Living with Osteoarthritis

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• QWhat kind of shoes should I wear if I have osteoarthritis?

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  A Sigma Nursing answered

  Wearing the right shoes is important if you have osteoarthritis. Running shoes do not appear to help ease the pain or reduce the risk of osteoarthritis (OA). One study found that there was less pressure on knees and hips when running barefoot compared to running wearing running shoes. Wearing flat shoes reduces stress on your knees and is a better choice for women who have osteoarthritis. Walking around barefoot while at home will further reduce the amount of stress put on the knees.

  Although it’s not a good idea to run while wearing flip-flops, walking in them is almost as good as going barefoot. Flip-flops that are lightweight with flat, flexible soles put less stress on the knees than shoes with rigid soles.

  Wearing heels, even if they aren't very high, can promote joint damage and worsen osteoarthritis.

  Foot orthoses, also called shoe inserts, can help correct knee adduction—movement of the knee while walking—and act as a shock absorber to take some of the stress off a knee that has been damaged by osteoarthritis (OA). There is also some evidence that orthoses may slow the progression of mild to moderate osteoarthritis of the inside of the knee and the foot. But the research is inconsistent. Some studies find that they reduce pain and stiffness, and enable people with OA to cut down on pain medication. Other studies find they provide limited, if any, benefit. 

• QWhat should I do to cope with osteoarthritis?

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  A Sigma Nursing answered

  Osteoarthritis is a debilitating condition and can be difficult to cope with. You need all the help you can get. To cope with your osteoarthritis, start with a visit to your doctor to discuss treatment that’s right for you. Here are some additional things you can do to cope:

  • Take your medications on time and follow your doctor's directions.
  • Use family and friends as support.
  • Exercise and find time to rest.
  • Reduce stress through relaxation, music, massage, yoga and getting enough sleep.
  • See a social worker or counselor.
  • Share your concerns with a support group of people who have arthritis too.
  • Keep a pain journal to document your symptoms or yourself and your doctor.
  • Stay educated about your condition.
  • Consider buying gadgets like jar openers and zipper pulls to make everyday tasks easier.
  • Make adjustments to furniture and fixtures, to make it easier and safer for you to get around the home and take care of everyday tasks without assistance. Move furniture to create plenty of space to walk around a room, keep lamp cords tucked away, make sure rooms and stairways are well-lit, and add back and neck supports to chairs, the sofa and the bed.
  • Install a raised toilet seat, replace the tub with a walk-in model or with a shower stall, and add handrails on the staircase or in the bathroom.

  Daily management of osteoarthritis requires reducing strain on the affected joint and managing pain and inflammation. Ways to reduce strain include keeping your weight at a healthy level, using supportive devices such as a cane, brace or shoe inserts; and taking breaks throughout the day to rest the affected joint. Pain and inflammation can be managed with acupuncture or massage and applications of heating pad and ice packs on the inflamed joint. You might also try topical creams that have pain relieving medications. Finally, a doctor may also recommend over-the-counter or possibly prescription drugs to help with the pain and swelling on a daily basis.

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• QHow can the weather contribute to osteoarthritis pain?

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  A Sigma Nursing answered

  Weather cannot cause osteoarthritis (OA), but some studies have found that the pain and stiffness of OA gets worse when the weather changes. One study found women experience more pain when the barometric pressure is higher. Another study found that people with osteoarthritis experienced more pain during cold or humid weather.

  Medication, regular physical therapy and other treatments may reduce the pain caused by OA.

• QHow can negative thinking affect osteoarthritis?

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  A Sigma Nursing answered

  When you live with the chronic pain of osteoarthritis, it is easy to get caught up in negative thoughts, such as, "I'll always be in pain" or "This pain is ruining my life." But negative thinking is counterproductive because it can lead to hopelessness that can discourage you from taking steps to improve your condition—such as exercising and losing weight.

  Talk to your doctor about different treatment options that may improve both your osteoarthritis pain and your mood.

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• QWhat do I need to know about caring for someone with osteoarthritis?

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  A Sigma Nursing answered

  Caring for someone with osteoarthritis requires patience and the knowledge of the individual's limits. Those affected with the disorder may not function at the same level they once did. It is important to realize that osteoarthritis can make people more susceptible to fatigue and weakness in the muscles. Treating the symptoms promptly and consistently as well as maintaining a level of relaxation has been shown to positively impact pain and fatigue. The person should be encouraged to engage in physical activity, though, as fitness can be a big help in dealing with the disorder. Also, make sure they take any medications exactly as prescribed.

  It’s always helpful to have a caregiver with you at your osteoarthritis (OA) appointments and procedures to help you ask questions, take notes about your condition and treatment options, and learn about at-home care after a procedure. Having a supportive, caring person with you at an osteoarthritis appointment or procedure can also be comforting.

  Some research suggests that people living in elderly communities, assisted-living facilities, or nursing homes don't get good enough care for their osteoarthritis. This is a significant problem since more than 80 percent of the elderly population has osteoarthritis. If you or someone you know has osteoarthritis, talk to the doctor about getting the best care.

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• QHow can I manage my osteoarthritis at work?

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  A Sigma Nursing answered

  Osteoarthritis (OA) and the pain and stiffness it causes in the joints can be a limitation at work, especially if your job requires you to stand or walk a lot. Certain jobs require repeating the same motions such as kneeling, lifting, bending or typing over and over. Repetitive motion can cause repetitive stress injuries to the joints of the hands, spine, hips and knees by wearing away cartilage that supports and cushions them, causing bones to rub against each other. This rubbing motion may cause osteoarthritis.

  Good posture—and not just at work—is vital when you have osteoarthritis. Sitting and standing up straight will protect the joints in your knees, hips, back and neck. To practice good posture, pretend there’s a string coming out of the top of your head that someone is pulling on to lengthen your spine and keep your shoulders back instead of slumped.

  Physical therapy, splints, braces and pain relievers can make it easier and more comfortable for you to get around on the job. If all else fails, surgery may be necessary.

  By law, your employer is required to make reasonable accommodations to help enable you to continue doing your job, or to transfer you to another job. Reasonable accommodations may include working from home, working a flexible schedule, and purchasing or installing assistive devices. An occupational therapist can work with your employer to discuss reasonable accommodations that may be necessary for you.

• QWhat are the dietary recommendations for someone with osteoarthritis?

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  A Sigma Nursing answered

  People with osteoarthritis should eat a healthy, low-fat diet. Maintaining a healthy weight through diet and physical activity can help slow the progression of osteoarthritis.

  A good diet with adequate sources of the antioxidant vitamins A, C and E might help protect joint cartilage.

  Foods can't cause osteoarthritis, but a poor diet can make the condition worse. A high-fat diet can cause weight gain and obesity, which trigger inflammation in the body, and can lead to joint damage and osteoarthritis. Fat also causes inflammation throughout the body. Inflammation of the joints is a leading cause of the debilitating pain that stems from osteoarthritis.

  More research needs to be done to determine how dietary practices are related to osteoarthritis.

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• QWhat type of exercise can I do if I have osteoarthritis?

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  A Dr. Geraldine M. Navarro, MD , Rheumatology, answered on behalf of UCLA Health

  Aerobic exercises that are good for osteoarthritis (OA) and easy on the joints include joint-friendly, low-impact exercises such as walking, swimming, bicycling and water aerobics. Avoid jolting exercise like jogging that causes the feet to pound the ground. Moderate intensity aerobic exercises that are good for OA include brisk walking, social dancing, use of conditioning machines, tai chi or yoga, sports, skiing, roller or ice skating, and doing heavy yard work. They can help slim people down as well. Aim for 30 minutes of low-impact aerobic activity for most days of the week.

  For strength exercises for osteoarthritis (OA), you can choose between machines and free weights. The machines are good because they ensure proper form, provide support and isolate specific muscles. However, they aren’t designed for all body types, and they only work a single joint at a time. Free weights allow for a greater range of motion, greater diversity of exercises and improved coordination and balance. The bad thing about free weights is you can do the exercises incorrectly and cause harm to other areas.

  If you have arthritis and are sore when you exercise, these pains are usually normal. Modify your program by reducing the frequency or duration of physical activity until your pain improves. You can also change the type of exercise to reduce impact on the joints. For example, switch from walking to water aerobics.

  Some warning signs to consider when you are exercising are sharp, stabbing or constant pains. You should see a doctor if:

  • the pain causes a limp
  • the pain lasts for more than two hours after exercise
  • the pain gets worse at night
  • rest, medication and hot and cold packs don't relieve the pain
  • any swelling increases

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• QCan an older person with osteoarthritic knee pain exercise?

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  A Dr. Pao-Feng Tsai , Geriatrics Nursing, answered on behalf of Sigma Nursing

  The elder should start with only about 20-30 minutes of low intensity exercise per day, 2-3 days a week. The elder may experience more knee pain, swelling, fatigue and weakness after exercise initially, due to the stress of exercise. However, exercise should provide better quality of life in the long run, including relief of mental stress, pain and disability. Taking analgesics before exercise may help reduce pain caused by exercise. Taking time to rest during exercise may be necessary. An average of 2-3 months may be needed for sedentary elders to adapt to the stress of exercise.

  
  

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• QWill wearing flip-flops help my osteoarthritis?

  2 Answers

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  A Sigma Nursing answered

  Flip-flops and sneakers with flexible soles may help ease the symptoms of osteoarthritis (OA). A study found that wearing flip-flops that are flat, flexible and lightweight appeared to put the least amount of pressure on the knees when compared to clogs or walking shoes. Walking in flip flops appeared to be similar to walking with bare feet.
  
  The finding is important because pressure or loading on the knee joint is a key factor in the development of osteoarthritis. But walking in flip flops may not be ideal for the elderly who may be more likely to fall wearing flip flops because of their loose-fitting design. People over the age of 65 should consult a doctor to determine the type of shoe that best suits their needs.

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