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Joint Management: Arthritis afflicts millions. Here’s how to cope



The dinosaurs had it. Cave painters in ancient Africa had it. Today, nearly one in three Americans (including kids and people of every racial and ethnic group) have it.

More than a hundred diseases and condi-tions affecting the joints and surrounding areas are labeled “arthritis,” which causes more disabilities than any other disease in America.

Osteoarthritis—brought about by deterioration of a joint’s cartilage—is the most common form. In fact, X-rays indicate some osteoarthritis in nine out of ten 40-year-olds. Half of adults 75 and over report they’ve been diagnosed with some form of arthritis.

Although experts say most people can prevent or manage symptoms with basic behavior modifications, about half of the population believes that nothing can be done.

Paul Zastrow was one of those people. Zastrow started feeling aches and pains in his knees and shoulders in his 40s, but it took him several years before he talked to to his doctor. Zastrow’s shoulder eventually got bad enough that he had to have an operation, and he still has a hard time doing any work that involves raised arms.

fitness1.jpgTerrier therapy

Now 61 and retired from his career as a high school science teacher in Hood River, Oregon, Zastrow uses simple solutions like hot showers and daily aerobic exercise to curtail discomfort. Every morning, he takes his Boston terrier puppy out for a walk.

“Sometimes my knees don’t want to work so well,” says Zastrow. “And sometimes my hip hurts. But it’s important to keep moving, and not to take any more [over-the-counter] pain medications than necessary.”

The amount of damaged cartilage is not as important as the way a patient takes care of the condition, according to Vijay Vad, M.D., author of "Arthritis Rx." Vad, a physician for the PGA golf tour, says that although activity modifications may be necessary to protect joints, it’s crucial to maintain a healthy weight and to keep moving.

Conversely, being overweight, having weaker muscles, or decreased endurance can aggravate flare-ups. In short, “The healthier the individual, the less likely they are to have bad joints,” says W. Hayes Wilson, M.D., Chair of the Medical and Scientific Committee of the Arthritis Foundation.

Researchers are searching in earnest for better ways to prevent, diagnose, and ultimately cure arthritis. Just three decades ago, physicians regularly advised avoiding exercise. That created a vicious cycle of patients becoming stiffer and crippled with pain. Today, experts agree that especially for those with mild to moderate arthritis, lifestyle choices are critical.

Small adjustments can add up to major results: A recent study found that losing 15 pounds improves knee osteoarthritis symptoms nearly 50 percent.

Prescription pills or surgery are last resorts for severe cases. Wilson says there are new drugs that “have been unbelievable in terms of rheumatoid arthritis,” which is a less common and often more severe form of the disease.

Can we expect a vaccine or a cure for arthritis in our lifetime? “It’s like world peace,” says Wilson. “It’s hard to put a time frame on that.”

Short Takes

Keep on moving

The Arthritis Foundation has a series of water-, land-, and chair-based exercise programs. Aquatic workouts offer the advantage of an aerobic workout without stressing joints and muscles the way that squats or stairs can.

The new “Tai Chi from the Arthritis Foundation” program was developed by a tai chi master who himself had arthritis. It deals with movement, breathing, and flexibility—without the traditional deep knee bends.

“Today we’re fascinated with yoga and tai chi because they focus on the self, they’re relaxing, and they help with the mind-body connection and flexibility,” says Doreen M. Stiskal, a professor at Seton Hall’s medical school who has also been volunteering with arthritis patients since she was first asked to lead a water exercise class 23 years ago.

“Especially if somebody’s recently retired, they may say, ‘My knees hurt, so why should I move more?’ Here’s where gaining knowledge and being a good self-manager comes in,” says Stiskal. “Do not hesitate to find good resources and to ask questions. The leading research about making behavioral changes or having a successful exercise program shows that the key is self-efficacy.” In other words, an individual’s belief in his or her ability to overcome obstacles is the key to actually doing so.

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24-May-06


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