STUDY OF ARTHRITIS IN YOUR COMMUNITY Arthritis Study Update Spring 2007 This newsletter provides regular updates on Upcoming Research Projects in the Study of Arthritis in Your Community and Osteoarthritis Pain related topics. It is provided to past and present study participants as well as individuals who have expressed an interest in our research.
During the last couple of years, we have asked
lots of questions about osteoarthritis (OA) pain.
Advancing Surveillance of
What does the pain feel like? Where does it hurt? How does it change over time? How does
Arthritis in Primary Care
it affect your life? It seems that the more we
learn about OA pain, the more questions we
According to the 2001 Canadian Community
have! Is it similar to other painful conditions?
Health Survey, approximately 91% of How does it vary over the course of the day? We Canadians have seen a primary care physician
are interested in exploring all of these questions
in the prior year. It has been estimated that 1 in
in an effort to better understand OA pain and
5 visits to primary care physicians is for
ultimately improve treatment options. The more
arthritis. Dr. Hawker and her colleagues believe
information we have about OA pain, the greater
that since primary care physicians follow their
our ability will be to find ways to manage OA.
patients for many years and play a key role in
health promotion and disease prevention, the
We have several new studies planned for 2007
primary care setting is the best environment for
that will explore the arthritis pain experience
characteristics of OA pain in more detail.
We are just about to start a new project,
Historically, OA pain has been presumed to be
the result of tissue damage in the joint. More
Canada, that will create an arthritis recently however, OA pain is being attributed surveillance registry using the Women’s not only to joint-tissue damage but to possible College Hospital Family Health Team, one of
neurological (nerve-related) mechanisms. Pain
the largest primary care provider teams in
that results from nervous system problems is
Canada. This registry will provide called neuropathic pain. Dr. Jackie Hochman, a comprehensive data on the nature and rheumatologist and MSc candidate at the impact of arthritis at a primary care level that
University of Toronto, is studying the link
would be too costly to collect on a national
between OA pain and the nervous system. Her
basis. The surveillance data will be used to
research will take an important first step toward
raise awareness of arthritis among identifying the relationship of pain symptoms to Canadians. It is hoped that this information
nervous system signs in patients with knee OA.
will inform policy development, on issues
As effective medications exist for the treatment
such as reimbursement for physical therapy,
of neuropathic pain, the identification of this
type of pain in patients with OA could lead to
improved treatment and quality of life, and
reduced disability among people with OA.
Interviews for the Study of Arthritis in Your Community
We are also just beginning a new clinical research study. This 16 week long study will
assess the effectiveness of duloxetine for
phase of The Study of Arthritis In Your Community is focusing on the pain and
fibromyalgia, depression and pain associated
with peripheral diabetic neuropathy. There is
have contacted us to let us know that you
evidence to suggest that it may be an effective
haven’t heard from our study interviewer in
way of helping to reduce OA knee pain. This
effectiveness and safety of duloxetine for
We know that one can experience pain and
treating OA pain among men and women aged
people tell us that they find it difficult to
If you are interested in learning more about any
of these projects, please contact the study
fatigue from that of other conditions. As a
office at (416) 323-6218 and we would be
New Consumer’s Guide
In order to meet our study goals, it is very
to Arthritis Medication
important that we clearly document the experience and consequences of living
with OA. As a result, in the past two years,
we have not been interviewing individuals
guide reviews the continued interest in the study and look
medications and therapies that are currently
available for treating osteoarthritis and
This 44-page guide is designed to answer
interviewed in the past year, we would like
common questions about arthritis to thank you again for contributing your
medications. It is not intended to replace your
time and for sharing your experiences with
speak with your doctor for a proper diagnosis
questionnaire, so you can expect to hear
and to discuss the treatment that is best for
If you have any questions about TheStudy of Arthritis in Your Community, or anything
Canadian Rheumatology Association and can
please feel free to contact us at: (416) 323-
be accessed on the Arthritis Society’s
website at www.arthritis.ca/publications. Are you a Martha or a Henry?
medication regularly, take less than the amount
prescribed, or sometimes don’t take it at all!
People like Martha and Henry often belittle
their pain saying it comes with age, or they
state they have a high pain tolerance. They
make fun of their pain. They personify it and
fight it. They avoid social outings and exercise
because of it. They fear they may become
addicted to pain medication. They say they are
not as badly off as they could be while they
don’t think their friends should have to suffer
any pain. They feel that their pain is not life-
threatening so it becomes part of their life.
They feel proud if they have not given in to it.
They say there is nothing they can do about it
even though they have not experienced the
possible pain relief that might be forthcoming
highlights arthritis research being done across
by taking their pain medication (prescription or
Canada. Copies of previous issues of “OA and You” can be accessed on our website
Because of the pain, Martha and Henry can’t
tie their shoelaces, can’t comb their hair, can’t
Martha and Henry grew up in the 1930’s and
walk more than a few steps and can’t get
1940’s, so they’re in their 70’s now. People like
enough sleep. OA pain has affected their social
Martha and Henry have been the subject of
life and makes it difficult for them to exercise.
many studies by the researchers of the Pain
As a result, they are unable to take advantage
and Fatigue in OA - New Emerging Team at
of the physical, psychological and social
Dr. Gillian Hawker’s Canadian Osteoarthritis
benefits that are often realized if pain is
pression years, those years when you didn’t
culturally diverse groups is necessary, but to
buy things you didn’t need, when you saved
benefit the current Martha and Henry subjects,
new clothes for “Sunday Best”, when you ate
researchers conclude that it is necessary to
all that was on your plate and wished for more,
when you looked out for others who might be
prescribed. The “take as needed” instruction
suffering, and when you would spend an hour
may be one of the reasons that Martha and
to pick up a dropped penny through a crack in
Henry don’t take pain prescriptions or over-the-
the wooden sidewalk. In the depression years,
counter pain medicine efficiently. Researchers
Martha and Henry saved and saved, they were
think that people with OA should be more
self-reliant and they “made-do”! These habits
closely observed for disabling pain by their
served them well through the years, but now
that Martha and Henry have OA, some of those
habits may not always serve them so well.
Henry is that failure to adhere to treatment
recommendations for pain medication means
that they are achieving less-than-satisfactory
arthritis Research Program shows that Martha
pain relief. This results in significant loss in
and Henry may suffer needlessly from OA pain
quality of life to themselves and their families,
and costs to the Canadian health care system.
Japanese or Mexican – often just as cheap and
In order to provide an appropriate level of pain
better for them than ‘fast food’. Cooking
relief, people living with OA, like Martha and
together could ignite a child’s life-long interest
Henry, and the clinicians that treat them need
in feeding him or herself well. Pick a recipe and
to address the reasons why pain medications
shop together, but make sure you’re not rushed
are not taken in the ways recommended to
together: let the child pick the seeds and it
Spring Fun with the Kids in Your Life!
Many kids these days lead lives just as hectic
and as tightly scheduled as their parents’. But
with the arrival of spring, and summer coming
up quick, the children in your life will be looking
something their parents don’t have much of –
free time! Here are some tips on ways to have
appropriate to the child’s level, one that appeals
fun that may fit your lifestyle and your budget.
to their imagination, or invent your own games. Excursions & Events: Information on free
Reading & Learning: Approach it in a relaxed,
activities in your community is available on the
unstructured way and kids may delight in
Internet, in the newspaper, at the local picking up some sign language, foreign community centre, library or bookstore. phrases, or learning about astronomy, plants, Museums and galleries often have one insects, you name it. Once you’ve found afternoon or night a week that is free, and with
something of interest, get a few books from the
a membership (often available at reduced rates
for seniors or families), you frequently gain
admission to affiliated institutions, attractions
A Few Final Tips: Be prepared to improvise. A
and events. Go on a discovery walk in a park,
visit with a grandparent, favourite aunt, uncle,
or family friend, shouldn’t be just another
different animals or types of leaves can you
scheduled appointment. Having time to relax is
spot? Or, take them to the dog park. Children
part of what makes time shared between you
often enjoy seeing the wide variety of dog
special. And remember, kids have limits to their
breeds, watching them interact, and asking
energy too. Plan your activities around their
regular nap times (especially with younger
children), as this will help keep the peace
Cooking & Gardening: Eating on the go tends
between you, the kids, and their parents too.
to mean eating a limited range of easy, quick
foods. Go out for Chinese, Greek, Indian, Thai,
Study of Arthritis In Your Community
Dr. Gillian Hawker, Principal Investigator
Canadian Osteoarthritis Research Program
Division of Rheumatology, Women’s College Hospital, 76 Grenville Street, 8th Floor East Toronto, Ontario M5S 1B2
Toll Free: 1 (877) 437 - 1591 In Toronto: (416) 323 - 6218 www.osteoarthritisresearch.ca
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