Understanding Arthritis — Types, Treatments, and Myths

From a lecture Series By Professor Dean Hodgkin, B.Sc.

Around 21 million people report that arthritis restricts their functional capabilities in some way, usually manifesting as pain, stiffness, loss of function, and in worse cases, loss of independence. When it comes to joint care, understanding what’s true and what’s not can help you take a positive action to reduce the painful effects of arthritis.
illustration of painful arthritis in knee

Physiology and fitness by The Great Courses

Physiology and Fitness
This fitness course educates you on your body and its response to a variety of exercises. It includes 12 workouts designed by a renowned fitness expert to achieve results.

Know Your Joints…

medical illustration of a synovial joint
Structure of a synovial joint

Synovial joints are the most common and most movable type of joint in the body of a mammal. They are encased by a capsule that encloses the joint cavity and is attached to the periosteum, which is the connective tissue layer that surrounds the bones.

The joint capsule provides support to the joint. The inner layer of this synovial membrane secretes synovial fluid, which is a vital lubricant to help reduce friction at the joint but also provides nourishment for the cartilage that covers the end of the bone. The purpose of this articular cartilage is to help with shock absorption and to reduce friction. The ligaments, help to provide stability.

Types of synovial joints
Types of synovial joints. (Click to enlarge)

So a warm up prior to exercise is such an important concept because moving the joints through their range of motion will stimulate the synovial membrane to produce lubrication in the form of synovial fluid.

A warm up prior to exercise is key, moving the joints through their range of motion produces synovial fluid—a lubrication for easier joint movement. This reduces friction and enhances the shock absorption by the articular cartilage — directly affecting the smooth performance of joint movement and therefore diminishing the risk of injury.

This can be achieved by doing some rhythmic movements such as shoulder rolls, elbow bends, knee bends, neck twists, arm, hip, wrist, ankle circles—all those types of movements will serve to get the synovial fluid moving in the joints.

What, Exactly, Is Arthritis?

Arthritis is actually an umbrella term for a huge number of rheumatic diseases that affect the joints and the soft tissues around them. This includes childhood arthritis, fibromyalgia and lupus that affect both sexes, all ages and in fact every ethnic group. The most common ailments are osteoarthritis, where a joint degenerates through years of wear-and-tear, whereas rheumatoid arthritis is an inflammatory disease affecting multiple joints.

Osteoarthritis

osteoarthritis in the hands.
The formation of hard nobs at the finger joints are a common feature of osteoarthritis in the hands.

Osteoarthritis is the most common form of arthritis and is caused by the degeneration of the hyaline cartilage – a key shock absorber on the end where bones articulate with one another. This can then result in the unprotected bone ends rubbing against each other, which leads to pain, stiffness, and reduced physical capability.

Since it is associated with wear-and-tear, osteoarthritis is commonly seen in the hands, knees and hips of the elderly. Although it actually results from repeated stresses on joints that are beyond their ability to withstand such forces, hence exercise being a key component in reducing the effects of the condition.

Certainly muscle weakness is an important issue. For example, those suffering osteoarthritis of the knee usually show reduced muscle mass in the quadriceps at the front of the thigh and the hamstrings at the rear. However, it’s not always easy to ascertain whether weak muscles caused the condition or vice-versa.

Rheumatoid Arthritis

A diagram showing how rheumatoid arthritis affects a joint (Click to enlarge)

Rheumatoid arthritis is an inflammation of the lining of the joint capsule that spreads to cause erosion of the cartilage and bone. This type of arthritis is often found in multiple joints, and commonly leads to visible deformity of the joint.

Again the likelihood of suffering increases with age, and women seem to be more likely to be afflicted more than men.

In worst cases, rheumatoid arthritis can affect the blood vessels and lead to issues in a number of organs, including the heart and lungs, with associated respiratory problems.

Common Myths About Arthritis

Here are a few common myths concerning arthritis and general health. How many of these have you heard to be true?

  • Myth: Arthritis only affects the elderly.
    Truth: around 60% of sufferers are under 65 including, children suffering from juvenile rheumatoid arthritis.
  • Myth: Arthritis leads to an inevitable decline in quality of life.
    Truth: medication, surgery, and exercise have proven to be effective treatments in limiting the effects of the condition.
  • Myth: Rest is the best option.
    Truth: research has made it clear that carefully prescribed types of exercise can restore functional ability and at the same time reduce pain.
  • Myth: Once arthritis sets in, there’s no way to improve it.
    Truth: patients of all ages and differing degrees of disability have made significant improvements in response to treatment.

Maintaining A Healthy Weight

Excess weight has been shown to increase pain in sufferers; easy to appreciate when you consider your knee has to accommodate around 5 times your body weight when walking up or down stairs. One notable study suggested that a weight loss of just 11 pounds resulted in a decrease in pain of an incredible 50%, so weight management programs, usually the combination of a sensible, healthy diet and regular varied exercise, are vital.

Maintaining An Active Lifestyle

As a result of inactivity, arthritis sufferers are at greater risk of lifestyle disease than the general population

As a result of inactivity, arthritis sufferers are at greater risk of lifestyle disease than the general population, so both cardiovascular and strength training are strongly recommended for the many measurable benefits they have on a wide range of health components. Fear of activity making the condition worse was proven unfounded in a 2003 study that revealed a mixed session of cycling, circuit training, and sport, performed 2 times per week for 2 years led to improvements in functional capability and improved mood status with no measured negative side-effects.

That same year research was conducted to establish whether resistance training could improve the strength of rheumatoid arthritis patients, just as it does for non-sufferers. Again 2 times per week for 2 years was the dosage and improvements in strength ranged from 19% to an amazing 59%, clearly proving the efficacy of strength training as a positive treatment option.

Inactivity due to arthritis can lead to increased weight, which can ramp up the risk of high blood pressure, osteoporosis, diabetes, cardiovascular disease, and some cancers. The American College of Sports Medicine confirms that loss of flexibility, muscle wastage and depression, all associated with arthritis, can all be positively influenced by exercise, even just at moderate to low intensity.

Any form of exercise will help to reverse the negative effects of inflammatory disease on muscle, will help to improve function in daily activities, and will significantly decrease the risk of disability.

Consult Your Doctor About A Fitness Program That Includes Flexibility Training

Flexibility training brings a number of positive benefits but clearly is of extra importance for the arthritis sufferer who faces reduced mobility if no action is taken.

  • You must be warm, so either practice your stretching after a hot bath or perform a gentle warm up beforehand.
  • Unlike strength training, stretching can be practiced every day.
  • Pay special attention to the key problem areas that affect many of us, particularly as we age, these being the lower back, the hamstrings at the back of the thigh and the front of the shoulders.
  • To avoid overstretching unstable joints, ease into each stretch position, just to the point of mild tension and then hold for around 30 seconds. Don’t worry if you notice differences from one side of your body to the other, this will happen.
  • Always avoid bouncing or jerking movements.

In Conclusion…

Not only is it okay for arthritis sufferers to exercise, but it’s actually a highly beneficial and obviously cost-effective treatment option. There are a number of different routes to achieving the necessary gains in cardiovascular fitness, strength, and flexibility. Whatever you choose to do, just remember — as long as you’re moving, you’ll be improving!

From the lecture series Physiology and Fitness
Taught by Taught by Professor Dean Hodgkin, B.Sc
Images by: By OpenStax College [CC BY 3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons
By Drahreg01 – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=1358952

3 Comments

  1. IMHO, taijiquan (tai chi) is the premier exercise discipline for improvement from arthritic conditions. I speak from personal experience: years of practicing daily tai chi (primarily the Yang style), have proven to me that this practice is key to keeping me mobile (able to walk around, pull weeds and use a shovel, etc., etc.), and keeping my joints largely free from pain. Anyone who experiences joint pain/stiffness would do well to give tai chi a try (for example, take a look at Dr. Paul Lam’s Rehabilitation Form on Youtube). Commit to 20 minutes daily and give yourself two months to evaluate whether you are benefiting. I suppose that I am proselytizing; I do wish to share the knowledge of the great health benefits that tai chi practice can provide.

  2. My problem is my lower back. Sometimes I simply ignore the pain, but other times the pain takes my by surprise. Why the difference?

  3. My problem is my lower back. Some times I simply ignore the pain. Other times it takes me by surprise. Why the difference?

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