Arthritis and Exercise
By Mary Ann Wilson, RN
An estimated 40 million Americans have arthritis. There are over one hundred types of arthritis: the two most common are osteoarthritis, and rheumatoid arthritis.
Osteoarthritis. The symptoms of osteoarthritis usually begin after age 40 and include:
- joint pain which increases with weight-bearing and decreases with rest
- loss of joint range of motion
- minimal inflammation or swelling
- joint crepitus may be present (cracking and popping noise with movement)
Osteoarthritis may be mild, moderate, or severe. It is a wear and tear disease in which there is a mechanical breakdown of the cartilage that protects the ends of bones. It begins gradually and becomes chronically progressive. As the cartilage becomes damaged, bone spurs or calcium deposits may develop, causing the finger joints or knees to enlarge.
Primary osteoarthritis occurs without a preceding injury, and the cause is not completely understood. Secondary osteoarthritis is due to a prior injury, birth defect, excessive joint stress due to obesity or overuse, or metabolic disorder such as gout or diabetes. Joints that are usually affected are:
- weight-bearing joints (hips, knees, and spine)
- middle and end joints of the fingers, and
- joint at the base of thumb
The treatment goals for osteoarthritis are to decrease pain, increase activity, increase strength, prevent disability, and maintain function.
Rheumatoid Arthritis. Rheumatoid arthritis may begin in middle age or before, even in childhood. The symptoms include:
- pain with significant joint inflammation and swelling (joints may be hot, red, and tender)
- stiffness which is greater in the morning
- decreased joint mobility
- fatigue, fever, and malaise may be present
Rheumatoid arthritis is a systemic (affects the whole body) inflammatory disease in which the body attacks itself. White blood cells attack the joint lining (synovial membrane). Abnormal cells in the joint fluid then destroy the cartilage, bone, and surrounding soft tissues that support the joint. Pain and deformity may result. Rheumatoid arthritis can also affect the heart, lungs, eyes, skin, and other organs.
Rheumatoid arthritis often affects the same joint on both sides of the body. The joints that are commonly affected are:
- fingers at the joint where they attach to the hand, and middle finger joints
- often affects the neck
- organs such as the eyes, heart, lungs, and skin may be involved
Rheumatoid arthritis does not affect the lower spine.
The onset of rheumatoid arthritis may be gradual or sudden.The course of the disease is variable. It can last several months up to a few years and then go into remission without joint damage; it can be characterized by chronic flares and remissions, ranging from mild to moderate, in severity; or it can be a severe, active process that results in significant joint damage and disability.
The treatment goals of rheumatoid arthritis are to manage pain, decrease inflammation, halt the progression of joint destruction, prevent disability, maintain function, and preserve a sense of well-being.
Treatment plans for both types of arthritis include:
- Arthritis and Exercise: A healthy combination of exercise and rest. Rest more during arthritic flares, and exercise more when you feel better. This is especially important if you have rheumatoid arthritis. Rest can help reduce the inflammatory process within the joint.
- Joint protection with the appropriate use of assistive devices
- Activity modification
- Weight control
- Nutritional diet
- Medications appropriate for the type of arthritis
HOW EXERCISE HELPS MANAGE ARTHRITIS:
Exercise helps manage arthritis by… maintaining and increasing joint range of motion
Exercise helps manage arthritis by… maintaining and increasing muscle strength
Exercise helps manage arthritis by… decreasing joint pain and stiffness
Exercise helps manage arthritis by… stabilizing joints
Exercise helps manage arthritis by… preventing joint deformities
Exercise helps manage arthritis by… improving physical conditioning
Exercise helps manage arthritis by… maintaining and increasing function
Exercise helps manage arthritis by… maintaining good body alignment and posture
Exercise helps manage arthritis by… decreasing fatigue and improving quality of sleep
Exercise helps manage arthritis by… reducing stress and encouraging a positive attitude