Arthritis and Exercise: How Physical Activity Can Help Alleviate Symptoms

 

 Arthritis includes over 100 different conditions that cause joint pain, swelling, stiffness and difficulty moving. While medication and therapies are essential for managing arthritis, exercise has proven to be powerful complementary tool. Arthritis affects various joints in the body, each with its own unique name. Did you know that the term “arthritis” itself derives from the Greek words “arthro” (joint) and “itis” (inflammation)?

Ancient Egyptian texts dating back to 1500 BCE depict descriptions and remedies for joint pain. Exercise has been acknowledged as a valuable therapy for arthritis throughout history. Ancient Egyptian and Greek civilizations employed movement and exercise in treating joint pain. Hippocrates, the father of medicine, prescribed exercise and massage for arthritic conditions. In the 20th century, Swedish physician Sven Thorell introduced therapeutic exercises for rheumatoid arthritis, pioneering the field of physical therapy.

 

It is estimated that over 350 million individuals worldwide suffer with arthritis making it one of the most prevalent medical issues. Osteoarthritis, the most common types of arthritis impacts over 300 million people especially those aged 60 years and older. Rheumatoid arthritis impacting approximately 1 % of the World’s population is more prevalent in women. Even children are not immune as around 300,000 children in the United States alone are diagnosed with juvenile arthritis.

Arthritis poses a significant economic burden with costs related to medical expenses and lost productivity estimated at around 300$ billion in the United States. Arthritis is also a leading cause of disability limiting daily activities for about 30 million Americans. Arthritis often occurs alongside other chronic conditions such as heart disease and diabetes. These statistics emphasize the need for effective strategies and interventions to lessen the impact of arthritis on individuals and societies worldwide.

 

Types of Arthritis:

• Osteoarthritis (OA): It is characterized by the gradual deterioration of joint cartilage resulting in pain, stiffness and limited movement. Commonly affected joints include the knees, hips, hands, and spine.
• Rheumatoid Arthritis (RA): Rheumatoid arthritis (RA) is an autoimmune disease where the immune system attacks the joints causing chronic inflammation, joint pain, swelling, stiffness and possible joint deformity. It can have an impact on a number of joints including the knees, ankles, wrists and elbows.
• Psoriatic Arthritis (PsA): PsA affects individuals with psoriasis and typically involves joint inflammation, pain, stiffness, and swelling. It commonly affects the fingers and toes but can also impact larger joints and cause nail changes and skin symptoms.
• Gout: Gout is characterized by the buildup of uric acid crystals in the joints causing sudden and intense joint pain, swelling, redness and tenderness. The big toe is often affected, but other joints such as the ankles, knees, wrists and fingers may also be involved.
• Juvenile Arthritis (JA): This term encompasses various types of arthritis that affect children and teenagers. Symptoms include joint pain, swelling, stiffness, fatigue and restricted range of motion. Different subtypes of JA may have varying patterns of joint involvement.
• Ankylosing Spondylitis (AS): Ankylosing sponylitis (AS) primarily targets the spine and sacroiliac joints leading to inflammation, pain and stiffness in the lower back and hips.  Over time, it can lead to fusion of the vertebrae, resulting in a stiff and less flexible spine.
• Lupus Arthritis: Systemic Lupus Erythematosus (SLE) is an autoimmune disease that can involve joint inflammation. Lupus arthritis typically leads to joint pain, stiffness, swelling and tenderness. Other symptoms of SLE can include skin rashes, fatigue, fever, and organ involvement.

Suitable Exercises:

Exercise is widely recognized as an essential component in managing arthritis symptoms and improving overall joint health. While the type and intensity of exercise may vary depending on the individual’s specific condition, there are several forms of exercise that are generally considered suitable for people with arthritis.

• Low-Impact Aerobic Exercises Low-impact exercises like walking, swimming and cycling are gentle on the joints and offer cardiovascular benefits without putting too much stress on the body. According to the Arthritis Foundation, engaging in regular aerobic exercise can reduce joint pain and stiffness while improving overall fitness levels.
• Range-of-Motion Exercises: Exercises that involve range of motions assists, maintains and enhances joint flexibility. They can be particularly beneficial for individuals with arthritis. According to a study published in the Journal of Rheumatology, range-of-motion exercises have shown positive effects on joint mobility and function in patients with rheumatoid arthritis.
• Strength Training: Strength training exercises help improve muscle strength and joint stability, which can alleviate arthritis symptoms. Resistance training with weights, resistance bands, or bodyweight exercises can be adapted to suit individual capabilities. The American College of Rheumatology states that strength training is safe and effective for individuals with arthritis and can enhance overall physical function.
• Tai Chi: Tai Chi is a gentle mind-body exercise originating from ancient Chinese martial arts. It involves slow, flowing movements and deep breathing. Multiple studies have shown the benefits of Tai Chi for arthritis management. A study published in the New England Journal of Medicine found that Tai Chi improved symptoms and physical function in individuals with knee osteoarthritis.
• Water Exercises: For those with arthritis, water-based exercises like swimming or water aerobics offer great low-impact options. The buoyancy of water reduces stress on the joints while providing resistance for muscle strengthening. The Arthritis Foundation reports that water exercise can enhance mobility, decrease pain, and improve quality of life for individuals with arthritis.

 

Safety Tips for Arthritis Exercise

When exercising with arthritis, it’s crucial to prioritize safety and take necessary precautions. Researchers from the Current Opinion in Rheumatology journal found that people with arthritis especially inflammatory kinds like rheumatoid arthritis are more likely to sustain joint injuries while exercising. Vigilance and appropriate exercise modifications are crucial to minimize the risk.

• Begin with a proper warm-up, including gentle stretching and range-of-motion exercises to get your body ready for physical activity.
• Protect your joints by using proper technique, avoiding excessive impact or repetitive movements, and listening to your body’s signals.
• Recognize warning signs such as sharp or prolonged pain, swelling, or increased joint stiffness, and modify or stop the exercise accordingly.
• Before beginning or changing an exercise program, especially if you have severe arthritis or other health conditions, it is essential to consult with healthcare professional to ensure it is safe and suitable for your specific needs.

 

Medications: Managing Pain and Inflammation:

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs work by blocking enzymes that produce prostaglandins, which contribute to pain and inflammation in arthritis. Common over-the-counter NSAIDs include ibuprofen and naproxen, while prescription-strength options are also available.
• Disease-Modifying Antirheumatic Drugs (DMARDs): DMARDs are prescribed primarily for inflammatory types of arthritis, such as rheumatoid arthritis. These medications slow down the progression of the disease, prevent joint damage, and reduce symptoms. Methotrexate is one of the most commonly used DMARDs for rheumatoid arthritis.
• Corticosteroids: Corticosteroids often referred to as steroids can offer quick relief from inflammation and pain when used as a short-term treatment. They may be administered orally, through joint injections, or intravenously for more severe arthritis flares.
• Biologic Response Modifiers: Biologic therapies are a newer class of drugs that target specific components of the immune system responsible for inflammation in arthritis. Biologics are usually prescribed for moderate to severe forms of arthritis when other treatments have not been effective.
• Analgesics: Analgesics are pain-relieving medications that do not possess anti-inflammatory properties. Acetaminophen is a commonly used analgesic for arthritis pain relief, especially for those who cannot tolerate NSAIDs.
• Janus Kinase (JAK) Inhibitors: JAK inhibitors are a newer class of medications that target specific enzymes involved in the immune response. They are used in the treatment of rheumatoid arthritis and certain other inflammatory arthritic conditions.
• Immunosuppressants: Immunosuppressive medications are used to lower the immune system’s activity and reduce inflammation in certain autoimmune arthritis conditions.

Medications may be used alone or in combination, and regular monitoring and adjustments are often necessary.

 

Exploring Joint Injections: 

Joint injections involve the direct delivery of medications or substances into the affected joint space, targeting the source of inflammation and pain. The two most common types of joint injections for arthritis management are corticosteroid and hyalunoric acid injections.

• Corticosteroid Injections: Corticosteroids are powerful anti-inflammatory medications that can provide rapid relief from joint pain and inflammation. These injections are especially advantageous for people with inflammatory arthritis like rheumatoid arthritis or psoriatic arthritis. Corticosteroids work by reducing inflammation and suppressing the immune response in the joint, providing significant pain relief and improving joint function.
• Hyaluronic Acid Injections: Natural joint fluid contains hyaluronic acid which lubricates and cushions the joint. The natural hyaluronic acid in the joint may lessen in osteoarthritis increasing friction and pain. Hyaluronic acid injections supplement the joint fluid, reducing joint pain and enhancing mobility. These injections are commonly advised for people with knee osteoarthritis and their effects can last for several months.

While joint injections can be highly effective for arthritis management, they may not be suitable for everyone. Individuals with certain medical conditions, allergies, or infections may not be ideal candidates for these injections. Additionally, joint injections are not a cure for arthritis, and their effects are usually temporary. Multiple injections may be required over time to maintain pain relief and joint function.

 

When to Consider Surgery: 

Although most cases of arthritis are managed with non-surgical treatments, there are instances when surgery becomes a viable option to alleviate pain, improve joint function, and enhance overall mobility. Here are some situations when surgery may be considered for arthritis:

• Lack of Response to Conservative Treatments: If non-surgical treatments, such as medications, physical therapy, and assistive devices, have been exhausted without providing adequate relief, surgery may be considered as a next step.
• Severe Joint Damage: When arthritis significantly damages a joint, causing deformity, severe pain, and limited movement, surgery may be necessary to repair or replace the joint. Joint replacement surgery, such as total knee or hip replacement, is a common procedure for advanced arthritis cases.
• Functional Limitations: Surgery may be advised to restore functionality and enhance quality of life when arthritis makes it difficult to complete ordinary duties or engage in everyday activities including walking, climbing stairs or performing simple tasks.
• Persistent Pain: Chronic, unrelenting pain that significantly affects an individual’s well-being and disrupts sleep and daily activities may indicate the need for surgical intervention.
• Joint Instability: Arthritis can lead to joint instability, making the affected joint feel loose or wobbly. Surgery may be an option to stabilize the joint and prevent further damage.
• Joint Deformity: Arthritis can cause joint deformities, such as bone spurs or malalignment. Surgical procedures can correct these deformities to improve joint mechanics and function.
• Advanced Osteoarthritis: In severe cases of osteoarthritis, where the cartilage cushioning the joint has deteriorated significantly, surgical interventions like osteotomy (bone realignment) or joint fusion may be considered.

It’s crucial for individuals considering arthritis surgery to undergo a thorough evaluation by an orthopedic surgeon or a rheumatologist. The decision to proceed with surgery is highly individualized and depends on factors such as the type of arthritis, overall health, age, and lifestyle. The surgeon will discuss the potential benefits and risks of surgery, as well as the expected recovery and rehabilitation process.

 

The Impact of Arthritis on Daily Life: Pain, Limitations, and Challenges:

 Arthritis has a profound impact on daily life, causing chronic joint pain, stiffness, and reduced mobility. Simple activities that was once effortless, such as walking or getting up from a chair, become challenging and painful. The constant pain and inflammation contribute to fatigue and decreased energy levels, making it difficult to accomplish daily tasks. Arthritis can also impair fine motor skills, making it challenging to perform delicate tasks like buttoning clothes or gripping objects.

However, arthritic individuals can often benefit from using specialized tools and assistive devices that help alleviate the challenges and limitations posed by the condition. These tools are designed to provide support, increase independence, and make daily tasks more manageable. Here are some examples of special tools that arthritic individuals use every day:

•  Adaptive Kitchen Utensils: Utensils with larger, ergonomic handles or those with built-in grips can make cooking and eating easier.
• Jar and Bottle Openers: Arthritic hands can struggle with opening tightly sealed jars or bottles. Jar openers with rubber grips or adjustable straps can provide extra leverage and help loosen stubborn lids.
• Reacher Grabbers: Reacher grabbers are long-handled devices with gripping jaws at one end. They help individuals with limited mobility reach and pick up objects without excessive bending or straining.
• Adaptive Tools for Bathing: Bathing can become more comfortable and safer with adaptive tools. Examples include long-handled bath sponges or brushes, shower stools or chairs, and handheld showerheads with extended hoses.
• Ergonomic Office Supplies: Arthritic individuals who spend long hours working at a desk can benefit from ergonomic office supplies. Ergonomic keyboards, mice, and wrist supports promote proper hand and wrist positioning, reducing strain and discomfort.

Also, online communities and support groups have flourished, connecting people with arthritis worldwide. These communities offer a platform for individuals to share experiences, seek advice, and provide mutual support. It is heartening to witness the strength and camaraderie within these communities.

 

Combining Exercise with Other Arthritis Treatments: Maximizing Management

 

• Physical Therapy: Physical therapy is a valuable treatment option for arthritis. It involves specific exercises, manual therapy, and techniques aimed at improving joint mobility, strength, and function. Combining regular exercise with the guidance and expertise of a physical therapist can optimize outcomes. A physical therapist can assess your individual needs, provide appropriate exercises, and ensure safe and effective exercise practices.
• Heat and Cold Therapy: Heat and cold therapies are commonly used to manage arthritis symptoms. Applying heat to affected joints before exercise can help relax muscles and increase blood flow, promoting better mobility and reducing pain. Cold therapy applied after exercise can reduce inflammation and swelling. Knowing when and how to combine these therapies with exercise can reduce pain further and increase the advantages of exercise.

 

Some Common Questions On Arthritis

How is arthritis diagnosed?

Diagnosing arthritis usually involves a combination of medical history, physical examination, imaging tests (X-rays, MRI, ultrasound), and blood tests to check for inflammation markers and specific antibodies.

 

What are the risk factors for arthritis?

Risk factors for arthritis include age, family history of arthritis, previous joint injuries, obesity, and gender (some types are more common in women).

 

Can arthritis be prevented?

Although some forms of arthritis cannot be prevented, adopting a healthy lifestyle, maintaining a balanced diet, managing weight, and avoiding joint injuries can lower the risk of developing certain types of arthritis.

 

Are there alternative therapies for arthritis?

Some individuals find relief from arthritis symptoms through alternative therapies like acupuncture, massage, and herbal supplements. While alternative treatments may offer relief, they should be used alongside conventional treatments and with the guidance of a healthcare professional.

 

I don’t have access to a gym or exercise equipment. What are my options for exercise?

There are many cost-effective options available. You can walk or exercise at home using online videos or mobile applications. Community programs, local parks, or walking groups may offer free or low-cost options as well.

 

Why is an integrated approach important for arthritis management?

Arthritis is a complex condition that affects various aspects of a person’s life. An integrated approach addresses the physical, emotional, and social aspects of arthritis, providing comprehensive care and improving overall well-being.

 

Are there specific exercises that are more suitable for bodybuilding with arthritis?

Yes, certain exercises are generally considered safer and more suitable for individuals with arthritis. These include exercises that target major muscle groups while minimizing stress on the joints, such as seated leg presses, chest presses, and seated rows. Nevertheless, it’s crucial to seek advice from a healthcare professional or physical therapist to identify the most suitable exercises for your individual condition.

 

Should I modify my bodybuilding routine if I have arthritis?

Yes, modifications to your bodybuilding routine are often necessary when you have arthritis.

Reducing the intensity, modifying the range of motion using smaller weights including rest times and concentrating on activities that are less taxing on the joints are some strategies that may be used to achieve this.

 

 Are there resources available for guidance and support in exercising with arthritis?

Yes, several organizations and online platforms provide valuable resources. Information, exercise regimens and management advice for managing arthritis are available from the Arthritis Foundation, Mayo Clinic and Centers for Disease Control and Prevention (CDC). Community programs, local fitness centers, and arthritis support groups can also provide guidance and support.