I. What is osteoarthritis
Osteoarthritis is also called degenerative arthritis, commonly known as “bone spurs”, “osteophytes”, but in fact is not an inflammatory disease, mainly degenerative changes, is the aging and wear and tear of the joints, especially the aging of joint cartilage. Osteoarthritis represents the aging of the joints and is therefore called age-related arthritis. Osteoarthritis is the most common joint disease and the prevalence increases rapidly with age; more than 50% of people older than 65 years have radiographic evidence of osteoarthritis, but 25% will be symptomatic. 80% of people older than 75 years will be symptomatic. Osteoarthritis is the leading cause of pain and disability in older adults.
The main cause of osteoarthritis is the destruction of articular cartilage, the softening and loss of elasticity of the articular cartilage matrix, the loss of strength, and the sclerosis or cystic degeneration of the subchondral bone and the formation of bone fragments. This results in pain and movement disorders, which can lead to severe disability of the affected limb. Although osteoarthritis begins in the articular cartilage, it affects the entire joint structure, including the subchondral bone, ligaments, synovium, joint capsule and extra-articular muscles, and eventually results in joint deformity and loss of function due to total loss of articular cartilage.
Osteoarthritis is a degenerative disease of the joints that used to be thought of as a disease unique to the elderly, but recently it has been discovered that human joints can develop asymptomatic degenerative changes as early as 30 years of age, or even younger. When you reach the age of 40 or 50, you will experience symptoms that indicate that the degeneration of your joints has reached your bones and it is too late to start paying attention. Osteoarthritis can occur in joints throughout the body and manifests as pain, swelling, friction sounds, deformities and limited movement in the corresponding joint. However, the incidence of osteoarthritis of the knee is the highest. Approximately 41% of patients with osteoarthritis have osteoarthritis of the knee. This is because the knee is a heavily loaded, active joint that is susceptible to trauma, strain, and wind and cold irritation. Simple knee degeneration first appears in the patellofemoral joint, and knee pain can appear in the 30s and 40s, manifesting as pain when going down steps and pain when standing up from a squat, but no discomfort when walking on a flat surface. When squatting, abnormal friction can be felt by touching the knee joint with the hand. Some patients may also experience swelling of the joint. This stage of the disease is often diagnosed as “chondromalacia patellae”. Osteoarthritis of the knee is a very slow progressive disease, taking more than 10 years or more from the first painful episode to the advanced stage of the disease. However, many factors can accelerate the progression of the disease, including significant internal or external knee deformity at a young age, overweight, or jobs that can aggravate the knee joint, such as long-term squatting, mountain field work, etc.
Second, what is the cause of our joints
The cause of osteoarthritis has yet to be studied in depth. At present, the disease is generally divided into two major types of primary and secondary. Primary is the most common.
1, age: age is the most risk factors, the incidence is directly proportional to age. With aging, repetitive use of the knee joint can stimulate inflammatory changes in the cartilage. In addition, the decrease in mucopolysaccharide content in cartilage in old age, the loss of chondroitin sulfate in the matrix, and the decrease in toughness make it vulnerable to mechanical injury and degenerative changes. Especially in more than 45 years old women are common, more than 50 years old women about 60% will be affected by this disease.
2, obesity: obese weight increases the load on the joints and due to changes in posture, gait, etc., resulting in changes in the biomechanics of the joints. Most obese people knee osteoarthrosis common site concentrated in the medial cartilage. Especially the lack of exercise obese people are more likely to suffer from this disease.
3, genetic: the prevalence of osteoarthritis in different races and populations is different and this inference is drawn.
4, estrogen: the incidence is higher in women and increases significantly after menopause, and is related to the discovery of estrogen receptors in articular cartilage. Therefore, many scholars inferred that the occurrence of osteoarthritis in female patients is related to estrogen.
5, climate factors: people who often live in a humid, cold environment have more symptoms. This may be due to the bottom of the temperature and poor blood circulation in the bone.
6, joint morphology: many patients with knee osteoarthritis have congenital knee valgus deformity or patellar subluxation deformity, etc.. The imbalance in the line of force makes these patients more susceptible to osteoarthritis than others of the same age.
7, joint strain: occupational types of work (miners, field workers, athletes, textiles, etc.) have a high prevalence. This means that strain on the joints can increase joint degeneration. Studies have shown that the incidence of knee pain and knee osteoarthritis in residents of buildings without elevators are higher than those in cottages.
8, other: joint trauma: fractures, dislocations, cruciate ligament and meniscal injuries can increase the local load and wear on the cartilage surface of the joint; severe trauma, especially fractures, may also change the function of other parts of the joint, leading to osteoarthritis. Rheumatoid arthritis, large osteoarthrosis, gout, diabetes, scoliosis and other diseases can lead to osteoarthritis of the knee joint.
Third, experts teach you how to self-care and self-medication of osteoarthritis
At present, medicine has no ability to reverse the course of osteoarthritis, and the condition of most patients will continue to develop and worsen. Therefore, the vast majority of patients require treatment. The basic goals of treatment are to relieve symptoms, improve function, delay the process and correct deformities, and improve the patient’s quality of life. Therefore, conservative treatment cannot completely cure osteoarthritis, but it can relieve the symptoms and slow down the process. Only in advanced stages, the use of artificial joint replacement surgery is the fundamental method to completely solve osteoarthritis.
1, self-care and self-medication The main treatment for osteoarthritis is non-pharmacological. Its preferred method is to implement a proper lifestyle and to master the relevant health knowledge. This has a better effect on reducing pain, reducing the number of visits to the doctor, improving the quality of life and maintaining joint function. This includes appropriate physical exercise, diet modification, weight loss, muscle strengthening and related physical therapy, etc.
1) Actively eliminate or avoid causative factors: Relieve stress and rest: Help patients to face the disease and build up confidence. Do not overload the joints, get wet, or get cold. Avoid prolonged standing and sitting, and do not leave the joints in a certain position for too long. Eliminate factors of joint strain: obese patients should lose weight appropriately, ride more, walk less, climb less, climb stairs, etc. According to the specific situation within the scope of the condition allows the correct and appropriate physical exercise to improve the metabolism of nerves, muscles and bones and joints to slow down the rate of its aging progress. This is because muscle exercise to increase joint stability not only relieves joint pain, but also prevents further development of the disease and facilitates its recovery. It should never be assumed that rest and inactivity is the only way to protect the joints. This is especially important for the weight-bearing knee joint. Pillows under the knee to relieve pain during sleep should be avoided. Wearing a knee brace or an elastic bandage is very helpful in protecting the knee and other joints.
2) Exercise therapy: Exercise for patients with osteoarthritis should be divided into two. Proper and appropriate exercise can prevent, delay and slow down the process of osteoarthritis. Beneficial exercises include: swimming, walking, cycling, supine straight leg raises or resistance training and non-weight bearing joint flexion and extension activities. Incorrect excessive exercise can aggravate osteoarthritis. Harmful exercises are those that increase joint torsion or overload the joint surfaces: activities such as climbing hills, stairs or squatting and standing. Appropriate sports exercises are quite beneficial in maintaining and improving joint movement and enhancing muscle strength of the affected joints. Active non-weight-bearing exercises are the main exercises to enhance muscle strength first, and then gradually practice to increase joint mobility.
Attachment.
Four-step practice method: A straight leg raise exercise: supine, the affected knee straight up 30-40cm, the heel is equivalent to the height of the toe on the healthy side, try to maintain in this position, can not hold on to rest the same time, the above count once. Then repeat the exercise, 10-15 times per group. Twice a day. If you can hold on for more than 1 minute, you can do weighted straight leg raise exercise. B weighted straight leg raise exercise: the same action as above, the back of the foot should carry a certain weight, can start from 1 kg, gradually increase to 5 kg, if you can hold on for more than 1 minute, you can do the next exercise. C weighted short arc exercise: the patient sits on the edge of the bed, a pillow under the affected knee, make it bend the knee 30 °, the affected foot weighted from 5 kg to start, gradually increase to 10 kg, sit on the edge of the bed. The patient sits on the edge of the bed with a pillow under the affected knee so that the knee is bent at 30°, the weight on the affected foot starts from 5 kg and gradually increases to 10 kg, and sits and lifts the leg to straighten the exercise, if the patient can insist for more than 1 minute, the next exercise can be performed.
Sitting knee extension exercise: the patient is placed on the bed, the affected knee is straightened as much as possible, the foot is extended, the ipsilateral hand presses down on the knee, the contralateral hand bends to reach the foot.
Sitting knee swing flexion and extension exercises: the patient sits on the edge of the bed, with the affected calf hanging down, and presses the affected limb with the help of the healthy limb to increase flexion.
Supine knee flexion exercise: the patient lies on his back, the affected limb is flexed at 90°, the affected knee is flexed as much as possible, and the healthy limb is used to assist in pressing the affected calf to increase the flexion of the knee joint.
Kneeling knee flexion exercise: The patient sits on his knees in bed and kneels backwards on his own to increase the angle of knee flexion. Lie down and “pedal the tricycle”: Every morning and evening, lie down in bed and imitate the action of pedaling the tricycle. The lying position can reduce the burden of the easily damaged joints; all joints from the ankle to the shoulder joint should be exercised.
Water exercise: Water exercise is supported by the buoyancy of water and can reduce the pressure of weight on the knee joint, especially in obese patients. It also helps to strengthen the patient’s cardiorespiratory function, improve muscle endurance, even if they accidentally fall, so it is not easy to lead sports injuries, more use of swimming can help the recovery of patients with osteoarthritis of the knee.
2. Diet therapy.
Currently targeted dietary therapy seems to lack in-depth research. The most common is the propaganda of supplement}. Patients with osteoarthritis of the knee should be given adequate attention in their diet.
Consume foods high in calcium: to ensure the normal needs of bone metabolism. The calcium intake of the elderly should be increased by about 50% compared to the average adult, that is, not less than 1200 mg of calcium per day composition, so it is advisable to eat more milk, eggs, soy products, vegetables and fruits, and if necessary, calcium supplements. However, there should be noted that calcium deficiency in the body mostly leads to leg cramps and osteoporosis, and osteoarthritis both have great differences in pathology and clinical manifestations. From a medical point of view, osteoporosis produces “osteophytes”, and this “osteophyte” is related to the above-mentioned osteophytes due to osteoarthritis and jointly affects the production of osteoarthritis disease, so calcium supplementation for the prevention and treatment of osteoarthritis disease It is not obvious that it will be effective, so do not stop other treatments just because you have taken calcium supplements.
Eat high amounts of vitamin D foods: Vitamin D can help the absorption of calcium. Therefore, you should take more D dairy products or tablets containing D to help the absorption of calcium.
Increase the intake of multivitamins: Vitamin C tablets are essential for antioxidants and type II collagen synthesis. Recent studies on micronutrients for osteoarthritis have found that a high intake of antioxidants, especially vitamin C, may protect the joints to prevent the progression of osteoarthritis, so taking vitamin C orally is beneficial. Other elements such as A, B1, B6, B12, C and D as well as elements necessary for building bone such as minerals like calcium, V, selenium, zinc and gummy foods increase intake appropriately. Joint protection and supplementation to prevent osteoarthritis
Although it is not yet possible to completely prevent osteoarthritis from occurring, there are measures that can be taken to reduce or delay the onset of osteoarthritis. These measures include reducing weight, avoiding high heels, protecting the joints from injury, such as avoiding repeated impact or torque on the joints, minimizing frequent ascent movements, repairing or suturing through arthroscopy if there is meniscal damage, treating joint ligament damage in a timely manner, and surgical anatomical repositioning of intra-articular fractures. If there is a deformity around the joint, surgery should be performed in time to correct the deformity. In addition, taking Vit A, Vit C, Vit E and Vit D supplements may also have a preventive effect on osteoarthritis.
Degenerative changes in cartilage may begin in the early 20s, and most people over 50 years of age can show osteoarthritis on X-rays. The key is to prevent the aggravation of the lesions from having a negative impact on life. In the “Bone and Joint Decade” program, it is believed that many doctors, health professionals, patients, and community groups will work together to raise awareness of musculoskeletal disorders and to further research and develop treatment and prevention measures. Advances in prevention, diagnosis, treatment and research will greatly improve the quality of life of older adults and bring benefits to the population.
Be proactive in your prevention efforts and be aware of early warning signs of arthritis: 1) pain, 2) joint stiffness, 3) swelling that sometimes occurs, and 4) difficulty moving the joint. If any symptoms occur within or around a joint and persist for more than 2 weeks, seek medical advice. Early detection and treatment is most important.