Arthritis comes in many different forms, but each type has one treatment in common: exercise.

"It really is a case of use it or lose it," Dr. Sean McMillan, rheumatologist at LDS Hospital, said during Saturday's Deseret Morning News/Intermountain Healthcare Health Hotline.

It's also not necessarily advice someone wants to hear when it hurts simply to move part or even a lot of your body. But "when muscles decondition, they atrophy and shorten up, which makes it worse," he said. "It's a vicious cycle. I pretty much require some physical therapy for my patients early on."

The formalized physical therapy is intended to show patients how to exercise for benefit without further stressing painful joints. It has to be done properly. And even active people, he noted, sometimes need a refresher.

Saturday's hotline on arthritis was extraordinarily busy. Dozens of callers waited 15 minutes or more to talk to the specialists, McMillan and Dr. Don Stromquist, also a rheumatologist at LDS Hospital.

Most of the calls concerned osteoarthritis, the most common form of the multi-faceted disease. It results from injury or wear and tear over time and typically affects older people — although increasingly doctors see patients in their 50s who require treatment.

Stromquist also recommended physical therapy and exercise to many of the callers. It's a non-pharmaceutical and important part of treatment that can bring a lot of relief. And it helps with weight control, which is a big issue if someone has arthritis in weight-bearing joints like the hips, knees or ankles. Even dropping a few pounds can reduce a lot of the stress on those joints.

"It needs to become part of your lifestyle," McMillan said.

Many of the callers said they suspect arthritis but don't know where to get help. Stromquist said people who have a family doctor should start there. But he said they also need to ask the right questions. Then he coached them on some of the things they might ask, depending on their situations.

It's not something, he said, that can be diagnosed in a phone call.

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Stromquist also noted that many of the callers he talked to, especially the older ones, seemed to think, "Why bother? I'm old, can they do anything for me?" The truth, he said, is many very elderly people, including arthritis sufferers, have a very good quality of life. They're active and, if they have pain, it can be managed with medications and exercise to strengthen the support system around the affected joints.

One woman said she had a knee replacement, but now her hip hurts. Stromquist told her to talk to the orthopedic surgeon about what might be causing it.

Both McMillan and Stromquist also noted there are self-help programs, support groups, education and activities sponsored by the Arthritis Foundation of Utah, 1-800-444-4993, or online at

The Deseret Morning News and Intermountain Healthcare team up on the second Saturday of each month to tackle a different hotline topic from 10 a.m. to noon. All calls are confidential.