Category Archives: Aging

exercise benefits mental health

Senior Tip: How Physical Exercise Benefits Mental Health

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exercise benefits mental health

We all know the importance of exercise in our lives. Exercise keeps our body, soul, and brain, healthy. It keeps us fit physically as well as mentally. According to Senior Guidance, older adults who exercise regularly have lower rates of getting any kind of mental illness. Moreover, exercise also helps in treating anxiety and depression. Many people believe that with growing age, exercise loses its effect. Hence, there is no need for elderly people to strain their bodies. That’s just not true. Exercise benefits mental health at every age.

Per health experts, regular exercise is highly beneficial for elderly people. It would not only let them live an active and healthy life but would help in increasing their life span. If you want to be physically, emotionally, and mentally fit, try doing regular exercise. Exercise benefits mental health by keeping seniors active and healthy, which would further help them live independently.

A regular, healthy part of senior living should be to find the motivation to do regular exercise. Routine exercise will help older adults become mentally strong and fight mental conditions like depression and anxiety, which are quite common at their age.

Benefits of exercise for aging adults and golden oldies include:

1. Helps You Sleep Better

One of the most common problems faced by senior people is the lack of sleep. As we get older, we tend to have a lighter and less deep sleep. Various researches have proved that exercise boost sleep. Regular exercise improves the quality of sleep. Physical activity like exercise increases the time of deep sleep, which further helps in boosting the immune system and controlling anxiety and stress. Moreover, exercise results in energy expenditure, which makes you feel tired, which results in longer and peaceful sleep.

2. Helps to Maintain the Level of Chemicals in Brain

Brain chemicals or neurotransmitters are responsible for how we feel, physically as well as mentally. This holds true for young and elderly people. Regular exercise stimulates the production of brain chemicals- dopamine, norepinephrine, and serotonin. Regular exercise boosts the release of these brain chemicals, which help us in improving our overall well-being. Exercise stimulates the production of norepinephrine, which counters the effect of stress response in our body. Exercise gives a relaxing and calming effect on our brain and body because of the release of serotonin. Hence, regular exercise is essential for senior people as it helps in maintaining the level of brain chemicals, which decreases mood disorder symptoms, reduces stress, and gives a feeling of calmness and relaxation.

3. Boosts Energy Levels

Fatigue is very common among elderly people. Exercise does not only help in overcoming fatigue but also increases the energy level in the body. Just taking a simple walk in the fresh air not only refreshes your mood but would also boost your energy levels. While exercising, we use the energy which is stored in our body and start making more of it. Sitting and remaining inactive will not bring any change in the state of fatigue. However, getting involved in some physical exercise will make you feel active.

4. Reduces the Muscle Tension

Muscle tension is another common health problem faced by elderly people. Prolonged semi-contracted state in muscles results in muscle tension. This further results in muscle pain and muscle spasm. One of the major causes of muscle tension is lack of exercise. In addition to this, with age, people start losing muscle mass and strength. Older adults who spend most of their time in remaining sedentary faces more muscle related problems. Tense muscles generally lack oxygen and vital nutrients. Exercise increases the flow of blood to muscle cells, which further increases the oxygenation in muscles.

5. Decreases the Risk of Falls

The risk of falls is much higher in older adults. Falls are quite dangerous for them as it not only causes physical damage to the body but also hampers their independence. Recovery time after falls increases with growing age. Regular exercise or enrollment in a fall prevention physical therapy program increases muscle strength and flexibility. Physical exercises result in better bone density, which makes bone stronger and reduces the risk of getting fractures and osteoporosis. Exercise reduces the risk of falls by improving coordination and balance.

6. Makes You Happier and Boosts Positivity

Regular exercise brings positivity in life and makes you feel happier. Exercise stimulates the release of the happy hormone ‘Dopamine’ in our brain. This hormone is very essential for feeling happiness. Studies state that with age, the dopamine level decreases in our brain. This makes regular exercise more important for senior adults.

7. Reduces the Risk of Developing Dementia

Recent studies show that inactivity increases the chances of Dementia among seniors, requiring memory care or assisted living at later stages of the disease. Dementia is an umbrella that covers various mental conditions, including judgment impairment, memory loss, etc. Regular exercise increases the blood flow to the brain, which keeps the cells healthy. Moreover, exercise increases the production of brain chemicals and growth factors, which helps in keeping existing cells healthy and also helps in the growth of new brain cells, which results in increasing memory and control thinking.

Regular exercise is essential for everyone irrespective of age. Exercise benefits mental health by reducing stress, depression, and anxiety. Just make sure to make exercise a part of your everyday regime. It will help you in living a healthy and happy life.

Please consult your healthcare provider before starting an exercise program. If you are looking for help developing an exercise routine that fits your needs and skill level, please reach out to your physical therapist for guidance.

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prevent joint pain physical therapy

6 Ways to Find Relief and Prevent Joint Pain

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prevent joint pain physical therapy

Joint pain is a common issue that can have many causes and can lead to an array of complications. Joint pain affects such a large percentage of the population. It is estimated that by the year 2030, 67 million—one in every four American adults—will have doctor-diagnosed arthritis. That doesn’t mean that we have to live in pain. It’s important to understand your pain and to take the steps needed to make sure it doesn’t lower your standard of living.

So, what are some great ways to relieve and prevent joint pain?

Going to Physical therapy

Physical therapy is a good solution for treating various joint pain symptoms. Physical therapists can help prevent or delay joint replacements, manage symptoms of arthritis/ chronic joint pain while providing tools to minimize pain or further damage to the joint, and help acutely injured joints recovery from injury. Improving flexibility and range of motion in the affected joints is also a key component in most physical therapy programs.

Getting enough movement and exercise

Even though the natural inclination for a person experiencing joint pain would be to move as little as possible, movement and light exercise will often time do the exact opposite, and be a great ally on your journey towards pain relief.

Good exercises for those who suffer from inflammation causing joint pain are aerobics, water aerobics, bicycling, burst training exercises, social activities that include movement, Tai Chi, light weight lifting, and yoga.

Go for a massage

Massaging the affected joint can be a treat, especially for joint pain occurring in the hips and knees. You can have this done at a treatment center, or have a professional who provides this type of service come to your home, but this is also something that a loved one can do for you, or that you can do yourself. An infographic from spa-hotels.ie has shown the benefits associated with massage therapy, including reducing joint pain and stress levels.

Maintain an ideal weight

Having a high BMI can cause joint pain. The more weight on the joint, the more effort is needed to move and support the body. Introducing movement and light exercise to a daily routine, as well as working towards a healthier diet, can reduce the strain on the joints. Before beginning an exercise regimen, it is important to consult your healthcare provider. A physical therapist or physician can introduce an exercise program that is tailored to your needs and ability level.

Eat an anti-inflammatory diet

Making the change to an anti-inflammatory diet is a great way to naturally alleviate joint pain. The Mediterranean diet is a good example of what anti-inflammatory eating habits should look like. One thing to be aware of is the fact that some of the most inflammatory foods out there are dairy and gluten products.

In order to mitigate joint pain through diet would be to eat a healthy amount fruits and vegetables, berries and nuts, various types of spices and herbs, as well as teas, such as green tea or ginger tea. Processed meats, fast food, artificial sweeteners, refined sugars, and chips should be cut as much as possible. Working with a nutritionist can help introduce long-term meaningful changes to a diet plan.

Get enough sleep

Believe it or not, the quality and quantity of sleep is a factor in pain relief. New research suggests that irregular sleep contributes to pain in a variety of ways, including the ability to tolerate pain. By adjusting your posture at night to keep pressure off of the painful joints, the body is able to more easily relax and allow for sleep. Exercising and remaining active throughout the day should also help you get better sleep at night.

As joint pain has become common, we tend to accept it as something we can’t really control. However, when looking at the most common causes for joint pain, we can clearly see that a sedentary lifestyle, high anxiety levels produced by stress, and unhealthy food choices are leading causes related to the issue in question.

In order to prevent inflammation, as much as in the purpose of relieving joint pain, we have to make better decisions regarding our way of living. This means creating an environment for ourselves and for our families where movement is valued and practiced on a daily basis. It also means that we should make an effort in order to ensure that there’s always a bit of time during the day to help clear one’s head by engaging in mindful practice, or by taking up a relaxing leisure activity. Equally important, it is essential to set dietary boundaries and to respect our body by not constantly abusing it with food that’s poor in nutrients, and lacks all of the advantages healthy food brings to the table when talking about the general health of the human body.

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fall prevention at home

Fall Prevention: Risks & Tips in your home

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fall prevention tips at home

While falls can happen anywhere, more than half of them happen in the home. One in every three adults 65 and older fall AT HOME each year in the U.S. One of the easiest ways to help prevent a fall is to make sure that certain tripping hazards are addressed and removed. We’ve compiled a short list below to help you get started.

COMMON WARNING SIGNS FOR FALLING ARE:

  • Feeling pain or stiffness when you walk
  • Needing to walk slower or to hold on to things for support
  • Feeling dizzy or unsteady when you get up from your bed or chair
  • Feeling weak in your legs
  • You take more than one medication
  • You have problems seeing
  • You have had at least one fall in the past year

RISKS TO CONSIDER WHEN FALL PROOFING YOUR HOME:

Lighting

  • Is the lighting adequate, especially at night?
  • Are stairwells well lit?
  • Is there a working flashlight in case of power failure?
  • Can lights easily be turned on even before entering
    a dark room?

Surfaces

  • Are there any wet surfaces that are frequently wet?
  • Are steps and stairs in good repair and the
    appropriate rise?
  • Do steps have handrails in good repair?

Trip Hazards

  • Are there throw rugs in the walking path?
  • Does the family pet often sleep in walking paths?
  • Is the carpet in good repair without tears or fraying?
  • Are there extension cords or raised door sills in the walking paths?
  • Is there a clear path from the bed to the bathroom?

If you feel that you are at risk for falls, talk to your physical therapy provider. Most physical therapy clinics offer fall risk assessments that can help determine any areas of risk. By participating in a fall prevention program, you can reduce the likelihood of a fall and increase the ability to live independently. Fall prevention programs mainly focus on core strength, flexibility, and patient education.

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FLYR_FallPrevention_HomeFalls

For more information about balance and fall prevention click the links below:


    
PT News PTandMe

PT News February 2019

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PT News PTandMe

This time in PT News we recap what our clinics have been posting throughout February 2019. We are excited to begin a new year of new posts featuring published articles from PTandMe partnering clinics!

 

2. Can I Exercise Safely with a Cold?
Written by the Therapy Team at The Jackson Clinics with physical therapy locations throughout Northern Virginia and Maryland.

The average adult gets one to six colds every year, with symptoms lasting a week to 10 days. Should you let these colds interrupt your exercise routine? Probably not, as long as you pay attention to what your body tells you. Read more

 

3. Physical Therapy for the Treatment of Osteoporosis
Written by the physical therapy team at Mishock Physical Therapy & Associates with locations throughout Montgomery, Berks and Chester, PA counties.

Osteoporosis is the leading cause of fractures in the elderly. It is a disease which causes diminished bone mass and leads to a decrease in bone quality which results in increased risk for bone fractures. Fractures can lead to functional disability, chronic pain, and at times, early death. Read more

seniors start exercising

Seniors: It’s Never Too Late to Start Exercising

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For years, seniors have attributed their aches, pains, and illnesses to the normal aging process. Age is often used as a reason to avoid exercise. But a regular exercise program can improve the quality of your life and help you avoid illness, including heart disease, stroke, and diabetes. As always, you should consult with your health care provider before starting any exercise program.

WHAT WE KNOW
Most people know that with age, come certain physiological changes. Studies show that we lose the following as we age:
• Lean muscle tissue—Most of us will lose muscle mass as we get older. We usually hit our peak muscle mass early—around age 20—and begin losing muscle mass thereafter.
• Aerobic capacity—The aerobic capacity is the ability of the heart and the body to deliver and use oxygen efficiently. Changes in the heart and decrease in muscle tissue decrease aerobic capacity.
• Balance—As we age, our ability to balance decreases, making falls and injuries more likely. The loss of muscle is a major contributor to losses on balance.
• Flexibility—Our joints and tendons lose some of their range of motion with age, making it difficult to bend and move around comfortably.
• Bone density—Most of us reach our peak bone density around age 20. After that, bones can become gradually thinner and weaker, which can lead to osteoporosis.

Fortunately, regular exercise can help delay some of these changes and give you the energy you need to do everyday activities like walking, shopping, and playing with your grandchildren. Exercise may even help decrease depression and stress, improve mood and self-esteem, and postpone age-related cognitive decline.

By adding endurance, strength, flexibility, and balance training into your routine, you will be healthier, happier, and more energetic.

senior push ups

ENDURANCE
Decades ago, doctors rarely recommended aerobic exercise for older people. But we now know that most people can safely do moderate exercises. Studies have shown that doing aerobic exercise just a few days a week can bring significant improvements in endurance.

Aim to get 30 minutes of moderate exercise—such as brisk walking, bicycling, or swimming—at least 5 days a week. You do not have to do 30 minutes at once—you can break these sessions up into two 15-minute sessions or three 10-minute sessions. Moderate exercise will cause your heart rate to rise and your breathing to be slightly elevated, but you should still be able to carry on a conversation.

STRENGTH
It is not just aging that makes people lose muscle. One of the main reasons older people lose muscle mass is that they stop exercising and doing everyday activities that build muscle.

Building stronger muscles can help protect your joints, strengthen your bones, improve your balance, reduce the likelihood of falls, and make it easier for you to move around in general. Even small changes in your muscle size and strength—ones that you cannot even see—will make things like walking quickly across the street and getting up out of a chair easier to do.

Aim to do strength exercises (eg, weight lifting) every other day, or at least twice a week. For each exercise, do three sets of 8-12 repetitions.

FLEXIBILITY
Increasing your overall activity level and doing stretching exercises can markedly improve your flexibility.

To improve the flexibility—or range of motion—of your joints, incorporate bending and stretching exercises into your routine. A good time to do your flexibility exercises is after your strength training routine. This is because you muscles will already be warmed up. Examples of exercises that you may enjoy include Tai chi, yoga, Pilates, and exercises that you do in the water.

By regularly stretching, you will be able to move around easier. You may also feel less stressed, and your posture will improve.

BALANCE
Just becoming more physically active will improve your balance and decrease your risk of falling. If you add some basic balancing exercises to your exercise routine, you will begin feeling more stable on your feet. Balance exercises can be done just about anywhere and usually require no more equipment than a chair.

Keep in mind that if you are having severe problems with balance, a fall prevention physical therapy program can be a great way to regain your balance, increase strength or improve flexibility.

GETTING STARTED
To avoid injury, start slowly. Add one or two sessions a week at first and progress from there as you begin to feel stronger. A physical therapist, or other health professional, can help develop a program that will be both safe and effective. Check with your local fitness or community center, which may offer exercise classes designed especially for older adults. Check with your primary health care provider if you are planning to participate in vigorous activities.

Remember, it is never too late to start exercising. The sooner you start, the sooner you will start feeling healthier, more energetic, and less stressed.

RESOURCES:
American Heart Association
http://www.heart.org

The President’s Council on Physical Fitness, Sports, and Nutrition
http://www.fitness.gov

CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

REFERENCES:

Effects of aging. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00191. Updated September 2009. Accessed April 4, 2016.

Exercise and physical activity: your everyday guide from the National Institute on Aging. National Institute on Aging website. Available at: http://www.nia.nih.gov/health/publication/exercise-physical-activity-your-everyday-guide-national-institute-aging-1. Updated February 16, 2016. Accessed April 4, 2016.

Physical activity: glossary of terms. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nccdphp/dnpa/physical/terms/index.htm#Moderate. Updated June 10, 2015. Accessed on April 4, 2016.

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

how do falls happen

How Do Falls Happen?

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Statistics show that the majority (60 percent) of falls happen on the same level resulting from slips and trips. The remaining (40 percent) are falls from a height. This document will summarize information on “falls on the same level” (slips and trips). Falls from an elevation, such as falls from ladders, roofs, down stairs or from jumping to a lower level, etc., will discussed in another document since each type of fall requires different features in a fall prevention program.

Slips
Slips happen where there is too little friction or traction between the footwear and the walking surface.
Common causes of slips are:
• Wet or oily surfaces
• Occasional spills
• Weather hazards
• Loose, unanchored rugs or mats, and flooring or other walking surfaces that do not have same degree of traction in all areas

tripping

Trips
Trips happen when your foot collides (strikes, hits) an object causing you to lose the balance and, eventually fall.
Common causes of tripping are:
• Obstructed view
• Poor lighting
• Clutter in your way
• Wrinkled carpeting
• Uncovered cables
• Bottom drawers not being closed, and uneven (steps, thresholds) walking surfaces

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Click here to see the Fit2Wrk presentation: Slips and Falls in the Workplace

For more information about balance and fall prevention click the links below:


    
Tips for Seniors: How to Avoid Injuries During Sports and Exercise

Tips for Seniors: How to Avoid Injuries During Sports and Exercise

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Tips for Seniors: How to Avoid Injuries During Sports and Exercise

Our bodies change with age. It may not be a pleasant thought, but at least most changes are gradual. One thing that does not change as the body ages is the need for physical activity. Physical activity promotes physical and mental well-being. Before you head out the door, learn why your risk for injury is higher as you get older.

As you age it’s possible to notice a couple of significant changes:

  • Tendons and ligaments lose some of their elasticity. This can lead to reduced range of motion in the joints, making these areas more prone to injuries. And unfortunately, older bodies tend to take a bit longer to recover from injuries.
  • A loss in muscle. This loss usually begins in the mid-40s (earlier if you are inactive) and may decline as much as 10% after the age of 50. This muscle loss can certainly mean a decline in physical abilities and make it easier to gain weight. Fortunately, regular exercise can significantly slow this muscle loss. If you do not use your muscles regularly, the tissues become weaker and less compliant.

Although older adults accumulate a variety of injuries, the most common injuries involve sprains (stretching or tearing of a ligament) and strains (stretching or tearing of a muscle or tendon) around the shoulders, knees, and ankles. These injuries may only cause minor soreness or stiffness. People often do not recognize soreness as a problem, and they work through the pain. This may lead to more soreness and injury. Other common injuries include tennis elbow, Achilles tendinopathy, and shin splints.

How to Avoid Injuries During Sports and Exercise

To live a longer, more productive life, you have to exercise. You may need to exercise at a lower pace or for shorter periods of time than you did when you were younger. Remember that you may not be able to play hoops to the level of your 30-year-old colleagues, or play as many back-to-back tennis matches as you once could. This is a great time to make some changes to your routine and play smart. Before you get started, follow these tips so you can avoid injuries during sports and exercise:

  • Get a basic medical screening. Talk with your doctor. Find out if you have any conditions that would put you in jeopardy while exercising. If you have a chronic condition that is limiting, you may be able to work out an activity plan within the scope of your ability.
  • Find a balanced exercise program. Do not rely on one sport to keep you in shape. Follow a program that includes cardiovascular activity, strength training, and stretching.
  • Warm up before and cool down after physical activity. Adding a few minutes to your warm up can make your workouts smoother. Cold muscles are more prone to injury, which is why you are asking for trouble if you skip the warm-up. Try some light jogging or walking.
  • Keep it regular. You will not make gains in fitness by cramming your activity into the weekend. Aim for 30 minutes of physical activity every day.
  • Take lessons. Hire a trained professional such as a physical therapist or licensed athletic trainer to help you attain and maintain proper form in your sport, even if it is weight training.
  • Get the right equipment for your sport. You want to make sure the gear you use for your activity is in good shape and used properly. Think about the condition of your shoes, or if you will need a helmet.
  • Follow the 10% rule. When you are ready to increase your activity level, do so in 10% increments. In other words, increase activity small increments per week. This rule also applies to working with weights.
  • Be cautious about adding new exercises. Whether you are a seasoned fitness enthusiast or new to exercise, avoid taking on too many activities at once. Add activities gradually.
  • Listen to your body. Pay attention to the messages your body is sending you. If your knees hurt after you ski, find an easier ski run or maybe think about a different activity that does not hurt your knees.
  • Be careful about jumping right back into your routine. Gradually return to your workout routine if you had to take a brief time out because of illness or injury. If an injury requires additional help make sure to follow the return-to-play guidelines provided by your physical therapist.
  • Seek professional help if you injure yourself. Consult your physical therapist for injuries that are not relieved with home care. Some injuries require medical treatment and will not go away on their own.

Old age no longer means less activity. In fact, it means quite the opposite. The more active you are the better your body will age. Play smart, listen to your body, and you will find more abilities than limits. For help finding a workout that fits your lifestyle and ability levels don’t hesitate to call your physical therapist. They have the expertise and skills needed to help keep you active and safely avoid injuries during sports and exercise.

RESOURCES:

Office of Disease Prevention and Health Promotion
www.health.gov

Sports Med—American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org

CANADIAN RESOURCES:

Healthy Canadians
http://www.healthycanadians.gc.ca

Public Heath Agency of Canada
http://www.phac-aspc.gc.ca

REFERENCES:

Effects of aging. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00191. Updated September 2009. Accessed October 26, 2016.

Making physical activity a part of an older adult’s life. Center for Disease Control and Prevention website. Available at: http://www.cdc.gov/physicalactivity/everyone/getactive/olderadults.html. November 9, 2011. Accessed October 26, 2016.

Physical activity guidelines for Americans. United States Department of Health and Human Services website. Available at: http://www.health.gov/PAGuidelines. Accessed October 26, 2016.

Sports injury prevention for baby boomers. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00178. Updated August 2011. Accessed October 26, 2016.

Last reviewed October 2016 by Michael Woods, MD  Last Updated: 12/10/2014

arthritis facts

Arthritis: Facing the Facts

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There are several types of arthritis, which can be defined as an inflammation, degeneration, or infection of a joint. Some types of arthritis just affect a few joints and are called oligoarthritis. Others affect many joints in the body and are called polyarthritis. Arthritis can be symmetric, meaning the pain and inflammation is roughly the same on both sides of the body. It can also be asymmetric, affecting just about any joint in the body at any given point in time. This article will talk about several of the major types of arthritis, including osteoarthritis, rheumatoid arthritis, septic (infectious) arthritis, and crystal arthritis (which includes gout).

OSTEOARTHRITIS (OA)

Osteoarthritis (OA) is slowly-developing form of arthritis that can affect nearly every joint and that can affect individuals as they age. Joints that take a lot of pressure or that have repetitive motion are at the greatest risk for OA. The disease can be relatively asymptomatic or severely debilitating, affecting the patient’s ability to participate in activities of daily living.

The primary problems with OA are joint pain and stiffness. Symptoms can affect just one joint or several joints. The pain is worse with movement and relieved by rest. There are three stages of pain. The first is stage 1 (predictable, sharp pain with movement). The second is stage 2 (more constant pain that affects daily activities). The third is stage 3 (constant dull/aching pain with unpredictable sharp flares). The pain is usually worse in the late afternoon and evening but can also be worse after awakening. It may interfere with sleep.

OA can be localized or generalized and can affect one single joint or multiple joints at a time. The joints that are particularly a problem for OA include the knees, hips, interphalangeal (hand) joints, facet joints of the neck and back, first great toe joint, and thumb joints. The other joints are less commonly affected, particularly if they are not moveable joints.

Patients with generalized arthritis usually have the distal interphalangeal joints of the fingers involved, the base of the thumbs, the first great toe joint, the spinal facet joints, knees, and hips. Gradually, more joints become involved and the patient becomes more debilitated. The main clinical marker for OA is Heberden’s nodes, which are hard lumps at the distal finger joints.

Diagnosis of OA

Imaging can help diagnose OA. The best test for osteoarthritis is the conventional x-ray. It allows for detection of the usual features of OA (including osteophyte formation, cysts on the bone, and joint space narrowing). An x-ray, however, isn’t very sensitive and doesn’t often correlate with symptoms.

As to specific joints seen on x-ray, the hands are usually bilaterally and symmetrically involved. The distal interphalangeal joints at the tip of the fingers are characteristically affected. Other joints affected are the other finger joints and the base of the thumb. There is a lot of aching and stiffness of the joints. The patient with Heberden’s nodes has nodal OA. Most individuals with nodal OA are female with a family history of the disease.

Erosive osteoarthritis is a rare but aggressive type of hand OA. There is subacute or insidious pain with soft tissue swelling and numbness of multiple finger joints. There is tenderness, redness, and soft-tissue swelling of the hands that is not seen in ordinary OA. Erosive OA is not connected to generalized OA as it affects mostly the finger joints and spares the thumb and metacarpal phalangeal joints. Erosive OA has a worsened outcome than regular OA and can be seen on x-ray showing joint erosions (wearing down) in up to 8% of patients.

The knee is a common site of OA and the most common cause of lower-limb disability in older adults. It is usually bilateral to some extent. The patellofemoral joint or the medial tibial femoral joint is most affected. Pain from patellofemoral joint OA is made worse by prolonged sitting, standing up from a low chair, and climbing stairs or inclines (coming down often being more painful than going up).

Osteoarthritis of the hip can be seen as increased pain, stiffness, aching sensation, and restricted movement of the hip joint. Pain secondary to hip arthritis is felt in the anterior groin but may involve the upper thigh and buttocks. It commonly radiates down the leg with thigh pain and knee pain common complaints. The pain is made worse by rising from a seated position and during the initial phases of walking.

Facet joint arthritis generally goes along with intervertebral disc degeneration—a term called “spondylosis”. The pain is localized primarily to the lumbar or cervical spine and, in the low back, the pain radiates to the groin, buttock, or thighs, ending at the knees. It is worse in the morning and when active with rotation or bending motions (or with neck rotation and lateral flexion in the neck).

OA can be differentiated from other diseases by clinical history and physical examination. Rarely are things like lab tests and x-ray recommended. The clinical findings are of persistent pain in overused joints, age older than 45 years, and stiffness of less than 30 minutes in the morning. Imaging and lab tests can be done if the person doesn’t meet the obvious clinical features (by history or physical examination). Constitutional symptoms (like weight loss and fatigue) or signs of inflammation of the joint point away from OA and need further evaluation.

Risk Factors for OA

OA has been found to be a complex interaction of many factors, including genetics, mechanical forces, joint integrity, and certain biochemical processes. Genetics is probably the rarest interaction, while things like occupation, aging, trauma, and repetitive movement play a stronger role. These are stronger for the hand and knee and less strong for OA of the hip. Common risk factors include age, being female, being obese, having no osteoporosis, certain occupations, playing certain sports, having an injury, muscle weakness, and proprioceptive deficits. Less common risk factors include genetics, having acromegaly, and having CPPD disease. Advancing age is the strongest risk factor. It occurs in less than 0.1 percent of those under 34 years but is present in more than 80 percent in those older than 55 years.

Previous injury seems to increase the risk of osteoarthritis of the knee and having congenital hip dysplasia enhances the risk of hip arthritis. Long-distance runners have an increased risk of knee injury and knee osteoarthritis. Having an injury during this sport will increase the risk of osteoarthritis of the knee. Knee meniscus injuries are common in OA of the knee. Having an amputation of one leg increases the pressure to the other leg and increases the chances of OA of the unaffected leg. Genetics play a small role in getting osteoarthritis. There is a genetic influence in getting osteoarthritis of the hands and knees.

Treatment of OA

The goals of the treatment of osteoarthritis are to decrease pain, improve function, and modify the process of joint damage. This depends on changing modifiable risk factors as there are no disease-modifying OA drugs. Usually a combination of treatments is recommended. Things like hyaluronic acid injections in the knee are not recommended because they do not work any better than placebo.

The mainstay of treatment for OA is nonpharmacologic interventions. These include weight management, orthotic devices, braces (if necessary). Exercise has been found to be as good as NSAID therapy with strengthening and aerobic exercises good choices. A loss of 10 percent of the body weight will decrease pain by 50 percent with knee arthritis and hip arthritis. Splints and knee braces are good for thumb and knee arthritis, respectively.

Second-line things for osteoarthritis include drugs, such as capsaicin, nonsteroidal anti-inflammatory drugs, duloxetine, and intra-articular corticosteroids. A combination of these can be tried. Duloxetine is also called Cymbalta, which is an SSRI antidepressant that works for arthritic and musculoskeletal pain disorders. If a few joints are affected, a topical NSAID is recommended, with oral NSAIDs used only if topical medications don’t work. Acetaminophen has a risky side effect profile and a negligible effect on OA pain, so it isn’t recommended. Opioids are not recommended as they don’t work well for OA and have a long-term dependence and abuse potential.

Surgery usually means total joint replacement—usually done for advanced hip and knee arthritis. Other surgical options include a partial meniscectomy or debridement of cartilage but these have no clinical benefit over placebo. Hip arthroscopy can be done but may not be beneficial in OA.

RHEUMATOID ARTHRITIS (RA)

RA is a symmetric, inflammatory, peripheral arthritis, affecting many joints. The untreated patient will have degeneration of the cartilage and deformities of the joints in a symmetrical way. The prompt recognition and treatment of the condition with DMARDs, which are disease-modifying antirheumatic drugs, will help manage but will not cure the disease. The presentation in the beginning is similar to other arthritis patients but, over time, there will be distinctive evidence of RA, with joint erosions, extraarticular manifestations, and rheumatoid nodules.

Clinical Findings in RA

The synovial joints are what are affected most in RA. The arthritis is usually symmetrical, leading to destruction of joints secondary to bony and cartilaginous erosion. It starts in the hands and feet and moves centrally so locomotion becomes difficult within 10-20 years after onset. The onset is gradual and involves many joints, although some people will have a single joint involved in the beginning. Systemic symptoms occur in about 33 percent of patients and include muscle aches, low-grade fever, depression, weight loss, and fatigue.

In “classic” RA, the patient has morning stiffness, joint pain, and swelling of joints. The MCP (metacarpophalangeal) joint and the PIP (proximal interphalangeal) joints of the hand are the main joints involved initially; however, a few patients can have thumb, wrist, or metatarsophalangeal (MTP) joint involvement. Eventually other synovial joints of both the upper and lower limbs eventually become affected. Morning stiffness is the most common feature of active RA. It tends to last longer than an hour in RA and less than an hour in people with other inflammatory diseases.

Physical signs and symptoms include joint pain and swelling of the small joints (primarily), plus the typical morning stiffness and decreased grip strength. The spine is usually not involved. There is progressive joint damage and deformities, with loss of physical impairment. Late findings of untreated disease include anemia, rheumatoid nodules, eye inflammation, blood vessel inflammation, neuropathy, and pericarditis.

The hands are typically involved at the MCP and PIP joints. Redness and thickening of the flexor tendons may be seen in the palm; nodules may be seen in these tendon sheaths, causing trigger finger and possible tendon rupture. In established RA, there may be an ulnar deviation of the MCP joints.

The second most common areas of involvement are the wrists. Loss of extension happens early on in the disease process and, later on, there is volar subluxation and radial drift of the wrist. The elbow may become fixed in the flexed position. Olecranon bursitis is very common. Shoulder involvement is a late finding, seen in just half of patients after 15 years.

Lower extremity involvement is usually with the forefoot and ankles. Hip involvement is a late finding. Knee involvement can lead to Baker’s cysts. The MTP joints of the feet are the primary joints in early disease with eventual lateral drift of the toes and plantar subluxation of the metatarsal heads. Heel pain will show itself and the ankle may be swollen. Knee swelling is also common and restriction of flexion can be seen. There will be weakness of the quadriceps muscles.

Lab and Imaging Studies in RA

Lab findings in RA include those things seen in the synovial fluid and blood, indicating that the disease is both local and systemic. Things that are seen include inflammatory joint fluid, anemia of chronic disease, and lab tests that are positive for rheumatoid factor (RF) and ACPA (anti-citrullinated peptide antibodies). About 80 percent of patients will be positive for RA and/or ACPA. About 25 percent will have a positive antinuclear antibody titer.

Plain films can tell a lot about the state or RA. There will be joint space narrowing and bony erosions—especially of the hands and feet. These erosions are cardinal findings in RA. MRI testing is more sensitive in detecting synovial inflammation. It is also more sensitive for bony erosions than plain films. Ultrasound is also sensitive for detecting joint inflammation. Doppler ultrasound is nearly as good as an MRI and is cheaper than the MRI examination.

Evaluation of Suspected RA

This disease is usually present in adults and the main finding will be inflammatory polyarthritis. The affected person will have joint pain and at least thirty minutes of stiffness in the morning. Peripheral joints tend to be prominently involved. Symptoms lasting less than six weeks might be a viral polyarthritis instead of RA. In such patients, an anti-cyclic citrullinated peptide (CCP) antibody titer, rheumatoid factor, and acute phase reactants can be done. It may take many visits to get a clear diagnosis.

The examination includes a thorough joint evaluation, expecting symmetric polyarthritis, limited ROM of the muscles, and some extraarticular findings, like rheumatoid nodules. The lab tests will often include an RF and anti-CCP antibodies as a positive result that will increase the chances of it being RA. In an initial evaluation, however, these will be positive only in 50 percent of patients with early disease.

Other tests that are done include the ANA titer (which can exclude lupus and other rheumatic diseases). The ANA titer, however, will be positive in a third of RA patients so follow-up testing, like the anti-dsDNA and the anti-Smith antibody test should be done as these are highly specific for lupus. The CBC is done to check for anemia of chronic disease, liver and kidney function tests are done, and a serum uric acid level is drawn.

Baseline plain x-ray will be done of the hands, feet, and wrists in order to document a baseline so as to monitor disease progression. Joint erosions may or may not be seen initially. There are other specific findings seen in other joint diseases that will point to other diagnoses as well. Arthrocentesis is done to exclude crystal disease like gout. Gram-staining, cell counts, crystal search, and cultures are done on the fluid. MRI and ultrasound are not routinely done but they are more sensitive tests and can be done in patients with normal plain x-rays.

Treatment of Rheumatoid Arthritis

The treatment of RA depends on controlling the synovitis in the joint and preventing injury to the joint. Treatment strategies have changed remarkably over the last twenty years with the institution of DMARD therapy earlier in the course of the disease process. The goals include early diagnosis, care by a rheumatologist, early use of DMARDs, and tight control having a goal of remission or significantly reduced activity. Now, NSAIDs and glucocorticoids are adjunctive therapies instead of primary therapies. DMARDs have become the primary therapy.

Making the diagnosis as early as possible is important because DMARD therapy works best if there isn’t any joint damage. Once diagnosed, the patient needs a rheumatology referral and follow-up care performed by a rheumatologist (as the disease outcome is better). These patients need comprehensive care that includes drug therapy, education, psychosocial interventions, physical and occupational therapy, nutrition counseling, screening for osteoporosis, and things like vaccines to prevent disease in their immunosuppressed state.

Therapies include NSAIDs and intraarticular steroid injections, biologic and nonbiologic DMARDs, and an oral janus kinase inhibitor. Conventional, nonbiologic DMARDs include hydroxychloroquine, sulfasalazine, methotrexate, and leflunomide. There are a number of biologic DMARD drugs, including TNF-alpha inhibitors (etanercept, infliximab, adalimumab, golimumab, and certolizumab pegol), anakinra (an IL-1 receptor antagonist drug), and tocilizumab (an IL-6 receptor antagonist drug).

DMARD therapy is started as soon as possible. With active RA, an NSAID and corticosteroid are used along with methotrexate (as a first line agent). Patients who can’t take methotrexate should have hydroxychloroquine, sulfasalazine, or leflunomide. Nonbiologic DMARDs can be taken with biologic DMARDs. NSAIDs and prednisone are used temporarily as adjunctive therapy.

RA will naturally have flareups that need management. DMARD therapy may need adjusting. Flareups of just one or a few joints can be treated with intraarticular glucocorticoid injections. Widespread flareups are treated with an increased glucocorticoid dose (oral or IM). IV methylprednisolone done three times daily can be effective in reducing a flareup. Increased doses of methotrexate can help as will increased doses of infliximab.

SEPTIC ARTHRITIS

Septic arthritis is an infection in the joint, usually caused by a bacterial organism; however, it can be caused by mycobacterial species or fungi. These types of infectious processes can result in severe joint destruction and later arthritis. Among adults presenting with an acutely painful joint, septic arthritis represents 8-27 percent of cases, depending on the location in the world. The average is about 10 percent of cases. Some patients will have gonococcal disease, while others will have prostheses that get infected.

Risk Factors for Septic Arthritis

About ten percent of cases of patients with an acutely painful joint have septic arthritis. Risk factors for the disease include age greater than 80 years, having a diagnosis of diabetes mellitus, having rheumatoid arthritis, having a prosthetic joint, having recent joint surgery, IV drug use, being an alcoholic, having a concurrent skin infection, and having a previous corticosteroid injection. Each of these risk factors is small but together they add up.

If a patient has bacteremia, they are more likely to have the bacteria harbor in an arthritic joint when compared to a normal joint. About 40 percent of septic arthritis patients had preexisting RA or OA in the joint affected by sepsis. RA predisposes the patient to septic arthritis to a greater degree than OA but less common joint problems, like gout, pseudogout, and Charcot joint disease can be predisposing factors. Being on immunosuppressive therapy for RA is a predisposing factor, making RA a slightly higher risk than the other joint diseases.

Most cases of septic arthritis come from a blood infection that spreads to the joint. Trauma, direct inoculation, extension of bone infection, or animal/human bite are other less common causes. Risk factors for bloodborne spread include IV drug use, the presence of indwelling catheters, immunocompromised states (like HIV), being a neonate, and being older.

When the infective organism is Staphylococcus aureus, enterococcus, or streptococcus, endocarditis should be suspected and IV drug use is the most common reason for this infective endocarditis. Most of these patients will have negative cultures of the blood because the bacteremia was transient and self-limited. It is unknown why only a small percentage of patients with bacteremia develop septic arthritis.

Bacterial arthritis can occur along with bacterial meningitis. The most common organism associated with both septic arthritis and bacterial meningitis is meningococcus. Rare cases of septic arthritis can stem from catheter insertion (such as hip arthritis and sternoclavicular arthritis). A ruptured colonic diverticulum can also cause septic hip arthritis by spreading through the tissues.

While many pathogens can cause nongonococcal bacterial septic arthritis, the most common bacterial species causing this in adults is MRSA (methicillin-resistant S. aureus). Less common organisms include S. pneumoniae, Enterococcus, Escherichia coli, and other gram-negative bacilli. Almost all cases are from a single organism (except for those caused by penetrating trauma to the joint space, polymicrobial bacteremia, or ruptured diverticulum causing a hip infection).

Clinical Signs and Symptoms of Septic Arthritis

These patients tend to present with a single inflamed, painful, and swollen joint. There is usually warmth and restricted movement. Crepitus would not be noticed and there are no nodules. Many patients are feverish but will not have chills or spiking fever. There may be evidence of other infections present that point toward the original source of the infection.

The knee is involved in more than half of all septic arthritis cases, with lesser joints being the hips, ankles, and wrists. Rarely, the pubic symphysis can become infected after pelvic surgery. About 20 percent of the time, the situation is oligoarticular or polyarticular, especially with those individuals having RA or another connective tissue disease (and in severely septic patients).

Diagnosis of Septic Arthritis

The definitive test is to identify the bacteria in the synovial fluid. There should be a joint aspiration before starting antibiotics with synovial fluid sent for Gram stain, culture, leukocyte count (and differential), and crystal analysis. The tap may need to be done under fluoroscopic, ultrasound, or CT guidance. The results of the fluid analysis would be as follows:
• There will be purulence with a WBC count of 50,000-150,000 cells per microliter (mostly neutrophils). The higher the WBC count, the greater is the chance of sepsis.
• The Gram-stain is positive in 30-50 percent of cases.
• The culture should be done and will be positive in most patients who haven’t recently been on antibiotics. Blood cultures are generally positive in 50 percent of cases so they should be done.

Treatment of Septic Arthritis

The two components of acute bacterial arthritis include antibiotics and drainage of the joint. The choice of antibiotic depends on the presentation, Gram stain, and probable organism. Gram-positive cocci deserve vancomycin as an empiric treatment as this might be MRSA. If it is found not to be MRSA but to be methicillin-susceptible S. aureus, then the agents of choice include cefazolin, nafcillin, or oxacillin. Second-line treatments for MRSA include daptomycin, linezolid, or clindamycin.

If the Gram stain shows gram-negative bacilli, the treatment is a third-generation cephalosporin, such as ceftriaxone, cefotaxime, and ceftazidime. IV drug users are at risk for Pseudomonas infections and should have a combination of ceftazidime or ciprofloxacin plus gentamicin (or another aminoglycoside). Immunocompetent patients with negative gram stain should be treated with vancomycin. Ultimately, the culture and sensitivities will help detect the correct antibiotic choice. Intraarticular antibiotics are not recommended.

GOUT

Gouty arthritis is a type of arthritic condition that causes extreme pain and swelling in the joints. It stems from having high uric acid levels in the bloodstream that form crystals of monosodium urate (MSU) in the joint space. The crystals are very irritating to the joint and will cause swelling and redness of the affected joint space. About a third of all patients with high uric acid levels will develop gouty arthritis. It isn’t clear why some people get gouty arthritis and why others will not get gouty arthritis.

It should be noted that the joints aren’t the only place where uric acid crystals can develop. They can precipitate in the kidneys (impairing kidney function) or in other parts of the urinary tract, causing pain and possible obstruction of the urinary system.

Gout is completely different from CPPD (calcium pyrophosphate dihydrate) deposition disease or “pseudogout”. The crystals are completely different and the etiologies are different. Some of the symptoms are the same, however, so it pays to have an arthrocentesis and crystal analysis in order to define what type of crystal disease a person has.

Risk Factors for Gout

Gout is an adult disease that usually is first manifest in men between the ages of 30-45 years or in women over the age of 55 years. There is no gender difference above 65 years. The prevalence is about 4 percent of all adults in the US. Risk factors for gout include hypertension, obesity, chronic renal insufficiency, fasting, and consuming alcohol on a regular basis. Overeating, especially those things with high fructose corn syrup, meats, and seafood, will increase the risk of gout. Diuretics will increase the uric acid level.

Flareups of gout in patients already known to have gout can include fasting, recently having surgery or an injury, drinking too much alcohol (especially wine), overeating, and taking certain medications.

Symptoms of Gout

Gouty arthritis flares or gout attacks involve the sudden onset of joint pain that is relatively severe and associated with tenderness, swelling, and redness of the joint. It usually affects one joint but can affect a few. The flareups are worse in the middle of the night and in the early morning hours. The inflammation reaches its peak at 12-24 hours and can improve within a few days or weeks. No one knows how the body resolves a gouty flare. The white blood cells increase in the joint space because of the crystals causing irritation of the lining of the joints.

Gouty Arthritis Phases

There are three basic phases of gout: the gout flare, intercritical gout, and tophaceous gout. In a gout flare, the big toe or knee becomes inflamed to begin with or multiple flareups can occur—accompanied by a fever. Some osteoarthritic patients will have flareups in the fingers instead of the toes. Intercritical gout is the time between flareups, which is generally less than two years, even with treatment.

Tophaceous gout is the type of gout where urate crystals build up around the joints, bursae, skin, bones, and cartilage. The buildups are called “tophi”. They may have bony erosion and joint damage called gouty arthropathy as a result. They usually aren’t painful but can inflame like joints, causing redness and tenderness. Tophaceous gout is rare with current treatment protocols except if a person cannot tolerate the medications, is taking cyclosporine for organ transplant, or is a woman past menopause on diuretic pills.

Diagnosis of Gout

Gout can mimic many other diseases. It is strongly suspected when a joint or few joints become acutely inflamed and then resolve within a few days, leaving behind no symptoms. The best way to confirm gout is to take a quantity of synovial fluid using an arthroscopy. The fluid can be evaluated under specialized light microscopy to see if the characteristic needle-shaped crystals can be seen. There will also be an excess of white blood cells in the synovial fluid. Crystals can be extracted from tophi as well. If arthroscopy cannot be done, the diagnosis is based on acute onset of symptoms, inflammation of one joint (usually the great toe), elevated uric acid levels, and complete resolution of symptoms between flareups.

Treatment of Gouty Flareups

The goal of treating gouty flareups is to decrease pain and inflammation. This is a short-term process that is based on the presence or absence of bleeding disorders, history of stomach ulcers, or history of kidney disease. If these are negative, NSAID drugs are the treatment of choice as well as glucocorticoid drugs. Corticosteroids can be given orally, injected into the joint or by injection. Commonly-used glucocorticoids include prednisolone, prednisone, and methylprednisolone. They can be used when NSAIDs or colchicine aren’t tolerated.

NSAIDs are okay if there are no bleeding problems (no warfarin), no stomach ulcers, and no kidney disease. Aspirin is not recommended because it can affect the uric acid level in the bloodstream. Colchicine is good with decreased kidney function and ulcer risk but can cause abdominal symptoms (like nausea, vomiting, diarrhea, and abdominal cramps). It is only taken orally.

There are preventative drugs that will decrease or reduce the number of gouty flareups. Colchicine is one drug that can do this and can be given in lower doses than is necessary to treat gouty arthritis flareups.

Some patients require long-term uric acid-lowering treatment. Lifestyle changes can help the situation. Medications can increase the uric acid excretion by the kidneys, decrease the production of uric acid, or can convert urate to allantoin (which is more easily excreted). These drugs are used when a flareup has resolved itself. Allopurinol works by preventing uric acid formation and is the most commonly used drug for this problem. Febuxostat does the same thing but cannot be used by people at risk for heart disease.

Probenecid increases uric acid excretion by the kidneys. Losartan is an antihypertensive drug used to decrease uric acid levels. Lesinurad is a second-line drug used with allopurinol or febuxostat. Pegloticase works by turning uric acid into allantoin, which is then excreted. It is given by IV and is used to rapidly lower the uric acid level. Allergic reactions and high cost make this prohibitive in many situations. The goal is a uric acid level of below 6 grams per deciliter. It shouldn’t be done too quickly and the individual requires excess fluid during the treatment time.

Arthritis- An infographic by GeriatricNursing.org

Website Sources for Arthritis

1. Understanding Arthritis. This is the site to start your search for arthritis answers. It’s a site created by the Arthritis Foundation and has a wealth of information on the site.
2. What is Rheumatoid Arthritis? This is a site designed by the Arthritis Foundation specifically about rheumatoid arthritis. It’s a good site for people who know they have RA and want to know the latest in diagnosis and treatment of this joint disease.
3. Let’s Dig Into Everything about RA-This is a site put out by a RA support organization that delves into rheumatoid arthritis and its management. They have resources for experimental RA treatment.
4. Septic Arthritis– This is a comprehensive review of septic arthritis designed for people who are health professionals or learned patients wanting to learn all they can about this condition.
5. Gout and Pseudogout– The patient with crystal arthritis will learn all they want to know on this comprehensive site. It’s designed for the person who wants to know the science and medicine behind these two types of arthritis.
6. The American College of Rheumatology puts out this information site for patients and caregivers who want to know about osteoarthritis and its manifestations.
7. Find a Rheumatologist – It isn’t always easy to find a rheumatologist near you if you have an arthritic condition. This site from the American College of Rheumatology will help you get the help you need from a board-certified rheumatologist.
8. Rheumatoid Arthritis – This is a medical site that shows pictures of patients with rheumatoid arthritis plus a comprehensive review of the pathophysiology, presentation, workup, and treatment of this type of arthritis.
9. Gout – This is a lecture series on gout that gives many slides showing pictures of gout and images that easily explain the disease state.
10. Osteoarthritis – This is a picture-filled slide presentation on osteoarthritis. For individuals wanting a visual image of what this disease looks like plus valuable information on the disorder, this is the site to visit.

True or False: Changes in the Weather Can Make Your Joints Stiff or Achy

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For many people, the flare-up of an arthritic knee or shoulder appears to signal a change in the weather—usually hinting that a storm is imminent.

The belief that achy joints accompany a weather change is so widespread, in fact, that it has just about been accepted as reality. Many doctors listen to patients complain that they experience stiff or aching joints before, during, or after changes in temperature, barometric pressure, or humidity.

Yet, in spite of the widespread belief in a connection between aches and pains and inclement weather, medical researchers have come up with little evidence to support it.

Evidence for the Health Claim
Changes in the weather such as barometric pressure, humidity, and temperature could theoretically affect the synovial fluid that lines and lubricates the joints if, for example, they had a chemical effect on the fluid which somehow increased inflammation (which causes pain). However, there is no conclusive evidence that supports this theory.

Since at least the mid-1800s, a number of medical, and so-called bio-meteorologic research studies have been carried out in an effort to establish a connection between health and changing weather conditions.

The results of these studies have been varied. Based primarily on a compilation of patient anecdotes (reports of arthritis sufferers, for instance), increased barometric pressure (in fair weather conditions) has been associated with increased joint pain. Conversely, others studies have shown a relationship between increased joint pain and decreased barometric pressure (in stormier weather). Still other studies have suggested that changing weather conditions can cause immediate pain in some patients and delayed pain in others.

weather changes

Evidence Against the Health Claim

It is important to note that because most studies on this subject have been based on anecdotal reports rather than carefully designed observational studies, their conclusions don’t constitute reliable scientific evidence. Furthermore, many doctors claim that the wide variety of arthritic conditions and sheer complexity of atmospheric variability makes coming up with meaningful connections between joint pain and weather conditions next to impossible.

There is also a psychological aspect to this belief. What are the chances that the connection between health and the weather is simply coincidental? Is it possible that arthritis sufferers link their stiff and achy joints to changes in the weather as a way of explaining an otherwise mysterious exacerbation of their condition? Some doctors suggest that patients who observe weather conditions when they experience pain may pay little or no attention to the weather when they don’t have any pain.

Furthermore, there is no definitive evidence that moving to a warmer or drier climate provides a cure for aching joints. Some doctors report that many patients claim that the pain disappears for a while, only to return a few months later.

by Rhianon Davies

REFERENCES:
Aches and Pains Index. UK Weather Channel Interactive Web site. Available at http://uk.weather.com/activities/health/achesandpains/achesandpainsindex.html. Accessed July 25, 2006.

Cold Weather Can Cause More Aches and Pains for Arthritis Sufferers. Marshall University Orthopaedics Web site. Available at http://musom.marshall.edu/medctr/orthopaedics/cold weather.asp. Accessed July 25, 2006

Shmerling RH. Whether Weather Matters For Arthritis. Available at http://www.intelihealth.com/IH/ihtIH/8799/9273/35323/341624.html?d=dmtHMSContent. Accessed July 25, 2006.

Weather and Joint Pain. Any Connection? Mayo Clinic Web site. Available at http://www.mayoclinic.com/health/joint-pain/AN00102. Accessed July 25, 2006.

Weather and Our Physical Health. BBC News Web site. Available at http://www.bbc.co.uk/weather/weatherwise/living/effects/. Accessed July 25, 2006.

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

Fall Prevention Physical Therapy

Physical Therapy for Balance & Fall Prevention

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“Falls are the leading cause of injury death for Americans 65 years or older. Each year, about 35–40% of adults 65 and older fall at least once.”
— Center for Disease Control

Physical Therapy for Fall Prevention
Physical therapy fall prevention programs are tailored around each individual’s needs. The length of the program is dependent on the severity of the symptoms and the goals of each individual. Most patients will follow a gradual path of three distinct phases. After an initial evaluation to determine needs and goals of patient and we will set up treatment plan with patient input. The first phase typically includes therapeutic interventions designated to decrease symptoms and the establishment of a Home Exercise Program (HEP). We will then Continue the use of therapeutic interventions with the addition of ADL modifications, and energy conservation techniques. Finally we will continue the program until the patient’s goals are met.

The main objectives in a fall prevention program are to:

  • Increase independence with Activities of Daily Living (ADLs)
  • Increase independence with functional mobility
  • Decrease fall risk
  • Prevent future fall
  • Increase safety

Pain Relief
Our PTandMe licensed physical therapists are skilled in helping patients significantly reduce the risk of falls so that seniors can continue to age independently. If you or someone you know may benefit from a fall prevention program – call a clinic near you today and see what options are available for you! To find a PTandMe partnering location in your area click here.