Arthritis Myths Busted: Tips for Relief

Posted October 2, 2024

SUMMARY

If you take one thing away from today’s talk, let it be this: there is always something you can do to feel better, even if you’ve been told otherwise.

You don’t have to accept joint pain as just a part of getting older. By focusing on correct movement and enlisting the help of professionals like physical therapists, you can reduce pain, improve function, and live a more active life.

In this report, we will discover the top 6 myths about arthritis and the facts around each of them. We will learn about what arthritis is, all about cartilage and what breaks it down. We will learn about joint pain, x-rays and the true cause of joint pain. Solutions will be offered, including 11 tips to manage painful arthritis and explore how physical therapy can help.

Common Myths About Arthritis

Let’s start by addressing some of the common myths surrounding arthritis that often make people feel like there’s no hope for improvement.

Myth #1: Arthritis pain is always related to joint damage.

Fact: Surprisingly, the amount of joint damage seen on an X-ray or MRI doesn’t always correlate with the level of pain someone experiences. Some people with significant joint changes feel little to no pain, while others with minimal changes may experience a lot of discomfort. Pain is influenced by many factors, including inflammation, muscle strength, and how well the joint moves, not just the structural condition of the joint.

Myth #2: Arthritis means you’re just getting old.

Fact: This is one of the most discouraging things people hear from healthcare providers, friends, or family. Just because you’re aging doesn’t mean you’re destined to live with pain or stiffness. Movement, proper care, and lifestyle changes can help you maintain good joint health and mobility well into your later decades of life. You’re not doomed to a life of joint pain simply because you’re older.

Myth #3: Movement makes arthritis worse: “wear and tear”

Fact: Many people think that moving painful joints will only cause more damage, but this couldn’t be further from the truth. Regular, controlled movement helps to strengthen the muscles around the joints, reduces inflammation, and improves flexibility. In fact, the right kind of movement can actually reduce pain and prevent further damage.

Myth #4: If you have arthritis, surgery is inevitable.

Fact: Surgery is often seen as the last resort for arthritis, but most people can avoid it with proper management, which includes strengthening exercises, physical therapy, and lifestyle adjustments. Surgery is sometimes necessary, but it’s far from the only solution, and it’s often not the best first step.

Myth #5: If You Have Arthritis, You Should Always Rest as Much as Possible

Fact: While rest is important during flare-ups, a sedentary lifestyle can cause joint stiffness, muscle weakening and can even worsen cartilage damage over the long term. Staying active, with appropriate exercises, helps maintain joint function and reduce pain.

Myth #6: Arthritis Is a Single Disease

Fact: Arthritis is an umbrella term covering over 100 different types of joint-related conditions. The five most common types of arthritis are: Osteoarthritis (“wear and tear arthritis”), Rheumatoid arthritis (autoimmune disease), Psoriatic arthritis (linked to psoriasis), Gout (caused by uric acid buildup), and Ankylosing spondylitis (affects the spine); each type involves joint inflammation, but with distinct causes and symptoms depending on the specific condition.

Arthritis Is About Your Cartilage… PAIN Is About Something Else

Cartilage and Its Nutrient Supply

Cartilage is a specialized connective tissue that covers the ends of bones in joints. Unlike most tissues in the body, cartilage is avascular, meaning it lacks blood vessels. As a result, it relies on a process called imbibition to receive nutrients and remove waste products.
Imbibition occurs when cartilage undergoes cyclic loading and unloading during movement. The compression and decompression of the joint creates a pumping mechanism that draws synovial fluid, rich in nutrients, into the cartilage and flushes out waste products.
Loading and Unloading of Joints: When you move and exercise, you apply varying amounts of pressure on your joints. This alternating pressure is critical for maintaining healthy cartilage. Movement compresses the cartilage, squeezing out waste products, and during unloading (when the pressure is released), fresh synovial fluid is drawn into the cartilage, delivering oxygen, nutrients, and essential molecules such as glycosaminoglycans and proteoglycans.

Cartilage Breakdown

Reduced Nutrient Flow: A lack of regular movement means the joints aren’t being loaded and unloaded, which hampers the ability of the cartilage to absorb the nutrients it needs for repair and regeneration. Over time, this leads to the degeneration of cartilage.
Stagnation: Prolonged periods of inactivity can result in stagnant synovial fluid within the joints. This stagnation limits the cartilage’s ability to effectively clear waste products, causing further degradation.
Weakening of Cartilage: Without regular loading, cartilage loses its ability to maintain its structural integrity. A sedentary lifestyle allows the cartilage matrix to break down due to lack of stimulation, weakening the tissue. This degradation makes it more prone to damage, such as tears or thinning, leading to conditions like osteoarthritis.

Muscle Weakness and Joint Instability

A sedentary lifestyle also leads to muscle atrophy, particularly around the joints. Muscles play a crucial role in stabilizing joints and distributing the mechanical load across them. When muscles are weak, more stress is placed directly on the joints, accelerating wear and tear.
Weak muscles can also contribute to poor joint alignment and abnormal movement patterns, which can further increase stress on the cartilage and exacerbate the risk of arthritis.

Inflammation and Synovial Health

Lack of movement can promote chronic low-grade inflammation, a major factor in arthritis progression. Sedentary behavior is associated with increased levels of inflammatory markers like C-reactive protein and cytokines, which can damage the synovium (the lining of the joint) and lead to arthritis.
Regular exercise has been shown to reduce inflammation, not only by improving circulation and nutrient delivery to joints but also by modulating the body’s inflammatory responses.

X-rays Don’t Tell the Whole Story When It Comes To PAIN

When you get an X-ray or an MRI, it may show things like cartilage loss, bone spurs, or even the dreaded “bone on bone.” But here’s the thing: these findings don’t always correlate with pain levels or how well you can move. Many studies show that people with severe changes on imaging might feel little to no pain, while others with less significant changes may feel quite a bit of discomfort.

Cartilage Loss and Pain:
- Cartilage loss itself doesn’t directly cause pain since cartilage lacks nerve endings. Pain in arthritis often stems from other joint structures like the bone, synovium, or surrounding soft tissues, which do have nerves.
Other Causes of Pain:
- Inflammation: Swelling in the joint’s synovium (synovitis) can cause pain even when the cartilage damage is minimal.
- Muscle Weakness or Imbalance: Poor muscle function around the joint can lead to stress and discomfort, independent of joint damage.
- Nervous System Sensitization: Chronic pain can result from the nervous system becoming overly sensitive, amplifying pain signals even when structural damage is mild.
- Biomechanical Issues: Abnormal joint loading or poor alignment can cause pain even when cartilage loss is not severe.

The presence of arthritis or cartilage damage on imaging doesn’t always correlate with the severity of pain, and pain can have multiple, complex origins not directly tied to the degree of joint damage.

Why Does Movement Help Arthritis?

Improves Strength: The muscles around your joints need to be strong to support the joint. When these muscles are weak, your joints take on more stress, which can increase pain. Strengthening these muscles can help offload some of that stress.
Increases Flexibility: When your joints are stiff, your body compensates by using other muscles or joints more, which can lead to even more pain. Gentle stretching and movement can improve the range of motion and make your daily activities feel easier.
Stimulates Cartilage Repair: As we discussed, cartilage relies on movement to get the nutrients it needs. Loading and unloading the joint through exercise helps keep the cartilage healthy by ensuring it gets nourished.
Reduces Pain Signals: Regular movement can help calm the nervous system and reduce the sensitivity of pain signals. When you don’t move, the body can become hypersensitive to pain. Gentle, consistent exercise helps reduce that sensitivity

If you take one thing away from today’s talk, let it be this: there is always something you can do to feel better, even if you’ve been told otherwise.

Remember, arthritis is not an inevitable part of aging, and movement is one of the most powerful tools you have to take control of your joint health. With the right approach, you can improve how you feel—and how you move.

11 Tips To Manage Arthritis, Especially If It’s Painful

If you’re too painful to exercise due to arthritis or another condition, it’s important to take a strategic approach to movement and pain management. Here are some steps you can take:

1. Consult a Healthcare Professional

Physical Therapist (PT): A PT can create a tailored exercise program designed to minimize pain while improving strength and flexibility. They can teach you gentle, safe movements that target specific areas without causing excessive discomfort.
Rheumatologist or Orthopedic Specialist: Consulting a doctor specializing in joint health can help determine the cause of your pain and recommend treatments such as medications, injections, or other interventions to reduce pain and inflammation.

2. Start with Gentle, Low-Impact Movements

Range of Motion (ROM) Exercises: Begin with gentle stretches and movements that help maintain flexibility without putting too much strain on the joints. ROM exercises are often done slowly and can be modified to accommodate your pain level.
Aquatic Exercise: Water-based exercises, such as swimming or water aerobics, are excellent for people with arthritis. The water supports your body weight, reducing the stress on your joints while allowing you to move more freely and painlessly.
Chair or Bed Exercises: If you can’t stand, try seated or lying-down exercises. Gentle movements such as leg lifts, arm raises, or ankle rotations can help improve circulation and keep muscles engaged without straining the joints.

3. Gradually Increase Activity

Start Slow: Begin with short sessions of movement, even if it’s only a few minutes a day. Gradually increase the duration and intensity of your exercises as your pain allows. Over time, your body will likely adapt, and the pain may lessen.
Use Interval Training: Break up exercise into small, manageable periods throughout the day. For example, doing 5-minute stretches or light activities several times daily can make movement more tolerable.

4. Apply Heat or Cold Therapy

Heat Therapy: Applying warmth to stiff or painful joints (via heating pads, warm towels, or hot showers) can help relax muscles, increase blood flow, and reduce stiffness before you start exercising.
Cold Therapy: Ice packs or cold compresses can be used after exercise to reduce inflammation and numb the pain, especially if your joints feel swollen or tender after activity.

5. Modify Activities to Reduce Stress on Joints

Use Assistive Devices: If walking or standing is painful, consider using devices like a cane, walker, or braces to offload pressure from your joints. This can allow you to engage in more movement with less pain.
Adaptive Equipment: If standard exercises are too painful, consider using adaptive equipment like resistance bands, foam rollers, or balance tools. These can make exercises more accessible and less painful.

6. Medications or Pain Relief Before Exercise

Topical Analgesics: Apply creams or ointments that contain pain-relieving ingredients (e.g., menthol, capsaicin, or NSAIDs) to the painful area before exercising to help reduce discomfort during movement.
Pain Medication: Over-the-counter pain relievers, such as acetaminophen or NSAIDs (e.g., ibuprofen or naproxen), can reduce inflammation and pain, making it easier to engage in physical activity.

7. Focus on Breathing and Relaxation Techniques

Deep Breathing: Use breathing exercises to help relax your muscles and reduce tension in your body. Controlled breathing can also help you manage pain and reduce anxiety associated with exercise.
Meditation and Mindfulness: Practicing mindfulness or guided meditation can help distract from the pain and create a more positive outlook on movement.

8. Rest and Recovery

Listen to Your Body: Pay attention to how your body responds to exercise. It’s important to balance activity with rest, especially during flare-ups. Don’t push yourself too hard on days when pain is severe.
Active Rest: Engage in gentle movements like walking, stretching, or swimming, even on rest days, to keep your joints from becoming too stiff while giving your body time to recover.

9. Consider Alternative Therapies

Massage Therapy: Gentle massage can help relieve tension in the muscles surrounding painful joints and improve circulation, which can make movement easier.
Acupuncture: Some people find relief from arthritis pain with acupuncture, which may help reduce inflammation and improve the body’s natural pain-control mechanisms.
Supplements: ask your doctor about taking Tumeric, as studies show decreased inflammation: for best absorption, look for curcumin phytosome (Meriva) and liposomal curcumin.

10. Work on Strengthening Core Muscles

Core Strengthening: Strengthening your core muscles can help stabilize your body and reduce the load on painful joints. Start with gentle exercises that target your abdominal and back muscles, even if you can’t do traditional weight-bearing exercises.

11. Jordan’s Pro Tips

Massage: massaging the muscles that attach to your painful joint can reduce tension on that joint itself, and often significantly reduce pain in that joint. Feel for firm, tender points, and use your hands, a tennis ball, massage gun or rolling pin to place gentle pressure on the tender point, then breathe and relax, being “more patient than the pain,” holding the pressure until the tender point feels less uncomfortable. Repeat on other points. Stay on the meaty muscle parts, not bone or nerve.
Isometrics: If you can’t move the involved joint without pain, you can still start strengthening the muscles around it by gently squeezing those muscles without moving the joint.
Move other joints: If you can’t move the involved joint without pain, move the other areas the body: especially the ones surrounding your painful joint. For example, if your knee hurts, get your hips and ankles/toes strong. For shoulder pain, gently squeeze the muscles between your shoulder blades (without shrugging). This will start getting you connected with your body and strengthen the area around the joint, which may end up being the thing that is needed anyway.

If you’re too painful to exercise, that’s the sign you need some help. That’s why we’re here at Active Healing Center.

How Physical Therapy Can Help

This is where physical therapy (PT) becomes so valuable. A physical therapist can work with you to develop a customized movement plan based on your specific needs and limitations. They’ll help you learn the correct movements to:

Strengthen muscles without causing pain.
Improve joint mobility to make your daily activities easier.
Teach proper alignment and posture to reduce strain on your joints.

Physical therapists are experts in helping people with arthritis and joint pain get back to doing the things they love. They won’t just give you generic exercises—they’ll tailor a plan that works specifically for your body, your pain levels, and your goals.

Conclusion

Remember, arthritis is not an inevitable part of aging, and movement is one of the most powerful tools you have to take control of your joint health. It doesn’t have to be intense or exhausting! Look closely at the 11 tips above: 75% of them involve being gentle with yourself. The days of “no pain, no gain” are over – especially in our practice. With the right approach, you can improve how you feel—and how you move and live your life.

Jordan Larson, PT