Aarthritis-37 Coping Strategies-[Part-1]
An estimated 37 million Americans are caught in the grip of some form of arthritis or rheumatic disease. And few of us will make it to a ripe old age without joining the fold. If one of these diseases has a hold on you, read on. While there are no cures, there are steps you can take to ease discomfort and get back more control over your life. There are more than 100 different forms of arthritis and rheumatic disease, with a host of causes, according to the Arthritis Foundation in Atlanta. Among the more widely known afflictions are osteoarthritis, rheumatoid arthritis, gout, and lupus. Osteoarthritis is primarily marked by a breakdown and loss of joint cartilage. Cartilage is the tough tissue that separates and cushions the bones in a joint. As cartilage is worn away and the bones begin to rub against each other, the joint becomes aggravated. In osteoarthritis, this breakdown of cartilage is accompanied by minimal inflammation, hardening of the bone beneath the cartilage, and bone spurs (growths) around the joints. "It will eventually affect virtually everyone in old age," says John Staige Davis IV, M.D., professor in the Division of Rheumatology at the University of Virginia School of Medicine in Charlottesville. Rheumatoid arthritis, on the other hand, is not an inevitable aspect of the aging process. For reasons unknown, the synovial membrane, or lining, of a joint becomes inflamed, so pain, swelling, heat, and redness occur. In the case of gout, needle-shaped uric acid crystals collect in the joints, due to a fault in the body's ability to metabolize, or process, purines. Purines are naturally occurring chemicals found in certain foods, such as liver, kidney, and anchovies. The disease primarily affects overweight, fairly inactive men over the age of 35 (see GOUT). Lupus, on the other hand, affects many more women than men. It is a condition in which the body's own immune system attacks healthy cells. The symptoms are wide-ranging, from joint pain to mouth sores to persistent fatigue. Researchers are beginning to understand what may predispose some people to arthritis. One clue to the puzzle: "There are indications that collagen, which helps form the body's cartilage, may be defective in some people," says Arthur I. Grayzel, M.D., senior vice-president for Medical Affairs at the Arthritis Foundation. While you cannot cure your condition, you can adopt a variety of coping techniques that will leave you more active and in control of your life.
Maintain movement in your joints as best you can.
This can help keep your joints functioning better
for a longer amount of time and, at the same time,
brighten your outlook on life. "Every patient should
keep active," says John R. Ward, M.D., professor
of medicine at the University of Utah School of
Medicine in Salt Lake City. "And remember that
even small movements mean a lot. If all you can
tolerate is a little housecleaning or gardening, for
instance, that's OK, too."
Exercise, exercise, exercise.
"Exercises work best when inflammation has
calmed down," notes Janna Jacobs, P.T., C.H.T.,
physical therapist, certified hand therapist, and
president of the Section on Hand Rehabilitation of
the American Physical Therapy Association
There are a few different types of exercises that
are used to help arthritis sufferers. The simplest,
easiest exercises that can be done by almost any
arthritis sufferer are called range-of-motion
exercises. They help maintain good movement by
putting the joints through their full range of motion.
You'll find several range-of-motion exercises
recommended by the Arthritis Foundation in
"Exercises for Arthritis." Isometrics, in which you
create resistance by tightening a muscle without
moving the joint, can help to strengthen muscles.
Weight-bearing exercises, such as walking, also
build muscle strength. While strengthening
exercises can be beneficial for the arthritis sufferer,
however, they should only be done under the
supervision and care of a therapist or physician,
says Grayzel. And, "anyone with any type of
cardiovascular disease should not do multiple
resistance exercises for a sustained amount of time,
" warns Ward. Stretching, which helps make the
muscles more flexible, is often recommended as the
first step in any exercise regime. Likewise,
warming up your joints before beginning any
exercise makes them more flexible. Massage your
muscles and/or apply hot or cold compresses or
both--whichever your health-care practitioner
recommends or you prefer. A warm shower is
another way to warm up. (See Extra! Extra! - "Heat
or Cold: Which Is Best?")
Give your hands a water workout.
Try doing your hand exercises in a sink full of
warm water for added ease and comfort, suggests
Don't overdo it.
Ward has come up with a "useful recipe" you can
use to see if you've overdone your exercise routine.
See how you feel a few hours after you exercise
and then again after 24 hours. If your pain has
increased considerably during that period of time,
then it's time to cut back on the frequency and
amount of exercise that you're doing, he says. Of
course, if the activity brought relief, you've found a
worthwhile exercise. Tailor your routine to include
the exercises that give you the most relief--and the
Play in a pool.
If you find even simple movements difficult, a
heated pool or whirlpool may be the perfect
environment for exercise (unless you also have high
blood pressure, in which case you should avoid
whirlpools and hot tubs). Try a few of your simpler
exercises while in the water. The buoyancy will
help reduce the strain on your joints. And, "the
warm water will help loosen joints and maintain
motion and strength," says Ward. Even a warm bath
may allow you some increased movement. In a
pinch, a hot shower may do: Running the stream of
water down your back, for instance, may help
relieve back pain.
Don't overuse over-the-counter creams.
These pain-relieving rubs give temporary relief by
heating up the joints. However, "frequent use may
activate enzymes that can break down the cartilage
in the joints," says Davis.
[To Be Continued]
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