Treating both depression and inflammation can reduce severe pain in people with rheumatoid arthritis (RA), Japanese researchers say.
They studied 218 RA patients who provided information about their pain levels, depression symptoms, year of RA onset, smoking and drinking habits and socioeconomic demographics. The researchers collected blood samples from the patients to measure levels of CRP, a protein produced by the liver. Levels of CRP rise during periods of acute inflammation. RA treatments often focus on reducing inflammation.
The study found that inflammation and depression each independently increased the likelihood of severe pain. The combined effects of high CRP levels and depression predicted severe pain even more strongly.
"Results of our research demonstrate the potential for clinicians to improve pain control by addressing their patients' psychological symptoms in addition to conducting anti-inflammatory therapy," study leader Dr. Masayo Kojima said in a news release.
The findings suggest that psychotherapy and/or psychotropic medication might be a priority for RA patients who experience severe pain without elevated levels of CRP.
"A clinical approach that takes into account both the body and the mind could have benefits and could enable optimal pain control," the researchers at Nagoya City University and Nagoya University Graduate Schools of Medicine said in a news release.
The study appears in the August issue of the journal Arthritis Care & Research.
Another report in the same issue found that RA patients with depressed spouses suffered worse disease progression over the one year studied. The Canadian study included 133 married RA patients.
"Our findings highlight the key role played by the spouse in disease course of individuals with RA, and point to the importance of including the spouse in clinical interventions," Anita DeLongis and colleagues at the University of British Columbia said. "The mood and mental health of the marital partner or other key members of the family may be critically important to consider in developing more effective and evidence-based treatment for RA patients."
Friday, February 26, 2010
Arthritis.Antibiotic doxycycline
A common antibiotic may slow the progression of osteoarthritis.
A new study shows that treatment with the antibiotic doxycycline slowed the deterioration of joint tissue in women with osteoarthritis of the knee.
Doxycycline is used to treat a variety of bacterial infections. Previous lab tests with animal and human tissue showed that doxycycline may help preserve joint tissue, say the researchers. They add that this is the first major study of the antibiotic as a potential treatment for osteoarthritis.
Osteoarthritis is a common form of arthritis that causes progressive destruction of the cartilage that cushions the joints. Common symptoms are joint pain and stiffness. When severe, osteoarthritis can cause loss of movement in the affected joint.
Antibiotic for Osteoarthritis?
In the study, which appears in the July issue of Arthritis & Rheumatism, researchers compared the effects of doxycycline to a placebo in about 400 obese women with knee osteoarthritis. Specifically, they measured the impact of treatment on the joint space in the affected knee. More joint space indicates a loss of cartilage and progression of the disease.
The women were randomly divided into two groups and received either 100 milligrams of the antibiotic twice daily or a placebo for up to two and a half years.
After 16 months of treatment, the study showed that the average loss of joint space in the diseased knee was 40% less among those who took doxycycline vs. the placebo. After two and a half years, the average loss among the antibiotic group was 33% less.
Although these results suggest the antibiotic slowed the progression of the osteoarthritis, researchers say it did not reduce the severity of joint pain reported by the participants.
However, researchers say the average level of pain was low in both groups, which may have provided limited opportunity for the treatment to show an effect on pain.
But doxycycline was associated with a reduction in the number of times the patients reported a 20% or more increase in knee pain.
Researchers say the study suggests that the antibiotic may provide benefits in the treatment of osteoarthritis but more studies will be needed to confirm these results.
A new study shows that treatment with the antibiotic doxycycline slowed the deterioration of joint tissue in women with osteoarthritis of the knee.
Doxycycline is used to treat a variety of bacterial infections. Previous lab tests with animal and human tissue showed that doxycycline may help preserve joint tissue, say the researchers. They add that this is the first major study of the antibiotic as a potential treatment for osteoarthritis.
Osteoarthritis is a common form of arthritis that causes progressive destruction of the cartilage that cushions the joints. Common symptoms are joint pain and stiffness. When severe, osteoarthritis can cause loss of movement in the affected joint.
Antibiotic for Osteoarthritis?
In the study, which appears in the July issue of Arthritis & Rheumatism, researchers compared the effects of doxycycline to a placebo in about 400 obese women with knee osteoarthritis. Specifically, they measured the impact of treatment on the joint space in the affected knee. More joint space indicates a loss of cartilage and progression of the disease.
The women were randomly divided into two groups and received either 100 milligrams of the antibiotic twice daily or a placebo for up to two and a half years.
After 16 months of treatment, the study showed that the average loss of joint space in the diseased knee was 40% less among those who took doxycycline vs. the placebo. After two and a half years, the average loss among the antibiotic group was 33% less.
Although these results suggest the antibiotic slowed the progression of the osteoarthritis, researchers say it did not reduce the severity of joint pain reported by the participants.
However, researchers say the average level of pain was low in both groups, which may have provided limited opportunity for the treatment to show an effect on pain.
But doxycycline was associated with a reduction in the number of times the patients reported a 20% or more increase in knee pain.
Researchers say the study suggests that the antibiotic may provide benefits in the treatment of osteoarthritis but more studies will be needed to confirm these results.
Antioxidants in pomegranates may thwart osteoarthritis
Researchers aren't making that declaration just yet. But they have found signs that natural compounds called antioxidants in pomegranates may thwart osteoarthritis.
Osteoarthritis is the most common type of arthritis, with more than 20 million patients in the U.S., according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).
The pomegranate study was done at Case Western Reserve University. The researchers included Tariq Haqqi, PhD, a professor of medicine. The results appear in The Journal of Nutrition.
Pomegranate Project
Pomegranate extract was pitted against osteoarthritis in lab tests. That's not the same as tests on people or animals, but it's a first step.
Pomegranate extract did two things in those lab tests. It cut levels of an inflammatory chemical called interleukin-1b (IL-1b). It also curbed enzymes that erode cartilage.
Cartilage is a hard but slippery coating on the end of each bone that helps bones slide smoothly past each other. Osteoarthritis develops when cartilage is broken down; exposed bone breaks down, causing pain, inflammation, and disability.
First Findings
This is the first study to show pomegranate's potential against osteoarthritis, note the researchers.
The results "indicate the pomegranate fruit extract or compounds derived from it may inhibit cartilage degradation in osteoarthritis and may also be a useful nutritive supplement for maintaining joint integrity and function," they write.
Researcher's Comments
"Arthritis is one of the foremost diseases for which patients seek herbal or traditional medicine treatments," says Haqqi in a news release.
"However, all the extracts and herbs have not been scientifically evaluated for their efficacy and safety. Indeed, some of them may even interfere with current treatments," he continues.
"Therefore, careful use of supplements and herbal medicines during early stages of disease or treatment may be made to limit the disease progression," says Haqqi.
As always, discuss any supplement use with your doctor.
Pomegranate Potion
The researchers didn't just crack open a pomegranate and put it in a blender. They also didn't use juice from the supermarket.
Instead, they made their own pomegranate extract from powdered pomegranate. Sophisticated filtering and measuring was used for science's sake.
The pomegranate has "been revered through the ages for its medicinal uses," write the researchers.
Antioxidants in pomegranates fight inflammation and may also counter cancer and heart disease.
In May, researchers reported that pomegranate juice may help prevent the return of prostate cancer. In March, another study showed that pomegranate juice may fight hardening of the arteries.
Pomegranate Season
Pomegranates are in season in the U.S. in the fall. They've got a thick, red, leathery skin. The seeds inside are the edible part.
Want to try a pomegranate? You might want to wear a bib or old clothes. The seeds leave a very strong stain and are used as a dye.
Osteoarthritis is the most common type of arthritis, with more than 20 million patients in the U.S., according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).
The pomegranate study was done at Case Western Reserve University. The researchers included Tariq Haqqi, PhD, a professor of medicine. The results appear in The Journal of Nutrition.
Pomegranate Project
Pomegranate extract was pitted against osteoarthritis in lab tests. That's not the same as tests on people or animals, but it's a first step.
Pomegranate extract did two things in those lab tests. It cut levels of an inflammatory chemical called interleukin-1b (IL-1b). It also curbed enzymes that erode cartilage.
Cartilage is a hard but slippery coating on the end of each bone that helps bones slide smoothly past each other. Osteoarthritis develops when cartilage is broken down; exposed bone breaks down, causing pain, inflammation, and disability.
First Findings
This is the first study to show pomegranate's potential against osteoarthritis, note the researchers.
The results "indicate the pomegranate fruit extract or compounds derived from it may inhibit cartilage degradation in osteoarthritis and may also be a useful nutritive supplement for maintaining joint integrity and function," they write.
Researcher's Comments
"Arthritis is one of the foremost diseases for which patients seek herbal or traditional medicine treatments," says Haqqi in a news release.
"However, all the extracts and herbs have not been scientifically evaluated for their efficacy and safety. Indeed, some of them may even interfere with current treatments," he continues.
"Therefore, careful use of supplements and herbal medicines during early stages of disease or treatment may be made to limit the disease progression," says Haqqi.
As always, discuss any supplement use with your doctor.
Pomegranate Potion
The researchers didn't just crack open a pomegranate and put it in a blender. They also didn't use juice from the supermarket.
Instead, they made their own pomegranate extract from powdered pomegranate. Sophisticated filtering and measuring was used for science's sake.
The pomegranate has "been revered through the ages for its medicinal uses," write the researchers.
Antioxidants in pomegranates fight inflammation and may also counter cancer and heart disease.
In May, researchers reported that pomegranate juice may help prevent the return of prostate cancer. In March, another study showed that pomegranate juice may fight hardening of the arteries.
Pomegranate Season
Pomegranates are in season in the U.S. in the fall. They've got a thick, red, leathery skin. The seeds inside are the edible part.
Want to try a pomegranate? You might want to wear a bib or old clothes. The seeds leave a very strong stain and are used as a dye.
Arthritis.Recipes
These recipes are packed with great taste, and the good nutrition that helps
limit the joint swelling of arthritis, keeps bones strong, and promotes overall
health! Some dishes are super easy, and others take a little bit more
preparation. But all provide delicious, balanced meals.
Breakfast
Pumpkin Pie Smoothie
Enjoy with a whole grain English muffin
1/2 cup canned pumpkin
1/2 cup milk
Pinch cinnamon
2 teaspoons sugar or artificial sweetener to taste
Combine all ingredients in a blender or food processor. Whip on high speed for 2
to 3 minutes, or until frothy. Serve immediately. Makes about 1 1/2 cups.
Peanut Butter Banana Smoothie
Pair this one up with a whole-grain English muffin, too
3/4 cup plain yogurt
1 medium banana
2 tablespoons peanut butter
2 ice cubes
Combine all ingredients in a blender or food processor. Whip on high speed for 2
to 3 minutes or until frothy. Serve immediately. Makes about 1 1/2 cups.
Berry Fluffy Pancakes
Serve with a glass of orange juice fortified with calcium and vitamin D
1 cup plain nonfat or low-fat yogurt
1 large egg
1 cup pancake mix
1 cup fresh blueberries or raspberries
In a bowl, combine yogurt and egg. Mix well. Add pancake mix and blend just to
combine. Lightly oil or spray a nonstick pan or griddle. Ladle out 2 tablespoons
batter for each pancake. Drop a few berries onto pancake. When edges are firm,
turn pancakes and cook 1 minute more. Serve immediately. This will give you 3
pancakes, but you can make extra and freeze.
Jazz-y Oatmeal
Prepare a packet or two of regular instant oatmeal in the microwave according to
directions, with milk or soy beverage. After cooking, stir in 1/2 cup applesauce
and 1/4 cup raisins (more if using 2 packets) and pinch of cinnamon, if desired.
Confetti Cottage Cheese
Add 1/4 cup dried pre-chopped apricots; 2 tablespoons chopped walnuts; and 1
tablespoon ground flaxseed to 1 cup low-fat cottage cheese. Serve on top of a
toasted Heart Healthy Cinnamon Raisin bagel from Sara Lee. One bagel supplies 48
grams of whole grain, the minimum amount experts recommend you get each day.
Waffle Sandwich
Toast two high-fiber waffles, such as Kashi Go Lean Original Whole Grain. Spread
each waffle with 1 tablespoon peanut butter or almond butter to make a sandwich.
Have with a glass of low-fat milk and fruit.
Lunch
Easy English Muffin or Pita Pizzas
Top each half of a whole-grain English muffin or a small whole-wheat pita round
with 1/4 cup marinara sauce and 1/4 cup grated cheese. Broil in a toaster oven
or in the regular oven for about 5 minutes, or until the cheese melts. Cool
before eating. Serve with a glass of orange juice fortified with calcium and
vitamin D.
Soup du Jour
Add an equal amount of cooked small whole grain pasta, such as DaVinci's whole
wheat elbows or leftover brown rice to a can of lentil or split pea soup (reserve
half for another meal). Serve with fruit and a glass of milk or 8 ounces low-fat
yogurt.
Scrambled Egg and Salsa Sandwich
Scramble one or two eggs. Fill each half of a small whole-wheat pita pocket with
the cooked egg. Top with mild salsa or ketchup and 1/4 cup grated cheddar cheese.
Enjoy with fruit or baby carrots and a glass of low-fat milk.
A Better Burger
Microwave a Perdue Frozen Seasoned Chicken Burger to have on a whole grain bun.
Or go vegetarian with Boca Burger's All American Meatless Burger. Pair with baby
carrots or presliced celery sticks and a glass of low-fat milk.
Dinner
No-Cook Roast Chicken Dinner
Purchase one or two (depending on how many are eating) roasted chickens from the
supermarket. Pick up pre-cut salad greens and a package of grape tomatoes. Add
chopped fresh, frozen, or low-sodium canned vegetables to your cart. Serve with
whole grain bread from the bakery. (Use leftover chicken the next day with
whole-wheat bread or sandwich wraps for lunch!)
Go With Grains
Add leftover chopped chicken, turkey, or beef, and cooked vegetables to tabouleh
mix from Fantastic Foods or Near East. Near East also makes Whole Grain Blends
that go well with meat and vegetables. Serve the combo over salad greens.
Simple Skillet Salmon for Two
Combine 1/2 cup orange juice, 2 tablespoons reduced-sodium teriyaki sauce, 1
tablespoon honey, and 1/2 teaspoon ground ginger in a small bowl. Transfer to
skillet and bring to low boil. Add 1 pound of salmon fillet, skin side up. Cover
and cook over low to medium heat until fish is flaky in the center. Serve over
cooked chopped frozen spinach and enjoy with couscous.
Diner Dinner
Prepare a 2-egg omelet with leftover or frozen chopped green vegetables and 1/4
cup feta or cheddar cheese. Enjoy with whole grain toast and fruit.
Spaghetti Supper
Start with store-bought meatballs and a jar of tomato sauce. Or, in place of
meatballs, add canned, drained chickpeas or browned 100% ground turkey breast to
spaghetti sauce for protein. Toss with frozen chopped veggies for fiber,
vitamins, and minerals.
Pizza Party
Order a thin crust vegetable pizza. Have with it canned or frozen fruit, and a
salad prepared from pre-washed greens, with grape tomatoes and grated carrots.
Arthritis and Simple Meals
Everyone wants to save time and energy in the kitchen. It's particularly important when aching joints from arthritis turn preparing a meal into a monumental task. We've put together some ideas for easy meals that take the strain off your hands and body and don't wear you out. At the same time, they manage to deliver great taste, as well as the nutrition you need to limit swelling from arthritis and stay strong.
And here's a tip: when you are feeling up to cooking, make extra. That way, you'll always have healthy food around to eat on your lower-energy days. If meal prep is largely out of the question for you, consider using your local Meals on Wheels program.
Frozen Meals for Bad Arthritis Days
Frozen entrees are quick and easy, especially when your arthritis is keeping you out of the kitchen. But they are notoriously high in sodium and low in fiber. If you know what to look for, there are plenty of good choices in the freezer aisle to serve as the centerpiece of a nutritious meal. Look for dishes that supply 800 milligrams of sodium or less; a minimum of 15 grams of protein; and at least four grams of fiber.
Even the healthiest frozen entrees skimp on produce and whole grains. Supplement with a cup of fresh or frozen cooked vegetables, and a slice of whole grain bread to make a complete meal.
Nearly-a-Meal Convenience Foods
Supermarkets abound with convenience foods that could be considered near-meals, easy for anyone with arthritis. Like most processed foods, they supply more sodium than you need, so look for lower-sodium varieties. These meal starters come up short on protein so they need to be supplemented with fruits, vegetables, whole grains, and dairy to make a balanced meal.
When arthritis makes cooking tough, enjoy a protein-packed bean soup such as lentil, black bean, or split pea. Invest in a reliable electric can opener to make it easier on yourself. You can also pick up a pre-roasted chicken, a breakfast burrito, sushi or other ready-made foods at most grocery stores these days. Plus, marinated albacore (white) tuna steaks and salmon fillets are available in easy-to-open packages and are ready to eat in seconds for lunch or dinner. In a pinch, even a can of season tuna - served on six crackers - makes an instant healthy meal.
The Role of Liquid Meals in Your Arthritis Diet
Liquid meals supply many essential vitamins and minerals, but they lack adequate protein and fiber to be considered a real meal. Plus, they aren't particularly satisfying and can leave you wanting more. And they are relatively expensive. But in spite of all that, they are not without merit; convenience is one of their virtues. Pair them with a piece or two of whole-grain toast or a whole-grain waffle and fruit to round out their nutritional power for an arthritis friendly meal.
Check the label to make sure the liquid meal contains a variety of vitamins and minerals. Most 8-ounce nutritional supplement drinks are fortified to provide 25% of the vitamins you need each day.
And here's a tip: when you are feeling up to cooking, make extra. That way, you'll always have healthy food around to eat on your lower-energy days. If meal prep is largely out of the question for you, consider using your local Meals on Wheels program.
Frozen Meals for Bad Arthritis Days
Frozen entrees are quick and easy, especially when your arthritis is keeping you out of the kitchen. But they are notoriously high in sodium and low in fiber. If you know what to look for, there are plenty of good choices in the freezer aisle to serve as the centerpiece of a nutritious meal. Look for dishes that supply 800 milligrams of sodium or less; a minimum of 15 grams of protein; and at least four grams of fiber.
Even the healthiest frozen entrees skimp on produce and whole grains. Supplement with a cup of fresh or frozen cooked vegetables, and a slice of whole grain bread to make a complete meal.
Nearly-a-Meal Convenience Foods
Supermarkets abound with convenience foods that could be considered near-meals, easy for anyone with arthritis. Like most processed foods, they supply more sodium than you need, so look for lower-sodium varieties. These meal starters come up short on protein so they need to be supplemented with fruits, vegetables, whole grains, and dairy to make a balanced meal.
When arthritis makes cooking tough, enjoy a protein-packed bean soup such as lentil, black bean, or split pea. Invest in a reliable electric can opener to make it easier on yourself. You can also pick up a pre-roasted chicken, a breakfast burrito, sushi or other ready-made foods at most grocery stores these days. Plus, marinated albacore (white) tuna steaks and salmon fillets are available in easy-to-open packages and are ready to eat in seconds for lunch or dinner. In a pinch, even a can of season tuna - served on six crackers - makes an instant healthy meal.
The Role of Liquid Meals in Your Arthritis Diet
Liquid meals supply many essential vitamins and minerals, but they lack adequate protein and fiber to be considered a real meal. Plus, they aren't particularly satisfying and can leave you wanting more. And they are relatively expensive. But in spite of all that, they are not without merit; convenience is one of their virtues. Pair them with a piece or two of whole-grain toast or a whole-grain waffle and fruit to round out their nutritional power for an arthritis friendly meal.
Check the label to make sure the liquid meal contains a variety of vitamins and minerals. Most 8-ounce nutritional supplement drinks are fortified to provide 25% of the vitamins you need each day.
Treat Paget’s disease.Calcitonin
A drug currently used to treat osteoporosis may also help protect the bone and slow or perhaps even halt the progression of osteoarthritis, according to early research.
A new study shows treatment with calcitonin, a hormone, effectively prevented erosion of knee cartilage in rat models of osteoarthritis. Osteoarthritis is also known as degenerative joint disease and is related to cartilage breakdown in the joints which can lead to joint damage.
Calcitonin is currently used to treat Paget’s disease of the bone and osteoporosis, as previous studies have shown that the hormone reduces bone loss. But researchers say these results suggest that calcitonin may also help prevent the joint destruction associated with osteoarthritis (OA).
New Option for OA
Osteoarthritis is the most common joint disorder and affects more than 10% of Americans. Treatment usually addresses easing the pain caused by joint stiffness and inflammation associated with osteoarthritis.
To date, no drug has been approved to prevent the gradual loss of cartilage caused by the disease. But a new understanding of the progression of the disease in recent years has prompted a surge of interest in developing disease-modifying osteoarthritis drugs aimed at potentially preventing the disease in those at risk, such as postmenopausal women.
In the study, published in Arthritis & Rheumatism, researchers compared the effects of treating female rats that had their ovaries removed with estrogen alone and estrogen plus calcitonin.
Loss of estrogen from age or other causes increases the risk of osteoporosis. Other research has suggested that hormone replacement therapy helps protect postmenopausal women from osteoarthritis. This study showed that estrogen therapy and calcitonin given to rats helped reduce the rise in compounds indicative of joint destruction of osteoarthritis.
Calcitonin and estrogen also worked effectively in protecting against surface erosions of joint cartilage.
“Calcitonin treatment may counter the acceleration of cartilage degradation and the related rise of surface erosions,” writes researcher Bodil-Cecilie Sondergaard, of Nordic Bioscience Diagnostics in Herlev, Denmark, and colleagues.
Researchers say these results are only preliminary, but they suggest that calcitonin merits further research in human clinical trials.
A new study shows treatment with calcitonin, a hormone, effectively prevented erosion of knee cartilage in rat models of osteoarthritis. Osteoarthritis is also known as degenerative joint disease and is related to cartilage breakdown in the joints which can lead to joint damage.
Calcitonin is currently used to treat Paget’s disease of the bone and osteoporosis, as previous studies have shown that the hormone reduces bone loss. But researchers say these results suggest that calcitonin may also help prevent the joint destruction associated with osteoarthritis (OA).
New Option for OA
Osteoarthritis is the most common joint disorder and affects more than 10% of Americans. Treatment usually addresses easing the pain caused by joint stiffness and inflammation associated with osteoarthritis.
To date, no drug has been approved to prevent the gradual loss of cartilage caused by the disease. But a new understanding of the progression of the disease in recent years has prompted a surge of interest in developing disease-modifying osteoarthritis drugs aimed at potentially preventing the disease in those at risk, such as postmenopausal women.
In the study, published in Arthritis & Rheumatism, researchers compared the effects of treating female rats that had their ovaries removed with estrogen alone and estrogen plus calcitonin.
Loss of estrogen from age or other causes increases the risk of osteoporosis. Other research has suggested that hormone replacement therapy helps protect postmenopausal women from osteoarthritis. This study showed that estrogen therapy and calcitonin given to rats helped reduce the rise in compounds indicative of joint destruction of osteoarthritis.
Calcitonin and estrogen also worked effectively in protecting against surface erosions of joint cartilage.
“Calcitonin treatment may counter the acceleration of cartilage degradation and the related rise of surface erosions,” writes researcher Bodil-Cecilie Sondergaard, of Nordic Bioscience Diagnostics in Herlev, Denmark, and colleagues.
Researchers say these results are only preliminary, but they suggest that calcitonin merits further research in human clinical trials.
The FDA has approved Voltaren Gel
The FDA has approved Voltaren Gel, the first prescription skin gel to treat osteoarthritis joint pain.
Voltaren Gel contains diclofenac sodium, a nonsteroidal anti-inflammatory drug (NSAID) that's also in oral Voltaren. The gel can be applied to joints that hurt because of osteoarthritis.
Osteoarthritis is the most common form of arthritis. It happens when the cartilage in joints breaks down and wears away.
The FDA approved Voltaren Gel based on studies that together included more than 900 patients with knee or hand osteoarthritis, according to Novartis, which makes Voltaren Gel.
Voltaren Gel was shown to cut pain in knee and hand osteoarthritis, states Novartis.
It wasn't evaluated for use on joints of the spine, hip, or shoulder, according to the drug's label.
The most common side effects reported in clinical trials of Voltaren Gel were skin reactions; 7% of patients had reactions on the place where the gel was applied..
Voltaren Gel contains diclofenac sodium, a nonsteroidal anti-inflammatory drug (NSAID) that's also in oral Voltaren. The gel can be applied to joints that hurt because of osteoarthritis.
Osteoarthritis is the most common form of arthritis. It happens when the cartilage in joints breaks down and wears away.
The FDA approved Voltaren Gel based on studies that together included more than 900 patients with knee or hand osteoarthritis, according to Novartis, which makes Voltaren Gel.
Voltaren Gel was shown to cut pain in knee and hand osteoarthritis, states Novartis.
It wasn't evaluated for use on joints of the spine, hip, or shoulder, according to the drug's label.
The most common side effects reported in clinical trials of Voltaren Gel were skin reactions; 7% of patients had reactions on the place where the gel was applied..
Shock-absorbing athletic shoes and clogs may be bad for arthritic knees
Those shock-absorbing athletic shoes and clogs designed to protect and cushion the feet may be bad for arthritic knees.
When researchers examined the effects of different types of footwear on people with knee osteoarthritis, they found that going barefoot put less stress on knee joints than wearing foot-stabilizing walking shoes or clogs.
Flip-flops and a flexible walking shoe were also better choices for minimizing impact to the knees during normal walking.
The researchers determined this by assessing a standard measure of knee joint impact, known as knee load.
"Knee loads play an important role in the progression of knee osteoarthritis," researcher Najia Shakoor, MD, of Rush Medical College, says in a news release. "Shoes have traditionally been engineered to provide foot comfort and little previous attention has been directed to the effects that shoes may have on loading of osteoarthritic knees."
She notes that flat, flexible shoes were best for minimizing the impact on knee joints.
The findings were presented at the annual meeting of the American College of Rheumatology in Boston.
Impact of Shoes on Osteoarthritis
According to the Arthritis Foundation, 21 million Americans have osteoarthritis, a chronic disease in which the cartilage that serves as a shock absorber in the joints is broken down over time.
Also known as degenerative joint disease, osteoarthritis is a leading cause of disability among adults. Obesity, age, and joint overuse or injury are risk factors for the condition.
In a 2006 study with a similar design, Shakoor and colleagues reported that going barefoot put less stress on knee joints than wearing everyday walking shoes.
In their latest study, the researchers examined knee loads among 13 women and three men (average age 56 years) with knee osteoarthritis while they were barefoot, and then while they wore a popular brand of clogs, a foot-stabilizing walking shoe, a flat, flexible walking shoe, and flip-flops.
Compared to walking barefoot, the clogs and foot-stabilizing walking shoes were associated with significantly higher knee loading.
"These results highlight the importance of re-evaluating the design of modern day shoes in terms of their effects on knee loads and knee osteoarthritis," the researchers write.
More Study Needed
Rheumatologist Dennis Boulware, MD, says he was surprised by the finding that shoes that are good for ailing feet may not be good for ailing knees.
"This does make me a bit concerned about advising patients about certain types of footwear," he says. "I will certainly pay more attention to knee complaints when I put someone in [foot-stabilizing] shoes for foot problems."
Boulware, who is chief of rheumatology for Kaiser Permanente, Honolulu, adds that larger studies are needed to confirm the findings.
"I am somewhat skeptical because of the small size of the study," he says. "But this is clearly something we need to know more about."
When researchers examined the effects of different types of footwear on people with knee osteoarthritis, they found that going barefoot put less stress on knee joints than wearing foot-stabilizing walking shoes or clogs.
Flip-flops and a flexible walking shoe were also better choices for minimizing impact to the knees during normal walking.
The researchers determined this by assessing a standard measure of knee joint impact, known as knee load.
"Knee loads play an important role in the progression of knee osteoarthritis," researcher Najia Shakoor, MD, of Rush Medical College, says in a news release. "Shoes have traditionally been engineered to provide foot comfort and little previous attention has been directed to the effects that shoes may have on loading of osteoarthritic knees."
She notes that flat, flexible shoes were best for minimizing the impact on knee joints.
The findings were presented at the annual meeting of the American College of Rheumatology in Boston.
Impact of Shoes on Osteoarthritis
According to the Arthritis Foundation, 21 million Americans have osteoarthritis, a chronic disease in which the cartilage that serves as a shock absorber in the joints is broken down over time.
Also known as degenerative joint disease, osteoarthritis is a leading cause of disability among adults. Obesity, age, and joint overuse or injury are risk factors for the condition.
In a 2006 study with a similar design, Shakoor and colleagues reported that going barefoot put less stress on knee joints than wearing everyday walking shoes.
In their latest study, the researchers examined knee loads among 13 women and three men (average age 56 years) with knee osteoarthritis while they were barefoot, and then while they wore a popular brand of clogs, a foot-stabilizing walking shoe, a flat, flexible walking shoe, and flip-flops.
Compared to walking barefoot, the clogs and foot-stabilizing walking shoes were associated with significantly higher knee loading.
"These results highlight the importance of re-evaluating the design of modern day shoes in terms of their effects on knee loads and knee osteoarthritis," the researchers write.
More Study Needed
Rheumatologist Dennis Boulware, MD, says he was surprised by the finding that shoes that are good for ailing feet may not be good for ailing knees.
"This does make me a bit concerned about advising patients about certain types of footwear," he says. "I will certainly pay more attention to knee complaints when I put someone in [foot-stabilizing] shoes for foot problems."
Boulware, who is chief of rheumatology for Kaiser Permanente, Honolulu, adds that larger studies are needed to confirm the findings.
"I am somewhat skeptical because of the small size of the study," he says. "But this is clearly something we need to know more about."
Show a risk for knee osteoarthritis
Is your ring finger longer than your index finger? That may show a risk for knee osteoarthritis, especially in women, a British study shows.
Osteoarthritis is the most common type of arthritis. In osteoarthritis, the protective cartilage that cushions the ends of bones within joints gradually wears away. It can affect almost any joint in the body but commonly involves the weight-bearing joints: the knees, hips, and spine.
Osteoarthritis becomes more common with age and extra weight. Finger length may also be a risk factor, according to the new British study.
It's not about whether your fingers are long or short. Instead, it's about the ratio between the length of your index finger (the second finger, counting from the thumb) and your ring finger (the fourth finger).
Handful of Osteoarthritis Risk
The British study included more than 2,000 people with severe knee and/or hip osteoarthritis and more than 1,100 people without knee or hip osteoarthritis.
The researchers, based at England's University of Nottingham, eyeballed the length of participants' ring and index fingers, following up with hand X-rays for precise measurements.
The key finding: People whose index finger was shorter than their ring finger were about twice as likely to have knee osteoarthritis, compared with other participants.
That pattern was stronger for women than for men. Among women, those with an index finger shorter than their ring finger were three times more likely to have knee osteoarthritis.
The finding may also be true for hip osteoarthritis, but because most participants with hip arthritis also had knee osteoarthritis, it was hard for the researchers to confirm that.
Other osteoarthritis risk factors -- including age, sex, BMI (body mass index, which relates height to weight), previous joint injuries, and physical activity -- didn't explain the results.
Rheumatology professor Michael Doherty, MD, and colleagues aren't sure how to explain their findings. They note that men are more likely than women to have index fingers that are shorter than ring fingers, so hormonal factors may be involved, but that's not certain.
Arthritis .Alternative Medicine
Arthritis .Alternative Medicine
Homeopathy may improve pain, joint tenderness, stiffness, and grip strength, especially when used in conjunction with NSAIDs.
Fish oil has been shown to reduce arthritis inflammation, lessen the need for painkillers, and possibly decrease joint stiffness. A diet low in animal and dairy fats may have similar effects. Excellent sources of fish oil include EPA/DHA capsules and oily fish such as salmon and mackerel.
At least a dozen different herbs have been used to ease the symptoms of both osteoarthritis and rheumatoid arthritis; most are considered anti-inflammatories. Ask your doctor about using any herbs, since they can interact with each other or with medication you are taking. In most cases, lack of careful studies means little is known about long-term effects. Herbs that have been used for arthritis are powdered ginger, borage seed oil, or devil's claw to reduce pain and swelling. Stinging nettles or turmeric may also lessen arthritis pain, stiffness, and inflammation.
Ayurvedic medicine uses herbal compounds internally and externally for arthritis symptom relief. Topical curcumin may help relieve the inflammation of rheumatoid arthritis; if taken in capsule form, it can reduce morning stiffness and boost endurance. In one study, a combination of Withania somnifera, Boswellia serrata, and Cucurma longa caused a significant drop in pain and disability for people with osteoarthritis.
At-Home Remedies for Arthritis
Heat and rest - traditional remedies for arthritis pain - are very effective in the short run for most people with the disease. Overweight sufferers should lose weight, especially when arthritis affects the lower back, knees, and legs. Consult a registered dietician who can help you plan a healthy weight-loss program.
In addition to treatments recommended by your doctor, you can use dry heat from a heating pad or moist heat in the form of a hot bath or a hot-water bottle wrapped in a towel to help relieve arthritis pain and stiffness. Regular exercise is important to keep the joints mobile. People with weakened, badly deformed fingers from rheumatoid arthritis benefit from specially designed utensils and door and drawer handles; people suffering weakness in the legs and arms can use special bathroom fixtures, especially tub rails and elevated toilet seats.
Though arthritis is not preventable, many people are able to prevent disability with a well-designed treatment program, including medications, exercise, and physical therapy when needed.
Homeopathy may improve pain, joint tenderness, stiffness, and grip strength, especially when used in conjunction with NSAIDs.
Fish oil has been shown to reduce arthritis inflammation, lessen the need for painkillers, and possibly decrease joint stiffness. A diet low in animal and dairy fats may have similar effects. Excellent sources of fish oil include EPA/DHA capsules and oily fish such as salmon and mackerel.
At least a dozen different herbs have been used to ease the symptoms of both osteoarthritis and rheumatoid arthritis; most are considered anti-inflammatories. Ask your doctor about using any herbs, since they can interact with each other or with medication you are taking. In most cases, lack of careful studies means little is known about long-term effects. Herbs that have been used for arthritis are powdered ginger, borage seed oil, or devil's claw to reduce pain and swelling. Stinging nettles or turmeric may also lessen arthritis pain, stiffness, and inflammation.
Ayurvedic medicine uses herbal compounds internally and externally for arthritis symptom relief. Topical curcumin may help relieve the inflammation of rheumatoid arthritis; if taken in capsule form, it can reduce morning stiffness and boost endurance. In one study, a combination of Withania somnifera, Boswellia serrata, and Cucurma longa caused a significant drop in pain and disability for people with osteoarthritis.
At-Home Remedies for Arthritis
Heat and rest - traditional remedies for arthritis pain - are very effective in the short run for most people with the disease. Overweight sufferers should lose weight, especially when arthritis affects the lower back, knees, and legs. Consult a registered dietician who can help you plan a healthy weight-loss program.
In addition to treatments recommended by your doctor, you can use dry heat from a heating pad or moist heat in the form of a hot bath or a hot-water bottle wrapped in a towel to help relieve arthritis pain and stiffness. Regular exercise is important to keep the joints mobile. People with weakened, badly deformed fingers from rheumatoid arthritis benefit from specially designed utensils and door and drawer handles; people suffering weakness in the legs and arms can use special bathroom fixtures, especially tub rails and elevated toilet seats.
Though arthritis is not preventable, many people are able to prevent disability with a well-designed treatment program, including medications, exercise, and physical therapy when needed.
Surgery .Arthritis
Surgery for Arthritis
Various forms of surgery may be needed to reduce the discomfort of arthritis or to restore mobility or joint function. Synovectomy is the removal of damaged connective tissue lining a joint cavity, and allows the body to regenerate new, healthy tissue in its place. This operation is most common in the knee. In cases of severe arthritic damage to the neck or foot, bones can be surgically removed or fused. Although movement is limited after such surgery, the operations relieve excruciating pain and help prevent further damage to nerves or blood vessels.
If arthritis pain and inflammation become truly unbearable, or arthritic joints simply refuse to function, the answer may lie in surgical joint replacement. Today, hip and shoulder joints - as well as smaller joints in elbows, knees, and fingers - can be replaced with reliable artificial joints made of stainless steel and plastic. This type of surgery can dramatically improve function and mobility.
Arthritis Pain Management
Because one of the most trying aspects of this disease is learning to live with arthritis pain, many doctors recommend training in pain management, including cognitive therapy. The National Institutes of Health has found that cognitive behavioral therapy, using education and behavior modification alongside relaxation techniques, is better than routine care for relieving arthritis pain. Such programs focus on improving patients' emotional and psychological well-being by teaching them how to relax and conduct their daily activities at a realistic pace. Learning to overcome mental stress and anxiety can be the key to coping with the physical limitations that may accompany chronic rheumatoid arthritis and osteoarthritis. Cognitive therapy may include various techniques for activity scheduling, imaging, relaxation, distraction, and creative problem-solving.
Alternative Medicine for Arthritis
A variety of alternative therapies are used for arthritis. Let your doctor know if you're considering them.
Some studies suggest that glucosamine and chondroitin supplements are as effective as NSAIDs for reducing pain, swelling, and stiffness in osteoarthritis. Studies in 2001 show some promise that they may slow the progression of osteoarthritis as well. More studies are underway to further investigate this. Typical doses are 1500 mg for glucosamine and 1200 mg for chondroitin daily. Glucosamine can raise blood sugar, so be sure to talk to your doctor before taking it, especially if you have diabetes. The antibiotic doxycycline may also show some potential in delaying the progression of osteoarthritis by inhibiting enzymes that break down cartilage. More research is needed to confirm these results.
The National Institutes of Health considers acupuncture an acceptable alternative treatment for osteoarthritis. Studies have shown that acupuncture helps reduce pain, may significantly lessen the need for painkillers, and can help increase range of motion in affected joints.
Available over-the-counter since 1999, the supplement SAMe has been shown in some studies to be as effective against osteoarthritis pain as NSAIDs, with the added benefit of fewer side effects.
Various forms of surgery may be needed to reduce the discomfort of arthritis or to restore mobility or joint function. Synovectomy is the removal of damaged connective tissue lining a joint cavity, and allows the body to regenerate new, healthy tissue in its place. This operation is most common in the knee. In cases of severe arthritic damage to the neck or foot, bones can be surgically removed or fused. Although movement is limited after such surgery, the operations relieve excruciating pain and help prevent further damage to nerves or blood vessels.
If arthritis pain and inflammation become truly unbearable, or arthritic joints simply refuse to function, the answer may lie in surgical joint replacement. Today, hip and shoulder joints - as well as smaller joints in elbows, knees, and fingers - can be replaced with reliable artificial joints made of stainless steel and plastic. This type of surgery can dramatically improve function and mobility.
Arthritis Pain Management
Because one of the most trying aspects of this disease is learning to live with arthritis pain, many doctors recommend training in pain management, including cognitive therapy. The National Institutes of Health has found that cognitive behavioral therapy, using education and behavior modification alongside relaxation techniques, is better than routine care for relieving arthritis pain. Such programs focus on improving patients' emotional and psychological well-being by teaching them how to relax and conduct their daily activities at a realistic pace. Learning to overcome mental stress and anxiety can be the key to coping with the physical limitations that may accompany chronic rheumatoid arthritis and osteoarthritis. Cognitive therapy may include various techniques for activity scheduling, imaging, relaxation, distraction, and creative problem-solving.
Alternative Medicine for Arthritis
A variety of alternative therapies are used for arthritis. Let your doctor know if you're considering them.
Some studies suggest that glucosamine and chondroitin supplements are as effective as NSAIDs for reducing pain, swelling, and stiffness in osteoarthritis. Studies in 2001 show some promise that they may slow the progression of osteoarthritis as well. More studies are underway to further investigate this. Typical doses are 1500 mg for glucosamine and 1200 mg for chondroitin daily. Glucosamine can raise blood sugar, so be sure to talk to your doctor before taking it, especially if you have diabetes. The antibiotic doxycycline may also show some potential in delaying the progression of osteoarthritis by inhibiting enzymes that break down cartilage. More research is needed to confirm these results.
The National Institutes of Health considers acupuncture an acceptable alternative treatment for osteoarthritis. Studies have shown that acupuncture helps reduce pain, may significantly lessen the need for painkillers, and can help increase range of motion in affected joints.
Available over-the-counter since 1999, the supplement SAMe has been shown in some studies to be as effective against osteoarthritis pain as NSAIDs, with the added benefit of fewer side effects.
Treatments for Arthritis
Treatments for Arthritis
Arthritis treatment generally includes occupational or physical therapy, exercise, drugs, and sometimes surgery to correct joint damage. Treatments for osteoarthritis can help relieve pain and stiffness, but the disease may continue to progress. The same was true for rheumatoid arthritis in the past. But treatments in recent years have been able to slow or stop progression of joint damage.
The duration and intensity of pain and discomfort depend on the type of arthritis and the degree of severity.
Conventional Medicine
In the case of localized pain, stiffness, and immobility, the typical three-stage arthritis treatment consists of medication to relieve pain and inflammation, rest to let injured tissues heal themselves, and exercise to rebuild mobility and strength.
Joint Protection
Learning to protect your joints is an important part of arthritis treatment. With the help of an occupational therapist, you can learn easier ways to do your normal activities, such as avoiding positions that strain your joints, using your strongest joints and muscles while sparing weaker ones, wearing braces or supports for certain joints and using grab bars in the bath, modified door knobs, canes or walkers, as well as using devices to help you with tasks such as opening jars or pulling up socks and zippers.
Your doctor may recommend pain relievers combined with regimens of heat, rest and exercise, physical therapy, and controlled application of deep heat to soothe affected joints.
Arthritis Medication
To reduce pain and inflammation in mild cases of rheumatoid arthritis and osteoarthritis, your doctor will probably prescribe aspirin or another nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen. Your doctor may also suggest acetaminophen for osteoarthritis.
In more advanced cases, your doctor may recommend corticosteroid joint injections - strong anti-inflammatories - to ease the pain and stiffness of arthritic joints. Depending on the individual, results range from temporary relief to long-lasting suppression of symptoms. Doctors are also using hyaluronate gel-like solutions in joint injections to further restore the cushion and lubricating properities of normal joint fluid thereby minimizing pain. Some examples are Hyalgan, Synvisc, Supartz, and Orthovisc.
In the early 1900s, researchers discovered that certain compounds containing gold, given orally or by injection, gave relief to some people who have rheumatoid arthritis and caused total remission in others.
Note, however, that because the side effects of gold treatment can range from minor skin rash to severe blood and kidney disorders, this treatment is generally approached with caution.
Newer treatments using low doses of chemotherapy medications (methotrexate) have produced dramatic improvements in severe rheumatoid arthritis, and these treatments show great promise of preserving joint function. Other strong medications that have come along since methotrexate are Arava, Azulfidine, Enbrel, Imuran, Neoral, Plaquenil, Remicade, Humira, Kineret, Rituxan, and Orencia. In general, they work by suppressing the overactive immune system. Apheresis is another treatment for rheumatoid arthritis that removes antibodies from the blood.
Specific arthritis treatment will depend on the nature and seriousness of the underlying condition. The major concern is for healing the affected area before more serious problems occur. Treatment of infectious arthritis typically involves large intravenous doses of antibiotics as well as drainage of excess fluid from the joints.
Arthritis treatment generally includes occupational or physical therapy, exercise, drugs, and sometimes surgery to correct joint damage. Treatments for osteoarthritis can help relieve pain and stiffness, but the disease may continue to progress. The same was true for rheumatoid arthritis in the past. But treatments in recent years have been able to slow or stop progression of joint damage.
The duration and intensity of pain and discomfort depend on the type of arthritis and the degree of severity.
Conventional Medicine
In the case of localized pain, stiffness, and immobility, the typical three-stage arthritis treatment consists of medication to relieve pain and inflammation, rest to let injured tissues heal themselves, and exercise to rebuild mobility and strength.
Joint Protection
Learning to protect your joints is an important part of arthritis treatment. With the help of an occupational therapist, you can learn easier ways to do your normal activities, such as avoiding positions that strain your joints, using your strongest joints and muscles while sparing weaker ones, wearing braces or supports for certain joints and using grab bars in the bath, modified door knobs, canes or walkers, as well as using devices to help you with tasks such as opening jars or pulling up socks and zippers.
Your doctor may recommend pain relievers combined with regimens of heat, rest and exercise, physical therapy, and controlled application of deep heat to soothe affected joints.
Arthritis Medication
To reduce pain and inflammation in mild cases of rheumatoid arthritis and osteoarthritis, your doctor will probably prescribe aspirin or another nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen. Your doctor may also suggest acetaminophen for osteoarthritis.
In more advanced cases, your doctor may recommend corticosteroid joint injections - strong anti-inflammatories - to ease the pain and stiffness of arthritic joints. Depending on the individual, results range from temporary relief to long-lasting suppression of symptoms. Doctors are also using hyaluronate gel-like solutions in joint injections to further restore the cushion and lubricating properities of normal joint fluid thereby minimizing pain. Some examples are Hyalgan, Synvisc, Supartz, and Orthovisc.
In the early 1900s, researchers discovered that certain compounds containing gold, given orally or by injection, gave relief to some people who have rheumatoid arthritis and caused total remission in others.
Note, however, that because the side effects of gold treatment can range from minor skin rash to severe blood and kidney disorders, this treatment is generally approached with caution.
Newer treatments using low doses of chemotherapy medications (methotrexate) have produced dramatic improvements in severe rheumatoid arthritis, and these treatments show great promise of preserving joint function. Other strong medications that have come along since methotrexate are Arava, Azulfidine, Enbrel, Imuran, Neoral, Plaquenil, Remicade, Humira, Kineret, Rituxan, and Orencia. In general, they work by suppressing the overactive immune system. Apheresis is another treatment for rheumatoid arthritis that removes antibodies from the blood.
Specific arthritis treatment will depend on the nature and seriousness of the underlying condition. The major concern is for healing the affected area before more serious problems occur. Treatment of infectious arthritis typically involves large intravenous doses of antibiotics as well as drainage of excess fluid from the joints.
Symptoms of osteoarthritis
Symptoms of osteoarthritis
Osteoarthritis is a disease of the joints. Unlike many other forms of arthritis that are systemic illnesses, such as rheumatoid arthritis and systemic lupus, osteoarthritis does not affect other organs of the body. The most common symptom of osteoarthritis is pain in the affected joint(s) after repetitive use. Joint pain is usually worse later in the day. There can be swelling, warmth, and creaking of the affected joints. Pain and stiffness of the joints can also occur after long periods of inactivity, for example, sitting in a theater. In severe osteoarthritis, complete loss of cartilage cushion causes friction between bones, causing pain at rest or pain with limited motion.
Symptoms of osteoarthritis vary greatly from patient to patient. Some patients can be debilitated by their symptoms. On the other hand, others may have remarkably few symptoms in spite of dramatic degeneration of the joints apparent on x-rays. Symptoms also can be intermittent. It is not unusual for patients with osteoarthritis of the hands and knees to have years of pain-free intervals between symptoms.
Osteoarthritis of the knees is often associated with obesity or a history of repeated injury and/or joint surgery. Progressive cartilage degeneration of the knee joints can lead to deformity and outward curvature of the knees referred to as "bow legged." Patients with osteoarthritis of the weight bearing joints (like the knees) can develop a limp. The limping can worsen as more cartilage degenerates. In some patients, the pain, limping, and joint dysfunction may not respond to medications or other conservative measures. Therefore, severe osteoarthritis of the knees is one of the most common reasons for total knee replacement surgical procedures in the United States.
Osteoarthritis of the spine causes pain in the neck or low back. Bony spurs that form along the arthritic spine can irritate spinal nerves, causing severe pain, numbness, and tingling of the affected parts of the body.
Osteoarthritis causes the formation of hard bony enlargements of the small joints of the fingers. Classic bony enlargement of the small joint at the end of the fingers is called a Heberden's node, named after a very famous British doctor. The bony deformity is a result of the bone spurs from the osteoarthritis in that joint. Another common bony knob (node) occurs at the middle joint of the fingers in many patients with osteoarthritis and is called a Bouchard's node. Dr. Bouchard was a famous French doctor who also studied arthritis patients in the late 1800s. The Heberden's and Bouchard's nodes may not be painful, but they are often associated with limitation of motion of the joint. The characteristic appearances of these finger nodes can be helpful in diagnosing osteoarthritis. Osteoarthritis of the joint at the base of the big toes leads to the formation of a bunion. Osteoarthritis of the fingers and the toes may have a genetic basis, and can be found in numerous women members of some families.
Osteoarthritis is a disease of the joints. Unlike many other forms of arthritis that are systemic illnesses, such as rheumatoid arthritis and systemic lupus, osteoarthritis does not affect other organs of the body. The most common symptom of osteoarthritis is pain in the affected joint(s) after repetitive use. Joint pain is usually worse later in the day. There can be swelling, warmth, and creaking of the affected joints. Pain and stiffness of the joints can also occur after long periods of inactivity, for example, sitting in a theater. In severe osteoarthritis, complete loss of cartilage cushion causes friction between bones, causing pain at rest or pain with limited motion.
Symptoms of osteoarthritis vary greatly from patient to patient. Some patients can be debilitated by their symptoms. On the other hand, others may have remarkably few symptoms in spite of dramatic degeneration of the joints apparent on x-rays. Symptoms also can be intermittent. It is not unusual for patients with osteoarthritis of the hands and knees to have years of pain-free intervals between symptoms.
Osteoarthritis of the knees is often associated with obesity or a history of repeated injury and/or joint surgery. Progressive cartilage degeneration of the knee joints can lead to deformity and outward curvature of the knees referred to as "bow legged." Patients with osteoarthritis of the weight bearing joints (like the knees) can develop a limp. The limping can worsen as more cartilage degenerates. In some patients, the pain, limping, and joint dysfunction may not respond to medications or other conservative measures. Therefore, severe osteoarthritis of the knees is one of the most common reasons for total knee replacement surgical procedures in the United States.
Osteoarthritis of the spine causes pain in the neck or low back. Bony spurs that form along the arthritic spine can irritate spinal nerves, causing severe pain, numbness, and tingling of the affected parts of the body.
Osteoarthritis causes the formation of hard bony enlargements of the small joints of the fingers. Classic bony enlargement of the small joint at the end of the fingers is called a Heberden's node, named after a very famous British doctor. The bony deformity is a result of the bone spurs from the osteoarthritis in that joint. Another common bony knob (node) occurs at the middle joint of the fingers in many patients with osteoarthritis and is called a Bouchard's node. Dr. Bouchard was a famous French doctor who also studied arthritis patients in the late 1800s. The Heberden's and Bouchard's nodes may not be painful, but they are often associated with limitation of motion of the joint. The characteristic appearances of these finger nodes can be helpful in diagnosing osteoarthritis. Osteoarthritis of the joint at the base of the big toes leads to the formation of a bunion. Osteoarthritis of the fingers and the toes may have a genetic basis, and can be found in numerous women members of some families.
Best exercises for knee arthritis
Low-Impact Activities
Being active may also help you lose weight, which takes pressure off joints. Other exercises that are easy on the knees: biking, swimming, and water aerobics. Water exercise takes weight off painful joints. Many community and hospital wellness centers, YMCAs, and pools offer classes for people with arthritis.
Don't give up favorite activities, like golf. Talk to your doctor or physical therapist about modifying painful moves.
Walking
With stiff or sore knees, walking may not seem like a great idea. But it's one of the best exercises for knee arthritis. It can reduce joint pain, strengthen leg muscles, and improve flexibility -- and it's good for your heart. The best part -- no gym membership needed.
Good form is key: Look forward, walk tall. Keep arms and legs moving, relaxed. Always ask your doctor before starting exercise when you have osteoarthritis.
Step Ups
This move helps strengthen your legs for climbing stairs. Face a stable step, both feet on the ground. Step up with your left foot. Follow with your right foot. Stand on top, tall and with both feet flat. Climb down in reverse: right foot down first, then left. Do 10 times. Rest, then repeat another 10 times. Then repeat, starting with right leg first. Too hard? Use a railing, wall, or lamppost for balance. Or try a lower step.
One Leg Balance
Your goal is to do this hands-free. Steady yourself on a chair, if needed. First, shift your body weight to one leg but do not lock your knee straight. Slowly raise the other foot off the ground, balancing on your standing leg. Hold for 20 seconds. Lower raised foot to the ground. Do twice, then switch legs. This move helps when getting out of cars or bending.
Too easy? Balance for a longer time. Or try with your eyes closed.
Sit to Stand
Practice this move to make standing easier. Place two pillows on chair. Sit on top, with your back straight, feet flat on floor (see left). Use your leg muscles to slowly and smoothly stand up tall. Then, slowly lower yourself back down to sitting. Be sure your bent knees don’t move forward of your toes. Try with arms crossed (see left) or loose to your side.
Too hard? Add pillows or use a chair with armrests and help push up with your arms.
Side Leg Raise
Hold back of chair for balance. Place your weight on left leg. Lift right leg out to the side. Keep right leg straight and outer leg muscles tensed. Don't slouch. Lower right leg and relax. Repeat 10 times. Rest. Do another 10, then repeat with left leg.
Too hard? Increase leg height over time. After a few workouts, you’ll be able to raise your leg higher.
Heel Raise
Hold back of chair for support. Stand straight and tall. Lift heels off ground and rise up on toes of both feet. Hold for five seconds. Slowly lower both heels to ground. Repeat 10 times. Rest. Do another 10.
Too hard? Do the same exercise, only sitting in a chair.
Pillow Squeeze
This move helps strengthen the inside of your legs to help support your knee. Lie on your back, both knees bent. Place a pillow between knees.
Squeeze knees together, squishing pillow between them. Hold for five seconds. Relax. Repeat 10 times. Rest, then do another set of 10.
Too hard? You can also do this exercise while seated. See photo to right.
Seated Hip March
This move can strengthen hips and thigh muscles to help with daily activities, such as walking or rising from a chair.
Sit up straight in chair. Slightly kick back your left foot but keep toes on the floor. Lift your right foot off the floor, keeping knee bent. Hold right leg in the air five seconds. Slowly lower your foot to the ground. Repeat 10 times. Rest and do another 10, then switch legs. Too hard? Use your hands to help raise your leg.
Quad Set
Is the straight leg raise too tough? Do quad sets instead. With these you don’t raise your leg. Simply tighten the thigh muscles, also called the quadriceps, of one leg at a time.
Start by lying on the floor. Keep both legs on ground, relaxed. Flex and hold left leg tense for five seconds, as seen in right-hand photo. Relax. Do two sets of 10. Then, switch to other leg.
Straight Leg Raise
To try this leg strengthening move, lie on the floor. Prop your back up on your elbows. Bend your left knee, keeping foot on floor. Keep the right leg straight, toes pointed up. Tighten thigh muscles of your right leg. Slowly and smoothly use your thigh muscles -- not your back -- to raise your leg.
Pause, as seen above, for five seconds. With thigh still tight, slowly lower leg to ground. Relax. Repeat 10 times. Rest. Do another 10; then switch legs.
Calf Stretch
Stretching exercises loosen muscles, improve flexibility, and help prevent pain and injury.
Use a chair for balance. Bend your right leg. Step back with left leg, slowly straightening it behind you. Press left heel towards the floor. Feel the stretch in your back leg.
For more of a stretch: Lean forward, bending the right knee deeper. Don't let the right knee go past your toes. Hold for 20 seconds. Do twice, then switch legs.
Hamstring Stretch
Warm up with a five-minute walk. Then, stretch. Lie down. Loop a bed sheet around your right foot. Use sheet to help pull and stretch leg up. Hold for 20 seconds. Repeat twice, then switch legs. Stretching is one of three important types of exercises for knee OA. Range of motion or stretching exercises keep you limber. Strengthening exercises build muscle strength to stabilize weak joints. Aerobic exercises, like walking, help lung and heart fitness.
How Much Exercise?
Start with a little. If you can do it without pain, do more next time. Aim for 30 minutes a day.
Over time you’ll build your leg muscles to support your knee and increase flexibility.
Some muscle soreness is normal, but hurting or swollen joints need rest. Take a break and ask your doctor’s advice. Ice painful joints and take acetaminophen or an anti-inflammatory pain reliever, like ibuprofen or naproxen, if your doctor says it's OK.
Help relieve pain
Although arthritis treatment usually includes medication, a tailored arthritis exercise program can help relieve pain and fatigue, and preserve joint structure and function.
The stiffness, pain, and swelling associated with arthritis can severely reduce the range of motion of joints (the distance joints can move in certain directions). Avoiding physical activity because of pain or discomfort also can lead to significant muscle loss and excessive weight gain. Exercise, as part of a comprehensive arthritis treatment plan, can improve joint mobility, muscle strength and overall physical conditioning, and help you maintain a healthy weight.
Once you know what type of arthritis you have and understand your symptoms, you and your doctor or physical therapist can develop a balanced program of physical activity to reduce the damaging affects of arthritis and promote optimal health.
What Are the Benefits of Exercise as an Arthritis Treatment?
A tailored program that includes a balance of three types of exercises -- range-of-motion, strengthening, and endurance -- can relieve the symptoms of arthritis and protect joints from further damage. Exercise also may:
- Help maintain normal joint movement
- Increase muscle flexibility and strength
- Help maintain weight to reduce pressure on joints
- Help keep bone and cartilage tissue strong and healthy
- Improve endurance and cardiovascular fitness
What Are Range-of-Motion Exercises?
To help relieve pain, people with arthritis often keep their affected joints bent -- especially those in the knees, hands, and fingers -- because it's more comfortable in that position. Although this may temporarily relieve discomfort, holding a joint in the same position for too long can cause permanent loss of mobility and further hinder the ability to perform daily activities.
Range-of-motion exercises (also called stretching or flexibility exercises) help maintain normal joint function by increasing and preserving joint mobility and flexibility. In this group of exercises, gently straightening and bending the joints in a controlled manner as far as they comfortably will go can help condition the affected joints. During the course of a range-of-motion exercise program, the joints are stretched progressively farther until normal or near-normal range is achieved and maintained. This helps to maintain comfort while function is preserved.
In addition to preserving joint function, range-of-motion exercises are an important form of warm-up and stretching, and should be done prior to performing strengthening or endurance exercises, or engaging in any other physical activity. A doctor or physical therapist can provide you with instructions on how to perform range-of-motion exercises.
Why Should I Also Do Strengthening Exercises?
Strong muscles help keep weak joints stable and comfortable and protect them against further damage. A program of strengthening exercises that targets specific muscle groups can be helpful as part of your arthritis treatment.
There are several types of strengthening exercises that, when performed properly, can maintain or increase muscle tissue to support your muscles without aggravating your joints.
Why Should I Also Do Strengthening Exercises?
Some people with arthritis avoid exercise because of joint pain. However, a group of exercises called "isometrics" will help strengthen muscles without bending painful joints. Isometrics involve no joint movement but rather strengthen muscle groups by using an alternating series of isolated muscle flexes and periods of relaxation.
Isotonics is another group of exercises that involve joint mobility. However, this group of exercises is more intensive, achieving strength development through increased repetitions or by introducing increasing weight resistance such as with with small dumbbells or stretch bands.
A physical therapist or fitness instructor (preferably one who has experience working with people with arthritis) can tell you how to safely and effectively perform isometric and isotonic exercises.
What Is Hydrotherapy?
Hydrotherapy, also called "aqua therapy" (water therapy), is a program of exercises performed in a large pool. Aqua therapy may be easier on painful joints because the buoyancy of water takes some of the weight off the painful joints while providing resistance training.
What Are Endurance Exercises?
The foundation of endurance training is aerobic exercise, which includes any activity that increases the heart rate for a prolonged period of time. Aerobic activity conditions the heart and lungs to:
- Use oxygen to more efficiently supply the entire body with larger amounts of oxygen-rich blood
- Build stronger muscles for endurance activity
When paired with a healthy diet, aerobic activity also is fundamental for controlling weight (which is important for people with arthritis since it reduces excess pressure on affected joints) and for improving overall general health.
At first, people with arthritis should perform about 15 to 20 minutes of aerobic activity at least three times a week, and then gradually build up to 30 minutes daily. The activity also should include at least 5 to 10 minutes of warm-up plus 5 to 10 minutes of cool-down.
Although peak benefits are achieved when an aerobic activity is performed continuously for at least 30 minutes, aerobic exercise can be spread out in smaller segments of time throughout the day to suit your comfort level, without overexerting yourself. Aerobic exercise should be performed at a comfortable, steady pace that allows you to talk normally and easily during the activity. Ask your therapist what intensity of exercise is appropriate for your fitness level.
During exercise, your heart's "training range," or target heart rate, should be closely monitored. To improve your body's aerobic condition, you should calculate your maximum heart rate-220 minus your age-and exercise at a level of intensity between 60% and 80% of your maximum heart rate.
Examples of aerobic activities include walking, swimming, low-impact aerobic dance, skiing, and biking, and may even include such daily activities as mowing the lawn, raking leaves, or playing golf. Walking is one of the easiest aerobic exercise programs to begin because it requires no special skills or equipment other than a good pair of supportive walking shoes, and it's less stressful on joints than running or jogging.
Biking is another good choice for people with arthritis, because it places less stress on knee, foot, and ankle joints. Swimming is also often recommended because there is minimal pressure on joints while in water.
Appropriate recreational exercise, including sports, can be helpful to most people with arthritis. These activities are best preceded by a program of range-of-motion and strength exercises to reduce the chance of injury.
How Do I Begin?
Regardless of your condition, discuss exercise options with a doctor before beginning any new exercise program.
People with arthritis who are beginning a new exercise program should spend some time conditioning with a program that consists of only range-of-motion and strengthening exercises, depending on their physical condition and level of fitness. Endurance exercises should be added gradually, and only after you feel comfortable with your current fitness level.
As with any change in lifestyle, your body will need time to adapt to your new program. During the first few weeks, you may notice changes in the way your muscles feel, your sleep patterns, or energy levels. These changes are to be expected with increased activity levels. However, improper exercise levels or programs may be harmful, making symptoms of arthritis worse. Check with your doctor and adjust your program if you experience any of the following:
- Unusual or persistent fatigue
- Sharp or increased pain
- Increased weakness
- Decreased range of motion
- Increased joint swelling
- Continuing pain
Regardless of the exercise program you select, it's important to begin slowly and choose a program you enjoy so that you maintain it. Make exercise part of your daily routine so that it becomes a lifetime habit.
Prevent arthritis
Osteoarthritis is a progressive degenerative disease that generally gets worse as you age. Trying to prevent arthritis is preferable to trying to treat the pain that comes with chronic arthritis.
1 .Learn how to relax. A tense muscle applies stress to a joint.
2.Balance rest and activity. Regular, moderate exercise 20 to 30 minutes a day, coupled with a full eight hours of sleep at night, is ideal for good musculoskeletal health.
3.Remember to avoid any exercise that produces joint pain lasting an hour after you finish exercising.
4.Practice good posture. Lift heavy items with your hip muscles, not your back.
5.Protect your joints. In cold weather, wear warm gloves to protect your knuckles, long underwear to protect your knee joints, and heavy socks to protect your ankle and toe joints.
6.Lose weight if you are overweight. If you reduce your weight by 12 pounds, you cut your risk of developing arthritis by half. - IS THIS TRUE, OR WHAT IF YOU LOOSE 100 POUNDS?
7.Avoid soft chairs, and sleep on a firm mattress.
8.Soak in a hot tub, especially after strenuous exercise.
1 .Learn how to relax. A tense muscle applies stress to a joint.
2.Balance rest and activity. Regular, moderate exercise 20 to 30 minutes a day, coupled with a full eight hours of sleep at night, is ideal for good musculoskeletal health.
3.Remember to avoid any exercise that produces joint pain lasting an hour after you finish exercising.
4.Practice good posture. Lift heavy items with your hip muscles, not your back.
5.Protect your joints. In cold weather, wear warm gloves to protect your knuckles, long underwear to protect your knee joints, and heavy socks to protect your ankle and toe joints.
6.Lose weight if you are overweight. If you reduce your weight by 12 pounds, you cut your risk of developing arthritis by half. - IS THIS TRUE, OR WHAT IF YOU LOOSE 100 POUNDS?
7.Avoid soft chairs, and sleep on a firm mattress.
8.Soak in a hot tub, especially after strenuous exercise.
How to Treat Arthritis
How to Treat Arthritis
Osteoarthritis is the most common type of arthritis, affecting at least 20 million Americans. It is degenerative, meaning that symptoms tend to worsen as you age. Proper treatment is essential to slowing the progression.
- Exercise 20 to 30 minutes a day, and get a full eight hours of sleep at night. Avoid any exercise that produces joint pain that lasts an hour after the exercise is over. Don't attempt to "walk off the pain."
- Practice good body posture, and lift heavy items with your hip muscles, not your back. Never carry something if you can pull it behind you.
- Practice range-of-motion exercises, or have physical therapy. Ask your doctor or local hospital about exercise classes or hydrotherapy, which is gentle exercising done in the water. Elevate the affected joint or joints for 15 minutes a day, several times a day.
- Apply warm compresses to the painful joints. Generally, 20 minutes on, 20 minutes off works best.
- Lose weight if you are overweight.
- Sleep on a firm mattress and avoid soft chairs.
- Protect your joints by wearing warm clothing.
- Ask your doctor about splints, canes, and/or surgery for unrelenting pain or deformity caused by arthritis.
- Practice yoga or listen to relaxation tapes. Muscles surround your joints, and a tense muscle applies stress to a joint.
- Talk to your doctor about taking aspirin for pain. It is the drug of choice for arthritic discomfort. Consider indomethacin, ibuprofen and/or naproxen for arthritic pain unrelieved with aspirin, or if you are allergic to aspirin.
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