On the occasion of International Arthritis Day, degenerative arthritis is an unpleasant feeling that every middle-aged and elderly person may face. In severe cases, it can even change the emotional personality and loss of human dignity. There are currently 355 million people worldwide who suffer from arthritis. In Asia, one in six people will suffer from arthritis, the world’s number one disabling disease, at some point in their lives. So how do we face and understand this problem? The authors have come into contact with a very large number of such patients in their clinical practice over the last 30 years and found that most of them have incorrect perceptions and therefore deviations in the choice of treatment, in the coordination of exercise, in the attention to details of life, etc., which seriously affect the evolution of the disease, until the improvement of function and quality of life. In April 1998, with the support of WHO, a symposium was held at Lund University in Sweden with more than 70 experts in orthopedics, rheumatology, osteoporosis, traumatology and physiotherapy and rehabilitation, at which Lars Lidgren proposed a decade of bone and joint for the period 2000-2010. On January 13-15, 2000, the WHO officially launched the Decade in Geneva, with 750 medical institutions signing the document and 37 governments supporting the Decade. In April 2001, China established the Ministry of Health Arthritis Prevention and Control Education Program Fund. The purpose of World Osteoarthritis Day, which is celebrated on October 12 each year, is to remind people to pay attention to the prevention and treatment of osteoarthritis. It is to remind people of the need for early prevention, diagnosis and treatment of arthritis to prevent disability. On the occasion of World Osteoarthritis Day, the authors would like to explain the issues related to degenerative arthritis, hoping to help those who have misunderstandings, improve their life and exercise methods through correct understanding, cooperate with the correct treatment, and regain a good quality of life. In summary, there are several types of misconceptions: misconceptions about the name of the disease I often encounter patients who say to me: “I have degenerative arthritis, not osteoarthritis.” Or “I don’t have arthritis, I have bone spurs.” And so on! This indicates that the patient has a misunderstanding of the name of this type of disease. In fact, whether it is called osteoarthrosis, osteoarthritis, degenerative arthritis, joint degeneration, osteophytes, etc., the pathological changes and formation mechanisms are the same. The pathological changes and formation mechanisms are the same thing. Only in the naming process, some are based on imaging characteristics, some are based on the developmental characteristics of the disease, and some are directly translated from foreign names. Therefore, no matter how many names there are, the basic pathological feature is the degeneration of articular cartilage, which leads to a series of joint pathological changes and clinical signs and symptoms. Misconceptions about the age of onset of the disease In clinical practice, we sometimes encounter the problem that when a doctor tells a patient that he has degenerative arthritis, the patient is surprised and asks the doctor how he got senile disease when he was just in his 40s. In his opinion, since it is a degenerative disease, it should be a disease of the elderly. People often think of arthritis as a disease of the elderly, but in fact, people of all ages, even children, can develop the disease. In fact, degenerative arthritis refers to pathological changes in the articular cartilage that make it difficult to repair, followed by cartilage fragmentation that stimulates the synovial tissue on the inner surface of the joint cavity, followed by changes in the joint fluid that further affect the metabolism of the articular cartilage, resulting in degeneration of the joint surface, exposure of the hard bone and further hardening changes, structural changes, etc. Therefore, it can be a major problem in the elderly, or it can be secondary to other causes, such as bacterial infections in the joints, internal and external injuries to the joint cavity, joint deformities, overexertion, malnutrition, obesity, diabetes, other autoimmune diseases, etc. Misconceptions about Exercise Methods Clinically, I often encounter patients who tell their doctors that they are trying to exercise in order to prevent joint degeneration. Some insist on hiking, some insist on leg pressing, some insist on walking backwards, some insist on brisk walking, some insist on boxing, some insist on dancing, and so on. Exercise a wide range of ways, even joint pain still adhere to, and even more to their own exercise plan, every day to adhere to, its spirit is very commendable. However, they do not know that improper exercise or inappropriate exercise will aggravate joint degeneration. Some patients also tell their doctors that they cannot move their joints because of inflammation, so they just lie down at home and move slowly when they are well. Some patients simply ask their doctors: Some people say they want to exercise when they have arthritis, but others say they can’t, so can they or shouldn’t they? All these show that there are misunderstandings among patients on this issue. Misconceptions about analgesic drugs: Analgesics play a pivotal role in the treatment of degenerative arthritis, especially non-steroidal anti-inflammatory drugs (also known as anti-inflammatory painkillers), which are among the most prescribed drugs in clinical practice. However, many patients refuse to take it because they are afraid of its side effects, in fact, both clinicians and patients have a tendency to over-exaggerate its side effects, which mainly come from gastrointestinal reactions and are prohibited for patients with gastric ulcers; however, it is controllable and does not cause serious consequences in the short term; of course, it has certain effects on the cardiovascular system, blood sugar and blood pressure, but the chances of side effects are relatively low after all. After all, it is relatively low, and as long as it is applied under the guidance of a doctor, it is controllable. Also, when doctors want to prescribe painkillers to patients, many patients will say: I don’t want painkillers, it just stops the pain and doesn’t solve the underlying problem, I want to prescribe anti-inflammatory drugs (i.e. antibiotics). It is important to know that the pain of degenerative arthritis is largely due to inflammation in the joint, and this inflammation is not caused by bacteria; non-steroidal anti-inflammatory drugs can inhibit the release of inflammatory factors and relieve pain, in fact, its main role is anti-inflammatory rather than pure pain relief; therefore, degenerative arthritis does not require antibiotics. In addition, many patients stop using painkillers as soon as the pain is relieved, but the pain recurs after a day or two. In fact, you can continue to take them for a period of time, while paying attention to joint protection and the application of some joint cartilage protectors. Therefore, the application of analgesic drugs in the acute phase of degenerative arthritis is necessary, but must be applied under the guidance of a doctor. Misconceptions about the effect of treatment: Many patients in the clinic will say: Doctor, my last arthritis attack has relieved the pain after treatment and resumed a normal life, but not long afterwards, the disease can not break the root? Or, “Doctor, the medicine you gave me last time didn’t work at all. It is important to know that the pathological basis of degenerative arthritis is the damage of articular cartilage, which has no regenerative capacity after the damage of articular cartilage, and we have three main types of drugs for the clinical treatment of degenerative arthritis: ① anti-inflammatory and painkilling drugs, which mainly play a role in improving the symptoms and cannot prevent the further development of cartilage lesions; ② relief drugs (such as glucosamine, diacetin), which can partially delay the development of lesions, but cannot reverse the development of lesions. (3) viscoelastic supplementation therapy, such as intra-articular injection of hyaluronic acid, which can lubricate the joints, protect the cartilage and improve the symptoms, but also cannot reverse the disease process. Therefore, if you do not pay attention to the protection of the joints and continue to climb mountains and stairs, which increase the burden on the joints, the joint cartilage will be more worn out and the pain will inevitably recur. In the advanced stages of the disease, the joint cartilage is severely worn out, joint movement is severely restricted, and pain is severe, so any conservative treatment is ineffective. Misconceptions about joint replacement: Joint replacement is an effective treatment for severe degenerative arthritis, which can relieve pain and improve the function of the affected limb. There are many patients suffering from severe degenerative arthritis in China, but only a few of them actually undergo joint replacement. The main reason for this is the lack of awareness of joint replacement. Many patients say: Will a metal prosthetic joint work in the body? After all, it’s a foreign body, won’t it cause a rejection reaction? In fact, as long as the surgery is evaluated by a doctor, it is generally safe and there are many methods of pain relief available. Some patients are afraid of surgery because they see that some of the patients around them do not have good post-operative results; in fact, joint replacement is a mature technology that has been used clinically for decades and has an excellent rate of 80-90% or more. Any kind of surgery has a certain failure rate, but it is very low after all, and what you see is only an isolated case.