Hello,
My wife has been diagnosed with Crohn’s Disease (~2011) and has tried nearly all of the medications to control the symptoms. They typically last a few months to a few years, currently she is on Azathioprin and Stelara. The GI symptoms are currently under control but she is having joint pain. She has seen a Rheumatologist, they said it is not RA but IBD-Associated Arthritis. I’ve read Dr. Baraki’s article on OA, listened to your podcast on it, and looked at the other threads in the forums. Aside from fish oil what other options are there to try and manage this? Are barbell exercises still a good to be doing with an inflammatory type of arthrits?
Thanks!
Does she do any exercise at all right now? This is one of those situations where you’ll have to start gently, increase slowly, and see how she does.
Exercise in general is known to have net “anti-inflammatory” systemic effect, and may provide her with some benefit – BUT the caveat is that her disease needs to be sufficiently well controlled that she can tolerate the exercise in the first place. With that said, we have LOTS of evidence of clear benefit from progressive resistance training in patients with rheumatoid arthritis (far less evidence on the other inflammatory arthritides).
The other, more complex piece here is the role of the brain. If you haven’t read my article “Aches and Pains” on the Starting Strength website and some of the associated resources from PainScience.com, I’d suggest you do so. While she does have a very clear biologic reason for pain (her autoimmune disease), psychosocial factors (anxieties, fears, and expectations about her pain) and things like Central Sensitization absolutely play a role here as well. In other words, even if her disease is biologically controlled, if she is anxious, fearful, and expecting that “hard” exercise will exacerbate her symptoms, she’s less likely to do as well with training. She needs to understand that exercise is generally safe, and that fluctuations in symptoms are expected and not dangerous.
Hope that helps.
Austin, thank you for the reply it helps a lot! Currently both of our exercise levels are low. Aside from chasing a toddler around, it’s just the occasional walk. I’m beginning the SSLP program, and I’m encouraging her to start as well. I will read the Aches and Pains and associated articles. She has expressed interest but is scared of doing squats as her knee has ‘given out’ randomly in everyday life. I was thinking that replacing full squats with box squats to build strength and confidence would be a good starting point. I got the idea from Starting Strength’s YouTube video teaching Dan an elderly man to squat and they started with them, though they rapidly went to full squats. Any thoughts or suggestions?
Again thank you for your time and expertise.
If you can get her to buy in with that method, I think it’s a fine place to start. That she’s afraid because her knees are randomly “giving out” suggests that she needs this training even more.
Good luck!