Prescription strength exercise

Webster's dictionary defines arthritis as an "inflammation of a joint or joints." That's an understatement for the nearly 40 million people who suffer from the disease. People from every walk of life, including the young and old, professional and non-professional athletes, are diagnosed with arthritis. Although heredity plays a crucial roll, it's impossible to predict who will be afflicted. Fortunately, however, there are now many ways to combat the physical pain and immobility that accompany arthritis.

Of the various types of arthritis, osteoarthritis is the most prevalent. It affects 75% of adults in the United States by age 65. Osteoarthritis is a degenerative joint disease in which the cartilage deteriorates allowing the ends of the bones (or joints) to be exposed. This exposure is followed by inflammation of joints which consists of pain, swelling and stiffness. Without the protective covering, the ends wear down and become misshapen, sometimes forming bony growths called spurs. Besides restricting movement, bony spurs can cause great discomfort.

There are several ways of developing osteoarthritis. Causes include heredity (some people have joints that "wear out" faster than others), obesity (excess weight places excessive strain on hips and knees) and physical stresses (overuse of joints, an accident or athletic injuries) that aren't given proper time or attention to heal.

The second most common form of arthritis is rheumatoid arthritis (RA). This type of arthritis affects about 2.5 million Americans. RA is a systematic disease that affects the entire body, including not only the joints but the eyes, heart, lungs, blood vessels, skin, muscles and nerves. With an inflammatory illness such as RA, the inflammation starts in the synovial membrane (fluids that cushion the joint) then spreads, possibly destroying the cartilage and bone. An attack has similar symptoms to the flu--aches, fatigue and fever.

There are many theories as to the cause of RA, but the most compelling is heredity. This is supported by the fact 80% of people with RA have a tissue type called HLA-DR4. However, having this tissue type does not guarantee that you will get it. Delaying treatment with this form of arthritis will only irritate the condition and lead to irreparable and permanent Joint damage.

Many new advances are being made to combat the pain, stiffness and immobility that can accompany an arthritis flare-up. One of the most natural of the self-healing methods is exercise. Research clearly shows that whatever people do for their arthritis, they feel better if they exercise as well. Arthritis exercise comes in three "prescription strengths" to be mixed and matched as your abilities increase.

1. Aerobic activities, such as walking and swimming, that build stamina and boost cardiovascular fitness. Aerobic exercise should only be low impact. Walking, bicycling (outdoor, stationary and recumbent), water walking and aqua aerobics are all good low-impact exercises.

2. Stretching, or range of motion exercises such as leg raises and finger curls, that keep joints mobile.

3. Strengthening exercises, including lifting light weights, that prevent muscle atrophy. It's important to listen to the body and not cross the pain threshold.

For aquatic exercise, water that is 86-92 degrees Fahrenheit is most comfortable for arthritis sufferers. When stretching, motion should be smooth and fluid so as not to lock or wrench any joint. When doing strengthening exercises, limit the repetitions required of a joint because overuse may lead to further joint destruction or inflammation.

If a joint is hot or red, gently move it through its range of motion. It is important to treat arthritic pain because, besides relieving discomfort, pain often accompanies inflammation which can damage joints. Minimizing inflammation and pain makes it easier to maintain normal joint motion as well as muscle tone around the joint. Discomfort often diminishes temporarily, and potential damage is reduced or eliminated, by the removal of joint fluid.

Pain relievers such as Tylenol, Anacin, Datril, Panadol, Advil, Nuprin and Medipren are at best mild anti-inflammatory drugs. Arthritic pain generally should be treated with antiinflammatory medications, not analgesics.

If arthritis is inadequately controlled by any of these drugs, cortisone may be considered. Cortisone is a corticosteroid, or steroid for short. They are most often used to treat RA and referred to as disease-modifying or remission-inducing agents. Long-term steroid use can be dangerous, but injecting them into a joint is not the same as taking them orally and shouldn't arouse the apprehension associated with steroids.

Along with medication, the application of heat or cold can help. If one doesn't work, the other often will. In fact, many people use hot and cold compressions. For some, applying heat directly to the involved joint immediately before exercising and cold afterward followed by a warm shower is effective.