A. JABBAR DENTAL CLINIC KARACHI

Sadia Khan

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Ismail Munir

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Time To Hit The Gym, Your Bones Are Calling!

Introduction

The term &quot;<a href="https://www.merisehat.pk/disease/osteoporosis-80">osteoporosis</a>&quot; literally translates to &ldquo;porous bone&rdquo;. Osteoporosis occurs when the bones lose minerals more quickly than they can be replaced. This causes the bones to become less dense, weak, and break more easily. The disease thins the bone framework. As a result, even a minor fall or bumps against furniture can cause a fracture. 
&nbsp;

For most people, the disease takes a silent course and they remain unaware of its presence until a fracture happens. Since osteoporosis generally does not present with any signs and symptoms, it is often referred to as the &ldquo;silent disease&rdquo;.&nbsp; 
&nbsp;

Osteoporosis is a common bone disease that affects both men and women, but middle- and older-aged women are more likely to have it as compared to men. In postmenopausal women, low estrogen levels increase the risk of disease. Moreover, the prevalence of the disease increases with age. 
&nbsp;

Osteoporosis typically presents with fractures and its associated complications. Spine, hip, and wrist fractures are the most common fractures in osteoporosis. Additionally, limited activity because of postural changes affects the individual&rsquo;s overall quality of life.&nbsp;&nbsp;

&nbsp;

Bones are formed by special cells in our body, called osteocytes. Similar to other parts of our body, our bones are also constantly being broken down and renewed. When we are younger, more bone is made than is broken down, which leads to bone growth. However, with age, the bone growth slows down and by the age of 25 to 30 years, it completely stops. This is the time around which peak bone mass is achieved.&nbsp; 
&nbsp;

In addition, sex hormones, such as estrogen and testosterone, play a pivotal role in maintaining bone strength in both men and women. However, during menopause, there is a significant decrease in the levels of estrogen. This triggers excessive bone loss. Women can lose as much as 10-20% of the total body bone mass during the first few years of menopause<a href="#accordion">[1]</a>. 
&nbsp;

Osteoporosis also triggers fractures of the spine that can cause pain, changes in posture, and loss of height. Similarly, when spinal fractures are compressed because of the force of gravity, it causes the spine to bend abnormally, a condition that is known as kyphosis.&nbsp; 
&nbsp;

Understanding The Importance Of Exercise in Osteoporosis

Fortunately, there are preventive measures and treatments available to combat this problem. Lifestyle changes and medical treatment can help reduce the risk of bone fractures and slow down further bone loss. Early diagnosis and fracture risk assessment can slow down the loss of bone density in people with osteoporosis. 
&nbsp;

Moreover, just like muscles gain strength from exercise, bones can also become stronger with physical activity. Exercising may be effective for the treatment of osteoporosis and the prevention of hip and spinal fractures. Studies have further shown that weight training prevents age-related decline in skeletal mass, and in some cases may also increase the mineral content of bones.&nbsp; 
&nbsp;

Exercising regularly helps with optimal improvement in bone density, even in women taking adequate dietary calcium. The skeletal benefits of exercise are not affected by hormonal status or age. Exercise programs are designed keeping in mind the individual’s physical condition, the current level of activity, their overall compliance, and objectives that need to be achieved. Generic programs that aren’t specifically designed to target the needs of the individuals and inadequate supervision will result in musculoskeletal complications and non-compliance. Moreover, exercise helps prevent osteoporosis-associated complications, irrespective of age and hormonal status.

<h4>"Hitting the gym when anxious can help calm you down. And our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan</a> can help you monitor your stress level!"</h4>

Each year, more than 2 million osteoporosis-related fractures are reported. What&rsquo;s more, most people are unaware of the fact that they have osteoporosis till they suffer a fracture. 
&nbsp;

While the exact cause of osteoporosis is still not known, there are many factors that contribute to osteoporosis, including:&nbsp; 
&nbsp;

<ul>
	<li>Ageing&nbsp;</li>
	<li>Lack of physical activity and an inactive lifestyle&nbsp;</li>
	<li>Decreased levels of estrogen&nbsp;</li>
	<li>Genetic predisposition&nbsp;</li>
	<li>Excessive use of thyroid hormone and cortisone&nbsp;</li>
	<li>Smoking&nbsp;</li>
	<li>Excessive intake of alcohol&nbsp;</li>
</ul>

&nbsp;

The loss of bone generally begins at the age of 35 and is more commonly seen in the lower forearm above the wrist, spine, and upper femur or thigh. Women lose 30-50% of their bone density after growth is complete, and men lose 20-30%<a href="#accordion">[1]</a>. The common osteoporosis-associated injuries in older adults include wrist fractures, spine fractures, and hip fractures.&nbsp;

During menopause, women lose calcium from the bone at a more accelerated pace compared to men. This results from the low estrogen levels during menopause.&nbsp; The hormone helps maintain bone mass and strength. Your doctor may recommend estrogen replacement therapy or other medications such as calcitonin.&nbsp;

&nbsp;

Moreover, certain medical conditions, medications, and treatments can also affect the strength of bones directly. Vitamin D deficiency, endometriosis, cancer, chronic lung disease, and an overactive thyroid or parathyroid gland can all affect bone density. Other risk factors include:&nbsp; 
&nbsp;

<ul>
	<li>Low intake of protein, potassium, vitamin D or calcium&nbsp;</li>
	<li>Inactive lifestyle&nbsp;</li>
	<li>Cigarette smoking&nbsp;</li>
	<li>Alcohol abuse&nbsp;</li>
	<li>Long-term use of medications such as some antiseizure drugs, or overuse of aluminium-containing antacids and glucocorticoids.&nbsp;</li>
	<li>Eating disorders&nbsp;</li>
	<li>Low levels of estrogen in women and testosterone in men</li>
</ul>

&nbsp;

Whether you&rsquo;re in your early 20s or late 50s, keeping the bones healthy at any age is a smart goal. However, people only realize the importance decades after they turn 50. Or when weakened bones have already led to fractures. 
&nbsp;

Fortunately, regular moderate-intensity exercise, for at least 2 hours and 30 minutes every week, can help reverse the damage. Fast walking and cycling are both examples of moderate-intensity exercise. Moreover, weight-bearing and resistance exercises help improve bone density and prevent osteoporosis. Similarly, it is also recommended for adults between the ages of 19 and 64 to do muscle-strengthening activities at least twice a week. The exercises target major muscle groups including the back, shoulders, chest, arms, hips, and legs.&nbsp; 
&nbsp;

If you have been diagnosed with osteoporosis, speak with your doctor before starting any new exercise regimen to ensure that it&rsquo;s the right fit for you.&nbsp; 
&nbsp;

<h5>1. Weight-Bearing Exercises&nbsp;</h5>

Weight-bearing exercises are tailored for your feet and legs to support your weight. High-impact weight-bearing exercises, for example, aerobics, dancing, skipping, running, and jumping up and down on the spot will help in strengthening your muscles, joints, and ligaments. Though, while exercising it is essential to wear footwear that provides your ankles and feet with adequate support. Moreover, weight-bearing exercises are also the perfect fit for people over the age of 60. The exercises can include brisk walking or a game of tennis.&nbsp; 
&nbsp;

<h5>2. Resistance Exercises&nbsp;</h5>

Resistance exercises are designed to strengthen muscles and improve bone density. Examples of resistance exercises include weightlifting, press-ups or exercise using other weight training equipment at the gym. If you have never exercised at a gym before, always ask for help from an instructor to ensure correct use and prevent any injuries.

&nbsp;

Conclusion

Ageing and declining hormone levels are normal physiological phenomena. But that should not be used as an excuse to live an unhealthy or sedentary lifestyle. While you may not feel as physically fit as when you were in your 20s, it’s never too late to hit the gym and reverse the damage. Studies have shown that exercising regularly can help improve bone density and prevent fractures.&nbsp;

[1].Ji, M.X. and Yu, Q., 2015. Primary osteoporosis in postmenopausal women. Chronic diseases and translational medicine, 1(01), pp.9-13.

Staff Writer

Iqra Mazhar

This article or video has been viewed by many visitors, and is popular.

All Work No Play Makes Jack A Dull Boy And Jill A Dull Girl

Physical activity is very important for a child&rsquo;s health. Children and adolescents who are active now are more likely to be active adults later. That&rsquo;s why it is imperative to promote an active lifestyle among children at an early age.

On one hand, a lack of movement is associated with obesity, <a href="https://merisehat.pk/disease/depression">depression</a>, and <a href="https://merisehat.pk/disease/anxiety">anxiety</a>, while on the other hand,&nbsp;physical activities have a positive impact on the social and psychological aspects of an individual&rsquo;s personality.&nbsp;

The sad reality is that more people are adopting a sedentary lifestyle these days. Staying indoors and spending time at home has become a norm. Children, especially, have become couch potatoes because they spend most of their time on their computers or tablets. This makes them dull and declines their cognitive skills or stamina. The only physical activity they indulge in is physical education (PE) at school, which unfortunately is optional, and not every child enrolls in it.&nbsp;

&nbsp;

Understanding Importance Of Childhood Physical Activity

It&rsquo;s unfortunate that despite knowing its benefits, there is a lack of physical activity among children in Pakistan. Parents play a crucial role in teaching their children the importance of physical activities. However, most of them are uninformed and are unable to persuade their children to indulge in healthy activities. So, parents should first acquaint themselves with the subject, before they talk to their children and encourage them to take up physical sports.

&ldquo;Active 1 + FUN&rdquo;, for instance, is one family-based intervention that has proven to be helpful. It&rsquo;s the parent&rsquo;s choice whether they prefer online materials or real-time interactive workshops to meet their child&rsquo;s basic psychological needs<a href="#accordion">[1]</a>. Parents exploring fun activities with their children can be a good bonding moment between the two, which can also enhance cooperation between them.&nbsp;

&nbsp;

Promoting physical activity among adolescents and children is very important for their growth and development. Additionally, it improves academic and cognitive performances. The World Health Organization emphasizes that children between the ages of 5 and 17 should spend at least 60 minutes per day on high-intensity physical activities, but only 20% of the children follow this rule of physical activity<a href="#accordion">[3]</a>. Furthermore, it was seen that girls between the ages of 13 and 15 lack physical activity in their daily routines compared to boys, and only 15.5% of them engage in it.&nbsp;

There are multiple reasons why children are inactive. For one, social norms and patriarchal ideologies in Asian countries deprive girls of taking part in sports activities or any other activities that require physical training. This has led to false perceptions perpetuated among teenage girls who think that games are only for boys.&nbsp;

Secondly, girls are more inclined toward social media, trending movies, and TV shows, while boys prefer online gaming<a href="#accordion">[4]</a>. However, the tide has been fast shifting and we now see both girls and boys enjoying sports and indulging in online gaming.&nbsp;

Unfortunately, for many children, they continue to lead a monotonous life, which involves school, homework, and lazing around at home in their free time.

&nbsp;

Circumstances are not always favorable for most children, considering the inflation and other constraints in our country. Here are some budget friendly activities that can be done:

<ul>
	<li>Drawing: Chalks can be a fun activity for children. Children can draw a maze on the floor or play hopscotch like the kids from the 90s. This activity is an encouragement for creativity and fitness.</li>
	<li>Dancing: The simplest way to get the kids moving is to play music and make them dance to the tunes. Parents can also engage in the activity with their kids. Studies show that dancing improves a person&rsquo;s health, calms them, and helps them sleep better at night<a href="#accordion">[5]</a>. Also, dancing is quite useful in reducing anxiety and depression<a href="#accordion">[6]</a>.</li>
	<li>Board Games: Board games are a great way to promote early learning in children. They help them identify colors,&nbsp;and develop hand-eye coordination and math skills.&nbsp;</li>
</ul>

&nbsp;

<h4>"Exercise is vital to managing stress. Find out your stress level with our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan </a>today!"</h4>

<ul>
	<li>Limit Screen Time: Parents should limit their children&rsquo;s screen time, which includes video games, tablets, and smartphones. If children are under the age of 5, their screen time should be less than 1 hour per day. Moreover, screen time is not recommended for kids under 2 years.</li>
	<li>Organised Sports: Organised sports, like football or cricket, are not enough to keep your children healthy. It&rsquo;s important to encourage them to stay active every day &ndash; a walk in the park and jumping rope are low-cost exercises that they can opt for.</li>
	<li>Skip The Elevator: When parents are out with their kids, they should encourage them to use the stairs instead of the elevator.&nbsp;</li>
	<li>Make Them Help Out: Whether it is grocery shopping or doing house chores, letting the children help ensures they are not only active but also learn essential life skills.</li>
</ul>

&nbsp;

<ul>
</ul>

<ul>
	<li>Growth: Exercise is as important as food for children to grow. It helps to build stronger muscles and bones. A healthy bone density or bone mass reduces the risk of bone-related diseases, such as osteoporosis, later in life.</li>
	<li>Better Fitness: Exercise helps build physical strength, which has multiple benefits for growing children. For example, they can walk longer distances and not get tired, they are more active, and they perform everyday tasks without getting lethargic. Additionally, exercise promotes stability and flexibility.</li>
	<li>Motor Skills: Physical activity builds motor skills that help children master basic movements. Motor skills include all tasks like feeding themselves, writing, and getting dressed.</li>
	<li>Posture: Children are habitual of slouching and exercise can improve their posture through core strength. Moreover, it protects the spine from deformity&nbsp;and reduces pain due to bad posture.</li>
	<li>Cognitive Development: Exercise helps in brain development. During exercise, the nerve cells in the hippocampus and the prefrontal cortex of the brain multiply to form new connections<a href="#accordion">[7]</a>. This improves concentration and memory, which are the basic needs of every child.</li>
	<li>Mental Health: Although most children dread exercising, it helps in relieving stress and anxiety<a href="#accordion">[8]</a>. The endorphin rush promotes a better mood.</li>
</ul>

&nbsp;

Key Points

<ul>
</ul>

<ul>
	<li>Physically active kids are happier kids.</li>
	<li>Exercise strengthens the bones and muscles, and prevents the children from gaining excess weight. Consequently, it reduces the risk of other diseases, like diabetes, osteoporosis, and cancer.</li>
	<li>Physical activity is also beneficial for mental health.</li>
	<li>Exercise also enables children and adolescents to have a better outlook on life. They are confident and have better cognitive and stress management skills.</li>
	<li>The release of endorphins during exercise positively correlates to happiness in children.</li>
</ul>

&nbsp;

[1] Ha, A.S., Ng, J.Y., Lonsdale, C., Lubans, D.R. and Ng, F.F., 2019. Promoting physical activity in children through family-based intervention: Protocol of the “Active 1+ FUN” randomized controlled trial. BMC Public Health, 19(1), pp.1-12.

[2] Habib, M.B., Nazeer, M.T., Mahfooz, M. and Safdar, M.S., 2022. Physical activity in Pakistani perspective: issues, implications, and recommendations. Journal of the Pakistan Medical Association, 72(2), pp.322-328.

[3] Imtiaz, A., ulHaq, Z., Afaq, S., Khan, M.N. and Gillani, B., 2020. Prevalence and patterns of physical activity among school aged adolescents in Pakistan: A systematic review and meta-analysis. International Journal of Adolescence and Youth, 25(1), pp.1036-1057.

[4] Lu, A.S., Baranowski, T., Hong, S.L., Buday, R., Thompson, D., Beltran, A., Dadabhoy, H.R. and Chen, T.A., 2016. The narrative impact of active video games on physical activity among children: a feasibility study. Journal of medical Internet research, 18(10), p.e6538.

[5] Gyrling, T., Ljunggren, M. and Karlsson, S., 2021. The impact of dance activities on the health of persons with Parkinson’s disease in Sweden. International Journal of Qualitative Studies on Health and Well-being, 16(1), p.1992842.

[6] Adam, D., Ramli, A. and Shahar, S., 2016. Effectiveness of a combined dance and relaxation intervention on reducing anxiety and depression and improving quality of life among the cognitively impaired elderly. Sultan Qaboos University Medical Journal, 16(1), p.e47.

[7] Bidzan-Bluma, I. and Lipowska, M., 2018. Physical activity and cognitive functioning of children: a systematic review. International journal of environmental research and public health, 15(4), p.800.

[8] Alves, J.M., Yunker, A.G., DeFendis, A., Xiang, A.H. and Page, K.A., 2021. BMI status and associations between affect, physical activity and anxiety among US children during COVID‐19. Pediatric obesity, 16(9), p.e12786.

Humza Khizer

I Like To Move It, Move It. Do You?

In arthritis, it is necessary to participate in joint-friendly physical activity to improve arthritis pain, mood, function, and quality of life. Choose activities which place less stress on the joints and are associated with a reduced risk of injury. Walking, biking and swimming are examples of joint-friendly activities. Being physically active can also delay the onset of arthritis-related disabilities and help with the management of other chronic conditions (diabetes, heart disease, and obesity). 
&nbsp;

These exercises should be revisited if there is a change in symptoms.&nbsp;

It is important to learn how to exercise safely and enjoy the benefits of increased physical activities with these &ldquo;SMART&rdquo; tips. 
&nbsp;

<ul>
	<li>Start low, go slow.</li>
	<li>Modify activities according to the severity of symptoms.</li>
	<li>Activities should be &ldquo;joint-friendly.&rdquo;</li>
	<li>Recognize ways to be active.</li>
	<li>Talk to a health professional. 
	&nbsp;</li>
</ul>

<h5>Start Low, And Go Slow</h5>

When starting or increasing physical activity, start slow and pay attention to how the body tolerates the exercise. People with arthritis will take more time for their bodies to adjust to the new level of activity. In the beginning, it is much better to start with a small amount of activity, for example, 3-5 minutes. Add a little at a time (like 10 minutes at a time), and allow sufficient time for your body to adjust to the new time frames introduced, before adding more time. 
&nbsp;

<h5>Modify Activities According To The Severity Of Symptoms And Stay Active.</h5>

Arthritis symptoms (stiffness, and fatigue) may come and go, and the affected person may have good and bad days. Try to modify your activity according to these highs and lows, but try to stay as active as possible, in a safe way.

&nbsp;

<h5>Activities Should Be &ldquo;Joint-Friendly.&rdquo;</h5>

Exercises should be easy on the joints. Walking, bicycling, water aerobics, or dancing are good examples of activities which have a very low risk of injury, and do not place undue stress on the joints.

&nbsp;

<h5>Recognize Ways To Be Active.</h5>

Safety is very important for starting and maintaining an activity plan. Before starting any exercise, it is advisable to consult a professional. You can also start with joining group classes offered by certified trainers. In case you decide to opt for making an exercise plan yourself, then ensure all safety measures are in place. For example, if your exercise plan is centered around walking, then use a route which is levelled, free of obstructions, well-lit and away from heavy traffic.

&nbsp;

<h5>Talk To A Health Professional</h5>

Your doctors can help you design personalized activity plans/goals along with addressing any related concerns.&nbsp;

&nbsp;

Here are some examples of exercise that you can choose:

<ul>
	<li>
	<h5>Low-Impact Aerobics Activities</h5>
	</li>
</ul>

These activities will not put stress on the joints and they include brisk walking, light gardening, group exercise classes, cycling, swimming, water aerobics, and dancing. 
&nbsp;

<ul>
	<li>
	<h5>Muscle-Strengthening Exercises</h5>
	</li>
</ul>

&nbsp;You can add some muscle-strengthening activities using light weights in your workout routine. Working with resistance bands and yoga could be a good alternative to explore on days when you are not in the mood for a walk on the treadmill.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Flexibility Exercises</h5>
	</li>
</ul>

&nbsp;These are recommended for people with arthritis. Many people with arthritis have stiff joints that make daily tasks difficult. Doing daily flexibility exercises will help to maintain their range of motions. 
&nbsp;

<ul>
	<li>
	<h5>Balance Exercises</h5>
	</li>
</ul>

Standing on one foot, walking backwards, and tai chi are some exercises recommended for arthritis patients with balance issues.&nbsp;

&nbsp;

It&rsquo;s normal to have a little pain, stiffness, and swelling after starting a new physical activity plan. It may take 6- 8 weeks for joints to get used to the new activity level, but sticking with the activity program will result in long-term relief in pain. 
&nbsp;

Here are some tips to manage pain during and after physical activity to stay on track with your activity plan:&nbsp;&nbsp;

<ul>
	<li>Continue modifying your physical activity program by exercising less frequently (fewer days a week), or for shorter periods of time (less time for each session) till you experience pain relief.&nbsp;</li>
	<li>Try different types of exercises that are joint friendly, for example, switch from walking to water aerobics.</li>
	<li>Proper warm-up and cool-down before and after exercise is essential.</li>
	<li>Exercise at a comfortable pace</li>
	<li>Use well-fitted and comfortable shoes.</li>
</ul>

&nbsp;

<h4>"Exercise releases endorphins, which help reduce stress. Try our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan </a>to monitor your stress level!"</h4>

Understanding importance of exercise for arthritis patients

For people with rheumatoid arthritis (RA), exercise is hugely beneficial for relieving pain and joint stiffness. 
&nbsp;

People with RA who exercise will find that they have less pain than those who do not. Exercise reduces painful symptoms, improves flexibility &amp; joint functions, increases range of motion, and boosts mood. 
&nbsp;

It is best to seek medical advice before starting any type of exercise plan, and work with a doctor and physical therapist to develop a proper exercise plan.

&nbsp;

The following types of exercise may help to get relieved the pain, joint stiffness, and other symptoms of RA: 
&nbsp;

<ul>
	<li>
	<h5>Stretching</h5>
	</li>
</ul>

Stretching can&nbsp; improve flexibility, increase range of motion and reduce stiffness. Daily stretching is important for relieving RA symptoms.

The ideal stretching routine is different for each person. The routine depends on which joints are affected and what symptoms occur. Stretches often involve slow and gentle movement of the joints of the knees, hands, and elbows.

&nbsp;

A typical stretching routine consists of:

<ul>
	<li>Warm-up by walking in place or pumping the arms while sitting or standing for 3 to 5 minutes.</li>
	<li>Hold each stretch for 20 to 30 seconds before releasing it. 
	&nbsp;</li>
</ul>

Repetition of each stretch 2 to 3 times. Yoga straps will help people maintain proper form while stretching. A dog leash is an alternative to yoga.

It is beneficial to work with a physical therapist who understands RA to learn the correct way to perform these stretches. 
&nbsp;

<ul>
	<li>
	<h5>Walking</h5>
	</li>
</ul>

Walking is a low-impact form of exercise that helps with aerobic conditioning, heart and joint health, and mood.

It is essential to stay hydrated and wear proper shoes, even if the walking is not strenuous. It is recommended to walk slowly initially, and then increase the pace gradually. 
&nbsp;

<ul>
	<li>
	<h5>Flowing Movements, Like Yoga And Tai Chi&nbsp;</h5>
	</li>
</ul>

Both tai chi and yoga combine gentle poses, deep breathing, flowing movements and meditation. They increase flexibility, balance, range of motion, and also helpful in reducing stress. 
&nbsp;

<ul>
	<li>
	<h5>Pilates</h5>
	</li>
</ul>

Pilates increases flexibility for enhanced joint health and is a low-impact activity. Pilates can also help with stability.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Water Based Exercises</h5>
	</li>
</ul>

Water helps to support body weight by minimizing gravity, which means that water exercises do not place a lot of stress on the joints.

Water aerobics, swimming, and other gentle water exercises increase flexibility, range of motion, strength, and aerobic conditioning. They can also reduce joint stress and stiffness. 
&nbsp;

<ul>
	<li>
	<h5>Cycling</h5>
	</li>
</ul>

Cycling is extremely helpful for the improvement of cardiovascular functions. As RA patients are at risk of cardiovascular disease, it is vital to keep the heart as healthy as possible. 
&nbsp;

Riding a stationary bike is a safe way to get the joints moving while improving cardiovascular fitness.&nbsp;Cycling also helps in reducing stiffness, increasing range of motion, and building endurance. 
&nbsp;

<ul>
	<li>
	<h5>Strength Training</h5>
	</li>
</ul>

Strengthening the muscles around the affected joints can help to increase strength, while reducing pain and other RA symptoms. Using a resistance band is one way to challenge the body, and build muscle over time. 
&nbsp;

<ul>
	<li>
	<h5>Hand Exercises</h5>
	</li>
</ul>

RA sometimes leads to limited use of the hands. The person with RA may lose their grip strength and find that they are dropping things. Slowly curling the fingers, bending the wrists up and down, spreading the fingers wide on a table and squeezing a stress ball are some ways to help increase strength and flexibility in the hands. 
&nbsp;

<ul>
	<li>
	<h5>Gardening</h5>
	</li>
</ul>

Light gardening can be a beneficial exercise for a person with RA.&nbsp;

&nbsp;

The following tips will help to improve comfort and safety for exercising with RA: 
&nbsp;

<ul>
	<li>
	<h5>Be Consistent</h5>
	</li>
</ul>

People need to exercise consistently to achieve meaningful results. It is important to practice regularly. RA patients will certainly benefit from consistent and lifelong aerobic and muscle strengthening exercises. 
&nbsp;

<ul>
	<li>
	<h5>Accessorize For Comfort And Protection</h5>
	</li>
</ul>

The following methods can help people exercise more comfortably with less injury risk and falls: 
&nbsp;

<ul>
	<li>always use a slip-resistant mat for yoga</li>
	<li>wear comfortable clothes&nbsp;</li>
	<li>wear good supportive shoes for preventing injuries and maintaining balance</li>
	<li>Seek variety 
	&nbsp;</li>
</ul>

RA symptoms may vary daily, and tend to come in waves. People often face flares and periods of remission. Doing an exercise and mixing up the daily routine will help people to avoid overworking one set of muscles and particular joints. For example, a person doing morning stretches on a daily basis may choose to add strength training twice a week, a water workout once a week, and yoga or tai chi twice a week, if symptoms permit. 
&nbsp;

<ul>
	<li>
	<h5>Adjust Exercises According To Symptoms</h5>
	</li>
</ul>

You should adjust your routine according to your symptoms, for example if experiencing hand pain, place your resistance band around your forearms, instead of holding it in your hands. On painful days, switch from cycling or swimming to taking a leisurely stroll.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Listen To Your Body</h5>
	</li>
</ul>

Listen to your body! It is crucial to avoid discomfort or injuries. It is vital to listen to the body and choose the right pace. If exercise causes discomfort or a flare, reduce the session. Do 10 minutes rather than 30.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Pay Attention To Small Things</h5>
	</li>
</ul>

Most exercises focus on large muscular groups. It is essential to make time for smaller groups, such as the hands and fingers. It is also important to do exercises with your toes and feet. Exercises that help in maintaining balance are equally important such as yoga. 
&nbsp;

<ul>
	<li>
	<h5>Work With A&nbsp;Physical Therapist</h5>
	</li>
</ul>

Working with a physical therapist who specializes in RA is an absolute must. These professionals will develop safe and personalized routines for you. This collaboration is particularly beneficial for people with a new RA diagnosis and those who are experiencing a severe flare.

&nbsp;

People with RA should avoid all those exercises that cause pain and are strenuous. These may include high-impact exercises that put excessive strain on the joints.&nbsp;

&nbsp;

<ul>
	<li>Exercise is tremendously important for people with rheumatoid arthritis (RA).&nbsp;</li>
	<li>Exercise helps improve aerobic fitness, boosts mood, helps with daily functioning, relieves symptoms, builds strength, improves joint function and increases flexibility.</li>
	<li>Exercise helps with management of RA by reducing flares.</li>
	<li>A personalized exercise plan should be created after consulting your doctor and a licensed physiotherapist.&nbsp;</li>
</ul>

&nbsp;

Disclaimer: This article is intended to increase awareness about the benefits exercise offers to patients suffering from arthritis (especially rheumatoid arthritis), and is not a substitute for a doctor&rsquo;s advice. Consult your doctor and physiotherapist before starting any exercise.&nbsp;

&nbsp;

[1]. Physical Activity Guidelines for Americans

[2]. Medically reviewed by Amy Elizabeth Wolkin, PT, DPT, MBA — Written by Kat Gál — Updated on April 12, 2021

Zareena Mushtaq

AL SHIFA CLINIC KARACHI

Syed Intisar Hussain

All About Vitamin D

&ldquo;If it&rsquo;s not neat or on the rocks, I am too old to drink that&rdquo;. z 
&nbsp;

But the thing is that osteoporosis, a disorder that causes bones to grow abnormally and become overly dense, does not come knocking on your bones after confirming the age, but it comes due to inappropriate amount of vitamin D in the body.&nbsp; 
&nbsp;

The recommended daily allowance (RDA) for vitamin D is 15 mcg per day (600 IU) for individuals who are 19 years old and above, regardless of their gender. However, for adults over 70 years old, it bumps up to 20 mcg daily (800 IU)<a href="#accordion">[2]</a>. 
&nbsp;

Vitamin D that comes from the skin or diet is in its inactive form and requires a 2-step process before it can be used by the body: 
&nbsp;

<ul>
	<li>Firstly, hydroxylation is carried out in the liver, where the enzyme vitamin D-25-hydroxylase (25-OHase) converts it into 25(OH)D.&nbsp;</li>
	<li>Secondly, 25(OH)D is subjected to further hydroxylation in the kidneys by the enzyme 25(OH)D-1-OHase (CYP27B1) to form the final active variant of vitamin D, namely 1,25(OH)2D. It is usually referred to as Cholecalciferol.&nbsp;</li>
</ul>

Moreover, vitamin D initiates the absorption of calcium in the gastrointestinal system, small intestine to be precise<a href="#accordion">[1]</a>. 
&nbsp;

Vitamin D always produces symptoms if it is not enough in the body. They would either be generalised or specific according to gender, age, and even routine sometimes.&nbsp; 
&nbsp;

Diseases relevant to vitamin D deficiency are extremely disturbing and definitely not worth it. On the other hand, prevention is extremely simple - adequate diet and ample exposure.

&nbsp;

Vitamin D deficiency is characterised into 3 types: 
&nbsp;

1. Mild (20-30 ng/mL)

2. Moderate (10-20 ng/mL)

3. Severe (&lt;10 ng/mL) 
&nbsp;

Studies prove that 1 billion people in the world go through vitamin D deficiency or insufficiency. A report presented by the National Health and Nutrition Examination Survey III (NHANES III) shows that 1% individuals in the US suffered from vitamin D deficiency, whereas 58% had insufficiency.&nbsp; 
&nbsp;

<ul>
	<li>Vitamin D deficiency is when a person&rsquo;s level drops to less than 7 ng/mL.</li>
	<li>Vitamin D insufficiency is when their levels are less than 25 ng/m. 
	&nbsp;</li>
</ul>

A study carried out in the South Asian region concluded that Pakistan had the highest prevalence, around 63-85%, followed by Bangladesh (50-83%) and India (61-73%)<a href="#accordion">[3][4]</a>.

&nbsp;

The major source for obtaining vitamin D is sunlight. Hence, if you do not go out in the sun enough, there is a huge probability you develop vitamin D deficiency, or VDD.&nbsp; 
&nbsp;

The physical activities of generation Z (anyone born between 1990 and 2010) have been consistently inconsistent because of their lifestyle, which revolves around indoor activities, surrounded by gadgets.&nbsp; 
&nbsp;

If only heated gadgets could also provide vitamin D. But till they don&rsquo;t, going out in the sun is the only option to avoid VDD. Use a sunscreen with a protection factor (PF) of 30 when you expose your skin to the sun.&nbsp; 
&nbsp;

Furthermore, an inadequate diet is why you might not have ample vitamin D in your system. People nowadays refuse to intake milk as it is apparently a &ldquo;child&rsquo;s drink&rdquo;, and they also avoid items like salmon, egg yolks and fruits. Everything is justified in balance; if you want to lose weight and do not have a pathological reason behind it, it is a much better approach to accommodate an egg yolk, so you up your vitamin D without increasing your calorie intake<a href="#accordion">[1]</a>.

There are theories that suggest that older people have fewer chances to get VDD, because mostly people of that age take supplements; hence, bridging the gap.

&nbsp;

Understanding Importance Of Vitamin D

<ul>
	<li>
	<h5>Protects Your Heart</h5>
	</li>
</ul>

Did you know that vitamin D plays a cardioprotective role in your body? Following a heart attack, it&rsquo;s likely you end up with scar tissue that debilitates the heart&rsquo;s functionality. This scar is developed by specialised cells called the cardiac colony-forming unit fibroblasts (cCFU-Fs). Vitamin D is a natural antagonist to stop cCFU-Fs from forming this scar. Thus, ensuring efficiency of the heart<a href="#accordion">[5]</a>.&nbsp; 
&nbsp;

<ul>
	<li><a href="#accordion">Reduces Risk Of Cancer</a></li>
</ul>

It has been proven by research that vitamin D can reduce your risk of developing cancer as well. Your chances of getting colorectal cancer decrease by 22% if your vitamin D is above the normal level, whereas the probability increases by 31% if the levels drop below normal.&nbsp; 
&nbsp;

Another study reveals that the higher the levels of vitamin D, the lower the risk of breast cancer<a href="#accordion">[5]</a>.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Manages Depression</h5>
	</li>
</ul>

Scientists have also seen that people <a href="https://merisehat.pk/disease/depression" target="_blank">suffering from depression</a> had low levels of vitamin D in their blood, and people with normal levels of vitamin D reported less of depression, implying that there may be a direct relation between the two. 
&nbsp;

<ul>
	<li>
	<h5>Improves Bone Health</h5>
	</li>
</ul>

Vitamin D is crucial to ensure your bone health. If a child lacks the optimum levels of vitamin D, he or she can develop rickets, which forces the bones to bend and give a bow-legged appearance. In adults, the variant is called osteomalacia, which leads to softening of the bone and muscular weakness as well<a href="#accordion">[5]</a>.&nbsp;

<ul>
	<li>
	<h5>Additional Benefits</h5>
	</li>
</ul>

Scientists now believe that basking in sunlight in order to synthesise vitamin D exposes one to the ultraviolet rays that help in preventing multiple sclerosis and Parkinson&rsquo;s disease<a href="#accordion">[5]</a>.

&nbsp;

A study done in 2017 had established that regulating vitamin D in the body prevents acute respiratory diseases.&nbsp; 
&nbsp;

Along with the fact that vitamin D boosts the antimicrobial peptide production, vitamin D is &ldquo;the&rdquo; talk of the town to help fight against COVID-19 as well. Researchers showed that 40% of the US population was deficient in Vitamin D, and was among those who readily contracted the viral disease. Hence, to put the theoretical knowledge to test, a study was conducted in which it was concluded that if you are vitamin D deficient, your chances of getting COVID-19 are 1.77 times higher<a href="#accordion">[6]</a>.&nbsp;&nbsp;

&nbsp;

Even though vitamin D seems like the most hyped about vitamin, it is still underrated. This has to do with the fact that deficiency related diseases are commonly dealt with prescribed supplementation. Vitamin D deficiency needs to be taken more seriously, as it can lead to extreme conditions ranging from weak bones to weak immunity. Hence, if you want to make sure that you are able to walk and are resistant to a number of sicknesses, get your vitamin D levels checked today!

<ul><li>The recommended daily allowance (RDA) of vitamin D is 15 mcg per day (600 IU) for adults who are 19 years old and above.</li><li>&nbsp;For adults over 70 years, it bumps up to 20 mcg daily (800 IU).</li><li>Vitamin D that comes from the skin or diet is in its inactive form, and requires a 2-step process before it can be used by the body.</li><li>First hydroxylation takes place in the liver; the second takes place in the kidneys, assisted by enzymes vitamin D-25-hydroxylase (25-OHase) and 25(OH)D-1-OHase (CYP27B1) respectively.</li><li>Vitamin D also initiates the absorption of calcium in the small intestine.</li><li>There are 3 categories of deficiency: mild, moderate, and severe.</li><li>Studies prove that 1 billion people in the world suffer from vitamin D deficiency or insufficiency.</li><li>A report presented by the National Health and Nutrition Examination Survey III (NHANES III) shows that 1% of individuals in the US suffered from vitamin D deficiency whereas 58% had insufficiency.</li><li>A study carried out in the South Asian region concluded that the prevalence rate of vitamin D was highest in Pakistan - around 63%-85%.</li><li>The major source for obtaining vitamin D is sunlight.</li><li>Use a sunscreen with a protection factor (PF) of 30 when going out in the sun.</li><li>Studies hypothesise that older people are less prone to get VDD because they usually take supplementation; hence, bridging the gap.</li><li>Vitamin D is a natural antagonist of the cardiac colony-forming unit fibroblasts (cCFU-Fs) and stops them from forming a scar. Thus, ensuring efficiency of the heart.</li><li>Studies support that your chances of getting colorectal cancer decreases by 22% if your levels are above normal, whereas the probability increases by 31% if the levels drop below normal.</li><li>People with normal levels of vitamin D have reported less depression.</li><li>Vitamin D is crucial to your bone health, as a deficiency can cause rickets in children and osteomalacia in adults.</li><li>Your chances of getting COVID-19 are 1.77 times higher if you are deficient in vitamin D.</li></ul>

[1] Nair, Rathish, and Arun Maseeh. “Vitamin D: The "sunshine" vitamin.” Journal of pharmacology & pharmacotherapeutics vol. 3,2 (2012): 118-26. doi:10.4103/0976-500X.95506

[2] Vitamin D. The Nutrition Source

[3] Hovsepian, Silva et al. “Prevalence of vitamin D deficiency among adult population of Isfahan City, Iran.” Journal of health, population, and nutrition vol. 29,2 (2011): 149-55. doi:10.3329/jhpn.v29i2.7857

[4] Siddiqee, M.H., Bhattacharjee, B., Siddiqi, U.R. et al. High prevalence of vitamin D deficiency among the South Asian adults: a systematic review and meta-analysis. BMC Public Health 21, 1823 (2021).

[5] Vitamin D: A review of recent research. Medical News Today.

[6] Stone W. A year in, here's what we know about vitamin D for preventing COVID. NPR.

Arbaz Ansari

Psoriatic Arthritis And Its Effect On The Spine

Understanding the Spinal Impact of Psoriatic Arthritis

Psoriatic arthritis (PsA) is a chronic inflammatory condition that affects joints, entheses, and the spine.

The signs and symptoms of PsA can vary from person to person, but patients commonly exhibit<a href="#accordion"> [2][3]</a>: 
&nbsp;

<ul>
	<li>Stiff joints</li>
	<li>Swollen joints, toes, and fingers</li>
	<li>Enthesitis or tenderness and pain at the points where tendons and ligaments attach to bone</li>
	<li>Psoriasis, a skin condition characterized by scaly, red, and itchy patches of skin</li>
	<li>Nail changes, such as pitting or separation from the nail bed</li>
	<li>Fatigue</li>
	<li>Uveitis or eye inflammation</li>
	<li>Back and shoulder pain and stiffness</li>
	<li>Chest and rib pain</li>
	<li>Foot pain</li>
	<li>Deformed joints from chronic inflammation 
	&nbsp;</li>
</ul>

When psoriatic arthritis affects the spine and the joints in the pelvis, the condition is known as psoriatic spondylitis. The symptoms then can also include<a href="#accordion">[14]</a>:

<ul>
	<li>Inflammation and stiffness in the neck or lower back that lasts for more than 30 minutes in the morning or after a period of rest</li>
	<li>Pain in the spine, especially in the sacroiliac joints</li>
	<li>Reduced range of motion</li>
	<li>Difficulty standing or sitting for long periods 
	&nbsp;</li>
</ul>

Although the precise cause of psoriatic arthritis is unknown, genetic, environmental, and immunological factors are believed to be responsible<a href="#accordion">[22]</a>: 
&nbsp;

<ol>
	<li>Genetics:The disease runs in families, indicating a genetic component of the disease.</li>
	<li>Environmental Factors:Certain environmental factors, such as obesity, bacterial and viral infections, heavy lifting, and trauma, have been linked to an increased risk of psoriatic arthritis. There is an inverse connection between psoriatic arthritis and smoking, except in individuals who are HLA-C*06-positive.</li>
	<li>Immune System Dysfunction:This type of arthritis is thought to be caused by an abnormal immune response, although the exact mechanism is not fully understood. 
	&nbsp;</li>
</ol>

You&rsquo;re Not Alone!

Generally, the condition affects 0.3-1% of individuals. Around 20% of patients with psoriatic arthritis will develop psoriatic spondylitis<a href="#accordion">[6]</a>. 
&nbsp;

The treatment of psoriatic arthritis aims to relieve symptoms, control inflammation, prevent joint damage, and improve function and quality of life. The treatment approach may vary depending on the severity and type of PsA and the individual&#39;s response to treatment.

The following are some commonly used treatments for PsA<a href="#accordion">[21]</a>: 
&nbsp;

<ol>
	<li>Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):These medications can help reduce pain and inflammation in joints and other affected areas. Examples include ibuprofen and naproxen.</li>
	<li>Disease-Modifying Antirheumatic Drugs (DMARDs):DMARDs can slow down the progression of joint damage and improve symptoms. Examples include methotrexate, sulfasalazine, and leflunomide.</li>
	<li>Biologic Agents:Biologics are a type of DMARD that target specific proteins involved in the inflammatory process. Examples include tumor necrosis factor (TNF) inhibitors (e.g., adalimumab, etanercept) and interleukin (IL)-17 inhibitors (e.g., secukinumab, ixekizumab).</li>
	<li>Corticosteroids:These medications can help reduce inflammation and pain, but are generally used for short periods due to their potential side effects.</li>
	<li>Physical Therapy And Exercise:These interventions can help improve joint flexibility, strength, and function.</li>
	<li>Surgery: Surgical treatment options are generally reserved for cases that don&rsquo;t respond to other treatments or where joint damage is so severe that there is a risk of the joints becoming permanently damaged. The most common surgical procedures are joint replacement, such as a hip or knee replacement, and joint fusion. 
	&nbsp;</li>
</ol>

Surgical options like decompression surgery or spinal fusion are recommended when the condition affects the spine. 
&nbsp;

While there is currently no known cure for psoriatic arthritis, several preventive measures can help reduce the risk of developing the disease or delay its onset. Some of these factors include<a href="#accordion">[21]</a>: 
&nbsp;

<ol>
	<li>Maintain A Healthy Weight: Since obesity is a risk factor, individuals may reduce their risk of developing the disease by maintaining a healthy weight through a balanced diet and regular exercise. Also, keeping the joints moving eases stiffness.</li>
	<li>Avoid Smoking And Alcohol: Smoking has been associated with this disease. Quitting smoking not only reduces this risk but also improves overall health. 
	Alcohol, too, can interact with the medications, so it&rsquo;s best to quit drinking alcohol to alleviate symptoms.</li>
	<li>Managing Stress: Chronic stress has been linked to an increased risk of developing autoimmune diseases, including psoriatic arthritis. Mindfulness meditation and yoga are stress-reducing techniques that can help lower the risk of developing the disease.</li>
	<li>Use Hot And Cold Packs: This helps ease muscle soreness. Cold packs, in particular, can reduce joint pain. 
	&nbsp;</li>
</ol>

Psoriatic arthritis is closely linked to psoriasis. Hence, early detection and treatment of psoriasis may help prevent the development of the condition or at least reduce its severity.

Also, people with a family history of psoriatic arthritis or with other risk factors for the disease should be monitored regularly by a healthcare provider. This will allow them to detect the disease early when treatment is most effective.

Although these preventive measures reduce the risk of developing PsA, it is important to remember that some people still contract the disease. 
&nbsp;

It is a chronic illness, which means it is long-lasting. As such, it affects a person&#39;s quality of life. However, most patients can control their symptoms with care and management. They can also move around and do their everyday tasks. 
&nbsp;

In conclusion, psoriatic arthritis can be a real pain in the back, but it doesn&#39;t have to be a life sentence of discomfort. With early diagnosis and proper treatment, many people with psoriatic arthritis can manage their symptoms and maintain their quality of life. And who knows, maybe we&#39;ll even discover a cure one day!

In the meantime, let&#39;s take a moment to appreciate the strength and resilience of our spines and the power of modern medicine to help us overcome even the toughest challenges. Now, if you&#39;ll excuse me, I need to go stretch my back and do some cat-cow yoga poses. 
&nbsp;

Key Takeaways

<ul>
	<li>People with psoriasis may experience psoriatic arthritis, a kind of inflammatory arthritis. It can develop at any age, but it is most commonly diagnosed in people between 35 and 55 years. In the juvenile form, the onset occurs around 9-11 years.</li>
	<li>The pain and disability caused by psoriatic arthritis can significantly impact a person&#39;s quality of life, including their ability to work and engage in social activities.</li>
	<li>Symmetric psoriatic arthritis affects the same joints on both sides of the body, such as the wrists, ankles, and knees.</li>
	<li>Asymmetric psoriatic arthritis affects different joints on each side of the body and can involve the fingers and toes. It does not have a specific pattern of joint involvement. It usually involves less than five joints at any one time.</li>
	<li>Arthritis mutilans is a rare and severe form of psoriatic arthritis that can cause joint deformities and bone resorption.</li>
	<li>The signs and symptoms of the condition vary from person to person, but some common ones include joint pain, swelling, and enthesitis.</li>
	<li>The first step in diagnosing the disease is a physical examination by a medical professional, which may involve a complete assessment of joints and the spine.</li>
	<li>The treatment of psoriatic arthritis aims to relieve symptoms, control inflammation, prevent joint damage, and improve function and quality of life. 
	&nbsp;</li>
</ul>

[1] National Psoriasis Foundation. (n.d.). About Psoriatic Arthritis.

[2] WebMD. (n.d.). Psoriatic Arthritis and Your Spine

[3] Ritchlin CT, Colbert RA, Gladman DD. Psoriatic Arthritis. N Engl J Med. 2017;376(10):957-970. doi: 10.1056/NEJMra1505557. PMID: 28273019.

[4] Villani AP, Rouzaud M, Sevrain M, et al. Prevalence of undiagnosed psoriatic arthritis among psoriasis patients: systematic review and meta-analysis. J Am Acad Dermatol. 2015;73(2):242-248. doi: 10.1016/j.jaad.2015.05.008. PMID: 26184080.

[5] Queiro R, Sarasqueta C, Belzunegui J, Gonzalez C, de Dios JR, Torre JC, Figueroa M. Psoriatic spondyloarthropathy: a comparative study between HLA-B27 positive and HLA-B27 negative disease. Semin Arthritis Rheum. 2002 Dec;32(3):157-63. doi: 10.1053/sarh.2002.35334. PMID: 12480076.

[6] Gladman DD. Psoriatic Arthritis: Epidemiology, Clinical Features, Course, and Outcome. Ann Rheum Dis. 2005;64(Suppl 2):ii14-ii17. doi: 10.1136/ard.2004.032482. PMID: 15708921; PMCID: PMC1766866.

[7] Memon AA, Samiullah S, Iqbal MP, Suhail S, Memon JM. Prevalence of psoriasis in Pakistan: An epidemiological assessment. Int J Dermatol. 2017;56(7):723-728. doi: 10.1111/ijd.13541. PMID: 28480996.

[8] Dogra S, Kaur I. Epidemiology of psoriasis in India. Indian J Dermatol Venereol Leprol. 2013;79 Suppl 7:S3-S9. doi: 10.4103/0378-6323.115500. PMID: 24051889.

[9] Coates LC, Helliwell PS. Psoriatic arthritis: state of the art review. Clin Med (Lond). 2017 Feb;17(1):65-70. doi: 10.7861/clinmedicine.17-1-65. PMID: 28148567.

[10] McGonagle D, Tan AL, Møller Døhn U, Benjamin M. The concept of a "synovio-entheseal complex" and its implications for understanding joint inflammation and damage in psoriatic arthritis and beyond. Arthritis Rheum. 2007 Nov;56(11):2482-91. doi: 10.1002/art.22819. PMID: 17968946.

[11] Ciccia F, Quartuccio L, Bazzichi L, Carubbi A, Di Napoli G, Giacomelli R, De Vita S. The impact of psoriatic arthritis on the spine: A systematic review and meta-analysis. Autoimmun Rev. 2021 Jul;20(7):102788. doi: 10.1016/j.autrev.2021.102788. Epub 2021 Apr 21. PMID: 33894202.

[12] Aletaha D, Smolen JS. Diagnosis and management of psoriatic arthritis. JAMA. 2018;320(18):1969-1970. doi:10.1001/jama.2018.13837.

[13] McInnes IB, Schett G. The pathogenesis of rheumatoid arthritis. N Engl J Med. 2011;365(23):2205-2219. doi:10.1056/NEJMra1004965.

[14] Kahlenberg JM, Fox DA. Advances in the medical treatment of rheumatoid arthritis. Hand Clin. 2011;27(1):11-20. doi:10.1016/j.hcl.2010.09.004.

[15] Gladman DD, Farewell VT, Wong K, Husted J. Mortality studies in psoriatic arthritis: results from a single outpatient center. II. Prognostic indicators for death. Arthritis Rheum. 1998;41(6):1103-1110. doi: 10.1002/1529-0131(199806)41:6<1103::AID-ART13>3.0.CO;2-5. PMID: 9627022.

[16] Rahimi H, Ritchlin CT. Altered bone biology in psoriatic arthritis. Curr Opin Rheumatol. 2019;31(4):330-336. doi: 10.1097/BOR.0000000000000623. PMID: 30920491

[17] Eder L, Thavaneswaran A, Chandran V, et al. Obesity is associated with a lower probability of achieving sustained minimal disease activity state among patients with psoriatic arthritis. Ann Rheum Dis. 2015;74(5):813-817. doi: 10.1136/annrheumdis-2013-204080. PMID: 24013658.

[18] Chimenti MS, Caso F, Alivernini S, Costa L, Tolusso B, Gremese E. Psoriatic arthritis and sacroiliitis. Front Med (Lausanne). 2018;5:224. doi: 10.3389/fmed.2018.00224. PMID: 30151431

[19] Singh JA, Guyatt G, Ogdie A, et al. Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. Arthritis Care Res (Hoboken). 2019;71(1):2-29. doi: 10.1002/acr.23870. PMID: 30748084.

[20] Karmacharya, P., Chakradhar, R., & Ogdie, A. (2021). The epidemiology of psoriatic arthritis: A literature review. Best practice & research. Clinical rheumatology, 35(2), 101692. https://doi.org/10.1016/j.berh.2021.101692

[21] Watson S. Psoriatic arthritis. Healthline

[22] Anwar Al Hammadi MD. Psoriatic arthritis. Practice Essentials, Background, Pathophysiology and Etiology

Madeeha Syed

Glucosamine For Arthritis: Does It Really Work?

Overview

Glucosamine is a naturally occurring compound found in the human body, particularly in the cartilage of joints. It plays a crucial role in maintaining the integrity and health of joint tissues, including cartilage, by supporting the production of molecules like glycosaminoglycans and hyaluronic acid, which are essential for joint lubrication and shock absorption.

The theory behind glucosamine supplements is that by providing additional glucosamine to the body, it may help to repair and protect damaged cartilage, alleviate joint pain, and improve joint function. These supplements are available in various forms, including glucosamine sulfate, glucosamine hydrochloride, and N-acetyl glucosamine, and can be found as over-the-counter products in health food stores and pharmacies. 
&nbsp;

Science Behind Glucosamine And Arthritis

<ol>
	<li>
	<h5>Osteoarthritis (OA)</h5>
	</li>
</ol>

Osteoarthritis is characterized by the gradual breakdown of cartilage in the joints, leading to pain and stiffness. Many studies have investigated the efficacy of glucosamine supplements in managing OA symptoms. Some of the key findings include:

<ul>
	<li>A notable study published in the New England Journal of Medicine in 2006 (the Glucosamine/Chondroitin Arthritis Intervention Trial, or GAIT) found that glucosamine and chondroitin sulfate, alone or in combination, provided no significant benefit for knee OA compared to a placebo in the overall study population. However, a subgroup analysis suggested that people with moderate to severe knee pain might experience some relief from the combination of glucosamine and chondroitin.</li>
	<li>A Cochrane review in 2015, which analyzed data from numerous randomized controlled trials (RCTs), concluded that glucosamine, in various forms, had a modest benefit in reducing pain and improving function in patients with OA. However, the authors noted that the quality of the evidence was low to moderate and called for further high-quality research. 
	&nbsp;</li>
</ul>

<ol start="2">
	<li>
	<h5>Rheumatoid Arthritis (RA)</h5>
	</li>
</ol>

Rheumatoid arthritis is an autoimmune disease that primarily affects the synovial lining of joints, leading to inflammation and joint damage. Unlike OA, RA involves a complex immune response. Therefore, the mechanisms by which glucosamine might work are less clear. Research on the effectiveness of glucosamine for RA is limited compared to OA, but some studies have explored its potential benefits:

<ul>
	<li>A small study published in the journal Rheumatology in 2007 found that glucosamine supplementation might reduce disease activity in RA patients. However, the sample size was small, and further research is needed to confirm these findings.</li>
	<li>A more recent review published in Frontiers in Immunology in 2018 discussed the immunomodulatory effects of glucosamine and suggested that it might have a role in regulating immune responses in autoimmune diseases like RA. Nevertheless, the authors emphasized that more extensive clinical trials were necessary to establish its efficacy. 
	&nbsp;</li>
</ul>

Consideration factors

<ol>
	<li>Dosage And Duration</li>
</ol>

The effectiveness of glucosamine supplements may depend on the dosage and duration of use. Some studies suggest that higher doses or longer-term use may yield better results, but this varies among individuals. Consulting with a healthcare professional is crucial to determine the appropriate dose for your specific condition. 
&nbsp;

<ol start="2">
	<li>Quality And Source</li>
</ol>

The quality and source of glucosamine supplements can vary widely among brands. Look for products that have been tested for purity and potency, and consider consulting with a healthcare provider or pharmacist for recommendations. 
&nbsp;

<ol start="3">
	<li>Potential Side Effects</li>
</ol>

Generally, glucosamine is well-tolerated with few side effects, mainly mild gastrointestinal symptoms such as nausea, diarrhea, or heartburn. However, individuals with shellfish allergies should avoid glucosamine supplements derived from shellfish sources. 
&nbsp;

Bottom Line

The question of whether glucosamine supplements work for arthritis remains a subject of ongoing debate and research. While some studies suggest potential benefits, the evidence is not yet strong enough to definitively recommend glucosamine as a primary treatment for arthritis. However, it&#39;s essential to consider individual responses to glucosamine, as some people do report significant improvements in joint pain and function.

Ultimately, the decision to try glucosamine should be made in consultation with a healthcare professional, taking into account the specific type and severity of arthritis, as well as other treatment options available. Furthermore, a holistic approach to managing arthritis, including exercise, weight management, and other dietary supplements like omega-3 fatty acids and turmeric, may provide additional benefits when combined with glucosamine.

As research in this field continues to evolve, future studies may provide more conclusive evidence on the effectiveness of glucosamine supplements for arthritis. Until then, individuals seeking relief from arthritis symptoms should explore a variety of treatment options and work closely with their healthcare team to find the best approach to manage their condition and improve their quality of life.

Umna Salah

Natural Relief For Arthritis: Exploring Effective Remedies

Arthritis is a prevalent and painful condition affecting millions of people worldwide. Characterized by joint inflammation, stiffness, and pain, arthritis can significantly reduce the quality of life for those who suffer from it. While conventional treatments like medication and surgery are available, many individuals seek natural relief options to manage their symptoms and improve their overall well-being. In this article, we&#39;ll explore a variety of natural remedies for arthritis, ranging from dietary changes and supplements to physical therapies and mindfulness practices. 
&nbsp;

natural remedies

<ol>
	<li>
	<h5>Dietary Modifications</h5>
	</li>
</ol>

Diet plays a crucial role in managing arthritis symptoms. Certain foods and dietary habits can either exacerbate or alleviate the condition. Here are some dietary modifications that may provide natural relief for arthritis:

a. Anti-Inflammatory Foods: Incorporating anti-inflammatory foods into your diet can help reduce arthritis-related inflammation. These include fatty fish (like salmon and mackerel), nuts, seeds, and colorful fruits and vegetables rich in antioxidants, such as berries, spinach, and kale.

b. Omega-3 Fatty Acids: Omega-3 fatty acids, found in fish oil supplements or as part of a diet rich in fish, can help reduce inflammation and joint pain. These essential fats can be a natural remedy for arthritis.

c. Turmeric And Ginger: Both turmeric and ginger contain potent anti-inflammatory compounds. Turmeric&#39;s active ingredient, curcumin, has been studied for its potential to alleviate arthritis symptoms. You can incorporate these spices into your cooking or take supplements.

d. Avoid Trigger Foods: Some people with arthritis find relief by identifying and avoiding trigger foods. These can include nightshade vegetables (like tomatoes and peppers), dairy products, and processed foods high in sugar and trans fats.

e. Maintain A Healthy Weight: Excess body weight puts added stress on joints, aggravating arthritis symptoms. Maintaining a healthy weight through diet and exercise can help reduce pain and inflammation. 
&nbsp;

<ol start="2">
	<li>
	<h5>Supplements</h5>
	</li>
</ol>

Supplements can complement a balanced diet and provide essential nutrients to support joint health. Some supplements that may offer natural relief for arthritis include:

a. Glucosamine And Chondroitin: These compounds are found naturally in cartilage and may help alleviate joint pain and slow the progression of osteoarthritis. Consult with a healthcare professional for proper dosing.

b. Omega-3 Fish Oil: As mentioned earlier, omega-3 fatty acids can reduce inflammation and joint pain when taken as a supplement.

c. Vitamin D: Adequate levels of vitamin D are essential for bone health. A deficiency may worsen arthritis symptoms. Consult with a healthcare provider to determine if supplementation is necessary.

d. Methylsulfonylmethane (MSM): MSM is a sulfur compound found in some foods and available as a supplement. It may help reduce pain and inflammation in arthritis sufferers.

e. Boswellia: Extracted from the resin of the Boswellia tree, this supplement has anti-inflammatory properties and may be effective in managing arthritis symptoms.

It&#39;s important to note that individual responses to supplements can vary, so consulting with a healthcare professional before adding them to your regimen is advisable. 
&nbsp;

<ol start="3">
	<li>
	<h5>Physical Therapies</h5>
	</li>
</ol>

Physical therapies can be natural and effective methods for managing arthritis symptoms. These therapies aim to improve joint function, reduce pain, and increase mobility. Some common physical therapies for arthritis relief include:

a. Physical Therapy: A physical therapist can create a customized exercise program to strengthen muscles around affected joints, improve flexibility, and alleviate pain.

b. Occupational Therapy: Occupational therapists help individuals with arthritis develop strategies to perform daily tasks with less joint stress. They may recommend adaptive equipment or techniques.

c. Hydrotherapy: Water-based exercises in a heated pool can reduce joint pain and improve range of motion. The buoyancy of water supports the body and reduces stress on joints.

d. Tai Chi And Yoga: These mind-body practices can improve balance, flexibility, and strength while promoting relaxation. Regular participation may help manage arthritis symptoms.

e. Massage Therapy: Massage can help relieve muscle tension and reduce pain associated with arthritis. It can also improve circulation and joint mobility. 
&nbsp;

<ol start="4">
	<li>
	<h5>Mindfulness And Stress Management</h5>
	</li>
</ol>

Chronic pain from arthritis can be emotionally distressing, and stress can exacerbate symptoms. Mindfulness and stress management techniques can provide natural relief by promoting relaxation and improving overall well-being:

a. Meditation: Meditation practices can help reduce stress, improve mental clarity, and promote relaxation. Mindfulness meditation, in particular, has been shown to benefit those with chronic pain conditions.

b. Deep Breathing: Practicing deep breathing exercises can reduce tension and anxiety, helping to alleviate pain and discomfort.

c. Biofeedback: This technique allows individuals to monitor and control physiological processes such as muscle tension and heart rate, potentially reducing pain and stress.

d. Cognitive Behavioral Therapy (CBT): CBT helps individuals identify and change negative thought patterns and behaviors that can exacerbate pain. It can be a valuable tool in managing the emotional impact of arthritis. 
&nbsp;

<ol start="5">
	<li>
	<h5>Herbal Remedies</h5>
	</li>
</ol>

Several herbal remedies have been used for centuries to alleviate arthritis symptoms. While scientific evidence on their effectiveness varies, some individuals find relief through the following herbal treatments:

a. Devil&#39;s Claw: Derived from the roots of a South African plant, devil&#39;s claw has anti-inflammatory properties and may reduce pain and stiffness.

b. Boswellia: As mentioned earlier, Boswellia extract has shown promise in reducing inflammation and arthritis-related symptoms.

c. Stinging Nettle: Nettle leaf may help reduce inflammation when taken as a supplement or brewed as a tea.

d. Willow Bark: Willow bark contains salicin, a compound similar to aspirin, which can reduce pain and inflammation. 
&nbsp;

<ol start="6">
	<li>
	<h5>Lifestyle Adjustments</h5>
	</li>
</ol>

In addition to dietary changes and natural remedies, making certain lifestyle adjustments can provide substantial relief for arthritis sufferers:

a. Rest: Adequate rest is essential for joint recovery and overall well-being. Ensure you get enough quality sleep each night.

b. Joint Protection: Using assistive devices like braces, splints, or ergonomic tools can reduce joint strain during daily activities.

c. Heat And Cold Therapy: Applying heat or cold packs to affected joints can alleviate pain and reduce inflammation.

d. Shoe Selection: Choosing comfortable, supportive footwear can help reduce stress on weight-bearing joints like the knees and hips.

e. Pacing Activities: Break tasks into manageable segments, and take regular breaks to avoid overexertion. 
&nbsp;

Natural relief for arthritis encompasses a broad spectrum of approaches, from dietary changes and supplements to physical therapies and mindfulness practices. While not all of these remedies may work for everyone, the combination of several methods can provide significant relief and improve the overall quality of life for individuals living with arthritis. It&#39;s essential to consult with a healthcare professional before starting any new treatment regimen, as they can provide personalized guidance and ensure that the chosen remedies are safe and appropriate for your specific condition. By exploring these natural relief options, arthritis sufferers can take steps towards managing their symptoms and enjoying a more comfortable, active life.

Unveiling The Sunshine Vitamin's Role In Arthritis: A Ray Of Hope

Arthritis, a collective term for more than a hundred different conditions affecting the joints, can be an agonizing journey for millions worldwide. While there is no one-size-fits-all solution for arthritis, recent research has cast a warm, sunny spotlight on vitamin D as a potential player in this painful puzzle. In this article, we will delve into the fascinating connection between vitamin D and arthritis, exploring how this sunshine vitamin might offer relief, hope, and a brighter future for arthritis patients. 
&nbsp;

Before we dive into the intricacies of the vitamin D and arthritis relationship, let&#39;s get to know the sunshine vitamin a little better. Vitamin D, often dubbed the &quot;sunshine vitamin,&quot; is a fat-soluble nutrient crucial for maintaining optimal health. The primary source of vitamin D for most people is sunlight exposure. When our skin is exposed to ultraviolet B (UVB) rays from the sun, it synthesizes vitamin D.

Vitamin D is vital for various bodily functions, including calcium absorption, bone health, immune system regulation, and reducing inflammation. Its role in the prevention and management of arthritis is currently under intense scrutiny. 
&nbsp;

Arthritis encompasses a wide spectrum of conditions, but the most common forms are osteoarthritis and rheumatoid arthritis.

<ol>
	<li>Osteoarthritis (OA): OA is often referred to as the &quot;wear and tear&quot; arthritis. It occurs when the protective cartilage that cushions the ends of your bones wears down over time. This can result in pain, stiffness, and limited joint mobility. 
	&nbsp;</li>
	<li>Rheumatoid Arthritis (RA): RA is an autoimmune disease where the immune system mistakenly attacks the synovium, the lining of the membranes that surround the joints. This leads to inflammation, pain, and joint damage. 
	&nbsp;</li>
</ol>

connection Between Vitamin D And Arthritis

The relationship between vitamin D and arthritis lies in their intricate interplay within the body. Let&#39;s explore the key aspects of this connection:

<ol>
	<li>Inflammation Reduction: Chronic inflammation is a hallmark of many forms of arthritis, including RA. Vitamin D has been found to possess anti-inflammatory properties, which can potentially help mitigate inflammation in arthritis patients. It modulates the immune system&#39;s response, reducing the production of pro-inflammatory molecules. 
	&nbsp;</li>
	<li>Immune System Regulation: Vitamin D plays a pivotal role in regulating the immune system, ensuring it functions efficiently without overreacting. In autoimmune diseases like RA, where the immune system attacks healthy tissues, vitamin D might help in restoring balance. 
	&nbsp;</li>
	<li>Bone Health: Osteoarthritis often leads to bone degeneration, and vitamin D is essential for maintaining strong and healthy bones. A deficiency in this vitamin can exacerbate bone-related issues, which are common in arthritis patients. 
	&nbsp;</li>
	<li>Pain Management: Arthritis is frequently accompanied by chronic pain. Vitamin D may help in reducing pain perception and improving the overall quality of life for arthritis sufferers. 
	&nbsp;</li>
</ol>

Numerous studies have explored the potential benefits of vitamin D in managing arthritis. Although the findings are promising, it&#39;s important to note that more research is needed to establish conclusive links. Here are some key studies and their findings:

<ol>
	<li>A study published in the Journal of Clinical Rheumatology in 2017 found that vitamin D supplementation was associated with a reduction in pain and disease activity in RA patients.</li>
	<li>Research published in the journal Arthritis Care &amp; Research in 2020 suggested that vitamin D supplementation may help prevent knee OA progression.</li>
	<li>A systematic review and meta-analysis published in the Journal of Bone and Mineral Research in 2017 indicated that vitamin D supplementation might have a role in reducing the risk of joint damage in RA.</li>
	<li>The Vitamin D for Knee Osteoarthritis (VIDEO) trial, a randomized controlled trial published in 2019, demonstrated that vitamin D supplementation improved knee pain and function in OA patients. 
	&nbsp;</li>
</ol>

While the potential benefits of vitamin D in arthritis management are exciting, it&#39;s essential to maintain optimal vitamin D levels. This can be achieved through a combination of sunlight exposure, dietary intake, and supplementation, if necessary.

The recommended daily intake of vitamin D varies depending on age, sex, and other factors, but a general guideline is 600-800 IU (International Units) per day for adults. However, individuals with arthritis or those at risk of vitamin D deficiency may require higher doses. 
&nbsp;

<h5>Sunlight, Diet, And Supplements</h5>

<ol>
	<li>Sunlight: Aim for 10-30 minutes of sun exposure on your skin a few times a week. Factors such as location, season, and skin tone influence how much sunlight you need.</li>
	<li>Diet: Include vitamin D-rich foods in your diet, such as fatty fish (e.g., salmon, mackerel), egg yolks, fortified dairy products, and fortified cereals.</li>
	<li>Supplements: Consult your healthcare provider before starting any vitamin D supplementation regimen. They can assess your specific needs and recommend the appropriate dosage. 
	&nbsp;</li>
</ol>

The relationship between vitamin D and arthritis is a captivating and evolving area of research. While promising findings suggest that vitamin D may play a role in reducing inflammation, managing pain, and improving overall joint health, more studies are needed to confirm these effects definitively.

If you&#39;re living with arthritis, it&#39;s crucial to consult with your healthcare provider to determine whether vitamin D supplementation is appropriate for your specific condition. Maintaining optimal vitamin D levels, whether through sunlight exposure, dietary choices, or supplements, can potentially offer a ray of hope in your journey towards managing arthritis and improving your quality of life.

As science continues to unravel the mysteries of this sunshine vitamin, arthritis patients can look forward to brighter days with the promise of reduced pain and improved joint health on the horizon.

تعارف

گٹھیا کی بیماری میں یہ ضروری ہے کہ جوڑوں کے درد کو کم کرنے کے لیۓ ایسی جسمانی سرگرمیوں میں حصہ لیا جاۓ جو نہ صرف درد کم کر سکیں بلکہ موڈ کو اور زندگی کی کوالٹی کو بہتر بنا سکیں ۔ ایسی سرگرمیوں کا انتخاب کریں جو جوڑوں پر کم دباؤ ڈالیں اور جن میں چوٹ لگنے کا اندیشہ کم ہو۔ چہل قدمی ، بائکنگ ، تیراکی ایسی ہی سرگرمیاں ہیں ۔ ایسی جسمانی سرگرمیوں سے گٹھیا کے سبب ہونے والی معذوری اوراس کے دیگر خطرناک اثرات سے بچا جا سکتا ہے(ذیابیطس ، دل کے امراض ، اور موٹاپا )ان سرگرمیوں میں علامات میں تبدیلی کی صورت میں تبدیلی کی جا سکتی ہے۔&nbsp;

یہ ضروری ہے کہ آپ یہ ضرور سیکھ لیں کہ کس طرح سے محفوظ انداز میں ورزش کی جا سکتی ہے۔ اور ان ' اسمارٹ' طریقوں سے کس طرح زيادہ سے زيادہ فوائد حاصل کیۓ جا سکتے ہیں۔<ul><li style="text-align: right;">آغاز ہلکا اور آہستہ کریں&nbsp;</li><li style="text-align: right;">علامات کی شدت کی بنیاد پر ورزش کو ترتیب دیں&nbsp;</li><li style="text-align: right;">سرگرمیاں جوڑوں کے لیۓ محفوظ ہونی چاہیں</li><li style="text-align: right;">چاک و چوبند رہنے کے طریقے پہچانیں&nbsp;</li><li style="text-align: right;">صحت کے ماہرین سے اس حوالے سے بات کریں&nbsp;</li></ul>آغاز ہلکا اور آہستہ کریں&nbsp;جب بھی جسمانی سرگرمیوں کو شروع کریں تو ان کا آغاز آہستہ آہستہ کریں ۔ اور اپنی دھیان اس طرف رکھیں کہ جسم ان مشقوں کو کس طرح سے برداشت کرتا ہے۔ گٹھیا کے مرض کے شکار لوگوں کا جسم کسی بھی نئی مشق کے ساتھ سیٹ ہونے میں زيادہ وقت لیتا ہے۔ آغاز میں یہ بہتر ہے کہ مشق کو بہت کم مقدار میں کیا جاۓ۔&nbsp;مثال کے طور پر 3 سے 5 منٹ ۔ اس کے بعد اس دورانیہ میں بہت آہستہ سے اضافہ کریں مثال کے طور پر اس سے دس منٹ تک کریں اور اس کے بعد جسم کو اس مشق کے ساتھ ایڈجسٹ ہونے کا موقع دیں ۔&nbsp;علامات کی شدت کی بنیاد پر ورزش کو ترتیب دیںگٹھیا کے مرض کی علامات (اکڑاہٹ اور تھکن ) آتی جاتی رہتی ہیں ۔ اس بیماری سے متاثر فرد کے کچھ دن اچھے اور کچھ دن برے ہوتےہیں ۔ اس وجہ سے اپنی سرگرمیوں کو اس حساب سے ترتیب دیں۔ مگر سست نہ پڑیں اور محفوظ انداز میں حرکت میں رہیں۔&nbsp;سرگرمیاں جوڑوں کے لیۓ محفوظ ہونی چاہیںورزش جوڑوں کے لیۓ آسان ہونی چاہیں ۔ چہل قدمی ، سائکلنگ ، پانی میں ایروبک ، رقص یہ تمام ایسی سرگرمیاں ہیں جن میں چوٹ لگنے کا اندیشہ کم ہوتا ہے۔ اور جوڑوں پر دباؤ نہ ہونے کے سبب محفوظ ہیں۔چاک و چوبند رہنے کے طریقے پہچانیںجسمانی سرگرمیوں کو پلان کرتے ہوۓ سب سے اہم چیز تحفظ ہے۔ کسی بھی ورزش کو شروع کرنے سے قبل کسی ماہر سے ضرور مشورہ کر لیں۔ اس کے لیۓ ایسی گروپ کلاسز میں بھی شمولیت اختیار کی جا سکتی ہے جو مستند ٹرینر کے زیر نگرانی ہورہی ہو۔ اس حالت میں کہ اگر آپ نے اپنے طور پر تنہا مشقیں کرنے کا فیصلہ کیا ہے جیسے کہ آپ نے چہل قدمی کا پلان بنایا ہے تو اس کے لیۓ ایسے راستے کا انتخاب کریں جو ہموار ہو ، رکاوٹوں سے پاک ہو، روشن ہو اور ٹریفک سے دور ہو۔&nbsp;صحت کے ماہرین سے اس حوالے سے بات کریںآپ کا ڈاکٹر آپ کے لیۓ ایسی سرگرمیاں پلان کر سکتا ہے جو آپ کی حالت اور ان کی علامات کو دیکھتے ہوۓ ترتیب دیا جا سکتا ہے۔&nbsp; &nbsp;آپ کتنی محنت کر سکتے ہیں؟ یہاں کچھ ایسی سرگرمیاں بتائی جا رہی ہیں جو آپ اپنا سکتے ہیں:<ul><li style="text-align: right;">کم اثر والی ایروبک سرگرمیاں&nbsp;</li></ul>یہ سرگرمیاں جوڑوں پر زيادہ دباؤ نہیں&nbsp; ڈالتی ہیں ، ان میں تیزی سے چہل قدمی ، باغبانی ، گروپ کی ایکسرسائز کلاسز ، سائکلنگ ، تیراکی ، واٹر ایروبک اور رقص شامل ہیں&nbsp;<ul><li style="text-align: right;">پٹھوں کو طافت دینے والی ورزشیں&nbsp;</li></ul>آپ ان سرگرمیوں میں پٹھوں کو طاقت دینے والی ہلکی پھلکی مشقیں بھی شامل کر سکتے ہیں۔ اگر آپ ٹریڈ مل پر چہل قدمی کے موڈ میں نہ ہوں تو اس کے متبادل کے طور پر یوگا بھی کیا جا سکتا ہے۔&nbsp;<ul><li style="text-align: right;">لچک بڑھانے والی ورزشیں&nbsp;</li></ul>یہ مشقیں گٹھیا کے مرض میں مبتلا افراد کو تجویز کی جاتی ہیں۔ اس مرض کے شکار اکثر افراد کے جوڑ اکڑ جاتے ہیں جس کی وجہ سے ان کو روز مرہ کے کام انجام دینے میں دشواری ہوتی ہے۔ روزانہ لچک بڑھانے والی ورزشوں کی مدد سے جسم میں حرکت کرنےکی صلاحیت کو بڑھایا جا سکتا ہے۔&nbsp;<ul><li style="text-align: right;">توازن والی ورزشیں&nbsp;</li></ul>ایک ٹانگ پر کھڑا ہونا ، پیچھے کی طرف چلنا ، اور تائی جی کچھ ایسی ورزشیں ہیں جو گٹھیا کے مریضوں کے توازن کو بہتر بنانے کے لیۓ تجویز کی جاتی ہیں۔&nbsp;

جسمانی سرگرمیوں کو شروع کرنے کے بعد ہلکا پھلکا درد، اکڑاہٹ ، اوور سوجن ہونا ایک نارمل بات ہے۔ جوڑوں کو اس روٹین سے ایڈجسٹ ہونے میں 6 سے 8 ہفتے لگ سکتے ہیں۔ لیکن ان مشقوں کو مستقل درجے پرجاری رکھنے سے طویل عرصے کے لیۓ دردوں سے نجات مل سکتی ہے۔&nbsp;مشقیں شروع کرنے کے بعد ہونے والے درد کو کم کرنے کے کچھ آسان طریقے ہم آج آپ کو بتائيں گے ۔&nbsp;<ul><li style="text-align: right;">درد کی صورت میں اپنی جسمانی مشقوں کے دورانیہ کو کم کر کے اس کو متواتر نہ کریں ۔ مگر ان کو ختم نہ کریں ۔ رفتہ رفتہ درد میں آرام مل جاۓ گا&nbsp;</li><li style="text-align: right;">مختلف اقسام کی مشقوں کو ٹرائی کریں مٹال کے طور پر چہل قدمی کو واٹر ایروبک میں تبدیل کر دیں&nbsp;</li><li style="text-align: right;">ورزش سے قبل جسم کو مناسب انداز میں وارم اپ اور ورزش کے بعد محفوظ انداز میں ٹھنڈا کریں&nbsp;</li><li style="text-align: right;">ورزش آرام دہ رفتار میں کریں&nbsp;</li><li style="text-align: right;">آرام دہ جوتے پہنیں&nbsp; </li></ul>

گٹھیا کے مریصوں میں ورزش کی اہمیت کی وضاحت

اس بیماری کے شکار افراد کے لیۓ ورزش جوڑوں کی اکڑ اور درد میں آرام پہنچانے کے لیۓ بہت مفید ثابت ہوتی ہے۔&nbsp;اس مرض کے شکار وہ افراد جو ورزش کرتے ہیں ان کو ورزش نہ کرنے والے لوگوں کے مقابلے میں کم درد کا سامنا کرنا پڑتا ہے۔ اس کے علاوہ ان کے جوڑوں کی لچک اور فعالیت بھی بہتر ہوتی ہے۔&nbsp;مگر یہ زيادہ بہتر ہے کہ کسی بھی قسم کے ورزش کا پلان بنانے سے قبل اپنے ڈاکٹر یا مستند فزيو تھراپسٹ سے رہنمائی حاصل کر لیں۔&nbsp;رہیومیٹڈ گٹھیا کے مریضوں کے لیۓ بہترین ورزش&nbsp;ایسے مریضوں کے لیۓ ذیل میں بتائی گئی مشقیں مددگار ثابت ہو سکتی ہیں؛&nbsp;<ul><li style="text-align: right;">کھنچاؤ&nbsp;</li></ul>کھنچاؤ والی ورزشیں جوڑزں کی اکڑاہٹ کو ختم کر کے ان کو لچکدار بناتی ہیں اور حرکت دینے میں مدد کرتی ہیں۔ فوائد حاصل کرنے کے لیۓ ان ورزشوں کو باقاعدگی سے کرنا ضروری ہے&nbsp;کھنچاؤ والی ان ورزشوں کی روٹین ہر فرد کے حساب سے مختلف ہو سکتی ہے۔ اس روٹین کا انحصار اس بات پر ہوتا ہے کہ کون سا جوڑ متاثر ہےاور اس کی علامات کیا ہیں۔ کھنچاؤ عام طور پر گھٹنے ، ہاتھوں اور کہنی کے جوڑوں کے لیۓ کیا جاتا ہےکھنچاؤ کی عام روٹین میں شامل ہیں ؛&nbsp;<ul><li style="text-align: right;">کسی جگہ پر چہل قدمی یا ہاتھوں کو حرکت دے کر&nbsp; کھڑے ہو کر یا بیٹھ کر 3 سے 5 منٹ تک خود کو وارم اپ کرنا ۔</li><li style="text-align: right;">کھنچاؤ کو 20 سے 30 سیکنڈ تک رکھیں&nbsp;</li><li style="text-align: right;">ہر کھنچاؤ کو 2 سے 3 بار دہرائيں ۔ یوگا کے طریقے اس کھنچاؤ کو کرنے میں مددگار ثابت ہو سکتے ہیں۔ ڈاگ لیش یوگا کے متبادل ثابت ہو سکتا ہے۔&nbsp;</li><li style="text-align: right;">بہتر یہ ہے کہ کسی فزیوتھراپسٹ کی مدد سے یہ مشقیں کریں جو اس بیماری کے حوالے سے معلومات رکھتا ہو۔&nbsp;</li><li style="text-align: right;">چہل قدمی&nbsp;</li></ul>چہل قدمی ورزش کی ایک بہت کم اثر ڈالنے والی قسم ہے۔ جو ایروبک حالت ، دل اور جوڑوں کی صحت اور موڈ پر اثر انداز ہوتی ہےیہ ضروری ہے کہ پانی کا زیادہ سے زيادہ استعمال کریں ، آرام دہ جوتے پہنیں ۔ آہستہ آہستہ چہل قدمی کا آغاز کریں اور اس کے بعد وقت کے ساتھ رقتار میں اضافہ کریں&nbsp;<ul><li style="text-align: right;">یوگا اور تائی چی جیسی مشقیں&nbsp;</li></ul>یوگا اور تائی چی کے آسان انداز ، گہرا سانس لینا ، مراقبہ کرنا ۔ ان تمام مشقوں سے جسم کی لچک ، توازن ، حرکت میں آسانی اور دباؤ سے نکلنے میں آسانی ہوتی ہے۔<ul><li style="text-align: right;">پائیلیٹس&nbsp;</li></ul>ورزش کے اس طریقہ کار میں کچھ وزن اٹھا کر ورزش کی جاتی ہے۔ یہ جوڑوں کی صحت کو بہتر بناتا ہے۔ اس سے جوڑوں کی طاقت میں بھی اضافہ ہوتا ہے۔<ul><li style="text-align: right;">پانی میں کی جانے والی ورزشیں&nbsp;</li></ul>پانی میں کشش ثقل کے سبب ہونے والا انسان کا وزن کم محسوس ہوتا ہے۔ جس کی وجہ سے وہ ورزشیں جو پانی میں رہ کر کی جاتی ہیں جوڑوں پر زيادہ دباؤ ڈالنے کا سبب نہیں بنتی ہیں۔&nbsp;پانی میں کیۓ جانے والے ایروبک ، تیراکی اور اس طرح کی دوسری کی جانے والی ورزشیں لچک کو بڑھاتی ہیں۔ جوڑوں کو حرکت کرنے میں آسانی فراہم کرتی ہیں۔ اس کے علاوہ جوڑوں کے دباؤ اور ان کی اکڑاہٹ کو بھی کم کرتی ہیں۔&nbsp;<ul><li style="text-align: right;">سائکلنگ&nbsp;</li></ul>سائکلنگ دل کے افعال کو بہتر بنانے میں بہت مددگار ثابت ہوتی ہیں۔ رہیومیٹڈ گٹھیا کے مریض میں دل کے امراض کا خظرہ بہت زیادہ ہوتا ہے۔ لہذا انس کے لیۓ ضروری ہے کہ وہ اپنے دل کی صحت کا خیال رکھیں&nbsp;سائکلنگ کس لیۓ کسی ایسی سائيکل کا استعمال بہتر ہوتا ہے جو کہ ایک جگہ فکس ہو۔ اس سے دل کی صحت بہتر ہوتی ہے ۔اس کے علاوہ اس سے درد برداشت کرنے کی صلاحیت بہتر ہوتی ہےاور جوڑوں کی حرکت کرنے کی طاقت بڑھتی ہے۔&nbsp;<ul><ul><li style="text-align: right;">مضبوطی کی مشق&nbsp;</li></ul></ul>جوڑوں کے گرد موجود پٹھوں کی طاقت گٹھیا کی علامت میں کمی اور درد میں کمی کا سبب بنتی ہے۔ اس کے لیۓ ایک ایسے بینڈ کا استعمال کیا جاتا ہے جو حرکت کے دوران پٹھوں کی طاقت میں اضافہ کرتا ہے۔ یہ جسم کے پٹھوں کو ایک اعتبار سے مزاحمت کے عمل کے ذریعے طاقت فراہم کرتے ہیں جو پٹھوں کی مضبوطی کا سبب بنتے ہیں۔&nbsp;<ul><li style="text-align: right;">ہاتھ کی ورزش&nbsp;</li></ul>&nbsp;رہیومیٹڈ گثھیا کے سبب بعض اوقات ہاتھوں کی حرکت بھی محدود ہو جاتی ہے۔ اور اس بیماری کے شکار فرد کی گرفت ختم ہو جاتی ہے جس سے ان کے ہاتھوں میں پکڑی چیزیں نیچے گر جاتی ہیں۔ اس علامت کو ختم کرنے کےلیۓ اپنی انگلیوں کو آہستہ آہستہ موڑیں ، کلائی کو اوپر نیچے گھمائيں اور اپنے ہاتھوں کی انگلیوں کو ایک ٹیبل پر پھیلائيں اسکے علاوہ اسٹریس بال کو دبائيں ۔ ان تمام مشقوں سے ہاتھوں کی طاقت میں اضافہ کیا جا سکتا ہے۔&nbsp;<ul><li style="text-align: right;">باغبانی&nbsp;</li></ul>گٹھیا کے شکار افراد کے لیۓ ہلکی پھلکی باغبانی بھی مفید ثابت ہو سکتی ہے۔

خلاصہ

درج ذیل طریقے گٹھیا کے مریضوں کے لیۓ مددگار ثابت ہو سکتے ہیں؛&nbsp;<ul><li style="text-align: right;">لگاتار کریں&nbsp;</li></ul>بہتر نتائج کے حصول کے لیۓ لوگوں کو ورزش باقاعدگی کے ساتھ کرنی چاہیۓ ہے۔ گٹھیا کے مریض اگر باقاعدگی سے ورزش جاری رکھیں تو اس صورت میں ان کو حاصل ہونے والے فوائد پٹھوں کی طاقت اور حرکت میں آسانی کی صورت میں مل سکتے ہیں اس کے لیۓ انہیں ایروبک اور پٹھوں کو طاقت دینے والی مشقیں کرنی چاہیۓ ہیں۔&nbsp;<ul><li style="text-align: right;">حفاظت اور آرام کا سامان&nbsp;</li></ul>ان طریقوں کے استعمال سے مریض بغیر کسی چوٹ یا گرنے کے اندیشے کے اپنی موڑش جاری رکھ سکتے ہیں؛&nbsp;<ul><li style="text-align: right;">ہمیشہ ورزش کے لیۓ ایسی چٹائی کا استعمال کریں جو پھسلتی نہ ہو</li><ul><li style="text-align: right;">آرام دہ لباس پہنیں&nbsp;</li></ul><li style="text-align: right;">عدم توازن اور گرنے سے بچنے کے لیۓ محفوظ جوتوں کا انتخاب کریں&nbsp;</li><li style="text-align: right;">یکسانیت سے بچیں&nbsp;</li></ul>گٹھیا کی علامات ہر روز مختلف ہوسکتی ہیں اور ان میں اتار چڑھاؤ آتا رہتا ہے۔ جس کی وجہ سے لوگ غصے اور مایوسی کے جزبات کے سبب اپنی روٹین کو ترک کر دیتے ہیں۔ ورزش اور روزمرہ کی روٹین لوگوں کے لیۓ ان کے پٹھوں اور جوڑوں کو فعال رکھنے میں مدد دیتی ہے۔ مثال کے طور پر اگر کوئی شخص ہر صبح کھنچاؤ کی مشقین اگر روزانہ کرتا ہے تو وہ اس کے ساتھ ساتھ ہفتے میں دو بار پٹھوں کوطاقت دینے والی ورزش یا ہفتے میں ایک بار پانی والے ایروبک کر سکتا ہے۔ اس کے ساتھ ساتھ اگر اس کی علامات اس کو اجازت دیں تو ہفتے میں دو بار یوگا یا تائی چی بھی کر سکتا ہے۔<ul><li style="text-align: right;">مشق کا انتخاب علامات کی بنیاد پر کریں&nbsp;</li></ul>آپ اپنی ورزش&nbsp; کا تعین اپنی علامات کی بنیاد پر کر سکتے ہیں۔ مثال کے طور پر اگر ہاتھوں میں درد ہو&nbsp; تو اپنے بازو کے گرد مزاحمت والا بینڈ لگایا جا سکتا ہے۔ اس کے علاوہ زيادہ دردوں والے دنوں میں سائکلنگ یا تیراکی کرنے کے بجاۓ ہلکی پھلکی چہل قدمی سے بھی کام چلایا جا سکتا ہے۔&nbsp;<ul><li style="text-align: right;">اپنے جسم کی سنیں&nbsp;</li></ul>اپنے جسم کی سنیں ! یہ ضروری ہے کہ تکلیف اور چوٹوں سے خود کو بچائيں۔ یہ ضروری ہے کہ اپنے جسم کی سنتے ہوۓ اپنی رقتار کا تعین کریں۔ اگر ورزش کرنے سے تکلیف اور تناؤ میں اضافہ ہورہا ہے تو اس کے وقت کو محدود کر دیں۔ تیس منٹ کے بجاۓ صرف دس منٹ ورزش کریں۔&nbsp;<ul><li style="text-align: right;">چھوٹی چھوٹی چیزوں پر توجہ دیں&nbsp;</li></ul>زيادہ تر ورزشوں میں بڑے پٹھوں کے گروپ پر توجہ مرکوز کی جاتی ہے۔ ۔ مگر یہ ضروری ہے کہ پٹھوں کے چھوٹے گروپ جیسے ہاتھ اور انگلیوں پر بھی توجہ دی جاۓ ۔ اس کے علاوہ اپنی ایڑیوں اور پیروں کی بھی مشق کی جاۓ ۔ اسی طرح یوگا جیسی مشقیں جو جسم کے توازن کو بہتر بناتی ہیں ان کو بھی کرنا چاہیے۔&nbsp;<ul><li style="text-align: right;">فزيو تھراپسٹ سے مدد لیں&nbsp;</li></ul>رہیومیٹڈ گٹھیا کی ماہر فزيوتھراپسٹ کا مشورہ اور رہنمائی ضروری ہوتی ہے ۔ یہ پروفیشنل ہر فرد کے حساب سے محفوظ اور منفرد مشقیں ترتیب دیتے ہیں۔ اس طریقے سے گٹھیا کے مریض کو کافی فائدہ ہو سکتا ہے<ul><li style="text-align: right;">کچھ مشقیں جن سے بچنا ضروری&nbsp;</li></ul>گٹھیا کے مریضوں کو ایسی تمام ورزشیں کرنے سے بچنا چاہیۓ جو درد میں اضافے کا باعث بن سکتے ہیں۔ یہ وہ مشقیں ہوتی ہیں جو پٹھوں پر زيادہ دباؤ کا سبب بنتے ہیں۔ &nbsp;

اہم نکات

<ul><li style="text-align: right; ">گٹھیا کے مریضوں کے لیۓ ورزش بہت ضروری ہوتی ہے</li><li style="text-align: right;">ورزش کرنے سے فٹنس ، موڈ ، اور روز مرہ کے افعال کی انجام دہی میں بہتری آتی ہے۔ یہ جوڑوں کے درد میں کمی کر کے ان کی حرکات ، پٹھوں کی طاقت اور لچک میں اضافہ کرتی ہیں۔&nbsp;</li><li style="text-align: right;">ورزش کی مدد سے گٹھیا کے مرض کے سبب ہونے والی مایوسی اور اشتعال کو کم کیا جا سکتا ہے۔&nbsp;</li><li style="text-align: right;">اپنے ڈاکٹر اور مستند فزيوتھراپسٹ کی مدد سے ہر مریض اپنی علامات کے حساب سے ورزش کا پلان بنا سکتا ہے۔&nbsp;</li></ul>اعلان لاتعلقی : یہ آرٹیکل گٹھیا کے مریضوں میں ورزش کی اہمیت بتانے کے لیۓ تحریر کیا گیا ہے ۔ یہ ڈاکٹر کے مشورے کا نعم البدل ۔نہیں ہو سکتا ہے۔ تاہم کسی بھی ورزش کو شروع کرنے سے قبل اپنے ڈاکٹر سے ضرور مشورہ کر لیں