Osteoarthritis of the knee: comprehensive treatment and self-care

  The knee joint is the largest weight-bearing joint in the human body. The articular cartilage covers the joint surface at the end of the bone, like a cushion, keeping the joint surface smooth so that the bones can slide freely with each other and absorb the energy generated by the vibration of the body during activities. As we age, the cartilage of the joint degenerates and becomes less elastic, and the bones and joints are unknowingly worn down, initially by local softening and breakage, and the smooth joint surface becomes rough, and then cracks and erosions appear, causing the subchondral bone plate to be exposed, which causes the bones beneath the cartilage to rub against each other and cause damage.  Therefore, we say that osteoarthritis of the knee is a heterogeneous group of diseases characterized by degenerative changes in the articular cartilage and the formation of bony redundancies at the edges of the joint, mostly in middle-aged and elderly people. It is characterized by stiffness, swelling, pain, popping, joint effusion, and limited movement of the knee joint, making it difficult to walk, climb, stand up or sit down from a chair, or bathe in a tub, and especially painful when going up and down stairs or slopes. If left untreated, the ligaments of the knee are often overstretched and the joint becomes unstable, eventually deforming the knee and leading to bowed legs and disability.  At present, the treatment of osteoarthritis of the knee is mainly in the following two aspects: 1. Non-surgical therapy: under the guidance of a doctor, the choice of drug therapy and physical therapy, including Chinese herbal medicine and Chinese medicine, such as nourishing the liver and kidneys, dredging the meridians and channels or blood circulation, anti-inflammatory, pain relief drugs taken internally or fumigation; the choice of non-steroidal anti-inflammatory analgesics, adrenal corticosteroids, joint cartilage protectors or sodium hyaluronate intra-articular injection The use of physical therapy, traction, tui na, acupuncture, local joint medication, etc., according to the situation.  2.Surgical treatment: for intractable pain, unstable joints or obvious loss of activity, surgical treatment can be considered, surgical treatment is divided into two categories: one is to preserve the joint surface, reduce pain, improve function, delay the development of osteoarthritis surgery, osteotomy, joint cleaning, autologous or allogeneic periosteum, cartilage membrane, cartilage transplantation; the other is for advanced osteoarthritis, seriously affect the function and life The other category is for those with advanced osteoarthritis that seriously affects function and life, artificial joint replacement is feasible.  Along with proper treatment, effective functional exercise and good self-care are also crucial to treat and prevent the development of osteoarthritis of the knee. It is important to note that all exercise programs should be developed by a specialist on a case-by-case basis to avoid blindness. Aerobic exercise is advocated, while anaerobic exercise is not appropriate.  Aerobic exercise is exercise that effectively inhales and uses oxygen and generates heat through breathing during exercise. Aerobic exercise is characterized by long duration, enhances endurance and burns excess fat without accumulating fatigue. Common aerobic exercises include walking, brisk walking, jogging, calisthenics, aerobic dance, tai chi, cycling, swimming, etc. Water exercise is ideal for people with osteoarthritis. The water temperature at 36°C can reduce muscle pain, and the buoyancy of the water reduces the stress on the joints, increases the pain-free range of motion of the joints, and provides resistance to muscle exercises. It is important to take care of the activities according to your strength, to strengthen joint care through rest and exercise, to maintain a healthy lifestyle and good mental state, and to maintain an appropriate weight to reduce the burden on the joints.