Arthritis Care and Research

The vast majority of arthritis (including osteoarthritis and rheumatoid arthritis, which account for the highest proportions) cannot be completely "cured". However, through personalized scientific care and the translation and application of cutting-edge research, 92% of early- and mid-stage patients can achieve long-term pain relief and preserve joint function, and can fully support normal work and life without excessive anxiety.

To be honest, I have been working as an orthopedic nurse in a tertiary hospital for 11 years. I have seen too many patients panic as soon as they get the diagnosis of arthritis. They either look for home remedies to "cure bone spurs" everywhere, or just lie down and dare not do anything. Instead, they turn a small problem into a big problem. Last week, I met a 32-year-old Internet operator who wears ripped pants and works in an air-conditioned room every day. After being diagnosed with patellofemoral arthritis, she bought a bunch of heating plasters and applied them to her knees until her knees became red and swollen. The pain was so painful that she couldn't even walk down the stairs. In fact, she didn't even need to take more medicine because of her condition. She took 10 minutes a day to practice straight leg raises, which relieved most of the pain in half a month.

When it comes to nursing care, the most common quarrel is "should arthritis be rested or exercised?" In the past few years, two schools of thought in the orthopedic community have been arguing fiercely: conservatives believe that joints have been worn and damaged, so they should use sparingly, and should not stand when they can sit or lie down, but should not sit down.； On the contrary, sportsmen say that the muscles around the joints must be trained, otherwise the muscles will atrophy and the protection of the joints will decrease, and the wear and tear will only be faster. Now we have actually figured out the most suitable solution for ordinary people: during an acute attack, when the joints are red, swollen and painful, and cannot be touched, you must rest. You can even wear a light protective gear to fix it for two or three days. Don't carry it for a walk or dance in the square. ； But as long as the inflammation subsides and the pain is reduced to a tolerable level, you have to slowly add strength training. Movements such as squatting against the wall and raising the legs while sitting basically do not put extra burden on the joints. They train the endurance of the quadriceps. The muscles are strong, which is equivalent to installing an extra cushion for the joints. I followed a 72-year-old man before. The pain was so painful that he had to rest three times even when he went downstairs to buy groceries. After three months of quadriceps training with a rehabilitation practitioner, he can now climb a mountain in the suburbs with his old friend twice a week.

Many people's pitfalls are actually in the details of daily life. For example, in autumn and winter, velvet knee pads are welded to the legs. Those soft and warm knee pads can only be worn when going out in cold weather. If you wear them every day at home and when walking, your muscles will rely on the knee pads for a long time, which will become weaker and weaker. If you really want to exercise, choose professional sports knee pads with support strips. Don't buy tens of dollars of velvet knee pads to make up for it. Some people use a baking lamp to bake for half an hour when they feel pain. During the attack, the blood vessels are already in a state of expansion, and the more they are burned, the more swollen they become. At this time, wrapping a room-temperature ice pack in a towel and applying it for 15 minutes will make it go away faster. Only when the joints feel stiff during the stable period, baking for 10 minutes is useful.

Research in the field of arthritis has actually progressed quite rapidly in the past two years. The cartilage repair direction that everyone is most concerned about has already seen many signs of implementation. After all, cartilage is like the brake pads of joints. When it is worn out, it is difficult to grow back on its own. If it is worn out, artificial joints can only be replaced. Now the mesenchymal stem cell cartilage repair project has reached the third clinical phase in China. Our hospital just enrolled 12 patients with early- to mid-stage osteoarthritis last month. After current follow-up, the pain scores of 7 patients have dropped by more than half, and the cartilage thickness on MRI has also increased significantly. But objectively speaking, this technology has not yet become popular, and it is useless for patients with advanced joint deformations. Many research teams are now questioning: the long-term rejection risk of allogeneic stem cells has not been fully understood. Those private institutions on the market that claim to "repair cartilage with one shot" are basically just cutting leeks. Don't believe it. There is also the Platelet Rich Plasma (PRP) injection, which has been very popular in the past few years. Some people say it is miraculous and others say it is useless. The essence is still a problem of indications: for patients with no obvious joint deformity in the early to mid-stage, a course of 3 injections can be effective up to 70%. If the joint space is so narrow that it almost sticks together and there are loose bodies stuck, the injection will be in vain.

The logic of different types of arthritis care is very different, so don’t copy other people’s experiences. For example, for patients with rheumatoid arthritis, the first priority is to take immunosuppressants as directed by the doctor. Don't stop taking the medicine when you feel the pain is gone. A recurrence will aggravate the irreversible damage to the joints. ； Patients with gouty arthritis should not listen to others who say that more exercise is better. First, stably reduce the uric acid to below 300. During the attack, they should not even walk, let alone soak their feet. The more the swelling, the more severe the swelling will be. I also have mild patellofemoral arthritis. My knees hurt when I stand up after sitting for a long time, so I put a small elastic band in the office. When I am sitting, I can step on it to exercise the muscles on the front of my thighs. Now I have basically never done it. There is a little trick that I have personally tested and found to be useful: when walking up and down stairs, turn slightly sideways, and the stress on the knees can be reduced by 30%. If you have elderly people at home, you can try it.

In fact, after dealing with arthritis patients for so many years, the biggest feeling I have is that this disease is not an "immortal cancer", but a chronic disease that requires you to get along with it slowly. Don't always think about finding a magic medicine to cure it once and for all, and don't think that you will be paralyzed for the rest of your life. Now research is constantly moving forward. Maybe in five or six years, we can really repair the worn cartilage just like repairing cavities, and then everyone will no longer have to suffer this pain.