- Managing the Pain of Osteoarthritis Day by Day Learn simple ways to help you cope with osteoarthritis pain and feel better day by day.
- Your 6-Week Walking Plan Your 6-week walking plan for arthritis relief.
- Coping With Arthritis Day by Day Coping strategies for living with osteoarthritis and managing pain.
- Ask Your Doctor About Arthritis Don't suffer in silence. Ask your doctor these 10 questions.
- Drop 10 & Improve Arthritis Pain Learn how losing just 10 pounds can help relieve pain and make you feel better.
- Understanding Osteoarthritis What happens when you have osteoarthritis? Get the facts here.
The hardest part of starting an exercise program is, well ... getting started. This can be an especially daunting task if you have osteoarthritis (OA), the wear-and-tear form of arthritis which causes joint pain and loss of function for 27 million Americans.
But "the more you move, the better you will feel," promises Laura Thorp, PhD, an OA researcher at Rush University Medical Center in Chicago.
"Walking is an easy way to get started and it can help you lose weight," she says. OA and obesity tend to travel together, and excess weight puts extra stress on your already creaky joints. Modest weight loss can help relieve your pain and restore function in your joints.
To make your challenge less daunting, WebMD devised this new, expert-approved, step-by-step, six-week walking program.
Step 1. Get medical clearance from your doctor. Do not pass go without it, says Thorp. "Never start an exercise program without talking to your doctor first, especially if you have been sedentary," she cautions.
Step 2. Seek guidance from a certified exercise trainer or a physical therapist, Thorpe says. If you are a couch potato by nature, a physical therapist can help design your walking program. He or she can also help you with your walking posture and teach you how to target the correct muscles when you warm up and cool down. If you are a more seasoned current or former exerciser, you can bypass this step.
Step 3. Start slowly. "If you are going to start an exercise or walking program and go full-force into it, you will get worn out," she says. "Set realistic expectations." Aim for walking three times a week for the first two weeks of this six-week program. "Start gradually and build up to 30 minutes on most days of the week." Keep a walking journal and record your progress. You can include information about how far, how long, and how often you walk.
Step 3a. Break it up. Walking does not have to be done consecutively for it to count. It can be done in brief spurts throughout your day.
Tip: Thirty minutes equals 3,300 steps a day. Consider buying a pedometer or step counter to help you keep tabs of your tracks.
Step 4. Grab a buddy. "Walking can be social," Thorpe says. "People walk in groups or go to the malls," she says. Now that you are a few weeks into the six-week program, you may need some extra motivation to stick with it. "Motivation and compliance are the biggest issue when it comes to engaging in regular exercise. "A walking group is motivating because there is accountability in a group," she says. For weeks three through six, shoot for 30 minutes on most days of the week with your buddy or walking group.
Step 5. Listen to your body. Now that you are walking more frequently and perhaps more vigorously, "there may be times when it's not a good idea to push it," says Michael Parks, MD, an assistant attending orthopaedic surgeon at the Hospital for Special Surgery in New York City. "Know your limits."
Step 6. Kick it up a notch. Once your daily walks have become a part of your routine, it's time to step things up. "Push it and go a little faster and a little longer," says Kevin D. Plancher, MD, an orthopaedic surgeon in New York City and Cos Cob, Conn., and associate clinical professor in orthopaedics at Albert Einstein College of Medicine in the Bronx, N.Y. This is good for your joints and your cardiovascular health. "The more you walk, and the faster you walk, the more you are building up the muscles around your damaged joints," he says. "We know if you can tone up certain muscles of the leg you can make a difference in the progression of your OA."
Tip: Increase the intensity by knowing and monitoring your heart rate. Here's how: Check your pulse periodically to make sure you are within your target heart rate, which is 50% to 75% of your maximum heart rate. This can be found by subtracting your age from 220. If you are 60, your maximum heart rate is 160, for example. When you start a walking program, aim for 50%. If you have been walking for some time, try to reach 75%.
Kevin D. Plancher, MD, orthopaedic surgeon, New York City and Cos Cob, Conn.
Michael Parks, MD, assistant attending orthopaedic surgeon, Hospital for Special Surgery, New York City.
Laura Thorp, PhD, assistant professor, anatomy and cell biology, Rush University Medical Center, Chicago.
American Heart Association web site: "Target Heart Rates."
Reviewed by Brunilda Nazario, MD on March 31, 2011
© 2010 WebMD, LLC. All rights reserved.
Important Safety Information About Cymbalta®
The most important information you should know about Cymbalta:
Antidepressants can increase suicidal thoughts and behaviors in children, teens, and young adults. Suicide is a known risk of depression and some other psychiatric disorders. Call your doctor right away or seek emergency help if you have new or worsening depression symptoms; unusual changes in behavior, such as agitation, irritability, impulsivity, or restlessness; or thoughts of suicide. Be especially observant within the first few months of treatment or after a change in dose. Approved only for adults 18 and over.
Cymbalta may be associated with serious side effects. Call your healthcare provider right away or seek emergency help if you experience any of the following:
- Itching, right upper-belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of life-threatening liver problems. Severe liver problems, some fatal, have been reported
- High fever, confusion, stiff muscles, muscle twitching, or racing heart rate, which may be signs of serotonin syndrome, a potentially life-threatening condition
- Abnormal bleeding, especially if Cymbalta is taken with aspirin, NSAID pain relievers (like ibuprofen or naproxen), or blood thinners
- Serious, possibly life-threatening skin reactions, which may include skin blisters, peeling rash, mouth sores, hives, or other allergic reactions
- Abnormal mood (mania), which may include greatly increased energy, severe trouble sleeping, racing thoughts, talking more or faster than usual, and reckless behavior
- Seizures or convulsions
- Decreased blood pressure upon standing, which can cause dizziness or fainting, mostly when first starting or increasing the dose. Cymbalta can also increase blood pressure. Your healthcare provider should check your blood pressure prior to and while taking Cymbalta
- Headache, weakness or feeling unsteady, confusion, problems concentrating, or memory problems, which may be signs of low sodium levels in the blood. Elderly people may be at greater risk
- Problems with urination, including decreased flow or inability to pass any urine
- Changes in appetite or weight. Children and adolescents should have height and weight monitored
Do not stop Cymbalta or change your dose without talking to your healthcare provider, as you could have side effects.
Cymbalta is not for everyone. Do not take Cymbalta if you:
- Are taking or have recently taken a monoamine oxidase inhibitor (MAOI), including the antibiotic linezolid, or Mellaril® (thioridazine). Taking Cymbalta close in time to these medicines can cause serious or even life-threatening side effects
- Have uncontrolled narrow-angle glaucoma (eye pain due to increased eye pressure)
Before taking Cymbalta, talk with your healthcare provider:
- About all your medical conditions, including
- kidney or liver problems, heart problems, or high blood pressure
- glaucoma or diabetes (Cymbalta may worsen diabetes or a type of glaucoma)
- seizures/convulsions, mania, or if you have bipolar disorder
- if you have ever had or been told you have bleeding problems, low sodium levels in your blood, or delayed stomach emptying
- About all prescription and over-the-counter medicines and supplements you take or plan to take, including
- antibiotics or medicines for migraine, mood, or psychotic disorders, to avoid a potentially life-threatening condition when taken with Cymbalta
- aspirin, NSAID pain relievers, or blood thinners, because they may increase risk for bleeding
- About your alcohol use (you should not take Cymbalta if you drink heavily)
- If you are pregnant or plan to become pregnant during therapy or are breast-feeding
Most common side effects of Cymbalta (this is not a complete list):
Nausea, dry mouth, sleepiness, fatigue, constipation, decreased appetite, increased sweating, dizziness. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Other safety information about Cymbalta:
- Cymbalta may cause sleepiness and dizziness. Until you know how Cymbalta affects you, you shouldn't drive a car or operate hazardous machinery
- People age 65 and older who took Cymbalta reported more falls, some resulting in serious injuries
How to take Cymbalta
Take Cymbalta exactly as directed by your healthcare provider. Do not open, break, or chew capsule; swallow it whole. Cymbalta is available by prescription only.
DD CON ISI 02OCT2012
©Lilly USA, LLC 2012. All rights reserved.
Cymbalta is a registered trademark of Eli Lilly and Company.
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