Dog Walking Helps Arthritic Joints

From arthritis.org/health-wellness

Daily walks keep best furry buddy happy — and your joints, too 

Any dog owner knows that take-me-for-a-walk look: puppy eyes pleading, head tilting, an “oh, please” woof and tail thumping. You probably think you’re doing Fido a favour when you give in and take him for a stroll. Turns out, he may be doing you the favour. Walking has many benefits for people living with arthritis.

Eager canine companions virtually guarantee that their humans walk daily, even when you’re tempted to stay home because of flares, lousy weather or plain old laziness. Walking a dog doesn’t require extra expense, special clothes or going to a gym, and dogs aren’t interested in breaking the routine by taking a day off or going on vacation. Consistency, such as sticking to daily walks, is key when it comes to gaining the benefits of exercise.

Research has shown that people who have dogs tend to be more physically active than those who don’t. Numerous studies have shown benefits of increased physical activity from dog walking, from potentially reducing anxiety to easing the impacts of COPD to an association with lower rates of cardiovascular disease. One small study found that people who had a dog walked more often and lost as much as 14 pounds in a year. That is particularly good news for people with arthritis, because research also has shown that for every one pound lost reduces pressure on weight-bearing joints by four pounds. 

When it comes to selecting a furry friend, you may want to avoid very large or active breeds unless they are properly trained not to pull, jump or otherwise put your joints at risk. Consider adopting a calm, middle-aged or senior dog from a shelter, where staff have already vetted its temperament. And look for leashes and other devices that help deter your pup from pulling or lunging.

https://www.arthritis.org/health-wellness/healthy-living/physical-activity/walking/walking-a-dog-benefits-joints

Can Vitamin D Help With Psoriatic Arthritis? Here’s What Experts Say

From healthcentral.com 

Research has found people with psoriatic arthritis tend to be low in this essential vitamin—but the jury is out on whether a supplement can help

Psoriatic arthritis, an autoimmune disease fuelled by out-of-control inflammation, can cause symptoms like joint pain, fatigue, and swelling from head to toe, so it's no surprise that people might be looking for ways to get relief. And one option that has gotten some attention is vitamin D, which some consider to be one of the best supplements for psoriatic arthritis.

But in reality, the relationship between psoriatic arthritis and vitamin D is—as with a lot of supplements —a tricky one to figure out, since the science behind it is still unclear. What might be driving the correlation? Vitamin D is one of the most promising vitamins for psoriasis (a related but still separate condition that appears on the skin), so there’s reason to be optimistic. So, do psoriatic arthritis supplements like vitamin D merit a spot in your medicine cabinet? Here’s what the experts say.

The Relationship Between Vitamin D and Psoriatic Arthritis

The connection between vitamin D and psoriatic arthritis is more complicated than it seems. Vitamin D, for reference, benefits your body on several fronts. “It’s important for bone health and has roles in the immune system and in maintaining skin health,” says S. Louis Bridges, Jr., M.D., a rheumatologist and physician-in-chief and chair of the Department of Medicine at the Hospital for Special Surgery in New York City.

Research has found that vitamin D deficiency was especially common among people with PsA—and that the lower their vitamin D levels were, the more disease activity, indicated by a higher DAPSA (Disease Activity in Psoriatic Arthritis) score, they experienced. DAPSA is a measurement of PsA severity that takes into account the joints affected, pain levels, and levels of C-reactive protein, which is an inflammation marker.

But it’s unclear whether low vitamin D levels are the cause or the result of inflammation, according to Dr. Bridges. “When there is inflammation, serum levels of vitamin D decrease,” says Dr. Bridges. “Low levels of vitamin D are associated with a variety of inflammatory states.” In other words, it’s like which came first—low vitamin D, which contributes to the uptick in inflammation and DAPSA, or the inflammation, which stifles the levels of vitamin D? It’s hard to say.

Should You Take Vitamin D to Treat Your Psoriatic Arthritis?

Taking vitamin D could be helpful if you have psoriasis alongside your PsA. “Oral vitamin D supplementation may have some benefits in psoriasis,” says Dr. Bridges, though he notes that most research focuses on the efficacy of topical creams applied to plaques (versus oral supplements). “They work by slowing down the rapid skin cell turnover associated with psoriasis and have immunomodulatory effects.”

As for psoriatic arthritis, vitamin D may help ease symptoms—in theory. But “there are no studies that definitively show this, and much more work is needed,” says Dr. Bridges. “We also need studies to understand the role of vitamin D in the development and treatment of PsA, and the differences in vitamin D metabolism between patients with PsA compared to psoriasis without arthritis.”

What are the Best Sources of Vitamin D?

Sunlight is the primary source of vitamin D. “Vitamin D is made or synthesized in the skin from its precursor, a type of cholesterol,” says Shailendra Singh, M.D., a rheumatologist at White County Medical Center in Searcy, AK. “When you're exposed to the sunlight, that vitamin D precursor is formed in the skin—and once that is formed, that is converted into its active form in the liver and the kidneys.” But if you don’t spend a lot of time outside, then sunlight alone might not be enough to make the amount of vitamin D you need.

If that’s the case, you’ll need to get it from your diet—and, ideally, you should be eating your vitamin D rather than taking it through a supplement, according to Dr. Singh. “There are several foods which are enriched in vitamin D,” he says. “Most of the milk available in the market is enriched with vitamin D, as are yogurt and cheese.” You can also find vitamin D in fatty fish and fish liver oil.

How Much Vitamin D You Need With Psoriatic Arthritis

Besides infants, most people need 15 micrograms (mcg) of vitamin D a day, according to the National Institutes of Health (NIH). (A cup of milk has 2.9 mcg, while three ounces of salmon and trout each have over 14 mcg.) Even if you have psoriatic arthritis, that’s all our experts recommended. “I do not recommend routine vitamin D supplementation to treat psoriatic arthritis,” says Dr. Bridges.

The Risks of Too Much Vitamin D

Because it can increase calcium absorption, taking too much vitamin D can lead to hypercalcemia—literally, excessive calcium—which in turn leads to nausea, vomiting, and kidney stones. And while too much vitamin D alone can lead to kidney failure, it's extremely rare, according to the NIH. Really, it only tends to become a problem if you’re taking a lot of different vitamins, according to Dr. Singh. “Overdosing on vitamin D is very, very difficult,” he says.

And, even when you take it in an over-the-counter supplement, “that vitamin D needs to be activated inside the kidneys and in the liver to become active vitamin D—and our body will only produce as much active vitamin D as it needs,” he says. The rest gets excreted out.

Talk With Your Doctor

If you’re curious about supplementing with vitamin D, talk to your doctor—but manage your expectations accordingly. If your doctor checks your vitamin D levels and they’re low, they might recommend a supplement, says Dr. Singh. And if they’re normal, then supplementing with vitamin D won’t add any extra benefit for your psoriatic arthritis. And remember, it’s not a cure-all, and should at most be part of an overarching treatment plan overseen by your doctor.

https://www.healthcentral.com/condition/psoriatic-arthritis/psoriatic-arthritis-and-vitamin-d

Hand and wrist arthritis: You have great options for relief

From novanthealth.org 

Charleston orthopaedic surgeon discusses treating the most common form of arthritis

Whether we type for a living or deliver heavy boxes all day, our hands and wrists can take a beating.

More than 50 million people in the U.S. have arthritis, a condition that damages the joints. Its most common form, osteoarthritis, is a chronic and degenerative disease that affects sensitive cartilage where bones connect to form a joint (think the wrist and knuckles).

Dr. Eric Angermeier

“It's a disease that does not discriminate much and affects a broad swath of people,” said orthopaedic hand and wrist surgeon Dr. Eric Angermeier, co-founder of the Hand Institute of Charleston - Mount Pleasant. To make an appointment, click here.

Angermeier explains how we come to suffer from arthritis and the treatment options that can bring pain relief.

What is arthritis?

The fundamental common element in all types of arthritis is that the cartilage breaks down. And as that cartilage thins and eventually goes away, what you have are two raw bone ends bumping into each other. That often means a lot of pain.

And, as Angermeier explains, a lot of hand and wrist arthritis is determined by genetics rather than wear and tear. Some people just have joints that wear out faster than others. That said, symptomatic arthritis peaks in our 60s or 70s because people are still active and using their hands a lot and aggravating their arthritis.

And while there is no cure for arthritis, advancing technology is helping surgeons rebuild joints to reduce pain and improve function while also promoting a faster recovery.

Are there certain professions that are more difficult for those affected by arthritis?

It really comes down to genetics in a lot of cases. If you have a direct injury to the cartilage of your joints, that can hasten the wear-and-tear of the cartilage. So, if you're in an occupation like construction, you’re more likely to have injuries to the cartilage that may accumulate over time.

But the flipside of that is you may have been one of these folks who was going to get arthritis anyway. If you’re a heavy manual labourer and happen to have arthritis, you're going to hurt a lot more because you're using your hands for heavier activities.

So it's a chicken-or-the-egg kind of situation. We used to think that heavy manual activities may have caused arthritis, but now we think that people with bad arthritis are probably going to get arthritis anyway, and it's the heavy manual activity that's aggravating it.

There are some outliers. If you’ve run ultra-marathons for many years, you're more likely than the average person to have arthritis and wear out your cartilage over time. But a lot of hand and wrist arthritis is determined by genetics and normal use. This is everyone from folks who enjoy gardening and crocheting all the way up to people working construction.

How can we prevent arthritis?

As we age and our cartilage wears out, the joints tend to get stiffer. One thing you can do to counteract the effect of osteoarthritis is to develop a daily regimen of finger stretching and wrist stretching that will help to maintain your range of motion. Even though the arthritis continues to progress, you'll be more functional.

But as yet, we don't have any known treatments, supplements, stretches, braces or other technologies that slow the progression of arthritis or prevent it. We truly don't have any tools to prevent osteoarthritis. Fortunately, we have many opportunities to treat it or help modify the symptoms of arthritis.

Two of the most common supplements are chondroitin and glucosamine (both found naturally in cartilage). You see both of these advertised a lot for people with arthritis, but there is no quality research that indicates that any supplement, those included, slows or prevents the development of osteoarthritis.

Although chondroitin and glucosamine do not prevent arthritis, there is some limited evidence that they can reduce arthritic pain in some patients and are generally felt to be safe. I just wouldn’t recommend spending a lot on supplements that don’t seem to be helping.

Who is a candidate for hand surgery, and how invasive is it?

You should always pursue non-operative treatment first. Usually, we'll try a steroid injection or two to see if we can get symptoms under control. But when that fails to yield adequate relief of pain and stiffness, the most commonly performed surgery for arthritis in the hand and wrist is a carpometacarpal [CMC] joint arthroplasty. It's essentially a reconstruction of the joint at the base of the thumb.

We've developed a minor outpatient procedure that is done through a single small incision, and we replace the bone-on-bone contact at the arthritic joint with an internal sling made from a tendon. The base of the thumb sits in a hammock-type structure that helps to prevent it from rubbing the arthritic bones.

This can significantly alleviate pain and improve strength and function. It’s one of the most satisfying procedures that we have to offer as hand surgeons because it can restore a tremendous amount of hand function.

The thumb represents about 50% of the overall function of the hand, so if you can get the thumb functioning pain-free and with more strength, that can change the quality of life for the patient.

What are the risks of surgery?

There's a very low risk of complications with this procedure and a very high rate of positive outcomes.

These procedures have become more and more minimally invasive, involving just a single incision at the base of the thumb, which helps speed recovery, causes less pain and lessens the risk of infection.

When should somebody make an appointment with an orthopaedic surgeon?

If there's anything bothering your hand or your wrist, I'd strongly encourage you to see a hand surgeon. I think the threshold should be pretty low to get things checked out. Hand and wrist arthritis is highly treatable and often with good results. And there are many different options available depending on where the arthritis is, the age of the patient and how active they are.

https://www.novanthealth.org/healthy-headlines/hand-and-wrist-arthritis-you-have-great-options-for-relief

The couples who cope together, stay together

From eurekalert.org

An Australian-first study has lifted the lid on how couples living with rheumatoid arthritis cope with the debilitating disease finding that those who cope with problems together had less psychological distress and better relationships.

The study, published in The Journal of Rheumatology examined dyadic coping - when a couple engages in joint problem solving, joint information gathering, or the sharing of feelings and mutual commitment - from both partners' perspectives using a sample of 163 couples.

“Dyadic coping, the process of coping that transpires between couples challenged by one partner’s illness, is an important predictor of disease adjustment and patient well-being,” says lead author Dr Manasi Murthy Mittinty from the College of Medicine and Public Health.

“Dyadic coping contributes to a sense of togetherness, encouraging couples to develop strategies as a unit to respond to stressful events, and it represents a protective factor for minimising the risk of divorce.

“Working together as a couple is crucial for managing the challenges they face when one partner has an illness, particularly in rheumatoid arthritis.”

Rheumatoid arthritis (RA) is an autoimmune condition that can cause irreversible tissue damage, progressive deformity and pain. Approximately 18 million people worldwide are living with RA, including nearly 456,000 Australians.

Although management of RA has improved dramatically due to biologics, some patients are still confronted by severe physical pain and stiffness and about 35% of people report experiencing mental and behavioural conditions, such as bipolar disorder, mania and anxiety disorder.

“We found that supportive dyadic coping leads to lower depression, anxiety, and stress for patients, as well as improved relationship quality. In contrast, negative dyadic coping increases psychological distress and reduces relationship quality for both partners,” says Dr Mittinty.

“By examining the interpersonal dynamics of couples grappling with chronic disease, we hope to significantly improve the quality of life for patients living with rheumatoid arthritis and their spouse.”

The study is the first in Australia to report dyadic coping from the perspective of both participants with RA and their spouses.

RA patients and their spouses were invited to participate in an online survey study if they were more than 18 years old and had lived together for more than a year. The survey included the Chronic Pain Grade Scale, Dyadic Coping Inventory, Depression Anxiety Stress Scale, and Dyadic Adjustment Scale.

“The results underscore the interconnected nature of dyadic coping, highlighting the need to consider both viewpoints in understanding its impact on couples.

“For decades, the focus has been limited to reducing patients’ illness-related distress and improving patient outcomes. More recently, scientists have adopted a new approach into understanding how illness in a spouse can affect the couple’s relationship and the other spouse’s well-being.

“Our findings demonstrate the reciprocal nature of dyadic coping that transpires between patients with RA and their spouses and showcases that integrating dyadic coping training in disease management may be a valuable resource for enhanced mental health outcomes and relationship quality of couples,” she adds.

The article, ‘Interpersonal Process of Dyadic Coping in Rheumatoid Arthritis: A Perspective From the Australian Rheumatology Association Database’, by Manasi M. Mittinty, Murthy N. Mittinty, Rachelle Buchbinder, Marissa Lassere, Vibhasha Chand, Samuel Whittle, Lyn March and Catherine Hill was published in The Journal of Rheumatology. DOI: 10.3899/jrheum.2023-0664

https://www.eurekalert.org/news-releases/1062990

A proactive approach to hip pain in younger adults: What is hip arthroscopy?

From uchealth.org

Hip pain in younger adults can be hard to diagnose. If non-surgical options fail, hip arthroscopy may help people return to pain-free activities

Younger adults suffering from certain types of hip pain can get relief, as well as potentially prevent future problems such as hip arthritis, with an outpatient arthroscopy procedure.

Arthroscopy for the hip is the relative new kid on the block compared to similar procedures done on the knee and shoulder. It can relieve pain in adults with certain hip problems who are not responding to nonsurgical procedures.

“The goal of hip arthroscopy is to get you back pain free to the activities you love, and it may postpone having hip arthritis for years or even decades,” said Dr. Jay Thompson, an orthopaedic surgeon in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center.

Hip pain in younger adults can be hard to diagnose. If non-surgical options fail, hip arthroscopy may help people return to pain-free activities. Photo: Getty Images

What is causing your hip pain?

The hip joint is like a basic ball and socket and is one of the largest joints in the human body – it is vital to movement. Pain there can happen for many reasons, such as wear and tear from age, traumatic accidents, genetic conditions and certain repetitive motions or exercises.

The origin of hip pain can be difficult to diagnosis, Thompson said. Patients usually have specific symptoms such as deep hip or groin pain, or pain that comes with squatting, skating or deep inflection motions.

Doctors may diagnose some patients with femoroacetabular impingement, or FAI, which is more commonly known as hip impingement. This occurs when excess bone causes the ball and socket of the hip joint to not fit together properly. Other patients may have a symptomatic hip labral tear, which is when the cartilage that lines and protects the hip socket is damaged.

“Many of us experience hip pain at some time or another, and these more specific conditions can be commonly missed,” said Thompson. “It’s best to see a specialist for evaluation and treatment.”

When is arthroscopy for hip pain in younger adults recommended?

Patients suffering from hip pain are usually referred to physical or occupational therapy for pain management, as well as told to rest and modify the sports or physical activity that they suspect is the source of the pain.

If the condition does not improve, medication or pain injections to relieve inflammation are typically prescribed. Doctors commonly use Injections not only to treat the pain but also to confirm the diagnosis, as hip pain can be originate from various sources.

If those non-surgical options don’t provide relief, hip arthroscopy may be recommended.

“Hip arthroscopy is a good choice for a patient who is in pain from hip impingement or a labral tear,” said Thompson. “Once treated, it can help prevent arthritis in the future.”

What happens during the procedure?

During hip arthroscopy, a patient is placed under anaesthesia. A surgeon makes a small incision in the hip and uses a special device with a small camera to see the joint. Loose or damaged tissue such as the labrum can be removed, repaired or reconstructed, and the bone can be reshaped to within normal tolerances.

The minimally invasive approach means that patients can go home the same day and typically have a quicker recovery time.

“Hip arthroscopy can improve hip pain and can even prevent or postpone a person from getting early onset hip arthritis,” said Thompson. “We can repair the labrum and reshape the bone. It’s not a 100% guarantee, but for patients in their 30s and 40s, it can give them another 10 to 20 years of good hip life.”

https://www.uchealth.org/today/proactive-approach-to-hip-pain-in-younger-adults-what-is-hip-arthroscopy/ 

Some rheumatoid arthritis patients are more vulnerable to pulmonary fibrosis than others

From koreabiomed.com

Some pulmonary fibrosis, the progressive hardening of the lungs that causes breathing difficulties, occurs in relation to rheumatoid arthritis (RA). Specific patient groups are at a higher risk of RA-related pulmonary fibrosis, which affects 3-15 percent of all RA patients.

“Rheumatoid arthritis mostly affects middle-aged women. However, suppose RA occurs in men or older adults. In that case, there are problems (due to higher chances of rheumatoid arthritis-related pulmonary fibrosis,” said Professor Kim Hyun-sook of the Department of Rheumatology at Soon Chun Hyang University Hospital Seoul on the Korean Blood Disease and Cancer Association's YouTube channel, “KBDCA.”

                                                                                                                            (Credit: Getty Images)

It's unclear why pulmonary fibrosis occurs in around 10 percent of patients with RA, an autoimmune disease. However, it is believed that some autoantibodies that attack the joints also attack the bronchi and alveoli of the lungs, causing inflammation and fibrosis.

In addition to being male and older, there are other characteristics of patients at high risk for RA-related pulmonary fibrosis.

“We test patients with rheumatoid arthritis for rheumatoid factor or anti-CCP (anti-cyclic citrullinated peptide) antibodies, and those with exceptionally high levels of the factor have a high risk of RA-related pulmonary fibrosis,” Professor Kim said. “Anti-CCP antibodies are normal at 5 to 15, but many patients with high levels are more likely to be hit at their lungs.”

Specific gene variants are also associated with the development of RA-related pulmonary fibrosis.

“We've looked at some genetic variants and found that certain genetic variants are associated with an increased risk of pulmonary fibrosis, so it may be important to get screened if you have a family history of the disease,” said Professor Yoon Hee-young of the Department of Respiratory and Allergy Medicine at the same hospital.

People with poorly controlled rheumatoid arthritis are also at higher risk for RA-related pulmonary fibrosis. Besides, there are other cases where the risk of pulmonary fibrosis is increased in people with rheumatoid arthritis regardless of the disease.

“Some patients may develop or worsen pulmonary fibrosis, not necessarily because of RA, but because they are taking medications that can affect the lungs (respiratory toxicants),” Professor Kim said. “Screening, diagnosis, and treatment should be tailored to each individual's risk.”

If diagnosed with RA-related pulmonary fibrosis, there is one thing that all patients should do -- stop smoking.

“Another important risk factor (for RA-related pulmonary fibrosis) is smoking,” Professor Yoon said. “Certainly, it has been reported that patients who smoke have a higher incidence of pulmonary fibrosis. We explain to patients that they should quit smoking if they are diagnosed with pulmonary fibrosis.”

https://www.koreabiomed.com/news/articleView.html?idxno=25487

Early rheumatoid arthritis tied to hypertension

From medicalxpress.com/news 

Patients with early rheumatoid arthritis (RA) have a high incidence of prevalent and incident hypertension, according to a study published online in the August issue of Rheumatology: Advances in Practice.

Brook Hadwen, from the University of Western Ontario in London, Canada, and colleagues used data from the Canadian Early Arthritis Cohort to explore the prevalence and incidence of hypertension and baseline factors associated with incident hypertension in early RA (2,052 patients).

The researchers found that the prevalence of hypertension at study enrolment was 26% (23% in women and 34% in men). Prevalent hypertension was associated with older age, diabetes, and hyperlipidemia in both sexes. In women, hypertension was associated with being overweight or with high alcohol consumption.

One quarter (24%) of the RA patients did not have hypertension at enrolment but developed hypertension during the median follow-up period of five years. Incident hypertension was significantly associated with the baseline factors of older age, being overweight, excess alcohol consumption, and having hyperlipidemia. There were no significant associations between RA-associated disease factors and treatments with prevalent or incident hypertension.

"Weight loss and lifestyle modifications such as changes in diet, exercise, and limiting alcohol intake may reduce the risk of high blood pressure and prevent heart disease," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

More information: Brook Hadwen et al, Risk factors for prevalent and incident hypertension in rheumatoid arthritis: data from the Canadian Early Arthritis Cohort, Rheumatology Advances in Practice (2024). DOI: 10.1093/rap/rkae066

https://medicalxpress.com/news/2024-10-early-rheumatoid-arthritis-hypertension.html

Does your body feel tight when you wake up? Learn how to manage morning stiffness with doctor-approved tips

From hindustantimes.com

Do you know morning stiffness can be the first symptom of early arthritis? Here's all you need to know about morning stiffness, its treatment and more

Morning stiffness is common among people with joint conditions. It manifests as difficulty in moving joints upon waking and often lasts for 30 minutes or more, says Dr Abhisar Katiyar, senior consultant and robotic surgeon-orthopaedics and joint replacement, Yatharth Hospitals Greater Noida. This stiffness is typically more pronounced in inflammatory conditions such as rheumatoid arthritis, he adds.

More about morning stiffness

Waking up with stiff joints can make simple tasks like getting out of bed or walking a challenge. According to Dr Yash Gulati, senior consultant, orthopaedics, joint replacement and spine, Indraprastha Apollo Hospitals, morning stiffness can be the first symptom of early arthritis. 

"If stiffness wears away rapidly, it could be due to age-related osteoarthritis, and if stiffness continues for a prolonged period throughout the day, it can be a symptom of an inflammatory type of arthritis," he says. Arthritis is a condition characterised by inflammation of the joints, leading to pain, stiffness, and reduced mobility.

                                          Even some light stretching will help keep your body healthy and fit. (Freepik)

Managing morning stiffness

According to Dr Abhisar Katiyar, management strategies include taking prescribed medications before bedtime, gentle stretching exercises before getting out of bed, and using warm compresses. Patients experiencing persistent morning stiffness should consult expert professionals for further evaluation, he adds.

Dr Yash Gulati suggests keeping the body moving to battle morning stiffness. "Gentle stretching before getting out of bed can help loosen tight muscles and improve joint mobility. Activities like yoga or a short morning walk can also boost circulation, easing stiffness. Applying warmth, such as taking a hot shower or using a heating pad, can soothe sore joints and relax muscles, making movement easier," he says.

"Additionally, staying hydrated throughout the day and eating a balanced diet rich in anti-inflammatory foods like omega-3 fatty acids can help maintain joint health. For those with arthritis, it may be necessary to consult a doctor to explore treatment options, such as medication or physical therapy. Taking steps to address morning stiffness not only helps with mobility but also sets a positive tone for the day, making it easier to engage in daily activities with less pain and discomfort," Dr Yash Gulati adds.

Disclaimer: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

https://www.hindustantimes.com/lifestyle/health/does-your-body-feel-tight-when-you-wake-up-learn-how-to-manage-morning-stiffness-with-doctor-approved-tips-101729418930826.html

Is it time for a knee replacement?

From health.harvard.edu

By Maureen Salamon

Find out why women undergo this common surgery more often than men — and how to preserve your knee health

Back in the day, going weak in the knees meant something good. Decades later, though, it's merely a glaring sign you may need to replace your natural knee joint — the largest in the body — with a metal and plastic version.

It's a growing phenomenon as the population ages and more people want to stay active as they grow older. Total knee replacement is one of the most common surgeries in the United States, performed in about 790,000 Americans each year — about 60% of whom are women.

What accounts for the sex gap? We're about 30% likelier than men to cope with arthritis in our knees — a propensity driven by factors such as hormones, joint laxity, and anatomical differences between the sexes. And arthritis pain happens to be the culprit that leads to most knee replacements, whether from wear-and-tear osteoarthritis, inflammation-driven rheumatoid arthritis, or post-traumatic arthritis stemming from an injury to the knee joint. 

Ligaments in the knee can also loosen, causing the joint to bend inward or outward. Women also experience this complication more often than men, says Dr. Scott D. Martin, director of the Joint Preservation Service at Harvard-affiliated Massachusetts General Hospital.

But while women are more vulnerable to these knee-wrecking issues, we're also more apt to jump on the problem and be evaluated for joint replacement.

"Men are more reluctant than women to come and get treated," Dr. Martin says. "Women come in sooner, and they tend to be better at sticking with the treatment plan."

Taking the leap

You might have already coped with years of limitations — difficulty walking distances, climbing stairs, or getting in and out of chairs — related to your knee problems. Before knee replacement becomes an option, your doctor will likely require you to have tried every available non-invasive treatment. These include pain relievers; injections of medications such as cortisone and hyaluronic acid, which can dampen inflammation or lubricate the joint; and physical therapy.

Any of the following situations might suggest it's time to consider surgery:

Pain slows you down no matter what you've tried. You're hobbled by pain that hinders you from doing the most basic things. The effects aren't just physical. "If you've tried everything else, it starts to physically, mentally, and emotionally affect you on a daily basis," Dr. Martin says.

Your walking is unstable. As the day goes on, your legs may feel stiffer and weaker. Your knee may even buckle. "After you've been up for eight to 10 hours, your muscles get angry, so you're feeling every step," Dr. Martin explains. "It's not that the arthritis progressed in six hours, it's that the muscles are fatigued." Moreover, this raises your risk of falling.

You need multiple medications to function. Getting through the day may require taking several forms of nonsteroidal anti-inflammatory drugs (NSAIDs) or even prescription pain relievers. But age factors into your ability to continue this regimen indefinitely, Dr. Martin says. Someone in her 40s will likely draw this strategy out for many years, while others in their 60s or 70s may be spurred by their dependence on pain relievers to go ahead with the operation.

Knee-sparing strategies

Even if you have knee problems, you might be able to delay replacement surgery while you protect your knees from further damage. Here are some ways to buy time:

Consider a less-extensive operation. Same-day arthroscopic procedures enable surgeons to use a tiny camera to visualize problems inside the joint and trim away damaged tissues.

Wear a knee brace. This can stabilize the knee, but the approach has drawbacks. "Some people swear by them, but they don't treat the root cause of the problem," Dr. Martin says.

Use topical creams or pain patches. These products can offer targeted relief without side effects common to systemic medications. But pain patches are more effective for muscular pain around the knee than pain deeper within the joint, Dr. Martin notes.

Stay active. Regular exercise — especially low-impact activities like swimming, biking, and walking — keeps leg muscles strong, alleviating knee strain.

Lose weight. If you already have arthritis or a knee injury, carrying extra weight "can greatly accelerate the wear on that knee," he says. "Losing weight can take pressure off the joint."

If you're interested in learning more about knee replacement, consult Harvard's online guide Total Knee Replacement. This in-depth look will help you decide if knee replacement is right for you.

https://www.health.harvard.edu/staying-healthy/is-it-time-for-a-knee-replacement

Ease arthritis symptoms this winter with these four breakfasts, nutritionist says

From getsurrey.co.uk

A nutritionist also revealed some popular foods that could make arthritis symptoms worse 

Arthritis and other joint problems are common in the UK, thought to affect more than 10 million people. While symptoms will vary depending on your specific condition, it can cause issues such as pain, inflammation, joint stiffness and even difficulty moving.

In the winter these symptoms can worsen as cold temperatures can heighten pain sensitivity, slow blood circulation and even cause muscle spasms. Although there is no cure for arthritis, there are ways to reduce pain and ease other symptoms.

As is the case with many medical conditions, focusing on what you eat is one such way to minimise the impact of arthritis. With this in mind, nutritionist Trevor Roberts, from Nutra Ingredients, recommended incorporating four anti-inflammatory breakfasts that could help reduce joint pain and improve overall health.

Smoothie bowls that contain yoghurt and fruit are one breakfast that could help ease arthritis symptoms (Image: Getty)

Oatmeal

According to Trevor, oatmeal topped with almonds and nut butter is a “smart choice” for breakfast. He said: “Oats are rich in magnesium, which is vital for activating vitamin D to assist with calcium absorption. Oats are an excellent choice for breakfast as their high fibre content helps regulate blood sugar levels, which can prevent spikes in inflammation and reduce arthritis pain."

Smoothie bowl

Made correctly, smoothie bowls can be both versatile and nutrient-dense. He continued: “Including dairy products provides calcium, a critical component for bone health, while berries, nuts and seeds are rich in antioxidants that can help lower inflammation and oxidative stress in the joints.

"Berries, such as blueberries, strawberries, and raspberries, are packed with antioxidants and anti-inflammatory compounds. Regularly consuming these fruits can combat chronic inflammation, a major contributor to arthritis symptoms.

"Greek yoghurt is beneficial for breakfast due to its rich protein and probiotic content. A healthy gut microbiome can positively influence inflammation levels, potentially easing the pain associated with arthritis.

"Nuts and seeds, including almonds and flaxseeds, offer powerful antioxidants and anti-inflammatory properties. Including them in your morning breakfast can help neutralise free radicals, protecting your joints from damage."

Egg and spinach

Trevor advised combining egg and spinach for a tasty breakfast wrap that can minimise arthritis symptoms. “Eggs are a natural source of vitamin D, which is crucial for calcium absorption, while spinach provides vitamin K, calcium, and magnesium—all essential for bone strength and joint function,” he said.

"Leafy greens like spinach and kale are often overlooked at breakfast, yet they are rich in vitamins and minerals essential for joint health. Their high fibre content also supports stable blood sugar levels, helping to minimise inflammation."

Salmon and avocado toast

Salmon and avocado on whole-grain toast is not only delicious but also packed with health benefits. He added: “The omega-3 fatty acids in salmon have powerful anti-inflammatory properties that can help alleviate joint pain, while whole-grain bread contributes to reducing inflammation overall.

Trevor also warned of foods and drinks to avoid this winter if you have arthritis or joint issues:

• Processed foods - they often contain unhealthy fats and additives that can trigger inflammation in your body, worsening arthritis symptoms
• Foods made with refined carbs - white bread and pastries can cause spikes in blood sugar levels, which may increase inflammation and lead to more joint pain
• Red meat - this is high in saturated fats, which can worsen inflammation and increase the risk of chronic diseases that affect your joints
• Processed meats - processed meats like sausages often contain preservatives and additives that can trigger inflammatory responses, leading to increased joint pain
• Foods high in sodium - these can cause fluid retention and increased blood pressure, which may worsen joint pain and discomfort.
• Coffee - drinking too much coffee might exacerbate symptoms for some people by triggering inflammation.
• Sugary drinks - drinks like soda and sweetened juices contain high levels of sugar, which can promote inflammation and contribute to weight gain, putting extra stress on your joints.

According to the NHS, common symptoms of arthritis include:

• Joint pain, tenderness and stiffness
• Inflammation in and around the joints
• Restricted movement of the joints
• Warm red skin over the affected joint
• Weakness and muscle wasting.

If you experience any symptoms of arthritis you should speak to your GP.

https://www.getsurrey.co.uk/news/health/nutritionist-breakfast-arthritis-symptoms-30178598