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Keep Moving: Exercise for Joint Pain Joint pain, or arthralgia, associated with autoimmune disease often includes stiffness that lasts more than an hour along with redness, swelling and warmth near the joint itself. It commonly affects joints on both sides of the body especially smaller joints of the hands and feet. Some of the most common autoimmune diseases associated with inflammatory arthralgia include rheumatoid arthritis, systemic lupus erythematosus, scleroderma, Sjogren’s disease and mixed connective tissue disease. The reason these patients experience joint pain is their irregular response to infection. Instead of the immune system attacking foreign invaders such as infection or injury bringing armed parties to fight, repair and then leave the site, patients with inflammatory arthralgia experience an attack on their own tissues. This causes a chronic inflammatory response while immune cells attack the tissues that surround the joint affected. Unless this irregular response is halted, the joint tissues will be destroyed and scarring will occur, often limiting movement. Less movement of joints encourages bone and muscle weakening, muscle imbalances, dislocations and eventually complete immobility of that site. One important way to mediate these negative joint changes is to exercise. Simple movements can reduce inflammation and pain, prevent the development of scar tissue, strengthen muscles, maintain bone strength, improve stamina, manage body weight, encourage a better night’s sleep and foster healthier self-esteem. Individuals who have not been active for some time should begin slowly, easing themselves into a new routine. Any patient should speak with their doctor regarding a new regimen before beginning to ensure a smooth and safe start. In order to preserve movement, patients suffering from joint pain should regularly practice range of motion and stretching exercises. These simple, non-weight bearing choices can be performed two to three times daily while performing other daily tasks. For example, your knee can be ranged while sitting at a meeting or lunch by simply extending the leg into the air, then returning to a position slightly under the seat, as tolerated. Stretching moves the joint and its surrounding muscles to the end or slightly beyond their normal range of motion. It is most important to hold the position for at least 30 seconds to produce lasting effects. Strengthening exercises help to build the muscles that surround a joint decreasing the load on the joint itself. Both isometric and isotonic exercises are encouraged but patients with more advanced diseases or experiencing a flare-up should try isometric exercises first. These involve simply contracting a muscle group in place without moving the joint. Again, these can be completed alongside everyday tasks. Using the knee as an example again, simply raise the leg into the air, contract the thigh muscles for 10 second intervals up to three to five times on each side, relaxing for 10 seconds between contractions. Conversely, isotonic exercises involve moving a joint through its range of motion against resistance. Often your own body weight can serve this purpose. Both isometric and isotonic exercises are encouraged to be performed every other day working up to three to five sets of eight to ten repetitions of each exercise. Of course no exercise regimen is complete without aerobic exercise. Improving cardiovascular health and joint symptoms by managing body weight can be accomplished even with low-impact activities such as swimming, bicycling and walking. Again, a doctor should be consulted before beginning any new activities. Most importantly, these exercise should be viewed as a way one can help improve joint pain at home while enjoying the company of others and completing daily living tasks. The key is to keep moving. For more information on this topic see the December/January issue of IGLiving Magazine online at http://www.igliving.com under Feature Articles.