Research shows that people with OA who take an active role in their own care report less pain and make fewer doctor visits. They also enjoy a better quality of life. Working with a team of healthcare providers enables people with the disease to minimize their symptoms, share in decision making about treatments, and feel a sense of control over their lives.
This section includes information about the following elements of self-care and managing OA:
- Resting joints after overdoing
- Assistive devices
- Warding off depression
- Relaxation techniques for pain relief
- Good sleep habits
Regular exercise can keep the muscles around affected joints strong and decrease bone loss and may help control joint swelling and pain. Finally, exercise promotes weight loss, which reduces most OA symptoms.
Four types of exercise are extremely beneficial to OA patients: Low-impact aerobic, range-of-motion, muscle-strengthening, and water exercises.
Aerobic exercise such as jogging improves overall fitness and endurance, reduces risk factors for heart disease, and enhances weight loss. Yet high-impact activities may hasten cartilage breakdown in patients who have OA of the knee or hip. Instead, low-impact exercises are recommended. These include bicycling, using an elliptical trainer at a health club, swimming, or walking.
Range-of-motion exercises involve moving a joint as far as possible without causing pain. The goal is to improve flexibility, which is key to joint function, and reduce pain and stiffness.
Muscle-strengthening exercises increase the support for a joint, thus reducing the load on them. Pushing or pulling against a stationary object—known as isometric exercise—builds up muscle without straining joints, because the joints remain immobile during these exercises.
Water exercises allow an aerobic workout, muscle strengthening, and range-of-motion, all while using water to support the body, reducing strain on joints and increasing comfort. Pool running is an aerobic exercise in water. Calf raises and high steps while standing in chest-deep water strengthen joints. Leg stretches while sitting on pool steps improve range of motion.
A physical therapist can help OA patients get started on an exercise program. Organizations like the Arthritis Foundation have local chapters that offer exercise classes.
For more information on exercise and losing weight, see our section on weight control.
When a person with OA pushes too hard, either in an exercise program or when doing household tasks or his or her job, joints will hurt. It is important to give the body time to recover. If there is joint pain (as opposed to muscle pain) that persists for two hours after ceasing an activity, consider it a warning sign that the joint should be rested for a day or so and that therapies like warmth and cold or painkilling drugs may be called for.
Don't eliminate the exercise or activity for good, since inactivity will make OA worse. Simply do the activity or exercise for a shorter period, or more gently. If this doesn't help, a physical therapist will be able to advise you on exercise techniques that cause less pain, and an occupational therapist will be able to do the same thing for household or work tasks.
When OA causes pain and restricts mobility, the simple tasks of daily living can become quite difficult. Devices designed to assist with self-care are available through pharmacies or through the Arthritis Foundation.
For dressing, a sock aid helps pull up socks without making people bend their legs or backs. A zipper pull has a large ring that attaches to the zipper tab, making it easier to grab.
For cooking and kitchen work, a jar opener grips lids. Wide-grip foam handles can be used on knives and forks and other utensils. A reach extender—a rod with a trigger-controlled clasp at the far end—allows people to pick up small objects.
Bathing aids include a long-handled sponge to assist with reach and a tub grab-bar for balance. An elevated toilet seat reduces the strain created by getting on and off traditional low seats.
For better mobility, devices include canes, braces, and orthotics.
Chronic pain and depression frequently go hand in hand. Depression can make working difficult, derail OA patients from their self-care programs, strain family relationships, and drain away any joy in life.
It is not inevitable, however. Patients can seek help if they learn to spot the signs of depression:
- Low spirits that last for two weeks or more
- Strains in relationships
- Lack of interest in work
- Sleeplessness or oversleeping
- Loss of appetite or overeating
- Crying or frequent, overwhelming sadness
- A sense of worthlessness
- Persistent headaches or digestive disorders
OA patients who think they are depressed should first consult their rheumatologist, who can evaluate whether any arthritis drugs might be causing the symptoms. Then they should consult a mental health specialist, such as a psychologist, psychiatrist, or social worker, who may suggest one or a combination of treatments, including cognitive or behavioral therapy or anti-depressant medications.
Patients can also help themselves to avoid feeling isolated by making a point to spend time with friends or by joining a support group. Participate in a favorite activity, even if participation feels like a chore. These efforts can often help lift a patient out of a dark mood.
Medication does not always sufficiently manage the chronic pain caused by OA. But there are several pain control techniques that use relaxation, and patients who practice them often find them quite effective for short-term relief. They also can give patients a sense of having much more control over their lives.
Deep-breathing exercises make a person aware that breathing is related to emotional states; controlling breathing can reduce stress, and stress reduction often reduces the sensations of pain.
Progressive muscle relaxation is a technique that teaches muscle-by-muscle relaxation, by getting patients to tense muscles and then release then, heightening awareness of the difference. Tense muscles can exacerbate feelings of pain; relaxed muscles can reduce them.
Guided imagery uses the power of patients' imaginations to visualize places or times where they are peaceful, pain-free, and healthy.
Biofeedback is a technique that uses electronic monitors to help patients learn to alter particular body functions. For instance, a heartbeat monitor sounds a high tone when the beat speeds up and a low tone when it slows down, and patients try to make the tone lower and lower, thus slowing their heart rate.
There are several ways to increase the likelihood of a good night's sleep, which is often difficult to achieve when joints are causing discomfort. Restful sleep decreases the likelihood of stress and pain during the day.
Choose a good mattress, along with quality bedding, to help make bedtime a welcome time of day.
Establish a regular and relaxing night-time routine, such as reading or drinking a cup of milk or noncaffeinated tea before lights out.
Keep work and other activities that require an active mind out of the bedroom.
Avoid caffeine, alcohol, and big meals before bedtime.
Last reviewed on 7/21/2009
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