I. Understanding osteoarthritis.
Osteoarthritis is a common chronic disease with more than one hundred types, including osteoarthritis, rheumatoid arthritis and frozen shoulder disease. Among them, osteoarthritis can develop in any joint and is one of the most common causes of disability in adults. Osteoarthritis, also known as degenerative arthritis, is a condition that results in joint pain, swelling, stiffness and severely restricted joint movement due to the destruction of joint cartilage. According to statistics, there are about 190 million people with osteoarthritis worldwide. 50% of people over the age of 50 have osteoarthritis, and 90% of women and 80% of men over the age of 65 have osteoarthritis, and the number is increasing.
Second, why osteoarthritis occurs.
In the past, it was thought that osteoarthritis was a lesion caused by the degeneration of joint cartilage as we age, just as car tires can rupture after years of overuse. In fact, not only that, but the occurrence of osteoarthritis also involves abnormalities in the metabolism of bone and cartilage, the real cause of which has not yet been clarified. However, it has been shown that overloading of the joints is the most important risk factor for osteoarthritis. Under normal conditions, articular cartilage covers the bone surface and acts as a cushion to cushion the joints from vibrational stress during movement, reducing friction and allowing the joints to move freely. When a joint is overactive or weighted, worn or torn, it can cause damage to the cartilage, causing its smooth surface to become rough and uneven. Our body tries to repair the damage by growing new bone tissue, but because this new bone tissue often grows in the form of spurs (bone growths), it can cause painful joint movement and thicken or deform the bone ends, narrowing the spaces between the joints and causing pain, swelling, joint weakness and limited movement. Other risk factors for osteoarthritis include being overweight (obese), multiple joint injuries, joint infections or other diseases, frequent weight bearing (e.g., lifting or bending), and a family history of osteoarthritis.
Third, how to identify osteoarthritis.
The most common symptoms of osteoarthritis are as follows: A pain and swelling: Early on, the joints are only slightly swollen and painful, which can gradually worsen later. The pain is usually more pronounced in the early morning or when the joint has been in a certain position for a long time, but is relieved after a little activity; if there is too much activity, the pain can be aggravated by friction in the joint. B. Stiffness: When the joint changes position after sitting or standing for a long time, the stiffness is more pronounced, and the symptoms will disappear only after a period of time and a slow return to activity. Some patients can even hear “creaking” and rubbing sounds when they move their joints. In advanced stages of the disease, the joints are severely damaged and can only be bent stiffly.
Osteoarthritis can develop in any joint. Joints with high activity or weight bearing, such as the neck, hands, knees, shoulders and elbows, are most prone to wear and tear and degeneration of joint cartilage, and are therefore more susceptible to arthritis, and their respective characteristics are as follows.
1, knee arthritis: the human body is most likely to get osteoarthritis is the knee joint. Arthritis of the knee often involves both knees, with local symptoms such as stiffness, pain, swelling, and warmth, whether walking, going up and down stairs, getting up, or sitting down, pain is felt, and even bathing can be difficult. If left untreated, the joints become unstable due to frequent overstretching of the knee ligaments, and eventually the knee joints become deformed, which can lead to bowed legs and even disability.
2, spinal arthritis: cervical 5, 6 and lumbar 3, 4 as the prevalent sites, this is due to degeneration, relaxation of the vertebral body, intervertebral disc and surrounding ligaments, degenerative protrusion of the intervertebral disc caused by the anterior and posterior edges of the vertebral body with bone superfluous hyperplasia, small joint synapses degeneration. Therefore, cervical and vertebral arthritis is often caused by local osteophytes that compress the nerves in the area, causing pain, weakness, numbness and tingling in the upper or lower extremities.
3, shoulder and elbow arthritis: middle-aged and elderly people who have been engaged in physical labor for a long time or have been engaged in a certain intensity are more likely to suffer from shoulder and elbow arthritis, which is due to the frequent use of upper limb lifting or weight-bearing, such as household chores, extracting heavy objects, wiping doors and windows, lifting furniture, etc., which can easily make the shoulder and elbow joints subject to wear and tear. If you often feel numbness and pain in your upper extremities, you may not be able to use your strength, or even find that your joints are not very flexible during outdoor activities. If you experience a variety of sounds, such as creaking, crunching, or rubbing, you may be suffering from shoulder or elbow arthritis. Sometimes, acute attacks of shoulder arthritis are characterized by a constant dull pain in the shoulder, which becomes sharp and intense when you move your upper arm, especially when -b lifting it over your head, and the pain increases at night, even affecting your sleep.
4. Finger arthritis: Osteoarthritis also often involves small joints that move frequently, especially the joints of the fingers. Osteoarthritis of the fingers has a certain degree of family heritability. The majority of female patients are post-menopausal women. In the distal finger joints, a small bony bump called a “Hippodrome nodule” may appear. A similar nodule, called a “Bouchard’s node,” may appear in the proximal finger joints. As a result, the fingers become thick and bony, with numbness or pain and stiffness.
IV. How to treat osteoarthritis.
Osteoarthritis often brings unbearable pain and much inconvenience to patients, but there is no complete medical cure for arthritis. If it is detected and diagnosed early and treated with appropriate medication and active self-protection as early as possible, the development of the disease can be slowed down and joint function can be preserved to the maximum, so that the patient can continue to lead a normal life.
(A) Drug therapy: The main drugs used for the treatment of osteoarthritis are non-steroidal analgesic anti-inflammatory drugs, analgesics and proprietary Chinese medicines.
1, proprietary Chinese medicine: the main role of proprietary Chinese medicine is to activate blood circulation and remove blood stasis, but the physical fall, Chinese herbal medicine does not have anti-inflammatory effect. If it is a topical oil, rubbing agent, wound ointment, when using often easy to dirty clothes, cause skin allergies, the penetration of drugs will also be limited.
2.Analgesics
3, non-steroidal analgesic anti-inflammatory drugs: because the patient site has an inflammatory response, simple analgesics can not lift the inflammatory symptoms, therefore, the first choice of drugs for the treatment of osteoarthritis is non-steroidal anti-inflammatory drugs, which has a rapid analgesic, swelling and anti-inflammatory effects. a, oral non-steroidal analgesic anti-inflammatory drugs: such as aspirin, ibuprofen, etc., such oral drugs have a common disadvantage, that is, more or less all exist Gastrointestinal side effects, direct damage to the gastric mucosa, and in individual cases, can even cause ulcers and bleeding in the upper gastrointestinal tract. B. Topical non-steroidal analgesic and anti-inflammatory drugs a Fotarine emulsion The active ingredient of Fotarine emulsion is diclofenac. Diclofenac can inhibit pain factors (such as prostaglandins and leukotrienes) by inhibiting cyclooxygenase and lipoxygenase, and thus has strong analgesic, anti-swelling, anti-inflammatory and anti-rheumatic functions. Since the emulsion form is used, combining the dual characteristics of lipophilic and hydrophilic of emulsion and gel, it can make the effective ingredients penetrate the skin quickly and reach the affected area directly, and provide timely anti-inflammation and analgesia. Clinical application shows that the emulsion can get satisfactory effect on neck, shoulder, waist and leg pain, bone spur and degenerative bone and joint disease; it also has special treatment for soft tissue trauma and rheumatoid arthritis; it can also have unexpected effect when combined with external use of Futalin emulsion for massage, massage and physical therapy. At the same time, it has the advantages of colorless, tasteless, non-polluting clothes, easy to apply locally, cool and comfortable, easy to carry, etc. In terms of pharmacoeconomics, Fotarine emulsion is also an economical and reasonable non-corporeal topical analgesic and anti-inflammatory drug. Therefore, it is a good choice for long-term anti-inflammatory treatment. Reminder of medication: If you apply 3-5 cm or more of Fotarine emulsion 3-4 times a day each time and rub gently to make the product penetrate the skin, the best therapeutic effect can be achieved.
4.Physical therapy: Ultrashort wave physical therapy or heat therapy helps to reduce the pain and swelling of the joints during acute attacks, thus improving the mobility of the joints.
5.Surgical treatment: If joint degeneration causes severe pain or mobility disorders, surgery is required if necessary. Surgery can smooth out the rough surface of the bone joint and orthopaedically shape the deformed bone. Artificial joint replacement is feasible for severe patients.
V. How to self-protection.
A, adhere to self-exercise: osteoarthritis patients to participate in exercise is worth encouraging. Moderate and regular exercise can not only make the muscles around the joints more powerful, so that the joints get stronger support, but also relax the tense muscles and relieve the pain caused by muscle tension. Exercise is also beneficial in maintaining the mobility of the joints to avoid stiffness and loss of function. However, attention should be paid to the following: exercise is not recommended during acute attacks, rest is the main focus; exercise intensity should be moderate, in order not to cause joint pain as the limit; should choose sports that can increase joint flexibility, stretch and strengthen muscle strength, such as swimming, walking, cycling, etc.; exercise process to prevent the joint from inappropriate stress and violence.
B. Lifestyle changes: such as weight control through diet control. Obesity increases the weight of the knee joint and is one of the risk factors for osteoarthritis of the knee joint.
C. Avoid overuse of joints: Attention should be paid to avoid overuse of joints in daily life, such as sharing the load as much as possible (using two hands to carry heavy objects), using large joints, (e.g., when pushing doors, try to use the shoulder instead of the hand), and maintaining good posture when standing.
D. Pay attention to the protection of diseased joints: The diseased joints should be properly protected from further injury or excessive activity. If necessary, a brace can be used to reduce the burden on the joint. If the pain in the shoulder or elbow joint is severe, a triangular scarf can be used to suspend the affected limb, and local hot compresses can also help relieve pain and promote recovery.
E. Use of assistive devices: These devices can enhance the patient’s independence in daily life, so that they do not have to rely on others everywhere due to joint pain and restricted activities, such as canes, walkers and other assistive devices.