Understanding and Managing Arthritis During National Arthritis Awareness Month

Osteoarthritis impacts millions of people worldwide. Arthritis, a condition characterized by joint inflammation, can cause pain, stiffness, and reduced mobility. This post will delve into joint health and pain management strategies, and provide low-impact exercises to improve flexibility and reduce discomfort.

Several surgical procedures in the extremities and spine can increase the risk of developing or accelerating post-traumatic osteoarthritis (PTOA). Invasive procedures like surgery, even to repair an injury, can often lead to a change in the joints’ biomechanics. If not rehabbed appropriately, these changes in movement patterns can result in wear and tear on the anatomical structures eventually leading to arthritic changes in these areas. Here are current statistics from the National Institute of Health (NIH): 

•  ACL reconstruction- Research indicates that the likelihood of PTOA is 3 to 5 times higher in knees that have undergone ACL reconstruction compared to the opposite, uninjured knee. 
• Meniscal repair-, especially when successful, is generally associated with a lower risk of developing osteoarthritis compared to meniscectomy or not repairing a meniscal tear. Some studies show that meniscal repair can be associated with a 25-50% lower risk of developing knee osteoarthritis compared to partial meniscectomy (APM).
  •  However, a failed meniscal repair can increase the risk of osteoarthritis. Other studies have reported a higher risk of osteoarthritis in cases of failed meniscal repair, with some studies even showing a 5-fold increase in risk. 
• Rotator cuff repair- can increase the likelihood of developing osteoarthritis in the shoulder joint, although the exact increase varies. Studies show that 10-20% of patients may develop progressive osteoarthritis after a rotator cuff repair. Factors like larger tear size, older age, and the number of suture anchors used can influence this risk. 
• Labral repair- particularly in the hip, is often associated with a slightly increased risk of osteoarthritis development or progression. While the exact increase in risk varies, some studies suggest that 1 in 5 people will develop osteoarthritis within two years after hip arthroscopy, including labral repair, which is comparable to the rate seen in patients with FAI syndrome treated non-surgically over a longer period. 
• Microdiscectomy- surgery can increase the risk of developing osteoarthritis, though the exact magnitude is difficult to quantify and varies depending on the patient and the surgical technique. Studies suggest around a 11% increase in risk compared to the general population. Additionally, the degree of surgical technique and extent of disc removal can influence the risk of segmental instability, which can contribute to osteoarthritis. 

 Joint Health Basics

Joint health is crucial for overall well-being. Joints are where two or more bones meet, and they allow for movement and flexibility. In arthritis, these joints become inflamed, leading to pain and limited function. Maintaining joint health involves several key factors.

Diet and Nutrition

Dietary Component	Benefits	Examples
Omega-3 Fatty Acids	Reduces inflammation	Fish, flaxseeds, walnuts
Antioxidants	Protects against cell damage	Fruits, vegetables, berries
Calcium and Vitamin D	Strengthens bones	Dairy, leafy greens, fortified foods

Weight Management

Maintaining a healthy weight reduces stress on joints, especially in the knees and hips. Even small amounts of weight loss can make a significant difference in joint pain and mobility. Losing 5lbs of weight can decrease the force on your body by approximately 20lbs.

Dr. G’s Recommendations for Pain Management 

Arthritis pain can be managed through various strategies. Physical therapy can improve joint function and reduce pain through targeted exercises and therapies. Appropriate exercise strengthens the muscles supporting the joints and improves flexibility. By strengthening support musculature like your glutes, core, and scapular stabilizers it will absorb some of the force away from the innate structures like your bones and joints. Low-impact activities like yoga, cycling, and swimming are recommended for individuals with arthritis.

Medications

Over-the-counter and prescription medications can help reduce pain and inflammation. Consult a healthcare provider for personalized recommendations.

Heat and Cold Therapy

Applying heat or cold packs to affected joints can provide temporary pain relief. Heat can relax muscles and reduce stiffness, while cold can reduce inflammation.

Assistive Devices

As a physical therapist, I have a knee jerk reaction to avoid assistive devices at all costs to prevent muscle wasting in the surrounding musculature needed to support your joints. However, balance safety while ambulating trumps all. Using assistive devices like canes, walkers, or braces can reduce strain on joints and improve balance, mobility, and safety when fitted properly. 

Low-Impact Exercise Programs

Low-impact exercises are ideal for individuals with arthritis, as they minimize stress on the joints while providing the benefits of physical activity.

• Walking- it’s a simple and effective low-impact exercise. Start with short walks and gradually increase the duration and intensity.
• Water Aerobics – is gentle on the joints and provides resistance for muscle strengthening. The buoyancy of water supports the body, reducing stress on the joints.
• Cycling– is another low-impact exercise that strengthens leg muscles and improves cardiovascular health. Use a stationary bike or ride on flat surfaces.
• Yoga and Tai Chi– involve gentle movements, stretching, and deep breathing, which improve flexibility and reduce stress.

Sample Weekly Exercise Schedule

Day	Activity	Duration
Monday	Walking	30 minutes
Tuesday	Water Aerobics	45 minutes
Wednesday	Rest	–
Thursday	Cycling	30 minutes
Friday	Yoga	60 minutes
Saturday	Walking	45 minutes
Sunday	Rest	–

Conclusion

By adopting a healthy lifestyle, managing pain effectively, and engaging in low-impact exercises, individuals with arthritis can improve their quality of life. Always consult with healthcare professionals before starting any new exercise program or making changes to medication.