"I'm too young to feel this old," says Vicki Inman, 41. She's always been very active, but a few years ago this mom of two teen girls was diagnosed with arthritis. "The pain became so severe I felt as if my leg were going to give out." Thankfully, she found a solution in exercise: "I have to do gentle stretches and yoga regularly, otherwise it's painful to walk," says Inman, who's currently based at the U.S. Army Garrison Fort Benning, near Columbus, Georgia, with her husband.
So what exactly is this thief of mobility that can strike so early? Arthritis is that creaky feeling you get climbing bleachers to watch your kid's soccer game. It's the ache in your hands when you're holding the dog's leash. A group of more than 100 different rheumatic diseases, arthritis doesn't discriminate based on age. It's also very common, affecting some 50 million Americans and more women than men.
But here's what arthritis is not: a done deal. "You don't have to become a statistic," says Robin K. Dore, M.D., clinical professor of medicine at the David Geffen School of Medicine at UCLA. "There are steps you can take now to possibly prevent, delay and stop arthritis in its tracks." Halt its onset by learning the truth and regaining your freedom of movement.
Myth: "Everyone will eventually get arthritis."
Reality: Arthritis is not like gray hair or taxes.
First and foremost, arthritis is a disease — and not everyone gets it. Keep the condition from taking away your ability to do what you love by understanding what fuels it. Osteoarthritis (OA) occurs when the cartilage that cushions your bones at the joints breaks down, leading to fluid accumulation, bony overgrowth and pain around the joint. "What makes all this happen is a combination of factors, including heredity, weight and previous injury," says Marci Goolsby, M.D., a sports medicine specialist at the Women's Sports Medicine Center at the Hospital for Special Surgery in New York. Emerging research has also linked a woman's exposure to PFCs (chemicals often found in products such as nonstick cookware and stain-resistant carpets) to OA.
While you can't control factors such as your family history, you can address issues such as your weight. Likewise, though you can't erase old injuries (joints that have sustained trauma are more likely to develop OA eventually), you can focus on avoiding new ones. For example, lift heavy items correctly by engaging your abs, bending at the knees and lifting with your butt muscles.
Myth: "Arthritis is not really a serious disease."
Reality: Untreated, it can prevent you from doing basic everyday tasks. Not to mention that it can increase your risk of depression, osteoporosis and heart attack. Besides, you wouldn't want your husband or kids to tough out pain. So why should you, especially when there are so many effective management techniques to help you get through your jam-packed day? More important, "we have no way of knowing from person to person whose arthritis is going to get worse," says Jason Theodosakis, M.D., associate professor at the University of Arizona College of Medicine in Tucson. "Taking preventive measures now, such as strengthening muscles around the knee joint, may allow you to avoid serious repercussions later, like knee replacement surgery."
Myth: "A few extra pounds only affects my hips and knees."
Reality: Extra weight can affect even non-weight-bearing joints. Yes, excess pounds put stress on your joints and cause cartilage to wear out faster. But it's not just about the number on the scale. "We don't fully understand the process yet, but we know that fat releases chemicals throughout the body that may damage cartilage in both weight-bearing joints, such as hips and knees, and non-weight-bearing joints, such as hands," says Dr. Theodosakis.
Try to slim down or maintain a healthy weight. One study showed that overweight women who lost 11 pounds reduced their risk of developing knee OA by half. Another revealed that dropping 15 pounds decreased knee pain by 50%. Whatever you do, avoid gaining weight. "You can make the pain worse by giving up," says Dr. Theodosakis.
Myth: "Nobody needs a diagnosis just for aching joints."
Reality: You need to know the cause — not all achy joints are OA. "Several conditions that mimic arthritis, such as tendinitis and bursitis, can be mistaken for OA," says Patience H. White, M.D., vice president for public health with the Arthritis Foundation. "If you don't have an accurate diagnosis, you could take longer to heal, suffer long-term joint stiffness or not receive the appropriate treatment."
For instance, rheumatoid arthritis (RA), an autoimmune disease that involves multiple joints, leads to stiffness that lasts all day as opposed to the morning creakiness of OA. With RA, receiving the appropriate drugs early on can decrease joint inflammation and slow the course of the disease to prevent joint deformity.
Myth: "Any regular doctor is fine for managing arthritis pain."
Reality: A specialist may offer more treatment options and better care. Rheumatologists, who focus on joint, muscle and bone diseases, have more experience in recommending drugs and dosing regimens specific to your aches and pains. For example, not all primary care doctors do injections of corticosteroids or hyaluronic acid, a lubricating substance that improves the quality of joint fluid. These injections can last a few months and may reduce the need for oral pain medications.
In addition, a physical therapist can teach you exercises for strengthening muscles around a particular joint. Physical therapy can also relieve RA, which may cause joints to lock up if you don't maintain flexibility. In some cases, your doctor may refer you to an orthopedic surgeon.
Myth: "Exercise is going to worsen my arthritis."
Reality: Working out actually prevents the progression of arthritis. We know what you're thinking: Who wants to move when her knee's on fire? "But exercise strengthens muscles that provide support to joints, and stronger muscles mean there's less load on that joint," says Yul Ejnes, M.D., immediate past chair of the Board of Regents for the American College of Physicians. "If all you can do at first is short walks of even a few minutes, that's fine. The important thing is to get moving." Because arthritis pain waxes and wanes, avoid overdoing it when you're feeling good. And listen to your body. If you're achy after a specific activity, such as lunges or certain yoga poses, then that's not an exercise you should be doing. Avoid high-impact activities such as running, and choose low-impact exercise such as swimming, cross-country skiing or tai chi instead. Vary your workouts so you don't overtax certain joints.
Myth: "A prescription drug is the best way to control arthritis pain."
Reality: Over-the-counter solutions work wonders for many people. "The first-round drug of choice for OA is acetaminophen," says Jeffrey C. Delafuente, M.S., professor of pharmacotherapy at Virginia Commonwealth University in Richmond. "It's effective and has few side effects." If acetaminophen doesn't provide pain relief, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, may help. Or try an OTC topical cream that contains capsaicin; apply it for several weeks to feel improvement. Wearing a thumb splint or knee braces may also reduce discomfort.
If OTC treatments aren't effective, oral NSAIDs are available in stronger prescription doses or in topical creams. For moderate to severe pain, a prescription COX-2 inhibitor (Celebrex) may be easier on the stomach. No matter what drug you take, follow your doctor's instructions for dosage and how long to continue treatment.
Having arthritis doesn't mean you must refrain from certain activities. It means you need to modify how you do them. "You're not going to be as supple as you were in your teens or 20s," says Nortin M. Hadler, M.D., author of Rethinking Aging: Growing Old and Living Well in an Overtreated Society. "But you can still function without putting your life on hold." Try these tips to ease the ache.
Change Your Grip
- Pick up items such as your purse with your entire hand instead of pinching them between your thumb and index finger.
- Choose writing, kitchen and crafting tools with thick or textured handles, which take less effort to grasp.
- Replace round knobs on cabinets with C- or D-shaped pulls — they're more comfortable to grab — and opt for lever-style handles for faucets and doors.
Improve Your Workspace
- Raise your computer monitor so that you're looking straight ahead instead of leaning forward and slouching. Poor posture can make back pain worse.
- Support your lower back with a small pillow.
- Prevent hunching by attaching an external monitor and keyboard to a laptop.
- Wear a phone headset to help prevent neck strain.
Simplify Your Chores
- Install laundry machines on platforms. That way you won't have to bend over to handle clothes.
- Use jar openers to reduce strain on your hands.
- Choose gardening tools with wider grips and long handles to avoid stooping. Sit when weeding instead of kneeling and squatting, which are hard on knees, or use a scooter wagon.
Tame the Pain
Is it dull or burning? Does it feel worse in the morning, on rainy days or while performing a repetitive activity like playing piano? An accurate description of your pain can help your doctor prescribe the best treatment. "Pain is very individualized. Arthritis feels different depending on the person," explains Scott Zashin, M.D., co-author of Natural Arthritis Treatment. Pay attention to what you were doing when the discomfort started, where the pain is centered and how long it lasts. You may want to keep a pain diary to help you remember.
Check arthriving.com and arthritis.org for ergonomically designed items and orthoinfo.aaos.org for more posture tips.
Originally published in the May 2013 issue of Family Circle magazine.
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