Arthritis Care

The core of arthritis care has never been the two extreme solutions of "taking painkillers when it hurts" or "moving less to save joints"; Type-adapted nursing plans, dynamic and static balance in the acute phase and remission phase, and long-term refined habit adjustments , and not only middle-aged and elderly people need care, but young people with a history of sports injuries, long-term desk work, and often staying in low-temperature environments must also pay attention to the condition of their joints in advance.

Xiao Zhou, a 28-year-old badminton enthusiast I met at the clinic last week, is a typical example. He was diagnosed with patellofemoral arthritis in his right knee. He heard from the elderly at home that he should save use of the joint. He didn't dare to run or jump for half a year and even took a taxi for commuting. As a result, the last time he came for a review, his quadriceps muscles had shrunk by almost two centimeters, and the pain when going up and down stairs was worse than before.

Many people’s misconceptions about arthritis care essentially lump all types of arthritis together. The logic of nursing care for the three most common types of arthritis is very different: osteoarthritis caused by wear and tear focuses on muscle strength maintenance and reducing excessive weight bearing; autoimmune-related rheumatoid arthritis requires first adjusting immune indicators according to the doctor's advice; and the core of gouty arthritis is controlling uric acid to reduce crystal deposition - I also met a 30-year-old gout patient.

There has been a debate for many years about "should you move more or less for arthritis?" In fact, both statements are correct, but they are applicable to completely different scenarios. What the elders say about "sparing use" corresponds to the acute stage: when the joints are red, swollen and painful, and cannot be touched, you must try to reduce the weight you bear. Don't carry it to climb stairs or run, otherwise it will only aggravate the inflammatory reaction. The "muscle strength training to protect joints" advocated in the field of sports medicine corresponds to the remission period: when the inflammation has subsided and only occasional soreness occurs, you need to specifically train the surrounding muscles. For example, training the quadriceps around the knee joint can help the joints share more than 30% of the pressure, which is more effective than any knee brace. Like Xiao Zhou, who just lays down regardless of the period, it is inevitable that the joints will be more unevenly stressed after muscle atrophy and the pain will be more frequent.

When it comes to the most frequently asked supplement, glucosamine, there is a lot of controversy. Previous guidelines from the American Academy of Orthopedic Surgeons did not recommend routine use of glucosamine because the relief effect for most patients was unclear. ； However, the domestic osteoarthritis diagnosis and treatment guidelines also mention that patients with moderate to mild cartilage wear may have a certain cartilage repair effect if they take it continuously for more than 3 months. I generally advise patients to try it for 2-3 months. If the frequency of pain does not decrease and the stiffness does not relieve, then don’t spend the money. Whether it is imported or added with other ingredients, the essence is not much different.

In fact, there is no need to devote a large amount of time to rehabilitation in daily care. I often tell patients a few small movements that they can do casually: when lying on the sofa and watching TV, straighten your legs and raise them at 15 degrees, hold them for 10 seconds, and then put them down. Do 20 exercises at one time to train your quadriceps muscles.； Don’t cross your legs when sitting in the office. Get up and stand for two minutes every half hour to move your knees and hip joints. ； When buying shoes, don't choose flat shoes with soles as hard as slate, and don't wear high heels over 5 cm. Heels of 2-3 cm put the least pressure on joints. There are also many people who wear thick knee pads when it comes to rainy days. They cover their legs with sweat and make them more susceptible to cold. Choose a thin one with support strips. When the pain is felt, wear it for 1-2 hours and take it off when it is relieved. Don't wear it every day, otherwise the muscles will become weaker and weaker.

There is another misunderstanding that has been circulating for many years: arthritis is caused by freezing. In fact, low temperature will not directly cause joint inflammation, but will only worsen the blood circulation in the already inflamed areas and amplify the pain. There is no need to wrap your joints like rice dumplings when using the air conditioner in summer. Just put a small blanket on your joints so that the air is not blowing on you. There is no need to wear long pants to protect your joints in the dog days of summer.

To be honest, arthritis is a very common chronic disease. At least two out of ten people have some joint problems. Don’t be too anxious and don’t take it seriously. Don't believe the "special treatments" and "radical remedies" mentioned on the Internet. This thing is just like wearing glasses. It cannot be solved once and for all. You can only slowly adapt to your body: rest when it hurts, move when you feel more comfortable, and see a doctor for regular follow-up to adjust the plan. It is better than any magic medicine.