Azam Anwar played a lot of competitive tennis in his youth, and trophies aren’t the only thing he has to show for it. An arthritic right knee reminds him of the years spent on the singles court.
“Your body starts talking to you, and you have to start backing off, trying other alternatives,” said Anwar, a Dallas cardiologist. He has had two surgeries on his knee.
Experts say there’s no need for Anwar, 49, and other baby boomers with arthritis to trade their Nikes for a rocking chair on Craigslist.
“People with arthritis might be living under the myth that they can’t be physically active, but now we know there is no doubt that, if you exercise, it keeps you more mobile as you age and builds muscle needed to support your joints,” said rheumatologist Patience White, chief public health officer of the Arthritis Foundation.
White said there are numerous ways to reduce achy joints and stay in the game, including:
• Incorporating stretching and strength training into workouts.
• Playing sports that don’t place a heavy burden on joints.
• Injections for temporary relief.
• Alternative therapies.
“Your most powerful asset may even be your state of mind,” White said.
Arthritis occurs when the cartilage and synovial fluid (the liquid between joints that helps them glide) are inflamed. There are many forms of it. Osteoarthritis, which Anwar has, is the most common and results from chronic wear-and-tear that comes with age. It’s more likely to occur sooner if a joint has been injured or been operated on, said Scott Zashin, clinical assistant professor of rheumatology at the University of Texas Southwestern Medical School in Dallas. “Typically I see it in the knee, but it can affect the spine, hips, hands, feet.”
Ditch the high-risk activities
Anwar knew the solution wasn’t to stop exercising, which could lead to weight gain. So he has modified his fitness routine. “You can’t be a hermit, but there are certain activities that are very high risk. Now I stretch a lot more, weight-lift, golf, walk a lot,” he said. “And if I want to play tennis, I play doubles.”
Hard-on-the-joints sports include football, skiing, basketball, and soccer, said Nicholas DiNubile, an orthopedic surgeon, in Havertown, Pa. DiNubile said walking, swimming, biking, and strength-training are healthier for the joints.
Stretching and core-strengthening activities like yoga and Pilates help stabilize weakened joints, said Nisha Manek, a rheumatologist at the Mayo Clinic. Start with a gentle program, she said. “Honor your limitations.”
Keep the weight off
Eating healthy shouldn’t be overlooked as an arthritis management strategy, said David Karp, chief of the rheumatic diseases at the University of Texas Southwestern Medical Center.
“In this country, obesity is one of the biggest risk factors for arthritis,” Karp said. “Overweight people can obtain joint relief even if they lose 10 pounds.”
In one study, arthritis sufferers who ate a Mediterranean-style diet reported improved well-being. Other research suggests omega-3 fish oil reduces joint inflammation, Manek said.
Medicate with caution
Over-the-counter and prescription drugs can help calm arthritis enough to make exercise comfortable, said Frederick Azar, professor of orthopedics at the University of Tennessee-Memphis. But they carry risks.
Avid basketball player Mark Liszt, 61, of Los Angeles landed in the hospital with an ulcer from prescription anti-inflammatory drugs he took for arthritic knees. “Now, I don’t take anything,” Liszt said.
Cortisone shots can reduce inflammation but also have side effects, Azar said.
“Hyaluronic acid is another weapon in our arsenal,” said Azar about injections of a fluid already present in joints. But Azar said not all patients benefit.
Mayo Clinic rheumatologists April Chang-Miller said Botox injected into specific muscles may ease pain. “Early studies are promising,” she said.
Beyond conventional care
Alternative therapies may help, but not all are clinically proven, Zashin said.
Researchers from Baylor Research Institute say more than half of patients in a 2007 study reported better movement and less pain after taking tart-cherry supplements.
Vitamin D is touted for bone health, but also believed to play a role in inflammation. A study out this month in the Archives of Internal Medicine associated D-deficiency with inflammation in healthy women.
Preliminary data from a Tufts study suggests that tai chi and chi gong exercises help knee osteoarthritis. Mostly, keep a positive attitude, said Theresa Nustvold, 44, of Amery, Wis., who has lupus-related arthritis. Once an avid runner, Nustvold now practices more joint-friendly walking and yoga instead. “You can’t lay down and let it get you. You’ve got to stay moving.”