Arthritis: the great crippler

IF French sculptor Auguste Rodin (1840-1917), often considered the greatest of his day, lived today, he might have managed to sculpt more than what he produced during his time.

The man behind such masterpieces as The Thinker and The Kiss spent his last three decades creating well-known sculptures—this despite the fact that he suffered from a severe and crippling case of rheumatoid arthritis.  He had his first severe attack of rheumatoid arthritis when he was 57, and over the years, his condition deteriorated, which left his arms paralyzed and hands deformed like claws of a bird.

Arthritis may be the oldest ailment on earth.  Mummies uncovered in Egypt had it, prehistoric man had it and dinosaurs had it.  If you’re reading this, perhaps you have it, or you know someone who does.

Oftentimes, arthritis is changed interchangeably with rheumatism.  But rheumatism is a more general term, according to Dr. Sandra Navarra, one of the country’s leading rheumatologists and founding member of the Arthritis Care and Research Foundation of the Philippines.

Arthritis means “any ache or pain.”  More specifically, it is a variety of disorders of the joints, muscles and connecting tissues.  As such, it falls under rheumatism.  “Arthritis is often seen as an inevitable part of old age, but there are more than 100 different forms of the disease, many of them affecting people of various ages, including children,” Dr. Navarra pointed out.

Generally speaking, there are two kinds of arthritis: osteoarthritis and rheumatoid arthritis. The most common joint disorder, osteoarthritis affects many people to some degree by age 70.  Men and women are equally affected, but the disorder tends to develop at an earlier age in men.

Usually, symptoms develop gradually and affect only one or a few joints at first. Joints of the fingers, base of the thumbs, neck, lower back, big toes, hips and knees are commonly affected.  Pain, usually made worse by exercise, is the first symptom.  In some people, the joint may be stiff after sleep or some other inactivity, but the stiffness usually subsides within 30 minutes after they start moving the joint.

Osteoarthritis frequently affects the spine.  Back pain is the most common symptom.  Usually, damaged joints in the spine cause only mild pain and stiffness.  However, osteoarthritis in the neck or lower back can cause numbness, odd sensations, pain and weakness in an arm or leg if the overgrowth of bone presses on nerves.

Rheumatoid arthritis, on the other hand, develops in about 1 percent of the population, affecting women two to three times more often than men.  Usually, rheumatoid arthritis first appears between 25 and 50 years of age, but it may occur at any age.  In some people, the disease resolves spontaneously, and treatment relieves symptoms in 3 out of 4 people; however, at least 1 out of 10 people eventually become disabled.

Rheumatoid arthritis may start suddenly, with many joints becoming inflamed at the same time.  More frequently, it starts subtly, gradually affecting different joints.  Usually, the inflammation is symmetric: When a joint on one side of the body is affected, the corresponding joint on the other side is also affected.  Typically, the small joints in the fingers, toes, hands, feet, wrists, elbows and ankles become inflamed first. The inflamed joints are usually painful and often stiff, especially just after awakening or after prolonged inactivity.

Cysts, which may develop behind affected knees, can rupture, causing pain and swelling in the lower legs.  About 30 to 40 percent of people with rheumatoid arthritis have hard bumps (nodules) just under the skin, usually near diseased areas.

There’s no cure for arthritis – at least not yet.  The good news is that there’s a lot you can do to alleviate the pain and stiffness and keep the creakiest of joints moving.  Try these strategies featured in The Doctors Book of Home Remedies (I and II) and Pain Remedies:

Eat your vegetables.

Researchers at the University of Oslo in Norway discovered that people with rheumatoid arthritis who began a vegetarian diet saw dramatic improvements in their conditions within one month after cutting out meat, eggs, dairy products, sugar and foods with gluten.  “A vegetarian diet is good, because the goal for arthritis sufferers is to cut as much saturated fat from their diets as possible and replace it with more polyunsaturated fat,” said Dr. Paul Caldron, a clinical rheumatologist and researcher at the Arthritis Center in Phoenix in the United States.

Use a dehumidifier.   If the humidity is kept constant in your house, it can help calm arthritis pain caused by weather changes, said Dr. Joseph Hollander, a professor at the University of Pennsylvania Hospital in Philadelphia.  When rain is on the way, the sudden increase in humidity and decrease in air pressure can affect blood flow to arthritic joints, which become increasingly stiff until the storm actually starts.  If you close the windows and turn on a dehumidifier —or run the air-conditioning in summer—you may be able to eliminate this short-term but significant pain.

“Probably the most important thing you can do for osteoarthritis is exercise as much as you’re able to,” said Dr. Halsted Holman, director and professor of medicine at Stanford University Arthritis Center in California. “You’ll find that the better your physical condition, the less arthritis pain you’ll have.”  He recommends low-impact exercises and, if tolerated, very light weight lifting with 1- to 2-pound dumbbells.  “Build up the muscle and tissue surrounding the joint,” he suggested.  “You can exercise on a floor mat, in a chair, on a stationary bicycle or in the water. The key is regularity, doing it no less than three times a week put preferably daily.”

Learn your food “triggers.” “Some people with rheumatoid arthritis seem to flare up after eating certain foods—especially alcohol, milk, tomatoes and certain nuts,” said Dr. Caldron.  “Although there’s really no telling what your trigger might be, if you notice your condition worsens after eating a certain food, then listen to your body and avoid that food.”  The same goes for foods that improves arthritis, such as fish and fiber; try to eat them more regularly.

Take time to smell the roses.  When you’re tensed up, you hurt more.  “Many people use relaxation as an effective way of diminishing arthritis pain,” said Dr. Holman. “It really doesn’t matter what you do—biofeedback, meditation, even listening to music—whatever helps you relax.  The point is to practice a regular relaxation period and then also to use relaxation when pain is particularly severe.”

Slim down.  “Being overweight can enhance damage to joints by putting excess pressure on them, resulting in worsening osteoarthritis, so I advise losing any excess weight you’re carrying,” said Dr. Richard Pope, an arthritis researcher at the Northwestern University Medical School in Chicago.  In fact, being overweight increases your risk of developing osteoarthritis, even if you don’t have it now.

 Try slow dancing.

Dancing is a good way to combine weight loss, exercise and stress reduction.  “Many of my patients participate in easy dance routines created as part of an overall education and activity program that shows them how to exercise while protecting their affected joints,” explained Dr. Pope.  “Easy, slow dancing is perfect for those with inflammatory arthritis, or osteoarthritis, because it’s low impact.”

Work wonders with watercise.  “Water exercises are excellent,” said Dr. Art Mollen, director of Southwest Health Institute in Phoenix, Arizona.  “Your pain will be significantly reduced in the water, and you become much more flexible in water than you are in air.  I can’t say enough about water exercises.”  The beginning exercise techniques are easy for anyone to follow.  They consist of waving, walking and bending motions performed in chest-deep water.  The more advanced movements look like aquatic dance steps designed to take advantage of water’s natural resistance and gentle buoyancy.

Reach for the “right” pain reliever.  Not all pain relievers are the same—at least for those with arthritis. “People with inflammatory arthritis should get more relief from aspirin or ibuprofen but may get more stomach irritation with these,” cautioned Dr. Caldron.  For over-the-counter pain relief without stomach irritation, he recommends acetaminophen.  Recommended doses of these drugs should be not exceeded, nor did regular dosing continue, for more than three weeks without consulting your physician.

 Immobilize the pain. “Splints, slings, cervical collars and other protective devices are extremely useful when an area is particularly painful or inflamed,” said Dr. Caldron.  But he cautions that you can’t leave on these devices for more than two days at a time.  Even though these devices help reduce pain, your muscles can “rely” on them and weaken very quickly.

Use ice and heat judiciously.  Although both ice packs and heat packs can provide some relief, don’t use either for more than 10 minutes at a time, advised Dr. Caldron.  Usually ice is used to prevent swelling but may also douse pain; heat in small doses may promote muscle relaxation and soothe pain.

Boost your vitamin C intake.  “Studies have shown that people with rheumatoid arthritis are deficient in vitamin C,” said Dr. Robert Davis, professor of physiology at the Pennsylvania College of Podiatric Medicine. His medical models have shown that a lack of vitamin C can aggravate rheumatoid arthritis and that strong doses of vitamin C can bring about regression of the disease.  “Vitamin C is definitely a good home remedy for someone with rheumatoid arthritis,” he said.

Get your spouse involved.  Though it’s only natural for a husband or wife to do whatever’s possible to help a mate who’s hurting, such help can often do more harm than good.  “When a wife tries to do everything herself and is constantly asking her husband how he feels, she is reinforcing his pain,” said Dr. Judith Turner, a psychologist with the Pain center at the University of Washington.  Her advice: Don’t be attentive and supportive only when your spouse is in pain, but also when he or she is feeling good and being active.  “That’s the time to say, ‘Gee, I’m really happy to see you doing things,’” Dr. Turner said.  “Praise is really important and something people tend to forget to do.”

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