Your questions on hobbies and arthritis

Q) I’m nearly 80, have had both hips replaced and now my left knee has finally given way. My consultant recommended total knee replacement, and a second opinion confirmed that this was the only option. I am however, a keen gardener, grow plants from seeds and at present am able to kneel to plant out. I am very reluctant to have to say goodbye to my garden, but I understand that if not impossible then kneeling would be difficult after a TKR. I am not on regular medication, though self-dose when I expect to be particularly active. I am still in full-time secretarial work. I am keen to explore the possibility of any other therapy that may help me to keep me gardening.

Judith, Buckinghamshire - 2012

A) A remarkable story! Not many people at 80 work full-time and manage to keep up their gardening. And you are right – kneeling may become difficult after a knee replacement, although with time, this should be possible. If you can continue as you are, this would be the best plan, at least for now. Can you cope with regular painkillers, and have you tried using one of the new non-steroidal anti-inflammatory or capsaicin creams that you can rub on your knee? If you can control your symptoms better this way, then maybe you can postpone matters until you retire.

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

Q) I'm 75 and have arthritis in my hands and knees. I've always been a keen gardener, but I'm finding it hard to manage as well as I used to, because my joints are stiff and painful.

Do you have any advice on what I can do to keep enjoying my garden?

Wendy, via email - 2015

A) Gardening is a great way to get exercise out in the fresh air and can help to keep the muscles around the joints strong and the joints themselves supple.

There are plenty of things you can do to protect your joints while gardening. You can find useful advice in our gardening and arthritis information.

There are three main things that I would highlight.

Lifting safely

If you're lifting things, keep them close to your body to spread the load over the larger joints of your arms and use your thigh and bottom muscles. This helps to avoid putting too much stress through the smaller joints in your wrists and hands.

Use the right tools

Using the right tools in the garden can be a huge help. This can include:

• long-handled tools to avoid reaching or bending
• rubberised handles to improve grip
• garden stools to cushion when kneeling and give support when moving to stand up.

Plan ahead

Try to plan the gardening activity ahead so that you can pace yourself and mix repetitive movements with heavier work. This will help to avoid overloading your joints and causing pain.

Happy gardening!

This answer was provided by Dr Tom Margham in 2015, and was correct at the time of publication.

Q) My mum has just had a total hip replacement following a fractured neck of femur. She suffers from osteoporosis. Please can you tell me whether she will be able to ride as a passenger in my Mini?

Kate, Lancashire - 2013

A) Every so often there is a question that is almost unanswerable. This is probably one of them! I am aware that the 'new' Mini is not as difficult to get in and out of as the old one, and you don't say which model you have. I also know that full flexion of the hip is discouraged in the first few months after a new hip operation, and this might hinder getting out of a small car. Apart from that, it is difficult to say. If you can, try to discuss with your mother's physiotherapist before attempting it, but in the end it may just be down to trial and error.

This answer was provided by Dr Philip Helliwell in 2013, and was correct at the time of publication.

Q) Could you please advise me whether or not any research findings have been published suggesting that the fine and repetitious movements in knitting would worsen or improve the symptoms of arthritis in the hands and elbows?

Judy, Ipswich, Suffolk - 2010

A) There's a wealth of evidence relating fine and repetitious movement to pain in the upper limb, mostly the forearms. There's more evidence relating to arm posture, such as keeping the wrist bent in the same position for hours. However, this is most likely muscular pain, not arthritis. For people with pre-existing arthritis, there's little research evidence to rely on. My patients with arthritis of the hands often mention that knitting and sewing have become difficult, if not impossible, and we do as much as we can to enable people to get back to this activity. So, to answer your question, there are very few research findings on this subject, but I'd encourage you to keep going with this activity if possible. If you're finding it difficult, ask your local rheumatology team for help.

This answer was provided by Dr Philip Helliwell in 2010, and was correct at the time of publication.

Q) I'm wondering if you have any research knowledge regarding flying and air pressure on the human body, particularly osteoarthritis, or if there's any reason for not flying or only flying for a certain length of time. I recently had a total hip replacement which seemed to be aggravated by an 11-hour flight from London to San Francisco, followed by a 4,000-mile car journey. I realise that a person with osteoarthritis shouldn't stay in one position for a length of time. I'd appreciate any comments you can make or tips on any travelling I might do in the future.

Glenys, Edenbridge, Kent - 2007

A) There's research on the relationship between barometric pressure and pain in joint conditions. Patients sometimes tell me that they can predict deterioration in the weather, such as a fall in barometric pressure. The same mechanism may result in an increase in joint symptoms when flying, as the usual flying cabin pressure is equivalent to about 8,000 feet. In your case, I think you've correctly identified the enforced inactivity as an additional cause of your symptoms. Don't forget you probably did more walking around on your trip as well. On future long-haul flights, I'd suggest taking the advice of the airlines and keep your joints moving while sat in your seat, in addition to getting up for a stretch regularly. If possible, try and persuade the check-in people to give you a seat with extra legroom.

This answer was provided by Dr Philip Helliwell in 2007, and was correct at the time of publication.

Q) There seem to be conflicting opinions as to whether it's safe to put methotrexate injections through the airport security scanner. Can you advise please?

Eileen - 2016

A) It is safe to put methotrexate injections through airport security scanners. Most medications aren't affected by the low doses of radiation emitted by airport screening machines, even if they're exposed several times in a trip.

Certain anti-rheumatic drugs called biological therapies, such as rituximab or etanercept, require special handling and controlled temperature storage for travel, and travellers sometimes worry about putting them through the x-ray machine. But according to the US's Federal Drug Administration, any harmful effects from x-rays on these medications would occur only at doses significantly higher than the radiation received from airport screening devices.

If a drug's effectiveness or safety could be affected by airport x-ray screening, the danger will be indicated on the label or package insert. If you're still concerned, you can call the manufacturer of each of your medications. Otherwise, simply ask to have your carry-on bag inspected by hand and make sure your medication is in a bag that can be easily separated from your other carry-on baggage to reduce delays.

Remember, you should always carry medication in its original, correctly labelled packages and travel with a copy of your prescription. Read more on flying with medication.

This answer was provided by Dr Tom Margham in 2016, and was correct at the time of publication.

Q) Is it safe to do trampolining if you suffer from rheumatoid arthritis?

Julie, via email - 2015

A) If you have rheumatoid arthritis and are keen to try trampolining, it's worth considering the following:

• Take things slowly and consider learning with an experienced supervisor or coach who understands your condition.
• Avoid trampolining if you're experiencing a flare-up, which are periods of increased pain and stiffness.
• Avoid any somersaults or jumps where you could land on your neck. This is because some people with rheumatoid arthritis are affected by the condition the top of their spine, which makes the joints in the neck less stable and therefore more susceptible to spinal cord injury.

This answer was provided by Dr Tom Margham in 2015, and was correct at the time of publication.