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Don't Take Arthritis Lying Down
Years ago, doctors hardly ever told rheumatoid arthritis patients to "go
take a hike" or "go for a swim." Arthritis was considered an
inherent part of the aging process and a signal to a patient that it's time to
slow down. But not so anymore. Recent research and clinical findings show that
there is much more to life for arthritis patients than the traditional
recommendation of bed rest and drug therapy.
What Is Rheumatoid Arthritis?
The word "arthritis" means "joint inflammation" and is
often used in reference to rheumatic diseases. Rheumatic diseases include more
than 100 conditions, including gout, fibromyalgia, osteoarthritis, psoriatic
arthritis, and many more. Rheumatoid arthritis is also a rheumatic diseases,
affecting about 1 percent of the U.S. population (about 2.1 million people.)1
Although rheumatoid arthritis often begins in middle age and is more frequent
in the older generation, it can also start at a young age.
Rheumatoid arthritis causes pain, swelling, stiffness, and loss of function in
the joints. Several features distinguish it from other kinds of arthritis:
 | Tender, warm, and swollen
joints.
| Fatigue, sometimes fever,
and a general sense of not feeling well.
| Pain and stiffness lasts for
more than 30 minutes after a long rest.
| The condition is
symmetrical. If one hand is affected, the other one is, too.
| The wrist and finger joints
closest to the hand are most frequently affected. Neck, shoulder, elbow,
hip, knee, ankle, and feet joints can also be affected.
| The disease can last for
years and can affect other parts of the body, not only the joints.2 |
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Rheumatoid arthritis is highly
individual. Some people suffer from mild arthritis that lasts from a few
months to a few years and then goes away. Mild or moderate arthritis have
periods of worsening symptoms (flares) and periods of remissions, when the
patient feels better. People with severe arthritis feel pain most of the time.
The pain lasts for many years and can cause serious joint damage and
disability.
Should Arthritis Patients Exercise?
Exercise is critical in successful arthritis management. It helps maintain
healthy and strong muscles, joint mobility, flexibility, endurance, and helps
control weight. Rest, on the other hand, helps to decrease active joint
inflammation, pain, and fatigue. For best results, arthritis patients need a
good balance between the two: more rest during the active phase of arthritis,
and more exercise during remission.2 During acute systematic flares or local
joint flares, patients should put joints gently through their full range of
motion once a day, with periods of rest. To see how much rest is best during
flares, patients should talk to their health care providers.3
The following exercises are most frequently recommended for patients with
arthritis:*
| Type
of Exercise |
Benefits |
Frequency
of Exercise |
| Range-of-motion
exercises, e.g. stretching and dance |
Help
maintain normal joint movement and increase joint flexibility. |
Can
be done daily and should be done at least every other day. |
| Strengthening
exercises, e.g. weight lifting |
Help
improve muscle strength, which is important to support and
protect joints affected by arthritis. |
Should
be done every other day, unless pain and swelling are severe. |
| Aerobic
or endurance exercises, e.g. walking, bicycle riding, and
swimming |
Help
improve the cardiovascular system and muscle tone and control
weight. Swimming is especially valuable because of its minimal
risk of stress injuries and low impact on the body. |
Should
be done for 20 to 30 minutes three times a week unless pain
and swelling are severe. |
|
Range-of-motion exercises, e.g. stretching and dance Help maintain normal
joint movement and increase joint flexibility. Can be done daily and should be
done at least every other day. Strengthening exercises, e.g. weight lifting
Help improve muscle strength, which is important to support and protect joints
affected by arthritis. Should be done every other day, unless pain and
swelling are severe. Aerobic or endurance exercises, e.g. walking, bicycle
riding, and swimming Help improve the cardiovascular system and muscle tone
and control weight. Swimming is especially valuable because of its minimal
risk of stress injuries and low impact on the body. Should be done for 20 to
30 minutes three times a week unless pain and swelling are severe.
* Adapted from Questions and Answers about Arthritis and Exercise.3
If patients experience
| Unusual or persistent
fatigue,
| Increased weakness,
| Decreased range of motion,
| Increased joint swelling, or
| Pain that lasts more than
one hour after exercising, |
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they need to talk to their health
care provider.3 Doctors of chiropractic will help arthritis patients develop
or adjust their exercise programs to achieve maximum health benefits with
minimal discomfort and will identify the activities that are off limits for
this particular arthritis patient.
Nutrition for the Rheumatoid Arthritis Patient
Arthritis medications help suppress the immune system and slow the progression
of the disease. But for those who prefer an alternative approach, nutrition
may provide complementary support. Some evidence shows that nutrition can play
a role in controlling the inflammation, and possibly also in slowing the
progression of rheumatoid arthritis.
Some foods and nutritional supplements can be helpful in managing arthritis:
| Fatty-acid supplements:
eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and gamma
linolenic acid (GLA). Several studies point to the effectiveness of these
fatty acid supplements in reducing joint pain and swelling, and lessening
reliance on corticosteroids.4,5
| Deep-sea fish, such as
salmon, tuna, herring, and halibut, are sources of EPA and DHA. GLA is
found in very few food sources, such as black currants and borage seed.
| Turmeric, a spice that's
used to make curry dishes, may also be helpful. A 95 percent curcuminoid
extract has been shown to significantly inhibit the inflammatory cascade
and provide relief of joint inflammation and pain.
| Ginger extract has been
shown to be beneficial in terms of inflammation.
| Nettle leaf extract may
inhibit some inflammatory pathways.
| A vegetarian or low-allergen
diet can help with the management of rheumatoid arthritis as well. |
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The benefits and risks of most of
these agents are being researched. Before taking any dietary supplement,
especially if you are using medication to control your condition, consult with
your health care provider.
What Can Your Doctor of Chiropractic Do?
If you suffer from rheumatoid arthritis, your doctor of chiropractic can help
you plan an individualized exercise program that will:
| Help you restore the lost
range of motion to your joints.
| Improve your flexibility and
endurance.
| Increase your muscle tone
and strength. |
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Doctors of chiropractic can also
give you nutrition and supplementation advice that can be helpful in
controlling and reducing joint inflammation.
Patrick Bernat, BA, ACA Media & Public Relations Associate Director,
Writer
Alan Adams, DC, MS, DACBN, Consultant
Joel Pins, PhD, MS, MPH, LN, Consultant
Nataliya Schetchikova, PhD, Editor
David Cundiff, MFA, Art Director
References
- Questions and Answers about
Arthritis and Rheumatic Diseases. National Institute of Arthritis and
Musculoskeletal and Skin Diseases. February 2002. Available from http://www.niams.nih.gov/hi/topics/arthritis/artrheu.htm.
- Handout on Health:
Rheumatoid Arthritis. National Institute of Arthritis and Musculoskeletal
and Skin Diseases. Jan. 1998, revised Nov. 1999. Available from http://www.niams.nih.gov/hi/topics/arthritis/rahandout.htm.
- Questions and Answers about
Arthritis and Exercise. National Institute of Arthritis and
Musculoskeletal and Skin Diseases. May 2001. Available from http://www.niams.nih.gov/hi/topics/arthritis/arthexfs.htm.
- Fortin Paul R., et al.
Validation of a meta-analysis: the effects of fish oil in rheumatoid
arthritis. J Clin Epidemiol, Vol. 48, 1995, pp. 1379-90.
- Navarro Elisabet, et al.
Abnormal fatty acid pattern in rheumatoid arthritis - A rationale for
treatment with marine and botanical lipids. J Rheum, Vol. 27, February
2000, pp. 298-303.
Courtesy of the ACA Website
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