Don't Let Osteoarthritis Keep You Down - Focus on Fitness - Harvard Commentaries

Stiff hands, swollen knees, aching back? Would anyone with these types of joint problems want to exercise? Why make the joints hurt more? These are just a few symptoms that a person with osteoarthritis (OA) may experience. Millions of dollars each year are spent on dietary supplements and devices to help relieve pain. A few, such as glucosamine, have scientific evidence that proves they can help. However, most do not. Exercise is a tried and true remedy, aiding in pain control, enhancing mobility, and slowing disease progression.

Osteoarthritis is a chronic condition in which ligaments weaken and tissue in the joints, known as cartilage, wears away. As this tissue deteriorates, bones rub against each other, causing pain and stiffness. Some of the pain also emanates from muscles and ligaments that surround the affected joints.

Obesity, advancing age, occupational overloading of joints, and joint trauma are major contributors to the development of OA. Every extra pound you carry around equals added stress to your knees, hips and back. Furthermore, injuries that seem to heal well can still set off a process of deterioration that can have devastating effects on the joints.

If there were one pill that someone with osteoarthritis should take everyday, it would be the “exercise pill.” Although medications reduce pain and inflammation, therapeutic exercises can strengthen muscles around a joint and boost flexibility, allowing you to perform daily tasks more easily. For example, exercises that strengthen the quadriceps help to reduce knee pain by strengthening the muscles and ligaments that help stabilize and support the knee joint. Combine strength, aerobic and flexibility exercises for the optimal fitness program. Your doctor, a physical therapist or a fitness expert can teach you how to do exercises at home. Hot bath, hot packs, or cold treatments applied before exercise can make activities easier. Exercising in the water can build strength and flexibility while the water's buoyancy reduces wear and tear on sore joints.

First, assess your fitness challenges. Then find fun and energizing exercises that you can do on a regular basis. Finally, embrace the positive results that you experience from a regular exercise program.

In addition to exercise, other lifestyle strategies can help you to live more comfortably with osteoarthritis.

Toss those uncomfortable shoes, such as the pumps that cramp your toes, rub your heels and squeeze your bunions. Avoid heels higher than 1 inch. Instead select a well-padded, well-fitting shoe with plenty of room for your toes. Comfortable feet energize all the joints.

Try supportive devices such as a cane or knee brace. A cane can improve how a joint functions, while reducing pain by taking weight off and resting a joint in the leg (such as a hip or knee). Use the cane in the hand opposite the painful side. A knee brace also can reduce the load on the knee.

Try splints to rest and protect affected small joints in the hands, especially the thumb.

Consider having a regular massage scheduled with a certified massage therapist, and treat yourself to a good rubdown. Massage helps to improve flexibility and may decrease pain.

Keep a journal. Write about your feelings, fears, frustrations, and happy times. Writing is therapeutic and fun!

Look for ways to help others. Helping others can be a great way to help you forget your own pains and problems, or at least to put them in perspective.

Cultivate your spiritual nature. Your thoughts affect your health. Spiritual beliefs and prayer can help people to nourish their hunger for inner peace and can relieve physical pain.

Forget the pastries for breakfast and grab some fruit and a little whole grain such as oatmeal. Losing even a few pounds can make your joints feel better. Make sure to get adequate calcium (about 1,000 milligrams) and vitamin D (400 to 800 units) daily to help keep bones strong.

Try gardening — it's hand exercise with the bonus of a bountiful yield. Digging in the soil can soothe sore hands.

Finally, celebrate life each day with laughter. Laughter relaxes muscles and can relieve pain, while supercharging your immune system.

Paulette Chandler, M.D., M.P.H. is a clinical instructor of medicine at Harvard Medical School and an attending physician at Brigham and Women's Hospital.