Arthritis

---

Arthritis

Here's a disease that's so common that nearly one in seven Americans already has it--and a new case is diagnosed every 33 seconds. In fact, arthritis is the most widespread chronic disease in people over age 45, even when you consider the untold millions who never see a doctor about that blasted pain in their joints.

When you do see a doctor about that blasted pain, he will usually tell you what kind of arthritis you have. Although there are more than 100 different types, most fall into two broad categories.

Inflammatory arthritis (or rheumatoid arthritis) is best treated with anti-inflammatory drugs, though diet and lifestyle changes may help. Noninflammatory arthritis (or osteoarthritis) results when cartilage in joints deteriorates from injury or excessive use. Weight control, proper exercise and pain relievers are the key treatments here.

Although arthritis is potentially crippling, there are things you can do that may help control it. Here's what doctors recommend.

Eat your vegetables. Researchers at the University of Oslo in Norway discovered that people with rheumatoid arthritis who began a vegetarian diet saw dramatic improvements in their conditions within one month after cutting out meat, eggs, dairy products, sugar and foods with gluten, such as wheat bread. "A vegetarian diet is good, because the goal for arthritis sufferers is to cut as much saturated fat from their diets as possible and replace it with more polyunsaturated fat," says Paul Caldron, D.O., a clinical rheumatologist and researcher at the Arthritis Center in Phoenix.

Try something fishy. One of the best sources of polyunsaturated fat is cold-water fish such as salmon, sardines and herring. "They are rich in omega-3 fatty acids, which have been shown to have some minor beneficial effect on reducing the inflammatory aspects of arthritis," says Dr. Caldron.

Get hot on hot pepper cream. Research shows you can ease the pain by rubbing the joint with an over-the-counter ointment called Zostrix, made from capsaicin--the stuff that puts the hot in hot peppers. "You need to apply it three or four times a day on the affected area for at least two weeks before you'll see any improvement. An initial burning sensation at the site is not unusual for the first few days, but this goes away with continued application," says Esther Lipstein-Kresch, M.D., an assistant professor of medicine at the Albert Einstein College of Medicine of Yeshiva University in New York City who has done research at Queens Hospital Center in Jamaica, New York, and who has studied the effectiveness of capsaicin cream. "I also advise washing your hands immediately after you apply it--or even wearing gloves when you apply it--because it can sting and you don't want to get it in your eyes." (Sorry, but eating hot peppers won't help relieve arthritis.)

Use a dehumidifier. If the humidity is kept constant in your house, it can help calm arthritis pain caused by weather changes, says Joseph Hollander, M.D., professor emeritus of medicine at the University of Pennsylvania Hospital in Philadelphia. When rain is on the way, the sudden increase in humidity and decrease in air pressure can affect blood flow to arthritic joints, which become increasingly stiff until the storm actually starts. If you close the windows and turn on a dehumidifier--or run the air-conditioning in summer-you may be able to eliminate this short-term but significant pain.

Remedies for Your Specific Aches From head to toe, there are specific arthritis treatments for specific body parts, according to Paul Caldron, D.O., a clinical rheumatologist and researcher at the Arthritis Center in Phoenix. Give your neck a break. Don't extend your neck by looking up for long periods. If you're painting, hanging curtains or doing other work that requires you to look up for long a time, get a ladder and bring yourself to the same level as the work. Support your shoulders. Don't sleep with your arms over your head, because that strains your shoulders. Dr. Caldron advises women to lighten their handbags so that they carry only what they need. And big-busted women are advised to get bras with more support to ease shoulder strain. Glove your hands. Wear gloves with a thick palm padding--like work gloves--whenever you're holding something tightly. With thick gloves you don't have to exert as much force on the hand joints to hold a heavy skillet, a broom or a wrench. Also, you can build up handles of tools and garden supplies with foam rubber padding or terry cloth, so you're exerting less force on the joints. Near squat or kneel. That's about the worst thing you can do to arthritic knee and hip joints. Wear running or walking shoes whenever possible. To ease the pressure on aching feet, you want footwear that provides comfort and support. When shopping for dressier footwear, look for shoes that have a wide toe box and good, built-in arch support. The best shoes have heels approximately 1 to 1 l/2 inches high, and they come up high on the instep. For men, a lace-up oxford, as opposed to a slip-on, is the preferable dress shoe.

Stay active. "Probably the most important thing you can do for osteoarthritis is exercise as much as you're able to," says Halsted R. Holman, M.D., director and professor of medicine at the Stanford University Arthritis Center in Stanford, California. "You'll find that the better your physical condition, the less arthritis pain you'll have."

Dr. Caldron recommends low-impact aerobic exercises and, if tolerated, very light weight lifting with one- to two-pound dumbbells. "Build up the muscle and tissue surrounding the joint," he suggests. "You can exercise on a floor mat, in a chair, on a stationary bicycle or in the water. The key is regularity, doing it no less than three times a week but preferably daily."

Learn your food "triggers." "Some people with rheumatoid arthritis experience flare-ups after eating certain foods--especially alcohol, milk, tomatoes and certain nuts," says Dr. Caldron. "Although there's really no telling what your trigger might be, if you notice your condition worsens after eating a certain food, then listen to your body and avoid that food." The same goes for foods that improve arthritis, such as fish and fiber; try to eat them more regularly.

Take time to smell the roses. When you're tensed up, you hurt more. "Many people use relaxation as an effective way of diminishing arthritis pain," says Dr. Holman. "It really doesn't matter what you do--biofeedback, meditation, even listening to music--whatever helps you relax. The point is to practice a regular relaxation period and then also to use relaxation when pain is particularly severe."

Slim down. "Being overweight can enhance damage to joints by putting excess pressure on them, resulting in worsening osteoarthritis, so I advise losing any excess weight you're carrying," says Richard M. Pope, M.D., an arthritis researcher and chief of arthritis/connective tissue diseases at Northwestern University Medical School in Chicago. In fact, being overweight increases your risk of developing osteoarthritis, even if you don't have it now.

Try slow dancing. Dancing is a good way to combine weight loss, exercise and stress reduction. "Many of my patients participate in easy dance routines created as part of an overall education and activity program that shows them how to exercise while protecting their affected joints," adds Dr. Pope. "Easy, slow dancing is perfect for those with inflammatory arthritis, or osteoarthritis, because it's low impact.

Reach for the "right" pain reliever. Not all pain relievers are the same--at least for those with arthritis. "People with inflammatory arthritis should get more relief from aspirin or ibuprofen (Advil) but may get more stomach irritation with these," says Dr. Caldron. For over-the-counter pain relief without stomach irritation, he recommends acetaminophen (Tylenol) Recommended doses of these drugs should not be exceeded, nor regular dosing continued, for more than three weeks without consulting your physician.

Immobilize the pain. "Splints, slings, cervical collars and other protective devices are extremely useful when an area is particularly painful or inflamed," says Dr. Caldron. But he cautions that you can't leave on these devices for more than two days at a time. Even though these devices help reduce pain, your muscles can "rely" on them and weaken very quickly.

Use ice and heat judiciously. Although both ice packs and heat packs can provide some relief, don't use either for more than ten minutes at a time, advises Dr. Caldron. Usually ice is used to prevent swelling but may also douse pain; heat in small doses may promote muscle relaxation and soothe pain.