The most common type of arthritis is osteoarthritis, a progressive disease of the whole joint that leads to the breakdown of joint cartilage and the underlying bone. When there is too much breakdown in the cartilage, it can result in bones rubbing together, which causes swelling and pain.

Andrea Nunn is a physiotherapist at Sunnybrook’s Holland Centre, where she works with patients who have osteoarthritis in the hip or knee, providing exercises and education through the GLA:D Canada program. She also helps patients rehabilitate following joint replacement surgery. Andrea shares some insights into how to reduce your risk of osteoarthritis. Read those tips below, as well as information on signs, symptoms and treatment options from GLA:D Canada and the Arthritis Society of Canada.

Signs and symptoms of osteoarthritis

While osteoarthritis can occur in any cartilage-covered joint, it is especially common in the knees, hips and lower spine because of the load these joints bear on a daily basis.

Typically, symptoms may begin with pain, either in the knee when it is bearing weight (standing, walking, climbing), or in the hip joint. In the hands, osteoarthritis is most common in the ends of the fingers and base of the thumb, leaving them feeling stiff and tender.

People with arthritis may notice that daily tasks become more challenging, such as putting on socks, getting into a car or even clenching a fist.

Symptoms may begin slowly, starting as pain with movement and, as the arthritis progresses, the pain will likely become more constant. Most people will see progression slow, sometimes even stop completely, but others will experience rapid deterioration.

If you are experiencing new pain or stiffness in your joints, or reduced mobility that is making it difficult to do daily tasks you could do before, reach out to your family physician.

Treatment

Since every patient will experience arthritis differently, doctors can’t predict how the disease will progress for an individual. It’s also why, even though a patient may get X-rays to see if there are any changes to the cartilage surrounding the joint, diagnosis is made based on symptoms because oftentimes, a patient is experiencing more severe symptoms than might be indicated in an X-ray.

There is no known cure for cartilage loss, so any treatments for arthritis are designed to reduce symptoms and improve joint function.

Exercise 

Osteoarthritis often causes pain, which can lead to people reducing their physical activity to accommodate the discomfort. According to GLA:D Canada, research has shown that reduced strength in the muscles can worsen arthritis symptoms, so maintaining consistent physical activity is important for patients with arthritis. Exercise can also improve overall health and wellness and quality of life.

People with arthritis can find benefit from improving strength, flexibility and cardiovascular fitness, but before beginning a new exercise program, speak with your family doctor.

Other treatment options

Other treatment options for arthritis can include referrals to healthcare professionals such physical therapists or occupational therapists. Medication is an option for pain management, and if arthritis becomes severe, surgery may be required. It’s important to stay in contact with your family physician who can help develop a plan of care based on Health Quality Ontario’s Quality Standards for Osteoarthritis. They can connect you with any other appropriate healthcare professionals to help manage arthritis symptoms and make a referral to a Rapid Access Clinic for assessment for surgery, if required.

Once diagnosed with osteoarthritis, you will have it for life, says Andrea, but symptoms will vary depending on the person and can be managed with treatment.

Reducing Risk

Andrea says there are several ways for people to reduce their risk of osteoarthritis.

“Preventing joint injury earlier in life can reduce your risk of developing osteoarthritis,” she says. “We’re seeing more joint injury prevention programs for young people playing sports now because there can be long-term consequences if you have traumatic injury to a joint, even as young as teenage years.”

Andrea says people who work in industries such as construction and are putting a lot of load on their joints on a daily basis should be aware of their risk of developing osteoarthritis and can take steps to reduce that likelihood.

“Trying to use ideal body mechanics is important—alignment of hip, knee and foot,” she says. “Being balanced in your whole posture and body will help too.”

Maintaining an optimal body weight can help prevent osteoarthritis. Andrea says two pounds of extra weight can increase the joint load by three to five times, which means that losing weight can improve symptoms of osteoarthritis.

Finally, Andrea says consistent movement and physical activity is important for healthy cartilage and strong muscles, both of which can reduce the risk of osteoarthritis.

“Muscles help absorb some of the load the joints would normally take,” she says. “They also help to improve stability of the joint.”

And she says cartilage needs “dynamic load” to stimulate it, so regular movement means the joints are loaded on a regular basis and that encourages cartilage to regenerate.

Living well with arthritis

Andrea emphasizes that an arthritis diagnosis doesn’t necessarily mean a lifetime of pain and discomfort. Symptoms can be managed, and with some simple adaptations (e.g. jar openers or sitting to put on socks and shoes), many patients will live healthy, active lives with arthritis.

The post Osteoarthritis: symptoms, treatment & reducing risk appeared first on Your Health Matters.

Find simple ways to move

If you have hip or knee osteoarthritis, staying active can be a challenge.

But staying active can help you manage your pain. Consider incorporating the options below in your daily routine:

• Aim for 3,000 steps a day. If you are able, you can work your way up to 6,000 steps or more! Use hiking poles or a cane to ease any pain and improve your walking pattern.
• To put less of a load on your hips or knees, biking and water-based exercises are great options.
• Mind-body exercises like Tai Chi can help to improve strength, balance and your mood.

It’s important to remember that aiming for 30 minutes of moderate exercise per day is a great way to start. “This doesn’t have to be one 30-minute chunk — you can exercise in 10-minute intervals throughout the day too,” says Patricia.

You might also consider attending a GLA:D Canada Hip and Knee Arthritis Exercise Program after consulting with your family doctor or arthritis specialist.

Get the most out of your virtual care experience

“Some aspects of your care might be a little different, so you might need to prepare a little more,” highlights Patricia when speaking of virtual care. As we continue to navigate the changes brought on by COVID-19, virtual care is a great avenue to improve your access to care while staying in the comfort of your own home.

For the best virtual consultation experience, here are a few tips:

• Dress in loose, comfortable clothing so you can move around easily.
• If your appointment will occur over the phone, think about how to best describe what your joint looks like.
• In the case that your appointment will be over a video call, make sure you are in a space where you can move comfortably and show your joints.
• Try to log in early so you can check your internet connection!

Watch Patricia’s full presentation in the archived video of September’s lecture:

For more information and resources on osteoarthritis, check out some of the resources below:

• A guide for patients having hip or knee replacement
• The Arthritis Society
• Health Quality Ontario, Quality Standards “Care for Adults With Osteoarthritis of the Knee, Hip, or Hand” Patient Reference Guide

The post Living well with hip or knee arthritis: A Speaker Series summary appeared first on Your Health Matters.

What is lupus? We spoke with a Sunnybrook expert about the disease, which disproportionately affects women in their twenties and thirties.

“Women are nine times more likely to get lupus than men, and especially women in their younger years,” says Dr. Shirley Chow, a rheumatologist of Sunnybrook’s Holland Musculoskeletal Program.

Lupus is an autoimmune condition that can cause swelling of joints and inflammation of tissues and in organs. Normally, the body’s immune system forms antibodies to fight infections or cells it recognizes to be separate or external. With lupus, the immune system no longer differentiates and begins to attack itself.

“We think that estrogen, in younger women, may play a role in increased risk for overactive or altered immune response,” says Dr. Chow.

I’m very aware some of my fans had noticed I was laying low for part of the summer and questioning why I wasn’t promoting my new music, which I was extremely proud of. So I found out I needed to get a kidney transplant due to my Lupus and was recovering. It was what I needed to do for my overall health. I honestly look forward to sharing with you, soon my journey through these past several months as I have always wanted to do with you. Until then I want to publicly thank my family and incredible team of doctors for everything they have done for me prior to and post-surgery. And finally, there aren’t words to describe how I can possibly thank my beautiful friend Francia Raisa. She gave me the ultimate gift and sacrifice by donating her kidney to me. I am incredibly blessed. I love you so much sis. Lupus continues to be very misunderstood but progress is being made. For more information regarding Lupus please go to the Lupus Research Alliance website: www.lupusresearch.org/ -by grace through faith

A post shared by Selena Gomez (@selenagomez) on Sep 14, 2017 at 3:07am PDT

Condition has ‘a thousand faces’

Lupus affects each individual differently. “It is the disease with a thousand faces,” says Dr. Chow, who adds that affected areas include the skin, joints, hair, heart, kidneys, lungs, blood, joints, brain and heart.

First diagnosis can be tricky

Systemic lupus erythematosus or SLE is the most common and serious type. Initial diagnosis can be difficult, says Dr. Chow, as lupus is systemic or affects the entire body, is very individualized, and symptoms range from flu-like symptoms such as fatigue, fever, joint pain and severe headache, to a red rash across the cheeks and nose, sensitivity to sunlight, hair loss, hives, fingers and toes changing colour in the cold, and a mild or severe decrease in kidney function. Because symptoms can be wide-ranging, Dr. Chow recommends individuals at risk for lupus should check in with their doctor.

A special blood test called antinuclear antibody (ANA) test can help determine if there is autoimmune activity, but does not provide a definitive diagnosis. And a positive ANA test does not make the diagnosis of lupus, as this result can be seen in up to 20 percent of the normal population. Other clinical features should be present, and more specific antibody tests, anti-dsDNA and anti-Sm antibodies, may be present. That’s where rheumatologists are the trained experts to help diagnose this disorder.

Potential triggers

Lupus is not contagious, but does have possible triggers. Colds, trauma, stress, and exposure to chemicals or sunlight can bring on an overactive immune response.

“Major hormonal shifts such as pregnancy require special attention. Though most moms with lupus have healthy babies, some may have high-risk pregnancies and should consult their family doctor or obstetrician,” says Dr. Chow.

Living with lupus

Most individuals with this lifelong condition can choose to be as active as they want to be. The key, Dr. Chow says, is to prevent or manage flare-ups that can happen from time to time, where symptoms become intense. She says a healthy diet, getting regular exercise and adequate sleep, not smoking, wearing sunscreen, getting immunized regularly and lowering your stress levels – these all have benefits to help individuals manage their unique condition. In severe flare-ups, short-term-use medications can help to relieve symptoms.

If lupus is left untreated, resulting inflammation in an affected area or organ can lead to tissue damage or possible loss of function. It is important to work with your health care provider to find the best treatment for each individual.

The post Lupus: an autoimmune disease that disproportionately affects young women appeared first on Your Health Matters.

“There’s nothing you can do for arthritis, you just have to live with it.”

FICTION

The facts: Actually, there’s a lot people can do for arthritis, and the most important is weight loss. Losing between 5 and 10 per cent of your current body weight (if you are overweight) can reduce pain dramatically by reducing stress on hips and knees. Talk to a physiotherapist about more ways to reduce pain and swelling associated with arthritis and how to improve your day-to-day function (like daily exercise!)

Find more information on body weight and arthritis from Johns Hopkins Arthritis Centre.

“If I exercise, it will make the arthritis worse.”

FICTION

The facts: Evidence shows the opposite! Exercise can help!

It might hurt a little when you start out – but keep at it!  Start with low impact exercise for a short amount of time and it won’t harm you. Try swimming, walking with poles or biking in bouts of 10 minutes. Find more information about that here.

“It isn’t serious, it’s just Arthritis.”

FICTION

The facts: Actually,  arthritis is very serious, especially when it starts to affect how much you can walk, and your ability to work and do the activities you enjoy. People can start to feel ‘down in the dumps’ or have a depressed mood when their life is affected in this way. Arthritis needs to be – and can be – treated.

“I should wait until I can barely walk before I get treatment.”

FICTION

The facts: Don’t wait that long! Evidence shows you may be disappointed with the results of hip or knee replacement if you wait too long. You may have a hard time getting good function back and that’s because your pre-operative function predicts your post-operative function. Talk to your orthopaedic care team about when to seek hip or knee replacement.

The post It’s Arthritis Month: Let’s separate fact from fiction appeared first on Your Health Matters.

You’ve got arthritis. Painful joints, stiffness and inflammation.

But don’t let that be an excuse to be sedentary. Being active may actually help ease some of the symptoms.

Arthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. Joints may become damaged over time and can lead to increased pain and decreased function.

It’s a common misconception that a diagnosis of arthritis means hanging up your running shoes and packing away your tennis racquet. But there are many ways you can modify your activities, find new activities and stay active with arthritis.

“Physical activity does not worsen arthritis. Physical activity can help manage arthritis!” says physiotherapist Suzanne Denis. “It can make everyday day activity easier as well as provide many other health benefits.”

Suzanne has some tips for living active with arthritis:

Stand up! Research is pointing toward the importance of being active, whether or not you have arthritis. Sitting too much isn’t good for your arthritis. And it’s not good for your overall health either.

Find middle ground. If you have lower extremity arthritis, some load bearing is good for bone density, but too high impact might be painful. Try something in the middle: activities in water, cycling, Tai Chi, some light running. Doubles tennis. Golf. Curling with an extender.

Avoid activity that’s too intense.  Also avoid activities that have twisting, high speed uncontrolled movements (like singles tennis) forcing end range of movement, or kneeling (though not everyone has difficulty with that). Avoid only if painful or modify (with a kneeling pad or towel rolled under shin)

Hot or cold? “You can use heat before your activity to warm up your joints,” she says. “If your joint is red or swollen, don’t use heat.” After activity, if you have some swelling or your joint feels warm, use ice for 10 minutes, Suzanne says. There’s no hard and fast rule. “You have to find out what works for you.”

Talk to your doc about anti-inflammatory medicines. Check with a doctor before using any oral anti-inflammatory medications. There are many topical anti-inflammatories that can also be considered.

If you have been inactive, talk to your health care provider or seek the help of a physiotherapist before adding activity into your life.

The post You can be active with arthritis appeared first on Your Health Matters.