ARTHRITIS - Primary caresherwoodparkpcn.com/ProgramsClasses/Documents/Arthrits... · 2016. 5. 31. · medicines can help control the pain of arthritis. Your doctor or pharmacist can

Dealing with painLiving with pain can be one of the hardest parts of having arthritis. Th is sheet has been written for you to understand the pain cycle and learn techniques that may help you cope with pain. Sources of further information are also included.

What causes pain?Arthritis pain can be caused by:• infl ammation, the process that causes heat and

swelling in your joints• damage to the joints• muscle tension, from trying to protect joints from

painful movements.For some conditions, such as fi bromyalgia, the cause of the pain is not fully understood.

Th e pain cyclePain, stress, fatigue (tiredness) and depression all aff ect each other. For example, people who feel depressed or anxious have been found to be more sensitive to pain. Th is can make your pain feel worse, which can lead to a continuing cycle of fatigue and depression.

Th e good news is that this pain cycle can be broken by using some of the strategies described below.

What can I do to manage my pain?Pain may limit some of the things you do, but it doesn’t have to control your life. Your mind plays an important role in how you feel pain. Th inking of pain as a signal to take positive action rather than being scared or worried about it can be helpful. Also you can learn ways to manage your pain. What works for one person may not work for another, so you may have to try diff erent techniques until you fi nd what works best for you.Here are some things you can try:• Take medicines wisely. Many diff erent types of

medicines can help control the pain of arthritis.

Your doctor or pharmacist can help you understand which medicines are right for you and how best to use them. See the Medicines and arthritis information sheet.• Exercise. Research has shown that regular appropriate

exercise can help reduce pain. It also keeps your joints moving, strengthens muscles to support your joints, reduces stress and improves sleep. A health professional (such as a physiotherapist) or your doctor can help you work out a program suitable for you. See the Physical activity information sheet.

• Use heat and cold. Th e benefi ts of heat and cold for arthritis are yet to be proven by research. However these treatments are soothing and safe when used carefully. Heat relaxes your muscles and stimulates blood circulation. You could try a warm bath, or place a heat pack or hot water bottle over the painful area for 15 minutes. Cold numbs the painful area and reduces swelling. Applying cold treatments, such as ice packs, to the painful area for 15 minutes may be especially useful for hot, swollen joints, such as during a ‘fl are’. You can repeat heat or cold treatments throughout the day. Make sure the temperature of your skin has returned to normal before re-applying, to prevent any tissue damage. Ask your doctor or physiotherapist whether heat or cold is best for you.

• Take care of your joints and save energy. Looking after your joints during your daily activities can help reduce pain, stress and tiredness. It involves simple habits such as:

- avoiding activities that cause pain - asking for help when you need it - using special aids and gadgets to make tasks easier.See the Saving energy information sheet.

ARTHRITISINFORMATION SHEET

1800 011 041 www.arthritisaustralia.com.au

For more information:To fi nd a physiotherapist, talk to your doctor, see the Australian Physiotherapy Association website at www.physiotherapy.asn.au or look under ‘Physiotherapist’ in the Yellow Pages.Books: Bernstein, Susan 2003, Th e Arthritis Foundation’s guide to pain management, Arthritis Foundation of America, Atlanta, GA.Nicholas, Michael 2006, Manage your pain: Practical and positive ways of adapting to chronic pain, ABC Books, Sydney.

Websites: Th e Arthritis Research Campaign (UK) www.arc.org.ukArthritis Foundation (US) www.arthritis.org

• Massage. Th ere are limited scientifi c studies that show massage reduces arthritis pain. However many people with arthritis fi nd it a useful way to relax and reduce muscle tension. Make sure the massage therapist has experience working with people who have arthritis. You can fi nd a qualifi ed therapist by contacting the Australian Association of Massage Th erapists at www.aamt.com.au or 1300 138 872, or the Institute of Registered Myotherapists of Australia at www.myotherapy.org.au or (03) 9418 3913.

• Acupuncture. Acupuncture is an ancient Chinese practice of putting small, thin needles into the skin at specifi c points on the body to block the pain signal. Th ere are mixed results from studies of acupuncture for arthritis. However some people may fi nd it useful alongside other proven treatments, such as medicines. Th e Australian Acupuncture and Chinese Medicine Association can help you fi nd an accredited practitioner at www.acupuncture.org.au or 1300 725 334.

• Transcutaneous electrical nerve stimulation (TENS)A TENS machine applies very mild electric pulses to block pain messages going from the painful area to your brain. TENS can be very useful for longer-term pain but does not work for all people. You should see a physiotherapist to trial a TENS machine, and to learn how to use it correctly, before you buy one.

• Mind techniques - Relaxation: Relaxation techniques, such as deep

breathing and visualisation (mental pictures), can help you reduce stress and muscle tension. Th ese techniques need to be practised and you may have to try several methods before you fi nd one that works for you. Th ere are many CDs and books available from your local Arthritis Offi ce or library to help you learn relaxation techniques.

- Distraction: Focusing your attention on something other than your pain can also help you cope with pain. Th is might involve exercising, reading, listening to music or other methods to take your mind away from your pain.

Contact your local Arthritis Offi ce for details of self management courses that can teach you these techniques. You may also fi nd it useful to see a psychologist to learn other mind techniques to help you cope with pain. To fi nd a psychologist contact the Australian Psychological Society on 1800 333 497 or visit www.psychology.org.au

CONTACT YOUR LOCAL ARTHRITIS OFFICE FOR MORE INFORMATION SHEETS ON ARTHRITIS.

Th ere may not be a cure for your pain but you can learn to manage it.Try diff erent techniques to fi nd what works best for you.

© Copyright Arthritis Australia 2007. Reviewed April 2010. Source: A full list of the references used to compile this sheet is available from your local Arthritis Offi ceTh e Australian General Practice Network, Australian Physiotherapy Association, Australian Practice Nurses Association, Pharmaceutical Society of Australia and Royal Australian College of General Practitioners contributed to the development of this information sheet. Th e Australian Government has provided funding to support this project.

Disclaimer: This sheet is published by Arthritis Australia for information purposes only and should not be used in place of medical advice.

Your local Arthritis Office has information, education and support for people with arthritis

Freecall 1800 011 041 www.arthritisaustralia.com.au

Guidelines to Physical Activity & Muscle/Joint Pain

Physical activity is a proven method in management of pain due to osteoarthritis, non-specific low back pain, chronic pain, etc.. However, it can be difficult to know when it’s okay to continue with an activity and when you should stop. Below are some general guidelines to follow:

GO

There is no increase in initial pain &/or symptoms.

You may experience mild discomfort with physical activity - it is okay to work through this.

It is not unusual to have mild to moderate muscle stiffness when initially starting a physical activity program. A short walk and some mild stretching can help alleviate these symptoms.

CAUTION

Pain/symptoms increase, but subside immediately when activity is stopped. - Ask yourself – is this pain that I normally experience OR is this new pain that

might be putting me at risk? - Take a rest break and try the activity again. Do as many repetitions &/or

minutes as you can before the pain increases and take another rest break. - If increased pain persists longer than 2 hours then stop the activity and talk to

your health care professional.

STOP

If you experience new or unusual pain/symptoms.

If you experience numbness or tingling. - If you normally have numbness and tingling, discontinue the activity if you

experience an increase in these symptoms.

If you experience sharp, shooting pain.

PLEASE NOTE: the following guidelines are NOT intended for use with angina and/or chest pain. If you experience pain in your chest and/or unusual shortness of breath, please seek immediate medical attention.

Page 1 of 4Copyright© 1999-2008 VHI

May 29, 2012Osteoarthritis Stretching Program

NECK - 2 Side Benders

Slowly tilt head toward one shoulder. Hold 20-30seconds. Repeat toward other shoulder.

Repeat times. 2Do sessions per day.2

NECK - 4 Extensors

Bend head forward. Hold seconds. Return to 20-30

starting position.


NECK - 6 Rotators

Turn head slowly to look over one shoulder. Hold seconds. 20-30Repeat toward other shoulder.


NECK - 8 Extensors / Flexors / Side Benders

From sitting position with back straight, slowly roll head in a full circle.Repeat times. Do sessions per day.8-10 2



SHOULDERS - 3 Posterior Deltoids / Rhomboids

Pull arm across chest until stretch is felt. Turn head away from pull. Hold seconds. 20-30Repeat with other arm.


ARMS - 7 Wrist / Flexors

With fingers interlaced and palms out, straighten arms in front of you until stretch is felt. Hold seconds.10-15


SHOULDERS - 5 Deltoids

With fingers interlaced behind back, straighten arms and turn elbows in until stretch is felt. Hold seconds.20-30


HAMSTRINGS - 1 Knee to Chest

Gently pull knee to chest until stretch is felt. Hold 20seconds. Repeat with other knee.Repeat times. Do sessions per day.2 2



BACK - 34 Hamstring Stretch: Active

Support behind knee. Starting with knee bent, attempt rightto straighten knee until a comfortable stretch is felt in back of thigh. Hold seconds.20-30

Repeat times per set. Do sets per session. 2 2Do sessions per day.2

LOWER LEG - 14 Gastroc

With strap or towel around ball of foot, gently pull back until stretch is felt. Hold seconds. Repeat with other foot.20-30Repeat times. Do sessions per day.2 2

LOWER LEG - 4 Ankle

Support one leg on the other and rotate that ankle clock-wise, then counterclockwise,

revolutions. Repeat 10with other ankle.


LOWER LEG - 2 Ankle - Inversion / Eversion

With leg relaxed, gently turn ankle and foot in and out. Move through full range of motion. Avoid pain. Repeat with other leg.




LOWER LEG - 1 Ankle - Plantar / Dorsiflexion

Relax leg. Gently bend and straighten ankle. Move through full range of motion. Avoid pain. Repeat with other ankle.Repeat times. Do sessions per day.10 2

Only stretch within your comfort zone. Stretching should NEVER be PAINFUL.

Only stretch until you feel a slight tightness in the muscle. If the stretch becomes painful, decrease how far you are stretching or speak to an Exercise Professional to help modify the activity.

Stretching is like massage for your muscle.

Do not hold your breath.

5/29/2012

1

Seated Hip MarchMarch

• This move can strengthen hips and thigh muscles to help with daily activities, such as walking or rising from a chair.

Sit up straight in chair. Slightly kick back your left foot but keep toes on the floor. Lift your right foot off the floor, keeping knee bent. Hold right leg in the air five seconds. Slowly lower your foot to the ground. Repeat 10 times. Rest and do another 10, then switch legs. Too hard? Use your hands to help raise your leg.

• Do quad sets instead. With these you don't raise your leg. Simply tighten the thigh muscles, also called the quadriceps, of

l t ti

Quad Set

one leg at a time.

Start sitting in a chair, or on the sofa with your leg stretched out in front of you.

• Flex and hold left leg tense for five seconds astense for five seconds, as seen in right‐hand photo. Relax. Do two sets of 10. Then, switch to other leg.

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Hamstring Stretch

• Lie down. Loop a bed sheet around your right foot Use sheet to help pull and stretch leg upfoot. Use sheet to help pull and stretch leg up. Hold for 20 seconds. Repeat twice, then switch legs.

Straight Leg Raise

• To try this leg strengthening move, lie on the floor. Prop your back up on your elbows. Bend your left knee, keeping foot on floor. Keep the right leg straight, toes pointed up. Tighten thigh muscles of your right leg Slowly and smoothly usethigh muscles of your right leg. Slowly and smoothly use your thigh muscles ‐‐ not your back ‐‐ to raise your leg.

Pause, as seen above, for five seconds. With thigh still tight, slowly lower leg to ground. Relax. Repeat 10 times. Rest. Do another 10; then switch legs.

5/29/2012

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Pillow SqueezePillow Squeeze

• This move helps strengthen the inside of your legs to help support your knee Lie on your back both knees bent Place a pillow between kneesknee. Lie on your back, both knees bent. Place a pillow between knees.

Squeeze knees together, squishing pillow between them. Hold for five seconds. Relax. Repeat 10 times. Rest, then do another set of 10.

Too hard? You can also do this exercise while seated. See photo to right.

Heel Raise

Hold back of chair for support. Stand straight and tall. Lift heels offand tall. Lift heels off ground and rise up on toes of both feet. Hold for five seconds. Slowly lower both heels to ground. Repeat 10 times. Rest. Do another 10.

Too hard? Do the same exercise, only sitting in a chair.

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4

Side Leg Raise

Hold back of chair for balance. Place your weight on left leg. Lift right leg out to the side. Keep right leg straight and outer leg muscles tensed. Don't slouch. Lower right leg and relax. Repeat 10 times. Rest. Do another 10, then repeat with left leg.

T h d? I lToo hard? Increase leg height over time. After a few workouts, you'll be able to raise your leg higher.

One Leg Balance

Your goal is to do this hands‐free. Steady yourself on a chair, if needed. First, shift your body weight to one leg but do not lock your knee straight. Slowly raise the other foot off the ground, balancing on your standing leg. Hold for 20 seconds. Lower raised foot to the ground. Do twice, then switch legs. This move helps when getting out of cars or g gbending.

Too easy? Balance for a longer time. Or try with your eyes closed.

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Walking

With stiff or sore knees, walking may not seem like a great idea. But it's one of the best exercises for kneebest exercises for knee arthritis. It can reduce joint pain, strengthen leg muscles, and improve flexibility ‐‐ and it's good for your heart. The best part ‐‐ no gym membership needed.

Good form is key: Look forward, walk tall. Keep arms and legs moving, relaxed. l k d b fAlways ask your doctor before

starting exercise when you have osteoarthritis.

Low‐Impact Activities

Being active may also help you lose weight, which takes pressure off joints. Other exercises that are easy on the knees: biking, swimming, and water aerobics. Water exercise takes weight off painful joints. Many community and hospital wellness centers, YMCAs, and pools offer classes for people with arthritiswith arthritis.

Don't give up favoriteactivities, like golf. Talk to a professional about modifying painful moves.

Tips to protect your joints

Start slowly to ease your joints into exercise if you haven't been active for a while. If you push yourself too hard, you can overwork your muscles. This aggravates your joint pain.

Consider these tips as you get started:

Apply heat to the joints you'll be working before you exercise. Heat can relax your joints and muscles and relieve any pain you have before you begin. Heat treatments — warm towels, hot packs or a shower — should be warm, not painfully hot, and should be applied for about 20 minutes.

Move your joints gently at first to warm up. You might begin with range-of-motion exercises for five to 10 minutes before you move on to strengthening or aerobic exercises.

Exercise with slow and easy movements. If you start noticing pain, take a break. Sharp pain and pain that is stronger than your usual joint pain might indicate something is wrong. Slow down if you notice inflammation or redness in your joints.

Ice your joints after exercising. This can reduce swelling and pain. Use a cold pack on your joints for 10 to 15 minutes.

Trust your instincts and don't exert more energy than you think your joints can handle. Take it easy and slowly work your exercise length and intensity up as you progress.

Don't overdo it

You might notice some pain after you exercise if you haven't been active for a while. In general, if your pain lasts longer than an hour after you exercise, you were probably exercising too strenuously. Talk to your doctor about what pain is normal and what pain is a sign of something more serious.

Tell your doctor if your exercise causes:

Persistent fatigue or increased weakness Reduced range of motion in your joints Joint swelling Continuing pain

If you have rheumatoid arthritis, whether you should exercise during general or local flares is up to you and your doctor. Consider working through your joint flares by doing only range-of-motion exercises, just to keep your body moving.

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Week Minimum Warm Up Push Cool Down Total TimeDays

1 3 5 min slow 5 min brisk 5 min slow 15 min












12-Week Guide to

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Sherwood Park-Strathcona County PCN, Suite 105-80 Chippewa Road, Sherwood Park AB. T8A 4W6

Exercise Diary

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Light)

Total Minutes and/or Total

Steps

Observations/Comments How did you feel?