Health ShortsArthritis
Act Promptly To Stop Inflammation
Early detection and treatment is crucial to avoid the disabling effects of rheumatoid arthritis, an inflammatory disorder that can strike at any age. Although there is considerable variation in the course of the disease, more than two thirds of patients have progressive inflammation that eventually causes considerable damage to joints and makes simple daily tasks difficult. Watch for early signs: puffiness in the joints of the hands and feet and an overall stiff feeling in the morning.
[SOURCE: P. Emery, I.B. McInnes, R. van Vollenhoven and M.C. Kraan, “Clinical identification and treatment of a rapidly progressing disease state in patients with rheumatoid arthritis,” Rheumatology, 2008;47(4):392-398] Anemia and Rheumatoid Arthritis
Anemia can add to the hefty burden of medical problems weighing on persons with rheumatoid arthritis, a chronic and painful inflammatory joint disease. Anemia can result from gastrointestinal blood loss caused by nonsteroidal antiinflammatory drugs used over the long term to treat chronic pain. Recent research shows that anemia may stem from another source: rheumatoid arthritis may interfere with iron metabolism and the maturation process of red blood cells.
[SOURCE: Edward Fitzsimmons and Roger Sturrock, "The Chronic Anemia of Rheumatoid Arthritis: Iron Banking or Blocking?" The Lancet, November 30, 2002] Exercise Key To Controlling Arthritis
Regular, moderate exercise has long been recommended as an key component of arthritis treatment; yet studies show that only 13 percent of patients get the exercise they need. Patients should talk to their doctors about the level of activity and the kinds of exercise most suitable. Possible activities include walking, recumbent bicycle riding, low-impact aerobics, yoga, tai chi, strength training, water exercise and swimming in a heated pool.
[SOURCE: Sherry Boschert, "CDC To Start Campaigns Aimed at Improving Arthritis Care," Family Practice News, October 1, 2002] Look for Signs of Disease Activity
With rheumatoid arthritis, doctors look for signs of “disease activity” or active inflammation, which must be treated aggressively with medication. “Longer and stronger” disease activity generally means increased damage to joints and greater disability. Pain is not necessarily a reliable sign of disease activity, but swollen and “boggy” joints usually indicate ongoing disease activity. Overall stiffness in the morning is a tell-tale symptom of rheumatoid arthritis, and the length of morning stiffness is usually an indicator of the severity of the inflammation.
[SOURCE: “Preventing joint damage from rheumatoid arthritis,” WebMD Medical Reference, Rheumatoid Arthritis Guide New Drugs Improve RA Outcomes
Early and aggressive use of new disease-modifying antirheumatic drugs (DMARDs) appears to be producing improved outcomes for rheumatoid arthritis patients. A Swedish study tracking more than 900 patients from the Oslo area between 1994 and 2004 found increased use of intensive therapy with DMARDs, accompanied by reduced disability and improved quality of life.
By 2004, according to the study, 10 percent of patients were being given DMARDs, including phased introduction of the newer biologic drugs.
[SOURCE: David Scott, “Rheumatoid arthritis is milder in the new millenium: health status in RA patients 1994-2004: Commentary from F1000,” F1000 Medicine, May 9, 2008; T. Uhlig, et al, “Annals of Rheumatic Diseases, January 24, 2008] Reducing Saturated Fats Brings Improvement in Arthritis Symptoms
A healthy diet low in saturated fats (but with higher levels of polyunsaturated fatty acids) was effective in reducing arthritis symptoms and decreasing the need for medication, according to a Moscow study. Two thirds of the subjects reported a marked decrease in joint pain after two weeks. Twenty-four percent were able to lower their intake of ibuprofen and prednisolone.
[SOURCE: "Arthritis Diet Remedies: Fact or Folklore?" PDR Family Guide to Nutrition & Health, Annual, 2001] Strength Training Helps Arthritis
Tufts University exercise physiologists found that arthritis patients undergoing a series of moderately intensive strength training exercises for four months had a 43 percent reduction in pain and a 44 percent improvement in ability to walk, climb stairs, sit and stand, according to a study published in the Journal of Rheumatology. The exercises included leg extensions with light ankle weights and modified squats involving getting up and down from a chair. According to the authors, these exercises were designed to strengthen specific muscles, decreasing the load on arthritic joints.
[SOURCE: "Exercise for Arthritis, Yes, But Which Kind?" Tufts University Health & Nutrition Letter, August, 2003; Miram E. Nelson, Ph.D., Kristin R. Baker, Ph.D., and Ronen Roubenoff, M.D., M.H.S. with Larence Lindner, M.A., Strong Women and Men Beat Arthritis, G.P. Putnum's sons, 2002] Tart Cherries Ease Joint Pain
Tart cherries have as many as 17 different antioxidant substances, and studies have shown they are several times more effective than aspirin or ibuprofen in easing joint pain and inflammation. Wild blueberries are high in anthocyanin, an antioxidant that may also play a role in fighting inflammation.
[SOURCE: "Antioxidants in Tart Cherries Fight Arthritis Pain and Inflammation," Immunotherapy Weekly, December 19, 2001]
Tight Control Loosens Stiff Joints Tight control of rheumatoid arthritis–involving frequent evaluation and change of treatment when needed to reduce inflammation–was confirmed as an effective treatment strategy by the BeSt (Behandel Strategieen) trial. The study found that, regardless of treatment, tight control resulted in improved symptoms and ability to function lasting up to four years. More than half of patients in a group treated with methotrexate plus a biologic TNF inhibitor were able to discontinue use of the TNF inhibitor while keeping the disease in remission.
[SOURCE: Arthur Kavanaugh, M.D., “Early rheumatoid arthritis: the potential role for biologic therapy,” Medscape Rheumatology, March 4, 2008] Vegetarian Diet, Strength Training Recommended To Combat Arthritis
Miriam E. Nelson of Tufts University, co-author of the book Strong Women and Men Beat Arthritis, recommends a vegetarian diet plus strength training as a way of improving the symptoms of rheumatoid arthritis. Arthritis patients in her 16-week strength training session improved their physical function by 44 percent. Nelson's anti-arthritis diet is high in omega-3 fatty acids, natural anti-inflammatory agents found in foods such as flaxseeds and walnuts. It also includes five to servings of fruits and vegetables and avoids the oils in processed foods that may make inflammation worse.
[SOURCE: "Pain, Away! (Scoop: Health Fitness Nutrition Diet Supplements Personal Care Environment," Vegetarian Times, March, 2003]
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