If you have arthritis, whether osteoarthritis or inflammatory arthritis, you might have thought about getting a cane or other assistive device to make everyday tasks easier. It can be a scary prospect psychologically — you might wonder, “Will having a cane mean I’m disabled?”
But a cane can help you stay mobile, active, and even safer. “I started using one when I kept having near-falling episodes, and then I fell and fractured my heel,” arthritis patient Angela Brown told us on Facebook. “I have been using one since. It has saved me on numerous occasions.”
How Canes Help Manage Arthritis Pain
There’s no doubt that canes can be beneficial for people with arthritis: One study even found that using a cane can actually help reduce the disease progression of OA. But how do you know when it’s time to get one?
“The use of cane is suggested in patients with chronic pain, balance, or gait issues,” says Shraddha Jatwani, MD, FACP, FACR, a rheumatologist with St. Vincent Medical Group. “Canes are used to reduce the weight bearing for the arthritic joint, thereby reducing pain, or to assist with balance when the balance problem is due to impaired sensation and/or mild leg weakness.”
Even though osteoarthritis and inflammatory types like rheumatoid arthritis affect the body in different ways, the symptoms that lead patients to get a cane are similar, says Greg Hartley, PT, DPT, a physical therapist at the University of Miami, president of the Academy of Geriatric Physical Therapy, and a spokesperson for the American Physical Therapy Association.
“The resulting pain is often the same, and that pain is what typically drives people to have difficulty walking and putting weight through the joint,” he says. “A cane is useful because it helps to offload the pressure that goes through the joint, allowing people to be more independent and stay ambulatory.”
Should You Get a Cane, Walker, or Scooter?
The type of assisted device you should get depends on your individual needs. “Patients should be evaluated for their endurance, balance, and ability to bear weight before selecting mobility aids,” Dr. Jatwani says. “Canes are most useful when the gait problem is unilateral [on one side] or is mild. It is most beneficial in unilateral arthritic problems like unilateral hip or knee OA.”
Assistive devices fall on a scale of least to most assistive, from canes to walkers all the way to scooters. “Walkers generally are used to treat bilateral gait problems, or when more body-weight support or balance support is needed than a cane can provide,” Dr. Jatwani says. Crutches or walking poles can also be used for bilateral issues.
Additionally, some people with very bad hand arthritis aren’t able to hold a cane. They find walkers that they can push with their forearms are better suited for them. “There are times that [using a cane] is difficult when my hands hurt really badly,” arthritis patient Jeannine Dawn Arteta wrote on Facebook. In addition, “patients should have good arm strength and coordination to be able to use a cane,” Dr. Jatwani says. “Usually patients with endurance issues, such as COPD or heart failure, are not good candidates for canes. They should use walkers or wheelchairs.”
But other people find walkers too hard to take around with them, and canes to be more convenient. “I have ankylosing spondylitis and started using a cane when I began to have problems walking. I live alone and it is too difficult to use a walker without someone to get it in and out of the car,” Ailsa Turrell told us on Facebook. You might also choose to use a cane in certain situations and a walker in others.
When possible, Dr. Hartley advises avoiding buying a scooter unless you really need one. “Once you start using a scooter it can really kind of snowball and you can get more and more de-conditioned,” he says. “You really want to try to stay active as long as possible. Once you get into the habit of using those it’s very difficult to get out of.”
Of course, if a scooter or wheelchair is the only way you can be mobile and engaged in social activities, you should use one — but they are generally not a starting point. Before purchasing one, consider borrowing one when needed at the grocery store, airport, or other places that require a lot more walking than usual.
Dos and Don’ts of Using a Cane
There are tons of cane options to choose from. Here are some tips to ensure you pick the right one for your needs.
Do pick a cane that’s adjustable. For example, a wooden cane may look cool, but chances are it won’t be exactly the right height without your needing to saw off the end.
Do pick a cane that feels comfortable. “Number one is make sure you’re getting a cane that is adjustable; number two I would recommend that a cane have some sort of a soft hand cushion that’s going to be comfortable,” Dr. Hartley says. “Third, make sure that it is fit appropriately to the right height.” The handle of the cane should hit at your wrist when your arm is hanging at your side. He also advises making sure the rubber tip on the bottom is replaced as needed so it doesn’t wear through.
Don’t hold the cane on your weaker side. When using a cane, you might be tempted to hold it on your weaker side — but that would be incorrect. “A cane should be used in the hand opposite to the affected limb, hip, or knee, and should be advanced with the affected limb when walking,” Dr. Jatwani says. “It helps preserve a normal gait pattern and keep the body weight over the base of support to ensure good balance.”
Do see an expert to make sure you’re using the cane properly. Most importantly, you should see a professional to make sure the cane is right for you and that you’re using it properly. “Ideally, the patient should be fitted for a cane and instructed in its use by a physical therapist,” Dr. Jatwani says. Dr. Hartley agrees, noting that he sees people all the time with ill-fitting canes. This can be a fall risk or actually make your condition worse. “I was in New York recently and I stopped a woman on Fifth Avenue. I said, ‘I really have to fix your cane!’” he laughs.
When to Use Your Cane
Having a cane doesn’t mean it has to be attached to your hand permanently. You may find you only need a cane during an arthritis flare, or that certain situations require using the cane and others don’t.
“People can often get around their house OK,” Dr. Hartley says. “But anywhere there is uneven terrain, slippery terrain, or anywhere that is unfamiliar and you don’t know what to expect, then you would want to take it with you. The other use is if you have difficulty walking a distance.” You may feel more secure getting out and about if you know you have your cane with you for when you get tired. It’s important to take it with you when you travel.
Adjusting Emotionally to Using a Cane for Arthritis
Although canes might seem to signify to you that your disease has progressed, try to reframe your thinking to how your cane is helping you maintain your quality of life.
“I try to encourage patients to stay as independent as possible for as long as possible, and that means staying active andengaging in your environment,” Dr. Hartley says. “To the extent a cane would allow you to do that, then you ought to be using it.”
Arthritis patient Joan Wzontek Alba says whether you’re on the first stepping stone of a cane or all the way to a wheelchair, use your device with pride. “Never be ashamed of whatever mobility aid helps you,” she says.