Ankylosing spondylitis

Movement, the best medicine?

I will be the first to admit that exercising is not in my genes, therefore I’m not one to say whether it is good or bad. I have read numerous accounts of people with AS who exercise regularly, then there are those, like me who find exercising very painful. I get out and mow/rake, water/snow ski but I do it very cautiously. Recently I tried to get back into yoga but on the third day I couldn’t even walk without pain in my sacrum which I can only attribute to the yoga (I was even doing the beginner series again). This was an interesting article put out by The Hindu and can find the original article here. I don’t necessarily agree with everything that is written but it does give one something to think about.

Movement, the best medicine

Regular exercise goes along way in staving off stiff and aching joints

By GEETA PADMANABHAN

It is about pain, age and joints. It is arthritis, an ailment already widespread and is on a relentless march. We know its power to cripple, its capacity to reduce mobility. Respecting its painful touch, we have dedicated a day for it (October 12). This year, those who suffer the arthritic “ouch”es are being told: “Move to Improve”.

Dr. AR Kesavan, Orthopaedic Surgeon, Global Hospitals helps us know the enemy. Arthritis is caused by damage to the ultra-smooth lining of the joints (and sometimes the underlying bone), he says. Then any movement of the joints sets off searing pain. All aches in joints, bones and muscles are broadly grouped as rheumatism.

Many avatars

Arthritis takes a hundred different avatars. Major ones are osteoarthritis (OA), rheumatoid arthritis, gout, ankylosing spondylitis, juvenile arthritis and systemic lupus. OA joins many of us when we enter middle/old age, attacking the spine, knees, ankles and the hips. In the fingers and wrists, it reduces grip strength.

Rheumatoid arthritis, an inflammatory variety, attacks 1 per cent of the population of whom 75 per cent are women in their 30s and 40s. A rheumatic fever flares up because of streptococcus infection. There is joint pain, it then affects the heart. The body senses the lining (mostly in the wrists, the finger joints and the feet) as foreign and causes swelling, in an auto-immune attack. It could be because of a genetic pre-disposition. Kids (10-15-year-olds) get juvenile rheumatoid arthritis. Ankylosing spondylitis (AS), another inflammatory arthritis, prefers the joints of the lower back. The inflamed and stiff joints give you the classic backache. Psoriatic arthritis occurs in 15 per cent of patients with psoriasis. A blood test or a throat swab test will determine the nature of the arthritis.

Prevent it

No matter what form it takes, or at what age it strikes, arthritis delivers a stinging blow. So look for prevention. First, keep your weight in check. The knees are sensitive to loading, the lining gets damaged. Go for a healthy diet and regular exercise, says Dr. Kesavan. Smoking damages the lining; hence, smokers are more prone to arthritis, so…. Small injuries to the ligaments when not properly repaired, causes them to wear off in 10-15 years, resulting in arthritis. Bow legs or knock-knees are now thought of as another reason for arthritis. Parents, check junior’s walk, and get it corrected. Correcting the deformity and retaining natural bones and muscles is better than acquiring an artificial knee later, is his advice.

Avoid running/jogging on hard surfaces. A jogger’s path should be firm with soft soil. Buy footwear — sports shoes — that are well-fitting and light. Walk within limits of pain tolerance. Obese people sometimes waddle to favor a troublesome leg. Instead they should exercise for proper movement and muscle strength in the leg, work for weight reduction and get advice on modifying their diet. Women are prone to osteoporosis in the per-menopausal stage and should take additional calcium. If an X-ray shows arthritis is baseline, the doctor will prescribe a non-surgical course of rest, physiotherapy and a mild analgesic.

Rheumatoid arthritis needs a mulch-disciplinary approach. Consult a rheumatologist, orthopedic surgeon and physical therapist. It can be controlled with standard anti-inflammatory medicines, and may even burn off in a couple of years. It needs follow-up, for adjusting the medicine.

Stress causes arthritis to flare up, though how it happens is not well understood. De-stress with music and laughter therapy, balance work and life. If you are sporty, golf and swimming are good choices. Massage decreases pain — to a point. Hot massage creates heat, and nerve endings are tricked into thinking pain has been replaced by heat. Heat has benefits; the oils used in Ayurveda have chemicals to improve blood supply. However, if the lining is completely damaged, hot massage can be counterproductive. Yoga helps, but go to the right people, early.

Treatment must be individualized, since the severity, impact and type of arthritis is different from person to person, says Dr. Kirthi, Global Hospitals. Disease-modifying drugs (DMARDS) — oral or injectable, relieve pain and stiffness, and suppress inflammation. Follow instructions and take the medication as advised regularly. Put joints through a full range of movement at least once a day. This retains their mobility, reduces pain, relieves stress and protects them by keeping the muscles strong. Unexercised joints get stiffer, but the wrong sort of exercise can strain the joints, damaging them further. Consult a physiotherapist for exercises. Rest is important too, especially when the joints flare up with pain or inflammation.

With more of us joining the “aged” and the “obese” brackets, arthritis will only be on the rise. Take it on early. Herbal concoctions, massage, yoga, walks, exercise, lean food, a clean, stress-free life — find the right combo for a pain-free life.

FACT FILE

* Most types of arthritis respond to gentle exercise routines if treated early.

* Ensure right balance of exercise and rest.

* Arthritis can be put off.

* A sensible diet-and-exercise regimen is a must.

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