Is exercise good or bad for osteoarthritis?

DEAR DOCTOR K: I like to exercise, but people in my family tend to get osteoarthritis. Is exercise good or bad for my joints?

DEAR READER: A joint is a place where two or more bones come together. Your question has a simple and a more complicated answer. The simple answer is: For most people, regular exercise is good for the joints. The more complicated answer is that certain types of exercise can put pressure on the joints.

I might have RA, how should I prepare for an appointment with a rheumatologist?

DEAR DOCTOR K: My doctor suspects I have rheumatoid arthritis. He wants me to see a rheumatologist. How should I prepare for this appointment?

DEAR READER: Rheumatoid arthritis (RA) is a long-lasting inflammatory disease that causes painful, stiff, swollen joints. If you do have RA, it's best to diagnose the condition early. Disease-modifying treatment, started as soon as possible, can slow or prevent the disease from wreaking havoc on your joints. Either your primary care doctor or a rheumatologist (a doctor who specializes in arthritis) will evaluate you.

What is pseudogout?

DEAR DOCTOR K: What is pseudogout? Is it related to gout?

DEAR READER: Pseudogout is a form of arthritis triggered by deposits of calcium crystals in the joints. As crystals accumulate in the affected joint, they can cause a reaction that leads to severe pain, redness, warmth and swelling. The attack often lasts several days, and can last weeks. As the name suggests, pseudogout can cause symptoms similar to those of gout. Gout is caused when another type of crystal, uric acid, accumulates in a joint. Gout commonly affects just a single joint -- most often the big toe. Pseudogout also can resemble osteoarthritis or rheumatoid arthritis, in making multiple joints ache simultaneously. It most often occurs in the knee, wrist, shoulder, ankle or elbow.

Does stretching help relieve arthritis pain?

DEAR DOCTOR K: Will stretching exercises help to relieve my arthritis pain?

DEAR READER: Yes, they will. That may seem strange. After all, arthritis affects the joints -- the ends of two adjacent bones and the space between them. In contrast, stretching involves muscles. But the joints and the muscles around those joints are intimately connected. A joint with arthritis hurts when it is asked to move. It is the muscles that move the bones that form a joint. When movement is painful, as it so often is for people with arthritis, it's natural to limit movement. For example, if you straighten a leg, and feel pain owing to arthritis in a knee, you'll tend to keep that knee bent.

What is the best way to treat ankylosing spondylitis?

DEAR DOCTOR K: I have ankylosing spondylitis. Can you discuss this condition and the best way to treat it?

DEAR READER: Ankylosing spondylitis is a form of arthritis in which the spine and other joints become inflamed and stiff. A person with this condition usually feels pain or stiffness in the lower back, especially in the morning or after inactivity. Pain tends to begin in the two joints between the spine and the pelvis (the sacroiliac joints) and be felt in the buttocks. It then works its way up the lower spine.

What are alternative therapies for rheumatoid arthritis pain?

DEAR DOCTOR K: I have rheumatoid arthritis. Medications have helped, but only up to a point. Can you discuss alternative therapies that might help to further relieve my discomfort?

DEAR READER: Rheumatoid arthritis (RA) is a long-term disease in which the body's immune system attacks healthy tissue lining the joints. This causes swelling, pain, redness and stiffness in joints throughout the body. Drug treatments slow the effects of the disease, but alternative approaches can also help to reduce inflammation and relieve pain.

Will running wear my knees out faster?

DEAR DOCTOR K: I'm 68. I've jogged regularly for decades, but I've recently developed a touch of arthritis in my knees. Will continuing to run make my knees wear out faster?

DEAR READER: Having mild arthritis in the knees should not stop you from running. And, in case you were wondering, running probably did not create the problem in the first place.

My doctor thinks I have rheumatoid arthritis — so why is she testing me for lupus and gout?

DEAR DOCTOR K: My doctor suspects I have rheumatoid arthritis, but she wants to test me for several other disorders, including lupus and gout. Why?

DEAR READER: Several other diseases can cause symptoms and joint changes that are similar to rheumatoid arthritis (RA), including lupus and gout. That's probably why your doctor is ordering the tests. She suspects you have RA, but she won't know for sure unless she rules out these other diseases.

What are drug-free treatments to relieve osteoarthritis hand pain?

DEAR DOCTOR K: I have osteoarthritis in my hand. Could you recommend some drug-free treatments to relieve the pain?

DEAR READER: Osteoarthritis causes stiffness and pain in the joints. It develops when cartilage -- the connective tissue that covers the ends of bones -- deteriorates. In a joint, the ends of two or more bones come together. The softer and more flexible cartilage that covers the ends of the bones acts as a cushion. If the cartilage were not there, the hard bones would grind against each other.

Should I take a joint support supplement if I have osteoarthritis?

DEAR DOCTOR K: I have osteoarthritis. It's improved some with physical therapy and weight loss, but not entirely. Should I give "joint support" supplements a try? Which ones?

DEAR READER: Your question reminds me of two of my patients. "John" was a man in his 50s whose pain from arthritis in his knees made it hard for him to play pickup basketball. Physical therapy and pain medicines helped, but not completely.