Osteoarthritis (OA) is a common disease and has many causes. It particularly affects weight bearing joints, such as knees and hips, but also involves the hands and the back.

OA causes painful, stiff joints with limited movement. Pain worsens with use, and stiffness increases with inactivity.

Back pain can be caused by OA or axial spondylitis (see below) and has many other causes, for example slipped disc. This is when cushioning discs in the back bulge more than they should and they can press on a nerve which creates pain in some cases. This pain can be felt in the buttock and/or down the leg and is known as sciatica.

Rheumatoid arthritis is a multisystem disorder in which immunological abnormalities characteristically result in symmetrical (both sides of the body) arthritis, and complications in other parts of the body, such as lungs and bones. It is the most common and disabling autoimmune arthritis, and genetic susceptibility is well-defined.

Musculoskeletal pain syndromes are increasingly frequent in young people, and many of these are solved by instituting appropriate therapy early. Over the counter painkillers do not usually work as well as they would in cases of headaches etc. Physiotherapy has a key role to play in many of the pain problems that can occur as a result of being flexible (hypermobile), also in the inherited problems from gene mutations, and where there is usually a family history.

Juvenile idiopathic arthritis (JIA) is an umbrella term for a group of conditions with mainly persistent arthritis occurring in a child or teenager below the age of 16. Sometimes there may be inflammation of the eye (uveitis) or the child may have high fevers and is generally unwell. Current treatment allows the majority of young people to resume normal life and education. At Parkside, we aim to develop a service that provides care from childhood through adolescence and into adult life.

Related autoimmune disorders include young onset versions of systemic lupus erythematosus (SLE), dermatomyositis, localized scleroderma, systemic sclerosis (very rare), and vasculitis (e.g.polyarteritis nodosa). These are rare multisystem diseases that affect other parts of the body, including skin, blood vessels, lungs and kidneys. Prompt diagnosis and early treatment with appropriate medication is key to a good outcome.

We aim to provide a good diagnostic service and initiate treatment. Follow up depends on the severity of the condition, which can fluctuate, and we have connections with the main children's hospitals in London, including Great Ormond Street Hospital.

Auto-inflammatory syndromes are multisystem inflammatory diseases that occur from birth. The key symptoms are periodic fevers that are not due to infections, accompanied often by a rash, tummy pains and joint pains. There is a broad spectrum of severity, and many types can be treated effectively. Early diagnosis and treatment can prevent later complications. Prof Woo has over a decade of experience in diagnosis and treatment of these rare problems.

Gout is a variable group of diseases which are associated with an increased serum urate concentration, recurrent arthritis, aggregated urate deposits (tophi), and kidney disorders. Gout is associated with hypercholesterolaemia and hypertension and hence with cardiovascular disease.

Axial spondyloarthritis is characterized by inflammation of the axial skeleton (back), arthritis and adjacent soft tissue (e.g. Achilles tendonitis). There are a number of distinct diseases:

- Ankylosing spondylitis

- Psoriatic arthritis

- Sexually acquired reactive arthritis (SARA)

- Arthritis associated with gastrointestinal disease

Lupus is a multisystem disease involving the immune system. This results in a wide spectrum of clinical manifestations which have a tendency towards exacerbation and remission. There may be significant overlap with other autoimmune rheumatic disorders such as rheumatoid arthritis.

Sjögren's syndrome is a chronic autoimmune disorder which leads to mucosal (e.g. mouth and eye) dryness and arthritis.

Polymyalgia rheumatica (PMR) is a disorder in which there is muscle stiffness, with ache and pain in the neck, shoulders, lower back, hip and thigh. These symptoms may also be associated with rheumatoid arthritis and temporal arteritis.

Giant cell arteritis causes the temporal artery to be tender to touch and there may be associated scalp pain and pain on chewing. If the eye is involved the disease may lead to severe visual impairment.

Osteoporosis is a disorder where there is a decrease in quality of bone, which may cause it to fracture. There are a number of causes and the most common is associated with the menopause. Men may also be affected, but this is uncommon. Osteoporosis can cause pain due to fracture and loss of height, which may be associated with heartburn and breathing difficulties.

One-Stop Osteoporosis Screening Service

A one-stop osteoporosis screening service is available by self-referral for women (65 years and over) and men (75 years and over).

For further information or to make an appointment please call:

Parkside Hospital: 020 8971 8025 

This is a condition characterized by muscle pain, with tender points, fatigue and sleep disturbance and headache. It occurs most frequently in the 30 – 60 year age group. Symptoms include:

- Post-viral syndrome

- Myalgic encephalopathy

All investigations, including those of inflammation and immunopathology, are normal. The cause of the disorder is multifactorial and poorly understood. Treatment tends to be patient-specific and usually responds to a graded exercise programme, in association with drug treatment, and patients require significant support.

Trigger finger is when fingers cannot straighten easily, and most commonly affects the tendons of the third and fourth fingers. It is often associated with repeated manual trauma resulting in nodules occurring in the tendons.

De Quervain's tenosynovitis is inflammation of the thumb tendons causing pain along the lateral border of the wrist. It is common in new mothers who are not used to carrying babies.

Carpal tunnel syndrome is common and is caused by compression of the median nerve in the carpal tunnel of the wrist. Early symptoms are painful tingling in the wrist and hands at night. It mainly affects the thumb, index and middle fingers and can extend up the arm. There may also be hand numbness and weakness.

Elbow pain is usually caused by mechanical overload on the tendons. Lateral involvement is called tennis elbow, and medial involvement is called golfer's elbow. Pain is made worse by movement.

There are a number of common causes of shoulder pain. Rotator cuff tendinitis may be caused by mild trauma (e.g. a sports injury) or in older patients may be caused by repeated impingement (rubbing) of the rotator cuff on the shoulder bones. Partial or complete tears may result and this can be associated with severe pain. Pain can be caused by elevating the arm and by palpating the tendon at the side of the shoulder.

Frozen shoulder can be caused by a variety of shoulder joint problems, such as tendinitis and arthritis, or may be associated with lung disease, heart attack or stroke. Pain is caused by movement and there can be decreased range of movement. It may also be painful to lie on the affected side at night.

Patella tendinitis is commonly caused by jumping, hurdling and running. The patella tendon may be painful and tender at its attachment to the patella (knee cap) or at its attachment to the tibia (lower leg bone).

A Popliteal (Baker’s) cyst causes swelling behind the knee joint. It may cause pain because of its size. When large, it may rupture into the calf causing severe pain and can mimic an acute deep vein thrombosis. Treatment is aimed at the knee abnormality.

Menisci are usually torn by compressive or rotational forces in the knee. Pain from medial and lateral tears is common, particularly after twisting injuries. There may be knee swelling and a reduced range of movement. Treatment is conservative, with rest and pain relief. If a full range of movement is not possible and pain does not subside, an orthopaedic surgeon may be required.