The Many Types of Arthritis
Arthritis, one of the most common of all illnesses, is actually
not a single disease, but includes many different conditions,
each having its own course and cause. What they all have in common
is that they affect the joints in the body.
Osteoarthritis, also called degenerative (or 'wear-and-tear')
joint disease, occurs when the smooth cartilage and bone beneath
begin to break down, being replaced with projections or spurs.
The cartilage erodes gradually, finally allowing bone to grate
painfully on bone. The initial cartilage deterioration usually
goes unnoticed because the nerve endings in the joint haven't
yet been affected. Pain appears gradually, commonly after age
40, and may progress in the early stages from discomfort only
after the joint is used, to constant pain, even during sleep in
later stages. The joints most often affected are the neck, back,
hips, knees, feet, the base of the thumb and the middle and end
joints of the fingers.
Your Physician or Nurse Practitioner
Your physician or nurse practitioner will evaluate your condition
by taking a history of your health as well as onset and symptoms
of your condition. This will be followed by a physical exam and
special tests, such as x-rays. Interestingly, by their mid-50's,
almost 80 percent of women will show some evidence of osteoarthritis
Medications can allow you to be active and mobile, since they
control pain and thus allow you to maintain joint movement. This
may slow the progression of the disease. The most common medications
for arthritis include anti-inflammatory drugs and appropriate
over-the-counter pain medications. Work closely with your physician
or nurse practitioner to find the drug that works best for you
with the fewest side effects. Finally, heat therapy in the form
of hot compresses or hot baths or showers may warm up the affected
joint and improve diminished flexibility.
Chiropractic Care for Osteoarthritis
Chiropractic care, which especially focuses on your musculoskeletal
health, is an important component in your management of osteoarthritis.
Your chiropractor will evaluate your particular condition using
their unique 'hands-on' approach, and provide the right spinal
adjustments, heat or muscle therapy. They can also recommend appropriate
range-of-motion or strengthening exercises.
Acupuncture and Traditional Chinese Medicine (TCM) for Osteoarthritis
Your TCM practitioner can provide you with some significant
pain relief for osteoarthritis. Acupuncture and herbal
formulas help the pain and swelling of arthritis the most in its
early stages, since TCM works best to prevent progression
of the disease. It cannot reverse actual joint damage. In the
early stages, a course of acupuncture will be given twice per
week with herbal pills daily for a period of two to three months.
For chronic arthritis, a regular course of herbs normally
control pain with treatment after four weeks. TCM can help reduce
continued use of medication for pain management, since acupuncture
allows the body to create more natural pain-killing chemicals,
and increases local blood circulation to reduce swelling.
Your attitude and the way you handle stress both play a large
part in managing your pain and achieving a good quality of life
despite your arthritis. One study showed that people who reported
high levels of stress experienced much more pain than those who
reported low stress levels. Some simple, stress-relieving exercises
performed on a regular basis can bring you a feeling of peace
and calm. Following are a few of the many techniques you may wish
use or learn more about:
- Massage--a delightful way to relax tense muscles and
experience healing touch.
- Deep abdominal breathing--induces a state of peace
and relaxation and counteracts the shallow breathing that can
often be induced by stress.
- Progressive relaxation--a gradual relaxing of muscles,
head to toe, which helps you discover and correct tight muscles.
- Affirmations and visualization--create the mind-body
connection to enhance relaxation and natural pain control.
- Meditation--calms the mind and relaxes the body.
Social Support - The Love and Help of Others
Don't overlook the value of social support and 'connectedness'
with other people in your life. It is not so much the quantity,
but the quality of our relationships that helps us to manage stress
and cope with pain. When you express your concerns about your
pain or arthritis to friends, relatives or medical personnel,
it will enhance their understanding of your needs and help them
- A balanced diet that includes fruits and vegetables, whole
grains, calcium-containing foods and appropriate amounts of
lean protein is your best basic plan in dealing with osteoarthritis.
This will help get you the majority of nutrients you need from
- Be sure to drink plenty of fluids and water.
- Managing your weight is also extremely important. Excessive
weight puts unnecessary pressure on your joints, thus worsening
- If you have questions concerning an appropriate caloric intake
for you, you may wish to consult with a nutritionist or dietician.
In addition, following are more specific recommendations:
- Get adequate calcium (see below).
- Eat fish containing omega-3 fatty acids (herring,
- Get adequate protein (through whole grains and
beans or 5 oz. of lean meat, chicken, fish, etc. per day)
- Eat high-quality complex carbohydrates (fruit,
vegetables, whole grains and legumes). To avoid getting
too many carbohydrates, limit your consumption of sugars
and processed flours.
- To ensure adequate intake of vitamins C and E and zinc,
eat foods containing these nutrients.
- Vitamin C- citrus fruits, strawberries, cantaloupe,
dark green vegetables, tomatoes, etc.
- Vitamin E- plant oils, green and leafy vegetables,
wheat germ, whole-grain products, liver, nuts and seeds.
- Zinc- meats, fish, poultry, grains, vegetables.
- Take pain medication with food to avoid stomach
Special Note on Calcium
The average American woman falls short of the 1,200 mg RDA for
calcium, taking in only about 400 to 500 mg. Both the National
Osteoporosis Foundation and the National Institutes of Health
recommend that postmenopausal women take 1,500 mg daily
to compensate for calcium loss. If your diet is already rich in
calcium, you may wish to take 1,000 mg per day. These dosages
are safe for the majority of women; however, check with your physician
if you have a personal or family history of kidney disease.
Not all calcium supplements are equally well absorbed. An acidified
form of calcium called calcium citrate is best, followed
by the less expensive calcium carbonate. Calcium lactate and calcium
gluconate are quite poorly absorbed. Take calcium pills with meals
and in divided doses to further enhance absorption.
Osteoarthritis and Exercise
You may have wondered about physical activity and osteoarthritis.
If the damage is partially caused by wear and tear on the joints,
won't exercise make that worse? The answer is a definite "no"--but
you must choose the right activities, ones that protect your joints.
In fact, the saying "use it or lose it" really applies
to your arthritic joints. Maintaining mobility through use of
the joint is vital in preventing stiffness and eventual immobility.
The kinds of exercise that will benefit your arthritis include
range-of-motion, muscle strengthening and aerobic activity.
- Range-of-motion exercises are designed to take each joint
through its full movement pattern. Routine daily activities
normally do this, but arthritis sufferers unconsciously favor
tender joints. So make the commitment to choose daily exercises
to gently stretch and move affected joints. Start by
repeating each exercise 2 or 3 times twice a day and progress
to 10 repetitions 4 times per day.
- Muscle strengthening exercises are important to help
prevent the weakened muscles so common around affected joints.
- Weight training which involves movement of the joint against
resistance should be undertaken only under the supervision
of a physical therapist. You can safely do isometric exercises
(contracting the muscle without moving the joint) on your own.
- Finally, select a moderate low-impact aerobic activity
to avoid any trauma to your feet, knees and hips. Activities
that qualify include walking, biking or stationary cycling,
or water activities in a pool heated to at least 80 degrees.
Try to accumulate about 30 minutes of aerobic activity most
days of the week, but make it a goal not to drop below four
General Guidelines for Exercising with Osteoarthritis
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- Coordinate your medication to receive maximum benefit during
your exercise session.
- Prior to exercise, use a warm bath, shower or hot pack to
increase flexibility; apply cold to reduce joint pain.
- Check with your physician before beginning an exercise program.
- Start slowly and gradually increase your repetitions for range-of-motion
and strength exercise and duration for aerobic sessions.
- If you experience pain, stop to rest, then resume at a slower
- Cut back on your sessions if joints are more painful the following
day or are still painful two hours after exercise.
- Always warm up before exercising. Gently move the joints and
muscles you'll be using to lubricate the joint and increase
- Never exercise to strain or exhaustion.
- To increase your enjoyment, exercise with a friend, accompanied
by music or in a beautiful setting.