Question

My mother had arthritis for 40 years, and when my little fingers became painful and disfigured, I reluctantly had to accept that I have it, too. My doctor persuaded me to try diclofenac, but because I'm not in too much pain I decided not to take it. Yesterday, for the first time, I found my grip affected and seemed to lose strength in my left hand. I want help managing this illness, but I don't know where to start. My doctor says my arthritis isn't bad enough for me to see a specialist yet. I'd rather not take drugs, but am open to dietary and exercise advice. I'm 49 and 4st overweight, though I go to the gym twice a week (mainly treadmill and bike), walk the dog a couple of miles daily and work with small children, so I'm on the go all day.

The dietician

Jacqui Lowdon

The best thing you can do is to lose weight, as you are putting stress on your joints. Also, if the arthritis progresses, being overweight will make you less mobile, and the less you move your joints, the more likely they are to seize up. You sound fairly active, so you must be eating more than you think. Keep a food diary of everything you eat and drink over a week - people are often shocked at the extent of their snacking. Reduce the fat and sugar in your diet as much as possible, and increase fibre.

Have at least five portions of fruit and veg a day (though avoid acidic fruits as some people find oranges, grapefruits or pineapple aggravate their symptoms), and try not to snack. Most women eat about 2,000 calories a day, so aim for 500 calories less for sustainable weight loss. If you find it hard, ask your GP to refer you to a dietitian or try a reputable weight-loss club. The British Dietetic website has lots of info on how to lose weight healthily (0121 200 8080; www.bda.uk.com)

· Jacqui Lowdon is a registered dietician at the University Hospital of Wales, Cardiff

The rheumatologist

David Doyle

Most muscle and joint aches don't develop into arthritis, so it's important to get a definitive diagnosis. Your mother having arthritis doesn't mean you will, though I understand why you're anxious. If you do have it, you have the right to demand a referral to a rheumatologist. Whether you have rheumatoid or osteoarthritis will determine treatment. Osteoarthritis is more common, starts around the menopause, and affects the joints - fingers, base of thumbs, knees, back.

This sounds more likely for you, which is fortunate as most people can work around it with lifestyle measures such as eating healthily, keeping fit and losing weight. Rheumatoid arthritis is more progressive, can start earlier and will need regular specialist attention. Whatever your diagnosis, charities such as Arthritis Care (0800 800 4050; www.arthritiscare.org.uk) offer helplines, forums and news on breakthroughs, and can improve the way you view your condition.

· Dr David Doyle is a consultant rheumatologist at Whipps Cross University Hospital, London

The acupuncturist

Angela Hicks

Research shows that acupuncture has a significant effect on joint pain, including both rheumatoid and osteoarthritis. The earlier treatment starts, the better the prognosis. An acupuncturist will give a diagnosis based on your symptoms and other signs they observe. Your symptoms suggest a build up of fluids obstructing your joints. Chinese medicine describes this as 'dampness'. Excess fluids might also explain why you are overweight in spite of exercising, and moving them might also enable you to lose weight.

Thus your practitioner may not treat your aches and pains directly, but will deal with their underlying cause. They may suggest dietary changes and avoiding 'damp'-forming foods like dairy produce and fats. Be optimistic about regaining your health and that you need not repeat your mother's illness. To find an acupuncturist, contact the British Acupuncture Council (020 8735 0400; www.acupuncture.org.uk).

· Angela Hicks is joint principal of the College of Integrated Chinese Medicine

· If you have a health question for our experts, email health@observer.co.uk