SAS - Health - Coping with Arthritis




Try weight loss, weight training and physical therapy before surgery, doctors say

By K.H. Queen

Many of us remember our grandparents wincing with pain and joking about ‘Uncle Arthur’ (arthritis) coming to visit. Surprise: Uncle Arthur visits young people too.

“Most people are surprised to learn they have arthritis,” says Dr. Jeffrey Carlson of The Orthopaedic and Spine Center in Newport News. “Most patients over 30 have some arthritis already.”

Osteo-arthritis (as opposed to rheumatoid arthritis, which is an auto-immune disorder) is a degenerative joint disease. “Our bodies are like any other machine—they wear out with time,” Carlson says. Arthritis shows up most often in the back, then in knees and hips, he says.

The good news—arthritis isn’t always painful, Carlson says. “One study looking at MRI scans of patients with no pain showed that 40 percent of patients over 40 had a disc herniation and no pain,” Carlson says. “The body is handling it.”

At some point, though, you may start noticing the pain, swelling and trouble moving that arthritis brings with it. You may be tempted to take it easy, but that’s actually the worst thing you can do.

“It’s counter intuitive—you’d think you’d want to protect the joint,” says Dr. Jenny Andrus, also of The Orthopaedic and Spine Center. “The most important thing is to keep the joint moving.”

You’d think that constant exercise would wear the joint out faster, Carlson says, but that’s not the case. “By that logic, ultimate marathon runners would burn out quicker, but they don’t.”

Weight-bearing exercise and strength training can help manage arthritis, Carlson says. Lighter weights with more repetitions are preferred to heavy weights, which put more pressure on the joints, he says. With heavier weights, you’re also less likely to work through the full range of motion, he says.

Going through the full range of motion is important to maintain the flexibility of the muscles and tendons around the joints, Carlson says. Depending on where you work out, you may be able monitor on a screen at each machine whether you’re lifting through the entire range of motion.

There’s one kind of weight bearing that’s not good for arthritis—carrying around an extra 20 or 30 pounds of fat, Carlson and Andrus say. Being overweight is especially hard on your knees, Andrus says.

“Maintaining an ideal body weight is very important,” Carlson says. “That takes as much pressure from the joints as possible.”

Trauma, such as falling down, can start or intensify arthritis, Carlson says. If you break a bone, that break also affects the nearby cartilage, he says. That’s one more reason to maintain good health. “You’ll have better reaction time and you can catch yourself rather than fall and break your wrist,” he says.

Physical therapy also can help in the battle against arthritis, Andrus says. For example, the muscles in the front of the thigh that extend the leg can be too weak while the muscles on the back of the thigh that bend the knee can be too strong or tight, she says. That puts pressure on the knee. Physical therapy strengthens those front thigh muscles to even out the pressure and strain on the knee, she says. PT also can help relieve pain, she says.

The old standby RICE for rest, ice, compression and elevation also can provide relief, Carlson says.

Medication, especially anti-inflammatory drugs such as ibuprofen, can help too, Carlson says. Acetaminophen can be used by those who can’t handle the side effects of ibuprofen, he says.

Be wary of herbal remedies that while not necessarily harmful, have not been proven to be beneficial, Carlson warns. The good news is that most people’s arthritis can be managed non-surgically, Andrus says.

When non-surgical methods haven’t provided relief, it’s time to consider surgery, Carlson says. Everyone has his or her own pain tolerance and desired level of activity. A knee or hip replacement can help you get back in the game. But your surgeon may want you to lose weight so you don’t put too much pressure on your new joint, Carlson says.

“If arthritis is getting in the way of the things you want to do, the things you need to do, getting in the way of your life—that’s when it’s time to do surgery,” Carlson says.

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