GREG BAKER/AP

Mild exercise like Qi Gong or Tai Chi can keep arthritis from worsening

What You Can Do
	You don't have to suffer. There are many ways to find relief
	By Alice Park

Posted Monday, June 9, 2003; 22:50 HKT
DRUGS
There is still no cure for arthritis, but many medications can relieve the pain in stiff joints
• Over-the-counter painkillers: For mild pain, acetaminophen should be your first choice, as it relieves discomfort without damaging the digestive tract. If pain persists, your doctor might recommend aspirin or ibuprofen, which can reduce the swelling and damage due to inflammation; anti-inflammatory drugs, however, can be harsh on the stomach
• COX-2 inhibitors: These newer analgesics tend to cause fewer stomach problems than traditional anti-inflammatories. But they are expensive, and recent studies have linked them to heart problems
• Tetracyclines: These antibiotics were designed to kill germs, but they can also slow erosion of the cartilage
• Hyaluronic Acid: Injections of this natural lubricant, particularly in the knee, can ease pain for as long as a year
• Corticosteroids: Shots of steroids, which reduce inflammation, can provide a short-term fix for joint pain. Continued injections, however, can worsen a damaged joint by masking discomfort and enabling you to continue destructive activities. Because their pain is limited to specific joints, osteoarthritis sufferers don't need the wider-ranging effects of corticosteroid pills

SURGERY
If pain persists, surgery can either relieve the pressure on joints or replace them altogether
• Arthroscopy: In this minimally invasive procedure, doctors clear away dying cartilage and smooth out rough joint connections through slit-size incisions. A recent study suggested that in some cases, arthroscopic surgery was no better than sham surgery—it seems to work best when the joint is still mechanically sound
• Bone fusion: Fusing bones together with pins or plates can eliminate the pain caused by a badly damaged joint; the joint, however, will never bend again
• Joint replacement: When the bones in a joint are damaged beyond repair, a substitute joint can in some cases be fashioned out of plastic or metal. Total hip replacement is the most common, but almost any joint, including the knee, thumb, elbow and shoulder, can be replaced
• Tissue repair: Failing joints can cause surrounding muscle, ligaments and tendons to tear or rip away from bones, requiring surgery to reattach or repair them

EXERCISE
Moving arthritic joints might hurt, but if you don't exercise them regularly they can permanently freeze up
• Water workouts: The buoyancy of water can help you move stiff joints without gravity's weight-bearing pressure
• Recumbent bicycle: The reclining position takes the burden off such susceptible joints as the knees and hips
• Walking: If it doesn't hurt too much, walking is one of the best ways to keep joints—from the ankles to the shoulders—from seizing up
• Low-impact aerobics: Any exercise that doesn't put pounding pressure on the joints can help build up muscle and keep ligaments and tendons flexible enough to give the joints the support they need

ALTERNATIVE THERAPIES
If taking standard pain-relief medications makes you uncomfortable, you may want to consider some of these alternative remedies
• Acupuncture: The Chinese traditionally believed it relieves pain by realigning qi (life energy). Western doctors think the judicious placement of needles might actually work by stimulating the release of endorphins, the body's own painkillers
• Glucosamines: Preliminary evidence suggests that these supplements, derived from lobster and crab shells, might help relieve arthritic pain possibly by encouraging cartilage growth
• Chondroitin Sulfates: Chondroitin is believed to help keep cartilage from breaking down; many arthritis sufferers take it with glucosamines

PREVENTION
While there is no guarantee that anything you do will prevent osteoarthritis, here are some steps you can take to keep your cartilage as healthy as possible
• Keep moving: Flexing joints lubricates and protects them, so exercise regularly. But avoid high-stress activities that pound on knees or hips
• Stay slim: Carrying too much weight puts extraordinary stress onto the knees, hips and ankles. Shed excess pounds to take a load off the joints
• Build muscle: Joints need a strong support system; maintaining muscle tone will help stabilize knees, hips and shoulders

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