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Living with Arthritis: Take an Active Approach

Arthritis is the leading cause of disability in the United States. According to the Centers for Disease Control and Prevention (CDC), it affects one out of every six adults in America. The CDC reports that arthritis is highly under treated. For some reason, many people are under the impression that arthritis is a normal part of aging and you just have to put up with it.

The truth is that there’s a lot you can do to decrease the pain and stiffness, and in some cases, even stop the progression of arthritis.

Osteo- and rheumatoid arthritis: the most common types
Osteoarthritis is the most common arthritis type. It’s often called the “wear and tear” disease. Joint pain, stiffness and swelling occur when cartilage wears away.

Cartilage is a sponge-like substance that protects the joints. When you apply pressure to a joint—such as the ankle, knee and hip joints during a walk—you squeeze water out of your cartilage into the space between your bones. The water mixes with other fluid there, and when you relax your joint, the cartilage reabsorbs the fluid.

Over time, the cartilage becomes less resilient. It becomes softer and more susceptible to wear and tear. It works less efficiently. This process results in pain, stiffness and swelling in and around the joints.

Rheumatoid arthritis (RA) is the second most common arthritis type. It’s a disease of the immune system. The membrane that surrounds the joints (the synovial membrane) forms extra, unneeded tissue. Cells in this tissue release enzymes that eat into cartilage, bone and soft tissues. Tendons and the joint capsule may become inflamed, causing pain and possible bone damage. If the progression of the disease is not stopped, joint deformity may occur.

Rheumatoid arthritis is more complex than osteoarthritis, but many of the lifestyle changes that affect both conditions are similar.

What you can do to manage the pain
The worst thing you can do for arthritis is give in to the pain and stop moving. Don’t stay home and watch television! There’s so much you can do, in so many areas of your life, to ease the pain and keep yourself living an active, productive life. It might mean that you need to take a second look at a lot of your habits and activities. Eating the right food, exercising regularly, keeping your weight in the healthy range, taking medication and investigating some alternative treatments—all of this can sound like a tall order. But little by little, you can make a big improvement in your quality of life.

The important thing is to make the kinds of changes you feel comfortable with. Nobody wants you to do anything that seems too radical for you. But the more areas of your life you look at and try to change for the better, the more likely you are to be able to stay active and enjoy your life.

Here are some suggestions that can get you on a good track.

What should you eat?
Eating the right kinds of food, and avoiding others, can actually help a lot of people manage their arthritis pain. Be sure you’re getting plenty of omega-3 fatty acids in your diet. Good sources of this essential fatty acid include:

  • Fish oils—salmon, herring, cod, trout and mackerel (fish raised on farms have a lower level of omega-3s)
  • Walnuts and walnut oil
  • Flaxseeds and flaxseed oil
  • Fruits and vegetable to keep your vitamin intake high

Additionally, some practitioners believe that ginger and turmeric can help reduce the inflammation of arthritis. It can’t hurt to try cooking with these two spices.

What foods should you avoid?

  • Butter
  • Hydrogenated fats (found in many snack foods, such as potato chips, crackers, corn chips, etc.)
  • Trans-fatty acids (found in many margarines, shortening and cottonseed oil and many fast foods)

Additionally, some healthcare professionals and researchers believe that pork and other pig products can cause inflammation. In fact, there are some professionals in the healthcare field who believe that avoiding all meats except fish is beneficial for people with arthritis, especially rheumatoid arthritis. This approach might seem a little radical, but it’s worth a try if you’re interested. If you think a vegetarian diet that includes fish sounds appealing, talk with your doctor, a dietitian or nutritionist to make sure you’ll be getting the right kinds of foods in your diet.

Manage your weight
It only makes sense—the less weight you put on your joints, the better your joints will feel. For instance, knee pain is one of the most common arthritis symptoms. When your knees hurt, it’s hard to make yourself get up and go. But if you keep your weight in the healthy range, you should notice a lot less pain in your knees.

If you struggle to keep your weight in the healthy range, you may want to get advice from a dietitian or nutritionist. These professionals can take a look at the foods and amounts you’re eating now, and then help you crate a food plan that eliminates some of less healthy stuff and focuses on adding other, nutritious foods that you’ll enjoy.

Nutritional supplements to try
There’s some evidence that glucosamine and condroitin sulfate help some people with arthritis, while other people see no improvement. The people who do see improvement notice better joint function, pain relief and less stiffness. It may take about eight weeks before you notice any improvement. Dosages generally should range from 1,000 to 2,000 milligrams per day. Ask your doctor about these supplements and about what dosage would be right for you.

Additionally, it’s possible that getting plenty of vitamins can help slow the progression of osteoarthritis. You may want to talk to your doctor about whether it’s a good idea for you to take vitamins C, D, E and beta carotene.

Acupuncture seems to help some people
There’s some evidence that acupuncture can help relieve the pain of arthritis, and very little evidence that acupuncture causes any harm at all. If you’re interested in giving it a try, find a licensed practitioner in your area. You could ask your doctor or other healthcare provider for a referral. Or see if you can get a referral from friends or family members.

Managing the pain with medication
For some people with arthritis, over-the-counter pain medication, such as acetaminophen, is enough. For others, stronger medications, such as NSAIDS (non-steroidal anti-inflammatory drugs), are more helpful. The problem is that these drugs can be hard on the stomach, especially after long-term use. Scientists are currently working to develop safer NSAIDS. One class of these drugs, called COX-2 inhibitors, is currently available. It helps with the inflammation of arthritis but is less likely to cause stomach ulcers and bleeding.

Additional medications that are being developed now would prevent or slow down joint damage or encourage new growth of cartilage.

Because there are so many medications that can help control arthritis pain, it’s really important to get to the doctor and talk about where your pain is, how it affects your life, and what drugs you can take to get the pain to a manageable level.

Exercise: a cornerstone of arthritis management
Exercise helps keep your joints flexible and it helps you manage your weight. The problem is that arthritis pain can often make people not want to exercise at all. But studies have shown that people with arthritis who exercise eventually feel less pain and notice improved joint function.

If you’re not already getting regular exercise, it’s important to start. Talk with your doctor about the kinds of exercises that would be good for you. Doctors often recommend walking and swimming for people with arthritis. Walking may be difficult at first, but the more you do it, the better it will feel and the farther you’ll be able to go. Remember, start small. Do it gradually. Eventually, you’re likely to notice big results.

The main message: if you have arthritis, you need a plan of action
No matter what kind of arthritis you have, the chance is good that there are ways to treat it that didn’t exist even five years ago. New medications and new information about the effects of lifestyle have made arthritis treatment more effective than ever before. When you think of arthritis, don’t imagine an elderly person sitting in a chair in pain, dropping out of life’s activities. It’s not like that anymore.

Talk with your healthcare providers—family doctor, nutritionist or dietitian, physical therapist, nurse practitioner—to put together an action plan that will help you stay in control of your arthritis and your life.


Source:
American Family Physician, 15 January 2003; Archives of Internal Medicine, 14 October 2002; Centers for Disease Control and Prevention; E Kamhi, E Zampieron. Arthritis. AlternativeMedicine.Com, Tiburon, California, 1999; National Institute on Aging; National Institute of Arthritis and Musculoskeletal and Skin Diseases; A Weil. Eating Well for Optimum Health. Alfred A Knopf, New York, New York, 2000



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