Bones and joints Archive

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:

Addressing arthritis, hearing loss, and cataracts will help preserve your independence.

Older age brings lots of physical changes, like stiffer joints and difficulty seeing or hearing. Those developments may not cause disability, but they may have an effect — even a subtle one — on your driving. That's why it's smart to be proactive once you notice physical changes, to find out how each condition can jeopardize your driving skills, your safety, and the safety of others on the road.

Common ailments

There are many physical changes that can affect your driving skills. The following are among the most common.

On call

Q. I have osteoarthritis. My right knee is especially painful and stiff. How do I know when the time is right for knee replacement surgery?

A. Timing is key. If you get the procedure too soon, you might not see enough improvement to make the surgery worth it. In addition, the younger you are when you have knee replacement surgery, the greater the chances it will not last and another surgery may be needed. But if you wait too long, you may subject yourself to unnecessary pain and disability.

They can offer temporary pain relief, but are they right for you?

If you're battling with a flare-up of arthritis, bursitis, or tendinitis, you may find relief from an injection of cortisone (a type of steroid).

"People turn to injections when conservative treatments like over-the-counter and prescription pain medication or physical therapy no longer work, and their pain begins to interfere with quality of life," says Dr. Rob Shmerling, clinical chief of rheumatology at Harvard-affiliated Beth Israel Deaconess Medical Center.

Ask the doctors

Q. I recently started experiencing a lot of pain in my hand from osteoarthritis. Can I reverse this condition?

A. You can't reverse osteoarthritis, but there are things you can do to manage your pain and improve your symptoms. Osteoarthritis occurs when the protective cartilage that acts as cushioning between your bones starts to fray and wear down over time. Eventually this enables the bones to rub together, which causes the pain you are experiencing as well as swelling and stiffness that makes it difficult to move your hand freely. Typically, when you have arthritis, the pain and symptoms will be worse at some times than at others. You may experience a flare-up one day and feel better the next. To help reduce the discomfort of a flare-up, talk to your doctor about medication to relieve pain. She or he may recommend an over-the-counter pain reliever. Some people also get symptom relief using a topical pain reliever that is rubbed into the skin. Other strategies that can ease pain are splints or braces, heat or cold therapy, activity modification, and exercises or physical therapy to increase flexibility and strengthen your hand muscles.

Research we're watching

To manage the painful joint disease known as osteoarthritis, people often take ibuprofen (Advil, Motrin) and naproxen (Aleve, Anaprox). But these and related drugs — known as NSAIDs — may account for the higher rates of heart disease seen in people with osteoarthritis, a new study suggests.

Researchers matched 7,743 people with osteoarthritis with 23,229 healthy people who rarely or never took NSAIDs. People with osteoarthritis had a 42% higher risk of heart failure and a 17% higher risk of coronary artery disease compared with healthy people. After controlling for a range of factors that contribute to heart disease (including high body mass index, high blood pressure, and diabetes), they concluded that 41% of the increased risk of heart disease related to osteoarthritis was due to the use of NSAIDs.

Can you do anything about hand and finger joint pain?

Everyone experiences the occasional painful hands and sore fingers, but when osteoarthritis strikes, it can put a hold on many aspects of your life.

"As osteoarthritis progresses, you may lose some hand mobility, like the ability to grasp and hold objects," says Dr. Robert Shmerling, clinical chief of rheumatology at Harvard-affiliated Beth Israel Deaconess Medical Center and senior faculty editor at Harvard Health Publishing. "Over time, osteoarthritis can make the joints deformed, so it's harder to open and close your hands."

Ask the doctor

Image: Karl Rosencrants/ Thinkstock

Q. It's been suggested that drinking 2 to 3 ounces of tonic water before bedtime can prevent leg cramps at night. Is that true?

A. Tonic water—and the quinine it contains—have been promoted for preventing leg cramps for decades despite the lack of evidence that they are effective. Quinine is FDA-approved only for treating malaria and is sold with a warning against using it to treat leg cramps or muscle pain, because it increases the risk of bleeding and heart rhythm disturbances. Tonic water contains no more than 83 mg of quinine per liter—a much lower concentration than the 500 to 1,000 mg in the therapeutic dose of quinine tablets. Drinking a few ounces of tonic water shouldn't be harmful, but it isn't likely to prevent your leg cramps.

Ask the doctors

Q. I have arthritis and my doctor recommended I start exercising, but I'm worried it will make my pain worse. Should I follow her advice?

A. Yes, your doctor is right. Although it may seem counterintuitive to move more when your joints hurt, studies have shown that exercise can reduce arthritis-related pain, fatigue, and stiffness. Exercise is also important for your overall health and can help reduce your risk of heart disease, obesity, and diabetes.

Inside your wrist, a slick tunnel passes through the carpal bones. The nerves and tendons of the wrist pass through this space, called the carpal tunnel. One of these nerves, the median nerve, controls sensations in the palm side of the thumb, the index and middle fingers, and half of the ring finger. It also transmits the impulses to certain hand muscles that allow the fingers and thumb to move. Carpal tunnel syndrome occurs when this nerve becomes irritated or squeezed. Symptoms include numbness, tingling, pain, or weakness in the hand of the affected wrist.

Because the carpal tunnel starts out narrow, it doesn't take much to aggravate or compress the median nerve. A number of conditions can make a person more prone to carpal tunnel syndrome. These include: