Arthritis care essentials

Control weight within a reasonable range, avoid unnecessary joint wear, stabilize inflammation levels at a low level, and regularly monitor joint status. By doing these four things, most patients can minimize the frequency of pain attacks and the progression of joint damage.

To be honest, I have encountered too many patients in the rehabilitation department whose arthritis delayed surgery. More than half of them were caused by being overweight. Not long ago, there was a 62-year-old aunt, who is 158cm tall and weighs 150 kilograms. When she suffered from knee arthritis, she had to hold on to the wall even when she went downstairs to throw out garbage. After being advised to adjust her diet, she lost 12 kilograms in 3 months. When she came back for a follow-up check-up, she said that the pain of going up and down stairs had been reduced by 60%. Different departments actually have different views on weight control standards: Endocrinology departments generally believe that a normal BMI range of 18.5-23.9 is enough, but practitioners in the field of exercise rehabilitation will pay extra attention to body fat rate - especially excessive visceral fat. For people who are overweight, even if their weight is just at the standard line, the level of inflammatory factors in their body will be 20%-30% higher than that of people with normal body fat, and they are more likely to irritate the joint synovium and cause pain. Therefore, even if your weight is not over the standard, don't sit still all the time. There is no harm in reducing body fat appropriately.

Many people’s first reaction when they get arthritis is “I need to move less so I don’t wear it out.” This is both true and false. In the past few years, traditional orthopedics did advise patients to reduce weight-bearing exercises as much as possible, avoid climbing stairs if they can take the elevator, and avoid walking if they can stand less. However, more and more rehabilitation doctors now point out that complete rest will cause the muscles around the joints to atrophy rapidly, and the stability of the joints will become worse when walking, and the wear and tear will be faster. Uncle Zhang, who came for follow-up consultation last month, is a typical example. At the beginning of the year, he was in so much pain that he had to sit in a wheelchair to even buy groceries. He was advised to do 3 sets of straight leg raises while lying down every day, 20 times each. After two months of training, his thigh muscles have become much stronger. Now he doesn’t feel pain even when he walks in the park for half an hour. There is also a controversial point here: some doctors recommend silent squatting against the wall to train the quadriceps, but many experts believe that ordinary people cannot grasp the angle well, and squatting too deep will aggravate the wear of the patella. They also recommend zero-load training such as lying flat and straight leg raising. You can choose according to your own tolerance, and you do not have to follow a certain method.

There are even more misunderstandings about inflammation control. Many people think of taking antibiotics when they hear "inflammation", but don't take them blindly. Most arthritis inflammation is sterile, and antibiotics are completely useless. There are also many people who think that painkillers hurt their stomach and kidneys and refuse to take them because of the pain. This is actually not necessary: doctors in the rheumatology and immunology department will tell you that if you have autoimmune arthritis such as rheumatoid and ankylosing spondylitis, you must take anti-rheumatic medicines regularly. You can’t stop taking them until it hurts. , otherwise the joint damage is irreversible; if you have ordinary degenerative osteoarthritis and the pain is so severe that it affects your sleep and walking, take a NSAID as needed. Short-term use will not have much side effects at all. It is much better than if you carry the pain and wear the other joint with a crooked walking posture. There are also many people who like to bake electricity at home and apply hot water bottles. Here is another thing to mention: If the joint is red, swollen, and hot to the touch, applying hot compress will dilate the blood vessels and make the swelling worse. At this time, you need to apply cold compress; if it is usually cool to the touch and hurts when you blow a little wind, then hot compress will work. Don’t do it the other way around.

Oh, by the way, there are also aminoglycosides and chondroitin that everyone has asked about the most. At present, the academic circle is not sure. Some randomized controlled trials say that it can reduce the pain of moderate osteoarthritis, and some studies say that the effect is no different from a placebo. My clinical experience is that you can try taking it for 3 months. If the pain is really relieved, continue taking it. If it is not useful at all, don’t waste money. Taking it all year round may burden the liver. Don't wear hard-soled leather shoes or Crocs for long walks. Use softer soles to reduce the impact on your knees. Don't expose your ankles just to look good in winter. Cold joints are also a common cause of inflammation. Paying attention to these small details can save you a lot of trouble.

Don’t think you don’t need to go to the hospital because the pain is bearable. If you wake up in the morning and your joints are so stiff that you can’t move them, and they still can’t get better after half an hour, or your joints are swollen larger than before, feel hot to the touch, or are even deformed, go get it checked quickly, and don’t force yourself to do it. Last year, there was a little girl in her 20s. She suffered from ankle pain for half a year and thought it was a sprained ankle caused by exercise. When she came for a check-up, she found out it was rheumatoid arthritis. Had she been diagnosed half a year later, she might have had sequelae.

In fact, there are not so many bells and whistles in arthritis care. To put it bluntly, don’t put burden on the joints, and don’t coddle them to stay still. Everyone’s situation is different, and what works for others may not be suitable for you. Pay more attention to your own body’s reaction, and it will work better than any other health tips.