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  1. 1. ARTHRITIS Dr. Michael Vanella
  2. 2. Living with Arthritis <ul><li>For decades, arthritis has been considered a part of </li></ul><ul><li>aging. But not anymore. Recent research points out that older people don’t have to suffer from arthritic pain. And, surprisingly, people much younger than 65 can develop arthritis. </li></ul>
  3. 3. The word “arthritis” means “joint inflammation” and there are two major types.
  5. 5. What is Osteoarthritis? <ul><li>Osteoarthritis is known as OA or degenerative joint disease </li></ul><ul><li>Affects more than 20 million Americans </li></ul><ul><li>More common in women than men </li></ul>
  6. 6. What is Osteoarthritis? <ul><li>The disease affects the cartilage – the slippery tissue on the ends of bones that meet in a joint. </li></ul><ul><li>Cartilage helps bones glide over one another. </li></ul><ul><li>In an OA patient, the cartilage is broken down and wears away. </li></ul><ul><li>As a result, bones rub against each other causing pain, swelling, and loss of motion. </li></ul>
  7. 7. What is Osteoarthritis? <ul><li>Majority of patients are over 65. </li></ul><ul><li>OA is NOT a by-product of aging. </li></ul>
  8. 8. Risk Factors for OA <ul><li>Family history </li></ul><ul><li>Being over-weight </li></ul><ul><li>Lack of exercise </li></ul><ul><li>Prior joint injuries </li></ul>
  9. 9. How is it Diagnosed? <ul><li>OA is diagnosed through </li></ul><ul><li>a combination of clinical </li></ul><ul><li>history, patient </li></ul><ul><li>examination, and x-rays. </li></ul><ul><li>Other tests such as </li></ul><ul><li>drawing fluid from the </li></ul><ul><li>joint are sometimes used. </li></ul>
  10. 10. The Signs of OA <ul><li>Diagnosis is easy </li></ul><ul><li>However it is harder to establish if OA is the cause of the patient’s symptoms </li></ul><ul><li>Treating doctor needs to make diagnosis, plus rule out other disorders and conditions that can make the symptoms worse. </li></ul><ul><li>Timely diagnosis and treatment can help manage pain, improve function, and slow degeneration </li></ul>
  11. 11. The Signs of OA <ul><li>Steady or intermittent joint pain </li></ul><ul><li>Joint stiffness after sitting, sleeping, or otherwise not moving for a long time </li></ul><ul><li>Swelling or tenderness in the joints </li></ul><ul><li>A crunchy feeling or the sound of bones rubbing against each other </li></ul><ul><li>If you experience any of these signs, consult your healthcare provider </li></ul>
  13. 13. What is Rheumatoid Arthritis? <ul><li>It is a rheumatic disease like gout, fibromyalgia, psoriatic arthritis, etc. </li></ul><ul><li>Known as RA. </li></ul><ul><li>Affects about 1% of the US population (about 2.1 million people). </li></ul><ul><li>Often begins in middle age </li></ul><ul><li>More frequent in the older generation </li></ul><ul><li>Young people and children can suffer from the disease. </li></ul>
  14. 14. Distinguishing Features of RA <ul><li>Tender, warm, and swollen joints </li></ul><ul><li>Fatigue, sometimes fever, and a general sense of not feeling well </li></ul><ul><li>Pain and stiffness that last for more than 30 minutes after a long rest </li></ul>
  15. 15. Distinguishing Features of RA <ul><li>The wrist and finger joints closest to the hand are most frequently affected. Neck, shoulder, elbow, hip, knee, ankle, and feet joints can also be affected. </li></ul><ul><li>The condition is symmetrical . If one hand is affected, the other one is too. </li></ul><ul><li>The disease can last for years and can affect other parts of the body, not only the joints. </li></ul>
  16. 16. EXERCISE
  17. 17. Should Arthritis Patients Exercise? <ul><li>Years ago, doctors hardly ever told OA, certainly not RA, patients to “go take a hike” or “go for a swim”. </li></ul><ul><li>Arthritis was seen as part of the aging process and a signal to a patient that it’s time to slow down. </li></ul><ul><li>However there is much more to life for arthritis patients than the traditional recommendation of bed rest and drug therapy. </li></ul>
  18. 18. Should Arthritis Patients Exercise? <ul><li>Exercise is the best forms of treatment for arthritis and prevention </li></ul><ul><li>It strengthens the muscular support around the joints </li></ul><ul><li>Maintains joint mobility and function </li></ul><ul><li>Increases flexibility and endurance </li></ul>
  19. 19. Should Arthritis Patients Exercise? <ul><li>Helps control weight </li></ul><ul><li>Improves mood and outlook </li></ul><ul><li>All these factors are important in influencing the severity of the symptoms. </li></ul>
  20. 20. RA Patients <ul><li>On the other hand need to rest to help decrease active joint inflammation, pain, and fatigue </li></ul><ul><li>They need to have a balance of the two </li></ul><ul><li>More rest during the active phases of RA </li></ul><ul><li>More exercise during periods of remission </li></ul>
  21. 21. Active RA <ul><li>The patients should put joints gently through their full range of motion once a day, with periods of rest. </li></ul><ul><li>To see how much rest is best during flare ups you should talk to your health care provider </li></ul><ul><li>If you experience unusual or persistent fatigue, increased weakness, decreased range of motion, an increase in joint swelling, or pain that last for more than one hour after exercising you NEED to talk to your health care provider. </li></ul>
  22. 22. Exercises for Arthritis Patients Can be done daily and should be done at least every other day. Help maintain normal joint movement and increase joint flexibility. Range-of-motion exercises, e.g. stretching and dance Frequency of Exercise Benefits Type of Exercise
  23. 23. Exercises for Arthritis Patients Should be done every other day, unless pain and swelling are severe. Help improve muscle strength, which is important to support and protect joints affected by arthritis. Strengthening exercises, e.g. weight lifting Frequency of Exercise Benefits Type of Exercise
  24. 24. Exercises for Arthritis Patients Should be done for 20 to 30 minutes three times a week unless pain and swelling are severe. Help improve the cardiovascular system and muscle tone and control weight. Swimming is especially valuable because of its minimal risk of stress injuries and low impact on the body. Aerobic or endurance exercises, e.g. walking, bicycle riding, and swimming Frequency of Exercise Benefits Type of Exercise
  25. 25. Exercise Tips <ul><li>Low-impact or non-weight bearing activities, such as walking, stationary training, and light weight training work best </li></ul><ul><li>Use strengthening exercises if the key muscle groups that relate to the function of the joints are weakened by the degeneration </li></ul>
  26. 26. Exercise Tips <ul><li>If you are overweight, start exercising carefully, so as not to put too much stress on the knee and ankle joints </li></ul><ul><li>Stair climbing, water aerobics, Theraband workouts, and similar exercises will help to keep the joints mobile without straining them </li></ul><ul><li>Learn to read the body signals and know when to stop, slow down, or rest </li></ul>
  28. 28. Nutritional Supplements <ul><li>Are often found to be effective </li></ul><ul><li>Glucosamine and chondrotin sulfate are the two most popular </li></ul><ul><li>When taken over a period of time, they tend to reduce pain and increase function, especially with the knee </li></ul><ul><li>They may slow the progression of the disease </li></ul>
  29. 29. Nutritional Supplements <ul><li>As with medications, take the right amount. </li></ul><ul><li>1,500 mg/day of glucosamine </li></ul><ul><li>1,200 mg/day of chondrotin sulfate </li></ul><ul><li>Different products may contain a different amount of the supplement-sometimes not corresponding to what’s on the label </li></ul><ul><li>To help choose the proper one check with a health professional </li></ul>
  30. 30. Nutritional Supplements <ul><li>Unlike the quick effects of </li></ul><ul><li>medications, it usually takes </li></ul><ul><li>several weeks before you </li></ul><ul><li>feel pain relief or </li></ul><ul><li>improvement in function </li></ul>
  31. 31. Nutritional Supplements <ul><li>Supplements may not be for everyone. Chondroitin sulfate may interfere with anti-coagulant medications. So talk to your prescribing physician before taking </li></ul><ul><li>Glucosamine and chondroitin sulfate have not been studied in pregnant women and should not be taken by them </li></ul>
  32. 32. How Can a Chiropractor Help?
  33. 33. How Can a Chiropractor Help? <ul><li>By the nature of their </li></ul><ul><li>work they can detect </li></ul><ul><li>the earliest degenerative </li></ul><ul><li>changes in the joints </li></ul>
  34. 34. How Can a Chiropractor Help? <ul><li>Trained to: </li></ul><ul><li>relieve pain </li></ul><ul><li>improve joint function </li></ul><ul><li>Through natural therapies: </li></ul><ul><li>chiropractic adjustments </li></ul><ul><li>trigger point therapy </li></ul><ul><li>physiotherapies </li></ul><ul><li>rehabilitative exercise </li></ul>
  35. 35. How Can a Chiropractor Help? <ul><li>Provide nutritional advice, recommending a change in </li></ul><ul><li>diet and perhaps the addition of vitamins. </li></ul>
  36. 36. THANK YOU