There Are Over 115 Types of Arthritis! This is a fact not widely known. Whereas osteoarthritis and rheumatiod arthritis may sound familiar, gout, lupus and carpal tunnel syndrome are forms of arthritis as well. There are also types that most people have never heard of before: polymyalgia rheumatica, ankylosing spondylitis, and Raynaud’s, Reiter’s and Felty syndromes, to name a few.

The word arthritis is derived from Latin roots that mean inflamed (itis) joint (arth). However, joints aren’t always involved. Scleroderma for example, affects the skin but may also involve the kidneys, bowels, lungs and joints. Polymyalgia rhematica involves inflammation of the blood vessels and can have severely debilitating effects.

Basically, each major type of arthritis involves a different type of tissue. Osteoarthritis, the most common form of the disease affecting 1 in 10 Albertans (Arthroscope 1998, Arthritis Society) involves the breakdown of cartilage. Rheumatiod arthritis begins with inflammation of the synovial membrane of the joints and may spread to other joint tissues and affects one per cent of the population. In ankylosing spondylitis inflammation of the ligament attachment to the bones of the spine and hips can lead to bony overgrowth that can eventually fuse the vertebrae into a single, immovable unit.

How Do You Get Arthritis? No one really knows. Genetics probably plays a part. Arthritis can run in families and genetic markers associated with an increased risk for developing rheumatoid arthritis and ankylosing spondylitis have been identified. Previous damage to a joint may also be a contributing factor. Research is being conducted to explore the possibility that infectious agents or an environmental trigger may initiate the inflammatory process in several forms of arthritis.

Who gets Arthritis? Anyone can: children, teenagers, young adults and older people. Arthritis is not just your grandmother’s problem. One in ten Canadians have

arthritis (Arthroscope 1998, Arthritis Society). The cost to our economy is almost 17 billion dollars.

Is There a Cure? Most forms of arthritis are chronic and may last a lifetime. A variety of treatments can control the pain and minimize joint damage for most people. But, everyone’s arthritis is different. What will work for one may not work for another.

Exercise Treatment
Of all the available treatments it is recognized that exercise is good for almost everyone. It was once thought that exercise could further damage arthritic joints. We now understand that exercise is extremely beneficial because it can help to keep you joints moving, provide support for the joint by strengthening muscles, help to keep bone and muscle cartilage tissue strong and healthy, and aid in the ability to do everyday things by improving health and fitness. People with arthritis can benefit from a balanced exercise program which includes different types of exercise.

Range of motion exercises help to reduce stiffness and keep joints flexible. The range of motion is the normal distance your joints can move in certain directions. They should be done smoothly, three to ten times each, usually everyday. These exercises should be performed before any more vigorous type of exercise.

When an arthritis patient can do fifteen minutes of continuous range of motion exercise they will have the motion and endurance required to add strengthening and aerobic exercise to their fitness program. It is important to note that daily activity should not replace range of motion exercises.

Strengthening Exercises
Strengthening exercises are especially important for a person with arthritis because they help maintain and increase muscle strength. Strong muscles help to absorb shock and support joints. Two common strengthening exercises for people with arthritis are isometric and isotonic exercises. Isometrics allow the patient to build muscle without moving painful joints. Isotonic exercises seem like range of motion but they become strengthening exercises by increasing the speed at which they are done, increasing the number of repetitions, or adding light weight – one or two pounds. Water exercises can help strengthen muscles because water provides resistance while providing support.

Endurance Exercises
Endurance exercises are beneficial because they strengthen the heart and build stamina. Many people with arthritis think that this type of exercise is not for them, until they realize walking and water exercise can provide a good aerobic workout.

Exercise Prescription Factors
For people with arthritis massaging stiff, sore areas or applying heat can make exercise a less arduous experience. A warm shower before exercising or applying a heating pad or hot pack to a sore area can help loosen up a stiff joint and relieve pain before exercising. If pain and swelling is involved, applying cold packs can help to reduce it.

The most common risk of exercise is working the joints and muscles too much. If pain in the joint persists for longer than two hours after exercise you should cutback on the amount of exercise being done.

Remember, exercise is only one part of a treatment program that also includes proper diagnosis by a doctor, medication, proper diet, rest and relaxation, splints in some cases, conserving energy; and heat and cold treatments.

• Persistent pain and stiffness after getting up in the morning.
• Uncommon pain, tenderness or swelling in any joint, especially if it is accompanied by fatigue, unexplained weight loss or fever.
• Recurrent or persistent pain and stiffness in the neck, lower back, knees, wrists or hands, especially if there is no apparent reason.
• Any recurrence of these symptoms, especially if they involve more than one joint in different parts of the body.

• Glenrose Rehabilitation Hospital. (1999). [VHS video]. Keep moving: exercise for people with arthritis. Edmonton, AB: Author.
• Canadian Fitness and Lifestyle Research Institute. (1997). Physical activity and osteoarthritis. The research file. Ottawa: Author.
• Casper, J., & Berg, K. (1998). Effects of exercise on osteoarthritis: A review. Journal of Strength and Conditioning Research, 12, 120-125.
• Gordon, N. F. (1993). Arthritis: your complete exercise guide. Champaign, IL: Human Kinetics.
• Iversen, M. D., Fossel, A. H., & Daltroy, L. H. (1999). Rheumatologist-patient communication about exercise and physical therapy in the management of rheumatoid arthritis. Arthritis Care and Research, 12 (3), 180-192.
• Shephard, R. J., & Shek, P. N. (1997). Autoimmune disorders, physical activity, and training, with particular reference to rheumatoid arthritis. Exercise Immunology Review, 3, 53-67.
• www.arthritis.ca
– The Canadian Arthritis Society includes a bookstore section on their website that highlights recommended print and video sources on exercise and recreation for people with arthritis.