Keep Moving to Manage Arthritis Pain
Jewel A. Stevens, MD, is a family medicine specialist at Atrium Medical Center in Middletown.
Q. What are the two types of arthritis and their causes? How is osteoarthritis usually treated? Can I prevent it?
A. “Well, Madge,” I said, “I’m not used to seeing you in June. Is everything OK?”
Madge, a healthy 68-year-old, is a retired Elder Beerman sales clerk. She usually comes into my office once a year, in October, for her annual checkup and refill of thyroid medication. Madge and her husband are avid golfers who stay in Florida during the winter to continue their hobby. I could see she was worried.
“My knees are bothering me,” she said. “They don’t hurt so much while I’m carrying my bag and walking, but in the evening, I’m having quite a bit of pain. My family thinks I should cut back and play only nine holes, but I really don’t want to. Do you think golf is hurting me?”
After examining her and getting some laboratory and x-ray testing, I was able to reassure Madge that she had osteoarthritis. Not only could she continue playing 18 holes of golf, but this exercise also was critical in her treatment. We discussed some ways she could deal effectively with her problem, and what we could do if her symptoms became much worse.
Like Madge, many people develop osteoarthritis, and knowledge is power. If you know how to work around it, you will not become crippled.
Arthritis can be divided into two main classes: aging and inflammatory.
Aging or “wear-and-tear” arthritis, called osteoarthritis, is thinning of the cartilage, the Teflon-like layer that coats the ends of bones at joints. This thinning creates rough places in the joints which no longer glide smoothly. Injury, inheritance, overweight and overuse are causes for premature osteoarthritis, but any person over age 50 will have some trouble with it.
Inflammatory arthritis includes rheumatoid, gout, lupus, psoriatic and ankylosing spondylitis. In these forms of arthritis, stiffness and pain last longer after you get up in the morning. If you have serious difficulty with joint motion after rest and need more than two hours to loosen up, you may have inflammatory arthritis. A joint specialist, called a rheumatologist, can best treat inflammatory arthritis.
For osteoarthritis, treatment starts on the conservative level. The old saying “motion is lotion” really applies. Since cartilage has a poor blood supply, nourish it by compressing and releasing joints in exercise. Work out regularly to keep muscles strong and protect joints from further damage. Exercise also causes the body to release natural morphine-like compounds to reduce pain.
We need at least 30 minutes of activity and 10 minutes of hard exercise each day to keep joints functioning at their best. Even those with significant knee or ankle problems can do water aerobics or ride an exercise bicycle. Taking pain medication before exercise, such as eight-hour time-release acetaminophen, can improve joint function by making motion much easier.
When these measures fail to keep you comfortable, joint injections with either “viscosupplementation” or steroids can provide relief for up to six months.
If destruction of joint surfaces becomes severe, joint replacement is usually required to stop pain and help you resume an active lifestyle. Usually you should wait until you cannot stand the pain any longer to ask for surgery, but waiting too long can lead to muscle wasting and prolong recovery. Your doctor can refer you to an orthopedic surgeon for a thorough evaluation.
A healthy lifestyle helps prevent crippling from arthritis. Maintain a reasonable weight so your hips, knees and ankles have less work to carry you about. Men should keep their waistlines at less than 40 inches, and women at less than 35 inches.
Run your plate “through the garden.” Make fruits and vegetables half of everything you eat so that your bones and joints have nutrients to function and repair. Bang those bones! Exercise regularly to keep muscles strong and cartilage healthy. Protect your joints from injury by wearing proper sports equipment and use good judgment to avoid dangerous activity and falls. Keep a joyful attitude about life.
Giving into pain and becoming a couch potato will only make arthritis worse. We cannot completely prevent osteoarthritis, but we can keep it from getting us down and out.
This information is for educational purposes only. Please talk to your physician for advice in all matters related to your health.