FREQUENTLY ASKED QUESTIONS

  1.   What is AWISH and how can it help me?

  2.   What can a support group do for me?

  3.   What is self-help?

  4.   What is Arthritis?

  5.   Is it important for me to know what type of arthritis I have?

  6.   What can arthritis medications do for me?

  7.   What else can I do for pain management?

  8.   What foods, supplements, or herbal remedies are helpful?

  9.   How much exercise is appropriate for the arthritis patient?

10.   What are the surgery options for arthritis sufferers?

1. What is AWISH and how can it help me?  

AWISH is a volunteer based, non-profit organization whose goal is to improve the quality of life of arthritis sufferers. We are volunteers with arthritis who have a personal interest in helping fellow sufferers improve their quality of life. We share the benefit of our experience one-on-one or in a group.

Unfortunately, our health care system is stretched very thin and the few available medical specialists don’t always have enough time to provide the support necessary for a chronic illness. AWISH complements the health care system by providing information sessions, support groups, coping techniques as well as exercise classes. We pool our collective experience to help the newly diagnosed. We provide opportunities for arthritis sufferers to meet people, start an exercise routine, or educate themselves on how to self-manage their disease. We understand the pain. We also see new and different ways of dealing with our illness and the depression which is often associated with it.

2. What can a support group do for me?  

Being diagnosed with a painful, often debilitating chronic illness can trigger feelings of fear, anxiety, anger, confusion, stress and loss of control. Talking to people in similar circumstances is a positive step toward understanding those circumstances. If you have arthritis, you may want or need to make some changes in your life. And you may have to keep making changes as the need arises. An arthritis self help group can help you find understanding, advice, support, and information. It’s not a place where people go and complain about their aches and pains. It’s more than that. It’s a place to educate and be educated. It’s an opportunity to make a difference in someone else’s life while finding some answers for you. Caregivers, partners, family, and friends are welcome.

3. What is self-help? 

One of the things we hear over and over again from arthritis sufferers is the need to be self-advocating. There are long waits to see specialists. There are medical tests that we’d like to know more about. There are medications to learn about and often a multitude of symptoms to interpret. Self-help can be simply reading a book on medications or writing down symptoms and/or questions that occur to you for your next doctor’s visit. It is also being aware that you, ‘the patient’, are now part of a treatment team that includes all the doctors, lab technicians, therapists, nurses and pharmacists you see, and you are its focus. A chronic illness with no cure requires a realistic treatment plan that will provide the best quality of life for you. The more you understand about the options available, and the more effectively you communicate with your doctor(s) influence the effectiveness of that treatment plan. A self-help group isn’t compulsory but it is a wonderful resource, like a library of other patients’ experiences. Our information is free - give us a call.

4. What is Arthritis?  

Arthritis is a general term that covers more than 100 separate medical conditions that affect the musculoskeletal system. Arthritis is not just grandma’s aches and pains; in fact many forms of arthritis can cause serious, crippling joint damage, and some forms can be life threatening. About four million Canadians suffer with arthritis, and that number is growing rapidly. The most common forms are osteoarthritis, juvenile arthritis, ankylosing spondylitis, rheumatoid arthritis, bursitis/tendonitis, lupus, fibromyalgia, scleroderma, psoriatic arthritis, Raynaud’s syndrome, polymyalgia rheumatica, gout, and osteoporosis.

5. Is it important for me to know what type of arthritis I have? 

There are more than 100 forms of arthritis and they are very different in their action and rate of progress. As well, the treatments may also be very different. We recommend that you seek a diagnosis and then ask questions about it and gather information on it. A doctor uses the information you give him/her about your symptoms to help decide what tests to do and confirm your diagnosis. So be precise. Keeping a journal of your symptoms is a good health plan and don’t forget to take it to your next doctor’s appointment.

6. What can arthritis medications do for me? 

The main goals of arthritis medications are to reduce inflammation, to slow down the disease process and to provide pain relief. To reduce inflammation, there are two types of drugs used: non-steroidal anti-inflammatory drugs (NSAIDs) (aspirin and related drugs) and corticosteroids (a synthetic hormone similar to cortisone, which is naturally found in our body and controls many important body functions). Both types of drugs reduce inflammation as well as pain, but corticosteroids are much stronger than NSAIDs. To slow down the disease process, the Disease Modifying Anti Rheumatic Drugs (DMARDs) are used. Some medications used in the treatment of a form of arthritis known as gout attempt to reduce uric acid levels. There are many different dosages and brands and combinations that your doctor may try to help keep your arthritis under control. Some take six weeks to six months to make a difference. Be sure to let your doctor know about any supplements or herbal remedies you are taking besides what he/she is prescribing. Your cooperation is essential to finding the right dose and medication for you. New medications become available as fast as research allows so be sure to ask your doctor about new possibilities in the near future. The new biologic medications for Crohn’s disease, Rheumatoid Arthritis, and Ankylosing Spondylitis are one example. Your pharmacist is a good resource for additional information on arthritis medications.

7. What else can I do for pain management? 

Pain is produced by chemical signals released from injured or damaged body parts.  However, the long-term, chronic pain associated with arthritis must be controlled. Arthritis pain is caused by joint inflammation, damage to joint tissues, muscle strain and fatigue. Each arthritis sufferer experiences different pain,  however, pain CAN be managed.

First, you can research your condition to find what causes your pain, and then learn about treatment options and therapies. Next, you must exercise regularly and protect your body, and always try to keep a positive attitude. Another important step in pain management is changing your habits, that is, identifying those that increase your pain and eliminate them. Hot and cold treatments may also be effective in reducing the pain and stiffness of arthritis. Medications are widely used in controlling and managing arthritis pain. However, these drugs may not eliminate the hurt completely and should be used with a combination of other therapies to completely manage pain.

Physiotherapy plays a very important part in the management of arthritis. It can help reduce pain and swelling, improve movement and posture, strengthen muscles and improve independent function. There are a variety of treatments a physiotherapist can perform, including heat, ice, splints, massage, electrical treatments, exercises, and hydrotherapy. Physiotherapists can also teach pain reduction and management skills, as well as how to protect joints from further damage.

Occupational therapy helps people to adapt to the limitations they may experience. The occupational therapist looks at how we use our affected joints each day and will suggest and teach new adaptations to prevent any further strain on the body. Small things we do each day can cause repetitive stress and pain to the joints. Even our posture, sitting and standing can cause unnecessary strain and pain.

Acupuncture In this traditional Chinese method of pain relief, qualified professionals insert very thin needles along defined tracts of the skin, stimulating the flow of “Qi” or life energy. The reason researchers believe that some people may experience pain relief from acupuncture is that the needles stimulate deep sensory nerves, causing the brain to release endorphins. Although there is no definitive scientific evidence that it works, many people have found acupuncture to be effective in treating arthritis pain.

Massage, the scientific manipulation of body tissue, can be used in the treatment of arthritis. A light massage produces a sedative effect on sensory and motor nerves, which translates into a local relaxation (of the affected area) and a reduction in the strain on the nervous system. Firmer massage stimulates and increases blood flow, which improves the nourishment of cells throughout the whole body. As well, massage helps eliminate waste materials from the body, which helps ease pain by flushing the area of chemical irritants that comes from inflammation.

Relaxation can help reduce the effects of pain and stress, both of which have the same effect on the body. There are a variety of different relaxation techniques and one must experiment until the one that works best is found. Some techniques are guided imagery, prayer, hypnosis, meditation, biofeedback, and relaxation audiotapes.

Aquatherapy is special exercises that are performed in a warm water pool. The heated water relaxes stiff muscles and eases pain, making it easier to exercise. This relaxation causes your brain to release endorphins, the body's natural pain reliever. As well, water provides buoyancy that can relieve joint pain, increase range of motion in the joint, and increase muscle strength. Check with your local pools for an arthritis aqua-program. Ideally the water should be 84 degrees Fahrenheit.

Yoga is an efficient treatment to ease arthritis symptoms because it encourages movement while providing a gentle exercise and relaxation program. It improves muscle tone, circulation, and joint flexibility, and may relieve inflammation and joint pain. As well, yoga can be modified to target specific joints such as the hand, fingers, and knuckles. There are many studies that show the physical and mental benefits of yoga as well as the relief of arthritis symptoms.

Tai Chi is a gentle way to get a thorough workout. Originally a martial art, Tai Chi is now practiced as a means of improving health and fitness. In spite of its slow non-impact movements, it improves balance, flexibility, strength, and cardiovascular fitness. Moreover, as a weight bearing exercise, it offers the added benefit of osteoporosis prevention.

8. What foods, supplements, or herbal remedies are helpful? 

Proper nutrition is very important in disease management. If taking arthritis medications, such as Non-Steroid-Anti-Inflammatory-Drugs, it is important to avoid alcohol since alcohol can interfere with the medication and cause unwanted side effects. Fluids such as water and fruit juices should be consumed regularly. A healthy, balanced diet is good for everyone and especially those with a chronic disease. Calcium is an important preventative factor for osteoporosis. Weight control is another important issue for arthritis sufferers, since added weight causes stress to joints. Following a healthy, balanced diet, and exercise are key to maintaining a healthy weight. According to the Arthritis Society, despite individual testimonials, sophisticated marketing campaigns and numerous books on the subject, no significant clinical evidence has emerged to support claims that arthritis is caused by certain foods, or cured through dietary modification. A balanced diet following the Canada Food Guide is recommended. One exception to this applies for patients with gout. Gout patients should avoid foods rich in purines, such as yeast and extracts, organ meats, tinned fish (sardines, etc.) and shellfish; as well as alcohol in large quantities.

Glucosamine is a sugar that our bodies produce and it is thought to have some role in the maintenance of cartilage. It is sold in health food stores and pharmacies as a dietary supplement. It is extracted from shellfish, and may in fact have a beneficial effect in osteoarthritis. Several five-year double-blind studies indicate that patients using glucosamine had no significant joint space narrowing whereas the patients on placebo had progressive joint space narrowing. Since there do not appear to be any adverse side affects from glucosamine, a patient might want to follow a three month trial program, but should first check with his or her doctor.

Research is limited, but there is a suggestion that Omega 3 fatty acids from cold water fish may provide modest, temporary relief from inflammation, however evidence is thin and large quantities may have to be consumed to achieve any benefit. More research is needed.

People with arthritis should be wary of herbal or ‘natural’ remedies for arthritis, for a variety of reasons. Such products are as yet unregulated in Canada and the quality and consistency of the manufacturing process is unknown. More importantly, many such products hold some risk of side effects, and their anti-inflammatory properties are usually insufficient to significantly affect the chronic inflammation of arthritis. Additionally, herbal remedies may react adversely with prescription or even over-the-counter medications. As a general guideline, you should be wary of any product that:

•    Claims it works for all forms of arthritis

•    Only uses testimonials (not data) to support its claims

•    Does not list its contents on the container

•    Claims that it harmless or all natural

•    Is made from a secret formula

•    Claims to cure arthritis

•    Is only available from one source, e.g. mail order or internet.

And remember, herbal remedies should never be used in lieu of your prescribed medications. Always tell your doctor about any alternative therapies and/or supplements that you are trying.

9. How much exercise is appropriate for the arthritis patient? 

Exercise is an important element in managing arthritis; however each person must determine what is appropriate for them, ideally in consultation with a physiotherapist. There are four different types of exercise that help arthritis: aerobic activities such as walking, swimming, cycling, or gentle aerobic classes; range of motion (ROM) or stretching exercises; strengthening exercises; and relaxation exercises. Walking is almost always recommended, and swimming is also beneficial. Depending on the location of your joint involvement, you may want to avoid high impact weight-bearing exercises such as jogging.

Gentle range of motion exercises should be a part of everyone’s daily routine. Choosing an exercise program should be based on your general level of fitness and the number of affected joints, not on the form of arthritis that you have. Everyone must choose a program that suits his or her own lifestyle to assure adherence to that program. Exercise during your ‘peak energy’ time. This is usually early in the morning for those with osteoarthritis and the afternoon for those with rheumatoid arthritis. Always warm up the body before exercising and remember to exercise at your own pace. Listen to your body. Your routine will probably change from day to day depending on your condition.

10. What are the surgery options for arthritis sufferers?

There are several benefits of joint replacement surgery for arthritis sufferers. The most important benefit is pain relief. However, surgery is only an option if other therapies (such as heat, exercise, and medication) don’t reduce the pain. Another benefit of surgery is improved movement and use of the damaged joint. Even the appearance of deformed joints can sometimes be improved by surgery. With changing technology, new surgical procedures are making joint replacement easier and more effective than ever before. An example of this is Unicompartmental Knee Arthroplasty. Instead of replacing the entire knee joint, only the diseased compartment of the knee is resurfaced and rebuilt. This procedure significantly reduces the patient’s pain levels and rehabilitation duration, compared with traditional knee replacements. Ideal candidates for this type of surgery are over 60 years of age and have osteoarthritis of the knee involving one compartment. For a first-hand account of knee replacement surgery, refer to the Personal Stories index and read New Knee, Pain Free by Carolyn McCourt.

Created for AWISH by Patricia McManus, This e-mail address is being protected from spambots. You need JavaScript enabled to view it Copyright 2009