Presented by The Arthritis Society Manitoba/Nunavut Division Pain Busters Workshop Presented by The Arthritis Society Manitoba/Nunavut Division

Our Mission To provide leadership and funding for research, advocacy and solutions to improve the quality of life for Canadians affected by arthritis VISION: Living well while creating a future without arthritis

ARTHRITIS FACTS The Arthritis Society is a non profit organization with 66 years of service to Manitoba We are not funded by government We are supported by the generosity of donors from Manitoba and the United Way

National Arthritis Facts 1 in 6 Canadians are living with arthritis 1 in 8 have osteoarthritis 60% are under 65 years of age 100,000 Canadians each year are diagnosed with arthritis There are over ? different types of arthritis? Even though there is no cure, a lot can be done to minimize the effects and control the inflammation. There are over 119 different types of arthritis and musculoskeletal conditions. 4.6 million diagnosed with arthritis. 4.4 affected by osteoarthritis

National Facts 4.6 million people diagnosed with arthritis 3 million with osteoarthritis 1.6 million with inflammatory condition many people have more than one form of arthritis

Provincial Arthritis Facts – Manitoba 250,000 people live with arthritis everyday in Manitoba Arthritis is the most common cause of long-term disability

Future of Arthritis Our next generation will be facing: 1in 4 with arthritis Osteoarthritis diagnosed every 60 seconds Rheumatoid arthritis diagnosed every 11 hours increase in Rheumatoid arthritis will be increased by 63% Over 10 million with arthritis

Why should I control my arthritis? Controlling your arthritis will help you to: reduce or eliminate pain continue to participate in daily activities prevent the disease from progressing reduce or prevent disability Maximize long term quality of life To participate in daily activities  To optimize mobility with minimal or no restrictions One may be able to prevent the disease from progressing to the point of joint deformity (which is permanent if it occurs) Achieving all of these goals will help to maximize your quality of life. 9 9

INTRODUCTION The Arthritis Society would like to provide you with information to make your own choices in managing your pain. Many people feel that there is nothing they can do about their pain. We will share ways to minimize, not eliminate your chronic pain.

What is Pain? Pain starts in different parts of your body but lives in your head. Acute Pain – injury or surgery Chronic Pain – over 3 months

Chronic Pain -Can be intermittent or persistent (12+ hrs./day) -Most common causes: arthritis, fibromyalgia and low back pain -Neuropathic pain: disease or injury to the nervous system itself Mayo Clinic says chronic pain may be caused by a process called sensitization.

Pain Cycle When you have disease , you have pain Pain causes tense muscles Tense muscles causes stress Stress makes you frustrated, fearful, angry This puts you in depression, that makes you very fatigued That make the complete cycle of pain.

DAILY PAIN LEVELS: Unmanaged Pain This is what an average level of pain looks like over the course of the day. Up and down.

DAILY PAIN LEVELS: Managed Pain This is what we would like to see. That you try and keep the pain at a reasonable level, more at a constant low, than lots of highs and lows.

Pain Management (physical) Heat: Hot Packs Warm baths or showers Electric blanket or heating pad Hot water bottle Cold: Gel packs Frozen popping corn kernels Heat is used to open up the flow of blood. It enables you to move your joints more easily as the muscles are relaxed from the heat Cold is used to restrict the blood flow. It would be used to help decrease swelling and inflammation. Both modalities can be used for all types of arthritis. You wouldn’t use heat on a joint that is already inflamed The frozen popping corn is regular popping corn placed in a freezer zip lock bag and put in the freezer. It will take on any shape of joint, knee shoulder etc. They can be left on as they will only stay frozen for about 15 minutes and then they take on your skin temperature. They will not cause any burn to the body. If you bag breaks you will have popping corn in the bed!!!

Pain Management (physical) Cautions to observe: Check if feeling is normal. Can you feel hot and cold? Skin in good condition? Do not apply heat over medication patches, as it can cause rapid absorption and side effects. Do not use hot or cold over any form of heat producing cream or ointment.

Pain Management (physical) Consider posture and positioning Supportive chairs Physical options: Massage Therapists Licensed acupuncturist

Pain management Distraction: Lemon Stairs Long time distraction: Gardening, music, movie, book Learning to relax muscles- Jacobson’s Progressive Muscle Relaxation

Managing Stress A daydream A happy event How would you spend a million dollars?

Symptoms of Depression loss of interest in friends or activities isolation or withdrawal difficulty or changes in sleep patterns

Symptoms of Depression loss of interest in personal care or appearance increased or decreased appetite

Symptoms of Depression unintentional weight loss or gain general feeling of unhappiness, crying

Symptoms of Depression loss of interest in sex, intimacy suicidal thoughts frequent accidents

Symptoms of Depression feeling tired or fatigued low self-image, loss of self-esteem frequent arguments or loss of temper feeling confused, lack of concentration

Dealing with Depression Importance of contact with others Planning ahead for a special event Getting out of the house everyday Doing something nice for yourself Doing something nice for others Movement like walking or stretching ENJOYING LIFE SHOULD BE A PRIORITY

Causes of Fatigue Active disease Lack of physical fitness Depression Poor nutrition Medications Stress Poor sleep

Fatigue Management schedule frequent rest periods during the day

Fatigue Management alternate heavy and light work sit to work, if possible communicate about your fatigue with others

Fatigue Management examine your lifestyle and philosophy - are you trying to do too much?

Fatigue Management ask for help use good body mechanics - posture maintain proper weight

Fatigue Management use your joints wisely – there are many assistive aids be organized, plan ahead Ask for help

Fatigue Management Healthy eating Exercise and physical activity Managing fatigue helps break the pain cycle It rejuvenates both the mind and body

Physical activity can help manage arthritis Fact! Physical activity can help manage arthritis (Move stage left) In fact – properly designed physical activity – in combination with other lifestyle changes, such as good nutrition - can actually help you manage your arthritis.

Physical Activity = Exercise = To avoid confusion, let’s clarify what I mean when I talk about physical activity, and what I mean by exercise. In this presentation, physical activity refers to activities that are a part of your everyday life. They include household, workplace and lifestyle activities that can help you become more active. Examples include gardening, mopping, and dusting. Exercise is a type of physical activity that uses exertion to improve physical fitness. Sample exercises we’ll discuss later, and those in the booklet have specific benefits for people with arthritis. The reason we make this distinction is that, when some people hear the word exercise, images of busy gyms and treadmills come to mind. Exercise is only one way to be physically active – there are other ways that suit many different needs. Even parking farther away from the entrance to the grocery store counts as physical activity. You do not need a fancy gym membership to exercise control over arthritis! 35

4 people in this picture. Notice how happy they are 4 people in this picture. Notice how happy they are. They have found an activity that they love to do, so that keeps them all very active all week. In this picture they have, hip and knee replacements, mastectomy, scoliosis, fibromyalgia, relapsing remitting polychondritis, post polio syndrome, osteoarthritis, rheumatoid arthritis. The importance of getting out, exercising and being a social butterfly. 36

Benefits of Exercise & Physical Activity Increases strength, mobility & balance Decreases pain and disability Increases blood circulation & joint nutrition Decreases body fat Decreases stress Improves bowel & bladder function Improves sleep patterns Improves heart & lung efficiency

Programs and Services We offer a self management program: Ease the Pain: Take charge of Arthritis Presentations on the different types of arthritis. Arthritis friendly exercise programs: Tai Chi for people with arthritis, PACE, Land Arthritis aquatics and Ai Chi - Water

PAIN MANAGEMENT TEAM YOU ? Podiatrist Social Worker Community The Arthritis Society Podiatrist Social Worker Community Resources Spiritual Leader Dietitian Occupational Therapist Psychologist YOU Pharmacist Registered Massage Therapist Colleagues Family Physician Nurse ? Rheumatologist Physiotherapist Family & Friends Nurse Practitioner

Contact Us: National website: www.arthritis.ca Phone: (in Winnipeg) 204 942-4892 Fax 204 942-4894 Toll free: 1-800-321-1433 Address: 105-386 Broadway, Winnipeg, R3C 3R6 E-mail: info@mb.arthritis.ca