It is often said that “people get old before their legs, and their legs get old in their joints”, and that older people have more or less joint pain, which many people simply think is “rheumatism”. Osteoarthritis is a degenerative joint disease that manifests itself as joint pain and restricted movement, and is most common in middle-aged and elderly people. Early prevention and treatment can minimize joint damage, reduce patients’ pain and improve their quality of life. Since 1998, World Arthritis Day has been celebrated on October 12 every year to draw attention to osteoarthritis and to remind people of early prevention, early detection and early treatment. The most common sites of osteoarthritis are the joints of the hands, knees, hips and spine, and the main lesions are cartilage destruction and osteophytes caused by various factors. Osteoarthritis is irreversible and early detection and treatment to slow down the progression of the disease is the main treatment principle. What are the risk factors? The pathogenesis of osteoarthritis is complex, but the following major risk factors are considered to be closely related to it. 1. Age Surveys show that the prevalence of the disease is 10% to 17% in people aged 40, 50% in people aged 60 or older, and up to 80% in people aged 75 or older. It can be seen that the number of osteoarthritis is increasing with age. Advanced age is the most direct risk factor for osteoarthritis, and research suggests that this is related to the natural degeneration of joints that occurs with age. As the body ages, the ability of articular cartilage cells to proliferate and synthesize decreases, making it difficult to maintain a balance between the anabolism and catabolism of cartilage tissue, leading to degradation and loss of articular cartilage and triggering osteoarthritis. 2. Gender The incidence of osteoarthritis is significantly higher in women than in men, and is especially common in postmenopausal women. Many studies suggest that this may be related to lower estrogen levels in women after menopause. Estrogen may have a protective effect on osteoarthritis, pending further evidence-based studies, and estrogen supplementation is also expected to be one of the treatment modalities for osteoarthritis. 3. Genetics The development of osteoarthritis runs in families, and it is very common for multiple members of a family to develop the disease at the same time. This may be related to a genetic defect caused by the abnormal metabolism of cartilage. 4, obesity For a long time obesity and overweight is considered a high risk factor for osteoarthritis, overweight will increase the weight of the knee and hip joint, accelerating the wear and tear of the joint. Studies have shown that the risk of knee osteoarthritis in obese patients is three times greater than in the control group, while weight loss can significantly reduce the risk of knee osteoarthritis, and weight reduction can also significantly reduce pain and activity impairment in patients with osteoarthritis. Therefore, patients with osteoarthritis should especially emphasize the importance of weight loss. 5, excessive exercise Table tennis players are more prone to knee osteoarthritis, soccer players also have a significant increase in lower extremity joint osteoarthritis, similar to many of the sports that subject joints to greater pressure and twisting can increase joint damage and induce osteoarthritis. In contrast, moderate exercise can maintain joint mobility, enhance joint stability, and does not increase the risk of osteoarthritis, but rather promotes cartilage repair and improves symptoms in patients who already have osteoarthritis. What is the most appropriate treatment? The progression of osteoarthritis is irreversible and the main goal of current treatment is to relieve symptoms and slow down disease progression. For patients with symptomatic osteoarthritis, medications are still the primary treatment modality. Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used class of drugs to control the symptoms of osteoarthritis. It has both analgesic and anti-inflammatory effects and provides symptom control and relief in most patients. Most NSAIDs are currently available in oral dosage forms, which have unavoidable gastrointestinal and cardiovascular adverse effects. Transdermal and other topical delivery methods can significantly improve their adverse effects and are receiving more and more attention from clinicians. Please refer to the clinical situation for specific medications and be guided by your doctor in person.