Arthritis: Not Just an Older Person's Disease
During my daily work routine, I see many patients in their twenties, thirties, and forties. They are an active population with many physical demands. Arthritis, or more appropriately called osteoarthritis (not to be confused with osteoporosis), might be thought of as an older person's disease. However, I see it nearly everyday on the x-rays of these younger generations.
Osteoarthritis is a degeneration of the cartilage in the joints. It is one of the most common causes of disability in the United States. It usually affects weight-bearing joints such as the hip, knee, hands, and spine. Other areas that can be affected are the ankle, wrist and shoulder.
Occasionally, inflammation and swelling are present. Risk factors for developing osteoarthritis are increased age, obesity, and high impact or prolonged weight-bearing activities which can cause cartilage breakdown. Other risk factors include low levels of vitamin D, vitamin C, estrogen deficiency, trauma, other forms of arthritis or joint disease, and malformed joints.
Although the exact mechanism of breakdown is unknown, once the arthritic process begins to occur, there is steady progression of disease. The most common symptoms are joint stiffness and activity-related pain. Stiffness is usually worse in the morning or when the joint has been inactive for a period of time. With advanced disease, the joint may grind or buckle. Pain may also alter mechanics, for example, a limp may lead to pain in other areas such as the back. X-rays may show a narrowing of the joint space, bone spurs called osteophytes, or abnormal calcium deposition such as sclerosis or cyst formation. Other studies or lab tests are usually not needed.
The main goals in the treatment of osteoarthritis are to minimize progression and control pain symptoms. However, there is no intervention that has been shown to halt or reverse osteoarthritis. Oral pain medications such as tylenol or non-steroidal anti-inflammatories, ie. ibuprofen, naprosyn, provide temporary relief and the latter can help reduce swelling. Capsaicin cream, which contains a cayenne pepper derivative, has had mixed results in pain relief. Short-term studies on glucosamine and chondroitin showed promise in regards to pain-relief, however, there has been no data to support a decrease in disease progression. With exceptionally painful or advanced cases, braces or splints may be needed, cortisone shots or shots of synthetic fluid may provide relief, or as a last resort, joint replacement surgery can be performed.
A functional approach to living with osteoarthritis uses education about the disease, stretching, adaptive exercise, and the use of energy modalities such as heat and cold. Stretching can ease stiffness and prevent or reduce joint contracture. Prior to exercise, the use of a heating pad or heat packs can further loosen tight joint structures and reduce stiffness. Exercise should avoid jumping, sudden or jarring motions, exertion when a joint is at its end range, or exertion to the point of fatigue. There are many activities that safely promote general conditioning including including bellydancing (most movements), yoga, tai chi, walking, swimming, riding a bike, or using an elliptical trainer. Afterwards, the use of ice packs can reduce joint swelling and the needs for oral pain medications.
Bellydancing is not without its risks, especially certain movements that stress the joint. The Turkish drop, for example, may injure many places such as the knees, the hips, the back, even the neck. It is best to avoid these altogether if you have any prior injury or health problems, have not "trained up" to the maneuver, or have any reservations about it. Even younger generations develop arthritis as a result of pushing their bodies "to the extreme," poor nutrition, or experiencing trauma. It is not just an older person's disease and once a joint has been significantly damaged, there is currently, no medical cure to halt or reverse progression. Dance safely and you will dance smartly.
Additional Information about Arthritis can be found at
the following websites:
www.arthritiscare.org.uk
www.arthritis.org
www.arc.org.uk
www.arthritis.ca
www.stillsdisease.org
