KEEP ON KEEPING ON
Expert tips to manage arthritis and stay active
THIS May is Arthritis Awareness Month. It’s estimated that a whopping 10% of the US population suffers from the 100 different diseases covered under the arthritis banner, which cause joint pain, stiffness, swelling and loss of function, said Healer.com cofounder Dr. Dustin Sulak, author of “Handbook of Cannabis for Clinicians: Principles and Practice” (Norton). Per the CDC, 24% of all adults in the US (about 58.5 million people) have arthritis.
“The symptoms are caused by degeneration of cartilage, bone and connective tissue in one or multiple joints,” said the Falmouth, Maine, based doc.
“The most common arthritic disease is osteoarthritis; as our population ages the number of people affected by osteoarthritis rises as well,” added Dr. Chris Morris of Arthritis Associates in Kingsport, Tenn., noting that half of all people over 65 have been diagnosed with osteoarthritis. In over 40% of those, they limit physical function.
The good news: “Although arthritis cannot be cured, it does not mean your quality of life needs to diminish. Staying active and adopting a nutrient-rich diet can significantly improve the symptoms,” said John Gallucci Jr., who has a doctorate in physical therapy and is the CEO of JAG-ONE Physical Therapy in NY, NJ and PA.
Prevention starts now
If you don’t have arthritis now, embracing a healthy diet and lifestyle is key to keeping it that way.
“As with all other chronic conditions, prevention is paramount,” said Dr. Elena Schiopu, associate professor of medicine, rheumatology division University of Michigan, in Ann Arbor, Mich. “Osteoarthritis starts the second we are born, as cartilage and bone do not regenerate, so [their] health needs to be preserved. Injury of the joints (which could be caused by trauma or overuse) and obesity are among the leading causes of accelerated osteoarthritis,” she said.
Avoid contact sports and strenuous unsafe activities from infanthood. “College football or gymnastics leave players unable to function in their 40s,” she said.
Lose weight
Symptoms of “wear and tear” may be improved if you can get the number on the scale down.
“Proper diet and weight management can significantly reduce symptoms of arthritis,” said Dr. Jonathan Ramin of Orthopedic Associates
of Hartford, a physiatrist who specializes in the nonoperative management of arthritis. “Losing as little as 10 pounds has been shown to decrease the progression of knee osteoarthritis by nearly half.”
Eat healthy foods
Allow us to reiterate: Excess pounds on your frame is no good for your joints. “Obesity also accelerates osteoarthritis of hand joints — the mechanism is not just mechanical wear and tear, but also a persistent inflammatory state that affects the cartilage health in all the body joints,” said Schiopu.
Focusing on anti-inflammatory foods is important. “The main focus has to shift to quality of the food, since the nutritious values of current grocery stores’ offerings are rapidly declining,” she said.
“Foods that help reduce inflammation include fatty fish, dark leafy greens, nuts, olive oil, green tea, berries, garlic and onion,” said Gallucci Jr. You should steer clear of alcohol and smoking, too.
Exercise
It may sound counterintuitive but moving can help with arthritis. “Low-impact activities that don’t put stress on the joints are extremely beneficial,” said Ramin. Swimming, walking, cycling, yoga and tai chi have all been shown to help people with arthritis-related pain, since low- or no-impact movement strengthens the muscles around the joints.
“This can improve the joint stability, improving function and reducing pain levels,” said Morris.
Approximately 150 minutes of moderate-intensity activity is recommended.
“Choose to perform physical activities that do not exacerbate your symptoms, and ones you’ve had success with in the past,” said Gallucci Jr. “Always incorporate stretching and gradual range-ofmotion exercises before and after. Avoid repetitive, high-impact physical activities such as running.”
Whatever you do, do something. “It’s important to avoid being sedentary because inactivity can make arthritis pain worsen over time,” said Ramin. “Regular exercise will improve mobility, prevent stiffness and strengthen the muscles.”
Get vitamin D
Make sure you’re getting enough of that sunshine vitamin, folks. “Those who have a low vitamin D level can reduce pain and inflammation by spending more time in the sun or supplementing with vitamin D3,” said Sulak. “It’s important for people with arthritis to ask their clinician to test their vitamin D level, and to work to get it to at least 40 ng/mL.”
Consider creams
“One major advancement is diclofenac gels [such as Voltaren] becoming available over the counter,” said Morris. “These contain an antiinflammatory, and the topical use is felt by most of us to be safer than oral forms, which have much higher risks of gastrointestinal, renal and cardiac side effects.”
Another agent available in creams is capsaicin, a chemical compound from chili peppers. “Regular use of caps aic in medications, containing such as Zostrix, can reduce the osteoarthritis pain levels,” he said.
Medical cannabis and hemp products (like CBD or CBDA) may help, said Sulak. “They’re typically more effective and have less side effects than anti-inflammatory drugs, and serve a dual purpose, decreasing pain from the arthritic joints and reducing inflammation that might be causing the arthritis.” He recommends using products that are 2% CBD and CBDA.
Get steamy (or freezing)
“Most people under estimate the symptomatic benefit of thermo therapy[ the application of heat and cold] for arthritic joints,” said Sulak. “Sauna or Epsom salt baths, cold showers or, even better, ice-cold plunges, can prothe vide relief for hours.”
Think positive
Have a PMA (Positive Mental Attitude), friends.
“The literature suggests that fearavoidance and psychosocial factors play a far greater role in the disability associated with osteoarthritis than structural pathology,” said Tom Oddo, a doctor of chiropractic medicine and the founder of City Integrative Rehabilitation in Midtown. Literally, the structure, function and status of the arthritic bones and joints in your body matter less than how you ‘feel’ about your condition.”