How You Can Cut Risk of Arthritis
With age, arthritis is inevitable--or so the folklore goes--and there’s not much to do except hobble off into the sunset as gracefully as possible.
That view is changing dramatically, at least for people with osteoarthritis, the most common form of the disease that affects 16 million Americans, making their joints inflamed, swollen and painfully stiff.
Arthritis is more common with age, everyone agrees. But researchers now know how to reduce the risks via lifestyle changes. Some say high-impact exercise, once thought a set-up for arthritis, is off the hook. New treatment options and new rehabilitation programs also help to keep arthritis patients moving.
Reducing Risks
One thing’s for sure, says Dr. Arthur Grayzel, senior vice president for medical affairs for the Arthritis Foundation in Atlanta. Being very overweight increases the chance of arthritis in the knee and probably in the hip.
Keeping weight near ideal is wise, he says, emphasizing that he’s not advising people be reed thin--just stay reasonably near their ideal weight. At least two studies show that people more than 20% above their ideal weight have an increased risk of osteoarthritis in the knee, Grayzel says.
Injuries to weight-bearing joints from sports or falls also seem to increase the risk of developing arthritis later, he says. While injuries can’t always be prevented, “take them seriously” when they occur, Grayzel advises. That means getting prompt and proper treatment for such injuries as torn knee cartilage and following through on recommended rehabilitation.
Exercise Debate
Does the wear and tear of exercise, especially high-impact activities like running, set people up for arthritis?
It’s an argument that has raged for years, with some research finding high rates of arthritis in overused joints of athletes. But two recent studies suggest otherwise.
Habitual physical activity during the middle-aged years is not associated with development of arthritis of the knee later, concludes Marian T. Hannan, a researcher at the Boston University Arthritis Center in the Journal of Rheumatology published in April.
With her colleagues, she evaluated more than 1,400 subjects and found “there was no increase in the risk of knee osteoarthritis with increasing physical activity in either men or women.” But the study showed that men who are physically active do tend to develop more bone spurs in later years, but experts disagree on whether these bone spurs lead to arthritis.
There are some relationships between occupational activities and arthritis, Hannan finds. Carpet layers, for instance, have a higher incidence of knee arthritis than those who don’t perform that type of physical activity on the job.
In another study, UC San Francisco researcher Dr. Nancy Lane found that running does not accelerate arthritis in the knee. Her research team compared 35 runners, average age 63, with 39 non-runners of the same average age over five years and reported the results recently in the Journal of Rheumatology. While arthritis tended to progress in subjects during the follow-up period, it was not accelerated in runners compared with non-runners.
Early Detection
Once arthritis is suspected, it’s important to see a doctor. The primary warning symptoms, says the Arthritis Foundation, include pain, swelling and stiffness, or loss of movement in or around joints. If any of those symptoms persist longer than two weeks, it’s wise to seek professional help.
Medical Relief
Often, arthritis pain can be controlled with over-the-counter pain relievers such as acetaminophen, says Grayzel. “As the disease progresses, there are a percentage of people who need more potent medicine.”
A mainstay of treatment is non-steroidal anti-inflammatory drugs. The downside of these drugs, however, is that they can cause ulcers.
Surgical Relief
Early intervention with arthroscopic surgery--often used to repair sports injuries--might help arthritis patients, too, says Dr. Kenneth Kalunian, UCLA assistant professor of medicine. In an ongoing study, he is using the arthroscope to irrigate and wash away debris around the joint.
The one-hour procedure is performed in the doctor’s office with local anesthesia. Kalunian hopes the irrigation process will reduce inflammation and pain. “Arthroscopic surgery may also help delay or prevent the need for total knee replacement,” he adds. UCLA is
one of five centers nationwide studying the approach.
Pumping Iron
Exercise is increasingly viewed as good treatment for arthritis, if supervised and done cautiously. “Although a lot of people believe they should stop exercising when they have arthritis, that’s not necessarily true,” says Nadine M. Fisher, assistant professor of rehabilitation medicine, University of Buffalo. “You can have a tremendous amount of improvement with the right types of exercise.”
In a recent study, Fisher directed 80 people with arthritis of the knee in a strength-training program. They started out with half-hour sessions three times a week and progressed to hourlong sessions three days a week. The results after three months: 90% had less pain, 85% had better muscle strength of the knee, and 95% were better able to perform daily activities.
Patient Responsibility
Patients can help themselves by educating themselves as much as possible, says Dr. Steven Weiner, a rheumatologist at La Palma Intercommunity Hospital, La Palma. He encourages his patients with arthritis to exercise if possible--”Swimming in a warm pool is ideal”--but tells them that every workout caveat applies doubly.
The Other Arthritis
Rheumatoid arthritis, the second-most common type of about 100 known forms, affects about 2 million Americans, says the Arthritis Foundation. Treatment is often more intensive, and the deformities related to rheumatoid arthritis are more severe than those related to osteoarthritis.
Among new treatments under study for rheumatoid are Chinese herbs. UCLA researcher Dr. Mark Borigini is giving rheumatoid-arthritis patients a mixture of 10 traditional herbs along with standard non-steroidal anti-inflammatory drugs. The herbs work, it is thought, by increasing release of natural anti-inflammatory substances.
Where to Call for Information
* The Southern California Arthritis Foundation, (213) 954-5750, has information and will refer consumers to support groups, exercise classes and other resources.
* The Arthritis Foundation operates a toll-free hot line, (800) 283-7800, from 9 a.m. to 7 p.m. EDT, Mondays through Fridays, and publishes a variety of brochures.
