Arthritis pain — A Mayo Clinic specialist addresses common questions about coping with arthritis pain.
Arthritis pain can be frustrating. And so is sorting through your pain relief options. To help you figure out the best means of relieving your arthritis pain, Gene Hunder, M.D., an emeritus rheumatology specialist at Mayo Clinic, Rochester, Minn., and a professor of medicine at Mayo Clinic College of Medicine, answers some commonly asked questions about arthritis pain. Dr. Hunder is an authority on rheumatology and is editor-in-chief of the book "Mayo Clinic Straight Talk On Arthritis."
What sorts of activities should generally be avoided, and what types of activities are good for most people with arthritis pain?
Activities that put sudden pressure or stress on involved joints — such as running and playing tennis — are likely to make the symptoms of arthritis in the lower extremities worse and may cause increased swelling and inflammation. Activities that are likely to help include exercises that strengthen your muscles, protect your joints, and reduce stress and joint damage. For example, strengthening the muscles on the front and back of your thigh (quadriceps and hamstrings) helps protect your knee and hip joints. Your doctor might be able to teach you some exercises to increase your muscle strength without abusing your joints.
Do what you can to stay physically active while taking into consideration the condition of your joints. For example, you may be able to walk a mile or more at a comfortable pace with well-fitting, cushioned shoes. But you probably have to give up on high-impact activities — for instance sports such as soccer that involve running — which put a lot of stress on many different joints. If your joints are too painful or damaged to allow an activity such as walking, then swimming or other water exercise may be a better choice for keeping you active and getting toned.
How can you reduce the stiffness and pain that come from sitting for a long time?
Many people with arthritis experience stiffness after sitting or resting, especially if they've used their joints actively before periods of inactivity. Most people with rheumatoid arthritis have stiffness after rest, such as in the morning. These are common symptoms of arthritis. Movement will tend to diminish some of the symptoms.
If you must sit for a long time, adjust your position often to prevent or lessen stiffness. For example, turn your head at different angles, shift the position of your arms, and bend and stretch out your legs. Such slight movements may help prevent excessive stiffness. Many times the stiffness may be worse for a few days after you've used your joint strenuously.
Are alternative treatments helpful for arthritis pain?
This question raises complex issues, and there's no short and easy answer that applies to all alternative arthritis treatments. Even the definition of alternative treatments varies from one source to another. For example, heat, massage and stretching — which help relieve arthritis symptoms for many people — have been listed as alternative treatment by some, but in reality these have been standard practice for many years.
The best treatments of this type are straightforward and have your doctor's or physical therapist's stamp of approval. Some activities may be more interesting and fun to do, such as tai chi. A good rule of thumb: If it keeps you active, then it's helpful.
The problem with many alternative preparations is that they haven't been adequately studied. In most people, arthritis symptoms vary from day to day. So if you take an herbal preparation, for example, on a day that you might have felt better anyway, you may become convinced that the herb made you better. In arthritis treatment studies, as many as 30 percent of people taking an inactive substance (placebo) improve, at least temporarily.
Finally, quality standards for over-the-counter alternative drugs don't exist. Research shows that there's a great variation in the amount of active substance in different brands and even different lots of the same brand. This alone may be reason to avoid them.
Finding an effective and safe medication for arthritis pain is a complex task that may take years. Trying to shortcut standard practices may lead to harmful effects and wasted money, time and effort.
Last Updated: 08/14/2007
