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Is exercise good for arthritis?

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.

What to do when reading gets harder

Treating underlying conditions and using helpful strategies may be all it takes to get you back on track.

Reading for pleasure is one of life's great gifts. It's an escape to another world or a path to increased knowledge. Plus, reading about a subject that's new to you challenges the brain, which may help create new brain cell connections. But many aspects of health can affect our ability to read in older age.

Physical changes

Chronic disease and age-related changes can have a big effect on your ability to read. Consider these factors:

Chest pain that's not a heart attack

Ask the doctor

Q. My brother went to the emergency room because he thought he was having a heart attack. Instead, he was diagnosed with costochondritis. What is that?

A. Costochondritis is caused by inflammation of the cartilage between the ribs and the breastbone, called the costosternal joints (see illustration). This uncommon condition can trigger a stabbing, aching pain that's often mistaken for a heart attack.

4 stretches to keep your shoulders in shape

Keeping your shoulder muscles flexible will help prevent injury.

The shoulder is the body's most complicated joint. It's where the ends of the collarbone, upper arm bone, and shoulder blade meet. And it's prone to arthritis (a wearing away of the cartilage between the bones), as well as tears or tendinitis (inflammation) in the rotator cuff — the group of tendons that helps you raise and rotate your arm. Shoulder pain can keep you from being able to raise your arms to get dressed, or reach up to a cupboard or out to a door.

But an easy way to stave off shoulder problems is to regularly stretch the muscles that support the joints. "The muscles need to be long and flexible to stay healthy. You're more vulnerable to injury when your shoulder muscles are tight and restricted," explains Clare Safran-Norton, clinical supervisor of rehabilitation services at Harvard-affiliated Brigham and Women's Hospital.

Taming carpal tunnel syndrome

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:

Great exercise that's easier on the joints

Aquatic therapy can reduce pain and pressure while providing an effective workout.

When you're struggling with joint pain, gravity can make exercise an unpleasant experience. But exercising in water, also known as aquatic therapy, can change all that. "It enables you to do many of the same exercises you'd do on land without applying the same force on your joints," says Gayle Olson, a certified athletic trainer at the Sports Performance Center at Harvard-affiliated Massachusetts General Hospital.

A leg up on peripheral artery disease

The condition causes leg pain and fatigue that make activity difficult, but lifestyle changes can improve how you feel.

The occasional leg pain or stiffness is often not cause for concern, but if pain or fatigue develops after just a few minutes of walking or climbing stairs, it could be an early sign of peripheral artery disease (PAD).

"PAD not only interferes with an active lifestyle, but also can put you at higher risk for a heart attack and stroke," says Dr. Michael Belkin, chief of the Division of Vascular and Endovascular Surgery with Harvard-affiliated Brigham and Women's Hospital. "You can't cure PAD once it occurs, so you want to take measures to avoid it as much as possible."

Rubbing it in

Pain relief creams and ointments can get the medicine right to where it hurts, and the smell is often familiar and soothing. But do they work?

When something like a knee hurts, there's a natural tendency to rub it. And if it really hurts, most of us will think about popping a pain-relieving pill of some kind — acetaminophen (Tylenol) for starters, or perhaps one of the nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn).

Undoing the harm: Tapering down from high-dose opioids

The CDC’s Guideline on Prescribing Opioids for Chronic Pain helps doctors and patients manage treatment at safe levels and avoid dependence. Any plan to taper medication dosage should be personalized to the patient’s needs.

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