Issues related to the care of arthritis patients

Whether it is the commonly occurring degenerative osteoarthritis or the autoimmune condition of rheumatoid arthritis, there currently is no method to achieve a “complete cure.” However, with proper medical care, the frequency of pain episodes and the risk of joint deformity can be reduced by more than 90%. The vast majority of patients are able to maintain normal physical activity and quality of life, without the need for surgical replacement.

A couple of years ago, when I was helping out in the rehabilitation department, I encountered two ladies who were both 62 years old and suffering from stage 2 osteoarthritis in their knees. One of them would just apply plasters and stay in bed whenever her knees hurt; she wasn’t even willing to go downstairs to buy groceries. When she came for a follow-up visit half a year later, the space between her joints had narrowed by nearly one-third, and she could only walk about 200 meters with the help of a cane； Another person adjusted their exercise routine along with ours for three months, and now they are able to go hiking in the nearby hills with their friends every week. Apart from occasional soreness after longer walks, they don’t experience any significant discomfort. To be honest, the vast majority of the differences in the quality of life for people with arthritis are due to details in their care.

Currently, there are two opposing viewpoints within the industry regarding the management of arthritis. Many experienced orthopedic doctors advocate for “conserving joints” – meaning minimizing movement and avoiding activities that put excessive strain on them, since damaged cartilage cannot be regenerated； Most doctors in the rehabilitation department do the opposite, urging patients to exercise their muscles, explaining that the less they move, the faster the muscles atrophy, and that without support for the joints, they will suffer even more friction. Actually, both sides are correct; it's just that the applicable situations are different. If you are in the acute phase, with joints so swollen that pressing on them leaves indentations and the pain is so severe that you can't even bend your legs, trying to walk two kilometers would be nothing but self-inflicted suffering. In this case, you should rest properly and, if necessary, use crutches to reduce the strain until the inflammation subsides ； But if the pain is only occasional and there is no stable period without redness or swelling, and if you spend every day lying at home, it won’t take three months before the quadriceps muscles atrophy significantly. The very muscles that are supposed to support the joints will weaken first, making the pain even more frequent.

I’ve really seen too many people fall into the trap of using heat packs whenever they feel pain. They just wrap a hot water bag around the affected area, only for it to become even more swollen and eventually make it impossible for them to walk. In fact, determining whether to use cold compresses or hot compresses is quite simple: As long as the joint is red, swollen, feels hot to the touch, and causes severe pain, apply an ice pack wrapped in a towel for 15 minutes. This can quickly reduce the acute inflammation ； If there is only a feeling of stiffness, soreness, and sensitivity to cold, without any swelling or heat, then applying heat therapy or moxibustion to relax the surrounding muscles would be helpful.

Previously, a patient also asked me repeatedly whether glucosamine, which is touted online as a miracle drug for joints, needs to be taken regularly throughout one’s life There is indeed a lot of controversy around this topic at present. The latest orthopedic guidelines from Europe and the United States state that glucosamine does not provide clear benefits for patients with moderate to severe arthritis, and its regular use is not recommended. However, many clinical practices in China have found that for patients under 70 years old who have only mild joint wear and tear, if taking glucosamine for three months results in significant relief, they can continue taking it. On the other hand, if there is no noticeable improvement after three months, it would be pointless to continue spending money on it—it would be just a waste.

Oh, right, there’s also one detail that people tend to overlook completely: Wear shoes. There was an old man who had been suffering from knee pain for over half a year. He tried every possible remedy, but nothing worked. Later, I noticed that he wore old cloth shoes with hard soles every day, claiming that they were soft and comfortable. In reality, however, the hard soles provided no cushioning at all, so the impact from walking directly struck his knees—no wonder it hurt. Later, I had him switch to a pair of sports shoes with heels about 3 cm high and a soft, flexible sole. Just a week later, he came to tell me that the pain had decreased significantly when walking. The same goes for knee pads. Don’t wear them all the time; doing so for extended periods can cause your muscles to become weaker due to “laziness.” There are only two situations in which it’s necessary to wear them: Either wear it when the pain is severe during the acute phase when going out, or wear it during activities that put a lot of strain on the joints, such as hiking or dancing in the square. There’s absolutely no need to wear it when just walking around at home or doing things like grocery shopping.

Many people ask whether having arthritis means they can no longer dance at square dances or practice Tai Chi It’s not that extreme at all. Just don’t force yourself to move when you’re in pain. Avoid squatting too deeply in Tai Chi, and don’t choose lively, jumping songs for square dancing. Moving at a slow pace can actually help nourish the cartilage with joint fluid, which is much better than just lying around at home. I also met a retired physical education teacher who, despite having stage 3 arthritis, swam twice a week. Now that he’s nearly 70, his joints are in better condition than many people in their 50s.

To put it simply, caring for arthritis essentially means working in partnership with your own body. There are no one-size-fits-all rules. If walking 3,000 steps causes pain, then walk 2,000 instead. If taking glucosamine helps, continue with it; if not, stop. Don’t believe in any miracle cures for arthritis, and don’t think that having it means you’re “useless.” With time and some adjustment, most people can live peacefully with arthritis for the rest of their lives.