How to Manage Your Osteoarthritis

How to Manage Your Osteoarthritis

(HealthDay News) — Osteoarthritis is the most common form of arthritis, affecting about 31 million Americans, and is the leading cause of disability among adults.

Known as OA, it causes pain and other symptoms in joints, which can affect the ability to do everyday tasks. There’s no known cure, but there are treatments that can relieve pain and maintain joint function, according to a rheumatologist at Wake Forest Baptist Health in Winston-Salem, N.C.

“Osteoarthritis is the thinning or wearing down of cartilage, which is the cushion between the separate bones in a joint,” Dr. Francis Luk said in a health system news release. “When your doctor says you have arthritis, most often they are referring to osteoarthritis.”

The main risk factors are aging, obesity, prior injury, repetitive stress on a joint and genetics. OA can occur in any joint, but the most common are knees, hips and hands.

“Symptoms vary from person to person but someone with osteoarthritis of the knee typically will have pain when they stand up from a seated position or when they’re walking, especially when going up and down stairs,” Luk said.

“With osteoarthritis of the hands, people typically experience pain when they do things that involve gripping — washing dishes, holding a wrench, opening a jar, things like that,” he added.

Treatments include over-the-counter drugs such as acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs, or NSAIDs, such as aspirin, ibuprofen (Advil, Motrin) and naproxen sodium (Aleve).

Other nonprescription options include topical creams and gels, such as those containing trolamine salicylate (Aspercreme), and the use of heating pads and ice packs.

Assistive devices such as canes, shoe orthotics, jar openers and tools with thicker handles can help with routine tasks.

For more advanced cases of OA, there are prescription pills and creams and steroid injections. The last resort is joint replacement surgery, especially of knees and hips.

“We always try to delay turning to surgery for as long as we can,” Luk said. “However, if you get to a point where you can’t walk from your living room chair to the bedroom, it would be a good idea to see an orthopedic surgeon.”

And, remember, two of the best ways to combat OA are maintaining a normal weight and getting regular exercise, he said.

“I tell people to do as much as they can tolerate until they have some pain and then rest,” Luk said. “I never recommend completely stopping activities, because the downside of inactivity is worse than osteoarthritis.”

More information

The American Academy of Family Physicians has more on osteoarthritis.

SOURCE: Wake Forest Baptist Health System, news release, Oct. 10, 2019

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Get Moving: Exercise Can Help Lower Older Women’s Fracture Risk

Get Moving: Exercise Can Help Lower Older Women’s Fracture Risk

FRIDAY, Oct. 25, 2019 (HealthDay News) — Older women who get even light exercise, like a daily walk, may lower their risk of suffering a broken hip, a large study suggests.

A number of studies have linked regular exercise to a lower risk of hip fracture — a potentially disabling or even fatal injury for older adults. Each year, more than 300,000 people in the United States aged 65 or older are hospitalized for a broken hip, according to the U.S. Centers for Disease Control and Prevention.

The new study, of more than 77,000 older U.S. women, took a deeper look at the types of exercise that are related to the risk of hip fracture and other bone breaks.

The researchers found that, on average, women who regularly exercised at any intensity — from walking, to doing yard work, to jogging — had a lower risk of hip fracture over 14 years, compared to inactive women.

It all suggests that even light activity is enough to curb the risk of these serious injuries, said study leader Michael LaMonte, a research associate professor at the State University of New York at Buffalo.

“We were happy to see a strong relationship between walking and lower hip fracture risk,” he said. “As we get older, we naturally do less-strenuous physical activity. This suggests that to lower your risk of hip fracture, you don’t need to do anything fancy. It can be as simple as walking.”

The findings “strongly support” longstanding recommendations for people to fit physical activity into their daily routine, according to Dr. Richard Bockman.

“Get out there and walk,” said Bockman, chief of the endocrine service at the Hospital for Special Surgery, in New York City.

Lower-impact activities do not have a big effect on bone density. But Bockman, who was not involved in the study, said that while bone density matters in hip fracture risk, other factors are also involved. They include muscle strength in the lower body, balance and agility, since broken hips are almost always the result of a fall.

The findings, published online Oct. 25 in JAMA Network Open, come from the Women’s Health Initiative — a study begun in the 1990s at 40 U.S. medical centers. It involved more than 77,000 women who were between the ages of 50 and 79 when they enrolled.

At the outset, the women reported on their usual physical activities, among other lifestyle factors.

Over an average of 14 years, one-third of the women suffered a bone fracture. When it came to hip fractures, women who’d reported higher amounts of physical activity at the study’s start typically had a lower risk.

For example, women who regularly got moderate to vigorous exercise, such as brisk walking or jogging, had a 12% lower risk of hip fracture than those who were less active. But there was also a link between “mild activity” — like slow dancing, bowling or golfing — and lower hip fracture risk. And the more often women walked, at any speed, the lower their risk of a broken hip.

The news wasn’t all good: Women who exercised at moderate to vigorous intensities had a relatively higher risk of a wrist or forearm fracture, compared to less-active women.

It’s not clear why, but LaMonte offered a guess: When women with more “functional ability” do fall, they may be more likely to stretch out an arm to break the fall, which is how wrist and forearm fractures often happen.

One question the study cannot address, LaMonte said, is whether starting exercise at an older age reduces hip fracture risk. Study participants who were physically active may have been active their whole lives.

But, he said, it is clear that “sitting less and moving more” is key in older adults’ overall health, with benefits such as better control of blood pressure and diabetes, and a lower risk of heart disease.

Besides exercise, older adults can take other steps to reduce their hip fracture risk, LaMonte noted. They include getting bone mass measurements as recommended by your doctor, and following a healthy diet with adequate amounts of calcium and vitamin D.

More information

The American Academy of Orthopaedic Surgeons has more on hip fracture prevention.

SOURCES: Michael LaMonte, Ph.D., M.P.H., research associate professor of epidemiology and environmental health, State University of New York at Buffalo; Richard Bockman, M.D., Ph.D., chief of endocrine service, Hospital for Special Surgery, and professor of medicine, Weill Cornell Medical College, New York City; Oct. 25, 2019, JAMA Network Open, online

Copyright ©2019 HealthDay. All rights reserved.
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After a Stroke, Your Bones Need Care

After a Stroke, Your Bones Need Care

THURSDAY, April 25, 2019 (HealthDay News) — Stroke survivors often face limited mobility, which quadruples their odds of osteoporosis, broken bones and falls. But most are never screened for these problems, new research reveals.

“Our study adds to previous research that found despite an increased risk, only a small number of people who have recently had a stroke are tested and treated for osteoporosis,” said lead author Dr. Moira Kapral. She is director of general internal medicine at the University of Toronto.

Impaired mobility can result in bone mineral density decline, which is associated with osteoporosis. The condition weakens bones and increases risk of fractures.

In this study, researchers looked at more than 16,500 Canadian stroke survivors, aged 65 and older, from Ontario. Of these patients, only 5% had undergone bone mineral density testing; 15.5% had been prescribed medications for osteoporosis within the year after their stroke, and only a small percentage were prescribed medications for osteoporosis for the first time.

Patients most likely to have bone mineral density testing tended to be younger, female and to have had low-trauma fractures in the year after their stroke.

Patients were more likely to be prescribed medications for osteoporosis after their stroke if they were female, already had the bone-thinning disease, had previously broken bones, had previous bone mineral density testing, or had fallen or broke bones after their stroke.

The study was published April 25 in the journal Stroke.

“This study offers more evidence that there is a missed opportunity to identify people with stroke at increased risk of fractures, and to initiate treatment to prevent bone loss and fractures,” Kapral said in a journal news release.

Less than one-third of older U.S. women are screened for osteoporosis. The maximum treatment rate for some high-risk patients is about 30%, the researchers pointed out.

More information

The U.S. Office on Women’s Health has more about osteoporosis.

SOURCE: Stroke, news release, April 25, 2019

Copyright ©2017 HealthDay. All rights reserved.
Step-by-Step Exercises for a Stronger Back

Step-by-Step Exercises for a Stronger Back

THURSDAY, April 11, 2019 (HealthDay News) — Are you neglecting or even unaware of the muscles in your back? If so, you’re putting yourself at risk.

The trapezius is the diamond-shaped muscle that runs from neck to middle back and from shoulder to shoulder across the back. The latissimus dorsi — or “lats” — are the large back muscles that run from either side of the spine to your waist.

Here are two strength-training exercises that will help you develop these muscles for better upper body fitness.

Important: Start with a weight that allows you to complete at least eight reps with proper form, perhaps as low as 2-pound dumbbells. Build up to 10 to 15 reps for one complete set, and progress from one to three complete sets before increasing the weight. Never jerk the weights — controlled, steady movement is what brings results.

Standing dumbbell rows target the trapezius muscles as well as the upper arms and shoulders. Stand straight, feet shoulder-width apart, with a weight in each hand. Your elbows should be slightly bent, the dumbbells touching the fronts of your thighs, palms facing your body. As you exhale, use a slow, controlled movement to lift the weights straight up by bending the elbows up and out to bring the weights to shoulder level. Hold for a second, then inhale as you lower your arms to the starting position. Repeat.

Bent-over one-arm rows target the lats as well as the upper arms and shoulders. To work the right side first, stand to the right side of a bench. Place your left knee and left hand on it for support. Your back should be nearly parallel to the floor. Hold a dumbbell in your right hand, palm facing inward. Using only your upper arm, bend at the elbow to lift the dumbbell straight up to your waist as you exhale. Hold for a second and then lower it with control as you inhale. Complete reps, then switch sides and repeat.

You can also do bent-over rows using both arms at once. Stand with feet about shoulder-width apart. Hold a dumbbell in each hand and, bending from the waist, bring your back to nearly parallel with the floor. Keeping arms close to your sides, bend the elbows to lift the weights, bringing them up to waist level. Hold for a second and then lower the weights with control as you inhale. Repeat.

More information

The American Council on Exercise has more on exercises targeting the back muscles.

Copyright ©2017 HealthDay. All rights reserved.
Walking, Not Riding, Boosts Health in Golfers With Knee Woes

Walking, Not Riding, Boosts Health in Golfers With Knee Woes

TUESDAY, Feb. 26, 2019 (HealthDay News) — Walking the golf course instead of riding in a cart offers heart health benefits that may outweigh potential joint harm for golfers with knee osteoarthritis, a new small study reports.

The study included 10 golfers with knee osteoarthritis who played two 18-hole rounds of golf. They walked the course in one round and used a golf cart in the other round.

Walking did increase the golfers’ knee inflammation, but they also got significant cardiovascular benefits, according to the researchers.

“The impetus for the study stemmed from the fact that the majority of rounds of golf in the United States are now played with a golf cart, which has been suggested to affect the health benefits of the sport. We wanted to measure the effect of this in individuals with knee osteoarthritis,” said study co-author Dr. Prakash Jayabalan. He is a clinician-scientist in sports medicine at AbilityLab, in Chicago.

More than 17 million people play golf in the United States each year. In nearly 70 percent of the rounds, golfers ride in motorized carts to travel between holes. Many golfers with knee arthritis may avoid walking because they think doing so may worsen their joint pain and cartilage degradation.

Osteoarthritis is often described as being caused by wear-and-tear on the joints, and it is a leading cause of disability for Americans aged 50 and older.

However, even though walking may increase inflammation in golfers with knee osteoarthritis, the researchers said there is evidence of cartilage remodeling effects in knees whether golfers walk or ride in a cart.

Golfers should consider their individual symptoms and follow their doctor’s advice, the study authors said in a news release from the Association of Academic Physiatrists.

“Walking exercise is commonly advocated for individuals with knee osteoarthritis. Our study suggests that golf may be a good prescription of walking exercise, particularly if they walk the course, as they get more health benefits,” said Jayabalan, who is also an assistant professor at Northwestern University Feinberg School of Medicine.

The study included people who played golf regularly, so Jayabalan said the next step would be to evaluate golf as an exercise intervention for occasional golfers.

The report was presented Thursday at the annual meeting of the Association of Academic Physiatrists, in Puerto Rico. The research should be considered preliminary until it is published in a peer-reviewed journal.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more on osteoarthritis.

SOURCE: Association of Academic Physiatrists, news release, Feb. 21, 2019

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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