I. Understanding osteoarthritis.
Osteoarthritis is a common chronic disease with more than 100 types, including osteoarthritis, rheumatoid arthritis, and frozen shoulder disease. 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 pain, swelling, stiffness and severely restricted joint movement due to damage to 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. Not only that, but osteoarthritis also involves abnormalities in bone and cartilage metabolism, the true cause of which has not yet been understood. 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 surface of the bone and acts as a cushion to cushion the joints from vibratory stress during movement, reducing friction and allowing the joints to move freely. When the 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 bone 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.
3. How to recognize 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 decreases after a little activity; if there is too much activity, the pain may 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 disappear only after a period of slow recovery. Some patients can even hear a “creaking” sound when they move their joints. In advanced stages of the disease, the joints are severely damaged and can only bend stiffly.
Osteoarthritis can develop in any joint, and 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, the respective characteristics of which 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, localized stiffness, pain, swelling, warmth and other symptoms, whether walking, going up and down stairs, getting up, sitting down Pain, even bathing will 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 site, 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 osteophytes, small joint synapses degeneration. Therefore, cervical and vertebral arthritis is often caused by localized 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 with a certain intensity are more likely to suffer from shoulder and elbow arthritis due to frequent use of upper limb lifting or weight bearing, such as household chores, heavy lifting, wiping doors and windows, lifting furniture, etc., which can easily cause wear and tear on the shoulder and elbow joints. 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 you lift it over your head.
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 also appear in the proximal finger joint. As a result, the fingers become thick and bony, with numbness or pain and stiffness.
4. How to treat osteoarthritis.
Osteoarthritis often causes unbearable pain and many inconveniences to patients, but there is no complete medical cure for arthritis. If the disease 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 somewhat limited.
2.Analgesics
3, non-steroidal analgesic anti-inflammatory drugs: because the patient site has an inflammatory response, simple analgesic drugs 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 effect. 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. The active ingredient of topical non-steroidal analgesic anti-inflammatory drugs is diclofenac, which is a boon for patients with chronic osteoarthritis. Diclofenac can inhibit pain factors (such as prostaglandins and leukotrienes) by inhibiting cyclooxygenase and lipoxygenase, so it has strong analgesic, anti-swelling, anti-inflammatory and anti-rheumatic functions. The emulsion form combines the lipophilic and hydrophilic properties of both emulsion and gel, thus enabling the active ingredients to penetrate the skin quickly and reach the affected area, providing timely anti-inflammation and analgesia. Clinical application shows that the emulsion can have satisfactory effect on neck, shoulder, waist and leg pain, degenerative osteoarthritis with bone spur; it also has special treatment for soft tissue trauma and rheumatoid arthritis; it can also have unexpected effect when combined with topical Fotarin emulsion for massage, massage and physiotherapy. At the same time, it has the advantages of being colorless and tasteless, not polluting clothes, easy to apply locally, cool and comfortable, and convenient to carry. In terms of pharmacoeconomics, Fotaralin emulsion is also an economical and reasonable non-body topical analgesic and anti-inflammatory drug. Therefore, it is a good choice for long-term anti-inflammatory treatment. Reminder of medication: If you use 3-5 cm or more of Fotarine emulsion each time, 3-4 times a day, gently rubbing, so that the product penetrates the skin, you can achieve the best therapeutic effect.
4.Physical therapy: Ultrashort wave physiotherapy 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 not only makes the muscles around the joints more powerful and gives the joints stronger support, but also relaxes the tense muscles and relieves 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, it should be noted that exercise is not recommended during acute attacks, and rest is the mainstay; the intensity of exercise should be moderate, so as not to cause joint pain as the limit; sports that can increase joint flexibility, stretch and strengthen muscles should be chosen, such as swimming, walking, cycling, etc.; attention should be paid to prevent the joints from inappropriate stress and violence during exercise.
B. Lifestyle changes: For example, 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.