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