Arthritis affects approximately 4 million Canadians (over 46 million Americans). As the medical community has been unable to determine the exact cause of arthritis, there is no cure as of yet. It is recommended that sufferers find a method that best alleviates the symptoms, and begin incorporating a therapeutic exercise program to help increase overall flexibility and better quality of living.
There are over 100 types of arthritis ranging from the most common forms such as osteoarthritis and rheumatoid arthritis to gout and Lyme disease. Stemming from the Greek words arthron, joint; and itis, inflammation, arthritis is the most prevalent medical problem in the world today. It is the oldest and most debilitating disease, and accounts for one in five visits to the doctor.
Osteoarthritis is a degenerative joint disease that manifests over a period of years. It generally does not affect children or young adults, but strikes after the age of 40. The protective cushioning barrier that cartilage provides to the joints, becomes fragmentized. The exposed bones are susceptible to friction, and try to rebuild themselves. This procedure results in thick, rough bone ends that restrict the range of motion and inflame surrounding tissue.
Rheumatoid arthritis (RA), on the other hand is an inflammatory condition that many researchers believe to be the result of the body's immune system attacking its own tissues or cells, especially the joints. Unlike osteoarthritis, RA tends to be symmetrical in the way it impacts the joints. Rheumatoid arthritis is unforgiving in that it affects the young and old alike. This connective tissue disease affects the entire body from joint pain, to dryness in the eyes, to swollen lymph nodes. The condition often goes into a period of remission.
There are a variety of remedies available to treat the symptoms of arthritis. Since the sales of these remedies have become a multi-billion dollar industry, medical politics is perhaps thwarting the efforts of finding an actual cure for the disease. Treatments for arthritis vary due in part to the type of arthritis and severity of symptoms. Some common treatments include oral analgesics such as codeine; topical analgesics that include creams or lotions designed to relieve pain; NSAIDs (non-steroidal anti-inflammitory drugs); corticosteroids to reduce inflammation; a vitamin called pantothenic acid which works best on RA; chondroprotective agents such as glucosamine; chondroitin sulfates; and antibiotic treatments. Results vary from patient to patient and some of the drugs come with a long list of undesirable side effects.
Canadians spend close to $4 billion on alternative medicine alone; that number jumps to $34 billion in the United States. The theory of holistic practitioners is that waste matter has built up in the body and the lymphatic system cannot rid the body of these wastes. Complementary treatments actively involve the patient in the role of taking responsibility for their own well being. The non-conventional therapies include acupuncture, copper bracelets, bee stings, herbal medicine, T'ai chi, yoga, and reflexology. It is not recommended that painkillers be discontinued during the complementary therapy stage. A common ground that most researchers tend to share is that after consulting with a trusted physician, the arthritic person should keep a positive attitude and use the method that has the best results for him/her specifically.
Most of the researchers do agree on another common area - that exercise, contrary to what one would assume, is actually beneficial to the arthritic person. Exercise can actually assist in reducing pain. Cartilage acts as a sponge, soaking up and releasing the synovial fluid required for lubrication between the bones. The cartilage cells no longer work properly, and the cartilage starts to deteriorate. The bones begin to grind together as there is no slippery surface to slide across. Therefore, exercise is essential not only to help keep muscles and tendons strong, but to lubricate the joints as well.
A recreational therapist can also be an asset to the arthritic patient. A therapeutic recreation (TR) program may include strength training, light aerobics, and stretching would greatly benefit clients suffering from arthritic ailments. As with any TR program, and especially when designing a physical activity program for older adults, it is important to set attainable goals and develop a routine that the patient can adhere to.
Flexibility refers to mobility of the muscles and range of motion of the joint. Stretching is designed to help maintain flexibility in the tendons and muscles. Range of motion exercises help to prolong normal joint movement and alleviate stiffness. According to the Arthritis Society, range of motion and stretching exercises should be briefly performed in the morning and prior to going to bed. Strengthening exercises should ultimately be incorporated and should be performed 45 - 60 minutes per day, three times per week. Recreational activities should eventually be added to the program. As participants in a therapeutic exercise program progress, incorporating recreational activities that include the aforementioned components to the schedule of regularly offered programs should assist clients in maintaining their mobility.
To encourage clients in pursing these types of activities outside of regular program times, a variety of activities that the client may enjoy should be introduced to ensure that s/he remains motivated. Examples of activities shown to assist in managing arthritis include aerobic exercises such as walking, cycling, and dancing. Activities that involve twisting and turning, such as ballet dancing and football, could aggravate the joints, and therefore should be avoided. Despite these efforts, individuals may still experience joint pain or flare-ups. Modified exercises that have also been demonstrated to have a therapeutic effect on arthritis sufferers include non- weight bearing activities, specifically water sports, such as swimming or water aerobics (aquasize). Consulting with a physiotherapist may also assist the recreation therapist in creating safe, effective exercises for a program.
An education session about arthritis and pain management prior to implementing an exercise program for arthritis sufferers at your facility is also recommended. Offering some general guidelines and recommendations may be beneficial. Prior to starting any form of exercise plan, the client should be advised to contact a doctor, especially if they have other health concerns. It is vital that the patient knows the facts of the disease, and is trained how to use their joints properly so as not to further damage them. Participants should also be advised not to take pain-relieving medication immediately prior to exercising as this could mask pain. In addition, participants should be encouraged to listen to the signals they receive from their bodies. Pain associated with exercise is a warning sign that too much strain is being put on the body.
"Study after study confirms that those who exercise stay healthier, live longer, and cope with chronic pain," according to Judith Horstman in The Arthritis Foundation's guide to Alternative Therapies. The benefits of exercise therefore are numerous. Flexibility is increased; and the patient has more of a feeling of being in control of the disease. Endorphins released during physical activity help to improve the emotional well being of the patients by lifting their spirits. Exercising can help alleviate pain in that excess weight, which may have been an extra burden to the patient, slowly melts away by incorporating this lifestyle change.
A common ground the researchers tend to share is that after consulting with a trusted physician, the arthritic person should use the method that has the best results for them individually. Though there is conflicting evidence as to which treatment arthritis sufferers should rely on, the main point most sources seemed to agree upon is the importance of exercise. By providing activities designed to improve flexibility and range of motion in an exercise program, in addition to recommending or introducing alternative physical activities that include these components, the recreation therapist can assist in minimizing pain and improving mobility. Encouraging clients to adopt a specific set of lifestyle changes through education and participation will most certainly help participants to maintain a positive attitude and direct them toward a more pain free existence.