For many in the over-40 set, changing positions from sitting to standing is often accompanied by a sound that belies the effort of the transition: For some it's a loud sigh, for others it's a groan.
Complaints of stiff knees, stiff back, stiff shoulders and, when you stop typing, stiff knuckles, are a familiar refrain in offices, workplaces and homes.
Casual conversation among colleagues and friends suggests stiff joints are a fact of getting older.
Not so, says Allison Ezzat, a physiotherapist with Aquatic Centre Physiotherapy in West Vancouver. Ezzat has been working clinically for eight years and is also working on her PhD with a focus on risk factors for osteoarthritis prevention. She is one of five speakers at the upcoming ROAR (Reaching Out With Arthritis Research) 2012 event.
Joint stiffness may be an early sign of arthritis, but it's not a normal part of getting older, says Ezzat.
"Getting older is one risk factor for getting osteoarthritis," she explains.
There are more than 100 different types of arthritis, but osteoarthritis is the most common form and affects about 15 per cent of the population. Most of the other types of arthritis are quite rare, notes Ezzat. For example, the next most common form of arthritis is rheumatoid arthritis, and that affects about one per cent of the population.
When most people talk about arthritis, they are usually referring to osteoarthritis. It is the traditional wearand-tear form of the condition. Stiffness in the morning, mild pain when you're getting up after sitting for a while and other soreness may be early signs of arthritis, but sudden onset of pain may not be an indication.
"Arthritis is something that usually comes on gradually," says Ezzat, adding it progresses over months and years.
Arthritis damage can be seen on X-rays as it affects cartilage and bone around joints, but the changes you see on an X-Ray don't always match up with the symptoms, notes Ezzat.
Two people can get an X-Ray that shows arthritis, but one person may be in lots of pain and the other may not have any pain.
Proper assessment by a doctor is recommended, but once a diagnosis of arthritis has been given, it's important to know that although there is no cure for osteoarthritis, there are options to help with the pain.
"It's true that once you have the joint changes that affect the cartilage and the bone and the other soft tissue structures around the joint you can't reverse those changes. Right now there is no cure for osteoarthritis. However there's a lot that you can do to modify or improve the symptoms," says Ezzat. "By exercising you're going to help to lubricate the joint, you're going to help to strengthen muscles around the joint to support the joint structures that are damaged, and you're also going to stimulate the release of endorphins that make you feel good."
Ezzat says physiotherapists can help arthritis patients learn exercises that will help reduce the pain.
Anyone with a medical condition, including arthritis, should consult a physician before starting any new exercise program. Once given the all-clear to begin exercising, patients should find activities that interest them.
Ezzat says it's not helpful for someone to choose something they won't enjoy. For example swimming is a good option because the water helps take some pressure off the joints, but if you don't enjoy swimming you probably won't stick with it.
Start slowly and pace yourself, says Ezzat of choosing a new activity.
"If your goal is to exercise regularly you have to start slow, and a physiotherapist can help you get the right exercises to strengthen the muscles around the joint, but then also help you know how to pace yourself and how to progress properly," says Ezzat.
The goal of exercise is to help patients feel better, not make their condition worse.
Contrary to popular belief, running is not off the list of options. Some people believe running creates too much stress on joints. However, Ezzat says while there is evidence to suggest elite athletes may experience some negative effects of running, the average person probably will not.
"It's not so much about a specific activity that you shouldn't be doing it's more about the amount of the activity you should be doing," she explains.
A patient with osteoarthritis should probably not be training for a marathon, but people with mild arthritis may be fine to train for a five-kilometre run or 10-kilometre run.
"Listen to your body," says Ezzat.
Whether or not you have arthritis, if you're doing an activity and you experience hip pain or other new pain, it's probably a sign something is not right, she adds.
Physiotherapists can help patients modify an activity or make sure they have the right technique to ensure it is safe and effective, says Ezzat.
Proper strength training (working out with weights) can be beneficial by improving the strength of muscles around a joint. But not all weight is good. Being overweight can load extra weight onto a joint that is not strong enough.
A BMI (body-mass index) of more than 30 is a risk factor for developing osteoarthritis.
Injury (e.g. tearing a ligament) is also a risk factor for osteoarthritis. Usually it takes about 10 years after an injury for signs of arthritis to emerge, but it can happen at any age after an injury, says Ezzat.
The role of ligaments in joints is to help hold a joint in the right position, so when someone tears a ligament, it may disrupt the way the joint moves, she explains, and that can lead to arthritis.
As part of her research, Ezzat is investigating more risk factors, including certain occupations that involve a lot of kneeling or lifting.
The main risk factors for osteoarthritis are not being physically active, aging, genetics and gender (osteoarthritis is more common in women than men).
Ezzat says the important thing to remember after receiving an arthritis diagnosis is that while there is no cure, there may be exercises you can do to relive the pain.
"You don't want to sit around and wait for the pain to get so bad that you need a joint replacement."
The ROAR 2012 arthritis event is presented by the Arthritis Research Centre of Canada at the Vancouver Public Library on Saturday, Oct. 13.
For more information visit www.arthritisresearch.ca/ROAR.
