ARTHRITIS AND JOINT HEALTH

WHAT IS ARTHRITIS

Arthritis is actually a category that includes over 100 different diseases.  By far, the most common form is osteoarthritis.  Osteoarthritis (OA) is generally thought of as “wear and tear” arthritis.  It involves a loss of joint cartilage resulting from friction in the joint over time.  OA is most common in weight bearing joints, such as knees, hips and spine, or in overused joints, such as knuckles and fingers.  Other forms of arthritis, including rheumatoid arthritis (RA), involve a loss of joint tissue due to an overactive immune system.  This tends to happen symmetrically in many small joints.  Neither type of arthritis can be fully cured, but there are many ways to treat and manage arthritis to improve function, decrease symptoms and enhance quality of life.

RISK AND PREVENTION

Risk factors for OA include: overweight, older age, former injuries, family history, and being female.  Risk factors for other forms of arthritis are less clear, although genetics seem to play a larger role.  Most older Americans have some form of arthritis.  Maintaining a healthy body weight, limiting activities that create strain for a particular joint, and properly treating injuries can help to prevent or delay arthritis onset.

MEDICAL MANAGEMENT

The progression of OA is not changed by medication, but medication can be used to help treat symptoms and allow you to be more comfortable and/or more active.  For more advanced OA, occasional injections may be helpful.  Eventually, when most or all cartilage has deteriorated, a partial or full joint replacement may be advised to dramatically improve long-term function.  Autoimmune arthritis, such as RA, requires ongoing medical treatment, usually through a rheumatologist, to help slow disease progression and prevent/reduce disease flares.

LIFESTYLE MANAGEMENT

As with most chronic conditions, the choices you make each day can impact how you feel and how your health changes over time.  Arthritis management is most effective when regular medical care is combined with healthy behaviors.

Weight loss.  Extra body weigh increases the stress on joints and speeds up the loss of cartilage in OA.  In fact, every extra pound of body weight translates to 7 extra pounds of pressure on active knees.  For this reason, weight loss of just 10 lbs has been shown to dramatically reduce arthritis symptoms in weight-bearing joints.

Appropriate activity.  Physical activity is recommended as part of all arthritis management.  It helps to maintain physical function, enhance joint stability, and promote weight loss.  It also reduces the loss of muscle tissue that can result from autoimmune overactivity in RA or the sedentary lifestyle that is common for people with OA.  It is important, however, to find activities that do not aggravate arthritis symptoms.  This may mean changing the type of activity (ie. from walking to swimming) or changing to smaller, more frequent bouts of activity (ie. 10 minutes, 3 times per day).  Be sure to speak with your doctor before beginning any new physical activity.

Appropriate rest.  If it hurts your joints, don’t do it.  While staying active is important, too much of the wrong activity could exacerbate your symptoms and prevent activity for days to come.  It is important to learn the difference between muscle stretching or exertion and joint pain.  If you feel mild sensation in the belly of the muscle during activity, or mild soreness in the day or two after a new activity, that is normal.  If you feel any sharp pain or sensation at the arthritic joint, stop immediately.  You may need to adjust your form, the activity, or the level of intensity.  For example, some people find that switching from an upright stationary bicycle to a recumbent (leaning back) one alleviates the stress on hips and knees.

Stress management.  It is stressful to be confronted with a painful condition that limits your activities, challenges your lifestyle, and makes you rethink your relationship with your body.  Don’t hesitate to rely on your support system.  Ask for help when you need it and talk with your spouse, friends, or family about how you feel. You may also want to find out what resources, events, and classes are available through your local Arthritis Foundation chapter.

Especially if you have autoimmune arthritis, stress can actually exacerbate symptoms.  Be sure to find time to relax, unwind and participate in activities you enjoy.  If you are struggling with stressful life circumstances, you may want to contact your EAP for additional support.

Diet.  One form of arthritis that is particularly impacted by diet is gout.  Gout has been called a “rich man’s disease” because flares can be brought on by a diet high in red meat and rich dairy.  Some people may also notice that specific foods bring on increased arthritis symptoms.  This varies from one person to another in the same way that other food reactions such as allergies can vary.  The best way to determine if your arthritis is associated with diet is to work with an allergist or keep food records to look for a pattern.  Regardless, a diet high in fresh fruits and vegetables with limited processed foods or additives is beneficial for overall health.

OTHER CAUSES OF JOINT PAIN

OA can only be diagnosed with an x-ray or other scan that shows how much space remains between the bones of a joint.  To diagnose RA, a rheumatologist will do some blood tests and assess symptoms to look for factors associated with the disease.  A family doctor may have suggested that your symptoms could be the result of arthritis without actually testing for a clear diagnosis.  If you are concerned that you may have arthritis, speak with your doctor.  You may also have joint pain for other reasons.  The connective tissue surrounding a joint can be irritated due to overuse, imbalance due to misalignment, or the result of an acute injury such as a ligament tear.  If you are experiencing increased pain in a joint, see your doctor to determine the cause and receive appropriate treatment.

If you have joint pain from arthritis or other causes, you may feel frustrated at the limitations it creates.  Those who are most effective at coping with such conditions have a positive outlook about adapting to these changes.  You might see it as incentive to finally lose weight, which will improve many aspects of your health.  In adjusting your activities, you may find a new pastime you enjoy.  You may also start taking better care of your body in a variety of ways that will serve you as you age.  Most older Americans live with some arthritis pain, and many can serve as examples of what a full life you can lead if you and your doctor work together with medical care and lifestyle change to manage it optimally.