The Best Medicine for Arthritis
For: Arthritis Remedies,
Old and New, December 2003
If you have osteoarthritis (OA), it need not limit your mobility—at least not if you keep moving. But many of the 40 million Americans who suffer from OA don't exercise because of pain and stiffness in their joints. Thus the muscles grow weaker and the joints become more painful.
OA is caused by a breakdown of the cartilage, the cushioning material of the joints. Time and use may wear it away, but OA is now known to be not simply wear and tear, but a disease that prevents the cartilage from repairing and renewing itself normally. Hips, neck, hands, knees, back, and feet are the most commonly affected areas. So far, there's no way to reverse cartilage damage, but there's hope for new treatments in the near future.
Meanwhile, the best thing you can do for OA is exercise. Understandably, if you have joint pain you may have formed the habit of walking more slowly and doing as little as possible. If this is the case, you need to get moving again—slowly and gently, but definitely.
The beneficial effects of exercise on OA were underlined by a study that appeared in the Journal of the American Medical Association in January. More than 430 adults, aged 60 or older, who considered themselves disabled by knee arthritis took part in exercise programs at medical schools in Winston-Salem and Memphis. One group walked 40 minutes three times a week (warming up in advance, cooling down after); another group did resistance training. The program lasted 18 months. People in both groups saw an 8 to 10% decrease in their disability level; their pain lessened, their walking ability increased. (A control group, which did no exercise, but simply got health education, did not get better). Though researchers used to be concerned that exercise could worsen OA, that didn't happen here, nor has it happened in other, smaller studies.
Inexpensive or free help
If you have arthritis and want to get moving, it's a good idea to check with your physician first, and possibly get a referral to a physical therapist. You can also ask the Arthritis Foundation for information (call 800-283-7800 to find your local chapter). It sponsors exercise classes, also available as a videotape. This safe and gentle program is a good way to begin if arthritis has made you sedentary. Your local Y or school district's adult education program may also have programs to suit your needs.
The exercises below are a way to begin, and fall into two categories:
Range of motion exercises relieve stiffness, restore flexibility, and help with joint movement. If you haven't yet lost your full range of motion, exercises like these can help prevent such loss, as well as minimize joint stiffness. Tai Chi, the gentlest form of martial arts training, offers excellent range-of-motion exercise.
Strengthening exercises are particularly important because weak muscles add to joint problems. Many studies have found that strength training can relieve knee pain, improve strength, and boost physical functioning. With isometric exercise, you contract the muscle without moving the joint. Isotonic exercises—using elastic bands, weights, or resistance machines—require you to move the joints and can result in greater strength gains. (For details about elastic-band workouts, see WELLNESS LETTER, March 1997.) Water workouts can be useful.
Don't forget aerobic exercise. Continuous movement for 10 minutes or longer, such as walking, swimming, and cycling (at low pedal resistance, over level surfaces at first) can definitely reduce pain and improve physical functioning. Rowing, water walking, aqua aerobics, and ballroom or other low-impact dancing are also excellent choices.
Keep in mind before you start
• Exercise slowly and carefully. Start with modest amounts and then increase. You may need instruction and coaching.• Gentle exercise should be a daily routine. It's a long-term project—not something you do only occasionally.
• Warm up before exercising.
• Heat can help. If your joints are stiff, take a warm bath or shower just before exercising. Or apply a heating pad or hot pack to stiff joints.
• Pick a time of day to exercise when you are least stiff and have less pain. If you take pain relievers, take them one hour before exercising.
• Avoid bouncing or high-impact exercise. Stretch slowly.
• Don't overdo exercise. If you feel more pain than usual or sudden pain, stop. If the pain persists, you've done too much. The advice of a trainer or physical therapist can be helpful in this case.
The Exercises:
| SHOULDER STRETCH. Reach one palm over shoulder and place back of other hand on lower back. Slide hands toward each other, trying to touch fingertips (many people can't reach that far). Alternate arms. |
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| ARM CURL. Hold one end of an elastic band in fist, palm up, the other end securely under arch of foot. Start with arm extended downward (but elbow not locked). Slowly curl forearm toward shoulder, keeping elbow close to side. Then lower slowly; repeat. Switch arms. |
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| LEG STRENGTHENER. Stand in front of chair. Slowly bend at hips and knees as if to sit down, but don't go all the way down to the seat. Lower your body as far as you can without sitting. Keep body upright. Slowly straighten back up. |
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UC Berkeley Wellness Letter, August 1997
