Berlin  - Like shocks in a car, cartilage provides a buffer, keeping the various bones in a human body from painfully jarring into each other during everyday activities.

Damage to this protective substance results in arthritis, with ailments all too familiar to most patients: pain, difficulty moving and infections. If the wrong joint is affected, every step taken can become torture. Unfortunately there's no way to heal arthritis.

"Unlike other human tissue, cartilage doesn't regenerate. There's no way to reverse the degradation," says Martine Eisele, an advisor at a clinic run by German insurer Techniker Krankenkasse.

That means patients need to find ways to live with the ailment and the pain it brings.

"Typical problems in the early stages of the disease include early morning pains," says Eisele. Starting to move often means serious joint pain, which subsides as the motion continues. In other cases, a patient might feel no pain, but find it sets in during the first steps after standing up. This kind of pain tends to go away after a short while.

However, chronic pain has a whole different character.

"Knee joints come under serious stress with jumping, sprints or lots of knee bends," says Martin Talke, an orthopaedist and rheumatologist in Berlin. Intense jogging is awful for people with arthritis in their toe, knee or ankle joints.

It's important for arthritics to avoid extreme or overexertion.

"But that doesn't mean you can't use the joints," says Nikolaus Wuelker, a professor of orthopaedics at Tuebingen University's clinic. "Just the opposite. Smooth, balanced, well-executed exercise movements are very useful."

Those kinds of movements keep the joints spry and provide more nutrients for the cartilage, which in turn slows down the advance of arthritis.

Thus, bicycling is better than walking, which is, in turn, better than jogging. "The best are movements in water, like aquajogging," says Talke. "That's because the strain on the joints disappears when the body's weight is supported."

There are ways to reduce the strains on joints from one's own body weight in everyday situations, for example, by reducing excessive standing. It's also a good idea to consider slimming down.

"Being overweight is a factor that favours the ailment," warns Eisele.

Physical therapy can also help. "It helps strengthen the underlying muscle," says Talke. That, in turn, stabilizes, protects and reduces pressure on the joint. Simultaneously, stressed muscles are relaxed, helping to improve bad posture.

Additionally, depending on the severity of the condition, patients can consider shoe inserts or special soles. There's no way to entirely avoid the pain - but there are ways to help control its severity. (dpa)