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By Andy Duckmanton, BOst (Hons), GOsC registered osteopath. Editorial update: 15 October 2026. Osteoporosis weakens bones and increases the chance of a fracture. Osteopenia means bone density is below the normal range but not low enough to be classed as osteoporosis; it does not always progress to osteoporosis. Osteopathic care does not treat the underlying loss of bone density or replace medical care. Tell your osteopath about low bone density and any previous fractures before assessment or treatment. Osteoporosis Basics Bone has an internal supporting structure. In osteoporosis, changes in this structure and a loss of bone make it more fragile. The illustration shows this in simplified form; it cannot be used to diagnose bone density. Osteoporosis often causes no symptoms until a bone breaks. A DXA scan, also called a DEXA scan, uses low-dose X-rays to measure bone density. Your clinician considers the result alongside your medical history, previous fractures and other risk factors to assess the likelihood of a future fracture and discuss appropriate care. Bone is living tissue that is continually broken down and rebuilt. In osteoporosis, bone loss outpaces the formation of new bone. When to seek medical help If you have osteoporosis and develop new back pain, particularly after a minor fall or lifting, seek medical advice rather than assuming it is a muscle strain. A spinal fracture is one possible cause. Seek an urgent GP appointment or contact NHS 111 if back pain starts suddenly and is severe, or is getting worse quickly. Call 999 or go to A&E for back pain with new loss of feeling around the genitals or anus, changes in bladder or bowel control, or weakness, numbness or tingling in both legs. See the NHS back-pain guidance for further advice. Managing Osteoporosis Weight-bearing activity and resistance exercise can help maintain or improve bone strength, while balance exercises can reduce the risk of falls. Build up gradually and choose activities suited to your fitness and fracture risk. Ask your healthcare team for advice if you are recovering from a fracture, have had spinal fractures or are unsure what is safe. The Royal Osteoporosis Society exercise guidance offers practical advice. Exercise supports bone health but does not replace prescribed osteoporosis medicine. Your GP or specialist can assess your fracture risk and discuss whether you need medication. Bisphosphonates are one group of medicines used to slow bone breakdown and reduce the risk of fractures. Other options may be appropriate depending on your circumstances; decisions about HRT should include a discussion of its benefits and risks with your prescriber. If a private scan has identified low bone density, share the results with your GP. Your healthcare team can also review calcium and vitamin D intake and advise whether dietary changes or supplements are needed. Read more about NHS osteoporosis treatment. Treatment Considerations Treatment needs to take account of your bone health and fracture history. Deep massage and spinal manipulation are not appropriate when the risk of a fracture is high, particularly after spinal fractures. A diagnosis of osteopenia alone does not establish which techniques are suitable: individual assessment is needed. At Eastbourne Osteopathy, Andy Duckmanton can discuss your symptoms, scan results and medical care before deciding whether osteopathic assessment or treatment is appropriate. Any care for muscle or joint symptoms must be adapted to your circumstances. If a fracture is suspected, medical assessment takes priority over hands-on treatment. Contact the clinic before booking if you are unsure about suitability. Sources and further information NHS: osteoporosis treatment NHS: bone-density scans Royal Osteoporosis Society: exercise for bones Reference links checked: 13 October 2026. Patient information from Eastbourne Osteopathy. About Andy Duckmanton, BOst (Hons), GOsC registered osteopath. This general information supports, and does not replace, an individual assessment. Browse all patient guides.

By Andy Duckmanton, BOst (Hons), GOsC registered osteopath. Editorial update: 15 October 2026. Snapping hip describes a click or snap felt or heard as the hip moves. It is also called coxa saltans. It is often painless, although some people have discomfort. A sound alone does not identify the cause or mean that treatment is needed. Anterior Snapping Hip At the front of the hip, the iliopsoas tendon can move over a bony prominence and produce a snap. Other tendons can also be involved. A nearby bursa may become irritated, but painless snapping does not inevitably progress to a more serious problem. The location of the snap, painful activities and any previous injury help guide assessment. Examination can check movement and whether symptoms are reproduced. Tightness or a sedentary routine alone does not establish the cause; imaging is sometimes considered if a joint problem is suspected. Lateral Snapping Hip On the outside of the hip, the iliotibial band can move across the bony prominence called the greater trochanter. This can produce a snap, sometimes with irritation of a nearby bursa. It should not automatically be attributed to an unstable knee or an old knee injury. At Eastbourne Osteopathy, Andy Duckmanton can assess painful snapping and discuss whether osteopathic care is appropriate. Depending on the findings, advice may include adapting aggravating activity and exercises suited to you. Any hands-on treatment should be appropriate to the assessment, with progress reviewed. For broader symptoms and appointment information, read the hip and thigh pain guide. Other Causes A labral tear or a loose fragment within the hip joint can cause clicking, catching or locking. Persistent pain or locking needs assessment; it should not be assumed to be a harmless tendon snap. Medical investigation may be needed. The AAOS snapping-hip guide explains the different causes. When to seek medical help Seek an urgent GP appointment or contact NHS 111 for sudden severe hip pain without an injury, a hot swollen hip, or hip pain with fever or feeling unwell. Call 999 or go to A&E for severe hip pain after an injury, inability to walk or bear weight, or tingling or loss of feeling after an injury. See your GP if pain is worsening, affecting sleep or normal activities, or has not improved after two weeks of self-care. See the NHS hip-pain guidance. Sources and further information AAOS OrthoInfo: snapping hip NHS: hip pain and medical-help advice Reference links checked: 13 October 2026. Patient information from Eastbourne Osteopathy. About Andy Duckmanton, BOst (Hons), GOsC registered osteopath. This general information supports, and does not replace, an individual assessment. Browse all patient guides.

By Andy Duckmanton, BOst (Hons), GOsC registered osteopath. Editorial update: 15 October 2026. Thoracic outlet syndrome (TOS) involves compression of nerves or blood vessels as they pass between the neck and upper chest towards the arm. It can cause arm or hand symptoms, but similar symptoms can have other causes. Medical assessment helps establish the diagnosis and whether nerves, blood vessels or both may be affected. Symptoms of Thoracic Outlet Syndrome Possible nerve-related symptoms include: pins and needles sharp or shooting pain numbness Symptoms may vary with activity or arm position. Some people also notice weakness, swelling, coldness or changes in the colour of the arm or hand. These symptoms are not enough to diagnose TOS by themselves. Assessment combines your history and examination and may require scans or other tests. Changes in the wrist pulse during an arm-position test cannot reliably confirm or exclude TOS on their own. When to seek medical help See your GP if you think you have TOS. Seek an urgent GP appointment or contact NHS 111 for one-sided arm pain with swelling, redness and warmth, as this can be a sign of a blood clot. Call 999 for sudden breathlessness with sharp chest pain and a cough or coughing up blood. Do not wait for a routine appointment. See the NHS information on thoracic outlet syndrome for further guidance. Vascular vs Neurogenic TOS Neurogenic TOS affects nerves; vascular TOS affects an artery or vein. The distinction matters because blood-vessel problems may need urgent specialist treatment. A normal-feeling wrist pulse does not rule out a circulation problem, and a pulse change during a movement test does not establish the diagnosis. Your medical team may arrange further investigations and advise on the appropriate treatment. Follow the medical-help guidance above rather than trying to decide which type you have from symptoms or a home test. Cervical Ribs Causing Thoracic Outlet Syndrome Some people are born with an extra rib above the first rib, called a cervical rib. It often causes no symptoms, but in some people it contributes to pressure on nerves or blood vessels. Finding a cervical rib does not automatically mean that surgery is needed. A specialist considers the symptoms, examination and investigations when recommending treatment. Managing TOS Management depends on the type of TOS and the findings of your medical assessment. It may involve rehabilitation, medicines or specialist procedures. Suspected blood-vessel involvement needs medical care; routine hands-on treatment should not delay that assessment. For some people with nerve-related TOS, a supervised rehabilitation programme may include gradual changes to shoulder movement, exercise and activity. Treatment should be individualised rather than based only on posture or the appearance of rounded shoulders. If you attend Eastbourne Osteopathy with arm or shoulder symptoms, Andy will assess whether osteopathic care is appropriate and discuss referral where needed. This does not replace medical investigation for suspected TOS. For more general information, read our arm pain guide or shoulder pain page. Sources and further information NHS: thoracic outlet syndrome Reference links checked: 13 October 2026. Patient information from Eastbourne Osteopathy. About Andy Duckmanton, BOst (Hons), GOsC registered osteopath. This general information supports, and does not replace, an individual assessment. Browse all patient guides.

By Andy Duckmanton, BOst (Hons), GOsC registered osteopath. Editorial update: 15 October 2026. An injury or a gradual increase in pain can interrupt running, classes, gym sessions or weekend sport. The next step depends on what happened, what you can now do and whether there are signs of a problem needing medical assessment. You do not need to be a competitive athlete to benefit from a clear rehabilitation plan. The aim is a suitable return to the activities you value. Injuries that need prompt help Contact NHS 111 if pain is severe or worsening, swelling or bruising is substantial, you cannot bear weight or use the area normally, or you feel feverish or unwell. A possible fracture, significant tendon injury or dislocation needs appropriate medical assessment. Go to A&E urgently after an injury if you heard a crack, the area is visibly deformed, becomes numb or tingly, or is cold, blue or grey. Do not keep testing the injury or wait for a routine osteopathy appointment. Do not drive yourself to A&E; arrange help or call 999 for an ambulance. In the early stages Protect the area from further harm and reduce activities that clearly aggravate it while establishing what has happened. The amount of rest and timing of movement depend on the injury: a fracture, tendon rupture and minor strain need different plans. For an uncomplicated sprain or strain, the NHS guidance below explains early care. A wrapped cold pack may help discomfort in suitable circumstances; seek advice first if sensation or circulation is impaired. A pharmacist can advise about pain relief. Do not stop prescribed medicine because of a general rehabilitation slogan. What an assessment considers Describe the activity, whether there was a sudden event, any sound or sensation at the time, and what happened afterwards. Previous injuries, training changes, sleep, work and other health issues can affect the plan. Examination may include movement, strength and relevant functional tasks. The clinician should explain the working assessment, what remains uncertain and whether further investigation or another service is appropriate. You do not need to choose a treatment technique before this discussion. Ask what the assessment suggests, what the proposed approach is intended to achieve and which alternatives are available. Plan the return around the demands Comfortable walking is different from sprinting, changing direction, heavy lifting or contact sport. Rehabilitation should rebuild the abilities your activity needs rather than rely only on the number of days since injury. For example, a return to recreational running might move from manageable everyday walking to suitable strength work and then gradual running, if the injury and assessment allow it. The stages and rate vary; this is not a programme for every injury. Try changing one demand at a time. Distance, speed, hills, load, session frequency and competition can each increase the challenge. Agree what you are progressing, how to judge the response and when to review. Injury Review the response Consider the effect during activity, later that day and after recovery. Increasing swelling, loss of movement, instability or worsening function is a reason to reassess. A setback may mean adjusting the amount or revisiting the original explanation. Choosing support and reviewing progress Physiotherapy, osteopathic assessment or medical care may be appropriate depending on the problem and the clinician's skills. Hands-on treatment, if suitable, should have a clear role alongside rehabilitation. It does not replace rebuilding the capacity your activity requires. Agree a meaningful goal and a review point, such as returning to a particular class or managing a shorter run comfortably. If recovery is not progressing as expected, discuss another assessment or a different approach. This general guide cannot clear you to return to sport after a specific injury. For more specific starting points, see knee pain, foot and ankle pain and meniscus injuries. Getting active covers everyday movement; After your osteopathy appointment explains reviewing treatment and follow-up. If shoulder stiffness has been assessed as frozen shoulder, the frozen-shoulder guide explains that condition and its treatment choices. Sources and further information NHS: sprains and strains NHS: physical activity guidelines for adults East Sussex Healthcare NHS Trust: foot and ankle rehabilitation resources NHS: physiotherapy Sources checked: 13 October 2026. Patient information from Eastbourne Osteopathy. About Andy Duckmanton, BOst (Hons), GOsC registered osteopath. This general information supports, and does not replace, an individual assessment. Browse all patient guides.

By Andy Duckmanton, BOst (Hons), GOsC registered osteopath. Editorial update: 15 October 2026. Back pain can make time in a car uncomfortable. A few adjustments may help you manage a journey, but the first question is whether you can drive safely. No seating position can guarantee a pain-free trip. Check that you can control the car You need to be able to operate the pedals, steering and other controls, observe traffic and react promptly. Pain, weakness, restricted movement or medication that makes you drowsy can interfere with this. Do not drive if you cannot control the vehicle safely; ask your clinician or pharmacist about medication effects when uncertain. Make adjustments while parked Set the seat so you can reach the pedals fully without overstretching and can steer comfortably. Adjust the backrest and any available support to a position that feels manageable. A small support may help some people, but it should not compromise the seat belt or controls. Check mirrors after changing your position. Keep frequently needed items accessible so that you are not reaching or twisting while moving. Check that the head restraint is correctly positioned according to the vehicle guidance, and that the seat belt fits properly after any adjustment. The aim is a workable position with safe visibility and control, rather than one exact posture. Make further adjustments only when safely parked. Plan stops before discomfort or fatigue builds The Highway Code recommends at least a 15-minute break after every two hours of driving to help prevent fatigue. You may need to stop sooner because of pain or tiredness. Choose a safe, legal stopping place. A brief walk or comfortable movement during a break may help you vary your position. Do not use a motorway hard shoulder or emergency area simply to stretch, and do not continue driving when you feel sleepy. Make the journey manageable Allow time for breaks. Where practical, share the driving, travel at a less demanding time or divide a long journey into stages. Another form of transport may be easier while symptoms are troublesome. Passengers can also change position during safe stops. While the vehicle is moving, keep the seat belt correctly fastened and avoid positions that compromise its protection. Getting in, out and handling bags Take enough time to get in and out without rushing. Try an approach that currently feels comfortable, such as sitting before bringing the legs into the car. There is no single technique everyone must use. Divide luggage into manageable loads and seek help with awkward items. Consider what the whole trip involves: loading the car, the drive itself and what you need to do on arrival. Build tolerance and review persistent symptoms If it is safe to drive, a shorter journey with planned stops may help you judge what is manageable before a long trip. Adjust duration gradually and notice the effect later in the day as well as while driving. Arrange an assessment if pain repeatedly limits journeys or is not improving. New weakness, altered sensation or difficulty using a leg needs medical advice before driving. Back pain with new difficulty passing urine, loss of bladder or bowel control, or numbness around the genitals or anus needs immediate A&E assessment. Do not drive yourself; arrange help or call 999 for an ambulance. For more detail, read the low back pain guide, back pain flare-up guide and persistent-pain guide. The getting active guide offers ideas for building everyday movement between journeys. Sources and further information The Highway Code: fitness to drive, fatigue and medicines NHS: back pain Sources checked: 13 October 2026. Comfort suggestions should always fit safe vehicle operation. Patient information from Eastbourne Osteopathy. About Andy Duckmanton, BOst (Hons), GOsC registered osteopath. This general information supports, and does not replace, an individual assessment. Browse all patient guides.

By Andy Duckmanton, BOst (Hons), GOsC registered osteopath. Editorial update: 15 October 2026. Rheumatic conditions cover a range of problems affecting joints, muscles and related tissues. Some need specialist rheumatology care. This article explains several inflammatory conditions and when to seek medical advice. What is a Rheumatic Condition? ‘Rheumatism’ is a broad term, not a specific diagnosis. Not every rheumatic condition is autoimmune. Rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis are inflammatory conditions that need medical assessment and, where appropriate, specialist treatment. Ankylosing Spondylitis and AxSpA Axial spondyloarthritis (AxSpA) causes inflammation affecting the spine and the joints between the pelvis and spine. Ankylosing spondylitis is a form in which characteristic changes can be seen on an X-ray. In non-radiographic AxSpA, these changes are not visible on an X-ray. Persistent back pain and stiffness should be assessed by a GP if an inflammatory cause is suspected. The course varies between people. Symptoms can fluctuate, and spinal fusion is not inevitable. Exercise and medical treatment can help manage symptoms; treatment may also help delay progression. Osteopathy cannot reverse fused joints or replace rheumatology care. AxSpA can also cause inflammation where tendons attach to bone and inflammation inside the eye. Ask for an urgent GP appointment or contact NHS 111 for eye pain, marked redness, light sensitivity or changes in vision. Loss of vision needs A&E or 999. Rheumatoid Arthritis (RA) Rheumatoid arthritis (RA) often begins in the small joints of the hands and feet, causing pain, swelling and stiffness. It can also affect other parts of the body. Early assessment matters: you should not wait for visible changes in joint shape before seeking help. Read more about rheumatoid arthritis and when to seek medical advice. Psoriatic Arthritis Psoriatic arthritis can cause painful, swollen and stiff joints, swollen fingers or toes, and nail changes. It occurs in some people with psoriasis, but joint symptoms also need checking if you have no known psoriasis. See your GP for recurring joint pain, stiffness or swelling; a rheumatology referral may be needed. How can Osteopathy Help with Rheumatic Pain? Persistent unexplained joint swelling needs prompt GP assessment, particularly when several joints or the small joints of the hands and feet are affected. An osteopathy appointment should not delay this. Features worth discussing with your GP include: persistent or recurring joint swelling morning stiffness lasting more than 30 minutes pain and stiffness affecting several joints, particularly the hands or feet These features do not establish a diagnosis. Sudden severe joint pain, a newly hot or swollen joint, or joint pain with fever or feeling unwell needs urgent GP or NHS 111 advice. Do not assume it is an ordinary arthritis flare; a joint infection can occur without fever. At Eastbourne Osteopathy, Andy can assess whether osteopathic care is appropriate alongside your medical care. Any proposed treatment or exercise advice would be adapted to your symptoms, diagnosis and current treatment. The aim is to support comfort and day-to-day movement, not to control the underlying inflammatory disease or prevent its progression. Suspected active inflammation or joint instability may require medical assessment before hands-on treatment. Sources and further information NHS: psoriatic arthritis NHS: rheumatoid arthritis NICE NG65: spondyloarthritis Reference links checked: 13 October 2026. Patient information from Eastbourne Osteopathy. About Andy Duckmanton, BOst (Hons), GOsC registered osteopath. This general information supports, and does not replace, an individual assessment. Browse all patient guides.

By Andy Duckmanton, BOst (Hons), GOsC registered osteopath. Editorial update: 15 October 2026. A torn meniscus can cause knee pain, swelling or difficulty bending and straightening the knee. Other problems can cause similar symptoms, so assessment matters. This guide explains possible symptoms, when to seek urgent help and how treatment is chosen. A meniscus is a C-shaped piece of cartilage that helps with joint stability and load distribution. The knees have two each: one on the inner side of the joint (medial) and one on the outer (lateral). How Meniscus Injuries Happen A meniscus can tear during a sudden twist or pivot, particularly when the foot is planted and the knee is bearing weight. Tears can also develop alongside age-related changes in the tissue, sometimes after a relatively minor movement. The circumstances of the injury are part of the assessment; they do not establish the diagnosis on their own. The same movement can happen in other sports. Running and turning sharply or unlatching awkwardly from cycling cleats can cause the same demand on the knee. But this injury is not limited just to sports; sometimes a simple trip or fall can cause a tear. Symptoms of a Torn Meniscus Symptoms may include pain, swelling, stiffness, catching or difficulty moving the knee fully. Clicking or intermittent pain alone cannot confirm a meniscus tear or identify its type, because other knee problems can cause similar symptoms. A knee that becomes stuck or cannot fully straighten needs prompt medical assessment; do not try to force it back into place. Pain may begin immediately or develop gradually, and some people describe a deep ache. The Unhappy Triad The meniscus might only be part of the injury. The Unhappy Triad is a term to describe a more complex knee injury, involving: the medial meniscus the anterior cruciate ligament (ACL) the medial collateral ligament (MCL) This describes a combined injury involving the ACL, MCL and a meniscus. It can occur with twisting and a force that pushes the knee inward, such as a blow to the outside of the knee. Assessment is needed to establish which structures are injured and whether further investigation or specialist care is required. Contact your GP urgently or NHS 111 for severe knee pain after an injury, inability to bear weight, a knee that cannot bend or straighten, or a hot, swollen knee. Knee pain with fever or feeling shivery also needs urgent advice. Go to A&E if the knee is visibly deformed or displaced, or you develop tingling or loss of feeling in the knee, leg or toes following the injury. Do not drive yourself to A&E. Osteopathy for Meniscus Injuries Recovery varies with the tear, its location, your symptoms and any other knee injury. The outer part of the meniscus has a better blood supply than the inner part, so healing potential differs. Many people are managed without immediate surgery, while persistent symptoms or a locked knee may require specialist assessment. At Eastbourne Osteopathy, I assess your symptoms, movement and medical history to discuss whether care is suitable or medical assessment is needed. Where appropriate, care may include advice about activity, a gradual exercise plan and suitable manual techniques. The aim is to improve comfort and function. Healing of a tear cannot be guaranteed. I will discuss progress and whether further assessment is needed. Related patient guides Knee pain: causes, assessment and next steps Choosing the right help for muscle and joint pain Sources and further information NHS: meniscus tear NHS: knee pain Reference links checked: 13 October 2026. Patient information from Eastbourne Osteopathy. About Andy Duckmanton, BOst (Hons), GOsC registered osteopath. This general information supports, and does not replace, an individual assessment. Browse all patient guides.

By Andy Duckmanton, BOst (Hons), GOsC registered osteopath. Editorial update: 15 October 2026. Foot or ankle pain can make walking, standing and exercise difficult. The most useful next step depends on where it hurts, whether there was an injury and what you can now do. The location alone is not enough to make a diagnosis. When to get urgent help Contact NHS 111 for severe pain, substantial or worsening swelling, an inability to walk or bear weight, or a sudden snap or pop with loss of function. A hot swollen area with fever or feeling unwell also needs urgent medical advice. Do not wait for a routine osteopathy appointment. After an injury, an obviously deformed foot or ankle, numbness, or a cold, blue or grey limb needs emergency assessment at A&E. Do not drive yourself. If you have diabetes, seek medical advice about new foot pain, especially with a wound, redness, heat or swelling; avoid trying to manage these changes solely with exercises. Common starting points Pain beneath the heel, particularly on the first steps after resting, may fit plantar heel pain. Read the plantar fasciitis guide for a fuller explanation and other reasons to seek assessment. Pain at the back of the heel or along the Achilles tendon can follow a change in activity. A sudden pop and difficulty pushing off or standing on tiptoe needs prompt medical assessment for a possible significant tendon injury. Pain and swelling after rolling an ankle may follow a sprain, but a fracture or other injury can look similar. Marked pain or difficulty bearing weight needs assessment. Stiff or swollen joints, pain around the forefoot and altered sensation can have several causes. Persisting swelling, numbness or tingling should be assessed rather than assumed to be a simple strain. What an assessment considers Describe the exact area, how symptoms began, recent changes in walking or sport, footwear and previous injuries. Mention diabetes, circulation or nerve problems, inflammatory arthritis, medicines and relevant operations. Assessment may include walking, joint movement, strength and suitable functional tasks, as well as checks for a problem needing medical care. Imaging is chosen to answer a clinical question, not automatically required for every painful foot. Practical adjustments While arranging advice, reduce activities that clearly worsen symptoms and choose comfortable, supportive footwear. An alternative activity may let you remain active without repeatedly aggravating the painful area. For a fresh uncomplicated sprain or strain, the NHS guidance below explains early care; a fracture or tendon rupture needs a different plan. As the condition allows, rehabilitation may include movement, strengthening, balance and a gradual return to walking or sport. The starting point and rate of progression should match the assessment. Increasing swelling, worsening pain or declining function is a reason to review the plan. Choosing the right service A GP or urgent service is appropriate when a medical cause or significant injury is suspected. Physiotherapy can help with rehabilitation; podiatry can be useful for foot-specific assessment, footwear and selected supports. NHS access depends on local criteria and the problem. Osteopathic assessment may be appropriate for some musculoskeletal symptoms. Any hands-on treatment should have a clear purpose alongside advice and rehabilitation. It cannot replace urgent investigation or treatment of infection, fracture or other medical disease. For a broader comparison of services, read Choosing the right help for muscle and joint pain. The Getting active guide includes practical ideas for rebuilding walking and everyday activity. Sources and further information NHS: ankle pain NHS: heel pain NHS: sprains and strains NHS: plantar fasciitis East Sussex Healthcare NHS Trust: foot and ankle resources Sources checked: 13 October 2026. A symptom guide cannot confirm the cause of an individual foot or ankle problem. Patient information from Eastbourne Osteopathy. About Andy Duckmanton, BOst (Hons), GOsC registered osteopath. This general information supports, and does not replace, an individual assessment. Browse all patient guides.

By Andy Duckmanton, BOst (Hons), GOsC registered osteopath. Editorial update: 15 October 2026. Arthritis describes a group of conditions that affect joints. Pain, stiffness and swelling can have different causes, so the diagnosis matters when choosing care. This overview helps you find the most relevant information. Osteoarthritis Osteoarthritis involves changes in the whole joint, including cartilage and bone. Its effect varies between people and it does not inevitably get worse. Treatment decisions should reflect your symptoms and daily function, rather than an X-ray description alone. The hip and knee osteoarthritis guide explains exercise, treatment choices and the limited role of hands-on care. If you do not have a diagnosis, begin with the knee pain guide or hip and thigh pain guide. Inflammatory arthritis In conditions such as rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis, inflammation has a central role. They may affect several joints and other aspects of health. Medical assessment and appropriate disease treatment are important. Rheumatoid arthritis: persistent swollen joints, early referral and living with treatment. Axial spondyloarthritis: symptoms and assessment: when back or buttock symptoms should prompt a discussion with your GP. Living with axial spondyloarthritis and ankylosing spondylitis: exercise, medical care and precautions after diagnosis. Symptoms to have assessed Ask your GP about unexplained joint swelling, prolonged stiffness or symptoms affecting several joints. Mention fatigue, psoriasis, bowel inflammation, eye problems and relevant family history rather than discussing only the most painful spot. A sudden very painful, hot or swollen joint needs urgent advice from a GP or NHS 111, particularly with fever, shivering or feeling unwell. Infection is one possible cause and may occur without every typical symptom. Do not assume it is your usual arthritis or wait for a routine osteopathy appointment. Supportive musculoskeletal care Advice about movement, daily tasks and exercise may help with suitable musculoskeletal problems. Any hands-on treatment should have a clear purpose and account for your diagnosis, medicines and other care. Osteopathy does not reverse arthritis, regrow cartilage or control inflammatory disease. If you have inflammatory arthritis, follow your medical team's plan and discuss new or worsening symptoms with them. Additional care should support that plan and should not delay referral. Pain can also be felt away from its source: for example, hip pain may be felt towards the knee. The referred-pain article explains why assessment sometimes includes more than the painful area. See Choosing the right help for a comparison of care options. Sources and further information NHS: arthritis NICE NG226: osteoarthritis NICE NG65: spondyloarthritis NHS: septic arthritis Sources checked: 13 October 2026. Patient information from Eastbourne Osteopathy. About Andy Duckmanton, BOst (Hons), GOsC registered osteopath. This general information supports, and does not replace, an individual assessment. Browse all patient guides.

By Andy Duckmanton, BOst (Hons), GOsC registered osteopath. Editorial update: 15 October 2026. Rheumatoid arthritis is an inflammatory condition in which the immune system affects the lining of joints. It can also affect other parts of the body. It differs from osteoarthritis and needs medical treatment aimed at controlling disease activity and limiting harm. Ask about persistent swollen joints Persistent joint swelling, pain and stiffness, particularly in the small joints of the hands or feet or in several joints, should be assessed by a GP. Tell them about fatigue, stiffness after rest and difficulties with ordinary tasks. You do not need to wait for a joint to change shape. Blood tests can help, but normal inflammation markers or negative rheumatoid antibodies do not rule out rheumatoid arthritis. NICE recommends urgent specialist referral for particular patterns of persistent joint inflammation even when these tests are normal or negative. Tests should not delay an appropriate referral. Treatment of the underlying disease Rheumatology care may include disease-modifying medicines, often called DMARDs, with monitoring and adjustments over time. The plan depends on disease activity, your health and your preferences. Do not stop prescribed treatment because symptoms improve after a hands-on appointment. Discuss medication questions and possible side effects with your medical team. Movement and everyday life A physiotherapist can help with suitable exercise and maintaining function. Occupational therapy may help with daily tasks and practical adaptations. Advice should take account of current inflammation, fatigue and which joints are affected, and may need adjusting during a flare. Useful goals might include fastening buttons, preparing food, walking to a shop or maintaining a hobby. Tell your team about changes in function so they can assess whether treatment and support are meeting your needs. Considering osteopathy Additional musculoskeletal care must fit your rheumatology plan. Tell Andy about your diagnosis, medicines, recent flares, fractures, joint replacements and relevant test results. Some techniques may be unsuitable. Osteopathy does not control the underlying immune disease, prevent its progression or replace DMARDs. Evidence for lasting benefit from osteopathy specifically for rheumatoid arthritis is limited. If a supportive approach is considered, agree a concrete goal and review whether it helps. Symptoms that should not wait A hot, very painful or swollen joint can have causes other than a rheumatoid flare, including infection. Seek urgent medical advice through your GP or NHS 111, especially if you feel unwell; infection does not always cause a fever. Rheumatoid arthritis can sometimes affect stability in the upper neck. New neck pain with weakness, altered sensation, clumsy hands or difficulty walking needs urgent medical assessment before neck treatment. Rapidly worsening neurological symptoms warrant emergency assessment. For a suspected flare or worsening swelling, use the contact plan given by your rheumatology team or speak to your GP. A routine osteopathy appointment should not delay this. The arthritis overview explains how rheumatoid arthritis differs from osteoarthritis and axial spondyloarthritis. Your medical team remains the main source of advice about disease management. Sources and further information NHS: rheumatoid arthritis diagnosis NHS: rheumatoid arthritis treatment NICE NG100: rheumatoid arthritis NHS: septic arthritis East Sussex MSK: warning signs of spinal cord compression Sources checked: 13 October 2026. Patient information from Eastbourne Osteopathy. About Andy Duckmanton, BOst (Hons), GOsC registered osteopath. This general information supports, and does not replace, an individual assessment. Browse all patient guides.

By Andy Duckmanton, BOst (Hons), GOsC registered osteopath. Editorial update: 15 October 2026. Carpal tunnel syndrome is compression of the median nerve as it passes through a narrow space at the wrist. It can cause tingling, numbness, pain or weakness. Other conditions can cause hand symptoms, so the pattern needs assessment. Recognising the symptoms Symptoms commonly affect the thumb, index and middle fingers and part of the ring finger. They may wake you at night or occur when the wrist is held bent. Some people notice an aching hand or forearm, difficulty gripping, or a weak thumb. The little finger is usually supplied by a different nerve. Symptoms there, neck-related pain or a different pattern may need another explanation. Do not diagnose a trapped nerve solely from a diagram or finger pattern. When to seek assessment See your GP if symptoms are worsening, not going away or not responding to home measures. Persistent numbness, loss of grip, dropping objects or visible loss of muscle at the base of the thumb should be assessed promptly. Sudden arm weakness with facial drooping or speech difficulty needs 999. Severe injury, a change in hand or arm shape, or sudden loss of feeling needs urgent assessment. See the arm and hand guide for help with other symptoms. Why can it happen? Often there is no single identifiable cause. Pregnancy, diabetes, arthritis and previous wrist injury can be relevant. Repeated hard gripping, vibrating tools or prolonged wrist bending may aggravate symptoms. Computer discomfort does not by itself establish carpal tunnel syndrome or prove that the keyboard caused it. Review your setup for comfort and reduce prolonged pressure on the wrist, while arranging assessment if symptoms persist. Symptoms during pregnancy should be discussed with your midwife, GP or treating team; they often improve afterwards but still need attention if severe or progressive. Wrist splints and everyday changes A night splint that keeps the wrist straight can help some people, especially when symptoms disturb sleep. A pharmacist or clinician can advise on a suitable fit. It may take several weeks to judge the benefit; do not delay medical review for worsening numbness or weakness while waiting. Reduce repeated hard gripping or wrist bending where possible, vary tasks and take breaks from activities that provoke symptoms. A comfortable desk arrangement may make work easier. Pain medicines can sometimes help discomfort but do not remove nerve compression. Hand exercises have limited supporting evidence and should be appropriate to the assessment, rather than repeatedly provoking tingling. Medical treatment choices A clinician will ask about the symptoms and examine the hand. Nerve-conduction tests, and sometimes imaging, may be considered when the diagnosis or severity is uncertain; not everyone needs them. A steroid injection may be offered when a splint has not helped enough, although symptoms can return. Carpal tunnel release surgery may be considered for persistent or more severe problems. Discuss likely benefits, risks, recovery and the consequences of waiting with the treating team. The NHS England decision aid can help prepare questions about these options. Where osteopathic care fits Andy can assess related muscle and joint symptoms and discuss activity changes or referral. Osteopathic treatment cannot be relied on to relieve pressure on the median nerve, reverse nerve damage or replace a medical treatment that is needed. If treatment is offered for an associated problem, agree its purpose and review whether it helps. Increasing hand weakness or persistent loss of sensation should lead to medical reassessment, not an open-ended course of hands-on treatment. Sources and further information NHS: carpal tunnel syndrome NHS England: making a decision about carpal tunnel syndrome Royal Orthopaedic Hospital: carpal tunnel symptoms and treatment Sources checked: 13 October 2026. General patient information; assessment and care depend on your individual circumstances. Patient information from Eastbourne Osteopathy. About Andy Duckmanton, BOst (Hons), GOsC registered osteopath. Browse all patient guides.

By Andy Duckmanton, BOst (Hons), GOsC registered osteopath. Editorial update: 15 October 2026. A diagnosis of axial spondyloarthritis can raise questions about work, exercise, treatment and the future. The condition varies between people. Care should reflect disease activity, your symptoms and the things you want to keep doing. Axial SpA mainly affects the spine and the joints linking it to the pelvis. Ankylosing spondylitis, also called radiographic axial SpA, is a form with characteristic X-ray changes. People without those changes can still have significant symptoms and need appropriate care. For signs that should prompt an initial assessment, read the shorter axial spondyloarthritis recognition guide. This article focuses on living with an established diagnosis. Understanding your treatment plan Rheumatology care considers pain, stiffness, movement, fatigue, inflammation and how the condition affects your life. Blood tests and imaging can contribute, but the whole clinical picture matters. Treatment may include anti-inflammatory medicines or specialist medicines that target inflammation, alongside exercise and physiotherapy. The choices depend on your disease, other health conditions and response to treatment. Ask what each treatment is intended to achieve, how it will be monitored and whom to contact about side effects or a flare. Do not stop prescribed medicine because symptoms improve after another treatment. Discuss changes with the prescribing team. Exercise and movement Physiotherapy and suitable exercise are important parts of care. A specialist physiotherapist can help with mobility, strength, posture, breathing exercises and aerobic activity appropriate to you. A programme should be achievable and adjusted when symptoms or circumstances change. Choose activities you value and can sustain. This could include a manageable walk, pool exercise or a suitable class, depending on your assessment and access. The goal is to support function and wellbeing, not to force a stiff spine into a particular shape. The Getting active guide offers general ideas, but your rheumatology or physiotherapy plan takes account of the condition in a way that a general article cannot. Work, rest and daily tasks Discuss changes that make everyday life easier: opportunities to change position, breaks from a demanding task, manageable lifting arrangements or help with fatigue. A small adjustment that you can use consistently may be more valuable than an ideal setup you cannot maintain. Sleep, mood and persistent pain are worth discussing with your team. They are part of the impact of the condition, not a distraction from it. Occupational therapy or other support may be appropriate when work or self-care becomes difficult. What about hands-on treatment? The National Axial Spondyloarthritis Society advises that manipulative therapies are not recommended for people with axial SpA. Spinal fusion, osteoporosis and inflammation can create important risks. Do not seek forceful manipulation to reverse a spinal curve or fusion. Discuss any additional treatment with your rheumatology team. Tell the practitioner about the diagnosis, medicines, fractures, bone health and any spinal fusion. Osteopathy does not suppress the underlying inflammatory disease or replace medical treatment and specialist rehabilitation. Flares and changes that need review Use the flare plan agreed with your team. A temporary adjustment to activity may help, but worsening symptoms or declining function should prompt a discussion about whether disease control or rehabilitation needs changing. Do not assume every new symptom belongs to a familiar flare. Eye pain, redness, light sensitivity or blurred vision needs urgent same-day medical advice because uveitis is possible. Contact your GP, eye service or NHS 111. Loss of vision requires emergency help at A&E or through 999. New severe spinal pain after a fall or injury needs urgent medical assessment, particularly if the spine is stiff or fused or you have osteoporosis. Even a relatively minor injury may matter. Do not have spinal treatment before it has been assessed. New weakness, loss of sensation, difficulty walking or new bladder or bowel disturbance also needs urgent assessment; rapidly worsening symptoms require emergency care. Questions for your next review How well is the current plan controlling inflammation and supporting daily life? Which exercise or activity goal should I focus on next? What should I do during a flare, and who is my first contact? Do bone health, fatigue, work or eye symptoms need further attention? Sources and further information NHS: treatment for ankylosing spondylitis NICE NG65: spondyloarthritis management NASS: complementary therapies and precautions NHS: uveitis Sources checked: 13 October 2026. Patient information from Eastbourne Osteopathy. About Andy Duckmanton, BOst (Hons), GOsC registered osteopath. This general information supports, and does not replace, an individual assessment. Browse all patient guides.