Arthritis is a pain, literally, and even though people experience improvement in their symptoms as the weather warms up, it’s still a good idea to keep up with taking care of your arthritis. The most important and best thing you can do for arthritis is to keep moving. Staying fit and maintaining a healthy weight strengthens your muscles, tendons and ligaments, which takes pressure off of your joints.
I think of arthritis in two broad categories: Osteoarthritis is what I call wear-and-tear arthritis. Some people are more prone to it than others by way of their genetics. A history of trauma such as having trashed your knee playing football in high school sets you up for degeneration of that joint as the years go by. The other type is inflammatory arthritis, like rheumatoid arthritis. This is caused by immune system malfunctions, cause severe destruction of joints, and fortunately now can be treated by newer medications that can greatly reduce inflammation and joint destruction. Today I am mostly talking about osteoarthritis.
If you already exercise, keep it up. If you don’t – you should, starting slowly so that you don’t make your joint pain worse. Look for activities that you enjoy and avoid putting additional pressure on your affected joints. Activities that I recommend are walking, cycling, swimming, low-impact or water aerobics, and yoga. The Arthritis Foundation has a more comprehensive list of activities on their website (http://www.arthritis.org/living-with-arthritis/exercise/arthritis-friendly/) that are good options for people living with arthritis.
Summer is a great time to increase the amount of fruits and vegetables in your diet, which may lead to losing some weight, and is generally good for you. I may have mentioned this before. You might try the Mediterranean diet. Studies have shown that people with arthritis benefit from this diet rich in fresh fruits and vegetables, fish, beans and olive oil.
There are a broad range of medications for treating arthritis pain. Many of them are available over the counter while others must be prescribed by your healthcare provider. Over-the-counter medications include acetaminophen, nonsteroidal anti-inflammatory drugs, and topical pain relievers. Acetaminophen is the safest but regular use of large amounts will damage the liver and kidneys. Combining it with regular use of alcohol increases the risk. The maximum acetaminophen dose is 4000 milligrams a day for adults, but I suggest keeping it under 2000 milligrams a day if taken for long periods of time. The anti-inflammatory drugs like aspirin, naproxen, and ibuprofen decrease pain and if taken regularly decrease inflammation but can also cause stomach ulcers, raise blood pressure and damage the kidneys. They can make heart failure worse. If you have chronic medical problems or are older be careful with them and talk to your health care provider about whether or not they are safe for you.
I take and recommend trying glucosamine, especially for arthritis of the hips and knees. The evidence for its benefit is mixed, but many of the studies are of short durations of only 6-12 months. I think of it as a supplement that exerts its effects over years. It is cheap and safe, and I think worth a try. If it helps then you can continue, and if not, you can stop to avoid the financial cost of taking something that doesn’t work for you.
For some, even when you do all the right things to care for your arthritis, the pain is still just too much. When you reach this point, your doctor may suggest surgery. There are many types of surgery that can restore function and relieve pain. Your doctor’s recommendation will be based on what kind of arthritis you have, your state of health, and your personal wishes and goals.
Dr. Bob Riggs is a family medicine physician practicing at Kaiser Permanente’s Riverfront Medical Center. His column appears biweekly in The Spokesman-Review.
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