Choose a medical condition that interest you and research it. Write about the possible use of hypnosis in the treatment of the condition as you see it. Osteoarthritis

The condition I have chosen is Osteoarthritis (OA). Arthritis means inflammation of the joints and osteoarthritis is the most common form In UK. It affects the joint cartilage and the bone tissue next to the cartilage. To appreciate the effect of this we need firstly to understand how the joint works. A joint is where two bones meet. Joints allow movement and flexibility of various parts of the body. The movement of the bones is caused by muscles which pull on tendons that are attached to bone.

Cartilage is a hard, smooth tissue that covers the end of bones. Between the cartilages of two bones which form a joint, there is a small amount of thick fluid called synovial fluid. This fluid lubricates the joint which allows smooth movement between the bones. The synovial fluid is made by the synovium. This is the tissue that surrounds the joint. The outer part of the synovium is called the capsule. This is tough and helps to give the joint stability. Surrounding ligaments and muscles also help to give support and stability to joints.

We know need to understand how osteoarthritis is caused. All normal joints and joint tissues are constantly undergoing some form of repair because of the wear and tear that is placed on them through our daily activities. However, in some people, it seems that this repair process becomes faulty in some way (perhaps because of severe wear and tear to the joints or a problem with the repair process) and OA develops. In joints with OA, the joint cartilage becomes damaged and worn. The bone tissue next to the cartilage can also be affected and bony growths can develop around the joint edges. These growths are called osteophytes and may be seen on X-rays. The joints and the tissues around the joints can also become inflamed. This inflammation is called synovitis.

Factors that may play a role in the development of OA include: * Age. OA becomes more common with increasing age. It may be that the state of the blood supply to the joint and the state of the natural mechanisms of repair become less efficient in some people as they become older. * Genetics. There may be some inherited tendency for OA to develop in some people. * Obesity. Knee and hip OA are more likely to develop, or be more severe, in obese people. This is because there is an increased load on the joints and a potential for more joint damage. * Gender/sex. Women are more likely to develop OA than men. Previous joint injury, damage or deformity. For example, this may include previous joint infections, a previous break in the bone of a leg bone, around the joint, or previous ligament injury that has caused the joint to become unstable. * Occupational overuse of a joint. For example, OA of the knee may be more common in elite athletes and elbow OA may be more common in people working with pneumatic drills. Who is likely to get osteoarthritis?
OA causes joint pain in around 8.5 million people in the UK. Primary OA develops in previously healthy joints. Most cases develop in people over 50. By the age of 65, at least half of people have some OA in some joint(s). It is mild in many cases, but about 1 in 10 people over 65 have a major disability due to OA (Mainly due to OA of one or both hips or knees). Secondary OA develops in joints previously abnormal for a variety of reasons. For example, it may develop in injured or deformed joints. This can occur in younger people.

Which joints are affected?
Any joint can be affected by OA but the hips, knees, finger joints, thumb joints and lower spine are most commonly affected. The shoulders, elbows, wrists, ankles, and toe joints are less commonly affected. In many cases, just a few joints develop symptoms with one or two becoming the most troublesome. In some people, OA develops in many joints.

What are the symptoms of osteoarthritis? * Pain, stiffness, and limitation in full movement of the joint are typical. The stiffness tends to be worse first thing in the morning but tends to loosen up after half an hour or so. * Swelling and inflammation of an affected joint can sometimes occur. (But affected joints are not usually very swollen, red or warm. If a joint suddenly swells up or becomes red or hot as this is a symptom that more commonly occurs with other types of arthritis) * An affected joint tends to look a little larger than normal. This is due to overgrowth of the bone next to damaged cartilage. * Deformities of joints due to OA are uncommon, but can sometimes develop. A person has poor mobility and problems walking if a knee or hip is badly affected. This may make you more likely to have a fall. * Bad OA that affects a person’s hip, you they may have difficulty in putting on shoes and socks and getting in and out of a car. In women, restricted movement of the hip can make having sex difficult and painful. * It is possible no symptoms may occur. Quite a number of people have X-ray changes that indicate some degree of OA but have no, or only very mild, symptoms. The opposite can also true. That is, a person may have quite severe symptoms but with only minor changes seen on the X-ray.

Some people with OA may develop other problems because of their symptoms. For example, pain can affect sleep for some people. Mobility problems may affect your ability to work and carry our family duties. Some people may get down or even depressed because of their pain and other symptoms.

The test to diagnose osteoarthritis based on age, typical symptoms and examination of affected joints. Tests such as X-rays or blood tests are usually not needed. X-rays or other tests are only done if the doctor is unsure about diagnosis and want to exclude other problems.

What is the outlook (prognosis) for people with osteoarthritis?
A common wrong belief is that OA is always a progressive and serious disease. The severity of symptoms varies. In many people, OA is mild, does not become worse, and does not make you any more disabled than expected for your age. However, in some people, the severity of OA and the disability it causes is out of proportion to your age. One or more joints may become particularly badly affected. Symptoms often wax and wane. Sometimes this is related to things such as the weather. Symptoms often improve in warmer months. A bad spell of symptoms may be followed by a relatively good period.

What are the aims of treatment for osteoarthritis?
There is no cure for OA but there are a number of things that can be done to ease the symptoms. For anyone with OA, the aim of treatment is to; * To help them to understand the condition and how to manage it. * To reduce any pain and stiffness. * To maintain or improve the mobility of your affected joint or joints. * To limit any joint damage. * To minimise any disability that may result from your OA. * To minimise any side-effects from drugs used as treatment.

OA is more common as a person get older but it isn't just part of getting older. You don't have to live with pain or disability. Various treatments may help and are discussed below.

General measures to help treat osteoarthritis;
Exercise
If possible, exercise regularly. This helps to strengthen the muscles around affected joints. To keep you fit, and to maintain a good range joint movement. Swimming is ideal for most Joints, but any exercise is better than none. Many people can manage a regular walk.

Weight control
If you are overweight, try to lose some weight as the extra burden placed on back, hips, and knees can make symptoms worse. Even a modest weight loss can make quite a difference.

How hypnotherapy can treat Osteoarthritis

Osteoarthritis can affect any joint although the most common are those of the hip and knees. The physical symptoms include stiffness of joint and pain. The extent of the pain can range from being mild to extremely very severe and can varying in degrees on a daily basis. It can lead to severe issues with mobility. Pain is a necessary alarm system to let the person know that something is wrong. Long lasting pain such as that caused by arthritis isn’t very easy to relieve. The pain from osteoarthritis can affects a person physically, emotionally and physiological. Mobility problems can make it difficult or impossible for a person to function well at work or at home. Getting in and out of cars, even putting shoes and socks on can become problematic. The changes causes by these conditions bring can create additional problems i.e. drive, travel on the bus, fatigue and financial difficulties. Theses in turn can result a multitude of emotions such as anger, increased dependence on others, low self esteem, fear, anxiety, negativity about the future failure (failure to stay as healthy as others, failure to enjoy sex because it is painful) isolation and depression. So managing the pain and the secondary issues which develop because of it, is essential, in order to ensure that the sufferer retains an enhanced quality of life and a sense of well being.

Hypnotherapy can help osteoarthritis suffer in several ways. Firstly, hypnosis can offer pain. It can help the sufferer live with their pain by reducing the sensitivity of the pain they perceive to feel, and by changing their attitude and their perception of pain. This can enable them to cope with symptomatic acute pain of osteoarthritis. Reducing the pain may help the person to reduce the drugs which they have to take in order to cope with the pain and swellings. Some drugs have side effects which can be quite unpleasant .So reducing the need for drugs will be better for the persons health. Hypnosis may even be able to directly reduce the swellings, inflammation and heat sensation produced in joints. Secondly it can help the sufferer to overcome the secondary symptoms such as anxiety and depression which also result because of the pain. Using hypnosis to relax can ease both anxieties, panic and reduces depression. Sleeping patterns can be disturbed as the sufferer may not be able to sleep because of the pain. Reducing the perception of pain coupled with relaxation can enable sufferers to get sufficient sleep.

Hypnosis can be used to promote a positive mind set and to remain mobile. One of the effects of pain is reduce the movement of the limb which causes pain but lack of use can make the muscles around the limb become wasted and weak, this will further decrease mobility and make the experience of moving more difficult. Exercise is important for general health but it is particularly important for the osteoarthritis suffer to exercise and strengthen the muscles around the painful joint as this helps to retain the mobility of the limb. Hypnosis can help the sufferer, to retain a positive mind and to motivate them to exercise even when they find it difficult and keep fitter and more supple and agile.

Being overweight can exacerbate the pain felt by the person. Reduced mobility can also cause the person to gain weight which will make not only the pain worse but could also knock their self esteem. Hypnosis can be used to help and motivate the sufferer to lose weight if this is an issue. Losing weight will not only help to ease the pain, encourage mobility but it can also promote a more positive self esteem.

Hypnosis can help the person to come to terms with their current situation and to remain positive. They may no longer be able to work as they want to or do the things that they use to. Dwelling on the negative feelings arising out the situation can result in feelings of isolation, anger, frustrations fear despondency and many other emotions which could lead to eventual depression. They could also have the spiralling effect of making the persons health deteriorates further. Hypnotherapy can be used it control and accept these emotions.

Hypnotherapy can help the sufferer to live actively in the society. The person may need to assess how they want to be presented to the outside world. If they are continually putting negative energy out into the world then that is what they will get back. As they learn to live with the boundaries that Osteoarthritis can put on them they may need to reassess their interaction on others and what they want to do with their lives. They may need help to accept and appreciate their personal qualities and what they have to offer to society. Hypnotherapy can help with this by assisting the person to look within and beyond their condition for inspiration and resolve.

Decreased mobility may mean that goals regarding work and leisure have to be adjusted to their current situation. Hypnosis can be used to alter their perception on these and reach a state where they can accept the reality of their situation and then seek realistic goals. Sometimes people become despondent and give up without trying because of the pain or anxiety and other emotions brought on by the anticipation of pain. They might stop even attempting things that they could probably still do i.e. walk to the nearby shop. Others may even stop going out altogether. Osteoarthritis can not only cause joint to stiffen but they can also give away. This can cause anxiety about falling over and leave the person feeling not only anxious but also venerable about their condition. Hypnotherapy can help to motivate the person to carry on working and trying to work within the boundaries that their condition places on them however care must be taken to ensure that the boundaries are physically and emotionally appropriate for them.

Pain and difficulty in moving limbs can cause the sufferer to become tired and deplete their energy, so that they can no longer cope physically and mentally with the demand made on them in their everyday lives. Some people may, particularly if they have previously been fairly independent, find it very difficult to accept help from others, even though it may be necessary. Others may be afraid to ask for help in case it is seen as a sign of weakness or because their own belief system has issues with it, particularly when external agencies are involved. Relaxations with the use of hypnosis can help the person to clarify their thought processes and put their problems into perspective and hypnotherapy can enable them accept help and support. Relaxation can also help to loosen joints which also help to reduce pain.

Hypnotherapy can help the sufferer live in the present. Chronic conditions such like osteoarthritis can challenge the person perceptions of the future and alter ideas about their own security. Sometimes the person may need assistance with living for today and letting go of the worry about the future that prevents them enjoying the moment. Hypnotherapy can help with this by allowing the sufferer to appreciate the world around them by using hypnosis to intensify their sensory perceptions of the world outside. This will enable them to notice the positive things going on around them.

Although, painful swollen joint and stiffness of the joints and mobility, are the main problems associated with osteoarthritis there are many other issues which can result as a consequence of these and which may impact the sufferer on personal, practical and emotional level. Depending on the severity of the condition, not only the pain but also the secondary issues can have an enormous impact on the way the person is able to live their life and on the changes that they have to make. Hypnotherapy can help the sufferer to adjust and accept the limitations and changes imposed by their circumstances in a positive way. Once the condition has been properly diagnosed hypnotherapy can also be used to reduce the pain and the physical symptoms which occur.

References:

Hadley,J. and Staudacher,C. 2001. Hypnosis for Change. New Delhi: New Age Books

Heap. M. And Dryden, W 1991. Hypnotherapy; A Hand book. Buckingham; Open University Press.

Karle H. And Boys , J.1987. Hypnotherapy: A Practical Handbook. London: Free Association books.