Fatigue and Osteoarthritis What can you do?

Transcription

1 Working Together for Healthy Joints Fatigue and Osteoarthritis What can you do? Louise Lydon, B.Sc., B.Sc. (OT) Occupational Therapy, Educator OASIS Program, Vancouver Coastal Health

2 Today s Objectives: What is fatigue? What factors contribute to fatigue? How is fatigue related to osteoarthritis? How do you track the source of fatigue? What steps can you take to reduce your fatigue with exercise, adaptive aids and pain management.

3 What is fatigue??

4 Source: The Arthritis Society

5 Areas of the body affected by OA Source:

6 Fatigue and Osteoarthritis RESEARCH Approximately 40% of OA patients have substantial fatigue (Wolfe et al) Adults with moderate OA participating in focus groups described their fatigue as debilitating and occasionally activity restricting (Gignac et al)

7 Fatigue in OA: Qualitative Study Client reported factors that influenced fatigue were: OA pain Pain medications Aging Various types of weather Poor sleep Mental health and feelings of depression Source: BMC Musculoskeletal Disorders :63

8 Fatigue in OA: Qualitative Study Client reported fatigue as impacting: Physical function Ability to participate in social activities Ability to perform household tasks To overcome fatigue, clients reported: Rest, exercise, avoiding or getting assistance for task as coping strategies Source: BMC Musculoskeletal Disorders :63

9 Negative Cycle of Pain and OA STRESS PAIN DEPRESSION LIMITED / LOST ACTIVITIES

10 Keep track of your energy output and fatigue

11 Tracking Your Fatigue Use a log book Keep it visible Rate your energy/mood Rate your pain Night joint pain? Review activities Coping strategies

12 OA Fatigue what can you do? Exercise Balancing activities Joint protection Adaptive aids Sleep Healthy eating

13 To move or not to move?

14 Osteoarthritis Cycle STIFF JOINTS DON T MOVE PAIN LESS ABLE TO DO THINGS LESS ENERGY

15 But it hurts! Start small, gradually increase Break up the activity (2, 3, or 4x/day) Warm up / Timing / Medication Minimize joint stress Water Exercise bike Walking aids Footwear/Orthotics Bracing

16 Pain Management Pain

17 Problem solving Planning Prioritizing Pacing The 4 P s

18 Balancing Activities

19 Daily Goal Setting Keep a daily log book to document short and long term goals Goals should be written SMART Specific Measurable Action based Realistic Timely

20 S.M.A.R.T Goal Setting Example: I am going to start exercising more. V.S. This month, I am going to walk around Douglas Park for 10 minutes 3 times a week to increase my exercise endurance.

21 Joint Protection 10 kg d Load on low back = 10 kg 10 x d 10 kg Load on low back = 100 kg To protect sore joints To avoid awkward postures Energy conservation Reduce fatigue Maintain independence with daily activities

22 Avoid Carrying Heavy Loads Each extra pound = 4-6 X Force!!!

23 Adaptive aids for joint protection

24 Shhhh

25 Culture shift and Sleep Thomas Edison, the father of artificial light, strongly opposed the power of a good night s sleep.

26 Why Do we Need Sleep? Body tissues/mechanisms are restored and repaired. Thinking, decision making and memory when we are awake Poor sleep linked to other health issues Blood is supplied to the muscles Energy is restored For our immune functions

27 Poor sleep Sleep and OA Decreased energy and concentration Increased cortisol and ghrelin Increased food intake Poor food choices Decreased activity Poor pain control Weight gain

28 Pain and Sleep Chronic pain sufferers (eg: headaches, arthritis, back pain) often do not sleep well. Pain and poor sleep lowers mood, energy and disrupts daily ability to function. 53% of people with chronic back pain and 75% of people arthritis have sleep problems.

29 Sleep Tips! Have a good mattress; not too firm or too soft Down and feather pillows are usually better than foam Sleep in a cool room Try a bath prior to bed, as the body cools afterwards and this promotes sleep

30 Sleep Hygiene 1. Get the right amount of sleep for you 2. Try to sleep through the night 3. Use the bed for sleeping, sex and reading. Avoid electronic devices 4. Try to sleep on a regular schedule (including weekends, holidays and vacations) 5. When you get up, stay up, try not to snooze 6. Limit napping to one in the afternoon not more than an hour

31 Sleeping With Pets Get them off the bed!

32 Healthy Eating

33 Weight and Osteoarthritis 1 pound = 4-6 pounds of force through hips and knees Small amounts of weight loss can significantly improve joint pain

34 Reduce sugar intake

35 Drink water!

36 Caffeine May disrupt sleep Effects of caffeine vary a lot from person to person. Caffeine stays in the blood stream for 3-7 hours. Caffeine withdrawal can cause agitation and sleep disturbance. Limit caffeinated drinks 3 (250 ml) cups a day

37

38 What is fatigue? Conclusion What factors contribute to fatigue? How is fatigue related to osteoarthritis? How do you track the source of fatigue? What steps can you take to reduce your fatigue with exercise, adaptive aids and pain management.

39 QUESTIONS?

40 Acknowledgements OASIS Program Vancouver Coastal Health The Arthritis Society Joanna Li Manager, Education & Services, Vancouver Coastal/Northern Regions

41 References Wolfe F, Hawley DJ, Wilson K: The prevalence and meaning of fatigue in rheumatic disease. J Rheumatology 1996, 23: Gignac MA, Davis AM, Hawker G, Wright JG, Mahomed N, Fortin PR, et al: What do you expect? You re just getting older. A comparison of perceived OA-related and aging related health experiences in middle and older-age adults. Arthritis Rheum 2006, 55:

42 Reference continued Fatigue in Osteoarthritis: A Qualitative Study. JD Power, EM Badley, MR French, AJ Wall, GA Hawker. BMC Musculoskeletal Disorders 2008, 9:63. Voith AM, et al. Nursing diagnosis: fatigue. In: Carroll Johnson RM, ed. Classification of nursing diagnoses. Proceedings of 8 th Conf NANDA. St. Louis: Mosby, 1989