Exercise, Nutrition and Alternative Therapies

Treatments for arthritis can include exercise and diet change, medications, alternative therapies such as T’ai Chi and Reiki and nutritional supplements, in addition to or replacing medication or surgery.

Exercise

It might seem counter-intuitive to exercise a joint that is wearing out, but all physicians agree that the key to managing arthritis is proper exercise. The important word here is “proper”.

Learning the proper technique for strengthening those muscles surrounding an arthritic joint normally involves physical therapy. It’s also important to know your own body and your genetic disposition to joint disease.

Aquatic exercise is probably the best exercise for overweight patients and those with severe arthritis. The Southern Maryland Branch of the Arthritis Foundation offers at least eight aquatics or warm water exercise programs locally. Gentle land-based exercises are offered through the Foundation at 11 locations locally.

“Use it or lose it,” says Dr. Edward McDevitt, orthopedic surgeon. “When you don’t use a body part, the muscles become stiff and you begin to lose range of motion,” he said. “And that will affect your quality of life. I try to help people find a kind of exercise they enjoy. Keep in shape and you’ll be happier and healthier.”

Exercise

Janet Hoffritz still loves to square dance. Twenty years ago, Ms. Hoffritz, now 73, developed osteoarthritis. After visiting her primary care physician, she began taking anti-inflammatory medication and had physical therapy. A few years later, she had arthroscopy surgery to try to give her knees a few more years. The pain was manageable, but in 1995, she finally decided it was time for replacements. Dr. Garrett Lynch replaced one knee and then the other one a year later.

Now she volunteers at the AAMC Spine Center. She said, “When you get arthritis, the best thing you can do is see a doctor and start exercising. Walking and swimming are great. The longer you leave arthritis untreated, the worse it gets.” She added, “And you have to keep up the exercise, before and after surgery.”

Weight control and nutrition

There’s no getting around it. Being overweight puts extra stress on your weight-bearing joints (ankles, knees, hips and back). In fact, when you put weight on one leg, the force across your joint is three times greater than your body weight.

“The longer I practice medicine,” said orthopedic surgeon Roy Bands, M.D. who specializes in spine surgery, “the more I realize the health of the joints is related to overall good health in general. What’s good for the heart is good for the spine, the lungs and the brain. You just need to try to maintain your ideal body weight. Use good nutrition and don’t smoke. There is a 20 times higher incidence of disc herniation with smokers because nicotine dries out the discs.”

Nutritional supplements have proved to be very helpful for many arthritis patients. Glucosamine, a natural building block of cartilage, has been shown to be useful in strengthening, repairing and revitalizing cartilage, and reducing pain, especially in the hands. Chondroitin sulfate is often taken in conjunction with glucosamine and has been shown to make the cartilage more elastic and spongy. Vitamins D and C also are often recommended.

Physiatrist Frederick Sutter, M.D. believes much of arthritis can be managed without medication and surgery. “You may need medication to get it under control, but the goal is to wean yourself off of it eventually. Certain nutritional changes can be made as well as lifestyle changes that can minimize the severity and keep you moving. But it’s not just ‘take a pill and you’re better.’ You have to be committed.” Dr. Sutter recommends patients include fish oils in their diet and reduce or eliminate sugar altogether. “It’s the white stuff that gets you in trouble. Sugar sets the stage for insulin swings in the body, and that can increase inflammation. Also,” he added, “some people are susceptible to some food groups, but it takes time and patience to figure it out.”

Orthotics

Several devices are available to help arthritis patients. They range from heel wedges, to braces and hand splints, to canes and wheel chairs.

Alternative therapies

Many patients with arthritis turn to alternative therapies to help them manage their pain, sometimes alone, or sometimes in conjunction with other therapies and medications. Acupuncture, Reiki, guided imagery, QiGong, and T’ai Chi and Pilates are all avenues you may pursue.

Alternative therapies & Nutrition

Nancy McGuckian is a scrapper. At 63, she’s suffered from arthritis for almost 20 years, along with fibromyalgia and carpal tunnel. “My fingers are getting deformed. I have problems with my hips, shoulder, knees and ankles.”

Dealing with pain is just part of her life. She tried medication, but the side effects were always worse than the pain, and she said, “I don’t like putting chemicals in my body.” She’s not a candidate for surgery. Support groups aren’t for her.

“I have to deal with this in a different way. I have learned to block the pain through my mind. Sure there’s an awareness that the pain is there, but I can control the intensity. I put my mind elsewhere. Partly I believe I’m too young and have too much to do to allow arthritis to slow me down,” she said.

Exercise helps. “I’m in the warm water pool in Edgewater at least two times a week and try for four. I go as often as I can. The water is about 88-90 degrees, and we’re in constant motion. I try to get every joint moving,” she said.

Weight control is another avenue for relief. For every pound you weigh, you put 3 pounds of pressure on your weight bearing joints. She said, “I’m a heavy person and I know that need to keep my weight down, so I’m working toward that now. I’ve cut out processed foods. I eat organically, and drink 8-10 glasses of water a day.”

More than anything, Ms. McGuckian says her ability to deal with the pain of arthritis is a realization that she is in control of her body. “I am responsible for me and I know what my role is. If I give in to the pain, then I penalize myself. I’m just grateful I can handle it this way.”

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