforce prematurely and earn less than those living without the disease.
This issue of JointHealth™ insight covers the important topic of arthritis in the workplace, and includes:
A discussion on the 2018 winners of Canada’s Best Workplaces for Employees Living with Arthritis award: The Government of Yukon and Université de Montréal.
A look at the impact of arthritis on the Canadian work force, and common challenges faced by employees with arthritis.
A special interview with Dr. Lacaille about her online education program, Making it Work™. The program is designed to help people with inflammatory arthritis deal with employment issues related to their disease.
RSVP by November 23! Register for this free event to hear and learn from inspirational women living with arthritis and leading health professionals!
Event date: November 26, 2018 Location:
The Westin Bayshore (Salon Ballroom D&E)
1601 Bayshore Drive,
Vancouver V6G 2V4 Free Registration:ramattersatwork.eventbrite.com Please RSVP by November 23, 2018.
300,000 Canadians live with rheumatoid arthritis (RA), and women are affected two to three times more often than men. For many people living with RA, career continuation and advancement can seem out of reach.
To help illuminate the accessibility of career progression for people with chronic diseases like RA, Women in Biz Network and Eli Lily Canada are launching a nationwide series of empowering events called RA Matters at Work.
Join them in an evening of lively discussion among a community of inspirational women living with arthritis. Speakers will share stories of difficulty and triumph while thriving in the workplace, and challenge the negative beliefs and self-doubt associated with living and working with a chronic disease.
Come learn from experts in rheumatology about advances in preventing work disability for people with inflammatory arthritis. The event will be moderated by ACE founder and president, Cheryl Koehn. Panelists include:
Dr. Diane Lacaille – Associate Scientific Director and Senior Research Scientist of Rheumatology, Arthritis Research Canada
Ms. Spencer O’Brien – Canadian Olympic Snowboarder, 2016 X Games Gold Medalist, 2 x World Champion, Olympian, person living with RA
Ms. Maya Joshi – Program coordinator, Arthritis Consumer Experts
Ms. Flora To-Miles – Managing Editor of Occupational Therapy Now, The Canadian Association of Occupational Therapists
Ms. Alison Stewart – Registered Rehabilitation Professional, Arthritis Research Canada Making It Work Research-Practice Program
The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”.
Pain is your body’s warning signal, letting you know that something is wrong in your body. When part of your body is injured or damaged, chemical signals are released that travel from nerve system cells (called neurons) to your brain where they are recognized as pain.
The future of arthritis care and the next generation of arthritis specialists
The Arthritis Alliance of Canada has looked carefully at how patients with arthritis receive timely diagnosis and treatment. Central to ensuring timely care is making sure there are adequate numbers of rheumatologists for making an early diagnosis and starting appropriate treatment. In 2015, the Canadian Rheumatology Association conducted a national workforce survey of rheumatologists across Canada. The survey found there is a current shortage of rheumatologists across the country that may worsen over the next 10 years because a third of the workforce reported plans to retire in the near future. This will occur at the same time as an expected increase in the number of arthritis patients within the next generation. Continue reading →