Arthritis
Arthritis
How You Can Beat the Pain
An estimated 37 million Americans have arthritis--but often it's not whom you'd expect.
Sure, you might understand if it was your mother or grandmother. After all, about half the people over age 60 have some form of this disease, making it the single most common chronic condition among older Americans.
But arthritis in people your age?
It can happen.
Despite its reputation for being as much a part of growing old as gray hair, arthritis is an equal opportunity deployer--of pain. "Many people aren't surprised to hear that arthritis is the leading cause of disability in people over age 45," says Paul Caldron, D.O., a clinical rheumatologist and researcher at the Arthritis Center in Phoenix. "But they are surprised to learn it's the single leading cause of disability among all ages."
The Hormone Link
Although there are more than 100 different types of arthritis, the most common are osteoarthritis and rheumatoid arthritis. Women are three times more likely than men to get rheumatoid arthritis, the most debilitating form of the disease.
Unlike osteoarthritis, rheumatoid arthritis typically affects the entire body. It is especially painful and commonly strikes in a woman's twenties and thirties.
"What's really sad is that many people have significant pain and loss of function, and there's nothing you can do to prevent it, since we don't know what causes it," says Arthur Grayzel, M.D., vice president of medical affairs for the Arthritis Foundation. "We know rheumatoid arthritis is an immunological disease, and like other immunological diseases such as asthma, lupus and thyroid problems, women get it at higher rates because they tend to have overactive immune systems. But there are also strong data to support that rheumatoid arthritis is related to hormones."
Researchers speculate that during our childbearing years, some of our hormones are assigned to protect fetuses from immunological attacks, says Dr. Grayzel. In the process, other parts of our bodies are left more vulnerable, and some researchers believe that's why some of us fall victim to rheumatoid arthritis. Even if a woman never bears a child, these hormonal changes still take place, which is why many childless women are among the nearly two million American women with rheumatoid arthritis.
The most common form of arthritis, osteoarthritis, affects 16 million Americans and results when the cartilage in joints deteriorates from stress, overweight or injury, which is often sports-related. "That's not to say that if you play sports, you'll get arthritis. But those who have experienced repeated injury to a joint, no matter how minor, have an increased chance of getting osteoarthritis," says Dr. Caldron. It strikes about 12 million women, who usually get it after age 55. Typical trouble spots include the fingers, feet, back, knees and hips.
A Burden to Body and Mind
Either form of arthritis can take a toll on an active life. Arthritis can slow down your movements and cause some pain in your muscles, joints or tendons. At worst, it can cause enough agony to require hospitalization or around-the-clock care, says Jeffrey R. Lisse, M.D., director of the Division of Rheumatology and associate professor of medicine at the University of Texas Medical Branch at Galveston. Arthritis can also result in sleeping problems, decreased sexual activity because of pain and a weaker cardiovascular system, since many sufferers stop exercising when they have pain and swollen joints.
But arthritis ages more than just the body. "Depression is almost universal among arthritis patients," says Dr. Lisse. "But a lot of people with arthritis also get what's known as learned helplessness. That occurs when someone starts out healthy and able to do things for herself, but over time, as the pain gets worse, she is less able to take care of herself. Someone else must assume these functions, so the person with arthritis winds up more and more helpless. In fact, some of the youngest patients in nursing homes are people suffering from severe arthritis, who are there because of the inability to care for themselves."
Adds Dr. Grayzel: "I think that society almost expects people to have arthritis when they're old, so when an elderly woman limps or uses a cane, it doesn't really surprise anyone. But when you're young and your body image is very different, the effects can be devastating. The fact is, a lot of people who have arthritis--athletes, movies stars and others in the public eye--won't admit it because it seems to have a negative image. Having arthritis makes you seem old before your time."
A Smart Strategy
But it doesn't have to be that way. You may not be able to prevent rheumatoid arthritis, but you can lessen its aging effects on you. And you may be able to prevent or lessen the pain of osteoarthritis. Here's how.
Lose weight. "Being overweight is a major risk factor, especially for arthritis of the knees and hips," says Dr. Grayzel. "Even when you're in your twenties or thirties, you should try to reduce your weight close to the normal range for your height. If you're 20 percent overweight--about 160 pounds or more for the average woman--you're a prime candidate for osteoarthritis. But any weight loss helps. If you lose just 10 pounds and keep it off for ten years, no matter your current weight, you can cut your risk of osteoarthritis in your knees by 50 percent."
Watch what you eat. Various studies show that food plays a crucial role in the severity of arthritis. Norwegian researchers discovered that patients with rheumatoid arthritis saw dramatic improvements in their conditions within one month of beginning vegetarian diets. Other scientists have found that omega-3 fatty acids, abundant in cold-water fish such as salmon, herring and sardines, also ease rheumatoid arthritis pain.
"A diet that's low in saturated fat and animal fat seems to be helpful," says Dr. Caldron. "Eating a lot of fresh fruits and vegetables and nonred meat sources of fat such as fish and chicken may cause the body to produce fewer pro-inflammatory substances. That's not to say a diet will cure arthritis, but it may modify the effects of arthritis.
"Some people react to certain foods, almost like an allergy," adds Dr. Caldron. "It may result from wheat or citrus fruits, lentils or even alcohol. The problem is, there's no way to test for this. But if you notice a significant reaction and more pain consistently within 48 hours after eating a certain food, eliminate it from your diet."
Get physical. Regular exercise to build your muscles and flexibility can keep osteoarthritis at bay or lessen its effects. Exercise is also recommended for rheumatoid arthritis, although workouts should be under a doctor's supervision and emphasize range-of-motion exercises.
"Exercise improves strength and flexibility, so less stress is placed on the joints and they can move easier and more efficiently," says John H. Klippel, M.D., clinical director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases in Bethesda, Maryland. "Inactivity, on the other hand, actually encourages pain, stiffness and other symptoms."
Weight lifting is particularly useful because it builds muscle tone, which is especially important for arthritis sufferers. Emphasize building the abdominal muscles to reduce back pain and the thigh muscles for knee pain, advises Dr. Grayzel. Meanwhile, aerobic exercise such as running, bicycling and swimming are also helpful for improving flexibility.
Slow down when you have to. When a joint is swollen and inflamed, continuing to use it doesn't help. "Don't exercise through the pain," says Dr. Grayzel. "Otherwise, you'll just hurt more." So even if you're on a regular exercise program, skip a day (or two) when your joints or muscles begin to hurt.
Get in gear. "A frequent cause of osteoarthritis is injury, so you should take full advantage of the various protective equipment for athletics," says Dr. Caldron. "By wearing protective gear, you'll lessen the likelihood of injuring or reinjuring joints, tendons and muscles, which reduces the risk of osteoarthritis." That means you should wear padding on your knees, elbows and other likely trouble spots in order to reduce injury. These pads are available at any sporting goods store.
Turn up the heat. For immediate relief, many people find that placing warm, moist heat directly on inflamed areas helps reduce pain, says Dr. Lisse. Hot water bottles, heating blankets and hot baths help. But use heat judiciously--no more than 10 to 15 minutes at a time. And be sure to take a break for at least one hour before reapplying. Over-the-counter analgesic balms such as Ben-Gay can also help ease pain when joints are hot, tender and swollen. But don't use them with heat, cautions Dr. Caldron. The two together may cause nasty reactions such as burning and blistering.
Or chill out to prevent pain. Ice, meanwhile, is sometimes recommended to prevent pain when joints are overworked or overused. Dr. Lisse suggests that you wrap some ice in a towel and gently apply it to your joints several times a day, 15 minutes on and 15 minutes off.
Also practice the other way to cool off--by finding ways to deal with the stresses in your life. When you're tensed up, you hurt more. But anything you can do to learn to relax--whether it's listening to music, meditating or taking up a hobby--can help, especially when pain is severe.
