What You Can Do: The Importance of Self-Care and a Good Health Attitude

Although health care professionals can prescribe or recommend treatments to help you manage your arthritis, the real key to living well with the disease is you. Research shows that people with osteoarthritis who take part in their own care report less pain and make fewer doctor visits. They also enjoy a better quality of life.

Living well and enjoying good health despite arthritis requires an everyday lifelong commitment. The following six habits are worth committing to:

1. Get educated: To live well with osteoarthritis, it pays to learn as much as you can about the disease. Three kinds of programs help people understand osteoarthritis, learn selfcare, and improve their good health attitude. They are:

• patient education programs
• arthritis self-management programs
• arthritis support groups.

These programs teach people about osteoarthritis, its treatments, exercise and relaxation, patient and health care provider communication, and problem solving. Research has shown that people who participate in these programs are more likely to have positive outcomes.

2. Stay active: Regular physical activity plays a key role in self-care and wellness. Three types of exercise are important in osteoarthritis management. Strengthening exercises help keep or increase muscle strength. Strong muscles help support and protect joints affected by arthritis. Aerobic conditioning exercises improve cardiovascular fitness, help control weight, and improve overall function. Range-of-motion exercises help reduce stiffness and maintain or increase proper joint movement and flexibility.

Most people with osteoarthritis exercise best when their pain is least severe. Start with an adequate warmup, and begin exercising slowly. Resting frequently ensures a good workout and reduces the risk of injury.

Before beginning any type of exercise program, consult your doctor or physical therapist to learn which exercises are appropriate for you and how to do them correctly because doing the wrong exercise or exercising improperly can cause problems. A health care professional can also advise you on how to warm up safely and when to avoid exercising a joint affected by arthritis.

3. Eat well: Although no specific diet will necessarily make your arthritis better, eating right and controlling your weight can help by minimizing stress on the weightbearing joints such as the knees and the joints of the feet. It can also minimize your risk of developing other health problems.

Exercises for Osteoarthritis

People with osteoarthritis should do different kinds of exercise for different benefits to the body. Consult your health professional before starting.

4. Get plenty of sleep: Getting a good night’s sleep on a regular basis can minimize pain and help you cope better with the effects of your disease. If arthritis pain makes it difficult to sleep at night, speak with your doctor or physical therapist about the best mattress, the most comfortable sleeping positions, or the most possibility of timing medications to provide more pain relief at night. You may also improve your sleep by getting enough exercise early in the day; avoiding caffeine or alcoholic beverages at night; keeping your bedroom dark, quiet, and cool; and taking a warm bath to relax and soothe sore muscles at bedtime.

5. Have fun: Although having osteoarthritis certainly isn’t fun, it doesn’t mean you have to stop having fun. If arthritis makes it difficult to participate in favorite activities, ask an occupational therapist about new ways to do them. Activities such as sports, hobbies, and volunteer work can distract your mind from your own pain and make you a happier, more well-rounded person.

6. Keep a positive attitude: Perhaps the best thing you can do for your health is to keep a positive attitude. People must decide to make the most of things when faced with the challenges of osteoarthritis. This attitude – a good health mindset – doesn’t just happen. It takes work, every day. And with the right attitude, you will achieve it.

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How Rheumatoid Arthritis Develops and Progresses

The Joints

A joint is a place where two bones meet. The ends of the bones are covered by cartilage, which allows for easy movement of the two bones. The joint is surrounded by a capsule that protects and supports it.  The joint capsule is lined with a type of tissue called synovium, which produces synovial fluid, a clear substance that lubricates and nourishes the cartilage and bones inside the joint capsule.

Like many other rheumatic diseases, rheumatoid arthritis is an autoimmune disease (auto means self), so-called because a person’s immune system, which normally helps protect the body from infection and disease, attacks joint tissues for unknown reasons. White blood cells, the agents of the immune system, travel to the synovium and cause inflammation (synovitis), characterized by warmth, redness, swelling, and pain–typical symptoms of rheumatoid arthritis. During the inflammation process, the normally thin synovium becomes thick and makes the joint swollen and puffy to the touch.

A joint (the place where two bones meet) is surrounded by a capsule that protects and supports it. The joint capsule is lined with a type of tissue called synovium, which produces synovial fluid that lubricates and nourishes joint tissues. In rheumatoid arthritis, the synovium becomes inflamed, causing warmth, redness, swelling, and pain. As the disease progresses, the inflamed synovium invades and damages the cartilage and bone of the joint. Surrounding muscles, ligaments, and tendons become weakened. Rheumatoid arthritis also can cause more generalized bone loss that may lead to osteoporosis (fragile bones that are prone to fracture).

As rheumatoid arthritis progresses, the inflamed synovium invades and destroys the cartilage and bone within the joint. The surrounding muscles, ligaments, and tendons that support and stabilize the joint become weak and unable to work normally. These effects lead to the pain and joint damage often seen in rheumatoid arthritis. Researchers studying rheumatoid arthritis now believe that it begins to damage bones during the first year or two that a person has the disease, one reason why early diagnosis and treatment are so important.

Other Parts of the Body

Some people with rheumatoid arthritis also have symptoms in places other than their joints. Many people with rheumatoid arthritis develop anemia, or a decrease in the production of red blood cells. Other effects that occur less often include neck pain and dry eyes and mouth. Very rarely, people may have inflammation of the blood vessels, the lining of the lungs, or the sac enclosing the heart.

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Occurrence and Impact of Rheumatoid Arthritis

Scientists estimate that about 1.3 million people, or about 0.6 percent of the U.S. adult population, have rheumatoid arthritis.* Interestingly, some recent studies have suggested that although the number of new cases of rheumatoid arthritis for older people is increasing, the overall number of new cases may actually be going down.

Rheumatoid arthritis occurs in all races and ethnic groups. Although the disease often begins in middle age and occurs with increased frequency in older people, children and young adults also develop it. Like some other forms of arthritis, rheumatoid arthritis occurs much more frequently in women than in men. About two to three times as many women as men have the disease.

By all measures, the financial and social impact of all types of arthritis, including rheumatoid arthritis, is substantial, both for the Nation and for individuals. From an economic standpoint, the medical and surgical treatment for rheumatoid arthritis and the wages lost because of disability caused by the disease add up to billions of dollars annually. Daily joint pain is an inevitable consequence of the disease, and most patients also experience some degree of depression, anxiety, and feelings of helplessness. For some people, rheumatoid arthritis can interfere with normal daily activities, limit job opportunities, or disrupt the joys and responsibilities of family life. However, there are arthritis self-management programs that help people cope with the pain and other effects of the disease and help them lead independent and productive lives.

*According to the National Arthritis Data Workgroup, the actual number of new cases of rheumatoid arthritis is lower than previous estimates due to changes in the classification for the condition, as cited in “Estimates of the Prevalence of Arthritis and Other Rheumatic Conditions in the United States,” Arthritis and Rheumatism, 58(1):15-25, January 2008.

Glucosamine

Description:
Glucosamine is an aminopolysaccharide (a combination of an amino acid – glutamine and a sugar – glucose). Glucosamine is concentrated in joint cartilage where it is incorporated in longer chains known as glycosaminoglycans and finally into very large structures known as proteoglycans. The proteoglycans function to attract water into the joint space for lubrication of the cartilage during movement.

Claims:

Reverses osteoarthritis

Protects joints and tendons from injury

Decreases inflammation

Theory:
The principle behind glucosamine supplementation is that the glucosamine is delivered to the joint space and incorporated into proteoglycans of joint cartilage to maintain structure and repair damage. Glucosamine may also stimulate chondrocytes (cartilage cells) to begin producing healthy new cartilage matrix (both collagen and proteoglycans).

Scientific Support:
There are numerous European studies showing a clear benefit of glucosamine supplements for relief of joint pain and stiffness associated with arthritis. Many of the studies have been criticized for lack of scientific control, short duration and small size, but recent meta-analyses of the smaller studies have supported the beneficial role of glucosamine supplements as a safe and effective approach to treating osteoarthritis. In general 1-3 months of glucosamine supplementation seems to be more effective than a placebo and at least as effective as analgesic and non-steroidal anti-inflammatory drugs (NSAID), like acetaminophen and ibuprofen, in reducing the joint pain of osteoarthritis. Until more rigorous studies are conducted in the United States, the Arthritis Foundation has stated that it cannot recommend glucosamine supplements as a treatment for osteoarthritis, but this stand has not stopped the Foundation from accepting financial support from the producer of the best selling brand of glucosamine supplements on the market – Rexall Sundown’s Osteo-Bi-Flex. Perhaps the supplements with the best clinical substantiation are Dona from Rotta Labs and Cosamin from NutraMax Labs.

Safety:
Occasional symptoms of gastrointestinal discomfort have been noted, but no significant adverse effects have been noted with glucosamine supplementation. Although there have been no long-term safety studies conducted in humans, animal studies on glucosamine have found it to be non-toxic. Diabetics may want to exercise a degree of caution when using glucosamine supplements, as there have been several animal studies and one small human pilot study that have suggested an increase in blood sugar levels during regular glucosamine consumption (though most of the animal studies have used injections of glucosamine).

Value:
Glucosamine supplements tend to be among the more expensive products on the shelf. A one-month supply of capsules can range from $15 to well over $100. Because they have to be consumed for 1-3 months before any noticeable benefit is apparent, you may need to invest a significant amount of money before you realize any benefits. However, because arthritis pain is one of the most debilitating conditions, most people dealing with such pain would gladly invest a dollar or so per day in a supplement that relieved their discomfort and helped repair their damaged cartilage tissue. For people with existing chronic joint pain, glucosamine supplements are probably worth the significant dollar investment for the benefits that they deliver. For those individuals with intermittent joint pain or those with more mild joint stiffness, the high cost associated with glucosamine supplements may not be justified – and the money might be better spent on other more relevant supplements.

Dosage:
No dose-response studies have been conducted with glucosamine supplements. Virtually all oral supplementation studies on glucosamine have used 1500mg per day – usually in 3 divided doses of 500mg each. While this level appears to be an effective dose, there is no information to suggest that a higher does would work better or faster – or that a lower dose would be less effective. A common supplementation strategy, which can decrease the daily cost of supplements, is to consume 1500mg of glucosamine per day for the first 60-90 days of your regimen, followed by a reduced intake of 250-750mg per day as a “maintenance level.” Following the initial 60-90 day period, dosage levels can be increased or decreased based on individual pain and stiffness levels.

Glucosamine Joint Pain Supplements

References:
1. Barclay TS, Tsourounis C, McCart GM. Glucosamine. Ann Pharmacother. 1998 May;32(5):574-9.
2. da Camara CC, Dowless GV. Glucosamine sulfate for osteoarthritis. Ann Pharmacother. 1998 May;32(5):580-7.
3. Deal CL, Moskowitz RW. Nutraceuticals as therapeutic agents in osteoarthritis. The role of glucosamine, chondroitin sulfate, and collagen hydrolysate. Rheum Dis Clin North Am. 1999 May;25(2):379-95.
4. Delafuente JC. Glucosamine in the treatment of osteoarthritis. Rheum Dis Clin North Am. 2000 Feb;26(1):1-11.
5. Denham AC, Newton WP. Are glucosamine and chondroitin effective in treating osteoarthritis? J Fam Pract. 2000 Jun;49(6):571-2. 6. Donohoe M. Efficacy of glucosamine and chondroitin for treatment of osteoarthritis. JAMA. 2000 Sep 13;284(10):1241; discussion 1242.
7. Houpt JB, McMillan R, Wein C, Paget-Dellio SD. Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. J Rheumatol. 1999 Nov;26(11):2423-30.
8. Leeb BF, Schweitzer H, Montag K, Smolen JS. A metaanalysis of chondroitin sulfate in the treatment of osteoarthritis. J Rheumatol. 2000 Jan;27(1):205-11.
9. Leffler CT, Philippi AF, Leffler SG, Mosure JC, Kim PD. Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. Mil Med. 1999 Feb;164(2):85-91.
10. Mautone G. Efficacy of glucosamine and chondroitin for treatment of osteoarthritis. JAMA. 2000 Sep 13;284(10):1241; discussion 1242.
11. McAlindon TE, LaValley MP, Felson DT. Efficacy of glucosamine and chondroitin for treatment of osteoarthritis. JAMA. 2000 Sep 13;284(10):1241.
12. McAlindon TE, LaValley MP, Gulin JP, Felson DT. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. JAMA. 2000 Mar 15;283(11):1469-75.
13. Rindone JP, Hiller D, Collacott E, Nordhaugen N, Arriola G. Randomized, controlled trial of glucosamine for treating osteoarthritis of the knee. West J Med. 2000 Feb;172(2):91-4.
14. Towheed TE, Anastassiades TP. Glucosamine and chondroitin for treating symptoms of osteoarthritis: evidence is widely touted but incomplete. JAMA. 2000 Mar 15;283(11):1483-4.

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Eating Right to Treat Hurting Joints

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Arthritis Treatments

We use this title because not all arthritis treatment is, shall we say, enjoyable. If you suffer from the painful effects of this debilitating condition though, very little can seem worse. The pain is often so severe that the simplest movements can cause anguish and even tears. But, there are treatments to help arthritis. Can they cure it? That is still to be seen, but many have shown to be effective in fighting off the pain. First, there are many different types of arthritis. The causes of each will help to determine the treatment. But, here, we will talk mainly of the treatment options available and then those that are quite possibly the best at treating rheumatoid arthritis.

The symptoms of any arthritis start with pain. There is pain in the joints in a way that limits the amount of movement a person has. Now, remember, as well, that arthritis can strike any individual, not necessarily just older people. So, if a child stops using a limb complaining of pain, a doctor should be seen. On top of this, if symptoms of pain are accompanied with fever a doctor should be seen immediately as this can be a sign of a deadlier arthritis known as septic arthritis. In all cases, arthritis is an inflammation in the joints. The problem in rheumatoid arthritis is that, in trying to deal with the inflammation, the immune system ends up attacking the cartilage in the joints. The end result is pain and lessened use of the effected joint.

In order to stop this process, arthritis treatments can be anything from surgery to medications. There are some good notes about medications, but in the end, they can not resolve the entire problem, only mask the pain for a while. Surgery is invasive and costly. Physical treatment is available and has shown good progress in helping some patients. There are also herbal remedies that have shown good signs of helping as well. There is one product that we would like to mention in a little more detail. What is so unique about this product, though, is that it is a natural treatment that can be taken.

In the treatment of rheumatoid arthritis in particular, collagen type II can be just as good as a cure to some individuals. This natural substance is actually a main component of cartilage itself. But, no injections are needed because this is an oral treatment. You will take a pill, in other words. There are many reasons why this medication works including the fact that it has an absorption rate of 70 to 90 percent. This means more of it is used and fewer doses are needed. There are other reasons why it works so well.

For instance, the immune system has a component of cells in the intestine called the GALT. This is where proteins are recognized as food or “friend” and therefore not treated as allergies or sensitivities by the digestive system. When collagen type II is ingested, the GALT recognizes this amino acid as a friendly protein. This action switches off the immune system’s attack on collagen elsewhere in the body as in arthritic joints. Instead of the immune system fighting the inflammation and destroying the remaining good material, the Galt simply tells it to stop. And, probably the most important aspect of this natural arthritis treatment is that it can also help to rebuild the damaged and destroyed cartilage. The combination of these two factors can help to restore a normal way of life.

For more information visit:Joint Advance Centre

How Do You Know if You Have Osteoarthritis?

Usually, osteoarthritis comes on slowly. Early in the disease, your joints may ache after physical work or exercise. Later on, joint pain may become more persistent. You may also experience joint stiffness, particularly when you first wake up in the morning or have been in one position for a long time.

Although osteoarthritis can occur in any joint, most often it affects the hands, knees, hips, and spine (either at the neck or lower back). Different characteristics of the disease can depend on the specific joint(s) affected. For general warning signs of osteoarthritis, see the box on the next page. The joints most often affected by osteoarthritis are described below.

Hands: Osteoarthritis of the hands seems to have some hereditary characteristics; that is, it runs in families. If your mother or grandmother has or had osteoarthritis in their hands, you’re at greater than average risk of having it, too. Women are more likely than men to have hand involvement and, for most, it develops after menopause.

When osteoarthritis involves the hands, small, bony knobs may appear on the end joints (those closest to the nails) of the fingers. They are called Heberden’s (pronounced HEBerr-denz) nodes. Similar knobs, called Bouchard’s (pronounced boo-SHARDZ) nodes, can appear on the middle joints of the fingers. Fingers can become enlarged and gnarled, and they may ache or be stiff and numb. The base of the thumb joint also is commonly affected by osteoarthritis.

Knees: The knees are among the joints most commonly affected by osteoarthritis. Symptoms of knee osteoarthritis include stiffness, swelling, and pain, which make it hard to walk, climb, and get in and out of chairs and bathtubs. Osteoarthritis in the knees can lead to disability.

Hips: The hips are also common sites of osteoarthritis. As with knee osteoarthritis, symptoms of hip osteoarthritis include pain and stiffness of the joint itself. But sometimes pain is felt in the groin, inner thigh, buttocks, or even the knees. Osteoarthritis of the hip may limit moving and bending, making daily activities such as dressing and putting on shoes a challenge.

Spine: Osteoarthritis of the spine may show up as stiffness and pain in the neck or lower back. In some cases, arthritis-related changes in the spine can cause pressure on the nerves where they exit the spinal column, resulting in weakness or numbness of the arms and legs.

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How Do Doctors Diagnose Osteoarthritis?

No single test can diagnose osteoarthritis. Most doctors use a combination of the following methods to diagnose the disease and rule out other conditions.

Clinical history

The doctor begins by asking the patient to describe the symptoms, when and how the condition started, and how the symptoms have changed over time. The doctor will also ask about any other medical problems the patient and close family members have and about any medications the patient is taking. Accurate answers to these questions can help the doctor make a diagnosis and understand the impact the disease has on the patient’s life.

Physical examination

The doctor will check the patient’s reflexes and general health, including muscle strength. The doctor will also examine bothersome joints and observe the patient’s ability to walk, bend, and carry out activities of daily living.

X rays

Doctors take x rays to see how much joint damage has been done. X rays of the affected joint can show such things as cartilage loss, bone damage, and bone spurs. But there often is a big difference between the severity of osteoarthritis as shown by the x ray and the degree of pain and disability felt by the patient. Also, x rays may not show early osteoarthritis damage before much cartilage loss has taken place.

Magnetic resonance imaging

Also known as an MRI, magnetic resonance imaging provides high-resolution computerized images of internal body tissues. This procedure uses a strong magnet that passes a force through the body to create these images. Doctors often use MRI tests if there is pain, if x-ray findings are minimal, and if the findings suggest damage to other joint tissues such as a ligament or to the pad of connective tissue in the knee known as the meniscus.

Other tests

The doctor may order blood tests to rule out other causes of symptoms. He or she may also order a joint aspiration, which involves drawing fluid from the joint through a needle and examining the fluid under a microscope.

It usually is not difficult to tell if a patient has osteoarthritis. It is more difficult to tell if the disease is causing the patient’s symptoms. Osteoarthritis is so common – especially in older people – that symptoms seemingly caused by the disease actually may be due to other medical conditions. The doctor will try to find out what is causing the symptoms by ruling out other disorders and identifying conditions that may make the symptoms worse. The severity of symptoms in osteoarthritis can be influenced greatly by the patient’s attitude, anxiety, depression, and daily activity level.

Joint Pain Supplements Review

Osteoarthritis Basics: The Joint and Its Parts

A joint is the point where two or more bones are connected. With a few exceptions (in the skull and pelvis, for example), joints are designed to allow movement between the bones and to absorb shock from movements like walking or repetitive motions. These movable joints are made up of the following parts:

Cartilage: a hard but slippery coating on the end of each bone. Cartilage, which breaks down and wears away in osteoarthritis, is described in more detail on the next two pages.

Joint capsule: a tough membrane sac that encloses all the bones and other joint parts.

Synovium (pronounced sin-O-vee-um): a thin membrane inside the joint capsule that secretes synovial fluid.

Synovial fluid: a fluid that lubricates the joint and keeps the cartilage smooth and healthy.

A Healthy Joint

In a healthy joint, the ends of bones are encased in smooth cartilage. Together, they are protected by a joint capsule lined with a synovial membrane that produces synovial fluid. The capsule and fluid protect the cartilage, muscles, and connective tissues.

A Joint With Severe Osteoarthritis

With osteoarthritis, the cartilage becomes worn away. Spurs grow out from the edge of the bone, and synovial fluid increases. Altogether, the joint feels stiff and sore.

Ligaments, tendons, and muscles are tissues that surround the bones and joints; they allow the joints to bend and move. Ligaments are tough, cord-like tissues that connect one bone to another. Tendons are tough, fibrous cords that connect muscles to bones. Muscles are bundles of specialized cells that, when stimulated by nerves, either relax or contract to produce movement.

How Does Osteoarthritis Affect People?

People with osteoarthritis usually experience joint pain and stiffness. The most commonly affected joints are those at the ends of the fingers (closest to the nail), thumbs, neck, lower back, knees, and hips.

Osteoarthritis affects different people in different ways. Although in some people it progresses quickly, in most individuals joint damage develops gradually over years. In some people, osteoarthritis is relatively mild and interferes little with day-to-day life; in others, it causes significant pain and disability.

Although osteoarthritis is a disease of the joints, its effects are not just physical. In many people with osteoarthritis, lifestyle and finances also decline.

Lifestyle effects include

• depression
• anxiety
• feelings of helplessness
• limitations on daily activities
• job limitations
• difficulty participating in everyday personal and family joys and responsibilities.

Financial effects include

• the cost of treatment
• wages lost because of disability.

Fortunately, most people with osteoarthritis live active, productive lives despite these limitations. They do so by using treatment strategies such as rest and exercise, pain relief medications, education and support programs, learning self-care, and having a good attitude.

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