This week is Bone and Joint Action week. Rolling Strong wants help drivers by raising awareness for the prevention and management of different forms of arthritis.
Before we get into the prevention and treatment of these conditions, let’s talk about a few facts:
- Over half of Americans are affected by musculoskeletal (bone and joint) conditions.
- Musculoskeletal conditions are the most common cause of long-term pain, physical disability, and poor quality of life.
- The prevalence of these condition will only increase due to extended life expectancy. New treatments need to be found and prevention measures need to be taken.
Arthritis comes in many different forms. These are the ones that affect drivers the most:
- Osteoarthritis causes flexible tissue (cartilage), at the ends of bones, to break down due to excessive wear and tear, injuries, age, obesity, genetics or weak muscles.
- Rheumatoid Arthritis is an autoimmune disease. This means the immune system attacks a part of the joint call the synovium. This is the tissue lining around the joint that produces fluid to help the joint move smoothly. RA makes the synovium thicker and causes pain and swelling. RA can also damage you heart, lungs, eyes and other organs, making early intervention and treatment paramount.
- Gout causes sudden and severe joint pain that usually starts in the big toe. Other joints and areas around the joints can be affected, such as the ankle, knee and foot. It’s the most common type of inflammatory arthritis. Men are three times more likely than women to develop gout. High uric acid levels cause monosodium urate crystals to form in and around the joint, resulting in inflammation and joint damage.
Management for osteoarthritis:
There is no cure for OA, but medication, nondrug methods and assistive devices can help to ease pain. As a last resort, a damaged joint can be surgically replaced.
Medications
Pain and anti-inflammatory medicines for osteoarthritis are available as pills, patches and creams, or they are injected into a joint. They include:
- Analgesics. These are pain relievers and include acetaminophen and opioids, prescribed by a doctor.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). These are the most commonly used drugs to ease inflammation and pain. They include aspirin, ibuprofen, naproxen, celecoxib.
- Counterirritants. These OTC products have ingredients like capsaicin, menthol and lidocaine. They irritate nerve endings, so the painful area feels cold, warm or itchy to take focus away from the actual pain.
- Corticosteroids. These prescription anti-inflammatory medicines work in a similar way to a hormone called cortisol. The medicine is taken by mouth or injected into the joint at a doctor’s office.
- Platelet-rich plasma (PRP). Available from a doctor by injection, this product has proteins that help ease pain and inflammation.
- Other drugs. The anti-depressant duloxetine (Cymbalta) and the anti-seizure drug pregabalin (Lyrica) are FDA-approved to treat OA pain.
Management for Rheumatoid Arthritis:
The goals of RA treatment are to:
- Stop inflammation or reduce it as much as possible (put disease in remission).
- Relieve symptoms.
- Prevent joint and organ damage.
- Improve function and overall well-being.
- Reduce long-term complications.
Medication
The types of medications recommended by your doctor will depend on the severity of your symptoms and how long you’ve had rheumatoid arthritis.
- NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation.
- Steroids. Corticosteroid medications, such as prednisone, reduce inflammation and pain and slow joint damage.
- Disease-modifying antirheumatic drugs (DMARDs). These drugs slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage.
Management of Gout:
Your doctor may prescribe these medications at the first sign of a Gout attack:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) – used to relieve the pain and swelling of an acute gout episode. They can shorten the attack, especially if taken in the first 24 hours.
- Corticosteroids – These drugs can be taken by mouth or injected into an inflamed joint to quickly relieve the pain and swelling of an acute attack.
- Colchicine – This anti-inflammatory medicine works best if taken within the first 24 hours of a gout attack.
Medications for Reducing Uric Acid Levels
The doctor will wait until the acute attack ends before starting medications to reduce your uric acid levels. Sometimes, these drugs can cause an attack at first because uric acid levels drop and crystals in the joints shift. Stick with the treatment plan to prevent future attacks.
- Allopurinol (Zyloprim) and Febuxostat (Uloric) are oral medications that reduce how much uric acid the body produces.
- Probenecid is and oral medication that acts on the kidneys to help the body eliminate uric acid.
- Pegloticase (Krystexxa) reduces uric acid quickly. It is administered by intravenous (IV) infusion.
Selfcare and prevention of an Acute Gout Attack
Steps to get the pain and swelling of a gout attack under control as quickly as possible:
- Call your doctor and make an appointment.
- Ice and elevate the joint.
- Drink plenty of fluids (no alcohol or sweet sodas that can increase uric acid buildup.)
- Do not eat foods high in purine.
- High-Purine Foods Include:
- Shellfish, including anchovies, sardines, herring, mussels, codfish, scallops, trout and haddock.
- Meats, such as bacon, turkey, veal, venison and organ meats like liver.
- Reduce stress, which can worsen the attack.
- Ask friends and family to help you with daily tasks to ease stress on joints.
Selfcare for prevention and management for all forms of Arthritis:
Hot and cold treatments
Heat treatments, such as heat pads or warm baths, tend to work best for soothing stiff joints and tired muscles. Cold is best for acute pain and swollen joints. It can numb painful areas and reduce inflammation.
Exercise
A good exercise program to help prevent or manage OA includes the following:
- Strengthening exercises build muscles around painful joints and helps to ease the stress on them.
- Range-of-motion exercise or stretching helps to reduce stiffness and keep joints moving. Joints need to move to make synovial fluid (the lubricant for our joints). Move your joints through their full range of motion, daily, but only up to the point where it doesn’t cause more pain.
- Gentle stretching and daily walks can also help.
- Aerobic or cardio exercises help improve stamina and energy levels and reduce excess weight.
- Balance exercises help strengthen small muscles around the knees and ankles and help prevent falls.
- Protect Joints making sure to warm up and cool down when exercising.
- Use your largest, strongest joints for lifting, pushing, pulling, and carrying.
- Balance rest and activity throughout the day.
- Physical Therapy can help with specific exercises to stabilize joints and ease pain.
Maintain a Healthy Weight
A BMI (body mass index) of 30 or greater puts extra stress on the hips, knees, feet and back. Losing weight helps to reduce pain and stop or slow down joint damage. Every pound of weight lost removes four pounds of pressure on lower-body joints. Fat itself is an active tissue that creates and releases pro-inflammatory chemicals. By reducing fat stores in the body, your body’s overall inflammation will go down. Several studies have shown that being obese reduces your chance of achieving minimal disease activity or remission if you have RA. Losing weight can reduce the overall severity of your arthritis. A 2017 analysis of 10 studies, published in Annals of Rheumatic Diseases, found that weight loss was beneficial for obese or overweight people with gout. People who lost weight had lower serum uric acid levels and fewer gout attacks.
Control Blood Sugar
- High glucose levels can make cartilage stiffer and more likely to break down. Diabetes causes inflammation, which also weakens cartilage.
Choose a Healthy Lifestyle
- Eat healthy food.
- The Arthritis Foundation recommends the Mediterranean Diet for the management of arthritis. Eat a diet rich in fruits, vegetables, fish, nuts, olive oil, whole grains, beans and low in processed foods and saturated fat.
- Avoid fast food, fried foods, sweets, and sugary drinks.
- Don’t smoke.
- Drinking in moderation.
- Get eight hours of sleep to help feel your best.
By: Dawn Harrison, PTA, Rolling Strong Wellness Coach