Do you think there is a possibility you could have a type of arthritis? Did the symptoms in yesterday’s post sound familiar to you? If yes, it is important to visit your primary care physician or a rheumatologist. Remember, arthritis is not just aches and pains, it is an illness and there are treatments.

Rheumatology is a sub-specialty of internal medicine that deals with problems in joints, soft tissues, and autoimmune disorders.

What is does the diagnosis process consist of?

Diagnosis of arthritic diseases will include a physical exam as well as an assessment of your medical history. The physician will also take test such as X-Rays to take a look at the condition of the inside of your joint and to rule out other causes of pain. The diagnosis process may also include joint aspiration. Joint aspiration is a procedure in which fluid is drained from the joint and examined.

After an arthritis diagnosis, the next step is to create a treatment program. The goal for a treatment program is to decrease joint pain, improve mobility, and help with the completion of day to day activities. It is important for patients to work with their rheumatologist to help create the best plan for them.

Arthritis Management includes a variety of different treatments:

     Physical Activity, Stretching, and Exercise – It is vital to keep your body moving while managing arthritis symptoms. Being active will help with joint stiffness, muscle strengthening, and the strengthening of other organs that can be affected by arthritis.

     Weight Control – Getting to and staying at a recommended weight can significantly help by reducing the stress on your joints.

     Assistive Devices – Assistive devices are an option for those patients who are not eligible for surgery, but their arthritis limits their physical activity. Devices can include shoe orthotics, supports, or braces.

     Physical Therapy – Physical therapy is working on your movement. This is a good option for those that can’t complete daily activities due to their arthritis. Therapy will mainly focus on improving flexibility, strength, coordination, and balance.

     Surgery – When joints are damaged severely due to arthritis, surgery may be an option.

Arthroscopy – This is a minimally invasive type of surgery where the surgeon will look inside the joint to examine the damage. They will also remove loose particles of damaged cartilage and repair other damages. This can reduce pain and improve function.

Arthoplasty – This is better known as a joint replacement. In a joint replacement, all or part of your joint is removed and replaced with synthetic parts.      

Medication – While the previous options can help arthritis patients, many patients will use medications to help control pain. Your rheumatologist will help decide what medication is right for you.

Analgesics – Medications that relieve pain.

Non-Narcotic – These would be over the counter medications like acetaminophen. This is a good option to start with as they are low in cost and have very minimal side effects.

Narcotics – These would be pain medications that you would require a prescription to receive. They can provide stronger pain relief, but they can come with side effects such as dizziness and nausea. Also, over time dependencies may develop as your dose increases because your body builds up tolerance.

NSAIDS – Nonsteroidal anti-inflammatory drugs can help reduce joint pain, stiffness, and swelling. Examples would be aspirin and ibuprofen. These too can come with side effects such as stomach pain.

Injectable Steriods – A doctor can inject your joints to relieve pain and swelling. These types of injections can only be done so many times a year as they could lead to infection or cartilage damage.

Topical Pain Relievers – These types of pain relievers come in the form of gels, patches, rubs, or sprays and are applied on the outside of the skin over a painful joint.

MYTH: Arthritis is a single condition.

TRUTH: Arthritis is a term that encompasses many different illnesses, not one single condition.

MYTH: Arthritis is more of a nuisance than an illness.

TRUTH: Arthritis is an illness, like diabetes or heart disease. Many types of arthritis require treatment and medications just like any other illness would.

To see more Myths about Arthritis, take a look at the Arthritis Foundation’s page at http://www.arthritis.org/about-us/myths/.

As our Arthritis Awareness Week comes to an end, we wanted to share the resources that OSMS has for our arthritis patients.

OSMS has a full service rheumatology department, with two rheumatologists, Dr. Davis and Dr. Utrie. Our department includes X-Ray machines, Bone Density scanners, a lab onsite for tests, and infusion therapy.

Look around on our website to learn more about our rheumatology department and physicians. You can make an appointment with our rheumatology department by calling 920.420.8113.

Next week we will be covering osteoporosis.

There is a lot of exciting news in April’s newsletter! The I’m Back campaign is back, so request your FREE shirt today, you only have this month. The Walk to Cure Arthritis is right around the corner and OSMS is proud to be the presenting sponsor this year. And are your little ones interested in health care? OSMS is taking part in an exciting month at the Children’s Museum by teaching kids about casting.

April 2015 Newsletter

3 Steps to Help You Decide

You finally saw an orthopedic doctor about the pain you’ve felt in your knees for the past several months. After an exam and some tests, your doctor says you have osteoarthritis. Whether it’s in your knees, hips or even your shoulders, an arthritis diagnosis may seem like a direct ticket to a joint replacement. But how long will the journey be before you reach the destination of surgery? A few months? A few years? A decade?

There is no clear cut answer to the question “when is the best time to get a joint replacement?”  What’s right for one patient won’t be right for another, so making this decision is a very individualized and emotional process. And in the end, every person who makes it will base their choice on different factors.

However, here are three steps we suggest taking to help make a decision on if you need a joint replacement and when is the right time to have it.

STEP 1: Look for physical and emotional signs.

• You are no longer able to perform everyday tasks without help due to joint pain or swelling.
• Joint pain is unmanageable and is significantly affecting your quality of life.
• You’ve tried exercise programs, physical therapy, medications and injections to relieve pain without long-term success.
• The medications or injections you are using help alleviate joint pain but cause other side-effects.
• Limited mobility has led to emotional side-effects like feeling depressed or isolated.

STEP 2: Weigh the benefits and potential disadvantages.

• Benefit – A joint replacement is a long-term solution, typically lasting 15-25 years.
  • However, if you are younger when you have the procedure, the risk of needing a second surgery to replace a worn out implant may increase.
• Benefit – A joint replacement alleviates most pain.
  • However, a replacement in one joint won’t stop pain from occurring in other joints affected by arthritis.
• Benefit – A joint replacement helps get you back to the activities you love.
  • However, the recovery takes time as well as a mental and physical commitment to rebuild and maintain strength and mobility.

STEP 3: Ask your orthopedic doctor lots of questions.

• How bad is the damage in my joint? Am I bone on bone?
• Do you have educational classes or resources to help me understand what to expect before, during and after surgery?
• What activities should I be able to go back to after a joint replacement?
• If I wait, will the surgery be more difficult?
• How long does it usually take to recover from a joint replacement surgery?
• Are there any other non-surgical options I should try?
• Is there a point when it’s too late to have a joint replacement?

Going through these three steps helps you determine three things, all of which are important in making your final decision:

1. Is your joint physically in need of a joint replacement?
2. Are you emotionally and mentally ready to have the surgery?
3. Will you get back to a higher quality of life after having a joint replacement?

If you had to describe a person with arthritis, most people would probably start by saying “someone 55, maybe even 60 years, or older.” And while more than 50 million adults do have arthritis – and your chances of having it increase with age – it also affects around 300,000 children.

Get answers to three common questions surrounding juvenile idiopathic arthritis (JIA or juvenile arthritis) from Dr. Paul Tuttle, a pediatric rheumatologist who will start at Orthopedic & Sports Medicine Specialists of Green Bay (OSMS) in July.

Q: How common is juvenile arthritis?

Dr. Tuttle: About one in every 250 children will be diagnosed with juvenile arthritis, making it just as common as juvenile diabetes (Type 1 diabetes). It’s four times more common than cystic fibrosis and sickle cell disease, and it’s ten times more common than acute lymphoblastic leukemia.

Q: Are the symptoms of juvenile arthritis the same as those in adults diagnosed with arthritis?

Dr. Tuttle: Arthritis (inflammation in the joint) affects different people in different ways depending on what disease causes the joint inflammation. However, arthritis is arthritis no matter how old you are. This means that joint swelling, warmth, morning stiffness, and pain are the same signs and symptoms whether young or old.

Inflammatory arthritis tends to be subtle and develops slowly over time at any age.  This subtle presentation in children can make it more difficult to spot right away compared to adults. Children may have minimal pain and a small amount of swelling can be easily missed. Moreover, abstract concepts such as “stiffness” can be difficult to communicate to their caretakers.  With children, some signs and symptoms to look for include:

• Wanting to be held more often
• Limping
• Morning stiffness or stiffness after a nap whereby parents may describe slowness or awkwardness with walking
• Not being as active as they used to be or as their peers are
• Rashes
• Low back or neck pain
• Heel pain
• Jaw pain
• Persistent unexplained fevers

Q: How does juvenile arthritis affect children over their lifetime?

Dr. Tuttle: In the past, when you would talk about juvenile arthritis it would be accompanied by stories of kids with leg-length discrepancies and pictures of children in wheelchairs. However, with advancements in medications, that doesn’t have to be their future. Today, treatments are tailored to each child’s type of arthritis, targeting specific pathways of inflammation that can vary from one type of arthritis to another.

Arthritis is still a life-long disease with no cure, but disease remission is often an attainable goal.  Through treating the disease early we can reduce or eliminate joint damage.  Because of this, I see kids with juvenile arthritis who are playing sports and living the normal, active life of a child.

Learn more about juvenile arthritis by watching Dr. Tuttle on Living with Amy.

Knee pain, hip pain…any joint pain can significantly impact your motivation to exercise. You may even think that exercise could make your arthritis worse.

But staying active with arthritis is possible. The truth is, exercise is a very important part of managing the joint pain, swelling and stiffness that goes along with arthritis. By keeping the joints flexible and the muscles around the joints strong, exercise can reduce the amount of stress put on the joints, and therefore, help reduce joint pain.

However, working out with arthritis does require switching to lower-impact, “joint-friendly” activities. Four of the best types are:

1. Walking
2. Water Exercise
3. Cycling
4. Yoga

Benefits of Walking

Walking is free, easy and provides so many health benefits. Here are a few reasons you should start walking:

• It keeps your joints healthy by improving the circulation of oxygen and nutrients in joint cartilage.
• It keeps leg muscles strong, which can take some of the stress off of arthritic knees or hips.
• It strengthens bones and can help prevent bone loss that may lead to osteoporosis.
• It helps with weight loss.
• It works the cardiovascular system and helps strengthen the heart.

Join a walking club to find motivation from others and to make walking more social. OSMS sponsors the Mall Movers walking program at Bay Park Square Mall. Simply stop by the Mall office to sign up!

Benefits of Water Exercise

• Water helps support your body’s weight while exercising, which reduces the amount of stress put on weight-bearing joints like the hips and knees. According to the Arthritis Foundation, doing water aerobics (as opposed to a class on a hard floor) reduces the impact on joints by 75 percent.
• It allows for greater freedom of movement. Since the water is helping to support your body, water exercise isn’t limited by your ability to balance. You can move through full range of motion without fear of falling.
• Water provides more resistance than air, so water exercise is a great way to strengthen muscles and improve cardiovascular stamina.

Types of water exercise include:

• Swimming
• Water walking (taking your walk from the park to the pool)
• Water aerobics

Benefits of Cycling

An important component to any exercise routine is cardiovascular activities. These help keep your heart strong and play a key role in weight loss. Some types of cardio exercise, like running or fast-paced fitness classes, are probably too high-intensity if you suffer from arthritis joint pain. That’s exactly why cycling is a great option. Cycling works your lower body muscles as well as your cardiovascular system, but it doesn’t put significant stress on weight-bearing joints.

Cycling can be done outside or on a stationary bike when the weather gets cold or if you have difficulties with balance.

Benefits of Yoga

Yoga is an activity that strengthens muscles and improves flexibility. And with the use of chairs, blocks and other props, it can be gentle enough on the joints to do daily.

However, to ensure that no unnecessary stress is put on your joints, it is important to find an appropriate style of yoga, learn how to do yoga poses properly, and understand when modifications may be needed.

July is Juvenile Arthritis Awareness Month. Back in May, we published an interview with Dr. Paul Tuttle explaining what juvenile arthritis is. Now, we want to explain why a rheumatologist is the best person to turn to if you think your child may have the disease, or if you or another loved one suffers from a different rheumatoid condition.

Rheumatologists are Detectives

Rheumatologists are physicians who specialize in the diagnosis and non-surgical treatment of diseases and autoimmune conditions that affect the bones, muscles and joints, including:

• Rheumatoid arthritis
• Juvenile arthritis
• Osteoarthritis
• Lupus
• Gout
• Osteoporosis
• Vasculitis
• Scleroderma
• And many others

Since these diseases don’t have one known cause, and many are the result of the immune system mistakenly attacking the body’s healthy cells, they can be difficult to diagnose. They often require a physician to look at many different factors – family history, symptom descriptions, lab tests, imaging exams and physical exams. This is especially true for juvenile arthritis, as the symptoms may be very subtle at first.

Rheumatologists receive extensive, specialized training to recognize the warning signs of rheumatic diseases and put together all the pieces for a proper diagnosis.

“Not all of the problems I encounter have simple answers,” says Dr. Paul Utrie, rheumatologist at Orthopedic & Sports Medicine Specialists of Green Bay (OSMS). “My goal is to work in a thorough, ethical manner to find answers and solve problems to the best of my ability.” 

Rheumatologists are Researchers

Rheumatic diseases are not only difficult to diagnose, but they can also be complex to manage and treat. That’s why rheumatologists are also researchers. Once they’ve done the detective work to determine a diagnosis, they must use their knowledge, past experience and new research to find the best possible treatment for each individual patient.

Rheumatic conditions also tend to change over time, which means rheumatologists have to continually learn and discover new solutions.

Rheumatologists are Health Partners

Whether juvenile arthritis or lupus, the conditions rheumatologists treat are often chronic diseases, meaning patients may have to live with them for several years or maybe even the rest of their lives. Therefore, a rheumatologist becomes more than just a doctor. They become a life-long resource, helping patients find relief from symptoms, overcome health conditions and maintain quality of life.

Meet the OSMS Rheumatologists:

Dr. Debbie Lim

Dr. Paul Tuttle

Dr. Paul Utrie

According to the National Council on Aging, nearly one-third of adults over the age of 65 experience a fall each year. These falls result in more than two million injuries from minor sprains or strains to severe hip fractures.

The three main risk factors for falls include:

• Physical – changes to your body’s muscles, bones, and joints.
• Behavioral – things you choose to do or not to do.
• Environmental – hazards within the environment.

For all these reasons, many older adults who have arthritis or osteoporosis or those who have had a total joint replacement may develop a “fear of falling.” This can start to limit the activities a person may do. However, staying active is actually one of the best ways to address the physical risk factors and can help prevent falls. Inactivity will eventually lead to loss of muscle strength, balance, and bone density, which not only increases the overall risk of falling but also the chances of a fracture from a fall.

Another way to reduce the risk of falling is to look at the environmental hazards that you can control. Since September 22^nd was Falls Prevention Awareness Day, we partnered with Rennes Health & Rehab Center to put together a quick guide on avoiding common – but sometimes hidden – environmental risk factors for falls. Our guide will focus on the interior of your home, bathrooms, and grocery stores.

Your Home

With furniture, electronics, stairs, toys, and clothing, there are a lot of hidden fall hazards within a typical home. Here are three easy ways to help decrease your risk of falling:

1. Ensure your home is well lit using bright light bulbs. This will help you quickly spot unexpected hazards such as cords, loose rugs, or a pulled out chair.
2. Make sure light switches are easily accessible. You’ll want to be able to turn the lights on as soon as you enter a space.
3. Use secure hand rails for all stairways, including those that only have a few steps.

Bathrooms

The bathrooms are probably the smallest rooms in your house, but they can have several hidden fall dangers. Here are three that can be easily fixed:

1. Clear up clutter. Put hair dryers, curling irons, or other corded items away in drawers or cabinets after use. This way cords aren’t hanging loosely around the bathroom. Also, keep smaller items off of the floor to prevent tripping.
2. Make sure floor mats and rugs are secured tightly to the floor. Tack them down or use floor grips to prevent movement.
3. Install grab bars by the toilet and shower in case you need an extra hand getting up, and look into toilet raisers and shower chairs. All of these items can give you extra peace of mind.

The Grocery Store

In the grocery store or other shops and restaurants, you don’t have control over the lighting, flooring, or bathroom layouts. However, there are still things you can do personally to address common environmental risk factors for falls. These include:

• Wearing high traction and supportive shoes that help prevent slipping on all types of flooring. They will also be helpful when floors get wet due to rain or spills within the store.
• Using hand rails or grab bars when available.
• Being aware of your surroundings and looking for potential, unexpected hazards such as wet floor signs, worn out floor mats, and loose carpet or rugs.

Find more resources on fall prevention from the National Council on Aging.

Join OSMS physicians Dr. Paul Tuttle and Dr. Benjamin Zellner to learn about the impact arthritis can have on the hands and wrists. They will discuss the symptoms and treatments for common forms of arthritis that affect the hands and wrists, including osteoarthritis and rheumatoid arthritis.

Event Details:

When: Thursday, February 2 | 8 – 9:30 am
Where: Bay Park Square Mall Food Court
Light refreshments will be provided.

Dr. Paul Tuttle, Pediatric and Adult Rheumatologist

Dr. Benjamin Zellner, Orthopedic Hand Surgeon

Only a physician can give you a definite “yes” or “no” to the question, “Do I have arthritis?” However, it’s important to understand what arthritis is and what the symptoms are so you know when it’s time to see a doctor for a diagnosis.

Recently, Dr. William Enright and Dr.Paul Utrie were on Living with Amy for National Arthritis Month. Check out the video to learn more about arthritis and its symptoms.

Arthritis Symptoms

• Joint pain
  • Pain that has lasted several weeks
  • Pain that comes and goes multiple times a month
  • Pain can be felt in one or multiple joints
• Stiffness and soreness
  • Joint stiffness in the morning or after periods of rest/inactivity
  • Soreness after activity or toward the end of the day
  • Joint stiffness that results in loss of mobility or difficulty with movement
• Swelling
  • Skin around the joint looks swollen or red
  • The joint feels warm
• Clicking, cracking, or grinding sensations when bending a joint

Why an Early Diagnosis is Important

Overtime, arthritis damages the joint’s cartilage, leading to increased pain, swelling, stiffness, and loss of mobility. If arthritis is diagnosed early, orthopedic or rheumatology physicians can provide treatments and management techniques that relieve symptoms and help reduce the amount of joint damage over your lifetime.

Download our early signs of arthritis checklist!

Dr. James Grace, orthopedic surgeon, answers 10 of the most common questions people ask after having a joint replacement.

See all of our educational videos here.

Since September is National Yoga Month, we talked with a couple of local instructors to learn more about the many benefits of yoga.

Some of the most commonly talked about benefits are the physical ones, like improved flexibility, increased strength, and better balance. These are why many people have started to include yoga in their fitness regimens. But beyond being a good workout, yoga has other physical benefits.

“Practicing yoga can help increase respiratory capacity, improve circulation, and enhance digestion,”‘ says Jackie Schechinger, a Green Bay yoga instructor and wife of OSMS physician Dr. Steve Schechinger.

Yoga also has a positive effect on a person’s mental health.

“The increased awareness to mindfully breath helps calm the nervous system and increase oxygen flow in the blood, which causes this wonderful duality of feeling calm yet energized,” says Jen Berres, owner of and instructor at Jenstar Yoga and Dance in De Pere.

While everyone can benefit from the strengthening and stress-reducing outcomes of yoga, it can be especially beneficial for two types of OSMS patients – athletes and those living with arthritis.

Yoga and Athletes

Competitive athletes are always looking to improve athletic skills and reduce the risk of injury. Yoga can help with both!

“Athletes tend to have a ‘go hard’ mentality about training, and a yoga practice brings balance to this mindset by teaching athletes to slow down and be in the moment,” says Jen. “It also creates better body awareness, which allows athletes to gain more range of motion, fluidity of movement, strength, stamina, and coordination. It is definitely a game changer, and many of the best athletes in the world are incorporating yoga into their routines.”

Yoga can also help with injury prevention and recovery.

“The improved body mechanics, balance, stability, and flexibility that an athlete can experience from yoga all work together to reduce the risk of injury,” says Jackie. “But perhaps the most important benefit for athletes is the increased mental awareness and focus to overcome an injury and elevate training and performance to the next level.”

Yoga and Arthritis

Despite the pictures of headstands, arm balances, and intricate twists that you may see on social media, yoga can be gentle enough for people living with arthritis.

“Yoga helps those with arthritis see better overall physical functioning, in particular increased joint range of motion, flexibility, and balance,” says Jackie.

Together, these outcomes can help reduce joint stiffness and pain so that people can continue to live actively.

“Joint pain is uncomfortable, but if you stop being active it can only get worse,” says Jen. “I have seen clients with arthritis feel a world of difference after only a few yoga classes.”

Learn more about yoga and arthritis from the Arthritis Foundation.

If you are new to yoga – no matter your age or activity level – it’s important to find a style and instructor that fits your needs and allows for appropriate modifications for individual restrictions, limitations, or injuries.

Since October is National Physical Therapy Month, we wanted to discuss the important role physical therapy plays in the treatment and recovery of many of the injuries and conditions that we care for at OSMS. So we sat down with Andy Taber from one of our partners, Advanced Physical Therapy and Sports Medicine, to learn more about how physical therapy and orthopedics work together. Andy is a Doctor of Physical Therapy, Board Certified Orthopedic Clinical Specialist, and Board Certified Strength and Conditioning Specialist.

If you sustain an orthopedic injury like a torn meniscus or broken elbow, or you are diagnosed with a condition like arthritis, your orthopedic physician might recommend physical therapy as a starting point for treatment. Physical therapy can often be an effective nonsurgical treatment to relieve pain and restore function.

“Physical therapy can assist the body in the natural healing process,” Andy says. “Through physical therapy, we can address mechanical faults to help an injury heal. We also develop prevention strategies to reduce the risk of injury in other limbs that may try to overcompensate for the injured area during the healing process.”

For example: if a person is dealing with pain, stiffness, and inflammation from osteoarthritis, a physical therapist can help relieve symptoms by:

• Evaluating, diagnosing, and correcting gait and posture abnormalities that may increase the breakdown of a joint or cause injury to another area of the body.
• Improving strength, range of motion, and flexibility around an arthritic joint to reduce pain and improve overall function.
• Implementing joint protection strategies in an effort to conserve the remaining cartilage in a joint.

When an orthopedic surgery is needed to treat an injury or condition, physical therapy continues to play an important role.

Whether it’s repairing a torn ACL or replacing a hip joint, the ultimate success of a patient’s recovery after surgery is partially dependent on the condition of the patient going into surgery.

“Doing physical therapy before an orthopedic surgery can help improve flexibility and build strength around the injured or arthritic area,” Andy says. “And as range of motion and strength increases prior to surgery, the patient is likely to have an easier time recovering these aspects of mobility and function after surgery.”

Once an orthopedic surgery is performed, physical therapy helps the recovery process in several ways, including:

• Implementing interventions designed to reduce pain and improve comfort in the hopes of reducing the need for long-term use of pain medications.
• Helping patients understand how to properly use assistive devices such as crutches, walkers, and canes.
• Restoring range of motion and strength of the surgical area.

“Once the body gets through the initial post-operative inflammation, and the healing process is well established, physical therapy continues to help patients return to their previous level of function,” Andy says. “This is done through progressive, individualized retraining of motions, postures, and activities related to what a patient wants to get back to.”

If you had to describe a person with arthritis, most people would probably start by saying someone 55, maybe even 60 years, or older. And while more than 50 million adults do have arthritis and your chances of having it increase with age it also affects around 300,000 children.

Get answers to three common questions surrounding juvenile idiopathic arthritis (JIA or juvenile arthritis) from Dr. Paul Tuttle, a pediatric rheumatologist who will start at Orthopedic & Sports Medicine Specialists of Green Bay (OSMS) in July.

Q: How common is juvenile arthritis?

Dr. Tuttle: About one in every 250 children will be diagnosed with juvenile arthritis, making it just as common as juvenile diabetes (Type 1 diabetes). It’s four times more common than cystic fibrosis and sickle cell disease, and it’s ten times more common than acute lymphoblastic leukemia.

Q: Are the symptoms of juvenile arthritis the same as those in adults diagnosed with arthritis?

Dr. Tuttle: Arthritis (inflammation in the joint) affects different people in different ways depending on what disease causes the joint inflammation. However, arthritis is arthritis no matter how old you are. This means that joint swelling, warmth, morning stiffness, and pain are the same signs and symptoms whether young or old.

Inflammatory arthritis tends to be subtle and develops slowly over time at any age. This subtle presentation in children can make it more difficult to spot right away compared to adults. Children may have minimal pain and a small amount of swelling can be easily missed. Moreover, abstract concepts such as stiffness can be difficult to communicate to their caretakers. With children, some signs and symptoms to look for include:

• Wanting to be held more often
• Limping
• Morning stiffness or stiffness after a nap whereby parents may describe slowness or awkwardness with walking
• Not being as active as they used to be or as their peers are
• Rashes
• Low back or neck pain
• Heel pain
• Jaw pain
• Persistent unexplained fevers

Q: How does juvenile arthritis affect children over their lifetime?

Dr. Tuttle: In the past, when you would talk about juvenile arthritis it would be accompanied by stories of kids with leg-length discrepancies and pictures of children in wheelchairs. However, with advancements in medications, that doesn’t have to be their future. Today, treatments are tailored to each child’s type of arthritis, targeting specific pathways of inflammation that can vary from one type of arthritis to another.

Arthritis is still a life-long disease with no cure, but disease remission is often an attainable goal. Through treating the disease early we can reduce or eliminate joint damage. Because of this, I see kids with juvenile arthritis who are playing sports and living the normal, active life of a child.

Learn more about juvenile arthritis by watching Dr. Tuttle on Living with Amy.

Knee pain, hip pain any joint pain can significantly impact your motivation to exercise. You may even think that exercise could make your arthritis worse.

But staying active with arthritis is possible. The truth is, exercise is a very important part of managing the joint pain, swelling and stiffness that goes along with arthritis. By keeping the joints flexible and the muscles around the joints strong, exercise can reduce the amount of stress put on the joints, and therefore, help reduce joint pain.

However, working out with arthritis does require switching to lower-impact, joint-friendly activities. Four of the best types are:

1. Walking
2. Water Exercise
3. Cycling
4. Yoga

Benefits of Walking

Walking is free, easy and provides so many health benefits. Here are a few reasons you should start walking:

• It keeps your joints healthy by improving the circulation of oxygen and nutrients in joint cartilage.
• It keeps leg muscles strong, which can take some of the stress off of arthritic knees or hips.
• It strengthens bones and can help prevent bone loss that may lead to osteoporosis.
• It helps with weight loss.
• It works the cardiovascular system and helps strengthen the heart.

Join a walking club to find motivation from others and to make walking more social. OSMS sponsors the Mall Movers walking program at Bay Park Square Mall. Simply stop by the Mall office to sign up!

Benefits of Water Exercise

• Water helps support your body’s weight while exercising, which reduces the amount of stress put on weight-bearing joints like the hips and knees. According to the Arthritis Foundation, doing water aerobics (as opposed to a class on a hard floor) reduces the impact on joints by 75 percent.
• It allows for greater freedom of movement. Since the water is helping to support your body, water exercise isn’t limited by your ability to balance. You can move through full range of motion without fear of falling.
• Water provides more resistance than air, so water exercise is a great way to strengthen muscles and improve cardiovascular stamina.

Types of water exercise include:

• Swimming
• Water walking (taking your walk from the park to the pool)
• Water aerobics

Benefits of Cycling

An important component to any exercise routine is cardiovascular activities. These help keep your heart strong and play a key role in weight loss. Some types of cardio exercise, like running or fast-paced fitness classes, are probably too high-intensity if you suffer from arthritis joint pain. That’s exactly why cycling is a great option. Cycling works your lower body muscles as well as your cardiovascular system, but it doesn’t put significant stress on weight-bearing joints.

Cycling can be done outside or on a stationary bike when the weather gets cold or if you have difficulties with balance.

Benefits of Yoga

Yoga is an activity that strengthens muscles and improves flexibility. And with the use of chairs, blocks and other props, it can be gentle enough on the joints to do daily.

However, to ensure that no unnecessary stress is put on your joints, it is important to find an appropriate style of yoga, learn how to do yoga poses properly, and understand when modifications may be needed.

July is Juvenile Arthritis Awareness Month. Back in May, we published an interview with Dr. Paul Tuttle explaining what juvenile arthritis is. Now, we want to explain why a rheumatologist is the best person to turn to if you think your child may have the disease, or if you or another loved one suffers from a different rheumatic or autoimmune condition.

Rheumatologists are Detectives

Rheumatologists are physicians who specialize in the diagnosis and non-surgical treatment of diseases and autoimmune conditions that affect the bones, muscles and joints, including:

• Rheumatoid arthritis
• Juvenile arthritis
• Osteoarthritis
• Lupus
• Gout
• Osteoporosis
• Vasculitis
• Scleroderma
• And many others

Since these diseases don’t have one known cause, and many are the result of the immune system mistakenly attacking the body’s healthy cells, they can be difficult to diagnose. They often require a physician to look at many different factors – family history, symptom descriptions, lab tests, imaging exams and physical exams. This is especially true for juvenile arthritis, as the symptoms may be very subtle at first.

Rheumatologists receive extensive, specialized training to recognize the warning signs of rheumatic diseases and put together all the pieces for a proper diagnosis.

“Not all of the problems I encounter have simple answers,” says Dr. Paul Utrie, rheumatologist at OSMS. “My goal is to work in a thorough, ethical manner to find answers and solve problems to the best of my ability.”

Rheumatologists are Researchers

Rheumatic diseases are not only difficult to diagnose, but they can also be complex to manage and treat. That’s why rheumatologists are also researchers. Once they’ve done the detective work to determine a diagnosis, they must use their knowledge, past experience and new research to find the best possible treatment for each individual patient.

Rheumatic conditions also tend to change over time, which means rheumatologists have to continually learn and discover new solutions.

Rheumatologists are Health Partners

Whether juvenile arthritis or lupus, the conditions rheumatologists treat are often chronic diseases, meaning patients may have to live with them for several years or maybe even the rest of their lives. Therefore, a rheumatologist becomes more than just a doctor. They become a life-long resource, helping patients find relief from symptoms, overcome health conditions and maintain quality of life.

Meet the OSMS Rheumatologists:

Dr. Michael Avery

Dr. Debbie Lim

Dr. Paul Tuttle

Dr. Paul Utrie

According to the National Council on Aging, nearly one-third of adults over the age of 65 experience a fall each year. These falls result in more than two million injuries from minor sprains or strains to severe hip fractures.

The three main risk factors for falls include:

• Physical changes to your body’s muscles, bones, and joints.
• Behavioral things you choose to do or not to do.
• Environmental hazards within the environment.

For all these reasons, many older adults who have arthritis or osteoporosis or those who have had a total joint replacement may develop a fear of falling. This can start to limit the activities a person may do. However, staying active is actually one of the best ways to address the physical risk factors and can help prevent falls. Inactivity will eventually lead to loss of muscle strength, balance, and bone density, which not only increases the overall risk of falling but also the chances of a fracture from a fall.

Another way to reduce the risk of falling is to look at the environmental hazards that you can control. Since September 22^nd was Falls Prevention Awareness Day, we partnered with Rennes Health & Rehab Center to put together a quick guide on avoiding common – but sometimes hidden – environmental risk factors for falls. Our guide will focus on the interior of your home, bathrooms, and grocery stores.

Your Home

With furniture, electronics, stairs, toys, and clothing, there are a lot of hidden fall hazards within a typical home. Here are three easy ways to help decrease your risk of falling:

1. Ensure your home is well lit using bright light bulbs. This will help you quickly spot unexpected hazards such as cords, loose rugs, or a pulled out chair.
2. Make sure light switches are easily accessible. You’ll want to be able to turn the lights on as soon as you enter a space.
3. Use secure hand rails for all stairways, including those that only have a few steps.

Bathrooms

The bathrooms are probably the smallest rooms in your house, but they can have several hidden fall dangers. Here are three that can be easily fixed:

1. Clear up clutter. Put hair dryers, curling irons, or other corded items away in drawers or cabinets after use. This way cords aren’t hanging loosely around the bathroom. Also, keep smaller items off of the floor to prevent tripping.
2. Make sure floor mats and rugs are secured tightly to the floor. Tack them down or use floor grips to prevent movement.
3. Install grab bars by the toilet and shower in case you need an extra hand getting up, and look into toilet raisers and shower chairs. All of these items can give you extra peace of mind.

The Grocery Store

In the grocery store or other shops and restaurants, you don’t have control over the lighting, flooring, or bathroom layouts. However, there are still things you can do personally to address common environmental risk factors for falls. These include:

• Wearing high traction and supportive shoes that help prevent slipping on all types of flooring. They will also be helpful when floors get wet due to rain or spills within the store.
• Using hand rails or grab bars when available.
• Being aware of your surroundings and looking for potential, unexpected hazards such as wet floor signs, worn out floor mats, and loose carpet or rugs.

Find more resources on fall prevention from the National Council on Aging.

Join OSMS physicians Dr. Paul Tuttle and Dr. Benjamin Zellner to learn about the impact arthritis can have on the hands and wrists. They will discuss the symptoms and treatments for common forms of arthritis that affect the hands and wrists, including osteoarthritis and rheumatoid arthritis.

Event Details:

When: Thursday, February 2 | 8 – 9:30 am
Where: Bay Park Square Mall Food Court
Light refreshments will be provided.

Dr. Paul Tuttle, Pediatric and Adult Rheumatologist

Dr. Benjamin Zellner, Orthopedic Hand Surgeon