Exercise & Prevention

Its easy to get stressed out from everyday pressures of work, family and other responsibilities. Now that the holidays are here, you may be feeling even more stress and anxiety. For those with arthritis or another chronic condition, the result may be increased pain.

Osteoarthritis develops when cartilage (the cushioning material that covers the ends of bones in joints) deteriorates. The reason this happens is not entirely understood, but several factors, including certain injuries, can increase the risk. A study published in the British Journal of Sports Medicine (May 2019) examined the connection between knee injuries and osteoarthritis. The researchers reviewed results of 53 studies that included a total of about 1 million adults who had an injury of the anterior cruciate ligament (ACL), an injury of the meniscus or a combination of knee injuries. (The ACL is a ligament in the knee, and the meniscus is a C-shaped piece of cartilage between the two bones at the knee.) The odds of developing knee osteoarthritis were more than four times higher following an ACL injury and more than six times higher after a meniscal injury or combination of injuries.

Evenity is different. The idea for it came from research on a group of people in South Africa with a rare disease that causes them to have extremely high bone density and bones that grow too much. They were found to have a gene mutation that blocks the production of a protein called sclerostin.

With robot-assisted joint replacement surgery, the surgeon can accommodate for each person's unique anatomy. "During knee replacement surgery, we place markers in the thigh bone and the shin bone and then we map out the ends of the bones," says Dr. Molloy. The computer detects the markers and overlays a map of the knee joint over a computed tomography (CT) image that was taken before the surgery. The surgeon can then very accurately position the components of the implant.

For the knee osteoarthritis study, the participants doing HIIT started with a seven-minute warm-up, during which they slowly increased the cycling intensity. This was followed by a high-intensity burst, during which they cycled at a cadence up to 110 revolutions per minute (RPM) for 45 seconds. Then they slowed down to about 70 RPMs for 90 seconds. They switched between high intensity and lower intensity a total of five times before a six- to seven-minute cool-down of light to moderate pedaling.

The number of osteoporosis drugs and the different ways they are taken can be confusing. There are pills, injections and infusions, taken weekly, monthly or at other intervals. Your doctor chooses the best drug based on a variety of factors. A small percentage of people who take bisphosphonates have gastrointestinal problems, such as nausea, stomach pain, constipation, diarrhea and gas. This may be one reason your doctor prescribed Prolia, which is given as an injection and is easier on the stomach.

Some studies, many of them conducted in Japan, found that supplementation with vitamin K1 or vitamin K2 improved bone mineral density, and a few studies showed a decreased risk of bone fractures. Some subsequent studies found that vitamin K supplementation had no effect on bone mineral density. Many of the studies conducted thus far are limited by flaws in the design or a small number of participants.

"If we're seeing a patient early on, when they have mild-to-moderate changes inside the knee joint, they have a much better chance of the injection lasting a long time," Golnick says. The effects of the injection can last for three months or more in someone with mild-to-moderate arthritis, but those with more severe arthritis could have a return of symptoms within a fewweeks.

Joint replacement seems appealing because it retains, and may even improve, range of motion in the wrist. "The problem is durability of the implant," says Dr. Shapiro. With wrist replacement, bones are removed and an implant composed of metal parts and a plastic spacer is inserted. These implants are not as predictably long-lasting as implants for other joints, such as hips and knees. And complications can be particularly challenging to treat.

"For some people, shoveling snow is the first strenuous physical activity they've done in a while," he says. "Preventive measures should be taken." Everyone should be getting regular physical activity, even when it's cold outside. This will keep your body in shape when it's time to do vigorous activities. It will also help to make sure your heart is up to the task.

When it's cold outside, wearing warm socks, gloves and a hat should keep your feet, hands, and ears sufficiently warm. Some people have a condition called Raynaud's syndrome. This generally benign condition causes blood vessels in the fingers and toes to be overly constricted, making them feel very cold. The nose, lips and ears can also be affected. Raynaud's also causes temporary color changes. An affected finger may turn white or bluish and feel numb. It may turn red as it rewarms and throb or tingle.

There's a common belief that gout is caused by overindulging in foods high in purines, such as red meat, seafood and alcohol. This is because purines break down to uric acid, which is the substance that at high levels in the body can lead to gout. But it's not that simple. In fact, a recent study, published in the journal BMJ (October 2018), found that genetics was far more likely to be responsible for variations in uric acid levels than food. High-purine foods raise uric acid levels only a very small amount.