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Protecting Your Joints When You Have Arthritis

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Recently, I was given the opportunity to speak to members of the Arthritis Foundation about managing their activities when dealing with osteo- or rheumatoid arthritis.  Many people either have osteoarthritis or rheumatoid arthritis or know someone who does.  However, not all people understand the fundamental differences between these two types of arthritis.  In osteoarthritis, the articular cartilage (the cartilage that lines the ends of your bones) starts to degenerate.  The joint space becomes narrowed and bone spurs can form at the edges of the joint.  Eventually, if enough degeneration occurs, there is injury to the bone lying underneath the cartilage and a person is told her joint is "bone on bone." In contrast, rheumatoid arthritis is an autoimmune disorder where the synovial tissue produces diseased and excessive synovial fluid.  Normally, a person's synovial fluid gives proper nutrition to your cartilage and lubricates your joints but rheumatoid arthritis interrupts this process. This results in swollen, red and painful joints that can lead to deformities in the involved joint(s) if untreated. Osteoarthritis is more common in the weight-bearing joints, like your knees, hips and spine where rheumatoid arthritis typically involves the hands, feet or neck (but is not exclusive to these).

Rheumatoid ArthritisOsteoarthritis

One of the key areas of treatment (especially if there is hand involvement) is joint protection, which allows one to perform your daily activities with less stress on the involved joints.  This includes avoiding positions that foster deformity, choosing the strongest joint available for the job, using good body mechanics, avoiding stationary positions and conserving your energy. 

Here are a few easy ways to protect your joints.  If a person's hands are involved (especially in rheumatoid arthritis), it is important to avoid tight gripping or pinching. These activities tend to foster deformity in a person's hands, especially the deformity of ulnar drift, where the fingers drift toward the pinky side of your hand.  Suggestions include building up your pen with tape or foam to avoid gripping it too tightly, sliding your hand through the handle of a travel mug rather than gripping the small handle of a coffee cup, and using the palm of your hand on a washcloth to wipe down kitchen counters rather than gripping it with your fingers.  If you need to use your arms to help push yourself out of a chair, be sure to push with your palms rather than your fingers.  You'll also place less stress on your finger joints if you use your forearm or shoulder to carry your purse or bag.  Also, while reading your newspaper or book, place it onto your forearms instead of grasping it with your fingers.
Bad coffee cup gripGood coffee cup gripBad wash cloth grip Good wash cloth grip










Last month's blog discussed the importance of posture, which plays a large role in body mechanics.  People with arthritis should also consider using a step stool to put objects on an overhead shelf rather than lifting it. You'll also decrease stress on your joints by pushing a heavy load rather than pulling it. Pushing allows you to use the bigger muscles of your legs whereas pulling places a lot more stress through your finger and spine joints.

It is also important to avoid keeping your body in the same position for any extended periods.  Unfortunately, lots of activities that we do on a daily basis force us to do just that. Activities like sitting, typing, driving or working at your desk should be broken up every 2 hours minimally. While driving, relieve your grip every 10-15 minutes by shaking out one hand, then the other. Periodically straighten out your knees while sitting to avoid stiffness.

Finally, conserving your energy takes some planning but is very worthwhile! It is very important to pay attention to the difference between the usual arthritis discomfort and new or more intense pain.  An activity that results in pain that lasts more than an hour after the activity is done must be modified. Also, you should alternate between easier and more challenging tasks.  This may require you to plan out your week but your arthritic joints will thank you!

Physical therapy plays a large role in the conservative management of arthritis.  Your physical therapy intervention typically includes mobility and strengthening exercises, manual therapy to improve mobility and pain levels, as well as education and pain control. If you feel your arthritis is making your daily activities too much of a challenge, please feel free to contact The Center for your physical therapy needs.

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