Arthritis & Other Joint Problems

Arthritis & Other Joint Problems

 

What is Arthritis?

Arthritis is a disease that affects the joints (the parts where bones meet and move). It can affect any joint in your body. There are many types of arthritis and rheumatic diseases, including osteoarthrtitis, rheumatoid arthritis, and fibromyalgia. If your symptoms are mild, medications may be enough to reduce pain and swelling. For more severe arthritis, surgery may be needed to improve the condition of the joint.

What Causes Arthritis?

Cartilage is a smooth substance that protects the ends of your bones. When you have arthritis, this cartilage breaks down and can no longer protect your bones. The bones rub against each other, causing pain and swelling. Over time,bone spurs (small pieces of rough or splintered bone) may develop, and the joint's range of motion becomes limited.

Symptoms

  • Joint pain and stiffness. Pain and stiffness get worse with long periods of rest or using a joint too long or too hard.

  • Joints that have lost normal shape and motion.

  • Tender, inflamed joints. They may look red and feel warm.

  • Feeling tired all the time.

Reducing Symptoms

Following a healthy lifestyle by eating healthy, reducing stress, and finding the right balance of rest and activity can help reduce symptoms of arthritis.

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What is Bursitis?

A bursa is a fluid-filled sac that helps cushion the muscles, tendons, and bones in a joint. When a bursa becomes inflamed, it's called bursitis. Common symptoms of bursitis include pain, tenderness, and swelling that limits movement of the joint.

What Causes Bursitis?

Bursitis is most often caused by overuse of a joint. The repeated movements irritate the bursa and cause it to swell. When that happens, other tissues in the joint have less space to move. Bursitis is most common in large joints such as the knee, shoulder, and hip.

Nonsurgical treatment involves both rest and exercise.

How is Bursitis Treated?

To help reduce pain and swelling, your doctor may recommend one or more of the following:

  • Rest gives the bursa time to heal. This means limiting activities that put stress on the joint.

  • Anti-inflammatorymedications help reduce painful swelling. In some cases, this can include injections of cortisone into the joint.

  • Splintsandsupportbandages improve your comfort and allow the bursa to heal.

  • Physicaltherapy may be used to increase flexibility and strengthen muscles that support the joint.

  • Aspiration removes excess fluid from the joint using a needle.

  • Surgery can be used to remove an inflamed bursa. This is rarely needed.

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What Is Osteoarthritis?

Osteoarthritis is a disease that causes the cartilage in your joints to break down. Cartilage is a smooth substance that protects the ends of your bones and helps your joints move. Osteoarthritis becomes more common as people get older. To diagnose this disease, your doctor will ask about your health history and perform an exam. X-rays may also be needed.

Knee joint with osteoarthritis

Healthy knee joint

Symptoms

Osteoarthritis can affect any joint, with women tending to get it in their hands. Weight-bearing joints, such as the hip and knee, are often affected in both men and women. Some of the more common symptoms of this disease include:

  • Joint pain and stiffness. Long periods of rest or using a joint too long or too hard can make pain and stiffness worse.

  • Weak muscles or wobbly joints.

  • Joints that have lost normal shape and motion.

If Surgery Is Needed

For people with severe joint damage, surgery can decrease pain and improve movement. Joint replacement is the most common surgery used to treat osteoarthritis. Joints in the knee, hip, and shoulder are replaced most often.

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Living with Osteoarthritis

Increasing muscle strength and joint motion can help you feel better.

Osteoarthritis is an ongoing problem. But it doesn't have to keep you from leading an active life. You can help control symptoms by exercising and watching your weight. Using special tools also helps make life easier. Be sure to see your doctor as requested for checkups and lab work.

Make Exercise Part of Your Life

Gentle exercise can help lessen your pain. Keep the following in mind when you work out:

  • Choose exercises that improve joint motion and make your muscles stronger. Your doctor or a physical therapist may suggest a few.

  • Try low-impact sports, such as walking, biking, or doing exercises in a warm pool.

  • Don't push yourself too hard at first. Slowly build up your endurance over time.

  • When pain and stiffness increase, cut back on your workout.

A healthy diet can help you lose unwanted pounds.

Watch Your Weight

If you weigh more than you should, your weight-bearing joints are under extra pressure. This makes your symptoms worse. To reduce pain and stiffness, try shedding a few of those extra pounds. The tips below may help:

  • Start a weight-loss program with the help of your doctor.

  • Ask your friends and family for support.

  • Join a weight-loss group.

Use Special Tools

Even simple tasks can be hard to do when your joints hurt. The special tools and aids listed here can make things easier by reducing strain and protecting your joints. Ask your health care provider where to find these and other helpful tools:

  • Long-handled reachers or grabbers

  • Jar openers and button threaders

  • Splints for your wrists or other joints

  • Large grips for pencils, garden tools, and other hand-held objects

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Understanding Osteoarthritis

If you're living with osteoarthritis (a condition that causes joint pain and stiffness), you're not alone. Most people will develop this common condition at some point in their lives. Osteoarthritis results when a joint begins to wear out. One or more joints in the body may be affected. The tendency to develop this condition may run in your family. Or it may be caused by an injury you had years ago. Your doctor can determine whether you have osteoarthritis or another type of joint problem that needs a different kind of treatment.

How Joints Work

A joint is a place where two bones meet. The parts of a joint help the bones move easily. Cartilage is smooth tissue that cushions the ends of bones, letting them slide against each other. The synovial membrane surrounds the joint. It makes a fluid that lubricates the joint.

When a Joint Wears Out

Through long use or injury, or because of a family tendency, the cartilage can become rough and damaged. It starts to wear unevenly. The ends of the bones then rub together, causing stiffness, pain, and sometimes swelling. Bony spurs may grow, enlarging the joint. The muscles around the joint may weaken.

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Osteoarthritis: Noninvasive Treatment Options

These therapies may help relieve pain and stiffness. If you decide to try one of these therapies, look for a licensed or accredited practitioner. Also, keep in mind that these therapies may have an effect on other treatment you are receiving. Always tell every healthcare provider what other kinds of treatment you are using.

Acupuncture and Acupressure

Acupuncture is a traditional Chinese technique. It uses small needles inserted in certain places on the body. Acupressure is similar, but uses pressure instead of needles. These techniques may stimulate the body's natural painkillers.

Massage

Therapeutic massage may help you and your muscles relax. It may also improve circulation and help joints stay more flexible. Look for a certified massage therapist. Many are trained to treat sore muscles that result from joint pain and stiffness.

Supplements

Some people believe that certain dietary supplements may help people with arthritis. But be careful: Herbs, vitamins, and other supplements may have an effect on medications you are already taking. Always talk to your doctor or pharmacist before trying a supplement.

Biofeedback

Certain functions of the body, such as rate of breathing and heartbeat, are usually automatic. Biofeedback is a way of learning to control some of these functions. It may help in reducing stress and coping with pain.

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Osteoarthritis: Common Sites

Osteoarthritis can develop in any joint. But some joints are more likely to be affected. Below are some of the common places where osteoarthritis can occur.

Neck

Joints between small bones in the upper part of the spine may wear out. Pain may travel to the shoulder or the base of the skull.

Lumbar Spine

Bony spurs may form on the joints between the vertebrae (spinal bones). And disks (cushions of cartilage between vertebrae) may wear down. Pain may affect the lower back or leg.

Hip

Cartilage damage can occur in the large "ball and socket" joint that connects the pelvis and thighbone. Pain may travel to the groin, buttocks, or knee.

Fingers

Finger joints may become enlarged and "knobby." Grasping objects may be hard, especially if the joint at the base of the thumb is affected.

Knee

The cartilage in the knee joint may wear down. Weakness or instability in the knee joint may make walking or climbing stairs difficult.

Toes

The big toe ("bunion") joint may be affected. Standing or walking may be painful.

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Osteoarthritis: Coping with Pain

There are many ways to control your pain. You're making a good start by learning about osteoarthritis and its treatments. Knowing more about this condition helps you work with your doctor to find answers to problems. Keeping a positive outlook can help you manage pain from day to day. And making time each day to relax and enjoy yourself may help you control osteoarthritis pain, instead of letting it control you. Try these methods to help you cope with, and even reduce, your pain.

Take Control

Relaxing may help relieve muscle aches that result from joint pain. To relax, try these techniques:

  • Breathe slowly and calmly and think of a peaceful scene.

  • Meditate by focusing your mind on one word, object, or idea.

Getting plenty of sleep can help reduce pain and let you function better. If pain is making it hard for you to sleep, ask your doctor about ways to control pain and ensure a good night's sleep. Cutting back on caffeine and alcohol can help you sleep better. So can going to bed and getting up at about the same time every day.

Distract Yourself

Getting your mind off the pain may seem hard to do. But it can actually help reduce pain. When you are in pain, try one of these ways of distracting yourself:

  • Watch a funny movie with a friend.

  • Listen to music you enjoy.

  • Read a novel.

  • Talk with friends or family.

  • Go to a museum, park, or other favorite attraction.

  • Arrange to do a regular activity, such as volunteer work.

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Osteoarthritis: Exercise

Regular exercise can help control osteoarthritis. Joints themselves can't be strengthened. But exercise can strengthen the muscles around the joints for better support. Exercise is also good for your overall health, and it's important if you need to lose weight. It can improve balance and coordination and help prevent falls. Working with a physical therapist or certified fitness trainer may help you get more benefit from exercise. Talk to your doctor before beginning an exercise program.

Low-Impact Aerobics

Aerobic exercise improves overall health and helps control weight. Low-impact forms of exercise limit stress on your weight-bearing joints. Try low-impact activities such as: water aerobics, walking outside or on a treadmill, bicycling, a low-impact aerobics class, using a stationary bicycle, elliptical trainer, or stair machine.

What About Sports?

Work with your doctor or physical therapist to find safe ways to continue to play your favorite sport. You may want to discuss these options:

  • Use a brace. Proper bracing may enable you to continue to play higher-impact sports.

  • Change your sport. Switch to a form of your sport that puts less stress on your problem joint. For example, switch from downhill skiing to cross-country, or from singles tennis to doubles.

For Flexibility

These exercises can be done every day.

  • Stretching is done by extending a muscle without jerking or bouncing. The stretch is then held for 10-20 seconds at a time.

  • Range-of-motion exercises are done by gently moving the joint as far as it can go in each direction without pain.

  • Yoga and tai chi promote flexibility through slow, gentle movement.

For Strength

These exercises can be done 3-4 times a week. Allow a day of rest between sessions. Warm up with 10-20 minutes of aerobic exercise followed by stretching.

  • Isometric exercises are done by tightening the muscles without moving the joint. This may be a good way to strengthen the muscles around a stiff joint.

  • Resistance exercises are done by pushing or pulling against a weight. Start with light weights. Slowly increase the number of repetitions and the amount of weight.

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Osteoarthritis: Managing Pain

You don't have to live with pain. In fact, you owe it to yourself to make sure your pain is treated. Pain can make it hard for you to be active and take good care of yourself. Untreated pain may make sleeping difficult. It may also lead to depression. There are things you can do and medications you can use to help you find relief. If one method of pain relief doesn't work for you, another may help. Discuss your options with your healthcare provider to make sure that you understand the pros and cons of each treatment.

Heat and Ice

Heat helps relieve stiffness. It is often used for morning stiffness or before exercise. Use low heat for no more than 20 minutes at a time. You may try:

  • A heating pad

  • An electric blanket

  • A warm shower

  • A jacuzzi or hot tub

Ice helps reduce pain and swelling. It is often used after activity. Ice the joint for 10-15 minutes at a time. You can use a cold pack or a bag of frozen vegetables (such as peas). Make sure to keep a cloth between the cold source and your skin.

Over-the-Counter Medications

Some arthritis medications can be bought without a prescription.

  • Acetaminophen is effective for moderate pain and does not cause stomach upset. It doesn't relieve swelling, though, and it cannot be taken if you have serious liver or kidney problems.

  • Nonsteroidal anti-inflammatories (NSAIDs), such as aspirin, ibuprofen, or naproxen, help relieve pain and swelling. Use of NSAIDs can cause stomach problems. Note: Do not take NSAIDs if you take medications that thin your blood, such as Coumadin.

Prescription Medications

Some arthritis medications require a healthcare provider's prescription.

  • Prescription NSAIDs are stronger than over-the-counter NSAIDs. They reduce pain and swelling. Use of NSAIDs may cause serious stomach problems and easy bruising. In rare cases they may lead to kidney or liver problems.

  • COX-2 selective inhibitors are a new type of NSAID used to treat arthritis pain. They are less likely to cause stomach problems than older kinds of NSAIDs. Other NSAIDs should not be taken along with COX-2 inhibitors. Talk to your healthcare provider before taking COX-2 inhibitors if you have a history of heart disease.

Topical Medications

Lotions and creams can be applied directly to the affected joint. They can be used along with some oral medications.

  • Aspirin creams may reduce swelling and relieve pain.

  • Capsaicin (hot pepper cream) is made from an ingredient found in chili peppers. It works by stopping production of a substance that helps send pain signals to the brain. It may cause a burning or stinging feeling when you first use it.

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Osteoarthritis: Tips for Daily Living

Making a few changes in your daily life can reduce stress on your problem joints. This helps protect the joints from further damage.

Your Surroundings

  • Pick up objects with both hands.
  • Arrange cupboards, closets, desks, and drawers to reduce reaching and bending.

  • Arrange furniture to make it safer and easier to get around.

  • Secure or remove rugs, power cords, and other items that might make you slip or trip.

Think Ahead

  • Combine errands so that you make fewer trips up and down stairs.

  • Break up loads of packages so that you carry less weight with each trip.

  • If you need help with chores or errands, arrange for it in advance.

  • If you need to lift something heavy, ask for help.

  • Plan your moves ahead of time to use your good joints.

Use What's Available

Sit on a chair or stool to reduce strain on your hips and knees.

To rest your hands, back, and neck:

  • Make sure that knives are sharp.

  • Use a "grasper" to reach and grab.

  • Use soap-on-a-rope in the shower.

To rest your knees, hips, and lower back:

  • Wear shoes that fit well and give your feet good support.

  • Choose chairs with firm seats and armrests.

Assistive Devices

  • In the kitchen, use two-handled knives and saucepans.

  • For gardening, use a rolling bench to sit on or to hold your tools.

  • In the bathroom, try using grab bars, a raised toilet seat, or a shower seat.

  • A cane, brace, or walker may help you walk more easily. Make sure that it's properly fitted and that you're trained to use it.