Ride into your Golden Years

Recognizing that I need to keep working for a good long time to support my horse habit and wanting a change, I've embarked on a new career in the health-care field.

Although we can’t turn back the hands of time, modern medical know-how and technology can allow us to keep riding into a ripe ol’ age. (My goal is to still be riding at 100.) Adherence to prevention strategies, as well as access to good medical care, can do wonders for your aging body (and our horses’ bodies, too).

A Look at Joint Health
Recognizing that I need to keep working for a good long time to support my horse habit and wanting a change, I’ve embarked on a new career in the health-care field. As part of my college study, I was placed in an internship with Tucson Orthopaedic Institute, a medical practice with approximately 30 medical and osteopathic physicians.

I recently spoke with Eric Feldman, MD, a physical medicine and rehabilitation specialist in our office, about preventing, minimizing, and treating arthritis – a common malady impacting our aging population, with an especially debilitating affect on riders.

Your genes, age, and gender influence how healthy you’ll be as you grow older, Dr. Feldman told me. Although you can’t change who you are, you can modify the impact of these factors on your joints and bones.

Arthritis is a common source of pain as people age, especially among people 50 years and older. Osteoarthritis (osteo=bone; arth=joint, itis=inflammation), the most prevalent type, is a disease that causes joint degeneration. It primarily affects weight-bearing joints, such as knees, hips, and the lower back, but it also commonly occurs in the neck, fingers and toes. The disease leads to joint stiffness, swelling, pain, and loss of mobility.

What You Can Do
Your weight, the kind and amount of exercise you get, the injuries you suffer over your lifetime, and sedentary occupations are osteoarthritis risk factors over which we have some control, Dr. Feldman explained.

Whenever possible, try to avoid trauma that will lead to arthritis later, such as contact sport injuries, overdoing it as a weekend warrior, and taking a spill from a horse. My wrist was surgically repaired after one of my horses dumped me and is more likely than my other joints to have arthritis in the future.
Occupationally, look for ways to reduce joint stress. Avoid prolonged sitting or standing. Change position frequently to help decrease strain on the lower-back and neck joints. If your job requires you to sit all day, stand or stretch in your chair every 15 minutes, even if only for 10 to15 seconds.

Exercise, specifically exercises that strengthen the muscles surrounding your knees, hips, and back, will help keep your joints functioning well. If you’re out of shape (as many riders are), Dr. Feldman recommends that you begin a home exercise regimen under the guidance of a physical therapist.

Being overweight significantly increases the risk of acquiring osteoarthritis, due to the strain the surplus pounds exert on weight-bearing joints (not to mention the strain those extra pounds put on your horse when he carries you).

Thin people are also more likely to get osteoarthritis. Dr. Feldman recommends that anyone who’s overweight or thin seek the guidance of a nutritionist.

Eating a balanced diet and taking a daily multivitamin is very important to overall health, Feldman emphasized. Depending on your age and gender, additional calcium and vitamin D can help keep bones strong and healthy.

Recommended Treatment
If you experience joint pain and stiffness that doesn’t improve over six to eight weeks, Dr. Feldman recommends having the condition evaluated by a primary care physician or a specialist: a rheumatologist, orthopedist, or physiatrist (doctor of rehabilitation medicine).

In most cases, the doctor will order an X-ray to further evaluate the degree of arthritis in your joints and to make sure there are no bone or joint fractures.

Occasionally, the physician will order magnetic resonance imaging (MRI) to further evaluate the soft tissues in and around the joint, such as cartilage, ligaments, and tendons. There’s currently no cure for osteoarthritis, but early diagnosis and treatment can reduce both the pain and long-term damage.

Initial arthritis treatment may involve low-impact aerobic activity, such as swimming, biking, or utilizing specific gym equipment. Medications for pain relief may include acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs, such as Advil or Aleve.

Other over-the-counter products may or may not help. Glucosamine and chondroitin supplements, although not a panacea, are safe for most people, and can help to decrease the pain and stiffness associated with mild forms of osteoarthritis (Dr. Feldman said it must be taken daily for a month for a person to notice any difference).

When I recently developed minor pain and stiffness in my thumb that has scar tissue from an old horse bite, a health professional suggested I simply rub it with MSM (methylsulfonylmethane) cream that I bought for $9 at a vitamin store; it did the trick.

Tell your doctor about any medications you take; even Tylenol can be extremely dangerous if used improperly, Dr. Feldman warned.

If the disease progresses and pain becomes severe, joint injections given by a physician with a powerful anti-inflammatory corticosteroid can temporarily reduce pain and stiffness. Viscosupplementation is a new kind of injectible medication that can help decrease joint pain and stiffness for up to six months, he added.

Surgery is reserved for people with advanced stages of osteoarthritis, who have significant loss of joint function. The most common surgery for severe osteoarthritis is a joint replacement, which can provide considerable reduction in pain, improve mobility, and allow people to do things that had previously become too painful.

Although hip- and knee-replacement surgery is now common, complications from blood clots and infection can occur.

Consider Your Horse
Your body and its joints dictate how long you’ll be riding in your golden years. And, by the way, Dr. Feldman’s exercise and weight tips generally apply to your equine companion, as well. Middle-aged horses commonly get arthritis, so consult your veterinarian for specific advice. TTR

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