by Wendy McBrair, MS, BSN, CHES
So you think you have arthritis, and you’re not sure what to do. If you’re like many people, you may try to ignore your pain and discomfort, hoping they will just go away. But ignoring your problem is not the answer. It is usually best to address the issue head-on, and the tips listed here can help you do just that.
Remember not to diagnose yourself, saying “it must be a little arthritis” and just ignoring your pain. Early visits to the doctor can help you get appropriate care and may also help prevent problems. There are more than 100 different types of arthritis, and each one may need to be treated differently. A doctor needs to be part of your care.
Find a doctor who knows about the different types of arthritis. This may be your family doctor, a rheumatologist, an internist, or an orthopedic surgeon. In most instances, your care will first be handled by the family doctor, unless he or she determines that a specialist is needed. Sometimes, people with arthritis need to see specialists other than rheumatologists and orthopedic surgeons. These other specialists may include podiatrists, dermatologists, physiatrists (medical doctors who help restore physical functioning), and health professionals such as occupational therapists and physical therapists. Remember that you can have a say in deciding when it is time to see a specialist.
Know that it may take time to obtain a specific diagnosis. A doctor who suspects arthritis will look at your medical history, give you a physical exam, and order blood tests and possibly x-rays. However, arthritis symptoms do not all show up at once, so the doctor may need to observe the course of symptoms over a period of time. Once the doctor is reasonably sure what type of arthritis you have, treatment can begin.
Come prepared to your doctors’ appointments and other health-care visits with an up-to-date list of your medicines — prescription, over-the-counter, and supplements. Listen carefully, ask questions, and write down instructions. It may be helpful to take someone with you. And let the doctor know if you do not feel comfortable with a particular treatment plan. There may be an alternative.
Learn about the type of arthritis you have and about what is considered appropriate care. In addition to the articles found in this magazine, there are many excellent pamphlets on arthritis and its care available from the Arthritis Foundation and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Books such as The Arthritis Helpbook by Kate Lorig and James F. Fries offer good introductions to arthritis and its treatment. The Arthritis Self-Help Course is also an excellent source of quality information on how to deal with arthritis and its symptoms. To find a course near you, contact the local chapter of the Arthritis Foundation. Again, make sure you check any resources you use with your doctor or another health professional.
Realize that your doctor may want you to take medicines such as anti-inflammatory drugs, pain relievers, and even joint injections. The goal of these medicines is to reduce pain (and in some cases, inflammation) and fatigue and increase mobility. For some types of arthritis, even stronger medicines may be needed. Fortunately, there are lots of choices. You and your doctor will work together to decide what is best for you. Learn about the medicines the doctor is suggesting. You can find information about medicines on the Arthritis Foundation and NIAMS Web sites (see tip #5), on the MedlinePlus Web site, or in books such as the Helpbook mentioned above.
Your doctor may want you to begin an exercise routine or program. This may be with either a physical therapist or a community organization such as the Arthritis Foundation, YMCA, or local hospital. Or it may be a program that you can follow by yourself at home. Many of these programs have been shown in studies to be helpful. But make sure that any program you begin is appropriate for people with arthritis and, if it is in a group, that it is led by someone who knows about arthritis. Know your limitations and increase the intensity of your program gradually. If you are in a group that exercises for an hour, for example, you may need to stay for only a half-hour, skip some exercises, or do fewer repetitions, at least for the first few weeks.
Arthritis can make you feel tired, and this needs management, too. When you are in pain or when you have a lot of inflammation, the tendency is to want to rest. However, too much rest can lead to deconditioning, which can end up increasing your pain, decreasing your mobility, and leaving you even more tired. It is best to work toward a balance of rest, activity, and exercise.
These can include the application of heat or cold to the affected joints. Heat can come in the form of microwavable packs, a hot shower or tub bath, a Jacuzzi, or a warm pool. Cold packs or ice are usually the best ways to apply cold (though ice should not be put directly on your skin). Talk with your doctor or physical therapist about what techniques to use and when and how to use them properly.
Popular techniques include guided imagery, tai chi, meditation, and yoga. These techniques work best when they are practiced regularly. Many can be learned from a video or audiotape or in a class at a local community center and can be a lot of fun.
The four p’s — pacing, planning, prioritizing, and problem solving — can serve as general guidelines for managing your arthritis, helping you conserve your energy, reduce fatigue, and still get things accomplished. Accomplish something every day, but stop whatever you are doing before you get tired, stiff, and sore. Avoid doing a lot on one day and being exhausted or in pain the next. Remember to rest between periods of activity. If you find that you cannot do all the activities you used to do, decide which ones are essential and which can be dropped. Alternatively, find creative ways to do things you used to do — or get someone else to help you do them. Occupational therapists can help you learn the four p’s and recommend energy conservation ideas and self-help aids and gadgets.
Try to get 8–9 hours of sleep each night. A rest or nap in the afternoon can also be very helpful. Being well rested helps make daily challenges less challenging. If you are having trouble sleeping, talk to your doctor or therapist.
Try to maintain a healthy weight, as being overweight puts more stress on your joints and makes getting around more difficult. See a nutritionist if you have questions or need help with healthful eating or weight loss. Discuss calcium and vitamin D with your doctor — these nutrients can help prevent osteoporosis (people with certain types of arthritis, such as rheumatoid arthritis, are at a higher risk of osteoporosis, as are people who take oral corticosteroids, often prescribed for inflammatory arthritis). Also, some medicines may require other changes to your diet. For example, people on oral corticosteroids are advised to reduce their salt intake because corticosteroids cause the body to retain salt, which can bring about high blood pressure and weight gain.
Discuss emotions or frustrations you may be experiencing with your family, friends, counselor, clergy, or support group. This can help you deal with the difficult feelings that can go along with arthritis. Adapting to a life with arthritis is hard, and most of us need a little support. In fact, studies have demonstrated that good social support is the key determinant to good health. If you feel depressed for more than a few weeks, talk to a mental health professional. Try not to be too hard on yourself. Adjusting to a chronic health problem takes time. Most of all, you should not feel guilty about your arthritis.
Know that sometimes surgery may be needed — though in most cases it is a last resort, only performed after you and your doctor have tried all other options. The good news is that surgeries such as total hip and total knee replacement can restore mobility and reduce your pain.
If you work outside the home, continue to do so if you can. Adjust both home and work schedules in whatever ways are open to you to make this possible. If you feel that you can no longer work, look into applying for disability benefits. Giving up your job is not easy, but if you do decide that work outside the home is not for you, look for other things you can do. Sign up for volunteer activities in your community, take up a new hobby, and make sure you keep fun in your life.
It may seem counterintuitive, but there is good that comes with arthritis, and at some stage, hopefully, that good will become obvious to you. You may find you have grown closer to your family and friends or learned more about what is really important to you. You may realize that you have incredible strength or have developed new talents. And you may have met others with arthritis who inspire you, as well as wonderful, capable doctors and other health professionals. Though the journey through life with arthritis will be more challenging, you can help yourself to meet the challenge.
Last Reviewed October 13, 2010
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