Arthritis might be the longest four letter word there is. No one wants to hear it about it. No one wants to think about it. But eventually, it comes for us all. Luckily, in the age of research, we have plenty of ways to combat the effects of arthritis and to protect joints well into our later years.
What is Arthritis?
Arthritis can be defined simply as: joint space narrowing. Quite literally, the space that normally exists between the bones in a joint becomes smaller. This can be due to a number of reasons, a few of which I’ll dive into briefly here.
This is the main form of arthritis that everyone thinks about when they hear the word, and rightfully so, as roughly 23% of people will be diagnosed with OA in their lifetime. This is also the form of arthritis that I’ll be referring to mostly throughout this post. So for all intents and purposes, when you read “arthritis” throughout this post, think “osteoarthritis” each time.
Osteoarthritis is caused by wear and tear on a joint. It’s easy to picture it in an athlete, as they put extreme stress through their joints and their bodies in general. But one doesn’t have to be an athlete to get osteoarthritis. In fact, it is often diagnosed and cited as the cause for much of the pain in people later in life.
Other Forms of Arthritis
Rheumatoid Arthritis, or RA, is a degenerative process that occurs in roughly 1% of individuals. RA is considered an autoimmune disease, as the body is essentially attacking itself, and the joints are the primary target of this attack.
Also known as simply Gout, this form of arthritis is caused by an excess of uric acid in the body, which crystallizes and causes pain and inflammation in the joints. One of the prime areas affected is the big toe, but all joints throughout the body can be subject to the pain caused by gout.
In some people with psoriasis, a skin condition, arthritis can develop. The classic symptoms of arthritis are present, including joint pain and stiffness. This condition was made famous by the golfer Phil Mickelson, through commercials for a drug to treat the condition.
What Can be Done About Arthritis Once Diagnosed?
Frustratingly, there is little that can be done about the actual condition. I say this because the joint space that was lost due to wear and tear can’t really come back. There are some practitioners who will say that they can cure arthritis with a surgery or a treatment, but once the space is gone… it’s gone.
That’s not to say, however, that the pain and symptoms caused by the arthritis necessarily have to be present. Those can be addressed through many different methods, allowing the arthritis sufferer to return to a happy, active life.
The aim of physical therapy when it comes to arthritic pain, or really any issue, is to achieve mutually agreed upon (between the PT and the patient) functional goals. These goals often include reducing pain, improving strength and improving limitations in range of motion (flexibility). There are a variety of treatment methods that the PT may incorporate, based on the patient’s specific issues, but as long as the end goals are reached, these can vary between practitioners.
Generally, exercise is going to have to be a component of any successful rehabilitation program for arthritis sufferers. Exercise programs will be tailored to the patient specifically, with the goal of opening up the joint by targeting specific muscles that are weak, or motions that are limited.
Some medications can mitigate the pain caused by the arthritis. However, these medications are likely only masking the pain. Making movements tolerable because the person can’t feel them as well, doesn’t mean the pain isn’t still there. And the underlying causes of the pain (i.e. movement dysfunctions) are certainly still there.
Why is this a problem? It might not be. The person may be able to take a mild medication, reduce their pain and live out the rest of their days with no other changes. However, oftentimes these medications will lose their efficacy once the person develops a tolerance.
Know that the caveat applies here, as always, that this is just my opinion.
Surgery is an absolute last resort for everything except for emergencies. There is no real way to “undo” a surgery, so it is my belief that absolutely every other conservative method should be trialed and extensive evaluation should be performed before surgery is considered.
This is especially true when it comes to arthritis. Undergoing a joint replacement (which is a common recommendation once arthritis is diagnosed) may be a viable option. However, in my experience, with a thorough movement evaluation and specific exercise prescription, pain can be managed, mitigated and sometimes even eliminated. No, exercise and physical therapy will not remove the arthritis. But the pain and stiffness can likely be reduced with PT, so why not at least give it a try first, before going under the knife?
These treatments need not be mutually exclusive. Often the answer lies with multiple treatments, coordinated together with the goal of getting the patient to where he or she wants to be. In fact, a combination of medication, physical therapy and surgery tend to have excellent outcomes when all care is geared toward the goal.
Can Arthritis be Prevented?
Short and unsatisfying answer: no one knows. Longer, more optimistic answer: Yes, probably!
There are numerous ways to put less stress on the joints, and thereby decrease the chances of developing arthritis later in life.
Proper Movement and Exercise
There is some debate about what the absolute ideal ways to move are. However, I would argue that there are certainly ways of moving that put excess stress on joints and that could be avoided. A strong body is a healthy body, and strong bodies are made through proper movement.
Take for example: ways of performing cardiovascular exercise. Movements like swimming and biking require no impact and therefore would not put as much stress on the joints as running would. However, as has been said many times, each person is individual and should be able to do whatever form of movement is most enjoyable for them. In those who like to run or do high impact activities, an evaluation and treatment plan performed by a skilled physical therapist or performance coach would be extremely helpful in preventing bad habits and lessening the chance of developing severe arthritis later in life.
Dietary recommendations are going to be slightly different for everyone, so a consultation with a dietician or nutritionist would be helpful in determining which diet plan would be best for each individual person. However, as a general statement, I think it would be fair to say that some foods can cause increased system wide inflammation, including the joints, for some people. And I hope no one comes after me if I give the general recommendation that eating whole foods, limiting processed products and prioritizing vegetables, are preferred dietary recommendations for all health concerns.
Maintaining a Healthy Weight
Being above your ideal body weight puts stress on the body systems in every possible way. The heart is forced to pump more forcefully to counteract the extra weight on the body, as well as to pump blood to all of the excess tissue; the skin can be stretched past its elastic point, and the bones have to support more weight than they are capable, at all times. Lifting weights for an hour or two a day puts stress through the bones, but after the lifting session is done, the bones are able to relax and repair. When a person is overweight, there is never a period of relaxation for the bones (or any body system). Everything is being taxed to the breaking point. Maintaining a weight above the ideal body weight can lead to early OA, increased incidents of sprains and strains, and general joint pain.
Most of the people reading this post likely already be diagnosed or will at some point be diagnosed with arthritis. I hope that by reading the above information, it serves to decrease the fear of the condition and to realize that there are ways to prevent and lessen the severity of arthritis, as well as ways of dealing with the symptoms of it, once it is present.
Disclaimer: The information provided in this post or anywhere on richardsonpt.com is no substitute for an evaluation by a licensed healthcare provider. Always consult with your doctor before beginning any exercise or diet plan.