Arthritis Archive

Ask the doctor

Q. I take warfarin for my atrial fibrillation. I know it can increase the risk of bleeding. Is it okay for me to take ibuprofen for my arthritis?

A. In general, you should avoid ibuprofen—which is sold as Advil, Motrin, and generics—while taking warfarin, because taking them together may further increase your risk of bleeding.

Even the healthiest people can find it hard to stick with an exercise regimen — and if you suffer from the joint pain of arthritis, moving your body may be the last thing you want to think about. But regular exercise not only helps maintain joint function, it also relieves stiffness and reduces pain and fatigue.

If you have arthritis, you want to be sure your exercise routine has these goals in mind:

Osteoarthritis, the most common form of arthritis, occurs when protective cartilage inside a joint wears down. This type of arthritis is unheard of in children and is rare in young adults, but often occurs in older people and people who are overweight. Because of this, osteoarthritis was long considered a natural product of aging and everyday wear and tear on joint cartilage.

However, many experts now believe the cause is much more complex. External factors, such as injuries, can set the stage for osteoarthritis, but how fast it progresses and how severe it becomes depends on a number of factors. Here are just a few factors that can increase your osteoarthritis risk.

Depression is fairly common among people suffering with rheumatoid arthritis (RA). Recent research suggests that depression may worsen RA symptoms and even make medications less effective. To date, the studies that indicate a connection between the severity of RA symptoms and depression have not been conclusive, so more research is needed. In the meantime, if you have RA and notice signs of depression, be sure to talk with your doctor.

Painful knees and sleeplessness often go hand in hand, but a form of counseling called cognitive behavioral therapy (CBT) can help with both problems, according to a study in Arthritis and Rheumatology.

The study involved 100 people ages 50 to 70 with wear-and-tear arthritis (osteoarthritis) in the knee as well as insomnia. They were chosen at random for either eight sessions of CBT or a comparison treatment, called desensitization therapy, known not to be very effective for insomnia.

A few simple measures can protect your most flexible joint and put it back in service after overuse or injury.

All you need to do is rotate your arm to realize what a marvel your shoulder is. It's the body's most flexible joint and one of the most essential. Whether you're reaching the top shelf, swinging a golf club, or washing your hair, "it's the one joint you can't stop using," says Karen Weber, a physical therapist at Harvard-affiliated Spaulding Rehabilitation Network. "We do a lot of repetitive motions with our arms. When our shoulder muscles aren't strong, we can set ourselves up for injury," Weber says.

A desire to stay active and a natural aversion to pain send nearly 800,000 Americans to orthopedic surgeons each year for a hip or knee replacement. And we're seeking these operations much earlier in life. According to Dr. Scott Martin, associate professor of orthopedic surgery at Harvard Medical School, this isn't a healthy trend. "A lot of joint replacements are being done because they can be," says Dr. Martin.

Every surgical procedure carries the risk of complications — or even death. Because the average joint that's replaced only lasts 10 to 15 years, having the procedure done at age 50 instead of 70 means there's a good chance you'll need a second procedure when you're older and at higher risk for complications.

Here are some steps you can take to reduce your reliance on medication to control symptoms and stay functional.