Osteoarthritis (OA) is a chronic joint disease characterized by focal degenerative articular cartilage lesions, bone loss, joint marginal bone formation and subchondral bone densification, mainly manifesting as joint pain and varying degrees of functional impairment. For the treatment of OA, still focus on the alleviation of symptoms, preservation or improvement of joint function, until today, there is no drug or surgery can exactly change the pathogenesis of OA, therefore, we should pay more attention to the prevention of OA and non-pharmacological treatment.
I. Patient education and social support
Specific areas of education involve various aspects related to the disease, including disease and joint function, joint protection, posture, energy conservation and psychology, etc., which can be carried out through the following three ways.
1. Community education; community-centered learning sessions on osteoarthritis of the knee are held regularly. Through trained professionals, they teach patients about knee OA prevention and treatment that is of interest to them, and provide training and instruction on relevant skills, especially for patients to understand the conventional mode of knee OA prevention and treatment. In addition, through the course, patients can exchange educational experience with each other.
2.Family education; For patients with serious functional impairment, elderly or impatient treatment in the hospital, family education is very important. Through the education of professionals to patients or family members, they can grasp the knowledge of OA prevention and treatment to facilitate better treatment and care, in order to improve the health status of patients and improve the quality of life.
3, social support: including information support, emotional support and material support, etc., can improve the patient’s understanding of the disease and enhance the confidence to return to society.
Second, exercise therapy.
Obesity is one of the risk factors for the occurrence of OA, especially knee OA. Exercise weight loss, is an effective adjuvant therapy for the treatment of knee OA. For obese patients with knee OA, weight loss is the key to treating the disease. Weight loss through a combination of physical exercise and diet can not only significantly improve the quality of healthy life, but also reduce risk factors, effectively improve the mobility of the affected limb and relieve pain. Exercise according to the specific circumstances of the patient, choose different treatment goals; participate in running and jumping, walking that swimming, etc. not only for mild and moderate OA patients but also for severe patients; but for severe joint pain or poor mobility of obese knee OA patients, exercise to lose weight is very difficult, therefore, can be controlled by diet to lose weight.
Modern medical research, the initial factor triggering OA is a change in the biomechanical balance of the joint, resulting in changes in joint stress, causing disruptions in the metabolism of articular cartilage cells, so through exercise can enhance the soft tissue around the joint toughness, cartilage and chondrocyte sensitivity to mechanical stress.
Third, auxiliary equipment.
For lower limb OA can use walking aids, such as walking sticks, knee pads and orthopedic shoes, to reduce the weight of the affected limb, to maintain muscle strength and joint mobility.
Fourth, acupuncture.
Domestic clinical reports and experimental studies on the treatment of OA with acupuncture are more, and its efficacy has been confirmed by clinical practice. At present, there is general agreement on the mechanism of acupuncture in the treatment of OA are mainly the following aspects:
1, related to the analgesic effect of acupuncture;
2, acupuncture can improve the microcirculation around the nerve root, eliminate inflammatory mediators, inhibit the transmission of injurious information, and relieve muscle spasm;
3, through the promotion of peripheral inflammatory tissue opioid peptide release and play a role in immunomodulation
V. Massage.
Recent experiments have proved that massage can reduce intraosseous hypertension, reduce abnormal blood viscosity, improve intraosseous microcirculation, promote the absorption of local inflammatory substances, thus reducing joint pain. But massage can not enhance muscle strength, nor can it prevent muscle atrophy or secondary atrophy caused by lower motor neuron disease.
Sixth, physiotherapy.
Physiotherapy is based on physiology, pathology, kinesiology, biomechanics, biophysics, biochemistry and other modern medical disciplines, the use of a variety of physical factors and movement factors through the nerve, body fluid system regulation on the human body to exert influence. The main ones are
1.Thermal therapy: commonly used thermal therapy are: short wave, microwave, ultrasound, transcutaneous electrical nerve stimulation, pulsed electromagnetic field therapy, etc.; thermal therapy is conducive to the stretching of tendons and muscle relaxation after exercise.
2, hydrotherapy: hydrotherapy is probably one of the most effective ways to improve joint function through the reduction of joint pain and muscle relaxation. Because the body weight in the water is only up to 1/8 of the land.
3, sand therapy: sand therapy is the use of a certain temperature of hot sand buried in the body, applied in many countries to treat rheumatic diseases do have efficacy, but the mechanism of action is little research; is generally recognized as the surface heat to enhance the elasticity of the joint collagen, reduce muscle spasm.
In conclusion, in the treatment and rehabilitation of OA, a single treatment method is ineffective and should be used for individual OA patients. A safe, simple and reasonable individualized comprehensive treatment plan should be developed to facilitate the improvement of the efficacy. Although non-pharmacological therapies can help to stop the development of OA and reduce or even eliminate its clinical symptoms, they are often neglected due to the lack of effective methods to confirm their efficacy, which should be taken seriously.