KEEP MOVING

Maintain movement in your joints as best you cane This can help keep your joints functioning better for a longer amount of time and, at the same time, brighten your outlook on life. "Every patient should keep active," says John R. Ward, M.D., professor of medicine at the University of Utah School of Medicine in Salt Lake City. 'And remember that even small movements mean a lot. If all you can tolerate is a little housecleaning or gardening, for instance, that's OK, too."

EXERCISE, EXERCISE AND EXERCISE

"Exercises work best when inflammation has calmed down," notes Janna Jacobs, P.T., C.H.T., physical therapist, certified hand therapist, and president of the Section on Hand Rehabilitation of the American Physical Therapy Association (APTA).
There are a few different types of exercises that are used to help arthritis sufferers. The simplest, easiest exercises that can be done by almost any arthritis sufferer are called range-of-motion exercises. They help maintain good movement by putting the joints through their full range of motion. You'll find several range-of-motion exercises recommended by the Arthritis Foundation in "Exercises for Arthritis."
Isometrics, in which you create resistance by tightening a muscle without moving the joint, can help to strengthen muscles. Weight-bearing exercises, such as walking, also build muscle strength. While strengthening exercises can be beneficial for the arthritis sufferer, however, they should only be done under the supervision and care of a therapist or physician, says Grayzel. And, "anyone with any type of cardiovascular disease should not do multiple resistance exercises for a sustained amount of time," warns Ward.
Stretching, which helps make the muscles more flexible, is often recommended as the first step in any exercise regime. Likewise, warming up your joints before beginning any exercise makes them more flexible. Massage your muscles and/or apply hot or cold compresses or both-whichever your health-care practitioner recommends or you prefer. A warm shower is another way to warm up.

GIVE YOUR HAND A WATER WORKOUT

Try doing your hand exercises in a sink full of warm water for added ease and comfort, suggests Jacobs.

DON'T OVERDO IT

Ward has come up with a "useful recipe" you can use to see if you've overdone your exercise routine. See how you feel a
few hours after you exercise and then again after 24 hours. If your pain has increased considerably during that period of time, then it's time to cut back on the frequency and amount of exercise that you're doing, he says. Of course, if the activity brought relief, you've found a worthwhile exercise. Tailor your routine to include the exercises that give you the most relief-and the most enjoyment.

PLAY IN A POOL

If you find even simple movements difficult, a heated pool or whirlpool may be the perfect environment for exercise(unless you also have high blood pressure, in which case you should avoid whirlpools and hot tubs). Try a few of your simpler exercises while in the water. The buoyancy will help reduce the strain on your joints. And, "the warm water will help loosen joints and maintain motion and strength," says Ward. Even a warm bath may allow you some increased movement. In a pinch, a hot shower may do: Running the stream of water down your back, for instance, may help relieve back pain.

DON'T OVERUSE OVER-THE-COUNTER CREAMS

These pain-relieving rubs give temporary relief by heating up the joints. However, "frequent use may activate enzymes that can break down the cartilage in the joints," says Davis.

PUT ON A SCARF

Not around your neck, but around the elbow or knee joint when it aches. 'A wool scarf is your best bet," says Jacobs. Be careful not to wrap it too tightly, however; you don't want to hamper your circulation.

PULL ON A PAIR OF STRETCH GLOVES

"The tightness caused by the stretchy kind may, in fact, reduce the swelling that often accompanies arthritis," says Ward. And the warmth created by covered hands may make the joints feel better "Wearing thermal underwear may have the same warming effect on joints," says Grayzel.

GET ELECTRIC GLOVES

Hunters use these battery--operated mitts to keep their hands toasty on cold mornings in the woods. "The gloves just may do the trick to keep your hands warm and pain-free," says Jacobs. She recommends keeping them on all night while you sleep.

TRY A WATER BED

According to the National Water Bed Retailers' Association in Chicago, many owners claimed in a study that their
rheumatoid arthritis "was helped very much by a water bed." And Earl I Brewer, Jr., M.D., former head of the Rheumatology Division of Texas Children's Hospital in Houston, believes he knows why. "The slight motions made by a water bed can help reduce morning stiffness," he says. "And a heated water bed may warm the joints and relieve joint pain.

SLIP INTO A SLEEPING BAG

If a water bed is out of the question, you might consider camping gear. "The cocoonlike effect of a sleeping bag traps heat, which can help relieve morning aches and pains," reports Brewer. He learned of its therapeutic effects when many of his patients told him that they got relief by sleeping in their sleeping bags on top of their beds.

GET "DOWN"

Brewer tells the story of a doctor from Norway who happened to stay in a bed-and-breakfast while on business in New York. The doctor; who was suffering from arthritis pain, slept peacefully each night in the B&B's bed and woke each morning pain-free. The bed was outfitted with a goose-down comforter and pillow. According to Brewer, the bedding's warmth and minute motion brought on the relief. For those who are allergic to down, an electric blanket may bring some relief.

WATCH YOUR WEIGHT

Being overweight puts more stress on the joints. As a matter of fact, a weight gain of 10 pounds can mean an equiva-lent stress increase of 40 pounds on the knees. So if you are carrying excess pounds, losing weight can help improve joint function. "People who lose weight can slow the progress of their osteoarthritis," says Grayzel.

PROTECTING YOUR JOINTS

In addition to easing discomfort, you can learn to live well with arthritis by protecting your joints. What's more, with a little planning and reorganizing, you can learn to do daily tasks more efficiently, so that you'll have more energy to spend on activities you enjoy. Here are some tips from the Arthritis Foundation that can help.

Plan ahead each day.

Prepare a realistic, written schedule of what you would like to accomplish each day. That way, you can carry out your most demanding tasks and activities when you think you'll have the most energy and enthusiasm-in the morning, for instance.

Spread the strain.

As a general rule, you want to avoid activities that involve a tight grip or that put too much pressure on your fingers. Use the palms of both hands to lift and hold cups, plates, pots, and pans, rather than gripping them with your fingers or with only one hand. Place your hand flat against a sponge or rag instead of squeezing it with your fingers. Avoid holding a package or pocketbook by clasping the handle with your fingers. Instead, grasp your goods in the crook of your arm-the way a football player holds the ball as he's running across the field-and you won't be tackled by as much pain.

Avoid holding one position for a long time.

Keeping joints "locked" in the same position for any length of time will only add to your pain and stiffness. Relax and stretch your joints as often as possible.

"Arm" yourself.

Whenever possible, use your arm instead of your hand to carry out an activity. For example, push open a heavy door with the side of your arm rather than with your hand and outstretched arm.

Take a load off.

Sitting down to complete a task will keep your energy level up much longer than if you stand.

Replace doorknobs and round faucet handles with long handles.
They require a looser; less stressful grip to operate, so you'll put less strain on your joints.

Build up the handles on your tools.

For a more comfortable grip, tape a layer or two of thin foam rubber, or a foam-rubber hair curler, around the handles of tools such as brooms and mops.

Choose lighter tools.

Lightweight eating and cooking utensils can keep your hands from getting heavy with hurt.

Let automatic appliances do the work for you.

Electric can openers and knives, for instance, are easier to operate than manual versions. An electric toothbrush has a wider handle than a regular toothbrush.

Say no to scrubbing.

Spray pots and pans with nonstick cooking spray and/or use cookware with a nonstick surface. Consider getting a dishwasher; too, to save your joints some work.

Keep your stuff within easy reach.

Adjust the shelves and racks in any storage area so that you don't have to strain to reach the items you need. Buy clothes with pockets to hold things you use often and need close by, like a pair of glasses. Use an apron with pockets to carry rags and lightweight cleaning supplies with you as you do your household chores. Store cleaning supplies in the area in which they will be used. Keep the same supplies in several places, such as the upstairs bathroom and the downstairs bathroom as well as the kitchen.

Use a "helping hand" to extend your reach.

For those items you can't store nearby, buy a long-handled gripper; the kind used in grocery stores to grab items from top shelves. Make household chores easier with a long-handled feather duster or scrub brush. Grab your clothes from the dryer with an extended-reach tool.

Don't overdo the housework.

Plan on tackling only one major cleaning chore a day, whether it is doing the laundry or cleaning the kitchen.

Velcro is the way to go.

Interlocking cloth closures on clothing and shoes can save you the frustration of buttoning and lacing.

Walk this way up and down the stairs.

Lead with your stronger leg going up, and lead with your weaker leg coming down.

Bend with your knees.

When reaching for or lifting something that's low or on the ground, bend your knees and keep your back straight as you lift.

Let loose with loops.

You won't need quite as tight a grip if you put loops around door handles, such as those on the refrigerator and oven. Have loops sewn on your socks, too, then use a long-handled hook to help you pull them up.

Dig out that little red wagon.

Heavier loads will be out of your hands if you use a wagon or cart that glides along on wheels. Use it to tote groceries or baskets of laundry, for instance.

Read with ease.

Lay your newspaper out on the table rather than holding it up to read. Likewise, lay a book flat or use a book stand to give your hands a break as you read.

Sit on a stool in the tub.

A specially made stool can give you a steady place to shower and can ease your way in and out of the tub.

Plant yourself on a stool in the garden.

Sitting, rather than stooping, over your flower beds or vegetable garden may help reduce the stress on your back and legs.

Ask for help.

Don't be afraid to ask your family members or friends for assistance when you need it. As the saying goes, many hands make light work. By sharing the load, you'll have more time and energy for the people and activities you enjoy.

Contact the Arthritis Foundation.
The Arthritis Foundation can let you know of joint-friendly or energy-saving items specially made for use by arthritis sufferers.
Call the Arthritis Foundation Information Line at 800-283-7800, Monday through Friday, 9:00 A.M. to 7:00 P.M. Eastern
time, to talk to a skilled operator who can answer your questions about arthritis.

Exercises for Arthritis

These exercises are recommended by the Arthritis Foundation. For best results, carry out the exercises in a
smooth, steady, slow-paced manner; don't bounce, jerk, or strain. Don't hold your breath; breathe as naturally
as possible. Do each exercise five to ten times, if possible. If any exercise causes chest pain, other pain, or
shortness of breath, stop. When your joints are inflamed, it's best to skip the exercises and rest. If you have any
questions, contact your therapist or physician. And remember. It may be some time before you feel the benefits
of regular exercise, so be patient with yourself

Shoulder: Lie on your back and raise one arm over your head, keeping your elbow straight. Keep your arm dose to your ear Return your arm slowly to your side. Repeat with the other arm.

Knees and hips: Lie on your back with one knee bent and the other as straight as possible Bend the knee of the straight leg and bring it toward the chest. Extend that same leg into the air and then lower the straightened leg to the floor Repeat with the other leg.

Hips: Lie on your back with your legs straight and about six inches apart. Point your toes up. Slide one leg out
to the side and return, keeping your toes pointing up. Repeat with the other leg.

Knees: Sit on a chair that's high enough so you can swing your legs. Keep your thigh on the chair and straighten out your knee Hold a few seconds. Then bend your knee back as far as possible to return to the starting position. Repeat with the other knee.

Ankles: Sit on a chair and lift your toes off the floor as high as possible while keeping your heels on the floor. Then return your toes to the floor and lift your heels as high as possible. Repeat.

Fingers: Open your hand with your fingers straight. Bend all the finger joints except the knuckles. Touch the top of the palm with the tips of your fingers. Open and repeat.

Thumbs: Open your hand with your fingers straight. Reach your thumb across your palm until it touches the base of the little finger. Stretch your thumb out again and repeat.

Heat or Cold:

Which Is Best?

There are no hard and fast rules when it comes to deciding which-heat, cold, or a combination of the two-will give you the best results. The bottom line, says John K. Ward, M. D., "Do whichever feels the best. "Here are some guidelines that may help you decide.
Heat relieves pain primarily by relaxing muscles and joints and decreasing stiffness. In some instances, however, heat may aggravate a joint that's already "hot" from inflammation, as is sometimes the case with rheumatoid arthritis. On the other hand, osteoarthritis causes minimal infIammation and may respond well to heat application. If you find that your compress cools down quickly, you may want to try methods that offer more consistent heating. An electric blanket or heating pad can provide sustained dry heat A worm shower, bath, or whirlpool can keep the wet heat coming. And using some method of warmth to loosen up the muscles before exercise can help them perform better.
Cold is ordinarily used to reduce pain in specific joints. Cold application should not be used with vasculitis(inflammation of the blood vessels) or Raynaud's phenomenon (a condition, characterized by spasms of the arteries in the fingers and toes, that may occur in conjunction with rheumatoid arthritis) without a doctor's approval, however. There are many ways to make a cold pack: Fill a plastic bag with crushed ice, use a package of frozen peas or frozen unpopped popcorn, or use a package of blue ice, for example. Apply the cold pack, wrapped in a thin towel, to only one or two joints at a time, so you don't get a chill.
You may find that alternating heat and cold gives you the most relief. For the best results, the Arthritis Foundation recommends the contrast bath: Soak your hands and feet in warm water (no more than 110 degrees Fahrenheit) for about three minutes, then soak them in cold water (about 65 degrees Fahrenheit) for about a minute. Repeat this process three times, and finish with a warm-water soak.

HERE A FEW WEBSITE TO LOOK FOR ATHRITIS

ARTHRITIS AND RHEUMATISM

AMERICAN COLLEGE FOR RHEUMATOLOGY