Dr. David Seaman: Exercise should be part of any arthritis treatment program

As a rheumatologist, I see patients seeking a diagnosis and treatment for a common ailment, arthritis.

Although medication can reduce pain and inflammation, and prevent disease progression, many patients continue to experience some degree of ongoing disease activity, which may lead to disability and difficulty in performing activities of daily living.

It's not only important that a patient has less pain and swelling from their arthritis, but also continues to function physically, emotionally and socially. Exercise can reduce disability and keep a person working.

The role of exercise in this cannot be overemphasized. Exercise is effective and safe for maintaining a great quality of life.

Arthritis is one of the most common causes of disability in the world. Osteoarthritis is the most common form of arthritis with about 528 million people affected globally.

In the United States, there are about 52 million people affected, which has increased from 29 million in 1990. The increase is due to many factors including an aging population and increasing obesity rates.

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Although we cannot keep from aging, we can make strides in lowering our weight. Proper nutrition plays a major role, as does exercise.

Physical activity, including aerobic and resistance exercise, should be part of a treatment program for all patients with arthritis. Once a patient’s pain and inflammation are under decent control, an exercise program should be initiated.

Generally, begin an exercise program at a low-level and increase gradually: "start low and go slow."

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Realize that the goal is to be able to maintain at least some level of activity for the rest of your life. Exercise helps reduce disease activity, fatigue and pain, and improves psychological well-being.

When a person starts exercising and feels empowered, they can get up and go to work in the morning, take care of the children, prepare meals, attend social gatherings, etc.

When a person stops using their joints, they are more likely to develop loss of joint motion, contractures and muscle atrophy. This then leads to further joint stiffness and weaker muscles.

The best forms of exercise for patients with arthritis are low-impact aerobic exercise and resistance training. It is important for overall health to get your heart rate up, but without causing further joint pain or damage.

Excellent examples include walking, swimming, cycling or cross-country skiing. If a joint becomes painful or swollen, it is okay to back off on the exercise temporarily.

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It is important to get back in the game as soon as possible though and avoid a sedentary lifestyle. The couch is your enemy.

Both physical and occupational therapy play a key role, particularly if a patient needs more guidance in performing certain exercises appropriately, so that injury is avoided.

Physical therapy and occupational therapy can reduce pain and inflammation, preserve joint function and improve strength. Usual activities of daily living that were once thought impossible, become possible.

Dr. David Seaman is a rheumatologist at UPMC Hamot.