BodySense Blog

Alternative Exercises That Provide Arthritis Pain Relief

If your arthritis pain is limiting your ability to work out and pain medication isn't doing enough, alternatives like yoga, tai chi, and hydrotherapy may improve your mobility and provide needed exercise.

Exercise usually isn’t the first thing you feel like doing when experiencing joint pain. But several studies have shown that physical activity can serve as a natural pain reliever for people suffering from arthritis pain.

“Any physical activity that involves stretching and strengthening is good for alleviating arthritis pain,” says Patience White, MD, chief public health officer of the Arthritis Foundation. However, “it is possible to overdo it. So, it’s important to clear it with your doctor and to exercise under the supervision of someone who knows if what you’re doing is appropriate for people with arthritis pain. Overall, we know that the benefits of physical activity far outweigh the risks.”

Meeting the Demand for Arthritis Treatment Options
A 2006 study showed that nearly 46 million people in the United States were living with arthritis — that’s 1 in 5 adults. According to the Arthritis Foundation, 67 million Americans are projected to be diagnosed with arthritis in the next two decades.

More people with arthritis pain means more demand for arthritis treatment options, beyond pain medication. And the demand for more natural pain remedies means an expanded idea of what constitutes physical activity. Besides traditional exercises like walking and weightlifting, Americans are developing a growing interest in alternative exercises, such as yoga, tai chi, and hydrotherapy. And research has shown that these forms of exercise can be a great help in providing arthritis pain relief.

Arthritis Pain Relief Studies
At a recent American College of Rheumatology Annual Scientific meeting, research was presented showing that yoga can offer significant rheumatoid arthritis pain relief by reducing joint tenderness and swelling.

In this study, scientists from Johns Hopkins University in Baltimore randomly divided 30 sedentary adults suffering from rheumatoid arthritis pain into two groups. One group participated in an eight-week yoga program that included yoga poses as well as deep- breathing, relaxation, and meditation techniques. The control group did not practice yoga during the eight weeks.

Members of the yoga group took two one-hour classes per week and were instructed to also practice the poses and breathing exercises at home. The research team found that those who participated in eight weeks of yoga classes had significantly less arthritis pain and fewer tender and swollen joints than they did before starting class. Those in the control group experienced no change in their arthritis pain.

Another recent study sought to uncover similar benefits for patients suffering from osteoarthritis. This study focused on tai chi and hydrotherapy, or exercises performed in water.

In the study, more than 150 sedentary people over the age of 60 who had chronic arthritis pain were divided into three groups:

• Group one participated in a 12-week regimen of tai chi
• Group two participated in 12 weeks of hydrotherapy classes
• Group three was a control group that did neither.

Researchers assessed how much pain the participants were having after 24 weeks, and found that members of both the tai chi and hydrotherapy groups achieved significant arthritis pain relief. Those people with both hip and knee arthritis felt better when they participated in one of these programs.

By Sara Calabro

Medically reviewed by Lindsey Marcellin, MD, MPH
2009 EverydayHealth.com

Joint Replacement Surgery for Arthritis

When all else fails, this arthritis treatment can ease your pain and return some "bounce" to your life.

When you have a joint so swollen and stiff that walking, climbing stairs, taking a bath, getting in and out of chairs, or even sleeping is difficult, you need, not want, to get some arthritis pain relief. If, with your doctor’s guidance, you’ve tried the laundry list of non-invasive arthritis treatments — changing your diet and exercise regimens, using walking aids like canes or braces, trying physical therapy, and taking pain medications — and you’re still in a desperate state, joint replacement surgery, the ultimate in arthritis treatment, may be the arthritis pain relief solution for you.

Arthritis Treatment: When to Consider Joint Replacement
How do you know when it’s right for you? That’s indeed the big question, says Craig Della Valle, MD, a member of the American Academy of Orthopaedic Surgeons (AAOS) and associate professor of orthopedics at Rush University Medical Center in Chicago. “We’re always weighing the risks with the rewards, and every patient is different.”

“While joint replacement surgery certainly has its place in the management of arthritic diseases, it should be considered the final option after all other medical options have been exhausted," says Christopher Morris, MD, a rheumatologist in Kingsport, Tenn. “Ideally, arthritic disease can be addressed early enough to prevent the need for surgery; however, there are some diseases, such as osteoarthritis, where we don't have treatments to prevent the disease and its progression.”

Joint Replacement Surgery: The Pros
There are many benefits to joint replacement surgery in people with advanced arthritis. They include:

• Great results. Why consider surgery as an arthritis treatment? Because it works. Almost all joint replacement surgeries dramatically improve patients’ lives — offering arthritis pain relief, restored range of motion, and a return to most or all “normal” activities (perhaps barring any Olympian-style high impact moves … your doctor will tell you how far you can go!).

• Better technology. In the past, doctors believed that the older you were, the better a candidate you would be for joint replacement surgery. But in recent years, artificial joints, called prostheses, have evolved to the point that they can withstand more stress and wear-and-tear, allowing them to last about 10 to 15 years. And yes, you can get a second, or even a third, prosthesis if needed.

• Motivation for a better you. The best candidates for joint replacement surgery are fit and healthy and have few pre-existing conditions beyond their arthritis. Obese patients can still be candidates; however, excess weight can slow healing and increase the risk of post-surgical infection. If you’re at a healthy weight for your height, your doctor will likely give you the go-ahead. And, if you’ve been looking for a great reason to shed some weight, being pain-free is a fabulous one.

Joint Replacement Surgery: The Cons
Like any surgery, joint replacement should not be taken lightly. Surgery should be doctor-recommended, preferably by an orthopedic surgeon, and only after extensive tests are performed. And while complications occur fewer than 2 percent of the time, there are still risks with joint replacement surgery. These include:

• Infection. Infection is always a risk with surgery, and can occur any time from immediately after surgery up until years later. While most infections can be treated with antibiotics, deep persistent infections may require additional surgery to remove and replace the prosthesis.

• Blood clots. To prevent blood clots from forming, patients are often given compression stockings to wear post-surgery as well as exercises to do that will promote blood flow. Some patients may be asked to take blood thinners as well.

• Loosening of the new joint. This can cause excess pain that may require additional surgery to fix.

• Dislocation of the new joint. This is the most common problem after hip surgery. Artificial hips are smaller than a human joint, so the ball could come out of its socket. Usually dislocation can be fixed if the patient wears a special brace. Additional surgery is not usually necessary.

• Wear and tear. Nothing stays brand new and some wear and tear on your prosthesis is expected. If the prosthesis becomes loose, however, additional surgery may be necessary.

• Nerve and blood vessel injury. Nerves and/or blood vessels around the replaced joint can be damaged during surgery. This type of damage is rare and often improves on its own over time.

• Joint stiffening. Sometimes the soft tissues around a new joint will harden (a process called ossification), which makes it difficult to move. Medications or therapies can help prevent this from happening.

• Requiring more surgery. Prosthetic joints last between 15 and 20 years, so the younger the patient, the more likely the need for a second or third surgery for new joints.

Points to Consider Before Joint Replacement Surgery
If you're thinking about joint replacement, it's important to get all the information you need before you make a decision. Be sure to ask your doctor about:

The type of replacement you'll need. The prosthesis can be either cemented into the surrounding bones or “uncemented” into place. Uncemented joints require that the patient’s bone grow into and attach to the device. Subsequently, these surgeries require longer recovery periods. Uncemented joints are most often recommended for younger, more active people with good bone quality. When both methods are combined, it’s called a “hybrid” joint replacement.

Recovery time. Your body will need time to get used to its new joint and for your muscles to grow strong again. Plan ahead and line up help. It may take weeks before you are 100 percent back on your feet. However, if you follow your doctor’s orders, your pain will lessen, your flexibility will increase, and your range movement will improve. Remember, this arthritis treatment works for most people.

By Anne Wells

Medically reviewed by Cynthia Haines, MD

Psoriatic Arthritis Relief through Exercise

A three-step fitness plan for strength and mobility.

Date updated: January 02, 2009
by Beth W. Orenstein
Content provided by Revolution Health Group

If you suffer from psoriatic arthritis, the thought of exercise may make you wince. However, physical activity maintains muscle strength and joint mobility, and both are needed to manage your disease.

You want to exercise regularly, but, says Stephen Lindsey, MD, head of rheumatology at the Ochsner Clinic Foundation Hospital in Baton Rouge, La., "you just don't want to overdo."

A little sore is fine, he says, "but if you're completely sore the next day, you probably did too much. A big part of choosing your exercise program, if you have psoriatic arthritis, is common sense."

Psoriatic Arthritis: The Best Exercise

Those with psoriatic arthritis know that the condition can affect different joints, from just the hands to a debilitating, deforming degree called arthritis mutilans.

Patients with psoriatic arthritis may perform three kinds of exercises:

• Strength training. These exercises are designed to increase muscle strength. The stronger your muscles, the more stable your joints. Using free weights is an excellent form of strength-training exercise. "You should opt for light weights with lots of repetition, and avoid heavy weights," Dr. Lindsey says. Do strength training exercises two to three times a week, on alternating days. Strength training exercises include two types:
  • In isometric exercises, you tighten muscles without moving your joints, like holding a 5-pound weight straight out in front of your body
  • In isotonic exercises, you tighten your muscles by moving your joints, like in more traditional weight training exercises, like bicep curls
• Range of motion exercises. These involve gently stretching your joints as far as you can in each direction. Performing range-of-motion exercises will help you keep your joints flexible and keep you from feeling stiff. You should perform range-of-motion exercises daily.
• Weight-bearing or endurance exercises. These exercises will improve your cardiovascular fitness and your overall health as well as your symptoms of arthritis. The best endurance or recreational exercises for people with psoriatic arthritis are walking, swimming, and biking, Lindsey says. If you are able, running is fine, too; just be sure to run on softer surfaces. Exercising at least two or three times a week for 20 minutes minimum should become your routine.

Psoriatic Arthritis Relief: Everybody in the (Heated) Pool

Many people with psoriatic arthritis find that warm water exercises can make them feel better. "Exercising in a pool is great because it takes the stress off your joints," Lindsey says.

You don't have to be a good swimmer to participate in water exercises. Local Ys and aquatics clubs often have classes for people with arthritis and related conditions, taught by specially trained instructors. Keep in mind that if you're using topical treatments for your psoriasis, you may need to reapply after leaving the pool.

Psoriatic Arthritis Exercise: Listen to Your Body

Your body will tell you how much exercise you need and when you're doing too much. Lindsey says it's best to start out slowly and build up your program. For example, he says, if you start a walking program, try 15 minutes the first day or two, then 20 minutes the third time and so on. "Gradually increase your time and how fast you walk, he suggests."

If you're not feeling particularly well one day, it's okay to skip your exercise routine, Lindsey says. If you are sore from a workout, take over-the-counter pain relievers like acetaminophen (such as Tylenol Arthritis) or nonsteroidal anti-inflammatories (NSAIDs) including ibuprofen (such as Motrin or Advil). "Just be sure you're not taking too much medication that could cause side effects," Lindsey says.

Psoriatic Arthritis Exercise: Talk to Your Medical Team

Because there are different types of psoriatic arthritis, your doctor, physical therapist, or occupational therapist can help you plan an exercise program that fits the severity of your illness. Seek their input and get moving on feeling better.

Everyday Health - Healthy Aging

How Exercise Helps Osteoarthritis

While researchers still don’t know the exact cause of osteoarthritis, we do know that being over the age of 60, carrying excess weight, and being out of shape all significantly increase your risk. If you already have osteoarthritis, or you want to decrease your risk of getting it, a regular exercise program can help.

Osteoarthritis: The Benefits of Exercise
There are many benefits to starting an exercise program — whether you have osteoarthritis or not — but for people with arthritis pain, there's added incentive to get moving. Regular exercise can help to:

• Reduce joint pain. Osteoarthritis destroys cartilage, special tissue that cushions our joints. “Exercise increases the lubrication to the cartilage of the joint, thus reducing osteoarthritis symptoms of pain and stiffness,” says Anne Menz, PhD, a physical therapist at Massachusetts General Hospital, in Boston, Mass. It may seem counterintuitive, but not exercising actually leads to stiffer joints and worse osteoarthritis.
• Strengthen muscles. As we get older the muscles and tendons that support our joints tend to get weaker. “Exercise strengthens the muscles around the joints to protect the joints and provide [extra] support,” says Menz.
• Decrease pressure on joints. Studies show that being even 10 pounds overweight greatly increases the stress across your knee joints with every step you take. “Exercise can aid in weight loss to decrease pressure on joints,” Menz says.
• Improve overall health. Osteoarthritis symptoms can keep you from being active, which not only aggravates your osteoarthritis, but is also bad for your heart. “Exercise decreases all the health risks associated with a sedentary lifestyle,” like high blood pressure, diabetes, certain cancers, heart disease, and stroke, notes Menz.

Osteoarthritis: Starting an Exercise Routine
“First, check with your doctor to get the green light,” advises Menz. She suggests starting slowly and finding enjoyable ways to incorporate exercise into your daily routine. “Start a walking program in your neighborhood, take ballroom dancing lessons with your spouse, or join an exercise class,” she advises. The more you enjoy the activity you choose, the more likely you are to stick with it.

Menz also recommends keeping an exercise journal; “A log will help keep you accountable and also provide motivation as you see you can do more each week.” For people who have not exercised in a long time or whose osteoarthritis symptoms make it too painful to jog or walk long distances, low impact exercise in a swimming pool can be very effective. “A water aerobics exercise class causes less stress on the joints, and most people can tolerate this type of exercise. Later on you can progress to land-based exercise,” says Menz.

Osteoarthritis: The Best Types of Exercise
People with osteoarthritis should consider adding the following types of exercise to their workout routine:

• Range of motion exercise. Stretching exercises are effective in preventing the osteoarthritis symptom of joint stiffness. You can get this type of conditioning exercise in a yoga or Pilates class.
• Aerobic exercise. Jogging, brisk walking, and swimming are all examples of exercises that get your heart rate up and increase blood flow to your muscles. They are very effective in helping to control the symptoms of osteoarthritis.
• Resistance training. Weightlifting and resistance-band training are strengthening exercises that help build up the muscles and tendons that support your joints.

“Your goal with osteoarthritis exercise training is to eventually work your way up to 30 minutes of aerobic exercise five days a week. This could be a stationary bike, walking, swimming, or dancing. You should also do strength training two to three days a week in an exercise class, or weights at the gym,” advises Menz.

If you are having trouble getting started, ask your doctor for a referral to a physical therapist. “A physical therapist can put together a program for you that includes pain relief strategies, range of motion exercises, stretching, and strength training,” says Menz.

Research shows that a good exercise program can slow down the progression of osteoarthritis and relieve osteoarthritis symptoms like pain and stiffness. Unfortunately, research also shows more than half the people who start an exercise program for osteoarthritis drop out within one year.

Ask your doctor or a physical therapist for tips on getting started and sticking with the program you choose. Then get out there and do your best to commit! “The most important thing is to be consistent. It may take six to eight weeks to see results. Listen to your body and balance activity with a good amount of rest,” says Menz. Remember that a good exercise program is one of the best ways to manage your osteoarthritis symptoms.

Everyday Health - Healthy Aging on 12/30/2008

                                       

Aching Joints?

Most active adults have experienced the results of wear and tear from daily activity, especially in their joints. Several studies have suggested that glucosamine sulfate can help maintain joint health by providing the building blocks needed for repair. These compounds are used by the body to manufacture the complex molecules that are essential for the normal structure and function of cartilage.

In addition, herbs and spices with anti-inflammatory activity - such as ginger, holy basil, turmeric, green tea, rosemary, scutlellaria and huzhang - may all help support healthy joint function.

DrWeil.com

Living With Osteoarthritis

Helping you soothe sore joints with treatment tips and advice on coping

Be a Part of Managing Your Condition
Self-care is central to successfully managing the pain and disability of osteoarthritis. By working actively with your team of health care providers you can learn to minimize the pain, share in decision making about your treatment, and maintain control over your life.

Research shows that people with osteoarthritis who take part in their own care report less pain and make fewer doctor visits and enjoy a better quality of life.

Use these tips to develop a good-health attitude and manage you arthritis:

• Focus on your abilities instead of disabilities.
• Focus on your strengths instead of weaknesses.
• Break down activities into small tasks that you can manage.
• Incorporate fitness and nutrition into daily routines.
• Develop methods to minimize and manage stress.
• Balance rest with activity.
• Develop a support system of family, friends, and health professionals.

Everyday Health - Healthy Aging on 12/30/2008

Staying Active at Any Age

Looking for the fountain of youth? Increasingly, experts are telling us that it's all about lifestyle, the choices you make, and, especially, staying active by engaging in regular physical exercise in your sixties, seventies, eighties, and beyond. Research on the subject is striking: Regular exercise may prevent or delay such serious health problems as heart disease and diabetes. It can boost energy and mood, reduce arthritis pain, and help you get a good night's sleep. And — maybe most important — regular exercise can help you maintain the physical health you need to continue living independently. "The best thing we know to ensure a good quality of life is to be physically active," says Dr. Tim Church, director of Preventive Medicine Research at the Pennington Biomedical Research Center in Baton Rouge, Louisiana.

Staying active, however, is often not quite as straightforward as it sounds. As you get older, wear and tear on joints and muscles can turn a once enjoyable exercise regimen into a painful experience, or make it difficult for you to start a new routine if you don't already exercise regularly. This doesn't mean that you should just forget about fitness in your later years, however. Whether you're a competitive athlete or a workout novice, you can still get the benefits of exercise simply by adapting what you like to do to your capabilities.

Staying Active: Time's Natural Impact

With each passing decade, our bodies lose more muscle mass and bone density, and, in turn, strength and flexibility. Fortunately, this process can be reversed at any stage in your life by revving up your physical activity. "You're never too old to exercise," says Dr. Rosanne Leipzig, professor and vice-chair of Geriatrics at Mount Sinai Medical Center, in New York City. "There are clinical trials, even in nursing home patients over age 90, showing that you can improve your health and well-being by starting to exercise at any age."

Most people in good health don't need their doctor's okay to start a moderate exercise program, such as daily walking. Under certain circumstances, however, a visit to the doctor's office is in order. "If you're past age 60 and have a serious chronic disease, let your doctor know before you begin exercising," says Dr. Church. "And if you're planning anything more rigorous than walking — say, biking, rowing, or swimming — certainly check with your doctor first."

Staying Active: The Exercise Rx

For overall health and well-being, it's important to incorporate four types of exercise into your routine:

Aerobic, or cardiovascular, activities, to make the heart and lungs work harder. Try to spend at least 30 minutes a day engaging in activities like biking, walking briskly, dancing, swimming, or taking a water aerobics class. You can also raise your heart rate simply doing chores around the house: vacuuming, gardening, raking leaves, or washing the car.

Strengthening exercises, to build bone density and strengthen muscles used for daily activities, such as climbing stairs. Aim to do strengthening exercises two to three times a week, using dumbbells, resistance bands, weight machines, or foam weights in a pool. To learn correct form and prevent injury, take a class at a gym, YMCA, or senior center.

Stretching, to increase flexibility and allow easier movement. Stretch on your own for 10 minutes a day, or sign up for a stretching class. Yoga and Pilates also incorporate many stretching techniques.

Balance exercises, to reduce the risk of falling. Tai chi and yoga can improve your equilibrium. Or practice standing on one foot, then the other — if possible, without holding onto a support.

Staying Active: Safely First

The following pointers can help keep you safe while you're exercising:

• Gear. Use proper equipment, such as well-fitting, supportive shoes for walking.
• Timing. Exercise in the cool of morning or during the evening on hot days.
• Hydration. Drink water or a sports drink before, during, and after you exercise. How much? "Your body will tell you," says Dr. Church. "If you feel thirsty, drink."
• Pacing. Start with light weights if you're new to strength building, and slowly add more weight.
• Injury. Stop if you feel any pain. "'No pain, no gain' does not apply to people in their sixties, seventies, and eighties," says Dr. Leipzig. "It can mean that you're hurting yourself."

If you experience any of the following warning signs of a problem, stop your workout and call your doctor:

• Pain or pressure in your chest
• Trouble breathing
• Light-headedness or dizziness
• Excessive difficulty balancing
• Nausea

Staying Active: Choosing a Trainer

If you're new to exercise or you'd like help reaching your fitness goals, consider hiring a personal trainer who has experience working with people in your age group. Look for someone who understands your fitness goals and any limitations you may have and who'll be able to motivate you effectively. You can start by asking friends and family members your own age for recommendations. It's helpful to schedule a "tryout" session with the trainer before signing a contract — if the fit isn't right, don't hesitate to ask him or her for a referral to someone else.

Staying Active: Fitness Gear

Exercise can be easier and more fun when you incorporate appropriate fitness tools:

• Pedometer, to count your daily steps.
• BOSU Balance Trainer, a half exercise ball with a platform on the bottom, for balancing and strengthening exercises (available with a balance bar).
• Mini trampoline, also known as a rebounder (some also come with a balance bar), for increasing stability or for an aerobic workout that's easy on the joints.
• Heart rate monitor, a chest strap that transmits your heart rate to a wristwatch so you can continuously monitor your heart rate during an aerobic workout. Some athletic shirts, tank tops, and sports bras now have chest straps built right in.

No matter what workout form you choose or what routines you prefer for staying active, "just keep doing it," advises Dr. Leipzig. "Get a friend to join you and choose forms of exercise that you enjoy so you can do them for life."

EverydayHealth.com

More Amazing News About Vitamin D

We’ve been hearing a lot about vitamin D recently. In addition to its contribution to bone health, it seems to prevent some types of cancer and protect against multiple sclerosis and rheumatoid arthritis. Now, a vitamin D researcher at the University of California, Riverside, has noted that “D” also affects insulin secretion and regulation, heart and blood pressure regulation, muscle strength and brain activity. Writing in the August 2008 issue of the American Journal of Clinical Nutrition, Anthony Norman, distinguished professor emeritus of biochemistry and biomedical sciences, says that cells in 36 organs respond biologically to vitamin D. He notes that a deficiency of “D” can affect all of those organs including bone marrow, breast, colon, intestine, kidney, lung, prostate, retina, skin, stomach and uterus. Norman recommends an average daily intake of 2,000 IU of vitamin D for all adults, a dosage some other experts have suggested. The current RDA is 200 IU for adults up to the age of 50, 400 IU for those ages 51 to 70 and 600 for those over 70. My current recommendation for supplementation is 1,000 IU.

DrWeil.com

Seasonal Joint Pain Bugging You?

Like our moods, our bodies can respond to changes in the weather. If you or a loved one suffers from seasonal arthritis, consider arnica (Arnica montana). This daisy-like mountain flower can help relieve the pain and stiffness associated with seasonal arthritis. It is also useful for addressing sprains and bruises as well as the soreness, swelling and muscle spasms from sports activity, and general muscle and joint pain. Available in tincture, homeopathic ointment, cream, salve and pills, arnica should only be used topically (non-homeopathic arnica is toxic if it enters the bloodstream and should not be applied in any form on broken skin or on an open wound). Look for pure arnica extract for topical applications. For arthritis, you may want to make an arnica compress: mix one tablespoon of arnica tincture in one pint of purified water. Dip a gauze pad in the mixture, then put it on the arthritic joint.

DrWeil.com

Bisphenol A exposure linked to cardiovascular disease, diabetes

Exposure to bisphenol A (BPA), a chemical used in the resins that line food and beverage containers and in the production of polycarbonate plastics, appears to increase the risk of cardiovascular disease and diabetes, according to epidemiologic findings reported in the Journal of the American Medical Association for September 17.

In the study, each standard deviation increase in urinary BPA levels, a proxy for BPA exposure, increased the risks of cardiovascular disease and diabetes by 39% each.

Findings from animal studies have raised concerns that low-level exposure to BPA may have a harmful in humans, senior author Dr. David Melzer, from Peninsula Medical School in Exeter, UK, and colleagues explain.

Most research has focused on the estrogenic activity of the chemical, but there is evidence that BPA may cause damage through other mechanisms, including disruption of pancreatic beta-cell function and obesity-promoting effects. Initially, it was believed that there was a safe threshold for exposure, but recent reports have questioned this.

The present study involved a cross-sectional analysis of data from the National Health and Nutrition Examination Survey 2003-2005. Included were 1455 subjects, between 18 and 74 years of age, who had urinary BPA levels measured.

As noted, higher urinary levels of BPA were associated with elevated risks of both cardiovascular disease (p = 0.001) and diabetes (p < 0.001). By contrast, BPA exposure did not appear to have an effect on the occurrence of other common diseases, including arthritis, cancer, liver disease, respiratory disease, stroke, or thyroid disease.

An increase in urinary BPA was also associated with abnormal levels of two liver enzymes. For each standard deviation increase in BPA levels, the likelihood of an abnormal level for gamma-glutamyltransferase and alkaline phosphatase rose by 29% (p < 0.001) and 48% (p = 0.002), respectively.

The current research supports animal data, but "independent replication and follow-up studies are needed to confirm these findings and to provide evidence on whether the associations are causal," the research team notes.

In an accompanying editorial, Dr. Frederick S. vom Saal from the University of Missouri, Columbia, and Dr. John Peterson Myers from Environmental Health Science in Charlottesville, Virginia, comment that this research "should stimulate further studies and reevaluation of the basic assumptions in chemical risk assessments that led to US Food and Drug Administration assurances that BPA is safe."

The editorialists add that the results "also heighten incentives for green chemistry (a new field based on collaboration between biologists and chemists to develop biologically inert chemicals for use in products) to find cost-effective replacements for BPA applications contributing to widespread human exposures."

JAMA 2008;300:1303-1310,1353-1355.

Reuters

Exercises To Help Prevent Osteoporosis

Johns Hopkins Medicine produces "Health Alerts" for the public. The topics cover a wide range of important health issues for Americans...a few deal with the musculoskeletal system. A recent alert reviewed exercises to strengthen bones and help in the treatment/prevention of osteoporosis. I have written blogs in the past for Revolution Health on the benefits of adequate calcium and vitamin D intake as well as exercises...especially weight bearing type exercises, i.e. against gravity. I found a new specific list of exercises very informative and wanted to share them with our readers.

Exercises are important to build bone and muscle strength, hopefully limit bone loss with aging, improve balance and co-ordination and help us stand and sit upright. Results of a recent "University of Arizona's BEST (Bone-Estrogen Strength Training) study show that those women who followed a regime of weight-bearing and resistive exercises faithfully for 4 years, while taking calcium citrate supplements, had significant improvement in bone mineral density...whether or not they were taking hormone replacement therapy".

Here are the 6 exercises recommended:

"Exercise 1 - Wall Squat. Stand with your feet shoulder - width apart, back against a wall. Hold a dumbbell in each hand with your arms at your sides, palms facing inward. Slowly bend your knees and lower your buttocks 8 inches or more (but do not allow your hips to sink below knee level). Pause, then slowly return to the starting position.

Exercise 2 - Back Extension. Lie face down on the floor with your legs straight, arms extended flat on the floor above your head, palms down. Keep your nose pointed downward and slowly raise your right leg and left arm off the floor (reach out as well as up). Keep your head and neck in line with your arm. Pause, then slowly return to the starting position. Now slowly raise your left leg and right arm together. Change sides and repeat.

Exercise 3 - One-arm Military Press. Lie with your back on a bed or bench with your feet flat on the floor, holding a dumbbell in each hand on top of your chest. Press the weight straight up with one hand. Pause, then return it back down. Barely touch your chest, then repeat with the other hand. Alternate sides and repeat.

Exercise 4 - Seated Row. Sit on the floor with your legs fully extended. Hook a resistance band on the balls of your feet. Wrap each end of the band around your hands. Keeping your back straight, pull the band toward you with both arms. Pause, then slowly release your arms straight in front of you again.

Exercise 5 - Leg Press. Lie on the floor, flat on your back, with your knees hugged into your chest. Place the center of a resistance band on the balls of your feet. Wrap each end of the band around your hands. Keep your elbows close to your sides and squeeze your inner thighs together as you press your legs up toward the ceiling. Pause, then draw your legs back down.

Exercise 6 - Lat Pull - down. Stand with your feet shoulder - width apart, knees unlocked, and abdominals tight. Grasp a resistance band with your hands slightly wider than shoulder - width apart. Lift your arms just above your head, palms facing forward as you look straight ahead. Extend your arms out to the sides at shoulder height, with your wrists firm and your elbows slightly bent. Pull your shoulder blades back and together and expand your chest. Return to starting position. Repeat."

Johns Hopkins suggests that as you start these exercises..."do one set of 6 to 8 repetitions of each exercise and gradually build up to doing 2 sets. Once you can easily do 2 sets of 6 to 8 repetitions, increase the weight by small increments, or move up to a higher - resistance band."

This exercise regime is beneficial because it stresses the bones with "against gravity" and resistive exercises. It is, also, unique because it builds bone in the specific areas that people with osteoporosis fracture..."the wrist, hip and spine". They, also, suggest that one "round out the regime" with standing stretches and "17 minutes of cardiovascular weight bearing activity such as stair climbing or treadmill walking". But, please speak to your doctor to make sure each of these exercises is appropriate for you...he/she may suggest some and not others depending on your age and health status.

www.johnshopkinshealthalerts.com/reports/back_pain_osteoporosis/2022-1.html?type

7 Lifestyle Tips from Harvard Health Letter

As a Harvard alum, I was heartened to read the April, 2008 issue of the Harvard Health Letter, which looked at how to manage seven common medical conditions through simple lifestyle changes rather than via medication. Here’s a summary:

1. Arthritis: Losing weight often makes arthritis less painful, and exercise can also improve mobility.
2. Poor Cholesterol Ratio: Your LDL level may drop by 5% if you avoid foods that are high in saturated fat. Additional soluble fiber may reduce LDL levels as well.
3. Cognitive Decline: Memory training and other “brain exercises” seem to help, but physical exercise may benefit the brain in healthy older adults even more.
4. Depression: Regular physical activity has been shown to have a potent antidepressant effect.
5. Diabetes: Regular physical activity exerts powerful control over blood sugar levels. Reason: the exercised muscle becomes more receptive to insulin, which in turn helps it pull sugar in from the bloodstream. Eating foods with lower glycemic loads also helps.
6. High Blood Pressure: Weight loss, exercise, and consuming less sodium all lower blood pressure.
7. Osteoporosis: Weight-bearing exercise stimulates bones to deposit more minerals and become stronger.

I was delighted to see such sensible advice in this excellent publication. Diet and exercise are indeed not only wonderful, proven ways to begin reversing many common health conditions; they are also excellent lifelong strategies to help prevent them from manifesting in the first place.

Dr. Weil on Healthy Aging

Massage Eases Pain of Knee Arthritis

A regular massage may do more than just relax your body: It also appears to reduce pain and improve function in people suffering from osteoarthritis of the knee, a new study suggests.

The authors of the study, the first of its kind, are now embarking on larger studies to confirm the findings and see if massage is a viable alternative or adjunct to drugs and other existing treatments.

"This is a very happy outcome, but it's a pilot study in that the duration is short and the population is small," said senior author Dr. David Katz, associate adjunct professor of public health and director of the Prevention Research Center at Yale University School of Medicine. "We think that the primary role for massage therapy will be to reduce dependence on pharmacotherapy, rather than replace it outright, and to delay any functional decline rather than reverse the disease. So, the question then becomes, what is the bang for the buck?"

Katz and his colleagues are now researching the cost of massage, in the hopes of convincing insurance companies that it can take its place as a legitimate therapy for this disease.

Osteoarthritis is caused by a progressive degeneration of bone cartilage and is the most common type of arthritis in the United States. The condition affects some 21 million people and is associated with aging.

Conventional treatments include pain medication, exercise, hot and cold therapy, corticosteroid injections and, possibly, surgery.

The medications used for osteoarthritis, however, are problematic. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, can cause serious gastrointestinal side effects. The cox-2 inhibitors such as Vioxx that were developed to bypass those side effects are now known to cause cardiovascular problems, and some, including Vioxx, have been taken off the market.

"Primarily therapy is NSAIDs, but the target population is the very group that is least tolerant of those drugs," Katz said. "The cox-2s were developed as alternatives to NSAIDs to offer less toxicity, and look at how that turned out. We've kind of left folks high and dry."

While massage has been shown to relieve chronic lower back pain and musculoskeletal disorders, there has been no research on massage to help osteoarthritis sufferers. At least until now.

For this study, appearing in the Dec. 11 issue of the Archives of Internal Medicine, 68 adults with osteoarthritis of the knee were randomly assigned to receive either standard Swedish massage therapy or to a wait-list control group that started massage eight weeks after the first group. All participants were encouraged to continue with their previous treatments and medications.

Individuals in the massage group received a one-hour Swedish massage twice a week for four weeks, then once a week for the following four weeks.

After the first eight weeks, participants receiving massage had improved flexibility and range of motion and reduced pain.

Those in the control group showed no changes in symptoms until they, too, started receiving massage. Then, during weeks nine through 16, they experienced benefits similar to the first group.

Interestingly, the benefits did not go away even when the massages were stopped.

"The very significant therapeutic response over eight weeks of therapy persisted eight weeks later," Katz said. "Two months after the last massage, they were still significantly better than baseline and significantly better than the control group. That exceeded our expectations."

There are two possible explanations for the improvements.

In the immediate time frame, Katz explained, "sensory input [the massage] competes with pain input in the spinal cord, travels faster and blocks pain symptoms."

Massage may also enhance blood flow to the region affected by osteoarthritis. "Since the acute pain of osteoarthritis is related to inflammation, increased perfusion brings an influx of cells to clean out the debris and facilitates, to whatever extent possible, bone and cartilage remodeling," Katz explained.

More studies are needed before doctors, patients and insurance companies can be persuaded to accept this as common practice, he said.

"The end game would be that this would be something people with osteoarthritis would be able to access routinely," Katz said. "We ultimately want to change the standard of practice, but we don't do that with one study."

Health Day

Yoga: Not Just for Chilling Out

Many people think of yoga as a wonderful way to relax. But any true yogi knows the practice can also be quite energizing. In fact, a new study suggests it might help a group of people even more in need of a boost than the average person: those fighting multiple sclerosis, a disease that often comes with bone-crushing fatigue.

Researchers at the Health & Science University in Portland, Oregon, discovered that people with MS who took a yoga class every week for six months -- along with doing poses at home -- reported being considerably less tired than a group who did nothing out of the ordinary. The study is the first in-depth trial of yoga for MS patients. Lead researcher and neurologist Barry Oken says that people whose symptoms are mild should be able to manage in a gentle class designed for seniors; those with more severe symptoms might prefer a class geared to people with MS.

Alternative Medicine Magazine

Active Old Dogs

I guess we are lucky to have what would be considered "Old Dogs";  Frida is in human age 15 years old and Mandy is a middle age Minature Schnauzer, age in human years 7.  We are fortunate to be able to go hiking daily and it keeps the dogs and myself sort of in shape.  (Dogs in great shape, friend of dogs in better shape then others.)  I've noticed the stiffness that we all seem to have when we have been on one of our 4-5 mile adventures over different terrain, today was a tad more noticeable then other days.  Knees; arthritis after a few surgeries has got me hurting more than usual.  The dogs seem to be limping with soreness in their hips---bring out the Knee Wrap for myself and the Extra Large and Large Pack for the dogs.  You have to visualize the three of us taking over the living room with the moist heat and aromatherapy filling the air.  Knee Wrap around my knee; Frida is lying on the Extra Large Pack and Mandy lying comfortably on the Large Pack.  The dogs and I know a good thing when when it is presented to us, we definitely know how to take advantage of the situation.  My knee feels better and dogs are still lying on their packs, what more can I tell you, but it feels good not to have to throw pills down theirs or my throat.