Arthritis Archive

Physical therapy may be an effective alternative to surgery in relieving joint and back pain.

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Exercising may be the last thing you want to do when you have a sore knee or aching back, but it might be the first thing you should do. Physical therapy has long been recommended following surgery. But for some, trying physical therapy before opting for surgery may be the better choice.

"You may be able to spare yourself the expense, pain, and recovery time of surgery," says physical therapist Karen Weber, clinical supervisor at Harvard-affiliated Spaulding Rehabilitation Outpatient Centers in Braintree and Quincy, Mass.

In the journals

Corticosteroid injections are used to ease short-term knee osteoarthritis pain, but a new study in the May 16, 2017, Journal of the American Medical Association suggests the treatment may not help in the long term.

Researchers recruited two groups of 70 people, average age 58, with knee osteoarthritis. One group received 40 milligrams of the steroid triamcinolone (Kenacort, Kenalog, Artistocort) every three months for two years, while the other group got placebo injections. By the end, pain scores — measured on a scale from zero for no pain to 20 for extreme pain — had dropped by only 1.2 points among the steroid group, while the placebo group's score dropped by 1.9 points, neither of which was clinically significant.

This common type of arthritis can show up suddenly and cause debilitating pain.

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The great artists Ludwig van Beethoven, Luciano Pavarotti, and Leonardo da Vinci had more than extraordinary talent in common; they were also sufferers of a type of inflammatory arthritis called gout. You may be at risk of joining their ranks if you have any potential triggers for the condition. "Most people are surprised by their initial gout diagnosis, unless they have a strong family history," says Dr. Mark Fisher, a rheumatologist at Harvard-affiliated Massachusetts General Hospital.

About gout

Gout is mostly a man's condition, although women can experience it, too. It's caused by a buildup of uric acid — a waste product from the breakdown of natural chemicals called purines (an essential part of DNA).

In the journals

Studies have shown that regular activity can help older adults with arthritis stay independent. How much is enough? Research published online Dec. 28, 2016, by Arthritis Care & Research suggests you may need as little as 45 minutes per week.

Federal guidelines recommend 150 minutes of moderate activity per week to prevent premature death and serious illness. However, reaching that number is tough to reach for people with arthritis; in fact, only one in eight men with knee arthritis meet this standard. In this study, researchers tracked several years of fitness activity for 1,629 adults (44% of whom were men), ages 49 to 83, with osteoarthritis in the hip, knee, foot, or some combination. Specific exercises or activities were not recorded, only the time invested per week.

How to distinguish the symptoms from other conditions, and what to do about treatment.

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When your joints ache, you may chalk it up to an old injury or to osteoarthritis — the wearing away of cartilage that's common in older age. But for two million people in the United States, aching joints are caused by rheumatoid arthritis (RA) — when the immune system mistakenly attacks the tissues lining the joints.

"People commonly assume RA pain is due to aging, overuse, or even the flu," says Dr. Robert Shmerling, a rheumatologist at Harvard-affiliated Beth Israel Deaconess Medical Center, and medical editor of the Harvard Special Health Report Rheumatoid Arthritis (health.harvard.edu/RA).

A study of people with osteoarthritis of the knee found that at the end of the study period, those participants who received more personalized attention via the web (including physical therapy sessions and information about pain management) had less pain and better movement function.

Your ability to grab, hold, twist , and squeeze is essential for many everyday functions.

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Think how much you rely on a strong grip every day. It helps you open cans, grip a golf club, hold a steering wheel, brush your teeth, and pick up a grandchild. "The ability to stay active and independent often begins with our hands," says Maria Cole, a physical therapist with Harvard-affiliated Spaulding Outpatient Center. "Weak grip strength can limit your enjoyment of many life pleasures, so you need to ensure your hand and grip strength always are up to the task."

A measure of health

Exercise your hands