Exercises for Chronic Health Conditions

Exercises for Chronic Health Conditions

Exercise can help prevent many chronic illnesses as well as make it easier to manage health conditions, from diabetes to joint pain.

In terms of prevention, aim for the recommended 150 minutes of exercise, like brisk walking or cycling, each week. Along with eating a healthy diet, this can cut your risk of diabetes by more than a third, plus increase your level of good cholesterol. Exercise also lowers body weight, blood pressure and triglycerides, thus reducing key risk factors for heart disease.

If you’re already managing a chronic illness, exercise may improve symptoms and reduce the amount of medication you need to take. It builds muscle, which helps you move more easily, and reduces stress, which can aggravate many health conditions. Back pain and arthritis improve with the right stretching and exercise plan. If you have diabetes, exercise can improve blood sugar control.

Exercise’s health effects on:

Heart disease: Regular aerobic exercise and interval training in particular are heart-healthy, boosting cardiovascular fitness.

Back pain: Core exercises strengthen the muscles around your spine, creating better support for your spine.

Arthritis: Exercise enhances the muscles that support your joints, making movement easier; it also eases stiffness.

Diabetes: Exercise helps you use insulin more effectively and lower your blood sugar level.

Asthma: Exercise can help control attacks.

If you’re managing an illness and haven’t been active, talk to your doctor about what exercises are safe, any precautions to take, what kind of discomfort is normal, and what are signs to stop, like feeling dizzy, short of breath or chest pain.

Working with your doctor is especially important when you have diabetes. Because exercise can affect blood sugar, you’ll need to take precautions to prevent blood sugar from becoming too low during workouts.

In terms of intensity, start off slow — that means you should be able to talk, but not sing, when working out.

More information

The Cleveland Clinic has detailed tips on exercising with a chronic condition to help you get started safely.

Non-Opioids Often Underused After Back Surgery

Non-Opioids Often Underused After Back Surgery

Spine and joint surgery patients aren’t taking advantage of common pain relievers like Tylenol or Motrin during their recovery, researchers say.

Instead, many are given opioids, such as oxycodone (OxyContin) or hydrocodone (Vicodin). These highly addictive narcotics are potentially deadly when abused. The United States is currently grappling with an ongoing opioid epidemic.

The new study also found that post-surgical patients improperly store and dispose of their unused opioid painkillers.

“It’s clear we need to empower patients to ask their physicians about non-opioid pain management options, as well as call on prescribers to be more thoughtful of their prescribing practices,” said study first author Dr. Mark Bicket. He’s an assistant professor of anesthesiology and critical care medicine at Johns Hopkins University in Baltimore.

Greater use of non-opioid painkillers means fewer opioids would need to be prescribed, making it less likely that they’d be lost, sold, taken by error or discovered by a child, Bicket said in a university news release.

The researchers found that six months after surgery, more than one-third of patients still had unused opioids at home. And more than 90 percent admitted that they weren’t stored safely.

Three-quarters or more said they had not received instructions on how to store or dispose of the opioids, the study authors noted.

The study included 140 patients, average age 56, who were surveyed two days, two weeks, one month and six months after surgery about their use of non-opioid painkillers. These drugs include nonsteroidal anti-inflammatory drugs (NSAIDs) such as Motrin and Advil, and acetaminophen (Tylenol).

Two days after surgery, 82 percent of patients were not using NSAIDs. Forty-four percent reported not using acetaminophen. Only 5 percent used both NSAIDs and acetaminophen.

One month after surgery, only 6 percent of patients reported use of multiple non-opioid medications.

Also one month after their operation, nearly three-quarters of patients said they had unused opioids. Almost half of these said they had 20 or more unused pills, and 37 percent said they had more than 200 morphine milligram equivalents of opioids. Some experts say that, at this dosage, a patient who has never had narcotic painkillers would overdose.

The vast majority of the study patients reported unsafe storage of opioids a month after surgery and said they had not disposed of unused pills.

The study was published recently in the journal Anesthesia & Analgesia.

More information

The American Academy of Family Physicians has more on pain control after surgery.

SOURCE: Johns Hopkins University, news release, April 30, 2018

Health Tip: When To Call Your Doctor If You Have Lower Back Pain

Health Tip: When To Call Your Doctor If You Have Lower Back Pain

Few people go through life without having episodes of lower back pain.

For some people, though, it’s a daily struggle.

The American Academy of Family Physicians says back pain may be controlled by maintaining proper posture and sitting, lifting, standing and exercising properly.

Others have to seek medical attention for relief. The academy mentions these warning signs that you should see a doctor about your aching lower back:

  • If pain radiates down your leg below your knee.
  • If your leg, foot or groin feel numb.
  • If you have fever, chills, nausea, vomiting, stomach pain or weakness.
  • If you have difficulty going to the bathroom.
  • If the pain was caused by an injury.
  • If pain is so intense that you can’t move.
  • If your pain doesn’t improve or gets worse after two weeks.
  • If you notice any muscle atrophy.
Ditch the Golf Cart. Your Aging Knees Won’t Mind

Ditch the Golf Cart. Your Aging Knees Won’t Mind

Golfers with knee arthritis should park the golf cart and walk the links instead, researchers say.

While using a golf cart may seem the obvious choice for golfers with knee problems, a new small study finds that walking provides much greater health benefits. Moreover, it’s not associated with increased pain, inflammation or cartilage breakdown, the researchers said.

“Individuals with knee osteoarthritis are often concerned about pain and may be more likely to use a golf cart,” said lead study author Dr. Prakash Jayabalan. He’s an assistant professor of physical medicine and rehabilitation at Northwestern University Feinberg School of Medicine in Chicago.

However, “this study has shown that golfers with knee osteoarthritis do not need to be concerned about worsening their disease through walking the course. In fact, walking provides the best health benefit,” Jayabalan said in a university news release.

More than 17 million Americans older than 50 golf regularly. Knee osteoarthritis is a leading cause of disability in this age group. The condition causes swelling, pain and difficulty moving the joint.

The study included 10 older golfers with knee osteoarthritis and five without the disease, which is usually caused by wear and tear of the joint.

On one day, the study participants played one round of golf (18 holes) walking the course. On another day, they used a golf cart to play 18 holes. On each occasion, the researchers monitored the participants’ heart rates to determine their level of exercise intensity, and took blood samples to measure markers of knee inflammation and cartilage stress.

On both occasions, the golfers had an increase in these markers, but there was no difference between use of the golf cart and walking, the findings showed.

When walking the course, the heart rates of the golfers with knee problems were in the moderate-intensity zone for more than 60 percent of the time, compared with 30 percent when using a cart.

But even using the cart, golfers met daily exercise recommendations, according to the study authors.

“Bottom line: walking the course is significantly better than using a golf cart, but using a golf cart is still better than not exercising at all,” Jayabalan concluded.

The study was presented recently at the Osteoarthritis Research Society International annual meeting in Liverpool, England. Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal.

More information

The Arthritis Foundation has more about osteoarthritis.

SOURCE: Northwestern University, news release, April 28, 2018

Too Much or Too Little Weight May Worsen Rheumatoid Arthritis

Too Much or Too Little Weight May Worsen Rheumatoid Arthritis

Obesity may accelerate and amplify the crippling symptoms of rheumatoid arthritis, new research suggests.

Conversely, the researchers also found that unexplained weight loss might also signal problems for these patients, because it could mean that they’re at greater risk for disability.

“While patients and rheumatologists may be focused mostly on disease activity, we should also consider this common condition [obesity], which can contribute to problems that are usually attributed to the arthritis itself,” said study author Dr. Joshua Baker.

“In addition, unintentional weight loss should alert us that the patient may be becoming frail and is at risk for developing new disability,” he added. Baker is an assistant professor of medicine at the University of Pennsylvania’s Perelman School of Medicine.

Rheumatoid arthritis is an autoimmune condition. It develops when immune cells that normally fight germs attack the lining of the joints, or cartilage. This causes the joints to swell and the surrounding bones, ligaments and muscles to gradually erode. Rheumatoid arthritis worsens over time, often leading to disability.

For the study, Baker and his colleagues looked at the effects of obesity on the progression of rheumatoid arthritis in just over 25,000 people with the disease.

The investigators found that the disease advanced more quickly among those who were very obese. This was true regardless of the level of inflammation in their joints.

In addition, people who were thin but lost weight without trying also became disabled more quickly.

The study was published April 30 in the journal Arthritis Care & Research.

“So, this study suggests that patients with rheumatoid arthritis and obesity would benefit from intentional weight loss through a comprehensive management strategy,” Baker said in a journal news release.”

“However, when we see that someone is losing weight without trying, it’s probably a poor prognostic sign, especially if they are already thin,” he added.

Although the study could not prove a cause-and-effect link, the researchers suggested that new treatments and strategies to help people maintain a healthy weight might help prevent disability among people with rheumatoid arthritis.

And, Baker’s team noted, the findings could help doctors recognize signs of frailty among their rheumatoid arthritis patients who may benefit from strength training and physical therapy.

More information

The Arthritis Foundation has more about obesity and rheumatoid arthritis.

SOURCE: Arthritis Care & Research, news release, April 30, 2018

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