Kan Toriguchi writes:
Yoko kashiwagi is a successful 42 year old media executive. She was a marathon runner in her college days and continued to run and exercise regularly well into her 30s. Over the last two years she has stopped exercising altogether, has taken up smoking cigarettes,and has gained 7 or 8 kilos. Ms. Kashiwagi says that she's been feeling more and more fatigued lately, and the crackling and stiffness in her left knee sometimes is very painful. In addition, she has noticed that her left knee gets swollen and red, especially when she has to work late into the night.
She may have osteoarthritis. The disorder often develops in only one or two joints at first. It is important to know which type of arthritis she has. The doctor is the best person to make an accurate diagnosis but she can help him or her by providing a clear description of her symptoms. To make an accurate diagnosis, a doctor needs as much information as she can provide. Here is some of the information the doctor needs: Where does it hurt? The location of her arthritis pain can help her doctor determine the type of arthritis she has and, possibly, the cause. When does it hurt? Knowing the time of day when her pain is most severe will help the doctor determine what type of arthritis she has. For example, prolonged pain or stiffness in the morning is often associated with inflammatory types of arthritis. When did the pain first start? This information can help the doctor determine if her arthritis is caused by an injury, an illness, or general wear and tear on her joints. It will also help the doctor evaluate how much damage to her joints or bones has occurred since the disease started.
In addition to her symptoms, the doctor should ask about any serious illnesses, operations, allergies, or injuries she has had. Because some forms of arthritis tend to run in families, the doctor will ask whether one of her parents, grandparents, or brothers or sisters has had arthritis.
The doctor will want to know about any medications she is taking. Some medicines that are fine to take alone can cause a harmful reaction when they are taken with another medicine. Before prescribing a drug for her arthritis, the doctor needs to know about any medications she is currently taking regularly, both prescription and over-the-counter drugs.
Does she have allergies to any medications? Some people are allergic to certain medicines. This is essential information for the doctor to know before he or she prescribes something for her arthritis.
Depending on the symptoms she reports and on her medical history, the doctor may take X-rays of the affected joints. X-rays can show if a bone is damaged by osteoarthritis and, if so, how badly. The doctor may also want to test a sample of her blood or of fluid withdrawn from inside the affected joints. These tests may help rule out other diseases and determine the type of arthritis that is causing her symptoms. Some types of arthritis become obvious only as they develop over time.
If she has osteoarthritis, she may not feel the pain right at the affected joint, but in an area nearby. For instance, if her hip is damaged by arthritis, she may feel pain in her thigh, groin, buttocks, or knee. Pain from arthritis in her spine can radiate to her neck, arms, or legs. Her lower back may be stiff and her arms and legs may feel weak or even numb. In her fingers, arthritis can make the joints red, swollen, tender, and aching and her fingertips numb or tingly. If she has arthritis in her knees, bending them can be painful; she may feel rubbing or grating inside her knees or pain when she walk up or down stairs.
Swelling occurs in the joint when the tender lining of the joint (the synovial membrane) becomes irritated and produces fluid that collects inside the joint. As more cartilage wears away, growths may form on the ends of the bones. These bony growths can make the joint look knobby and swollen. If there is any swelling the absence or presence of swelling in her joints can indicate the type of arthritis she has. If the swelling is caused by inflammation, she may have rheumatoid arthritis or another type of inflammatory arthritis. If the swelling is caused by growths of bone (bone spurs), she probably has osteoarthritis. The goal of every treatment for arthritis is to reduce pain and stiffness, allow for greater movement, and slow the progression of the disease.
Weight loss and exercise are usually the first treatments recommended. Because of the potential side effects of many drugs that are used for treating osteoarthritis, medication is usually recommended only after weight loss and exercise have not been effective in relieving symptoms.
The best form of treatment for Kashiwagi is exercising, I think.
Although questions remain about how much exercise is too much, regular exercise is known to be very effective for relieving the pain and stiffness of osteoarthritis and may help slow the progression of the disease. Here are some good reasons to exercise if she has arthritis: Exercise strengthens the muscles that support the joints, which helps protect the joints from further damage and can reduce the pain of arthritis.
Exercise improves the flexibility of the joints so the more easily she can move them without pain. Exercise can make her feel better mentally and emotionally by relieving stress and elevating her mood.
The exercise program that will work best for her is one that fits her lifestyle and physical abilities. Doctors generally recommend a combination of stretching exercises, mild strengthening exercises (such as lifting weights), and low-impact aerobic exercises (such as swimming, walking, or bicycling). It's important to talk to her doctor before she begins any regular exercise program. The doctor can help her determine which exercises are best for her, how often she should exercise, how much exercise she should do to make her exercise session more comfortable.
When she is exercising, doing housework or chores, or engaging in other activities, rest frequently, change positions regularly, and stretch her muscles between periods of exertion. Pacing her activities throughout the day can help her save energy and reduce stress on her joints. It is best to exercise several times throughout the day for shorter periods than to do it all in one long session. Begin and end each exercise session with a warm up and cool down by walking around slowly for 5 minutes before and after. Exercise at a rate at which she can speak comfortably.
Stretching exercises, which are also called range-of-motion exercises, are good for helping to reduce stiffness in the joints and improve their flexibility. Stretching exercises include anything that requires regular movement of a joint to its fullest capacity. For example, holding arms out to sides and circling them in a windmill fashion stretches the shoulder joint. Some forms of water exercise use warm water to loosen joints and help them stretch. Doing stretching exercises for a few minutes every day can significantly improve the movement in the joints.
Strengthening exercises help maintain or build the muscles around the joints, which helps keep the joints stable. Stronger muscles also improve the joint's movement. Lifting light weights, such as 1- to 2-pound dumbbells, every other day is often enough to make a difference. (Muscles need a day off in between to rest and rebuild.) But before beginning any type of weight training, talk to the doctor. She will need to be carefully instructed in this type of exercise to avoid injury and further damage to her joints. Some forms of water exercise include strengthening exercises.
Fitness exercises, also called aerobic exercises, increase endurance, strengthen heart and lungs, and give energy. Try to exercise aerobically for at least 60 to 90 minutes each week. Brisk walking, swimming, and bicycling are good fitness exercises if she has arthritis because they allow for smooth rather than jerky movements. Swimming is especially good if she has arthritis in her knees or hips because the water supports her weight, which reduces stress on those joints.
In terms of Ms K's long term improvement, first she had better ask for help. Her family members and friends can play a critical role in helping you learn to live with arthritis. Talking with loved ones about the difficulties you are having can help prevent depression and improve your ability to cope with your illness. Then, second, she had better protect her joints. She can avoid excessive stress on smaller,more fragile joints by using larger or stronger joints to carry things. For example, carry grocery bags using your forearms or the palms of your hands instead of your fingers. Carry food on a tray, using your forearms and hands instead of your fingers. Use lightweight, plastic dishes. Then, third, she needs to change her lifestyles she should stop work late into the night, because when she has to work late, her knee gets swollen and red. Also she must pay attention to her health, because she is familiar with complication from arthritis since her father.Last, the most important is to educate herself. The more she knows about her illness, the more control she will have over it and the more successful her treatment is likely to be.
| Click the BACK button to return to the student index.|