May is Arthritis Awareness Month and SIMEDHealth Rheumatologist, Dr. Rodriguez, discusses the different types of arthritis, arthritis causes, symptoms, and treatment options.

In the U.S. 58.5 million people have arthritis. According to the CDC, "Arthritis is a leading cause of work disability, with annual medical care and lost earnings costs of $303.5 billion." Joints are where the bones meet, and arthritis is inflammation or destruction of a joint. SIMEDHealth Rheumatologist, Dr. Miguel Rodriguez, discusses the common symptoms of arthritis including pain, swelling, stiffness, redness, and decreased range of motion. If you have these symptoms or you or someone you love is suffering from arthritis, talk to your doctor to receive proper treatment. To schedule an appointment with our Rheumatology clinic, click here.

If you're unable to see the video, watch here https://youtu.be/WkbAqJOJJTg

https://www.cdc.gov/chronicdisease/resources/publications/factsheets/arthritis.htm

Normally presented in the form of joint swelling, stiffness, and pain, arthritis affects 1 in 5 adults in the U.S. and is the leading cause of disability. Not only is May arthritis awareness month, but it’s also the beginning of a season for summer travels and family activities.

Here Dr. Tina Brar, of SIMEDHealth Rheumatology, provides us with some tips on how to best manage symptoms to make the most of your summer.

Water Activities:

Because those with arthritis have a limited range of motion, it can be difficult to remain active. However, during the summer months, you can help to relieve the pressure on your joints by getting in the water. Additionally, Dr. Brar recommends yoga and tai-chi-like exercise to help strengthen the muscles around your joints to stabilize them.

“Regular activity is important for any healthy lifestyle.  A lack of activity is what allows your joints to get stiff and for muscles to weaken and deteriorate,” Dr. Brar said.

Scheduled Breaks:

“As long as you’re not straining yourself, frequent movement and stretching will help to alleviate your joint stiffness,” Dr. Brar said.

While you’re traveling and getting outside this summer, Dr. Brar recommends taking scheduled breaks to stretch as well as scheduled breaks to rest. It’s important to balance your periods of activity with periods of rest.

Diet for Weight Loss:

Sometimes activity for weight loss is not always possible if you have arthritis. However, dieting for weight loss can be especially important in helping to improve quality of life. According to Dr. Brar and the Arthritis Foundation, one pound of fat on your abdomen puts an additional 4 to 5 pounds of pressure on your knees.

Watching your diet will help to alleviate pressure on your joints and keep you more mobile during summer activities.

Supplementation:

“Arthritis is a wide-spread problem. There are multiple types of arthritis and not all are treated the same,” Dr. Brar said.

When it comes to supplements, Dr. Brar said there’s no harm in taking turmeric or glucosamine, which are popular among the arthritis community. However, you should talk with your doctor prior to taking them.

Dr. Brar said she believes that those with arthritis should still be able to live fully.

“While we can’t yet cure arthritis, we can manage how it affects our lifestyle,” she said.

If you’re experiencing additional symptoms or need help managing your arthritis, request an appointment to talk with a SIMEDHealth Rheumatologist today.

Run a Half Marathon: New Year’s Resolution

Thank you to everyone who submitted their New Year’s resolution for the Health Goals 2018 project. New Year’s Resolution #1 was submitted by Kelly of Gainesville. Kelly wants to “recover from an ankle injury and complete a half marathon.” 

Dr. Miguel Rodriguez, a SIMED rheumatologist in the Gainesville Arthritis Center, has run numerous marathons. He weighed in on the situation and provided a few tips.

1. Get a good pair of running shoes for your specific foot type. The following shoe stores can evaluate how you run and recommend the right shoes for you:
- The Gainesville Running and Walking Store - http://runningandwalkingstore.com/
- Lloyd Clarke Sports - https://www.lloydclarkesports.com/
- Fit2Run - https://www.fit2run.com/

2. Make sure to warm up and cool down and stretch your feet and ankles.
- Dr. Rodriguez recommends and uses the YOFIT foot stretcher. - http://a.co/i4cKCKN
- If you don’t want to purchase a foot stretcher, you can still stretch your ankle and feet using your surroundings as a tool. For instructions and a video walk-through, visit the New York Road Runners website: http://www.nyrr.org/youth-and-schools/running-start/coaching-videos/high-school/stretches-strength/ankle-stretches

3. Follow a half-marathon training plan.
- There are apps and many available resources online that will prepare you for a half marathon. Dr. Rodriguez suggests using Jeff Galloway’s half marathon training plan: http://www.jeffgalloway.com/training/half-marathon-training/

4. Avoid overeating.
- Running and being more physically active is not an excuse to eat poorly. Stick to a paleo or Whole 30 approach for your food.
- The Whole 30 diet focusses on healthy, unprocessed food. People who follow the diet avoid consuming grains, alcohol, added sugar, dairy and other unhealthy foods. You would wait until 30 days after starting the diet to weigh yourself for the first time. Learn more: https://whole30.com
- The paleo diet also avoids processed food, dairy, grains and alcohol and focusses on eating food as our ancestors did many years ago. Learn about the paleo diet: https://robbwolf.com/what-is-the-paleo-diet/
- You can also use the slow cooker to make sure you always have food ready. When you increase your activity, you will get hungry. The internet has an abundance of free recipes for whatever you want to eat. One of Dr. Rodriguez’s favorite recipes is Slow Cooker Kalua Pig: http://nomnompaleo.com/post/10031990774/slow-cooker-kalua-pig

5. If you are looking for support, resources are available in the area.
- The Florida Track Club hosts group runs: https://floridatrackclub.wildapricot.org/
- Local running stores also host events: https://www.fit2run.com/store-event-calendar/

With these tips in mind, you will be well on your way to running a half marathon. Remember to take your time and move at your own pace. If you experience any pain, take a break and consult a doctor if necessary. 

To schedule an appointment with Dr. Rodriguez in Gainesville, call (352) 378-5173 or request an appointment online. For an appointment with another rheumatologist, call:
Gainesville: (352) 378-5173
Ocala: (352) 291-0245
Chiefland: (352) 378-5173
Lady Lake (The Villages): (352) 391-6450
Or request an appointment online.

Tai Chi is a meditative martial art that features slow, gentle movements and deep breathing. It is a series of exercises that flow from one to the other with an emphasis in proper posture. It is meditation in motion.

By SIMED Rheumatologist Dr. Miguel Rodriguez

Low Risk

I recommend tai chi to my patients because it is a low impact exercise that may benefit people with arthritis. There is a low risk of injury for the patients, and most people can do tai chi. Medical evidence on tai chi is difficult to find because people have difficulty studying it in randomized controlled trials. There is also a lack of funding for the studies, but from the research that exists, tai chi has been found to be very beneficial for the aging population.

"A growing body of carefully conducted research is building a compelling case for tai chi as an adjunct to standard medical treatment for the prevention and rehabilitation of many conditions commonly associated with age," says Peter M. Wayne, assistant professor of medicine at Harvard Medical School and director of the Tai Chi and Mind-Body Research Program at Harvard Medical School's Osher Research Center.

Tai Chi For Arthritis Part 1 (Shoulder): 

Highly Beneficial

For patients with arthritis, tai chi improves balance, muscular strength, mobility, flexibility, and psychological health. It also decreases pain and helps prevent falls.

I recommend patients do tai chi at least one hour per week, but they can start at their own pace and increase as tolerated. I think it’s better to start slow and keep doing it over the long term than to overdo it the first day or week and stop.

Tai Chi For Arthritis Part 2 (Neck): 

Starting Tai Chi

Elder Options offers tai chi classes in Gainesville for patients with arthritis and for improving one’s balance. I also recommend watching videos on YouTube and checking out the library, which is a great resource and sometimes has postings on the bulletin board for tai chi.

Who Should and Shouldn’t Do Tai Chi

Patients with arthritis, osteoporosis, recurrent falls, and fibromyalgia would benefit the most from tai chi.

If you have a limiting musculoskeletal problem or medical condition – or if you take medications that can make you dizzy or lightheaded – check with a doctor before starting tai chi. Tai Chi has an excellent safety record, so chances are that you’ll be encouraged to try it. If you feel uncomfortable doing anything, you should stop and talk with your doctor.

In addition to tai chi, patients should stay active, work on their weight and reduce their stress.

Tai Chi For Arthritis Part 3 (Spine):

If you would like to schedule an appointment with Dr. Rodriguez, please call the SIMED Arthritis Center in Gainesville at (352) 378-5173 or request an appointment online.

For an appointment with SIMED Rheumatology in any of our locations, call:
Gainesville: (352)378-5173
Ocala: (352) 291-0245
Chiefland: (352) 378-5173
Lady Lake (The Villages): (352) 391-6450

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Arthritis is a disease that impacts more than 50 million Americans, making it the number one cause of disability in the country. That means 1 in every 5 adults, 300,000 children and countless families are affected by arthritis. – Arthritis Foundation, 2016

Dr. Miguel Rodriguez of SIMED Arthritis Center breaks down some of the components of how arthritis works and why it’s such a debilitating disease.

How does someone develop arthritis?

“You can break up arthritis into two different types, there is osteoarthritis and inflammatory arthritis. Osteoarthritis is a result of wear and tear that ends up happening as a function of age or it could be a result of long term repercussions of having some type of trauma to the body. For example, if you break your ankle and as it heals you continue to walk on it, you can develop arthritis in your ankle. Then there is inflammatory arthritis which is generally classified as an auto immune disease so that means that someone’s own immune system is reacting against their own joints” says Dr. Rodriguez.

Are there certain predisposition to arthritis?

So again we are breaking it up into two different types of Arthritis. Obesity is a big modifiable risk factor for osteoarthritis. The wear and tear of weight bearing joints can be accelerated by obesity. As we get older, we will all eventually develop osteoarthritis.

Inflammatory arthritis can be passed down genetically from family members. Then there are certain things like Gout, which can be from being overweight or having bad kidney function.

Are there precautions someone can take to reduce their chance of arthritis?

It helps to maintain a healthy lifestyle. Staying active is important to keep your weight down. For every pound you lose, your taking four pounds off the knees.

What are some ways to cope with the symptoms of arthritis?

In general you want to try and stay active. Physical Therapy can be helpful to demonstrate safe exercise and stretches that can help decrease joint pain and improve conditioning. Topical creams can be beneficial for pain relief, and for some people, acupuncture helps.

What types of medications are there for arthritis and what do they do?

With Osteoarthritis you are trying to relieve pain so you start off with over the counter medicine like Tylenol(acetaminophen),which is your safest oral medication. Then you have anti-inflammatory medicines such as, Advil(Ibuprofen) and Aleve(Naproxen). Some of these anti-inflammatories are also available in prescription strength. Then you have opiates for extreme pain associated with osteoarthritis.

We consider rheumatoid arthritis a prototypical inflammatory arthritis. To treat patients, we generally start off with steroids in order to get the inflammation under control. Then we use different medications to keep the inflammation under control while we take away the steroids.

DMARD’s Biologic s are exciting newer medications we use to control the autoimmune reaction either individually or in combination to control their inflammatory arthritis. By getting control of the inflammatory symptoms, we are able to decrease or hopefully get people off their steroids.

What are the symptoms of Rheumatoid arthritis?

Joint swelling is the biggest symptom of rheumatoid arthritis. The joints will be visibly swollen, generally the hands will be most affected. This can really impact your day to day routine. For example, if you have to be at work at 8 o’clock, you may need to get up earlier to wait out the stiffness. The stiffness can last up to an hour after waking up. This is something you can help to differentiate between inflammatory arthritis and osteoarthritis.

What type of doctor should someone go to if they think they are developing arthritis?

You can see a Primary Care doctor if you think you are developing arthritis and they can refer you to see a specialist if need be. Your Primary Care doctor can send you to a rheumatologist, a specialist in arthritis. The Rheumatology works with other specialists if the arthritis results in complications requiring surgery or other interventional procedures.

Is there any research going on for arthritis relief?

There is a lot of research going on for rheumatoid and inflammatory arthritis. For these types of arthritis, they are generally caused by the immune system so there are different ways of working on modulating the system to stop the long term damage from the chronic inflammatory process.

Can arthritis be "cured"?

No unfortunately it cannot be cured. However, the idea is to be able to control the systems. So the rheumatoid arthritis will hopefully become in like diabetes or hypertension in some patients. Which means they will have to take medicine all the time but they won’t have any symptoms, or long term complications.

I understand some of the newer arthritis medications cant be taken by mouth. How are these medications administered?

An infusion room is where patients can receive medicines called biologics which are medicines used to control inflammatory arthritis. These medicines are given through an IV and block specific parts of the immune system that are responsible for the swelling or inflammation that cause rheumatoid arthritis. Many rheumatologist, including here at SIMED arthritis center, have infusion rooms incorporated in their clinics.

Can people develop both types of arthritis?

Yes, people can develop both inflammatory and osteoarthritis. People with inflammatory arthritis continue to age and their joints experience the typical wear and tear that leads to osteoarthritis.

As a Doctor how do you diagnose one over the other?

As a Rheumatologist the most important thing we do is have the patient give us a detailed health history and we do a physical exam. This helps differentiate if the problem is an ongoing issue between inflammatory arthritis and osteoarthritis. The doctor can tell the difference between the two by palpating the stiff joints as well as looking at the pattern of the joints involved.

Dr. Rodriguez encourages you to take control of your arthritis this year! If you’re not sure how to start you can begin by scheduling an appointment with a Primary Care physician or a Rheumatologist today! Click here to request an appointment online.