Q. I'm not that old, but I'm already feeling aches and pains in my joints.

My doctor sent me for blood tests and X-rays and tells me that I have early osteoarthritis from normal wear and tear. What can I do to slow it down?

A. The wonders of modern medicine have extended our life expectancy. As our hearts beat longer, we tend to put more miles on our skeleton. There is a steady increase in people who are fortunate enough to live to an advanced age with a sharp mind, but who feel trapped inside a stiff and painful body.

In the absence of trauma, this is often a combination of osteoarthritis and osteoporosis, which is a separate condition in which bones become thin and brittle.

User-friendly physical activity throughout life is the single best approach to prevent and slow degenerative disease. The most effective regimen involves a balanced triad of activity: cardio combined with resistance and flexibility training.

Cardio is any activity that keeps your heart rate up for a sustained period. Shoot for a minimum of 30 minutes three times per week. If possible, go for 60 minutes six times per week.

The easiest way to determine if your heart rate is up is if you have broken into a sweat. Running, biking, swimming and paddling are the most common outdoor forms of cardio. Every gym will provide you with loads of indoor choices such as the elliptical, the stair climber and the treadmill.

Many cardio activities also provide resistance training, yet often only for one part of the body. A good resistance training workout will cycle through both the upper and lower body each week. Weight lifting is the classic form of resistance training. Loading the long bones of the body is critical to staving off osteoporosis.

The third essential activity to ensure a healthy frame is flexibility training. In our 20s and 30s, we can usually get away with ignoring flexibility training, but by the time we hit our 40s and certainly 50s, those of us who have done only cardio and resistance training start falling victim to a slew of injuries in the spine and extremities. Yoga offers comprehensive benefits that include not only flexibility but also stress reduction and mental focus.

Do you want to get it all in one place? An intensive regimen of yoga, martial arts, dance or Pilates can encompass the entire triad: cardio, resistance and flexibility training. Enjoy!

Dr. Ira Zunin, M.D., M.P.H., is medical director for the Manakai O Mālama Integrative Healthcare Group and Rehabilitation Center, www.manakaiomalama.com. He is board certified in preventive medicine. Submit your questions to info@manakaiomalama.com.