Old injuries can cause new problems

A broken or badly sprained ankle can lead to pain years later, but exercise can reduce the risk.

A forgotten injury or illness can come back to haunt you. Here's how to keep problems in the past.

Eighteen years ago, Jeannie Echtinaw was rushing to work, fell down the stairs, and broke her ankle. Fortunately, the fracture healed well. But 10 years later, she developed arthritis in the joint.

"It became weak, swollen, and painful, and today it's hard for me to get around," says Echtinaw, now 58, of Lake Odessa, Mich.

It didn't have to be that way. You probably don't realize that an injury or illness you thought was long behind you can evolve into a new problem years down the road.

But if you've suffered troubles that can deliver a double whammy -- a fracture, a bout of food poisoning, or even a childhood case of chickenpox -- you can reduce your chances of falling victim a second time, or at least find effective ways to cope.

That was then: You broke a bone or tore -- sprained a ligament.

This is now: A fracture near a joint significantly increases your risk of developing arthritis as much as 15 or 20 years down the line, says Dr. William Doherty, an orthopedic surgeon at Melrose-Wakefield Hospital outside of Boston. When you break your arm or leg, you may injure tissues that keep bones aligned; a slight misalignment can cause bones to grind -- wearing away cartilage and causing arthritis. A worse break can crack cartilage, leading more directly to painful joints.

Protect yourself: Exercise regularly. Strong muscles help keep bones in position and absorb the impact of daily activities. Try bicycling or swimming; they're gentle on your joints.

Ease your pain: If you develop arthritis, talk with your doctor about the best treatment. Again, exercise helps: In a 2001 study of older, arthritic women, only 37 percent of those who worked out became limited in their movement, compared with 53 percent of those who didn't exercise. Nonsteroidal anti-inflammatory drugs -- NSAIDs -- can also reduce discomfort. For more serious pain, you may need a cortisone injection directly into the problem area or joint replacement surgery.

That was then: You had food poisoning or traveler's diarrhea.

This is now: Experts say that about 10 percent of people who have an episode of bacterial gastroenteritis -- inflammation of the gastrointestinal tract -- develop irritable bowel syndrome, a chronic condition involving abdominal pain, cramping, gas and diarrhea or constipation.

Protect yourself: The minute you feel food poisoning symptoms, take a bismuth subsalicylate medication such as Pepto-Bismol.

"It may prevent bacteria from clinging to the wall of the gastrointestinal tract and help a you eject the bad stuff faster," explains Dr. Patricia Raymond, an associate professor of clinical internal medicine at Eastern Virginia Medical School. The sooner, the better: It's possible that the longer the illness-causing bacteria stay in your body, the greater the chance your inflammation will worsen and cause IBS later on.

Ease your pain: Prescription drugs like Lotronex can improve severe cases. Probiotics -- foods or supplements containing "good" microorganisms -- can also help and pose no risk. Look for products with at least 1 billion microbes per dose; try Align or Florastor, available online or at drugstores. Hypnosis is another option: More than 70 percent of IBS patients taught to send healing thoughts to their guts saw a significant reduction in symptoms after 3 months of weekly practice, report English researchers.

That was then: You had a case of chickenpox in earlier years.

This is now: You have about a 20 percent chance of developing shingles, according to the National Institute on Aging. The condition comes from a reactivation of the chickenpox virus, which lies dormant in your nerves after your initial infection. It can make an encore, particularly as you age and your immune system weakens. The consequences are serious: Blisters, fever, and fatigue can last for more than a month. In more than 40 percent of cases after age 70, shingles damages nerve fibers, causing long-lasting and excruciating pain.

Protect yourself: Zostavax, the first shingles vaccine, is designed for people over age 60 and cuts risk by about 50 percent. Exercise boosts its benefits -- those who receive the shot and practice tai chi have twice the increase in immunity as those who only get the injection, notes a recent study. Researchers think any activity or meditation may do the same.

Ease your pain: See your doctor right away to discuss antiviral drugs; they can speed your recovery and decrease pain if taken early enough.