Arthritis is a general term which basically means inflammation of the joints. There are over 200 forms of arthritis, and can affect anyone in any decade of their life. The most common form is osteoarthritis, which occurs when the cartilage in the joints break down, usually because of wear and tear. Commonly found in the weight bearing joints i.e. hips, knees, ankles, and spine, and in the hands and wrists, it is characterised by pain and stiffness in the affected joint. Other symptoms can include ‘catching’, clicking, grinding or crunching noises, muscle wasting and weakness around that joint causing a sensation of giving way.
The NICE guidelines (National Institute for Health and Clinical Excellence) promote 3 core treatment options in the management of arthritis. These are education, advice and access to information; strengthening exercise and aerobic fitness and weight loss if overweight or obese. A balanced, nutritious diet is also recommended.
Everybody’s experience of arthritis is different, but it need not stop you from doing what you love to do. Most people can lead a full active life with arthritis, by making a few modifications to their lifestyle, and by proper management of the condition. Arthritis tends to have a pattern of flare ups and remissions, making it difficult to determine how much activity is right. A health professional such as a physiotherapist can assist you in determining how much activity is right for you, and will guide you with regards to exercises and lifestyle changes.
Various lifestyle changes can assist in the management of arthritis:
• Maintaining your ideal weight for your height - Increased weight puts more stress through the joints, and is associated with faster progression of osteoarthritis.
• Pacing your activities is a useful way to control the pain. For example, if you tend to do all your housework in one day, try splitting it over a few days, with adequate rest between tasks. Although it takes a bit of getting used to, pacing has been shown to be a very effective way for people to manage pain.
• If you suffer with pain in your back, hips, knees, or ankles and feet, it is worth considering your footwear. Supportive, well cushioned footwear is ideal for shock absorption and improving the position of the foot, which reduces stress on the joints.
• If you suffer with arthritis, exercise is probably not the first thing that would come to mind, but appropriate exercise is exactly what your joints need:
Range of movement exercises - take your joints through their full range of movement, maintaining and lubricating the joints are beneficial for people of all ages to maintain flexibility.
Strengthening exercises - are extremely important, as weakness of the muscles around the joints has been linked with reduced function and increased disability in arthritis.
Appropriate aerobic exercise - such as walking or bicycle riding is also beneficial, in improving your mood generally, as well as assisting weight maintenance and general well being.
Other therapies - such as acupuncture, massage and supplements can be of assistance, and can be a useful adjunct to self management, particularly during flare ups.
Living with arthritis can be made easier by managing the symptoms. It is best to maintain as much independence and activity as possible for both physical and emotional reasons. A good physiotherapist will be able to assist in devising an exercise programme for you that would include all these aspects to help you manage your condition.
Cathy Kwan, Physiotherapist