Coping with Arthritis in Its Many Forms
Use It or Lose It
In the past, doctors often advised arthritis patients to
rest and avoid exercise. Rest remains important, especially during flares. But
doing nothing results in weak muscles, stiff joints, reduced mobility, and lost
vitality. Now, rheumatologists routinely advise a balance of physical activity
and rest. Exercise offers physical and psychological benefits that include
improved overall fitness and well-being, increased mobility, and better
For example, twice a week for three years, Elsie Sequeira,
81, of Concord, CA., has attended a water-based exercise class sponsored by the
Arthritis Foundation. "It's helped me a lot," she says. Sequeira has
rheumatoid arthritis in her shoulders and legs. She had also had a mild stroke
and got to her first classes with the help of a walker and an attendant.
A few weeks passed before she saw any improvement, but
within a few months she no longer needed either the walker or the attendant.
"The warm water is very soothing and we can do things in the water that we
couldn't do on land," Sequeira says. She enjoys the social contact, and
feels better able to take care of herself. "I don't feel so hamstrung,"
Joints require motion to stay healthy. That's why doctors
advise arthritis patients to do range-of-motion, or flexibility, exercises
every day -- even during flares. Painful or swollen joints should be moved
Strengthening and endurance activities are also recommended,
but should be limited or avoided during flares. Arthritis patients should
consult their doctors before starting an exercise program, and begin gradually.
Exercises must be individualized to work the right muscles while avoiding
overstressing affected joints. Doctors or physical therapists can teach proper
ways to move.
Muscle strength is especially important because strong
muscles better support and protect joints. "Several studies show that if
you improve muscle strength, you decrease pain," Boulware says. Joints will
probably hurt during exercise, but shouldn't still hurt several hours
"There's a fine line between doing too much and too
little," says rheumatologist William Ginsburg, M.D., of the Mayo Clinic,
Jacksonville, FL. "Sometimes people have to be reminded to slow down and
listen to their disease."
Support groups and arthritis education can help people learn
how to listen to their disease, and cope with it. "The psychological
aspects are very important because that's what changes people's lives,"
Participants learn practical things, such as how to: get up
off the floor after a fall, protect joints with careful use and assistive
devices, drive a car, get comfortable sleep, use heat and cold treatments, talk
with their doctors, and cope with emotional aspects of pain and disability.
They may also learn to acquire and maintain what health experts have long
touted -- a positive attitude.
Health education not only improves quality of life, but also
lowers health-care costs, and the benefits are lasting, according to studies at
Stanford University, Palo Alto, Calif. Four years after a short Arthritis
Self-Management Program, participants still reported significantly less pain
and made fewer physician visits, even though disability increased. The benefits
came, not from the specifics taught, but from improved ability to cope with the
consequences of arthritis -- in other words, confidence. "It's the same
thing that any good coach tries to instill," says Halsted R. Holman, M.D.,