Hydrotherapy for Rheumatoid Arthritis: Does It Work?

From healthline.com

Luis Alvarez/Getty Images

If you have rheumatoid arthritis (RA), you’ve likely heard that exercise can help. Physical activity may reduce RA symptoms and make daily activities easier.

The best types of exercise for RA are those that work on your:

• strength
• flexibility
• range of motion
• aerobic conditioning

Exercising in the water covers all these areas.

Hydrotherapy is one type of water exercise. It’s low impact, so it takes the pressure off your joints. You can also customize it to your level of fitness and ability. This makes it a good choice for people living with RA.

This article explores what hydrotherapy is, how it may help with RA, and three hydrotherapy exercises to try.

What is hydrotherapy?

Hydrotherapy, also known as water or aquatic therapy, is a type of exercise you perform in a pool. The water should be warm and the depth should be at a level somewhere between your waist and shoulders.

If you’ve seen a water aerobics class in session at a recreation centre, you’ve witnessed a type of hydrotherapy. A personal trainer or fitness instructor usually leads this kind of class.

You can also do hydrotherapy under the supervision of a physical therapist. In this setting, you might use exercise equipment like a treadmill or stationary bike while in the pool.

In addition to general fitness, people use hydrotherapy to:

• improve circulation
• promote relaxation
• treat conditions involving the musculoskeletal system
• ease anxiety, pain, and depression

You may also use hydrotherapy to help reduce the symptoms of some types of arthritis.

How does hydrotherapy work for RA?

RA is an autoimmune disease involving inflammation and joint damage from free radicals called reactive oxygen species (ROS) and immune cells. Hydrotherapy can help slow this damage.

A 2017 study including 40 people with RA found that a combined treatment approach of medication and hydrotherapy reduced damage from ROS.

It did so by improving the oxidant-antioxidant status in affected individuals. The study authors recommended including moderate-intensity hydrotherapy exercise in RA treatment.

Benefits

A 2012 research review found that hydrotherapy reduces RA symptoms like pain and joint tenderness while relieving tension and improving mood.

Hydrotherapy enables people with RA to exercise more comfortably and be less prone to joint injury. Even though exercise has clear benefits for people with arthritis, some people may be less likely to work out if they experience discomfort.

Hydrotherapy helps remove this barrier. Because the water supports your weight, there’s reduced pressure on your joints and less pain. The warmth of the water also helps soothe pain and improve circulation.

Water creates resistance as you walk through it or move your arms and legs against it. This resistance builds your strength.

It also improves your aerobic fitness, which is important for heart health. With RA, there’s an increased risk of heart disease.

Exercises

You can adapt hydrotherapy to any fitness level. Whether you’re just starting your fitness journey or an experienced athlete, there’s likely a water workout that’s right for you.

Exercise at your own pace and stay hydrated. Remember to pay attention to how you feel and take a break if you experience discomfort.

Water walking

Benefits of water walking for people with RA include strength and aerobic conditioning.

How to do it:

1. Standing in a swimming pool, walk forward 10 to 20 steps.
2. Walk backward to your starting point.
3. Continue for 5 minutes.

Hip kicks

This exercise may help people with RA increase their strength, aerobic conditioning, flexibility, and range of motion.

How to do it:

1. Hold the edge of the pool for support, facing along the edge of the pool.
2. Start with the leg farthest from the pool edge. Keep your leg straight and raise it in front of you so that your leg is parallel with the pool edge, then lower it to its starting position and repeat.
3. Using the same leg, raise it to the side, then lower and repeat.
4. Turn around so you are holding the edge of the pool with your other hand and do both movements with your other leg.
5. Repeat with three sets of 10 kicks for each leg.

Forward lunge

Benefits of the forward lunge for people with RA include building strength, flexibility, and range of motion.

How to do it:

1. Hold the edge of the pool for support.
2. Take a giant step forward and lower yourself onto your front leg while keeping your head above water. To protect your front knee, make sure it stays behind your toes.
3. Return to your starting position.
4. Do the same movement with your other leg.
5. Repeat with three sets of 10 lunge steps per leg.

The takeaway

Hydrotherapy is exercise performed in water, which may be more comfortable than dry-land exercise for people with RA.

You can do hydrotherapy in group classes at your local recreation centre pool. You can also do it with a physical therapist in a specialized setting, like a rehabilitation centre or clinic.

Hydrotherapy benefits people with RA by reducing symptoms, increasing comfort, and improving overall health.

https://www.healthline.com/health/rheumatoid-arthritis/hydrotherapy-for-ra#exercises

What’s the Connection Between Rheumatoid Arthritis and Acne?

From healthline.com

Rheumatoid arthritis (RA) is a chronic autoimmune condition that can cause inflammation in multiple areas of your body. People with RA generally experience painful swelling in their joints, often several joints at the same time.

RA usually affects your:

• wrists
• hands
• feet
• knees

However, it can also affect tissues in your:

• lungs
• eyes
• heart
• skin

Since RA can affect the skin, you might be wondering whether it could cause acne or similar concerns.

Learn more below about whether there’s a connection between RA and acne. This article also looks at other skin conditions related to RA, plus treatments for acne and management options.

Is there a connection between rheumatoid arthritis and acne?

There isn’t much scientific evidence to show acne is related to RA. People who have RA and acne may be experiencing the two conditions independently.

However, research has shown that RA is related to certain other skin conditions. We discuss these in greater detail below.

RA and certain types of acne are inflammatory conditions.

RA is a type of autoimmune, inflammatory arthritis. This means that if you have RA, you have higher levels of inflammation in your body, particularly in your joints.

Though acne may not be related to RA, it’s also an inflammatory condition.

People with acne most commonly experience skin lesions on their:

• face
• upper arms
• back
• trunk

According to a 2020 review, causes of acne can include:

• genetic factors
• hormonal conditions
• overexposure to sunlight
• certain medications
• restrictive clothing

Other skin issues with RA

If you have RA, you may develop other skin conditions, including the following:

Rheumatoid nodules

Around 25 percent of people with RA develop rheumatoid nodules. Typically these nodules only develop in those who test positive for rheumatoid factor or anti-CCP (cyclic citrullinated peptide) antibodies in their blood.

Rheumatoid factor is a protein your immune system produces. It can trigger inflammation, resulting in the destruction of healthy body tissues, especially in the lining of your joints.

Rheumatoid nodules occur most often in white males and can range in size from several millimetres to a few centimetres across.

They usually appear on the extensor surface (area on the outside of a joint) of the arms around the elbow and on pressure points like the fingers and heels. Rheumatoid nodules can also occur in the lungs.

Rheumatoid vasculitis

This is a serious complication of RA that happens in less than 1 percent of people with the condition. It occurs in severe and long-term RA.

Rheumatoid vasculitis causes inflammation in small and medium blood vessels throughout the body — usually those that bring blood to nerves, organs, and skin.

It can present in different ways on the skin, including skin ulcers and blood spots.

Felty’s syndrome

Felty’s syndrome is a combination of:

• splenomegaly (enlarged spleen)
• leucopenia (fewer white blood cells)
• arthritis

It occurs in less than 1 percent of people with RA and can cause:

• rheumatoid nodules
• leg ulcers
• darkening of the skin on the shins and ankles

Granulomatous dermatitis

Granulomatous dermatitis is a plaque-like rash that can be painful and itchy. It usually appears on the trunk and insides of the thighs, but it can develop anywhere on the body.

This condition is uncommon and usually develops only with severe RA in people who test positive for rheumatoid factor.

Medication effects on the skin

RA medication can also cause skin changes, such as rashes. Ask your doctor about possible side effects of your medication and what to do if any occur.

Treatment

Check with your doctor if you’re living with RA and experience skin changes. These could relate to RA or be reactions to RA medication.

If your doctor diagnoses acne, they may suggest an acne treatment.

Your doctor may also refer you to a dermatologist, who specializes in the diagnosis and treatment of skin conditions. They can answer your questions about treatment outlook and side effects.

Topical treatments for acne

Topical treatments for acne include:

• Retinoids: remove dead skin cell build-up
• Antibiotics: kill skin bacteria
• Azelaic acid: removes dead skin and kills bacteria
• Benzoyl peroxide: reduces skin bacteria

Oral medication for acne

Oral treatments for acne include:

• Antibiotics: fight bacterial infection
• Hormonal therapies: help acne flares that hormones have triggered
• Isotretinoin: helps prevent clogged pores and reduce swelling

Other therapies for acne

There are also other acne therapies you can ask about, including:

• Light therapy: kills bacteria using particular wavelengths of light
• Manual extraction: a healthcare provider removes whiteheads and blackheads with special equipment
• Chemical peel: removes surface skin

Therapies for skin conditions in RA

If you have a skin condition with RA, your doctor can recommend treatment based on the type and severity.

Generally speaking, healthcare professionals focus on preventing infection and helping increase comfort for people with RA.

A skin rash may be a sign that your RA treatment isn’t working properly, so treatment for your rash may start with changing your treatment for RA.

Management options

You can help your acne treatment work better by practicing good skin care habits, such as:

• Wash your face twice daily and after sweating.
• Shampoo daily if you have oily hair.
• Avoid picking or popping acne and touching your face.
• Use an oil-free moisturizer so your skin won’t overproduce oil.
• If you wear makeup, use products that are oil-free.
• Get enough sleep.
• Practice stress management.

If you have an RA skin rash, an over-the-counter (OTC) medication may ease the pain. Options include acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil or Motrin).

Ask your doctor to recommend an OTC medication or a prescription medication if you are experiencing severe discomfort.

The takeaway

There doesn’t appear to be a connection between RA and acne, but scientific evidence on this topic is limited. More research needs to be done in this area before a conclusion can be reached.

However, RA is associated with other skin conditions, such as rheumatoid vasculitis. If you’re experiencing skin changes with RA, speak with your doctor.

If you are experiencing acne — whether or not you have RA — speak with a healthcare professional to determine the best treatment for you. Topical, oral, and other treatments are available.

Good skin care and lifestyle habits, like regular face washing and stress management, can also help.

https://www.healthline.com/health/rheumatoid-arthritis/ra-and-acne#takeaway

What a Juvenile Arthritis Diagnosis Really Means for Kids and Parents

From sports.yahoo.com

For nineteen years I took our daughter Annierose to Boston Children's Hospital for joint taps, fever spikes, bleeding ulcers, alarmingly high liver enzymes, MRSA, and staph infections. Why? Because she has juvenile arthritis.

Juvenile arthritis, or JA, is an umbrella term for the rheumatic and inflammatory diseases that affect nearly 300,000 kids and teens in the U.S., more than the total of juvenile diabetes and cystic fibrosis cases combined. Despite so many cases of JA, it's not talked about nearly as much as other conditions.

While JA is an autoimmune disease that can last a lifetime and has no cure, children who are diagnosed, like mine, can live happy, full, and extraordinary lives. Here's what parents need to know about juvenile arthritis.

Understanding Juvenile Arthritis Symptoms

Peter Chiraseveenuprapund, M.D., a paediatric rheumatologist at Rady Children's Hospital-San Diego and associate professor of clinical paediatrics at UC San Diego School of Medicine, says the hallmark symptom of JA is joint swelling and pain. Stiffness in the morning or after sitting for awhile is also a visible sign. This is a full list of symptoms:

• Pain

• Stiffness

• Joint swelling

• Difficulty moving

• Fatigue

• Blurry vision or dry, gritty eyes

• Rash

• Appetite loss

• High fever

All that said, it can be challenging for parents to recognize symptoms. We were unaware of our daughter's compensations. As a three-year-old, it was not unusual to ask to be carried. Sliding down the carpeted stairs on her bum was cute. Not using her tricycle was her choice.

But when her thumb, ankle and knee swelled, our paediatrician sent us to Children's where Annierose was diagnosed with Juvenile Idiopathic (meaning unknown) Arthritis. Watching our active little daughter was now tinged with concern. Was she kicking her leg out to the side when running to avoid bending her ankle? Was she sitting sideways instead of cross-legged because her knees hurt? Was she disguising a limp when she waddled and said, "Look, Mommy, I'm a penguin"?

Getting a Juvenile Arthritis Diagnosis

Blood tests are done to diagnose JA but a negative result does not preclude the absence of the disease. MRI or CT scans, X-rays and ultrasounds can be ordered to check for joint damage. Eyes have to be checked for JA-related diseases that can cause cataracts, glaucoma, vision loss and blindness.

A physical exam is crucial to check joint tenderness and swelling, test range of motion and look for signs of pain. It didn't matter if Annierose denied pain. Our paediatric rheumatologist kept his eyes on her face while lifting and bending her arms and legs. He could detect the slightest flinch, indicating pain and inflammation. Controlling the JA is crucial because inflammation increases growth in that joint. At one point Annierose's right leg was longer than the other. Fortunately her other leg caught up, eliminating the need for surgery. Since children's joints are always growing, inflammation can cause severe deformities.

Juvenile Arthritis Treatment Options

Treatment for JA involves a combination of medication, physical therapy, and exercise. Our daughter has taken drugs used in chemotherapy treatments (Methotrexate), pain relievers, steroids, and biologics (Enbrel, Humira, Orencia, Xeljanz.) Twenty years ago, the first biologic (a medication that alters cellular actions) lifted children out of wheelchairs. But biologics are expensive and compromise the immune system, leaving patients vulnerable to serious infections. Most biologics are administered by injection or infusion. Some children, like ours, develop a needle phobia, adding additional trauma. We consulted psychologists, behavioural therapists, parents, even a hypnotist. Every gimmick or technique worked—for about six months.

Finding Support as a Family

The journey through a chronic paediatric illness can be an overwhelming labyrinth of information and emotion that affects the whole family. Annierose's younger brother was inevitably dragged along to countless medical appointments with one or two-hour-long waits. A sick child requires more of a parent's attention. But after recovering, the family balance is restored. The challenge of coping with a chronic illness is that it never goes away. My husband, a physicist, looked at JA from a scientific perspective which helped us make treatment decisions. As a musician, I produced the emotional reaction to having such limited options.

The Arthritis Foundation's (AF) programs were a godsend. Meeting other families and sharing our experiences was a welcome release valve. Annierose found empathic friends at AFJA summer camp and our family benefited from the wealth of information at the annual AFJA conferences. We had fun as a family, taking advantage of the conference locations: learning about civil rights at Atlanta's Martin Luther King Centre, checking out Washington D.C.'s Spy Museum and testing the rides at Hershey Park and Disney World.

The AF also supports medical research. Andrea Ring, senior director of JA and young adults program, reports that the AF awards fellowship training grants to universities that offer innovative training programs for rheumatologists who will practice in underserved areas. There are currently six states with no paediatric rheumatologist. This means families have to fly or drive long distances with overnight stays for a routine check-up. These expenses affect the entire family.

Despite the challenges of JA, Annierose is completing graduate school as a violin performance and music theory major. With the help of ten daily medications, she can play piano and soccer, ski and hike. We have never let JA dictate our lives, but we have had to make adjustments, a life skill that will serve both our children well.

https://sports.yahoo.com/juvenile-arthritis-diagnosis-really-means-180921449.html

Scorpion venom to help those with arthritis

From abc12.com

Fifty-four million Americans suffer with arthritis. It is the leading cause of disability in the U.S. Treatments used to control arthritis may have side effects that are worse than the condition itself. Now, a potential new treatment using scorpions can give millions of arthritis sufferers much need relief.

Swelling, stiffness, and pain. Arthritis is tough on your joints, but the treatment used to control it could be even tougher.

“Currently in a lot of arthritis diseases, patients are given steroids. But they have to be given very sparingly because of the strong toxic side effects they can have,” explained Natalie Nairn, PhD, Vice President of CDP Therapeutics at Blaze Bioscience.

The effects can include hypertension, glaucoma, osteoporosis, and even immune suppression which can leave patients vulnerable to infections. When a patient takes a dose of steroids either orally or by injection …

“It hits both the joint that you want, but everything else along the way,” illustrated Dennis Miller, PhD, Executive Vice President of Development at Blaze Bioscience.

But now, researchers have found a protein in scorpion venom that can deliver drugs directly to cartilage in the affected joint.

“This can be an excellent way to deliver drugs to inflamed joints of arthritis and get them concentrated where they need to be and help them avoid other tissues we don’t need them to be in,” elaborated Nairn.

The researchers tried this method on an animal model …

“In our top doses, all the animals were showing much less inflammation in their joints,” Miller described.

With fewer side effects. This isn’t the first time the team used scorpion venom for medical purposes. Researchers found that another protein found in scorpion venom can bind to cancer cells, helping doctors to spot them more easily during surgery. But for arthritis …

“What this could actually provide patients with is a good long-term solution to produce anti-inflammatory effects,” Miller concluded.

The researchers say they hope to have this in the clinic setting within the next two years. They are also looking at scorpions for other types of cancers and GI disorders.

https://www.abc12.com/2021/02/22/scorpion-venom-to-help-those-with-arthritis/

My Rheumatoid Arthritis Inspired Me To Become A Personal Trainer

From yahoo.com

Liv Loo, as told to Meghan Rabbitt

Some of my earliest memories are from when I was about 4 years old. I’d go into my mom’s room, curl up into a ball on her floor, and cry because I was in so much pain. Not knowing what was going on with me—or how to help—my amazing mother read every medical encyclopaedia she could get her hands on and took me to countless doctor appointments. Before I was even in kindergarten, I was diagnosed with rheumatoid arthritis (RA)—an autoimmune disorder that causes a painful swelling in your joints and can even damage other organs, like your eyes, skin, lungs, and heart.

Thankfully, the medical specialists I saw were able to treat my symptoms and I was able to have a pretty normal childhood. But as anyone with RA knows, the disease can be elusive, disappearing for stretches and then resurfacing when you least expect it. I’ve had intense bouts of pain—or “flare-ups”—my entire life thanks to my out-of-whack immune system causing inflammation throughout my entire body.

                                                                   

Learning to live with pain

I’m 30 years old now and more often than not, I feel pain in all of my joints—my knees, hips, back, elbows, wrists, and even my fingers. While medication goes a long way toward treating my symptoms, flare-ups still happen, especially when I’m dealing with a lot of stress.

Like many people living with an invisible illness like RA, I tried to hide my chronic condition from my friends and co-workers for a long time. Because others can’t see that something is going on in my body or feel the agony I’m in, I used to be afraid that I’d be called a complainer, a hypochondriac, or a liar. For years, I just wanted to be like everyone else and to feel “normal”.

But about four years ago, something shifted for me. At the time, I was working at a doggy daycare and boarding facility. My job was physically demanding but I loved my colleagues and spending time with animals. While my incredible bosses knew about my condition, they didn’t realize how serious it was; I’d downplayed symptoms for years. But eventually, pretending I wasn’t in near-constant pain became too mentally and emotionally draining, so I decided to tell them how serious my condition actually was. They couldn’t have been more supportive.

Coming clean crystallized two things for me: I wanted to start focusing more on my physical health, and I also wanted to help others living with RA and other chronic pain conditions.

The healing power of movement

During the years that I was hiding my pain from others, I barely worked out. But after I started talking more openly about my RA, I also started asking my body what it needed—and the answer was almost always gentle, intentional movement.

I began taking fitness classes at a nearby gym and tried everything from dance to indoor climbing. While I took classes with a lot of incredible trainers, few of them really understood my condition or how to put together a full physical regimen that would be both strengthening and healing for me. So, I decided to become a certified personal trainer myself.

Soon after I received my NASM certification in 2017, I fell in love with aerial fitness—an exercise class that uses aerial silks and trapeze to build strength, balance, and flexibility. What I loved most about the low-impact workout was the way it taught me how to tap into every muscle in my body. I knew I wanted other women—especially those who were dealing with RA or other chronic pain conditions—to feel that same connection with their bodies that I was finding transformative.                    

Inspiring others to work with their pain

Last year, I started my own business, MovetoLiv, a personal training service that specializes in designing fitness regimens for people with chronic illness. I absolutely love working with this community because we’re fighters. And what I am committed to helping everyone understand is that, while it’s important that we fight the disease, that doesn’t mean we should fight our own bodies.

What I know for sure is that when you have a chronic illness, you have to listen to your body. One way I do this is by personifying it. One day, I’ll tell my boyfriend something like, “My hand hurts—she is cranky today!” I’ve found that doing this one simple thing has helped me learn my body’s language. These days, I know that when I feel pain, it’s my body trying to say she needs or wants something. Sometimes that means I need to stop what I’m doing and sit down. Other times it means getting off my butt and doing some squats.

What I try to teach all of my clients—and remind myself often, too—is to be kind to yourself. It’s not your fault that you have a chronic illness. There will be days when you simply hate your body and want out of it. It’s OK to be in that place. But then, when you’re ready, ask yourself what you can do to flip the switch and get into a different, more positive place. Because when you’re able to show your brave, beautiful self some compassion, there’s no end to how strong you’ll feel.

https://www.yahoo.com/lifestyle/rheumatoid-arthritis-inspired-become-personal-140000704.html                                              

8 Things I Wish People Understood About Psoriatic Arthritis

From healthline.com

By Bonnie Jean Feldkamp

This unpredictable and often invisible illness is hard to manage — and even harder to understand

I’ve had psoriasis since I was in kindergarten. I’d never even heard of psoriatic arthritis (PsA) — nor did I know that psoriasis could lead to arthritis — until I received a PsA diagnosis at age 35.

After 10 years of living with PsA, I’m still trying to wrap my brain around all of its intricacies.

One day, I can be flat on my back trying to figure out how to roll over without wincing in pain.

Other days, I’m hunched over my garden pulling weeds and planting flowers all day long. I treasure those days. Those times when I feel almost normal.

This roller coaster of unpredictability in my symptoms makes it hard to understand, let alone cope with or make plans for.

I’m still figuring it out, so I know that I can’t expect my loved ones to fully understand this disease. That said, here are eight things I really want people to understand about living with psoriatic arthritis.

I don’t look sick 

Psoriatic arthritis is often an invisible illness.

Medications help control the joint swelling and skin symptoms people can see, but joint pain and fatigue still remain and vary in their severity.

I don’t say it out loud every time something hurts, and I don’t admit to everyone that I need a nap. This also means PsA can be a very lonely disease.

I spend a lot of time inside my head navigating invisible symptoms so I’m not a downer to my family and friends.

The road to diagnosis is long 

There’s no blood test to confirm you have PsA. The diagnosis is a medical puzzle.

When my symptoms first emerged, they started with hip pain that I mostly felt at night. I bought a new mattress thinking that was the issue. Then, my right foot swelled so much I couldn’t put shoes on. My right knee also swelled.

Something was definitely not right.

My doctor ran blood tests for gout and rheumatoid factor. They checked for fractures through X-rays.

I bounced between an orthopaedic surgeon who planned to operate on my swollen knee and my primary care physician. It was the orthopaedic surgeon who finally referred me to a rheumatologist, where I received the proper diagnosis of PsA.

Treatment isn’t easy either

Figuring out a treatment that works was a heart-breaking period of trial and error.

It also included fighting with my health insurance company for access to newer, better, and therefore more expensive treatments.

At the time, biologics were new on the market. My health insurance required many months of failed treatments before they would approve a new one. This meant the disease continued to progress each time a drug didn’t work for me.

I walked with a cane, controlled swollen joints with steroids, and spent a lot of time in bed on a heating pad. All of this while coping with the fact that I had gone from being an active mom to feeling like a piece of furniture in my own home. I even had to quit my job.

While our family adapted to mom in a medical crisis, I satisfied my health insurance by going through their approved list of drugs that all ultimately failed. After 6 painful months, my rheumatologist won the fight for my access to biologic injections.

Biologic treatment was a game-changer for me. It gave me my quality of life back and it’s the treatment I still use.

Fatigue is a constant negotiation

PsA is an autoimmune disease, which means my immune system is always on the attack.

The fatigue is like always having a bad cold, except I’m not fighting a virus, I’m fighting my own body. It feels like my head is in a fog and my body feels run-down and heavy.

There’s no runny nose to signal to everyone else that I’m constantly in the midst of battle. I’ve always wanted a T-shirt that read, “I’m so bad, I kick my own ass.”

Rest has to be built into every action plan. Vacations and holiday commitments are brutal. Even work and household chores require daily time allotted for rest.

Movement is necessary

I know what you’re thinking, “Wait a minute, you just said fatigue was the battle!”

Yes, however, I also can’t sit in one place for too long. Joints need movement to remain loose, and if I don’t move enough, it feels like I’m turning to stone with joint stiffness.

I walk or exercise and stretch daily, gauging my limitations as I go.

This makes travel challenging. For example, road trips require frequent stops for walking.

Every day is a balance between getting enough exercise and not overdoing it, and sometimes I don’t know I’ve overdone it until it’s too late. Sometimes, what’s too much one day is not enough the next.

Most times, I know when an activity will be too much and I plan accordingly. It takes practice, experience, and listening to my body. Even then, I sometimes get it wrong.

There’s a lot of fear, anxiety, and sadness involved

One morning while making breakfast, back spasms took me to the floor and an ambulance carted me to the hospital.

Another time, my knee flared for weeks and I struggled to bend it. It was painful and difficult to get in and out of bed, never mind going up and down the stairs.

Once, I had to give up wearing my fitness tracker for 6 months because my wrist flared.

I’ve lived with this disease for more than 10 years now, and it’s still hard for me to cope with new pain and I still can’t identify all the triggers.

With pain comes worry that it may be my new normal.

I never know if pain is here to stay and if I’ll need to cope with it indefinitely. Sometimes, one bad day is just one bad day. Other times, it lasts for months and involves physical therapy or surgery before I get any relief.

And yes, sometimes it is a new normal that requires a workaround in my life. Regardless, new pain is fraught with fear, anxiety, and sadness that feels a lot like grief.

Because my treatment requires immunosuppressant drugs, my body’s defences are muted, leaving me susceptible to infections.

Even before the pandemic, I didn’t open public doors or push elevator buttons with my bare hands and I always had hand sanitizer in my car. Still, I’ve contracted my share of oddball infections.

Now, we’re in the midst of a pandemic that is raising the fear response in so many of us who are immunocompromised.

It’s difficult to access care

Since my diagnosis, I’ve lived in three different cities. Finding a rheumatologist I like and trust has been a challenge.

There’s a shortage of rheumatologists and it’s getting worse. It’s projected that by 2030, the demand for rheumatology professionals will exceed the supply by 102 percent.

For this reason, I travel to teaching hospitals to manage my PsA in fellowship programs. Not only is the care backed by the latest science, but I hope I’m part of a solution that not only helps me but helps strengthen the discipline for future rheumatology patients.

PsA is not my identity

Most people I encounter have no idea that I have PsA. My daily health management is a part of my life that I accept, but I will not allow it to keep me from having a full life.

I’m active professionally and in my community. I do my best to control what’s within my power.

I don’t want pity or exceptions made, but I want people to truly understand and go with the flow when plans change. Let me decide if something is too much. Don’t make assumptions or exclude me because you think you know.

Enjoy dancing with me on good days, but also understand that my bad days warrant rest.

When in doubt, ask.

Medication can slow it down, but PsA doesn’t stop. Thanks to newer treatments, it’s not a fast, downward slide. It’s more like a roller coaster, with ups, downs, and curves.

I plan to do all I can to enjoy the ride.

https://www.healthline.com/health/psoriatic-arthritis/what-i-wish-people-understood-about-psoriatic-arthritis#Its-difficult-to-access-care

The ultimate Arthritis diet: Foods you should consume if you suffer from joint pain

From timesnownews.com

Arthritis can cause severe joint pain. A proper diet should be followed in order to get relief from the pain as you cannot exercise much because of the condition

New Delhi: Arthritis is a disease in which one or more joints of your body swell up and cause pain and stiffness. There may be redness of the skin around the joint and many people complain that the arthritis pain gets worse during the morning. Arthritis is mostly noticed in adults above the age of 60, but in some cases, children also develop symptoms of this condition and have to go through a painful lot. Research and studies suggest that arthritis is more common in a woman as compared to men and can also be caused due to obesity. 

Foods you should consume if you suffer from arthritis and joint pain

1. Ginger- Ginger has anti-inflammatory properties which are beneficial for joint pain. It can be consumed with either tea or warm water. Ginger has a positive effect on reducing swelling and pain around the joints. It is also used in several ayurvedic medicines. Including ginger in your diet has various other benefits too, like weight loss, treating nausea, increasing metabolism and so on. 
2. Apple cider vinegar- There are certain acids in apple cider vinegar which help in absorbing toxins and flushing them out of the body. Apple cider vinegar dissolves the acid crystals that build up in the joint and in turn reduces pain and inflammation. It can be consumed with water or honey. Honey also has anti-inflammatory properties which is a win-win. A spoon of apple cider vinegar in the morning, afternoon and evening can heal your joint pain and arthritis quickly. 
3. Turmeric- Turmeric has a major compound named curcumin which alleviates symptoms of any sorts of joint pain and arthritis. It can be consumed with warm milk before bed to show maximum results. Turmeric has healing properties and can be both eaten and applied around the troubled area. It is used as a medicine in several cases because of its medicinal properties and can do wonders for you. 
4. Fox Nut- Fox nut also popularly known as makhane, is a very important food for curing arthritis and any other kind of joint pain. It has properties that strengthen your bones. It also reduces inflammation and relieves pain. Fox nut can be consumed either directly or with milk to give the best results. Milk contains calcium, which again is beneficial for the bones and should be an important component of your diet. 
5. Spinach- Spinach particularly contains antioxidants and plant compounds which help in fighting the disease. It reduces swelling and redness around the joint. It causes relief in pain and makes movement possible. Spinach decreases the effect of arthritis and is very beneficial in the long run. 

Disclaimer: Tips and suggestions mentioned in the article are for general information purpose only and should not be construed as professional medical advice. Always consult your doctor or a dietician before starting any fitness programme or making any changes to your diet.

https://www.timesnownews.com/health/article/the-ultimate-arthritis-diet-foods-you-should-consume-if-you-suffer-from-joint-pain/701263

Gaining Hip Pain Relief Through Chiropractic Care

By James Schofield

Hip pain comes from a variety of sources and causes varying amount of disability for those experiencing the condition. Fortunately, many people suffering from hip discomfort can gain a measure of pain relief from safe, gentle, effective chiropractic care. This article will discuss causes of hip pain, some natural, alternative methods of hip pain relief and how doctors of chiropractic are trained to assess and treat hip pain related conditions.

During my 35 years of chiropractic practice I have seen many patients experiencing hip pain. There is not one single cause for those suffering from this malady. Different patients experience pain of the hip from differing causes.

Some people have hip pain because the hip has arthritic degeneration. This simply means that the hip joint, which is a ball and socket joint, has experienced wear and tear and now is bone on bone. When I treat a patient of this type I initially assess what might be done to help. First, I always check to see if the pelvis is in good alignment and that the pelvic joints have normal movement. If the pelvis is out of alignment and moving improperly, I will perform chiropractic adjustments to correct alignment and movement. I also like to use a soft-tissue technique where I apply gentle, sustained pressure into the muscles and fascia to aid in the repair of these injured tissues. While these methods can't correct arthritis, they can help reduce inflammation and irritation of the hip joint and help patients to gain a great deal of relief of their hip discomfort.

There are other patients who come to me with what they call hip pain but point to the area where the rear pocket of their pants or slacks is located. This is not the true hip joint, but an area of the pelvis called the sacroiliac joint. The sacroiliac joint is located on both sides of the lower back. It is not located in the centre of the back but more so off to the sides. The sacroiliac joint is a gliding joint. It glides back and forth as we walk. If it is out of alignment and not moving properly it responds very well to chiropractic adjusting. People with this problem usually respond very well to their chiropractic care.

Sometimes, the hip joint itself can become injured due to trauma or a repetitive stress. If this is the case, we can help the inflamed and irritated tissues to repair with electrical muscle stimulation and ice application. At the appropriate time, gentle chiropractic manipulations of the joint help restore alignment and movement.

Doctors of chiropractic are trained to assess and treat hip conditions. It is important to look at the whole patient and not just the actual hip joint, which would limit all the possible causes and the various treatment opportunities available. Chiropractic care is a drug-free, non-surgical, safe, effective, gentle approach for patients to gain pain relief.

https://ezinearticles.com/?Gaining-Hip-Pain-Relief-Through-Chiropractic-Care&id=10414646

Arthritis treatment: Curcumin improves pain, physical function, and quality of life

From express.co.uk

ARTHRITIS is a common condition that causes pain and inflammation in a joint. One of the most common types of arthritis is osteoarthritis. Taking curcumin has been shown to treat osteoarthritis.

In the UK, more than 10 million people have arthritis or other, similar conditions that affect the joints. Osteoarthritis is the most common type of arthritis in the UK, affecting nearly nine million people. As the NHS explains, osteoarthritis initially affects the smooth cartilage lining of the joint.

"This makes movement more difficult than usual, leading to pain and stiffness," says the health body.

Osteoarthritis symptoms can greatly diminish one's quality of life but you can improve the condition by making healthy interventions.

Evidence suggests taking curcumin can improve many of the symptoms associated with osteoarthritis.

Curcumin is the anti-inflammatory compound found in turmeric that gives it its yellow colour.

                           Curcumin improves arthritis symptoms, according to a review (Image: Getty Images)

A review published in the journal Dovepress aimed to summarise the anti-osteoarthritic effects of curcumin derived from clinical and preclinical studies.

Many clinical trials had been conducted to determine the effectiveness of curcumin in osteoarthritic patients. According to the review, patients with osteoarthritis showed improvement in pain, physical function, and quality of life after taking curcumin.

To arrive at this conclusion, a total of 15 relevant clinical studies on the effects of curcumin supplementation on osteoarthritic patients were retrieved.

What to avoid

While some food items are anti-inflammatory, others can make osteoarthritis worse so are best to be avoided.

According to the British Dietetic Association (BDA), Several popular diet books on arthritis advocate avoiding foods such as dairy products or the nightshade vegetables (tomatoes, potatoes, bell peppers and aubergines).

"Though there is some evidence that food avoidance may help rheumatoid arthritis patients, there is no evidence of benefit in osteoarthritis patients," says the BDA.

Diet is not the only remedy for osteoarthritis - exercise can help too. Although it may seem counterintuitive, research shows that people can and should exercise when they have osteoarthritis.

"In fact, exercise is considered the most effective, non-drug treatment for reducing pain and improving movement in patients with osteoarthritis," explains the Arthritis Foundation (AF).

Different types of exercise play a role in maintaining and improving the ability to move and function.

According to the AF, walking and aquatic exercises are particularly good for most people with osteoarthritis.

                            Walking and aquatic exercises are particularly beneficial (Image: Getty Images)

As the health body explains, aerobic exercise also reduces fatigue and builds stamina, while helping control weight by increasing the number of calories the body uses. This is important because excess weight can place pressure on the joints, amplifying symptoms.

Examples of this type of exercise includes walking, jogging, bicycling, swimming or using the elliptical machine.

Other exercises for osteoarthritis include:

• Range of motion or flexibility exercises
• Strengthening exercises.

https://www.express.co.uk/life-style/health/1395960/arthritis-symptoms-treatment-osteoarthritis-curcumin

Common types of arthritis explained

From medicalnewstoday.com

Arthritis is a painful rheumatic condition that causes joint inflammation. There are many different types of arthritis that can affect the joints and other areas of the body and cause similar symptoms, such as pain, swelling, and stiffness.

There are more than 100 different types of arthritis. Some common types of arthritis include osteoarthritis (OA), rheumatoid arthritis (RA), and psoriatic arthritis (PsA).

Below, we explore these conditions, as well as other diseases that can present with arthritis. We also discuss potential treatment and when to seek medical guidance.

OA

Cavan Images/Getty Images

According to the Centres for Disease Control and Prevention (CDC), OA affects over 32.5 million adults in the United States.

Symptoms

Symptoms of OA include:

• pain and swelling in the joints
• joint stiffness
• limited range of motion

People often experience OA symptoms in the hips, hands, and knees.

Risk factors

The following increase the likelihood of developing OA:

• joint overuse, which can happen due to aging
• joint injury
• being female
• obesity
• a family history of OA

RA

RA is an autoimmune condition that causes painful swelling and inflammation in the joints. It typically affects the hands, wrists, and feet.

Symptoms

RA does not only affect joints. It can also cause problems in other organs of the body, including the heart, lungs, and eyes.

While some people experience a sustained progression of the disease, the intensity of symptoms usually comes and goes. Symptoms may include:

• pain, stiffness, and swelling in several joints at once
• fatigue
• unexplained weight loss
• fever

Another characteristic of RA is symmetrical involvement. This means pain and signs of inflammation occur on both sides of the body and in the same joints.

Complications

RA can cause lasting tissue damage, which can lead to:

• recurring pain
• destruction of joints
• deformity or incorrect alignment of joints
• limited joint mobility

Some people who have RA may also need assistance walking.

Risk factors

Some RA risk factors include:

• being older
• being female
• having specific genes
• smoking or being exposed to cigarette smoke early in life
• having never given birth
• having obesity

Psoriatic Arthritis

PsA is an autoimmune condition.

Symptoms

Symptoms of PsA include:

• swelling, pain, and stiffness in the joints
• extreme fatigue
• nail changes

PsA joint involvement is asymmetric, affecting different joints on either side of the body.

This type of arthritis can develop in people with a skin condition called psoriasis, which causes scaly, flushed, or silvery patches of skin. These patches can look different depending on a person’s skin colour.

Risk factors

Researchers still do not fully understand what causes this form of arthritis. However, having a family history of PsA may increase a person’s risk of developing this condition.

Gout

Gout is a type of arthritis that causes painful swelling, often in a single joint at a time.

Symptoms

Symptoms of gout can flare up and go away quickly. They include:

• pain and swelling
• flushed skin
• a joint that feels hot to the touch

Swelling is common in the big toe. Often, it also affects the knee or ankle joint.

Risk factors

A person may be at higher risk of developing gout if they:

• are male
• have overweight or obesity
• take certain medications, such as diuretics or beta-blockers
• drink alcohol
• follow a diet rich in purines or fructose

Health conditions that may lead to gout include:

• heart failure
• high blood pressure
• diabetes
• kidney disease

Gout may also occur due to metabolic syndrome, which is not a condition in itself. It refers to a number of characteristics, diseases, or habits that can make a person more likely to experience other health conditions, such as heart disease, stroke, or diabetes.

Lupus

This chronic illness is an autoimmune condition that commonly affects females aged 15–44 years.

Lupus is not a type of arthritis in itself. However, arthritis is one of the most common symptoms of this condition.

Symptoms

One symptom of lupus is the characteristic butterfly rash that can develop on the face. Other rashes can also develop on the arms, hands, and face. Rashes can worsen after sun exposure.

While symptoms may differ from person to person, they generally include:

• joint and muscle pain
• fever during flare-ups
• hair loss
• chest pain
• kidney issues
• sores in the mouth and nose
• chronic fatigue
• problems with memory
• anaemia
• eye irritation, dryness, and inflammation
• cold sensitivity with colour changes of the hands and feet

Juvenile arthritis

Juvenile arthritis, also known as childhood arthritis, affects children or even infants.

Symptoms

Symptoms of juvenile arthritis include:

• joint pain and swelling
• joint stiffness
• a rash
• fever
• fatigue
• eye inflammation
• loss of appetite
• difficulty carrying out daily activities

Cause

There is no known cause of childhood arthritis. It appears to affect children regardless of race, age, or background.

Diagnosis

Reaching a definitive diagnosis may take time, because many types of arthritis are similar or resemble other conditions.

Typically, a doctor will first check a person’s medical and family history. They will also ask about symptoms and perform a physical exam. They may run tests such as:

• imaging tests, including X-rays, MRI scans, or ultrasound scans
• nerve tests
• blood test
• joint fluid tests
• skin or muscle biopsies

Treatment

Arthritis management depends on the type of arthritis. There are different forms of treatment available.

Medications

Medical treatment for arthritis may involve:

• over-the-counter nonsteroidal anti-inflammatory drugs for relief of pain and swelling caused by inflammation
• corticosteroid injections administered by a physician
• topical pain relief creams and gel
• disease-modifying antirheumatic drugs
• biologics

Surgery

Surgery may not be necessary for everyone with arthritis. However, it can benefit certain complications of arthritis that result in malalignment of joints and functional limitations due to damaged joints. It can also help with intractable pain, which is when a person experiences pain that is difficult to treat or manage.

Common surgeries for arthritis include:

• foot, ankle, hand, or wrist surgery
• hip or knee replacement surgery

Physical therapy

Physical therapy can be a great option for people with arthritis. It can help ease pain or increase activity.

Behavioural changes that can help with arthritis may include:

• getting regular exercise
• quitting smoking, if applicable
• reaching or maintaining a moderate weight
• eating a healthful diet

Home remedies

Some people find certain home remedies helpful in relieving pain and swelling from certain types of arthritis. These may include:

• hot and cold therapy
• mindfulness strategies, such as meditation
• massage

When to contact a doctor

If a person has experienced joint symptoms that last more than 3 days, they should seek treatment from a healthcare professional.

Similarly, if a person has joint symptoms at different times within a month, they should also contact a doctor.

Living with arthritis

Medications and other treatments can help a person manage chronic symptoms, such as pain and swelling.

Pain will come and go with many types of arthritis. However, even if the pain resolves, a person should still seek treatment.

It is important to treat arthritis early. If left untreated, some types of arthritis may worsen over time and cause permanent disability.

Summary 

Arthritis is a painful condition that causes joint inflammation.

Different types of arthritis can cause similar symptoms. It is vital to get the correct diagnosis, as it can help determine most effective treatment options.

The right treatment may also prevent future complications and help a person live a more active life.

https://www.medicalnewstoday.com/articles/types-of-arthritis

6 Ways Psoriatic Arthritis Can Affect Your Nails

From self.com

And tips to care for your nails

Psoriatic arthritis nail changes are one of many frustrating aspects of the autoimmune disorder. Psoriatic arthritis commonly causes pain in places like your fingers, toes, wrists, knees, ankles, or lower back, according to the Mayo Clinic. However, people with psoriatic arthritis frequently develop nail psoriasis, too, which may lead to discomfort and interfere with your ability to do daily tasks, like open a container. In fact, up to 80% of people with psoriatic arthritis have nail lesions, according to a 2017 paper published in Reumatologia.

So why is this important? You may be able look to your nails for some insight into your psoriatic arthritis. “Noticing nail changes in the setting of psoriatic arthritis can be an indicator that your psoriasis is progressing within your body, creating inflammation in various parts of the nail structure and hands,” Scott Paviol, M.D, a board-certified dermatologist in Charlotte, North Carolina, tells SELF.

Below are six nail changes that commonly occur with psoriatic arthritis as well as tips to help you care for your nails.

1. You see grooves in your nails.

Nail pitting is the most common nail symptom associated with psoriatic arthritis. Pits are small indentations that may look like pricks from a small needle, the Mayo Clinic explains. “This is caused by inflammation in the nail matrix,” Dr. Paviol says. The nail matrix is the root of your nail, and when it’s inflamed, you may notice several other symptoms along with nail pitting, according to Marisa Garshick, M.D., a New York City–based board-certified dermatologist. “If the entire nail matrix is involved, the nail can appear brittle, crumbly, and whitish,” she tells SELF. A topical retinoid can help clear up pitting, but your treatment may vary depending on your unique symptoms, according to the American Academy of Dermatology Association (AAD).

2. Your nails are discolored.

You’ll also want to watch out for oil drops, which are irregular yellow-brown patches visible through the nail plate, says Dr. Garshick. Sometimes, the spots are called salmon patches, because of their colouring. You can identify these by looking for a yellowish-brown spot nestled between a white oily patch and the pink part of your nail. It may be possible to treat mild cases with a topical retinoid, but you might need a combination of oral medication and ultraviolet radiation therapy if your nail psoriasis has progressed, according to the AAD.

3.Your fingernail separates from your nail bed.

This condition, called onycholysis, happens when your fingernail becomes loose and separates from your nail bed, explains Dr. Garshick. Generally, the nail separates starting at the tip and travels down to where your nail meets the skin. In severe cases, people can lose their entire nail. The space created by this separation can lead to an infection, which we’ll get to next. Furthermore, you might notice the separated part of your nail looks opaque and has a white, yellow, or green tinge, according to the Mayo Clinic. Onycholysis treatment includes topical retinoids, steroid injections, or a combination of oral medication and ultraviolet radiation therapy, according to the AAD.

4. You have swollen, reddened skin around your nails.

Sometimes people with psoriatic arthritis develop a skin infection around their nails called paronychia, explains Dr. Garshick. This can happen when your nail separates from the bed, when your nails are cracked, or when you have broken skin that allows bacteria, dirt, or other organisms in the cut, according to the Cleveland Clinic. With paronychia, the skin around one or more of your fingernails may suddenly be swollen, reddened, and painful. Paronychia typically requires medical attention; treatment depends on the severity of your infection but could include antibiotics, according to the Cleveland Clinic.

5. Your nails have white spots.

Many people get white spots on their nails, a condition called leukonychia. Sometimes, these are caused by injury or from biting or picking your nails, meaning white spots alone don't necessarily mean your psoriasis is progressing. However, leukonychia can be a sign of psoriatic nails, particularly if you also notice some of these other changes, like pitting. The best way to treat leukonychia is generally managing its underlying cause.

6. Your nails always break.

Weak nails are another classic symptom of psoriatic arthritis, according to Norman Gaylis, M.D., a rheumatologist in Miami. “The tell-tale signs of psoriatic arthritis include a change in the texture of the nails; they are often more brittle and break,” Dr. Gaylis says. Having brittle nails doesn’t necessarily mean that you have also developed nail psoriasis, but it is worth watching for if you have psoriatic arthritis. It's a good idea to protect weak nails by wearing gloves whenever you're participating in activities where they could break.

How to treat and care for psoriatic arthritis nails

It’s best to err on the side of caution and consult with your physician if you’re at all worried about your nails, Dr. Garshick says. “For any individual who has psoriatic arthritis and is experiencing any nail changes, it is always a good idea to talk with your doctor, since it can be important to determine if it is related to psoriasis or not,” Dr. Garschick says.

Dr. Paviol suggests tracking your nail changes (including in your nail’s shape, color, and texture) and how long they’ve been happening in a journal. It can be helpful to make notes of other psoriatic arthritis–related changes, such as new joint symptoms and any skin lesions. If you experience any of these nail changes and joint pain (particularly in new areas), then you may want to talk to your dermatologist or rheumatologist if you have one. (Of course, it’s understandable if you’re worried about scheduling a doctor’s appointment during the pandemic. Many physicians offer telehealth sessions, and you can even send a photo of your nails ahead of your appointment. Here’s more about getting medical care during COVID-19).

In terms of treatment, your doctor may prescribe a pharmacological medication that targets just your nail symptoms or a medication that treats your psoriatic arthritis overall. Ultimately, the treatment will depend on your specific situation.

“Importantly, while some of these medications have been studied specifically for the treatment of nail psoriasis, if someone is struggling with nail psoriasis and psoriatic arthritis, it is important to consider both of these factors when selecting a treatment to be sure to select a medication that will work well for both,” explains Dr. Garshick.

Protecting your nails from injury can help you avoid some of these conditions, particularly if your nails are weak, explains Dr. Paviol. Here are six ways to care for your nails, according to Dr. Paviol and the AAD:

• Trim your nails. Short nails can help prevent your nail from lifting off the nail bed and limit dirt build-up under your nails.
• Wear gloves when doing any type of manual work. You may want to consider wearing gloves when washing dishes, cleaning the house, or doing any other activity that can injure or cause your nails to break. This also helps protect your fingers from irritating cleaners.
• Resist biting your nails and picking or cutting your cuticles. This helps you avoid skin irritation and infection.
• Use moisturizer. Lathering on lotion within three minutes of washing your hands can keep your skin moisturized, which is important since psoriasis makes your skin and nails dry.
• Avoid scraping underneath your nails. Removing the build-up under your nails can cause an infection or loosen your fingernails.
• Stick to your natural nails if possible. Your nails have a greater risk of separating from your nail beds when you use artificial nails. However, it’s fine to lightly buff your nails and use nail polish.

It’s easy to dismiss subtle nail changes, but Dr. Paviol says it’s really important for your overall health to seek medical attention as soon as you’re able to. “Since psoriasis, including nail psoriasis and psoriatic arthritis, is a systemic inflammatory condition, it is a good idea to treat the inflammation quickly and get the process under control in order to limit further damage to the body,” Dr. Paviol says.

https://www.self.com/story/psoriatic-arthritis-nails

Is Your Rheumatoid Arthritis Worse Than You Realize?

From everydayhealth.com

Don’t be so quick to dismiss your symptoms as “normal.” Watch for these signs that you should call your doctor

Once you’ve been diagnosed with rheumatoid arthritis (RA), you may think your pain and other symptoms are all part of your “new normal.” But they don’t have to be.

“It’s important that people with RA monitor their symptoms closely and know their ‘normals’ and ‘abnormals’ to make sure that they are still responding appropriately to their treatment,” says Shereen N. Mahmood , MD, a rheumatologist at Montefiore Medical Centre and assistant professor of rheumatology at Albert Einstein College of Medicine, both in New York City.

Your RA Management Plan May Need to Be Adjusted Over Time

Everyone’s experience with RA is different, as is how well the condition responds to treatment. So it may take some time — and trial and error — to find the right medication regimen.

Most people newly diagnosed with RA start treatment with a disease-modifying drug called methotrexate. But many will need another drug to achieve full symptom control, according to the Arthritis Foundation.

“When changing medications or doses, you may experience a period of mild RA symptoms associated with waiting for the new medication to take effect or mild side effects associated with the medication or dose change itself,” Dr. Mahmood notes. “Often, these symptoms resolve with a little time, but if they persist or worsen, you should talk to your rheumatologist.”

Even if you’ve achieved remission, your RA symptoms could return, particularly if you taper your dosage or stop taking your medication altogether. 

In fact, in a study published in June 2020 in the Annals of the Rheumatic Diseases, 63 percent of those who had their anti-tumour necrosis factor (TNF) dose tapered experienced a flare, and 19 percent showed signs of disease progression at 12 months. Among those for whom their anti-TNF dose remained stable, just 5 percent experienced a flare and only 10 percent showed signs of disease progression.

In addition, some people who take an anti-TNF biologic drug develop antibodies to the drug over time, which limits their effectiveness. Antibodies are cells created by your immune system to fight off infections, and if they mistakenly attack anti-TNF drugs, they can cause the drug not to work as well or increase your risk for side effects.

That’s why it’s important to monitor your condition and talk to your doctor if you experience any changes in how well your RA is regulated.

The Role of Regular Check-ups

When it comes to managing RA, it’s vital that you take charge of your health and be your own advocate to ensure you receive the care you need and maintain a high quality of life. Doing so may warrant regular check-ins with your doctor.

Because RA is a chronic, or long-term, condition, you should see your rheumatologist frequently anyway — ideally every 3 months or sooner — particularly in the first few months after diagnosis, as you start treatment, according to Mahmood. This can help you establish a long-term partnership with your rheumatologist, and allow them to better monitor your symptoms, check for medication side effects, and perform routine blood tests as well as X-rays and magnetic resonance imaging (MRI), if needed, she says.

Signs You Should Call Your Doctor

Aside from routine visits, Mahmood recommends consulting your rheumatologist if:

• You’re experiencing new or worsening symptoms, including joint pain, swelling, or stiffness, especially in the morning 
• You’ve changed treatment regimens and are experiencing more frequent or severe flares
• You keep getting infections
• Your RA is affecting your ability to go about your day-to-day activities 
• Your RA is impacting your quality of life
• You’re not satisfied with how well your RA is controlled

“Sometimes you may experience other related symptoms, including fatigue or unexpected tiredness, low-grade fevers, dry eyes, or unusual skin rashes,” Mahmood notes.

A Treatment Change May Help

“It’s important that you pay attention to these symptoms, as they may be a sign that your treatment isn’t working as well as it should,” says Mahmood.

New or worsening symptoms may also be a sign that your RA is progressing and you need to adjust your treatment.

To regain control of your RA, your rheumatologist may: 

• Adjust your medication dose
• Add another medication to your treatment regimen 
• Switch you to another drug class altogether

It’s Normal to Assess and Reassess Your RA Treatment 

It can take some trial and error to find the right treatment or combination of treatments to get your RA under control. Even then, you may have to reassess a previously successful treatment plan if your RA worsens over time. This process is normal for people with the condition, Mahmood explains.

“Ultimately, the patient-rheumatologist relationship is long term,” Mahmood explains. “Together, you can learn your ‘normals’ and limitations, create goals, and address problems as they arise so that you can continue to live your best life.”

https://www.everydayhealth.com/rheumatoid-arthritis/is-your-rheumatoid-arthritis-worse-than-you-realize/

Arthritis treatment: Could CBD reduce the severity of symptoms in the painful condition?

From express.co.uk

ARTHRITIS pain is the hallmark of the condition, alongside swelling and stiffness in the joints. Affecting more than 10 million people in the UK, could cannabidiol help relieve an achy body?

Cannabidiol (CBD) is found within the cannabis plant, certified the Food Standards Agency. Widely available in supplement form in the UK, what evidence is there that they can relieve painful symptoms of arthritis? The charity Arthritis Foundation explained CBD is "an active compound" that isn't intoxicating, but "may cause some drowsiness". Animal studies suggest that CBD has "pain-relieving and anti-inflammatory properties".

These effects are yet to be validated in "quality studies in human", however anecdotal evidence suggests CBD application has led to noticeable pain relief.

In addition, some people with arthritis who have tried CBD said they noticed an improvement in their sleep and a reduction in anxiety.

So far, "no serious safety concerns have been associated with moderate doses" of CBD.

However, CBD might "might interact" with arthritis medication, such as:

• Corticosteroids
• Certain antidepressants
• Certain medications for fibromyalgia

Specifically:

• Prednisone
• Tofacitinib (Xeljanz)
• Naproxen (Aleve)
• Celecoxib (Celebrex
• Tramadol (Ultram)
• Amitriptyline (Elavil)
• Citalopram (Celexa)
• Fluoxetine (Prozac)
• Mirtazapine (Remeron)
• Paroxetine (Paxil)
• Sertraline (Zoloft)
• Gabapentin (Neurontin)
• Pregabalin (Lyrica)

Arthritis: Could CBD help relieve painful symptoms? (Image: Getty)

"Doctors have not been able to say who might benefit from CBD," said the charity.

• This includes dosage and which form, however there are agreements on the following:
• CBD is not a substitute for disease-modifying treatment for inflammatory arthritis.

Patients who are interested in trying CBD should first talk to the health care provider who treats their arthritis before trying CBD.

Oral consumption

CBD in capsules, food or liquid form is absorbed through the digestive tract.

The delayed onset for CBD may take up to two hours, whereas a liquid tincture sprayed under the tongue could get to work within 15 minutes.

                                CBD drops can be placed under the tongue (Image: Getty)

Topical applications

CBD lotions and balms can be applied to the skin over painful joints in the body.

The Food Standards Agency (FSA) stated CBD extracts are sold as:

• Oils
• Drops or tinctures
• Gel capsules
• Sweets and confectionery
• Bread and other bakery products
• Drinks

Found naturally within the cannabis plant, there has been "little research about the effects they may have".

The FSA don't recommend CBD "for people in vulnerable groups, unless under medical direction". These include:

• Pregnant and breastfeeding women
• People taking any medication

As a precaution, healthy adults are advised not to take more than 70mg per day, "unless a doctor agrees more".

Researchers from the department of neurochemistry at the Maj Institute of Pharmacology, in Poland, looked at CBD used for pain relief.

"Numerous anecdotal findings testify to the therapeutic effects of CBD," noted the researchers, echoing what the Arthritis Foundation stated.

In vitro studies (meaning tested on microorganisms, cells, or biological molecules) have indicated that CBD has "anti-arthritic activity".

This is because CBD "promoted chondrocyte and synoviocyte apoptosis".

Animal studies have also supported the beneficial pain relief effects of CBD. However, "animal studies cannot always be translated into human results", so the findings are limited.

As time goes on, more research will mount on CBD and its pain relief effects, and any side effects that may come to light.

https://www.express.co.uk/life-style/health/1392867/arthritis-symptoms-treatment-pain-relief-cbd-benefits

A healthy lifestyle lowers risk of arthritis

From monitor.co.ug

Arthritis is an inflammation of the joints that can cause devastating joint pain which can be so severe to a patient. The disease, according to health experts is caused by normal wear and tear, body attacks on the immune system, infection and injury among others.   

Dr James Elima, the Director Gulu Regional Referral Hospital, notes that among female patients, the disease is commonly caused by hormonal imbalance. “During menstrual period women experience amino acid concentration in the urine which spreads to the joints.  Also the use of certain family planning drugs may result into such inflammation in the joints,” says Dr Elima.

The experts intimate that there are more than 100 different kinds of arthritis and related conditions affecting patients across the globe including Uganda.

Arthritis just like other non-communicable diseases is becoming prevalent as experts focus their attention on the fight against Covid- 19.

Why we hear less about non-communicable diseases 
Dr Mallon Nyati, a consultant in orthopaedics surgery from Mulago Hospital notes that health experts tend to put more emphasis in controlling communicable diseases than non-communicable ones. 

“As health experts we give more attention to infectious diseases because they spread from one person to another through close contact. They cause high mortality and morbidity rate leading to panic. They therefore, get quick attention by health experts and governments because they can actually be controlled,” says Dr Nyati.

Dr Nyati contends that major focus has been put in primary health care in controlling diseases such as malaria, cholera among others because it is cheap to implement in terms of costs and public measures can be implemented.

“But non-communicable diseases are lifestyle diseases which do not kill directly, patients can live with them for such a long time and actually die from other disease infections. Also, they are difficult to manage and the treatments are expensive. This is why the burden is left on the individual,” he notes.

Types of arthritis 
Dr Nyati puts the disease in two categories namely; infective arthritis such as chromatin arthritis which he says affects mainly the young children because of their weaker immune system. Although the number of children suffering from this is verse across the globe, in Uganda it is on a very minimal rate.

The second category is degenerative types of arthritis which he says are common in adults and aging people. These are types which affect people due to their lifestyle and genetic makeup.

Osteoarthritis 
Also called degenerative arthritis, is the commonest type. Its symptoms include the cartilage in the joints breaking down, eventually causing the bones to rub together due to inflammation with subsequent pain, bone injury and bone outgrowth formation.

It may occur in just one or two joints, on one side of the body. Age, obesity, injuries, family history increase the risk of getting this type of arthritis. It is usually diagnosed using x-ray images and testing of sample fluids to establish presence of arthritis and the infection rate.

Rheumatoid arthritis
In this type of arthritis, the body attacks healthy joint tissue. In most cases both joints are affected and this may end up affecting the heart, lungs, eyes causing dry eyes and mouth. It leads to difficulty in sleeping.

To diagnose this form of arthritis patients need anti-cyclic citrullinated peptide, complete blood count and reaction of body protein test.

Gout
Gout is a form of arthritis caused by the accumulation of urate crystals inside one’s joints. It is caused by a biochemical abnormality in the body.

Dr Nyati stresses that unlike the common misconception, consuming of red meat or alcohol does not cause gout.  However, if consumed in excess, red meat may lead to too much protein in the body thereby attracting other diseases to affect the joint.

“When a person consumes excess protein which is comprised of amino acid, this needs to be expelled through urine but if it becomes concentrated, it is likely that the crystals end up in the joints causing gout,” says Dr Nyati.

Gout, he said is not common in Uganda, and it is more common in men than women.  

Infectious and reactive arthritis 
This is an infection in one of the joints that causes pain or swelling. The infection can be caused by bacteria, viruses, parasites or fungi. It can start in another part of the body and spread to the joints accompanied by fever.

The reactive type can occur when an infection in one part of your body triggers immune system dysfunction and inflammation in a joint elsewhere in your body. The infection often occurs in the gastrointestinal tract, bladder or sexual organs.

Patients speak out
Saidhia Angucia, 38, a resident of Mbuya Zone II says she was diagnosed with osteoarthritis in 2018. She used to experience swollen knees but after treatment the pain is less frequent.  Occasionally the pain comes in the joints for which she takes painkillers.

Christine Adoch, 58, a resident of Atiak in Gulu says doctors at Gulu Regional Referral Hospital diagnosed her with Rheumatoid Arthritis in 2017. Because it was already in a severe state she underwent an operation to extract fluid which was effective.  

Statistical data
According to statistics from World Health Organisation, non-communicable diseases including arthritis affect about one per cent of the population. Dr Elima says he treated 46 patients last year; those suffering from general arthritis were 16 cases, those suffering from septic arthritis caused by injuries were five and those suffering from Osteoarthritis were 25.

There were no deaths and in most cases hospitals upcountry register very minimum cases, he notes.

Dr Nyati notes that in Uganda, there is no concrete data regarding patients suffering from the various types of arthritis. Usually health workers rely on research carried out by health experts and students on case by case basis.

Citing a study done by a group of scientists in Entebbe, Mityana and Nakaseke where 267 patients were sampled, it indicated that 59.6 per cent with injuries had the possibility of developing joint arthritis.

Remedies
The causes and treatment options available vary from one type of arthritis to another.

Dr Nyati, recommends carrying out reasonable exercise to keep the joints fit. The exercise must not be excessive leading to joint injuries which may result into disease infection because ligaments and cartilages may get damaged.

“For instance excessive sports activities such as athletics and football among others may lead to injuries and such sports persons may end up contracting arthritis in later age,” he says.

Some cases can be managed through treatment but surgery is recommended to drain off the accumulated liquid as well as replacement of knee bones with artificial bones for severe ones.

https://www.monitor.co.ug/uganda/magazines/healthy-living/a-healthy-lifestyle-lowers-risk-of-arthritis--3275950

Does exercise contribute to arthritis? Here’s what research says

From marinij.com

By Dr. Salvatore Iaquinta 

A friend says she doesn’t do any strenuous exercise in order to keep her hip and knee joints like new for old age. She doesn’t want to get arthritis and plans on going to the grave with “all her original parts.”

I give her credit for being amusing, but does her plan have any merit? Does exercise contribute to arthritis? And does anyone care what you go to the grave with?

When the time comes, the replacement parts I’m buried with will be the least of my worries.

It would seem like exercise does contribute to arthritis. We all know the former football player with a “bad knee” from those years in high school or college. One of the most famous medical studies of all time actually looked at exercise and arthritis, but most people don’t know it.

The Framingham study started in 1948 in Framingham, Massachusetts. This longitudinal study of just around 5,200 residents is most well known for its observations on heart disease and stroke. This study showed the risks of cigarette smoking, high cholesterol, high blood pressure and obesity. This landmark study is still going today and one of the things being followed is exercise and its effects. The participants reported exercise and injuries, and even had knee X-rays at the beginning of the study and then later points.

Over the decades, some of the group developed knee arthritis. There was no link between exercise (specifically jogging and walking) and arthritis in both symptoms and radiologic findings on follow-up X-rays. Jogging wasn’t worse than walking. Obesity was found to be a risk factor for arthritis, but the more active overweight subjects didn’t get arthritis any more than more slender active patients.

What about the flip side — is strenuous exercise actually good for joints? An Australian study of about 300 adults found the participants who did the most vigorous weight-bearing (not swimming) exercise had the thickest knee cartilage with one exception — those who had injuries.

Taking it another step forward, another study of more than 430 avid runners found no evidence that running caused arthritis throughout 20 years of observation. What they did find was that the runners had less musculoskeletal disabilities than the non-runners. And the runners had a mortality rate 39% lower than the non-runners. These studies have been repeated with college athletes and have not found exercise, even strenuous repetitive exercise, as a risk factor.

So, why is there so much knee arthritis? Injuries. Old injuries have been found to be a leading cause of joint arthritis. Getting back to the old football player, it was the trauma — the sprains or cartilage tears or even fractures — that contribute to arthritis. Another problem is age. Cartilage loses its ability to heal as you get older.

Your parents might be part of the problem. People inherit the growth pattern of their parents, this includes minor abnormalities in how bones are shaped and how they can lead to arthritis. Being female, women unfortunately are more likely to develop arthritis as they get older.

Lastly, as previously mentioned, being overweight adds a disproportionate amount of pressure on the knees. Every extra pound of weight adds 3 pounds of weight to the knees.

Once you have arthritis is when you switch to the exercises that improve muscle strength without significant weight impact. Walking and swimming are great, and even yoga and tai chi help with balance and flexibility.

So is my friend right? Probably not. Not exercising does not seem to help and another study found that weakness of the leg muscles around the knee seems to be its own risk for arthritis. The cardiovascular and other musculoskeletal benefits of exercise outweigh the risk for arthritis as long as you do it safely.

Having all your original parts in the grave doesn’t seem worth it if you never really live. Take a hike — there’s a whole world out there.

https://www.marinij.com/2021/01/31/does-exercise-contribute-to-arthritis-heres-what-research-says/