Arthritis is inflammation of the joints in one or more parts of the body.

There are more than 100 different types of arthritis, and they all have different causes and treatment methods.

The symptoms of arthritis usually appear gradually but they can also happen suddenly. Arthritis is most commonly seen in adults over 65 but it can develop at any age.

Osteoarthritis
The NHS website provides an overview of osteoarthritis, including living with and managing the condition.

It also has information about specific treatment, from lifestyle change to surgery, and gives links to more information on other websites.

Versus Arthritis (Formerly Arthritis Research UK)
Versus Arthritis is a leading organisation involved in research about prevention and the treatment of arthritis in the UK. It provides information and free resources on many conditions. The most relevant for lower limb conditions are

• Hip pain
• Knee osteoarthritis
• Foot and ankle pain
• Exercises to manage pain
• Diet and arthritis

Rheumatoid arthritis
Rheumatoid arthritis is a long-term condition that causes pain, swelling and stiffness in the joints, most commonly in the hands, feet and wrists, but it can also cause problems in other parts of the body.

Simple daily tasks can become difficult or take longer, and you may have to change the way you carry them out.

Information on NHS Choices

• Rheumatoid arthritis
• Symptoms
• Causes
• Diagnosis
• Treatment

The ‘Living with Rheumatoid Arthritis‘ page on the NHS website tells you about some things you can do to help keep the condition under control and reduce joint damage. There is also information about self care.

The National Rheumatoid Arthritis Society (NRAS) runs self-management courses to help you manage arthritis. Sometimes, meeting with other people who have the condition can be really helpful, and NRAS have information about local courses.

Asthma is a common long-term condition that can cause coughing, wheezing, chest tightness and breathlessness. It is characterised by intermittent symptoms and is often due to an underlying allergy (for example, to domestic pets) but can sometimes occur after respiratory infection or exposure to allergens in the workplace, or it can occur with hayfever.

Asthma usually starts during childhood but can begin at any age. Many children grow out of asthma in their teens but the condition may become long-term, particularly when it comes on in adulthood. Some people experience seasonal symptoms and only need treatment at certain times of the year.

Information on the NHS website

• All about asthma
• Living with asthma
• Symptoms of asthma
• Causes of asthma
• Diagnosing asthma

Other useful Information
The British Lung Foundation also provides useful information.

Help to stop smoking
Giving up smoking has huge health benefits. It is never too late to give up. Just because you’ve tried to give up before and not succeeded, does not mean you can’t do it. Many people make several attempts before they succeed. Find out more on the Healthy Somerset website

Feeling and being in control of your asthma is very important, The key to good asthma control is being clear about what asthma means, how and why asthma is treated and ensuring you have a personalised asthma action plan – such as a plan that makes it clear what your day to day treatment should be, what seems to trigger your asthma, how to recognise deterioration and what to do if your asthma is playing up.

It is also very important to stop smoking because asthma inhalers do not work nearly as well if you smoke.

Living with asthma
You can find the most comprehensive information about self-care, asthma action plans and living with asthma at Asthma UK. Asthma UK also provides useful advice, publications and forums.

It is very important that, if you or your child have asthma, the condition and treatment is reviewed at least once a year. An asthma action plan should come out of this review. The review is usually done by your doctor or practice nurse, but referral to a hospital specialist (paediatrician or adult chest doctor) is necessary for patients who have had a hospital admission, whose condition is unstable or needs a lot of treatment, or if the diagnosis needs to be clarified.

The Taunton Breathe Easy Support Group meets every month to provide support and information for people living with a lung condition, and for the people who look after them. It is run by members, with help and support from the British Lung Foundation.

Autism is a lifelong developmental condition, it affects the way a person communicates and how they experience the world around them.

Autism is described as a spectrum condition. This means that while people with autism, including Asperger Syndrome, share certain characteristics, they will be highly individual in their needs and preferences.

Some people with autism can live relatively independent lives but others may face additional challenges, including learning disabilities. People with autism may also experience over- or under-sensitivity to sounds, touch, tastes, smells, light or colours.

Increasing awareness is vital to making sure that people with autism or Asperger Syndrome receive the right support and understanding throughout their lives.

Diagnosis
For a formal diagnosis you should visit your doctor to discuss your concerns. Your doctor should refer you for a specialist assessment, which can help identify and diagnose autism.

Most people with autism receive a diagnosis in childhood, but some adults may not have been diagnosed because the condition was not as widely recognised and understood when they were children.

Visit the Autism Wessex website or Autism Somerset for more information.
The National Autistic Society website has more information about autism and Asperger Syndrome, including diagnosis, myths, facts, statistics and help topics.

Back, or spinal, pain is one of the most common medical problems. It affects 8 out of 10 people at some point during their lives. Episodes of back pain may be acute, sub-acute, or chronic depending on how long they go on for.

The pain may be felt as a dull ache, shooting or piercing pain, or a burning sensation. It may radiate into the arms and hands as well as the legs or feet, and may include tingling, weakness or numbness in the legs and arms. The most common area of pain is the lower back, or lumbar area.

Low back pain video by Dr Mike Evans

Cancer is a common condition and there are over 200 different types. In the UK the four most common ones are

• Breast Cancer
• Bowel Cancer
• Prostate Cancer
• Lung Cancer

There are many services in Somerset to support people who have cancer and their family members.

If you have any unexplained symptoms visit your doctor to discuss these. Most unexplained symptoms are nothing to worry about however seeking advice early is really important as it can help to rule out cancer or ensure you start on a treatment as soon as possible.

Skin cancer
Somerset has a relatively high incidence rate of malignant melanoma (skin cancer). The most common sign of melanoma is a change to a mole or a new mole. The best way to prevent all types of skin cancer is to avoid overexposure to the sun.

• Skin cancer
• symptoms
• prevention

Reducing the risk of cancer
Leading a healthy lifestyle can help lower your risk of developing certain cancers. You can do this by

• eating a healthy balanced diet
• maintaining a healthy weight
• drinking less alcohol
• stopping smoking
• protecting your skin from sun damage

Information about Cancer on the NHS website

• Types of Cancer, including signs and symptoms
• Free screening programmes are available to pick up any problems early
• Information about Cancer Medications
• Prevention

Useful Links

• Information on living with cancer on the NHS website
• Maggies Centres
• MacMillan Cancer Support provide information and advice and local services
• Information on the Cancer Research UK website
• Positive Action on Cancer provide counselling and online counselling services to anyone affected or bereaved by cancer or other life threatening illness.

The Beacon Centre in Musgrove Park Hospital provides a range of services including a Macmillan Citizens Advice service.

For a list of support groups in your area please use our community directory.

Cardiovascular disease (CVD) is a general term for a disease of the heart or blood vessels. The main types of cardiovascular disease are

• coronary heart disease
• stroke
• peripheral arterial disease
• aortic disease
• heart failure

Chest pain
Chest pain can be caused by anything from muscle pain to a heart attack and should never be ignored. Phone 999 and ask for an ambulance immediately if you develop sudden severe chest pain.

For more information about chest pain visit the NHS website Chest pain page

Living with a heart condition
There is information about living with a heart condition and caring for someone with a heart condition on the British Heart Foundation website. This includes information about returning to work, rehabilitation, holiday and travels and more.

Cardiac Rehabilitation Courses
If you have a heart condition you may benefit from a Cardiac Rehabilitation Course.

Preventing heart disease
Leading a healthy lifestyle will help keep your heart healthy. For more information please visit our Keeping healthy page.

An NHS health check can help to identify your potential future risks of developing heart disease or other health conditions.

Other useful links
Living with heart failure – NHS
For more information about services in Somerset, please search our Community Directory

For a detailed list of support groups in your area please use our directory of local support groups.

Chronic kidney disease (CKD) is a long-term condition where the kidneys do not work effectively. It is common and mainly associated with ageing.

By leading a healthy lifestyle and following your doctor’s advice it is possible to live without symptoms or further deterioration of your kidney function.

• Information about kidney disease
• Information about diagnosis and screening programmes
• Information about treatment
• Information about living well with CKD

Keep your kidneys healthy
Leading a healthy lifestyle, including not smoking and maintaining a healthy blood pressure, can help to keep your kidneys healthy.

NHS health checks can help to identify potential future risk of developing kidney disease and other health conditions

Medicine sick day rules
These apply if you are unwell with vomiting, diarrhoea, fevers, sweats or shaking. For more information contact your pharmacist, doctor or nurse.

Transport to dialysis
For advice about patient transport services to dialysis, contact the Patient Transport Advice Centre on 01278 727444.

You can find more information on the British Kidney Patient Association website.

For more information about services in Somerset please use the directory of services and support groups.

COPD stands for chronic obstructive pulmonary disease. This is the name for a collection of lung conditions, including chronic bronchitis, emphysema and chronic obstructive airways disease. People with COPD have difficulties breathing, often because their airways have narrowed and become restricted.

Information on NHS Choices

• Diagnosing COPD
• Causes of COPD
• Treating COPD
• Symptoms of COPD
• Living with COPD

The British Lung Foundation has information and advice about living with COPD, including managing flare-ups, dealing with breathlessness and leaving hospital.

Some patients with COPD need to see a lung specialist. Your doctor will advise whether this is necessary for you. There are lung specialists in Taunton, Yeovil and Weston-super-Mare hospitals, with more clinics running at various community hospitals in Somerset.

Somerset’s BOC Community Respiratory Service provides Home Oxygen Assessments and Reviews (HOS-AR) and rehabilitation classes for patients with lung conditions.

Patients are referred to the service by their doctor and are given the tools to manage their condition themselves and stay in the best health possible. BOC has a webpage for patients and carers which explains local services and links to other information and support.

Help to stop smoking
The main cause of COPD is smoking. It is very common, and one in fifty patients in Somerset is thought to have the condition. It is very important that COPD is diagnosed at an early stage. Treatments can be very helpful, but the most important thing is to receive support to stop smoking. It is never too late to give up. Just because you’ve tried to give up before and not succeeded, does not mean you can’t do it. Many people make several attempts to stop smoking before they succeed.

Caring for someone with COPD
If you care for someone with COPD you can find information to help you on the Support for you and your carer page of the British Lung Foundation website.

The Taunton Breathe Easy Support Group meets every month to provide support and information for people living with a lung condition, and for the people who look after them.

Useful links
The Active Cycle of Breathing Techniques
How to access exercise – British Lung Foundation

Diabetes is a long-term condition that affects your body’s ability to process glucose, the main sugar in your body. There are two types of diabetes, type 1 diabetes and type 2 diabetes, and they can have serious health consequences. But, by carefully managing the condition, people with diabetes can still lead full, healthy and active lives.

Type 2 diabetes is linked to being overweight. Having a healthy diet and lifestyle can help manage the diabetes and reduce your risk of developing it.

Prediabetes
Having type 2 prediabetes, often called borderline diabetes, means that you have blood sugar levels that are higher than normal but not yet high enough to be classed as diabetes. If it is undiagnosed or untreated, you may develop type 2 diabetes. The good news is that by making small changes to your lifestyle, type 2 diabetes can be prevented, and the effects of prediabetes can be reversed.

Information on the NHS website

Information about the symptoms of diabetes
A simple self-assessment tool to find out if you are at risk of developing diabetes

Things you can do

• Be active. Aim to do 30 minutes of activity at least 5 days a week. Start with 20 minutes on 3 days each week in the first month. Do something you enjoy!
• Eat healthily. Replace fat (especially saturated fat) with healthier options. Build up to 5 portions of vegetables and fruit over a few months.
• Stop smoking. Get professional help to quit, because smoking can lead to the development of other conditions.
• Reduce your alcohol consumption. Everything can be enjoyed in moderation!

More information on the NHS website

• Healthy living with diabetes
• Travelling and holidays
• Diabetes and your child
• Diabetes and pregnancy
• Looking after your feet
• Looking after your eyes

You can also find local podiatrists on the College of Podiatry website

Other services in Somerset
NHS Change4life
Healthy Somerset (Formerly Zing)
For a list of services and support groups in your area please use the Community Directory

Digestive complaints such as constipation, heartburn and bloating are very common, and can usually be fixed with lifestyle changes and pharmacy remedies. There is more information about digestive health on the NHS website

Coeliac Disease
Coeliac disease is a common digestive condition where a person has an adverse reaction to gluten.

• More information about Coeliac Disease
• Coeliac UK

Crohns Disease
Crohns disease is a long-term condition that causes inflammation of the lining of the digestive system. It can affect any part of the digestive system, but most commonly occurs in the last section of the small intestine (ileum) or the large intestine (colon).

• More information about Crohns Disease
• Crohns UK

Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a common, long-term condition of the digestive system. It can cause bouts of stomach cramps, bloating, diarrhoea and constipation.

• More information about IBS
• IBS Network

Reflux Disease
Gastro-oesophageal reflux disease (GORD) is a common condition where acid from the stomach leaks out of the stomach and up into the oesophagus (gullet).

• More information about Reflux Disease

In a busy day our lower limbs take the brunt of the impact when we stand, walk and run. Because of this load-bearing joints are vulnerable to injury and overload.

Knees
Knee pain – the NHS website provides an overview of knee pain and information about many of the conditions that can cause this problem. There are links to treatment information and a guide for when to seek medical attention.
Knee pain and other running injuries – information about knee, shin, achilles and heel pain, and muscle injuries. It provides treatment advice and links to more information about treatment and prevention of injuries, and tips on running programmes and technique.
Knee replacement surgery – an explanation of the procedure. It also details the indications, alternatives, time to recover, and risks and benefits.
Knee ligament (ACL) surgery – an explanation of the operation, including why it would be carried out, the alternatives, the recovery time, and risks and benefits.

Hips
Hips – an explanation of hip replacement surgery. It details why the operation would be carried out, the alternatives, the recovery time and risks and benefits.

Feet
Bunions – information which explains the condition and gives information about surgical and non-surgical options. The treatment options page and the bunion decision aid give information about surgical options and risks and benefits.
Flat feet – information and some simple self-management advice, exercises and guidance about when to seek medical attention.

Video exercises

Explanation

Straight leg drop

Bent knee drop

More explanation and load progression

There are services in Somerset to help and provide care for people living with HIV and AIDS. We will provide appropriate care to people living with HIV and AIDS once you have been assessed by a social worker or an occupational therapist.

Adult Social Care locality officers will be able to respond to specific needs and signpost on to the appropriate local agency. A support worker from the Eddystone Trust (formerly PASW) will be able to advise on a range of local and national services and will support you as appropriate.

You can find more information on the websites below.

• Somerset Council – Care and support assessment
• The Eddystone Trust
• nam aidsmap
• NHS website – HIV and AIDS

Continence problems affect about 1 in 3 women and 1 in 5 men. You don’t have to put up with this. We tend not to talk to the doctor because we are embarrassed. The good news is that for 70% of people the symptoms can be improved and even cured.

What’s normal
Going to the toilet four to seven times a day, and passing between half a pint and a pint of urine each time.

What’s not normal
If you have pain in your bladder, blood in your urine or difficulty passing urine, then you should see your doctor. You should also see your doctor if you have a change in bowel habit, blood or mucus in your faeces, have stomach pain or unintentional weight loss.

If you have to go to the toilet urgently, frequently or have urinary incontinence or bowel incontinence then support and advice is available.

What you can do

• Make changes to your lifestyle, such as losing weight, not going ‘just in case’, avoid caffeine
• Pelvic floor muscle training (exercising your pelvic floor muscles by squeezing them)
• Bladder training, so that you can wait longer
• Keep hydrated, drink more water, add liquid food to your diet such as soups

Your doctor or the Somerset Continence Service can tell you what type of bladder or bowel problem you have, give general advice about controlling symptoms, give information about pelvic floor exercises and bladder training and give treatment with prescribed medicines.

You can contact the Continence Service on 01935 848247 or find more information on the AgeUK Incontinence website.

You can find information about the different types of incontinence on the NHS Choices website.

NHS – Bowel incontinence
NHS – Urinary incontinence

The liver is the second largest organ in the body. It works hard, performing hundreds of complex functions. In the UK, liver disease is on the increase. Three of the main causes of liver disease in this country are

• alcohol misuse
• obesity
• undiagnosed hepatitis infection

There are more than 100 different types of liver disease. The links below give you information on the three main types. There is more information about the liver and liver disease on the NHS website and the website of the British Liver Trust.

Alcohol Related Liver Disease (ARLD) refers to liver damage caused by alcohol misuse. It covers a range of conditions and associated symptoms.

Non-alcoholic Fatty Liver Disease (NAFLD) is the term for a wide range of conditions caused by a build-up of fat within the liver cells. It is usually seen in people who are overweight or obese.

A gradual weight loss programme along with regular exercise, will help to reduce the amount of fat in your liver.

Hepatitis
Hepatitis can occur as the result of a viral infection or because the liver is exposed to harmful substances such as alcohol.

More information on the NHS website
Information from the Hepatitis C Trust

Local support groups
Many people who have a liver disorder find it useful to meet with other people who also have a liver disorder. For details of local support groups see our support group directory or visit the British Liver Trust website

Useful information on NHS Choices

NHS 12-week weight loss plan
Information about obesity on the NHS website
Information about food and diet on the NHS website

Other useful information

GUTS UK Charity
British Liver Trust
Information about the health effects of alcohol and your liver from Drink Aware
Change 4 Life

Nerve and brain – neurological – conditions is a general term that covers a range of conditions which affect the brain, spinal column or nerves through illness or injury. There are around 600 different neurological conditions.

The NHS Choices A-Z of conditions provides helpful information.

Neurological conditions tend to either be from a sudden onset, needing urgent medical care, or a slower onset with a gradual deterioration. Some of the most common conditions are listed below with links to useful information about them.

Often, people who have had a neurological condition have problems with a number of other areas, such as sensory loss, communication, thinking, fatigue, movement.

You can find more support and help for everyday living, such as equipment, care and support and information about sensory loss in other parts of this website.

Many people with a neurological condition find it helpful to meet with other people with the same condition. You can find information in our Community Directory and by following the useful links below.

Sudden onset

Brain injury and concussion
Headway Somerset

Encephalitis
Encephalitis on the NHS website
Encephalitis Society

Guillan Barre Syndrome
Guillan Barre Syndrome on the NHS website
Gain Charity

Meningitis
Meningitis on the NHS website
Meningitis Now

Spinal cord injury
Spinal Injuries Association

Stroke
Sub arachnoid haemorrhage on the NHS website

Progressive conditions

Dementia
Dementia on the NHS website
Alzheimers Society

Motor Neurone Disease
Motor Neurone Disease on the NHS website
Motor Neurone Disease Association

Multiple Sclerosis (MS)
Multiple Sclerosis on the NHS website
MS Society

Parkinsons
Parkinsons on the NHS website
Parkinsons UK

Other long-term neurological conditions
For some people, neurological problems can be a result of other long-term conditions, or, is something that is not changing and they have had throughout their life.

Brain tumours
Brain Tumours on the NHS website
The Brain Tumour Charity

Chronic Fatigue Syndrome/ME
Chronic Fatigue Syndrome on the NHS website
Action for M.E.
The ME Association
Somerset Partnership Chronic Fatigue Syndrome/ME Service

Diabetes
Diabetes UK

Epilepsy
Epilepsy on the NHS website
Epilepsy Action

Migraine
Migraine on the NHS website
Migraine Trust

A stroke is a serious, life-threatening medical condition that happens when the blood supply to part of the brain is cut off.

If you suspect that you or someone else is having a stroke, phone 999 immediately and ask for an ambulance.

The main stroke symptoms can be remembered with the word FAST

Face – Arms – Speech – Time
Face – the face may have dropped on one side, the person may not be able to smile or their mouth or eye may have drooped.
Arms – the person may not be able to lift both arms and keep them there because of arm weakness or numbness in one arm.
Speech – their speech may be slurred or garbled, or they may not be able to talk at all despite appearing to be awake.
Time – it is time to dial 999 immediately if you notice any of these signs or symptoms.

More information about the symptoms of a stroke and the main causes.

Leading a healthy lifestyle can help to reduce the risk of a stroke. There is more information on the NHS website

• Atrial Fibrillation (AF)
• Treating stroke
• Recovering from a stroke

Transient ischaemic attack is where the supply of blood to the brain is temporarily interrupted and causes symptoms similar to a stroke.

It is sometimes called a mini stroke, and the symptoms often only last between 30 minutes and a few hours. TIAs should be treated seriously because they are often a warning sign that you are at risk of having a full stroke in the near future. Leading a healthy lifestyle can help to reduce the risk of stroke.

You can find more information on the on the NHS website.