Arthritis affects around 10 million people in the UK and as well as causing pain, stiffness and loss of function, can also lead to feelings of isolation, anxiety and depression.
Anxiety and depression can significantly affect how well people with arthritis function and what will happen to them in the future. People with osteoarthritis of the knee and who have anxiety and depression and fear of the pain of arthritis have worse function than people who are not depressed or anxious. These feelings can lead to reduced levels of activity, more pain and potentially more isolation and depression in an ever-declining vicious circle. They are also three times more likely to not take their medicines as instructed, and may therefore be at higher risk of future joint damage and disability.
That is why improving mood and anxiety for people with arthritis should be a priority as it can be an effective way of improving function, reducing pain and improving outcomes. One therapy that has been considered to reduce stress in long-term physical conditions is mindfulness-based stress reduction (MBSR).
Mindfulness is a form of meditation derived from Buddhist practices. It is currently very fashionable but has actually been practiced in the West for more than 30 years, and for thousands of years if counting the link to Buddhist meditation. Mindfulness is a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts and bodily sensations.
The first MBSR programme was developed by Jon Kabat-Zinn at the University of Massachusetts and was designed to help people in hospital deal with pain and other emotional issues. Although the programme has been used since 1979, it is only recently that researchers have become interested in whether mindfulness works and if so, how this might happen.
In clinical studies, mindfulness has been shown to help with anxiety and depression and can also help some people with the pain and distress of arthritis, as well as back and neck pain.
Mindfulness may also help people with rheumatoid arthritis as it improves pain and stiffness, which leads to improved feelings of well-being, ultimately improving function and quality of life in the long-term.
Mindfulness is recommended by the National Institute for Health and Care Excellence (NICE) for some people with depression and you should ask your GP if this applies to you. The official MSBR course is an 8-week course taught by certified trainers but it is possible to learn some simple mindfulness techniques at home using a free introductory online course on the Mental Health Foundation website or the introductory meditation app offered by Headspace.
UK charity Arthritis Action encourages people with arthritis to explore self-management techniques to empower them to deal with the pain and stress associated with the condition. Mindfulness is one of those techniques which can help them achieve a sense of well-being and a positive outlook on life.
Wendy is a Consultant Rheumatologist at North Hampshire Hospitals NHS Foundation Trust and UK Charity Arthritis Action's Medical Advisor.