Joint pain after activity is the most common phenomenon in middle-aged and elderly people, especially in women. 40 years old and above, due to the upcoming pre-menopause, female hormone secretion gradually decreases, bone tissue loosening, the tissue around the joint metamorphosis, coupled with women’s own ligaments around the joint, muscle laxity, instability during the activity of poor protection of the joint, easy to damage. It brings them physical pain, inconvenience in movement and even disability, and also increases the burden for families and society, which seriously affects the quality of life of middle-aged and elderly people. Chen Xiaoming, Department of Orthopedics, Siping Central Hospital Caring for the elderly and paying attention to joint health is an obligation for each of us as children, and it is also our effort to better support the elderly in their old age. Therefore, we all might as well learn some knowledge about bone and joint diseases. Here are our answers to some key questions: ● What is osteoarthritis? Osteoarthritis is characterized by abnormalities in the biochemical metabolism of joint cartilage and structural damage, resulting in metamorphosis of cartilage tissue, proliferation of joint fibers and ultimately pain and loss of joint function. Misconceptions about arthritis: Arthritis is not an inflammation of the joints. In terms of inflammation, there are two types of inflammation: infectious inflammation, which is the result of infection with bacteria or viruses, and sometimes septic inflammation. The second is aseptic inflammation, or injury inflammation, and osteoarthritis belongs to the latter. Therefore, it is incorrect for some middle-aged and elderly people to take “anti-inflammatory drugs” (antibiotics) when they encounter diseases with the name “inflammation” or swelling. To prevent misunderstanding, it is sometimes simply called osteoarthritis. How does osteoarthritis occur? Within a normal joint again, the surface of the bone is covered by cartilage. Cartilage provides a smooth contact surface for the movement of the joint, acting like a flexible cushion that protects the bone and cushions the pressure. Cartilage contains proteoglycans, water, electrolytes, collagen fibers, and other substances. When they develop abnormal growth and metabolism due to disease, injury, or metamorphosis, cartilage is susceptible to structural damage such as decreased elasticity and localized wear, which then leads to inflammation of the synovial membrane within the joint, triggering joint swelling and pain. When the condition further develops with cartilage destruction, the bone is exposed and forms osteophytic bone spurs, leading to joint deformation and resulting in osteoarthritis. Common symptoms of osteoarthritis: Osteoarthritis can affect all joints in the body, the most common of which is the knee joint. When you move your knee joint, you will feel pain, sometimes a grinding sound or a stuck feeling, and when you go up and down stairs or stand up, you will experience tearing or pins-and-needles pain that is not relieved after rest. At first, you may feel stiffness in your joints in the morning or after sitting for a long time, but after moving around, you may feel better. As your condition worsens, the range of motion of your joints becomes smaller and you have difficulty squatting, resulting in limited movement and loss of function. What are the risks of osteoarthritis? Osteoarthritis is the leading cause of disability in middle-aged and elderly people. Long-term joint pain and impaired joint movement can greatly reduce the quality of life of the elderly, affect their physical and mental health, and even shorten their life expectancy, as well as make it more difficult for family members to care for them. What should I do if I suspect that I have osteoarthritis? If you find that you have the above symptoms, you should go to a regular general hospital orthopedic department in time to receive relevant examinations and make a clear diagnosis, and follow the doctor’s instructions to adhere to the appropriate amount of load-reducing exercises and treatment. How to treat osteoarthritis? This is the most concerned and confusing issue, with many misconceptions. Often, after multiple visits, they are still unclear about their condition and always think that the doctor did not say anything, which leads to selective re-diagnosis, which is actually the result of their own lack of understanding and skeptical attitude. For the purpose of caring for your own body, you should learn the habit of learning and understanding the knowledge and common sense of what diseases you have. Because some diseases require not only the guidance of doctors, but also the cooperation and self-treatment of patients. In particular, osteoarthritis requires comprehensive treatment to be effective, while single medication is poor. The treatment of osteoarthritis is a chronic and long-term process, patience and confidence, do not give up treatment because you do not see improvement or suspect that the diagnosis is wrong, as well as think that the drugs are not the right symptoms, everywhere to ask for the magic recipe which is not objective, but also futile. Although there is no complete cure for osteoarthritis, but through active treatment can achieve the purpose of reducing pain, delaying the progress of the disease, improving joint movement and preventing joint disability, osteoarthritis treatment means a lot, only adhere to early, timely and appropriate systemic treatment, on the basis of drug therapy, but also through physical therapy, correct physical exercise and life care is the right. I. Drug therapy is divided into two categories, both non-specific drugs (also called symptom improvement drugs) and specific drugs (also called disease control drugs) 1. non-specific drugs: such as analgesics (acetaminophen), non-steroidal anti-inflammatory drugs (aspirin, Protaxon), hormones (mostly local closed with) Chinese herbal blood activators and analgesic cream. Such drugs can only relieve symptoms, not improve the condition. Although pain brings suffering to patients, it is a protective reflection in itself, and its presence can remind patients to reduce the weight of diseased joints and avoid overuse, so as not to aggravate the condition. Patients should not make the mistake of thinking that their condition has recovered because the pain has disappeared. When the patient’s symptoms are controlled, the drug dose should be reduced or stopped in time. 2. specific drugs: such as chondroitin sulfate, glucosamine sulfate and hyaluronic acid, the first two drugs are available in oral and injectable form, and the third party is only used for intra-articular injection. These drugs are slow to take effect, usually requiring several weeks of treatment to take effect, but the effect can last for a period of time after stopping the drug, with cartilage protection, can slow down, stabilize and even reverse the process of osteoarthritis cartilage damage, is the cure for patients with osteoarthritis. Physiotherapy, exercise and daily care Physiotherapy in the acute stage is mainly to relieve pain, reduce swelling and improve symptoms, while physiotherapy in the chronic stage is mainly to enhance local blood circulation and improve joint function. Heat therapy 15-20 minutes before each joint movement can help relieve pain and reduce stiffness. Traditional treatments such as acupuncture, massage and tui na can also be effective, but should not be done more often. Appropriate load-reducing exercises are beneficial to the recovery of the disease, such as walking, swimming, cycling and dancing, etc. Avoid strenuous activities such as climbing and jumping rope. Physical exercise follows the principles of low intensity, rhythm, uninterrupted and long duration. Each time 20-30 minutes, 4-5 times a week, to have 2-3 days rest. If there is persistent pain in the joints after exercise, the intensity of exercise should be reduced and the duration of exercise should be shortened. It is important to establish a reasonable lifestyle and adjust the intensity of labor to protect the onset joints. Heavy people should lose weight moderately, avoid wearing high heels, and do not sit on low stools or sofas for a long time. Avoid long-term ambulation, pay attention to the warmth of the affected joints, and frequent hot baths are beneficial to the protection of joint cartilage. Third, surgical treatment when the joint lesion is serious, there is persistent pain and obvious dysfunction, we should consider surgical treatment. Surgical methods include arthroscopic joint cleaning and artificial joint replacement. Therefore, whether to take surgical treatment and what kind of treatment should be communicated with the physician and follow the physician’s arrangement.