Your questions on aids and equipment

Q) I'm 55 and have arthritis in my knees and hands. At the moment, my knees are particularly painful. I am looking for a knee support, but there are so many different ones on the market, so I was wondering if you could recommend one.

My husband and I like to go walking, but I'm struggling at the moment.

Liz - 2017

A) Sorry to hear you're struggling at the moment, but you're doing the right thing by keeping moving and not giving up on your love of walking.

Knee braces and supports are recommended as an add-on treatment for osteoarthritis of the knee in the National Institute for Health and Care Excellence (NICE) guidelines. There are lots of different options on the market and the main functions you need to look out for are:

• additional stability
• compression support
• comfort.

Devices range from simple neoprene supports right through to mechanical hinged braces, and the choice of which one is best often relies on what you'll be using it for and the parts of the knee affected by osteoarthritis.

The NICE guidelines do suggest assessment to advise on the most suitable type of brace. This assessment could be done by a physiotherapist. Most importantly, you should try on the options available to you and see what they're like in the real world, as you are looking for a solution to aid your mobility and reduce your pain levels.

If you're a keen walker, it's also worth considering purchasing a pair of walking poles, as these do reduce the load passing through the knees significantly and offer additional help with overall balance.

This answer was provided by Dr Tom Margham in 2017, and was correct at the time of publication.

Q) I have osteoarthritis in my fingers, mainly my left hand index finger (why that one specifically I don't know) and I type for a living. Is there anything I could use to support my finger while typing, so it doesn't ache so much?

Lorna - 2017

A) Simple, inexpensive, one-finger splints are readily available online, but if you’re not confident about choosing one, an occupational therapist or hand therapist should be able to give you advice on the best one for you. Your GP should be able to refer you to see one of these therapists.

It would also be a good idea to:

• consider investing in an ergonomic keyboard that reduces strain on the wrists, hands and fingers
• make sure your chair and desk are at the right height, so you have an overall relaxed posture in your neck and shoulders
• adjust your chair so your hips and knees are at right angles to give you good support for your lower back.

This answer was provided by Dr Tom Margham in 2017, and was correct at the time of publication.

Q) Approximately four years ago, I fell and broke five bones in and around my ankle. Following surgery and a speedy recovery, I later developed arthritis throughout the ankle area. Obviously, this was very unpleasant and painful, particularly in the cold Canadian winters. Earlier this year, I put a whole-house water filter in my house, which among other things removes chlorine from the water. To my surprise, I've not felt any arthritis pain since installing the water filtration system! To your knowledge, is the absence of chlorine and diminished arthritis related? For example, as I write, it's minus 30 degrees (without the wind chill), and I have no pain whatever.

Ray, Moose Jaw, Saskatchewan - 2009

A) I've not heard of this one before. It's well known that a fracture involving a joint can lead to arthritis in that same joint after a number of years. You sound to have developed symptoms of arthritis quite soon after the accident. I don’t want to appear sceptical, but I wonder if the symptoms you had in the ankle following the severe injuries were due to the trauma and that these symptoms have improved with time, as they do. However, having said that, the good news is that your pain is gone and whether it was time (as I suggest) or chlorine elimination (as you propose) doesn’t matter. On another note, you don’t give personal details such as age, but has anyone considered the state of your bones generally? People living in very northern latitudes, such as you, are susceptible to vitamin D deficiency, which can cause a fall in bone density. Enjoy the rest of your winter.

This answer was provided by Dr Philip Helliwell in 2009, and was correct at the time of publication.

Q) I have arthritis in one knee and in my hands and I regularly swim (not breaststroke) up to a mile about five times a week. I use flippers on my feet and paddles on my hands – is it advisable to use these aids?

Esther, Eastbourne, East Sussex - 2012

A) If you don't experience any reaction to the swimming, such as knee pain and swelling, then I think you're fine to continue pounding the pool as you do.

The fact that you're exercising at all is to your advantage. I note you're, correctly, not doing breaststroke (which is generally not recommended with knee problems).

This answer was provided by Dr Philip Helliwell in 2012, and was correct at the time of publication.

Q) Why does the pain in my arms, feet and legs increase as the sun goes down and become more and more severe as the night progresses? I usually regard the approach of dawn with a mixture of relief and dread, as getting out of bed is agony. Any information or advice you can give me will be really welcome.

June, Norbury, London - 2012

A) Physicians are generally interested in the periodicity of patients' symptoms, as it may provide a clue to the underlying illness. Inflammatory arthritis is generally much worse in the morning and late in the evening. Patients with inflammatory arthritis also complain of stiffening up overnight and may be woken with night pain. This may in part be linked to the natural rhythms of the body, and how much of our own cortisone we make (generally less at night). Inactivity also probably contributes, but one of the more significant factors at night is that there is nothing else around to distract you from your joints and muscles! How can you deal with this? It is your doctor's job to ensure that your arthritis activity is kept well under control, and this is the prime concern. In addition, it might help to take a hot bath before retiring, to relax your muscles and sooth your joints. Try taking a long-acting (12-hour) painkiller or anti-inflammatory tablet in the evening to ensure adequate control of your symptoms overnight. Some patients of mine even plan to get up during the night to reduce the amount of morning stiffness, but that's taking things a little far, I think.

This answer was provided by Dr Philip Helliwell in 2012, and was correct at the time of publication.