It’s the catch-22 of arthritis: The more pain you have, the less you want to move — but the less you move, the more pain you have.
But movement is exactly what your body needs to combat your disease, says Lisa Folden, an occupational therapist and naturopathic lifestyle coach at Healthy PhiT Physical Therapy & Wellness in Charlotte, North Carolina. “Movement in the joints encourages the production of synovial fluid, which lubricates the joint spaces and makes movement more comfortable over time,” she explains.
Thankfully there is a way to break this vicious cycle: Enter the occupational therapist (OT), a professional therapist who specialises in helping you not just maintain your lifestyle but thrive with less pain. This is a broad definition of an occupational therapist from the American Occupational Therapy Association: “Occupational therapists and occupational therapy assistants help people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities.”
We interviewed seven OTs to get the tips they wished all their clients with arthritis knew and followed. Here’s what they told us:
1. Wake up and stretch
Before you do anything else, take a few moments to stretch. You don’t even have to get out of bed, Folden says. “Everyone should stretch in the morning, but people with arthritis have a much higher risk of developing significant muscle tightness and contractures in the joints due to avoiding movement,” she explains, which contributes to a vicious cycle of pain and inactivity. “Stretching the muscles of the body helps to stop this dangerous cycle right away.
Focus on the entire body, specifically the hamstrings, quads, calves, back muscles and shoulders.” Gentle range-of-motion stretches can help you feel active even on days when you have a lot of pain or fatigue.
2. Take the pain out of hair care
Holding your arms above your head to wash, blow dry or style your hair can be impossible with shoulder, wrist or hand pain. Adapt your routine to your needs, Folden says. You can flip your head upside down to make washing and drying easier on your shoulders. Or consider purchasing a “dome” style hair dryer that doesn’t require you to hold your arms up.
3. Get creative with clothing
The trick to getting dressed or undressed while dealing with arthritic joints is to get creative, Folden says. First, be a more discerning shopper. Look for clothing with elastic waists, large zippers and other easy-on/easy-off features. To make your current wardrobe more manageable, “there are tons of adaptive tools you can purchase, from long arm grippers to extended shoe horns to button hooks,” she says.
Keep a chair near your wardrobe so you can sit down while you get dressed. “Put on one garment at a time and take your time. Plan ahead so that you don’t feel rushed,” she adds.
4. Take a walk every day
Walking may be the last thing you feel like doing, but if you want to feel better, you need to make a daily walk a top priority, says Zach Kovacevic, an occupational therapist at Texas Physical Therapy Specialists. Research has found that for every additional 1,000 steps you walk per day, you are 12 per cent less likely to need a total knee replacement and if you walk 6,000 steps a day or more, you reduce your risk by more than half, he says. “Walking can decrease pain, pain medication usage and sick leave,” he says.
5. Give strength training a try
Many people with arthritis avoid weight lifting because they worry that the repetitive motions will injure their joints. Strengthening the muscles around your sore joint will help improve joint pain over time by taking pressure off it, says Jasmine Marcus, a physical therapist at McCune and Murphy Physical Therapy in Ithaca, New York. “Targeted strength training can reduce your pain significantly,” she says. However, you should check with your doctor about which exercises are safe for you.
6. Try the neck slide
Aching, sore necks are a symptom of many types of arthritis and can lead to headaches and disability if untreated. One non-medicinal way to deal with neck pain is a “neck slide stretch,” says Chicago-based therapist Katy Lush. “Slide your head down like you’re making a double chin. Then nod your chin towards your chest and hold for a few breaths. Slowly lift your head back up. Repeat it again and lean your head side to side when it’s hanging forward for an extra stretch,” she explains.
7. Stretch out sore hips
Arthritic hips can make every daily activity — from walking to sex — feel so much harder. Gently stretching them every day can help keep the joints loose and lubricated, reducing pain, Lush says. “While seated, cross your right ankle over your left knee. Sit up straight. Grab onto your right shin and calf and twist them towards you. Hinge forward an inch or two and hold. Repeat on the left,” she explains.
8. Play your thumb like a joystick
Hands, and thumbs in particular, are one of the most common places to feel arthritis pain. When your pain is flaring it can make seemingly simple things, such as turning on the tap or opening a package of food, feel impossible.
One quick way to help alleviate some stiffness is to do the joystick stretch, Lush says. “Make a thumbs up with your right hand, and then grab the thumb with your left hand. Lightly draw the thumb back like a joystick and lean it a little to the right for an extra stretch. Repeat on the left hand,” she says.
9. Take a Pilates class
The combination of stretching and strengthening makes Pilates a perfect exercise for loosening up stiff joints. It also decreases pain and increases range of motion, says Lush, who is also a Pilates instructor who frequently works with arthritis patients. The trick is to find a Pilates instructor who specialises in arthritis.
Are there are particular moves you should modify or avoid? That depends on which of your joints are the most problematic, she says. Group fitness classes can be a great way to socialise and exercise at the same time. Use your judgement about how you feel — avoid pushing yourself during an active flare.
10. Install ride apps
Uber was invented for a reason — and it’s not just for getting drunk people home from parties. “Driving with arthritis can be tough, not just for comfort but also safety. So if you don’t feel safe and comfortable, then you absolutely shouldn’t drive,” Folden says. Install a ride app, such as Uber, so you’ll always have a safe option if you’re having a bad flare. In the meantime, she advises working on stretching your neck, wrists, ankles and hands.
11. Trick out your toilet
The key to a comfortable bathroom experience is to get a height-adjustable seat you can place over the toilet. “This item is not super expensive and will give the option of finding the height that is perfect for you,” Folden says. “By raising the height of the toilet, you ensure that your knees have a little less load on them and getting down to and up from the toilet will be much easier.”
12. Refresh your spice rack
Some herbal supplements have been shown to help reduce inflammation, one of the primary causes of arthritis flare-ups, says Kulraj Singh, a physiotherapist and occupational therapist at the Tavistock Clinic in England. His favorite? “I recommend my clients use turmeric as it’s been shown in research to help reduce symptoms of arthritis,” he says.
13. Buy a snazzy water bottle
Okay, you could just buy a plain old boring water bottle, we guess. The point is to stay well-hydrated all day long, as dehydrated joints are flaring joints, Folden says. “Water really is the fountain of youth and life,” she says. “Staying hydrated improves blood flow, which affects synovial fluid and makes all activity more tolerable.” Buy an eye-catching water bottle and take a sip every time you notice it.
14. Go “forest bathing”
Stress can be an important trigger of arthritis pain and swelling. This is why it’s so important to take steps to reduce and manage stress in your life, especially if you have an inflammatory arthritis, like rheumatoid arthritis, Singh says. Easier said than done though, right? He recommends a Japanese practice called Shinrin-yoku or “forest bathing,” which basically involves simply being outside, in nature, with no distractions.
15. Bring out your inner zen with tai chi
All the occupational therapists we interviewed agree: The more you move, the better you’ll feel. Even if your joints don’t seem to think so at first. In addition to more traditional exercises like walking and strength training, people with arthritis respond very well to tai chi, a low-impact Chinese martial art that combines stretching, rhythmic calisthenics and meditation, Folden says.
16. Get coffee with your best friend
Arthritis can be terribly isolating, making you feel like you can’t do what you love and, worse, that no one understands what you’re going through. But while your loved ones may not truly know arthritis, they do know you — and that’s the important part, Singh says. Sometimes all you need is a listening ear and a little sympathy to feel better about your situation. Then make sure you return the favor. Listening to your loved ones vent can be a good way to distract yourself from your own problems.
17. Consider weight loss part of your treatment plan
Talking about weight loss with your doctor or other members of your health care team can be uncomfortable, and docs may not always bring it up. But losing even a little weight can do a number on your arthritis symptoms if you’re overweight.
Your joints, very literally, bear the load of your body when you move so a simple way to help relieve arthritic joints is to lighten the load on them. And you don’t have to lose a jaw-dropping number — dropping just 5 per cent of your weight can improve your pain by 30 per cent. If you can drop 10 per cent of your weight — 8 kilos from an 80 kilo frame — you could cut your pain levels in half, he explains.
18. Take up pottery or join a book club
During a bad arthritis flare-up, living a “normal” life can feel impossible, but you need to do everything you can to maintain your routine and enjoy activities that you love, Folden says. “I tell my patients to do all the things that bring you joy and make you happy. Spend time with family and friends. Visit museums. Work on your garden. Whatever activities bring a smile to your face, do them and often,” she says. “Living with a chronic condition like arthritis should not rob you of your life or your joy.” (That said, sometimes you need to bow out of plans when you feel really crappy.)
19. Cut down on sugar
What’s life without cake? Perhaps a life with less pain, says Matt Huey, MPT, an occupational therapist in the Dallas/Ft Worth area. “Eating processed foods — and especially too much sugar — may worsen arthritis symptoms,” he explains.
It can be hard to give up your favorite treats, especially when you feel like you’re already giving up so much to your disease, but cutting down on sugar will reduce inflammation and can help you lose weight. He recommends talking to a dietitian who specialises in arthritis to help get you on a proper program.
20. Don’t get freaked out by your scan results
Getting regular imaging tests — X-rays, MRIs, or CTs — is part of diagnosing and monitoring all types of arthritis. But many people look at their scans, see the level of damage, and freak out, Kovacevic says. “Know that it’s very common for people have arthritic changes on their scans, but have no pain symptoms,” he explains.
How your arthritis is treated is based on a combination of physical exams, what your blood and imaging tests show, and how you feel on a daily basis. It’s your doctor’s job to monitor your tests and discuss with you whether your current treatment options are doing a good-enough job preventing disease progression.
21. Remember that pain doesn’t have to mean panic
Once you have arthritis, every little twinge and tweak can make you wonder if a flare is returning with a vengeance (understandable), but it’s important to be patient and observe when your pain starts, Marcus says. “During a flare-up, I tell my patients not to panic or make rash decisions, such as insisting on surgery,” she says. “Most flare-ups will resolve with some combination of gentle exercise, heat or ice, and anti-inflammatories.”
22. Make an appointment with an occupational therapist
Obvious? Yes, but it must be said, Huey says. Making (and keeping) regular appointments with your occupational therapist can be the difference between painful disability and living a life that’s not controlled by arthritis, he says. “We can do an assessment on how you are moving and show you basic things to keep you from getting stiffer and help you get stronger,” he says. “We are the experts in movement. Talk to us.”
- Choosing Your Healthcare Team
- Health and Community Services for People With Chronic Health Issues
- Using Your Brain to Manage Your Pain
This article has been adapted, with permission, from a corresponding article by Charlotte Hilton Andersen on the CreakyJoints US website. Some text and information have been changed to suit our Australian audience.