TGCTs typically involve the synovium, or thin layer of tissue or membrane that covers the inner surface of the joint spaces; bursae, or small fluid-filled sacs that cushion the bones, tendons, and muscles around the joints; and tendon sheath, or layer of membrane that covers a tendon, according to the National Organization for Rare Disorders (NORD). According to a review published in February 2017 in the journal Orthopaedics and Traumatology: Surgery and Research, there are two main types of TGCT: localized and diffuse. Localized TGCTs, which typically impact the fingers or wrist (although they can also appear in the foot, ankle, knee, and hip joints) are slow-growing tumors that are usually limited to a specific area of the joint. The review says they can be effectively treated by surgically removing the tumor, and the rate of recurrence is low. Diffuse TGCTs, which commonly affect the large joints, such as the knee, hip, ankle, and elbow, are more widespread. If left untreated, they may cause arthritic damage and degeneration to the joint and the surrounding cartilage and bone. This type of TGCT is more difficult to treat with surgery, and the recurrence rate is high, but the Food and Drug Administration approved a new drug called pexidartinib in 2019 for treatment of diffuse TGCT that has been shown to be effective in reducing tumors and improving symptoms. Here are some healthy habits that can be beneficial for TGCT.

  1. Exercise regularly. While no exercises are specifically tailored to TGCTs, Dr. Theodoropoulos says, physical activity in general can help relieve the pain and stiffness caused by the tumors. In general, low-impact exercise such as walking, swimming, or biking can help you maintain a healthy weight, keep your heart healthy, and strengthen your muscles, according to the Arthritis Foundation. Before you start an exercise regimen, be sure to get your doctor’s approval, as the wrong activities may strain your joints.
  2. Watch your weight. A review of existing research published in October 2019 in the Annals of Translational Medicine notes that weight loss is a safe and effective way to reduce knee pain and stiffness in people who have osteoarthritis, and TGCT symptoms, such as pain, joint stiffness, swelling, and reduced range of motion, are similar to those of arthritis pain, according to a study published in April 2016 in the journal Clinical Therapeutics. That study used various scoring scales, including ones used to measure osteoarthritis and rheumatoid arthritis outcome, to evaluate the symptoms of individuals with TGCT. According to a study published in January 2018 in the Interactive Journal of Medical Research, as many as 70 percent of people with TGCTs in their lower extremities have the disease in their knee.
  3. Eat an anti-inflammatory diet. Reducing inflammation can improve your overall joint health, says Theodoropoulos. One way to help do that is to pay attention to your diet. There are certain types of food that can increase inflammation, including red meat, dairy products, and other foods that are high in fat, so it’s a good idea to avoid them. Instead, focus on foods that have been linked to reduced inflammation, such as fruits, vegetables, legumes (beans), nuts, grains, and fish. According to a study published in January 2018 in the journal Nutrients, the Mediterranean diet, which features many of these foods, can help reduce signs of inflammation.
  4. Get your vitamins. Two specific nutrients have been linked to joint health: calcium and vitamin D. Calcium is needed for strong, healthy bones, which can take pressure off your joints. Recommended calcium intake is 1,000 mg a day for men up to age 70 and women up to age 50 and 1,200 mg a day for women over 50 and men over 70. Calcium-rich foods include milk, yogurt, cheese, tofu, canned sardines with bones, and fortified cereals, according to the National Institutes of Health (NIH). You also need about 600 international units (IU) of vitamin D a day or more, depending on your particular health needs. According to the NIH, vitamin D helps your body absorb calcium, aids neuromuscular and immune function, and reduces inflammation to boot. Foods that are high in vitamin D include cod liver oil, salmon, canned tuna, and fortified milk and orange juice. You should be able to get enough of these nutrients by eating a well-balanced diet, but be sure to talk to your doctor about whether you might need a vitamin D or calcium supplement.
  5. Consult a physical therapist. The National Comprehensive Cancer Network recommends that a physical therapist be part of the care team for people with TGCT. A physical therapist can show you exercises to help relieve joint stiffness and strengthen the muscles around the affected joints, both before and after surgery. The American Physical Therapy Association offers basic information on physical therapy and can also help you find a professional in your area.
  6. Pay attention to pain. If you’re feeling joint pain after surgery or radiation treatment for TGCT, it could be a sign that the condition has returned. It may also be an indication that your physical activity levels — exercise or day-to-day activities at work or at home — are taxing your joints. If you feel any discomfort, discontinue all activities that cause pain until you and your care team have had a chance to investigate. “If you’re experiencing ongoing pain and/or swelling, talk to your doctor,” Theodoropoulos says.
  7. Talk to your doctor if TGCT affects your daily life. TGCT typically affects adults between the ages of 25 and 40, with a median age at diagnosis of 30, according to NORD. That means many people impacted by this disease are relatively young working adults. The January 2018 study notes that physicians who treat TGCT should be aware that people with this condition frequently experience symptoms, such as pain and limited range of motion, that can interfere with daily activities and participation in work, sports, and hobbies, even after treatment. Individuals with diffuse TGCT can be particularly affected, because there is a high recurrence rate, and the tumors tend to be more difficult to treat with surgery. If you experience limitations in your daily life from TGCT or feel frustrated, anxious, or depressed, be sure to talk to your doctor. There are ways to address these issues by working with a physical therapist, a mental health professional, or other healthcare providers who can help you manage your TGCT-related concerns.