Aarthritis-37 Coping Strategies-[Part-1]
An estimated 37 million Americans are caught in the grip of some form of arthritis or rheumatic disease. And few of us will make it to a ripe old age without joining the fold. If one of these diseases has a hold on you, read on. While there are no cures, there are steps you can take to ease discomfort and get back more control over your life. There are more than 100 different forms of arthritis and rheumatic disease, with a host of causes, according to the Arthritis Foundation in Atlanta. Among the more widely known afflictions are osteoarthritis, rheumatoid arthritis, gout, and lupus. Osteoarthritis is primarily marked by a breakdown and loss of joint cartilage. Cartilage is the tough tissue that separates and cushions the bones in a joint. As cartilage is worn away and the bones begin to rub against each other, the joint becomes aggravated. In osteoarthritis, this breakdown of cartilage is accompanied by minimal inflammation, hardening of the bone beneath the cartilage, and bone spurs (growths) around the joints. "It will eventually affect virtually everyone in old age," says John Staige Davis IV, M.D., professor in the Division of Rheumatology at the University of Virginia School of Medicine in Charlottesville. Rheumatoid arthritis, on the other hand, is not an inevitable aspect of the aging process. For reasons unknown, the synovial membrane, or lining, of a joint becomes inflamed, so pain, swelling, heat, and redness occur. In the case of gout, needle-shaped uric acid crystals collect in the joints, due to a fault in the body's ability to metabolize, or process, purines. Purines are naturally occurring chemicals found in certain foods, such as liver, kidney, and anchovies. The disease primarily affects overweight, fairly inactive men over the age of 35 (see GOUT). Lupus, on the other hand, affects many more women than men. It is a condition in which the body's own immune system attacks healthy cells. The symptoms are wide-ranging, from joint pain to mouth sores to persistent fatigue. Researchers are beginning to understand what may predispose some people to arthritis. One clue to the puzzle: "There are indications that collagen, which helps form the body's cartilage, may be defective in some people," says Arthur I. Grayzel, M.D., senior vice-president for Medical Affairs at the Arthritis Foundation. While you cannot cure your condition, you can adopt a variety of coping techniques that will leave you more active and in control of your life.
Keep moving.
Maintain movement in your joints as best you  can.
This can help keep your joints functioning  better
for a longer amount of time and, at the same  time,
brighten your outlook on life. "Every patient  should
keep active," says John R. Ward, M.D.,  professor
of medicine at the University of Utah School  of
Medicine in Salt Lake City. "And remember  that
even small movements mean a lot. If all you  can
tolerate is a little housecleaning or gardening,  for
instance, that's OK, too."
Exercise, exercise, exercise.
"Exercises work best when inflammation  has
calmed down," notes Janna Jacobs, P.T.,  C.H.T.,
physical therapist, certified hand therapist,  and
president of the Section on Hand Rehabilitation  of
the American Physical Therapy  Association
(APTA).
There are a few different types of exercises  that
are used to help arthritis sufferers. The  simplest,
easiest exercises that can be done by almost  any
arthritis sufferer are called  range-of-motion
exercises. They help maintain good movement  by
putting the joints through their full range of  motion.
You'll find several range-of-motion  exercises
recommended by the Arthritis Foundation  in
"Exercises for Arthritis." Isometrics, in which  you
create resistance by tightening a muscle  without
moving the joint, can help to strengthen  muscles.
Weight-bearing exercises, such as walking,  also
build muscle strength. While  strengthening
exercises can be beneficial for the arthritis  sufferer,
however, they should only be done under  the
supervision and care of a therapist or  physician,
says Grayzel. And, "anyone with any type  of
cardiovascular disease should not do  multiple
resistance exercises for a sustained amount of  time,
" warns Ward. Stretching, which helps make  the
muscles more flexible, is often recommended as  the
first step in any exercise regime.  Likewise,
warming up your joints before beginning  any
exercise makes them more flexible. Massage  your
muscles and/or apply hot or cold compresses  or
both--whichever your health-care  practitioner
recommends or you prefer. A warm shower  is
another way to warm up. (See Extra! Extra! -  "Heat
or Cold: Which Is Best?")
Give your hands a water workout.
Try doing your hand exercises in a sink full  of
warm water for added ease and comfort,  suggests
Jacobs.
Don't overdo it.
Ward has come up with a "useful recipe" you  can
use to see if you've overdone your exercise  routine.
See how you feel a few hours after you  exercise
and then again after 24 hours. If your pain  has
increased considerably during that period of  time,
then it's time to cut back on the frequency  and
amount of exercise that you're doing, he says.  Of
course, if the activity brought relief, you've found  a
worthwhile exercise. Tailor your routine to  include
the exercises that give you the most relief--and  the
most enjoyment.
Play in a pool.
If you find even simple movements difficult,  a
heated pool or whirlpool may be the  perfect
environment for exercise (unless you also have  high
blood pressure, in which case you should  avoid
whirlpools and hot tubs). Try a few of your  simpler
exercises while in the water. The buoyancy  will
help reduce the strain on your joints. And,  "the
warm water will help loosen joints and  maintain
motion and strength," says Ward. Even a warm  bath
may allow you some increased movement. In  a
pinch, a hot shower may do: Running the stream  of
water down your back, for instance, may  help
relieve back pain.
Don't overuse over-the-counter  creams.
These pain-relieving rubs give temporary relief  by
heating up the joints. However, "frequent use  may
activate enzymes that can break down the  cartilage
in the joints," says  Davis.
[To Be Continued]
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