We've all seen the TV ads ─ nice-looking woman in her fifties, sitting on a nice sofa in a nice living room, rubbing her hands, in obvious pain. Of course, she's not Lady Macbeth, trying to rub off the imagined blood of her murdered husband. She's a woman with arthritis.

According to the Center for Disease Control, arthritis is the leading cause of disability in the United States.1 Approximately 47 million people have doctor-diagnosed arthritis and 17 million have arthritis-attributable activity limitations.

Osteoarthritis, the most common form, is a degenerative condition affecting the joints and the soft tissues around the joints ─ the associated cartilage, ligaments, and tendons. The most commonly affected areas are the spine, the hands, and the shoulders, hips, and knees. The pain of arthritis, the reduced mobility, and the lifestyle accommodations needed for pain avoidance are discouraging and may even lead to depression.

Many anti-inflammatory drugs are available for the treatment of arthritis, and in recent years many of these have been found to cause severe side effects. Vioxx is the most notorious of these ─ cardiovascular complications caused a worldwide recall of the drug. Celebrex, another well-known arthritis medication, was also found to increase the risk of heart attack and stroke at high doses.

The very good news is there are several wellness-based treatment alternatives to long-term medication. These include exercise, diet, and in many cases, chiropractic treatment.

Exercise is critical in restoring mobility and, over time, in reducing pain.2,3 Persons with osteoarthritis often experience a vicious cycle of deteriorating symptoms. Pain causes reduced mobility (pain avoidance), which (paradoxically) actually causes more pain, which causes further reductions of mobility . . . . Activities of daily living ─ getting out of a chair, opening a jar, bending and lifting ─ become a real challenge as the person struggles to avoid further pain.

So, restoring mobility is key. Exercise ─ very gently at first ─ is the answer. Range-of-motion activities to get the joints moving again are very beneficial, including
• Arm circles
• Wrist circles
• Shoulder shrugs
• Side-to-side bending for the lower back
• Gentle knee bends
• Ankle circles
• Flexing and pointing the feet

Walking is a perfect exercise for treatment of arthritis. Begin by walking one block, then two, then around the block. Walk five minutes daily for a week, then increase by a minute or two each day. Get up to 15 minutes of gentle walking, then begin to gradually increase your pace. The increased mobility will not only reduce pain, but also provide a cardiovascular benefit and improve one's ability to perform activities of daily living.

Chiropractic treatment, in combination with an exercise program, may assist in restoring joint mobility and reducing pain. Gentle chiropractic manipulative therapy is designed to improve mobility of spinal joints. As spinal joint motion improves, pain lessens, and a positive cycle of return-to-function begins.

1"Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation." CDC Morbidity and Mortality Weekly Report 55(40);1089-1092, 2006.
2Huang MH, et al: A comparison of various therapeutic exercises on the functional status of patients with knee osteoarthritis. Semin Arthritis Rheum 32(6):398-406, 2003.
3Suomi R, Collier, D: Effects of arthritis exercise programs on functional fitness and perceived activities of daily living measures in older adults with arthritis. Arch Phys Med Rehabil 84(11):1589-94, 2003.