Arthritis and Pain Management

Pain and discomfort are side effects of arthritis. The goal is to distinguish between pain that is normal and pain that is abnormal.

With physical activity it is normal to feel some discomfort but not extreme pain.

Before you start, a hot shower or bath, heating pad, electric blanket, or a hot towel is sometimes recommended prior to exercise. Heat helps to decrease pain and stiffness and makes exercise easier to perform.

Use the 2-hour pain rule: if you feel pain 2 hours after exercise then it is an indication that you have overexerted yourself and therefore the workload is inappropriate.

You also need to listen your own body and pain tolerance, especially when executing exercise in a group. Keep in mind that everybody has different fitness levels and pain tolerances.

Progress slowly and modify when necessary. For example, you can decrease repetitions and speed of the movement when appropriate or use both legs (squat) instead of doing lunges which are harder on the front knee.

Use proper body mechanics by avoiding quick directional changes.

Protect your joints by:

  • Avoid positions that compromise the joint.
  • Use joint-stabilizing positions when appropriate (e.g., use a fisted-hand position versus a flat-palm position when the wrist is extended at 90 degrees).
  • Use stronger and larger joints for support when possible.
  • Avoid being in one position for a prolonged period of time.
  • Conserve energy.
  • Caution against overexertion or overloading joints.
  • Use adaptive equipment if necessary.
  • Stop any movement at the point of experiencing pain.

Non-weight-bearing activities such as aquatic exercise, rowing OR cycling may be better for you if pain persists for a longer period. Activities that use smooth, repetitive motions such as walking, cross-country skiing, biking, upper-body ergometry, elliptical training and swimming may be well tolerated.

Include flexibility and relaxation in your exercise program. These reduce muscular tension and smooth muscles and joints. In case of flare-up or a bad day, relaxation and gentle stretching, like yoga (get more info about my yoga here), may be all that is indicated.

Avoid becoming chilled which leads to increased muscle tension: bring a sweater or a blanket to execute the flexibility or relaxation at the end of your exercise program.

Appropriate footwear is essential, not only for injury prevention, but for comfort. I usually say to my clients that when shoes are getting yellow (dirty) it is time to invest for a new pair because the cushions on the bottom of them are too compressed and do not absorb shocks anymore which leads to feel discomfort or pain in the knees. Here are some points to consider for your next purchase: a wide toe box for comfort; a wide sole for stability; extra cushioning and/or depth for an accommodating inserts (orthotics); and Velcro for ease of use.

Consider the best time of day to exercise. Usually people with rheumatoid arthritis and ankylosing spondylitis tend to be less stiff and sore later in the day while those with osteoarthritis may be better able to tolerate exercise in the morning.

Use your medication properly. Refer to your physician when needed or visit the Arthritis Society.

Source: Exercise and Arthritis by DSW Fitness, Center for Continuing Education
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