One Short, Brisk Walk a Day May Keep Arthritis at Bay

One Short, Brisk Walk a Day May Keep Arthritis at Bay

MONDAY, April 1, 2019 (HealthDay News) — Less than 10 minutes a day of brisk walking can help prevent disability in people with arthritis pain in their knee, hip, ankle or foot, researchers report.

Just one hour a week of brisk physical activity “is less than 10 minutes a day for people to maintain their independence. It’s very doable,” said lead study author Dorothy Dunlop. She’s a professor of preventive medicine at Northwestern University’s Feinberg School of Medicine in Chicago.

“This minimum threshold may motivate inactive older adults to begin their path toward a physically active lifestyle with the wide range of health benefits promoted by physical activity,” Dunlop added in a university news release.

She and her team analyzed four years of data from more than 1,500 older adults in Baltimore, Pittsburgh, Columbus, Ohio, and Pawtucket, R.I., who had pain, aching or stiffness in their lower joints from osteoarthritis but were initially free of disability.

The participants’ levels of physical activity were monitored using a wearable device.

An hour a week of moderate-to-vigorous physical activity reduced their risk of disability, the study found. Specifically, the activity reduced the risk of walking too slowly to safely cross a street by 85 percent, and their risk of not being able to do daily living activities — for example, morning routine tasks such as walking across a room, bathing and dressing — by nearly 45 percent.

By the end of the four years, 24 percent of participants who did not get a weekly hour of brisk physical activity were walking too slowly to safely cross the street, and 23 percent had difficulty performing their morning routines, according to the study.

About 14 million older Americans have symptomatic knee osteoarthritis, the most common type of osteoarthritis. About 2 in 5 people with osteoarthritis — most of whom have it in their lower joints — develop disability.

Federal guidelines recommend low-impact physical activity for older adults with arthritis, and recommend that older adults do at least 2.5 hours a week of moderate-intensity activity.

But that amount of activity can be too much for inactive older adults with lower extremity pain, according to Dunlop.

“We hope this new public health finding will motivate an intermediate physical activity goal,” she said. “One hour a week is a stepping stone for people who are currently inactive. People can start to work toward that.”

The study was published April 1 in the American Journal of Preventive Medicine.

More information

The Arthritis Foundation offers exercise tips.

SOURCE: Northwestern University, news release, April 1, 2019

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What’s the Right Age to Test for Osteoporosis?

What’s the Right Age to Test for Osteoporosis?

Osteoporosis is a threat to many women, especially after menopause. But the lead up to weak, brittle bones can start much earlier in life.

When bone density drops but isn’t yet at the level of osteoporosis, it’s called osteopenia. Osteopenia affects more than 33 million Americans over age 50, men and women, while 10 million have osteoporosis.

Yet the DEXA scan, the painless X-ray-based test that measures bone density, isn’t recommended for women until age 65, when they may need bone-building drugs to avoid fractures. For men, the prevalence of osteoporosis doesn’t increase with age until 80, but even then, there are no screening guidelines. So, what’s the answer?

Cost versus benefit is one reason insurers don’t universally cover the scan for women under 65. But you may be a candidate for earlier testing if you broke a bone after age 45, are losing height, are developing a slumped or hunched posture, or have sudden, unexplained back pain.

If you’re healthy but have concerns about bone health or risk factors for osteoporosis, you can talk to your doctor about earlier testing.

Factors that can increase your fracture risk include your height and weight — very thin women are at greater risk. Not getting enough exercise, smoking, drinking alcohol, a family history of osteoporosis or having a parent who broke a hip are others. Having a disease or taking medications associated with an increased risk of osteoporosis also increases your risk of fractures.

For better bone health, make sure your diet includes good sources of calcium-rich foods, that you get enough vitamin D through sunlight or a supplement, and that you get regular, weight-bearing exercise. That includes activities done while standing, like walking, which helps develop bone. Limit alcohol to one drink a day and don’t smoke.

More information

Harvard Health has more on osteopenia and osteoporosis.

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Pooch Peril: More Elderly Are Fracturing Bones While Dog Walking

Pooch Peril: More Elderly Are Fracturing Bones While Dog Walking

WEDNESDAY, March 6, 2019 (HealthDay News) — Walking the dog can be great exercise for seniors, but there could be one downside: bone fractures.

Fractures suffered by elderly Americans while walking their dogs have more than doubled in recent years, new research shows.

Still, taking your dog for a walk can also bring big health rewards, one joint specialist said.

“Pets can provide companionship for older adults, and the physical exercise from regularly walking a dog may improve other aspects of physical and psychological health,” said Dr. Matthew Hepinstall, who wasn’t involved in the new study.

“So, the risks of walking a dog should be balanced against potential benefits,” said Hepinstall, who helps direct joint surgery at Lenox Hill Hospital in New York City.

The new research was led by Kevin Pirruccio, a second-year medical student at the University of Pennsylvania. His team tracked national data and found that among people aged 65 and older, fractures associated with walking leashed dogs rose from about 1,700 cases in 2004 to almost 4,400 cases in 2017 — a 163 percent rise.

More than three-quarters of the fractures occurred in women, with hip and arm fractures being the most common. About half of all fractures occurred in the upper body, with fractures of the wrist, upper arm, finger and shoulder leading the way.

The most common type of fracture was a broken hip (17 percent). That’s cause for concern, Pirruccio’s team said, because the death rate linked to hip fractures in people older than 65 is close to 30 percent.

The researchers added that the study only involved data on fractures treated at emergency departments. The actual number of dog walking-related injuries among seniors might even be higher if injuries not typically seen in a hospital — for example, tendon or muscle tears — were factored in.

Why the rising rates of fractures tied to dog walking? The study authors theorized that increased pet ownership and a greater emphasis on physical activity for older adults may be driving the trend.

In a university news release, Pirruccio stressed that walking your pooch each day “has repeatedly demonstrated social, emotional and physical health benefits.” It’s also “a popular and frequently recommended activity for many older Americans seeking new ways to stay active,” he said.

On the other hand, “patients’ risks for falls must be factored into lifestyle recommendations in an effort to minimize such injuries,” Pirruccio said.

Hepinstall agreed.

“The take-home message for older adults and their families is that, when choosing to care for a pet, be sure to consider the strength and coordination of the older adult, and the size and expected behavior of the pet selected,” he advised.

Pet ownership and care may need to be re-assessed with age, Hepinstall added.

“When the mobility of older adults changes, they should be encouraged to re-evaluate their ongoing ability to care for any pets,” he said. “This will help ensure that the health and other needs of the adult and of the pet can be properly managed.”

The study was published March 6 in JAMA Surgery.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases offers advice on preventing falls and fractures.

SOURCES: Matthew Hepinstall, M.D., associate director, joint preservation & reconstruction, department of orthopaedic surgery, Lenox Hill Hospital, New York City; University of Pennsylvania, news release, March 6, 2019

Copyright ©2017 HealthDay. All rights reserved.
Is Your Hand Pain Arthritis, Carpal Tunnel or Something Else?

Is Your Hand Pain Arthritis, Carpal Tunnel or Something Else?

FRIDAY, March 1, 2019 (HealthDay News) — You use your hands nearly every minute of the day, so any time they hurt it’s important to find out why.

Certain conditions can affect people who do the same hand movements for hours every day. Repetitive strain injury can cause pain in muscles, nerves and tendons. Carpal tunnel syndrome swelling compresses a key nerve. The lesser known de Quervain’s tenosynovitis typically affects tendons on the inner sides of the wrist.

An autoimmune disease like rheumatoid arthritis often causes joint pain. Without treatment, it can lead to deformities in your hands. The wrist and finger joints are common targets of osteoarthritis, which occurs over time from normal wear-and-tear.

Treatment might start with an over-the-counter or prescription NSAID to temporarily relieve pain, but their long-term use has been linked to side effects such as liver or kidney damage and elevated heart attack risk.

Stronger medications may be needed to stop a degenerative disease like rheumatoid arthritis. Corticosteroid injections are an occasional option to reduce inflammation. Heat can ease stiffness while a cold pack can relieve soreness. If you have a chronic condition, an occupational therapist can teach you how to limit stress on joints when using your hands. During a flare, he or she might suggest a splint to stabilize your hand.

Sometimes surgery is needed. Dupuytren’s contracture, a thickening under the skin on the palm of the hand, can develop into firm lumps that cause fingers to bend inward. Unless lumps are removed early, it may be impossible to straighten fingers later on. If other options don’t help carpal tunnel and de Quervain’s, surgery might be the answer.

Many conditions worsen without appropriate treatment, so don’t delay in seeing your doctor or a hand specialist.

More information

The American Academy of Orthopaedic Surgeons has more on painful hand conditions.

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Health Tip: What to Eat if You Have Arthritis

Health Tip: What to Eat if You Have Arthritis

f you have arthritis, there are foods that may help you feel better.

A diet that’s rich in vitamins and minerals, and includes fruits, lean proteins, fish, vegetables, nuts and healthy oils may be most beneficial, the foundation says.

But it cautions against changing too much, too soon. Gradually swap out ingredients at each meal, and you may feel a big difference in how you feel and how well you can manage your pain and discomfort, the foundation adds.

Copyright ©2017 HealthDay. All rights reserved.
Brisk Walks May Help, Not Harm, Arthritic Knees

Brisk Walks May Help, Not Harm, Arthritic Knees

If you suffer from knee arthritis and worry that walking will only worsen your damaged joint, a new study suggests you put your fears aside, slip on some sneakers, and take a brief but brisk walk.

The researchers estimated that if older adults with the condition added just 5 minutes of brisk walking to their day, their odds of needing knee replacement surgery could dip by 16 percent.

On the other hand, light walking — akin to a “stroll” — may have no impact, said lead researcher Hiral Master, a Ph.D. candidate in biomechanics and movement sciences at the University of Delaware.

Her team reached those conclusions by digging into data from over 1,800 older adults with knee arthritis who wore portable devices that tracked their walking intensities for at least four days.

Over the next five years, 6 percent of the participants had total knee replacement surgery.

The researchers used the data on people’s walking habits to examine the effects of replacing “non-walking” time with time spent walking at different intensities. The findings showed that substituting just 5 minutes of down time with moderate-to-high intensity walking was linked to a 16 percent decline in the odds of needing knee replacement surgery.

The study authors defined “moderate-to-high” intensity as more than 100 steps per minute. In laymen’s terms, Master said, that’s a “brisk” walk that gets your heart rate up — not a stroll around the block.

The findings were presented Saturday at the American College of Rheumatology’s annual meeting, in Chicago. Such research should be considered preliminary until published in a peer-reviewed journal.

Knee osteoarthritis develops when the cartilage cushioning the joint gradually breaks down, which can eventually result in bone scraping on bone.

The condition is common among middle-aged and older Americans. According to the Arthritis Foundation, up to 13.5 percent of men and 19 percent of women aged 45 and older have knee arthritis that’s severe enough to cause pain and other symptoms.

And those patients often wonder whether walking is good or bad for their arthritic joints, said Dr. Paul Sufka, a rheumatologist at the University of Minnesota, in Minneapolis.

“They often ask whether they should minimize their activity, keep doing what they’re doing, or intensify,” said Sufka, who is also with the American College of Rheumatology’s communications committee.

“The general advice we give to patients is to stay active,” Sufka said. But, he added, the truth is there is too little evidence to give patients definitive recommendations.

The new findings do not prove that brisk walking directly lowers the risk of needing knee replacement surgery, Sufka noted.

But, “this gives us some useful information to bring to the discussion,” he added.

Overall, Sufka said, research does suggest it’s better for people with knee arthritis to be active rather than sedentary. And that’s not just for the sake of their knees. Physical activity has a range of health benefits, including lower risks of heart attack and stroke.

Master agreed, and pointed out that exercise can help arthritis patients’ mental well-being, as well as physical.

And it doesn’t take a huge lifestyle change, she explained. The new findings suggest people can benefit from adding a short, brisk walk to their day.

In fact, Sufka said, such incremental shifts may be best.

“The best exercise program is the one you can actually stick with,” he said. “If right now, you’re walking around the block every day, what would be 5 percent or 10 percent more than that? You can gradually build from where you are.”

And what if walking is painful? That’s a tricky question, Sufka acknowledged. Some patients might benefit from physical therapy rather than only exercising on their own, he said.

Beyond aerobic exercise like walking, strengthening exercises for the leg muscles supporting the knees can also be helpful, he suggested.

More information

The Arthritis Foundation has an overview on knee arthritis.

SOURCES: Hiral Master, P.T., M.P.H., Ph.D. candidate, biomechanics and movement sciences, University of Delaware, Newark, Del.; Paul Sufka, M.D., assistant residency director, internal medicine residency program, University of Minnesota, Minneapolis, and member, communications and marketing committee, American College of Rheumatology; Oct. 20, 2018 presentation, American College of Rheumatology annual meeting, Chicago

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