Arthritis care essentials

The core essence of arthritis care is Long-term individualized joint load management There is no universal "cure", nor is there a shortcut of "putting on a plaster if it hurts and ignoring it if it doesn't hurt". The core logic is to maintain joint function and reduce the frequency of attacks as much as possible without aggravating joint wear and tear. The specific plan needs to be adjusted based on the type of arthritis, the stage of onset, and personal physical conditions.

I just met a 28-year-old girl in the clinic last week. She wears ripped pants all year round and her ankles are exposed in winter. After the temperature dropped recently, her knees hurt and she had to struggle to go up and down stairs. The X-ray showed early cartilage wear. She thought she was just frozen. After wearing a hot compress for a week, the swelling became worse. In fact, this kind of misunderstanding is really too common. Many people's care for arthritis is still at the extreme of "either doing it blindly or caring for it blindly".

For example, the most controversial issue is exercise. Many patients ask as soon as they come in, "Should I walk more and exercise or should I lie still?" ”In fact, the traditional view of orthopedics is that in the acute stage (the stage when the joints are red, swollen, hot, and painful, and the pain is significantly aggravated during activities), weight-bearing should be minimized, use crutches when necessary, and avoid climbing stairs, squatting, running and jumping, to prevent further wear and tear of cartilage. ； However, follow-up data from the Department of Rehabilitation shows that after the inflammation subsides and enters a stable period, proper non-load-bearing muscle strength training such as straight leg raises and wall squats can strengthen the quadriceps muscles of the thighs, which is equivalent to adding a layer of "cushion" to the joints, which can actually reduce the friction of daily activities on the cartilage. I have an old patient who has suffered from knee arthritis for three years. He used to have to rest after walking for half an hour and insisted on practicing silent squats for 15 minutes every day. Now he feels no discomfort when he goes out for a two-hour walk in the park.

Oh, by the way, weight is really ignored by too many people. Don’t think that gaining three to five kilograms will not affect you. Let me give you a calculation: when walking normally, the pressure on the knee joint is 2-3 times of the body weight. When squatting or going up and down stairs, it can be 5-7 times. If you are 10 kilograms overweight, it is equivalent to carrying an extra 50 kilograms of weight every time you squat. Can your joints not be worn out? There was a middle-aged male patient who weighed 180 kilograms and suffered from knee pain for two years. He also took medicine and physical therapy, but it was always repeated over and over again. Later, he lost 20 kilograms after listening to advice. Now the frequency of attacks has dropped by at least 60%. He said that "it is more effective than any special medicine."

There are also many people who think that arthritis is caused by freezing. In fact, cold itself will not directly cause arthritis, but it will constrict the blood vessels around the joints and worsen blood circulation. Metabolic waste cannot be discharged in areas with inflammation, and the pain will worsen. So it’s right to wear thin knee pads when it’s cold or in an air-conditioned room, but don’t buy ones that are too tight to tighten your legs. On the contrary, they will compress blood vessels and affect circulation, which is not worth the gain. By the way, I have to mention the pitfalls of hot and cold compresses: when you have redness, swelling, heat and pain in the acute stage, if you use a hot water bag to apply it suffocatingly, the blood vessels will expand and the tissue will exudate more and the swelling will become more severe. At this time, you should wrap an ice pack in a towel and apply it for 10-15 minutes to contract the blood vessels and reduce the swelling. ； In the stable period, when you only feel coldness and stiffness, you can then apply heat or use a warm baby to make it really comfortable.

Many people also ask whether they should take ammonia sugar and chondroitin? This academic community has indeed been arguing for many years. The latest European and American guidelines do not recommend routine aminoglucose supplementation for patients with osteoarthritis, because large-sample studies have shown that for patients with moderate or above cartilage wear, the improvement effect is about the same as that of a placebo. ； However, after so many years of clinical observation in China, for young people with early cartilage wear, frequent joint popping, and only slight pain, many people reported that the discomfort was reduced after taking aminoglucose supplements for about three months. This is actually an individual difference. There is no absolute good or bad. Take it if it works, and stop if it doesn't work after three months. Don't treat it as a "miracle medicine".

Oh, and the most critical point, don’t forget: if you have rheumatoid arthritis, gouty arthritis, or other types of arthritis related to autoimmunity and metabolism, don’t just take care of yourself. You must see a specialist to review your indicators regularly and standardize your medication. You cannot control the progression of the disease by just “maintenance”, so don’t waste the opportunity for treatment.

I have been dealing with arthritis for more than ten years, and my deepest feeling is that your joints are your own, so don’t follow other people’s care methods - some people are fine if they walk 10,000 steps a day, but it hurts if you walk 5,000 steps, so don’t hold on. Pay more attention to the feeling of your joints at ordinary times. If it hurts, just rest and don’t do anything. It is more reliable than any other folk remedies.