Years ago, in Morocco to write a travel story, I rode my first camel. Who knew that those stubborn, one-humped Dromedaries don’t simply sit to let you dismount—they lunge forward. And so, alas, did I, landing squarely on my right hip. Since it bothered me only intermittently, I stupidly didn’t get it checked out—for many years. Much to my dismay, it was confirmed that osteoarthritis (OA) had set into the joint. And for someone who’s blood pressure rises to dangerous levels at the sight of anyone in a white coat—including the butcher (or the vet), suffice it to say that I was terrified that the only remedy was a total hip replacement.
According to the Arthritis Foundation, OA, an inflammatory ailment, affects not only the joints but the tissues that surround them, along with other connective tissue, and is the leading cause of disability in the United States. Indeed, an estimated 22.7% (54.4 million) of adults have doctor-diagnosed arthritis, with significantly higher age-adjusted prevalence in women than in men. Alas, prevalence increases with age.
I won’t regale you with stories about my hip replacement! (Call me!) However, going through that experience I realized the need for patients and care givers to understand the potential impact of the disease and how best to manage it. It can be a critical part of making the decisions to make good on your intent to live a healthier lifestyle that is Better Than Before.
Let’s start with learning a little more about the illness itself. Arthritis is a complex family of musculoskeletal disorders consisting of more than 100 different diseases or conditions. Although common belief is that arthritis is a condition affecting the elderly, two-thirds of people with arthritis are under the age of 65, including 300,000 children. Also, arthritis affects people of all ethnicities.
The vast majority of sufferers, about 27 million Americans have what I have, Osteoarthritis (OA), which is characterized by a breakdown of joint cartridge. A vast majority of OA patients are elderly. But it could be genetic. (Thanks, dad!)
The rest of arthritis sufferers have the more severe form, Rheumatoid arthritis (RA), the most common type of autoimmune arthritis that affects over 1.3 million Americans, is an extremely painful autoimmune disease that occurs when the immune system begins to attack healthy tissue resulting in swelling and joint pain.
Arthritis in general takes a heavy toll. Indeed, each year, it accounts for 44 million outpatient visits and over 900,000 hospitalizations. In fact, it’s the leading cause of disability in the United States and is a more frequent cause of activity limitations than heart disease, cancer or diabetes. By some estimates, 67 million Americans will have arthritis by 2030. Scary stats indeed!
Scientists are studying factors that may cause arthritis such as genetics, autoimmune disorders, lifestyle and environment. While there is no cure to date, there are many things you can do about it— especially if you have osteoarthritis. Medications aside, such lifestyle modifications as proper exercise, sound nutrition and a healthy frame of mind go a long way toward relieving the pain, slowing down the progression, and even delaying the onset. That said, here are 12 suggestions from my Ladder to a Better Quality of Life that I have gleaned from the experts, to help you go about your daily activities with ease, feeling even Better Than Before.
Less is more: There are some age and genetic components to osteoarthritis, but small behavior modifications can make a huge difference. If you are overweight, meaning that your body mass index is 25 or greater, know that even one extra pound is the equivalent of four pounds of pressure over each knee. Think about it. If you lose just 5 pounds, that’s 20 pounds less stress on your knees, and your hips and back as well.”
Shift your focus: Certainly, a chronic condition can compromise your everyday life, and it’s not unusual to long for the “old you.” But focusing on your pain can cause it to become even more unbearable. Feelings of sadness and anger may precede recognition of the kinds of burdens your arthritis has placed on your work function and/or outlook on life. It is helpful to realize that mood changes in the context of new life challenges are very normal and understandable.
Calm yourself down: Anyone with arthritis knows the meaning of constant pain. And what causes that pain is inflammation. One of best ways to combat inflammation is to follow an anti-inflammatory diet rich in fresh vegetables and omega-3 fatty acids (in fatty fish such as salmon and sardines, as well as walnuts, soybeans, flax seeds, canola oil and pumpkin seeds) and low in animal fats. Leave the white carbohydrates (bread, pasta, rice and potatoes) off the plate.
Schedule a joint session. It may seem counterintuitive, but one of the most effective methods for decreasing joint pain and stiffness is regular exercise. Research has shown that exercise can increase bone density, keep joints stable, improve joint function and flexibility, decrease pain and improve balance. While there are many different exercise methods to choose from, your exercise routine should incorporate resistance training (light weights, machines or resistance bands), low-impact aerobics (brisk walking, cycling, or swimming) and stretching. If you are experiencing substantial pain, consider swimming or water aerobics, which provide resistance with very little impact.
Twist again: Studies have shown that some alternative therapies can have a positive effect on helping manage arthritis symptoms. A friend of mine swears that gin-soaked raisins make her feel better. She claims that the juniper in gin are anti-inflammatory and therefore makes the pain less. (I say it’s the alcohol!) More scientific is a study by the University of Pennsylvania School of Medicine researchers who examined the effects of lyengar yoga, which focuses on posture and breath control, for people with osteoarthritis of the knee. After an eight-week course of weekly 90-minute classes, there was a statistically significant reduction in pain, physical function and mood.
Rally the troops: My friend Patricia told me how her mother, a nurse, suffered from extreme arthritis and knew that exercise would help keep her weight under control and her joints from stiffening even more. But she needed incentive—and that encouragement came from a physical therapist and her grandchildren. “Did you do your exercise homework?” her kids would say. They would keep track of how many reps Grandma did with her exercise bands, cheering and clapping as she completed each set. This became their after-school routine. After just a short period of time, Patricia’s mother began to feel better and was grateful that her family inspired her to stick with her therapy.
Bend the rules: My neighbor Debby is determined not to let her arthritis get the better of her. Having no time to go to a gym, she has created her own fitness program. “I don’t use a footstool or grabber in the kitchen as I prefer to have to stretch and reach to get things down,” she says. “I bend and stretch and do the floors by hand. When I put things away that I use regularly, I place them at the back of the cabinet instead of the front. I then have to bend down and reach back to get things out.” She takes the stairs when she can, too. “Some days I don’t want to walk up six flights of stairs to my apartment,” she says. “But I still walk up two to three and catch the elevator up from there.”
Bring it on home: It is important to incorporate a good home care therapy plan to help decrease and alleviate symptoms. To that end, try doing 10 minutes of gentle stretching exercises every morning to relax stiff muscles along with applying ice when in pain (15 minutes on at a time, four times a day) or heat when feeling stiffness (15 minutes on at a time, four times a day). Sleeping 8 -10 hours a night and taking naps during the day can help you recover from a flare-up more quickly and may even help prevent flare-ups. Also, avoid staying in one position for too long and positions or movements that place extra stress on your sore joints.
The tip of the iceberg (lettuce): A healthy diet is a great start. Stick to an anti-inflammatory regimen like the Mediterranean diet – you know the drill, easy on the acidic foods like sugar, white flours, and alcohol, and sticking with leafy greens, whole grains, and lean proteins.
I can assure that if arthritis does get too painful, surgery such as a hip replacement is extremely effective. But other than telling everyone that you broke your hip heli-skiing down Mount Everest — let’s keep the camel episode between us — do whatever lifestyle steps you can do to avoid it.
