Arthritis care issues and care measures

The core problems of arthritis care are centered on improper pain control, accelerated joint function degradation, and omissions in the prevention and control of complications. The corresponding core principles of care are "layered intervention, dynamic and static balance, and individual adaptation." There is no one-size-fits-all solution. All measures must be adjusted based on the patient's arthritis type, disease course, and daily habits. Blindly following so-called "nursing tips" may actually aggravate joint damage.

To be honest, the most common trap I encounter in the clinic is that I only think of taking care of it when it hurts, and let it go completely if it doesn’t hurt. Last month, Aunt Zhang, a 62-year-old patient with knee osteoarthritis, endured the pain for almost half a year. Every time the pain was so painful that she couldn't sleep, she would take one ibuprofen. Later, the pain threshold became higher and higher, and she couldn't hold it down even with two pills, and she developed chronic superficial gastritis. In fact, when it comes to pain intervention, the views of Chinese and Western medicine do not conflict, but the applicable scenarios are far from each other: the mainstream stepped-drug regimen of Western medicine is more suitable for the acute phase. For mild pain, topical non-steroidal anti-inflammatory drugs are preferred to avoid oral gastrointestinal irritation. If the pain is moderate or above, oral or local injections are considered. ； Traditional Chinese medicine's moxibustion, acupressure, and plaster application are more suitable for soreness and discomfort in the remission period. If the joints are already red, swollen, hot, and painful, and moxibustion is applied, it will aggravate the inflammation and exudate, making the pain worse. Don’t take it hard because you think it’s just a medicine, but it’s a poison. Repeated painful stimulation will cause the muscles around the joints to continue to spasm and accelerate the wear and tear of the cartilage. The gain outweighs the gain.

There is another misunderstanding that is even more subtle: you can either lie flat and not move to "restore your joints," or practice blindly to "strengthen your joints." There was a 38-year-old patient with rheumatoid arthritis. When he was first diagnosed, he was afraid of becoming disabled in the future. He walked 20,000 steps a day and did squats with fitness bloggers. During the three-month review, the joint effusion was twice as much as when he was diagnosed. He was in so much pain that he couldn't even walk down the stairs. There are actually two different intervention ideas in the sports rehabilitation circle: one group advocates giving priority to low-load weight-bearing training and strengthening the muscles around the joints to stabilize the joints. ； Another school of thought advocates doing non-weight-bearing joint range of motion training first to avoid additional wear and tear. In fact, there is no right or wrong between the two ideas, but the adaptation stages are different: when the joint swelling is obvious in the acute stage, just do ankle pumps while lying down, and slowly flex and extend the joints, without putting extra pressure on the joints. ； After the redness and swelling subside, slowly add strength training such as wall squats and seated leg presses. Even if you only practice for 5 minutes each time, it will be more effective than walking 10,000 steps blindly. I often joke with patients that you know your joints best. If the pain does not subside for more than 2 hours after practicing, it means you have practiced too much. Stop immediately. Don't hold on "in order to get better quickly."

Many people only focus on joint pain when taking care of their joints, often missing more hidden complications. There was an old patient who had been suffering from arthritis for 12 years. Recently, he kept complaining that his lower back was so painful that he couldn't straighten up. After taking a lumbar spine X-ray, he discovered that his left leg was in constant pain and he was afraid to put any force on it. When he walked, he put all his weight on his right leg, which resulted in mild scoliosis. There are also patients with rheumatoid arthritis who only focus on the joints and ignore the possible accompanying dry eye syndrome and interstitial pneumonia. Patients with gouty arthritis only focus on pain relief and forget that uric acid control is the fundamental. These omissions are the core reasons for the later decline in quality of life.

As for specific nursing measures, there are actually not so many rules. Don’t adjust your daily medication blindly. Topical anti-inflammatory drugs, anti-rheumatic drugs, and uric acid-lowering drugs must be taken according to the doctor’s advice. Don’t stop without thinking that the symptoms have subsided. The side effects of regular medication are much smaller than taking them unexpectedly when you feel pain. Choose shoes with thick soles and soft soles for daily wear. Don’t wear hard-soled shoes or high heels just to look good. When going out in winter, add knee pads and elbow pads to your joints. Don’t let the cold wind blow directly, but don’t wrap yourself up too thickly to restrict blood circulation. People ask about health products like glucosamine and chondroitin the most. I usually say it straight away: patients with mild osteoarthritis may have some relief after taking them, but patients with moderate to severe osteoarthritis or those with rheumatoid or gout are basically useless. If you feel comfortable after taking them, just keep taking them. If you feel they are useless, don’t waste money. No one stipulates that "people with arthritis must take glucosamine."

I have been in the clinic for almost ten years, and I have seen too many patients who either feel like they will be paralyzed for the rest of their lives after suffering from arthritis, and are too anxious to do anything. In fact, arthritis is a chronic disease like high blood pressure and diabetes. Nursing care is a matter of gradual progress. There is no need to pursue any "perfect care plan". Just observe your body's reaction, slowly adjust to find a rhythm that suits you, and review it regularly. Most people can maintain a normal quality of life, and it is not that scary at all.