man with arthritis pain
4 questions you should ask
by Karen Lerner

According to the Centers for Disease Control and Prevention, nearly one in four adults in the U.S.—24%—are living with arthritis, making it one of the most common conditions home medical equipment (HME) providers are likely to encounter.

While there are more than 100 types of arthritis, the most common are osteoarthritis, which is caused by joint degeneration, and rheumatoid arthritis, which is caused by an abnormal response of the immune system that causes it to attack the lining of the joints. Regardless of the type of arthritis, many of the basic symptoms are the same: tenderness at joints, stiffness, a limited range of motion, and pain during or after movement, particularly at the hips, hands, knees and feet. Challenges facing arthritis sufferers include managing pain, fatigue, limited mobility and dexterity, and difficulty bending and performing other activities of daily living (ADLs).

Understanding these challenges and asking a few key questions about a customer’s life with arthritis can help HME providers offer a full range of targeted solutions to improve their quality of life. Here are four to try.

1. How are you moving?

When it comes to arthritis, I like to say, “The more you move, the more you move.” Among its many benefits, physical activity helps replenish lubrication to the joints, strengthen the muscles that support them and keep off weight, minimizing pressure on the joints. However, many arthritis sufferers frequently avoid physical activity due to the discomfort it brings to their hips, knees and other joints.

Mobility aids such as canes, walkers and rollators can help take the pressure off aching knees and hips to help users get up and going. For users with severe arthritis in their hands, a forearm crutch or comfort-grip cane can help reduce pressure on leg joints with minimal grip. HME providers should be sure to highlight mobility aids that have ergonomic features, can be adjusted to the user’s height and weight and are lightweight. While heavier walkers and rollators such as those made of steel offer stability and strength, lightweight versions, including those made of aluminum or carbon fiber, are easier to direct and control for arthritic users. Lightweight mobility equipment also puts less strain on the body and helps keep muscles moving and reduces fatigue.

2. How are you managing your pain?

Pain is a fact of life for arthritis sufferers. Medical professionals often focus on treating this pain through medication, including nonsteroidal anti-inflammatory drugs to reduce pain and inflammation and antidepressants, which have shown success in treating sufferers of chronic pain. In the case of rheumatoid arthritis, pain treatment can be combined with disease-modifying antirheumatic drugs that act on the immune system to reduce the inflammation underlying the pain, and corticosteroids.

Depending on the medication, side effects can range from gastric issues to liver damage to higher risk of some types of cancer. By helping arthritis sufferers move non-drug interventions to the front lines of their arthritis management plan, you can reduce reliance on medications and in turn allow them to experience fewer side effects.

Heat therapy is one of the oldest and least expensive ways to loosen stiff joints and soothe sore muscles. Heating pads and heated blankets can provide soothing dry heat and can be particularly useful at bedtime, when aching joints can disrupt a good night’s sleep.

More often overlooked is the power of moist heat to treat arthritis. Warm baths and showers soothe joints, boost circulation and, in the case of rheumatoid arthritis, help move about the synovial fluid that accumulates in joints and makes them stiff. However, arthritis can make getting into and out of the tub a challenge.

By guiding customers toward solutions that can help them bathe more easily, HME providers can empower patients to take advantage of one of the most widely available and side effect-free forms of pain management. Grab bars, bath chairs and bath benches are great tools for helping users stabilize themselves and reduce bending as they enter the shower, while automated bath lifts can help arthritis sufferers enjoy full-body submersion with a simple remote control.

A less familiar option for most customers is transcutaneous electric nerve stimulation (TENS) provided through a TENS unit. These small battery-operated devices use electrodes to deliver low-voltage electrical impulses that are thought to decrease pain signals to the brain and to stimulate the production of endorphins, which are the body’s natural painkillers.

While effectiveness varies from person to person, TENS units have worked for many arthritis sufferers, providing inexpensive and fast-acting pain relief with few side effects. The pads can be placed closely around a single joint to provide targeted therapy or across a larger affected area. Users may also try applying the pads to their lower back, where knee and hip nerves originate. Some TENS machines even combine heat therapy with nerve stimulation to provide two-in-one therapy and relief.

3. How are you sleeping?

According to the Arthritis Foundation, as many as 80% of people with arthritis have trouble sleeping. With achy, stiff and sometimes swollen joints, getting comfortable, dozing off and staying asleep can be a tall order. And unfortunately, the relationship between sleep and arthritis pain goes both ways, with poor sleep quality linked to increased inflammation and pain.

Several HME products can help your customers obtain better sleep. Using a therapeutic mattress overlay or a medical-grade mattress replacement can relieve pressure on joints to help arthritis sufferers fall asleep and stay asleep. Bed or assist rails that support the joints when getting up and down can also make it easier to get into bed and get a restful night of sleep. As mentioned earlier, sleeping with a heating pad or heated blanket can provide soothing dry heat. For added benefit, consider using two to create a sandwich of warmth. Bed wedges for a variety of position options can also positively impact sleep, as can fully articulating beds, which can even turn into chairs. This is an area where HME providers can really add value by educating consumers on the benefits of medical-grade versus consumer-grade beds and support surfaces.

4. What activities of daily living do you find challenging?

Basic tasks like zipping clothing, opening medication bottles and eating may become challenging due to limited dexterity caused by arthritis. Numerous assistive aids can help, including jar openers and dressing aids that make putting on footwear, buttoning and zipping easier. Extended-handle reachers and step stools make reaching up or down for needed items safer and less painful. Adaptive utensils with more easily gripped handles and adaptive drinking cups reduce pressure on individual joints or reduce the range of movement needed to eat and drink.

Individuals who have problems standing up and sitting down due to the pain they have in their knees or hips may benefit from the reduced bending required to use a hip chair, while those that have trouble standing for longer periods may wish to try out an adjustable-height stool that can allow them to work at kitchen counters, for example.

For the customer who has trouble getting around or going to medical appointments, bringing home basic health equipment like a pulse oximeter and blood pressure cuff can also give them the ability to monitor their vitals without making a trip to a clinic, allowing for additional independence.

Conclusion

While there is no cure for arthritis, customers with the condition can see significant improvements in their symptoms and quality of life through the right home medical equipment. By asking the right questions about how arthritis has affected both customers’ days and nights, you can gain valuable insight into the products they need to reduce their pain and get the most out of life.



Karen Lerner, RN, MSN, ATP, CWS, is a wound care, long-term care and rehab specialist with more than 35 years of industry experience. She began her career as a critical care nurse specialist in major teaching hospitals from Florida to New Jersey. Lerner received her undergraduate degree from Duke University and her graduate education from the University of Florida. Since October 2013, she has worked as part of the clinical team at Drive DeVilbiss Healthcare. Visit drivemedical.com to learn more.