Arthritis care essentials

Control acute attack symptoms, reduce additional wear and tear on joints, and adjust lifestyle habits in the long term. Arthritis care plans for different types and stages vary greatly. Don’t blindly copy other people’s experiences, let alone believe in the so-called “several courses of treatment” folk remedies.

Let me tell you an example that I encountered last week when I was helping out in the orthopedic clinic: 57-year-old Aunt Zhang was diagnosed with knee osteoarthritis three years ago. She heard the old sisters in the community say, "Joint pain is caused by rust. Just climb mountains and wear it out."

When it comes to the choice of exercise for arthritis, there are currently different opinions in different fields: the mainstream view of Western medicine is that articular cartilage is like the brake pads of a bicycle. Once worn, it is basically non-renewable. Try to avoid activities such as mountain climbing, climbing stairs, and squats that can put pressure on the joints up to 3-6 times the body weight. Priority is given to swimming, elliptical machines, wall squats, and other activities that can exercise muscle strength without causing too much burden on the joints.； Some schools of traditional Chinese medicine believe that moderate activities can dredge local qi and blood in joints and relieve stiffness. Some patients even report that the pain is relieved after walking slowly for half an hour every day. In fact, there is really no need to argue about right or wrong. The judgment standard is very simple: after you finish a certain exercise, if the pain and swelling of the joints completely subside within 24 hours, you can continue to do it. If the pain persists for two or three days, then stop immediately no matter how useful others say it is.

Speaking of this, many people may ask, as the old saying goes, "Arthritis comes from the cold." Does it mean that wearing more clothes and wrapping up tightly in autumn and winter will be fine?

This is actually only half true. Cold itself will not directly cause arthritis, but it will worsen the blood circulation in the joints and prevent inflammatory metabolites from being discharged, which will induce pain and swelling. Therefore, keeping warm is indeed useful, but there is no need to overdo it. I have a 28-year-old patient with ankylosing spondylitis who always wears velvet waist and knee pads when going out in winter. In summer, the temperature of the air conditioner in the office never drops below 26 degrees, and he even puts a blanket over his legs. The frequency of attacks in the past two years is indeed more than half lower than when he didn't care about it before. But if you have gouty arthritis, keeping warm is far less important than controlling uric acid. A meal of beer, seafood, and animal offal will still hurt even if you are wrapped in cotton pants.

What is easier to get into than exercise and keeping warm is actually the problem of medication. Hey, I have seen too many people go to extremes: either they will take two pills of ibuprofen if it hurts, stop taking the medicine immediately if it doesn’t hurt, and will not even take the slow-acting anti-rheumatic drugs prescribed by the doctor, or they will not dare to take any medicine for fear of side effects, and they will not come to see a doctor until their joints are deformed. You must know that if it is arthritis caused by autoimmunity such as rheumatoid arthritis and ankylosing spondylitis, taking only painkillers is equivalent to "hiding one's ears and stealing the bell". Inflammation has been destroying the joints, and when it becomes deformed, it will never go back. There is also glucosamine, which is the most frequently asked question. There are currently differences in domestic and foreign guidelines: most European and American guidelines believe that glucosamine has no clear therapeutic effect on osteoarthritis, and routine use is not recommended. ； Some domestic guidelines suggest that patients with early- to mid-stage osteoarthritis can try taking it for 3 months. If the pain is relieved after eating, they can continue taking it. If it doesn’t work, stop taking it. There is no need to bear the IQ tax.

In fact, many people ignore that small, inconspicuous daily habits can have a greater impact on arthritis than taking medicine and injections. I used to have a programmer friend who was diagnosed with patellar chondromalacia at the age of 29, which is an early stage of knee osteoarthritis. He used to sit in a low gaming chair every day, working on projects for four or five hours at a time, and his knees were so painful every time he stood up. I bought an office chair that was just high enough for my feet to rest flat on the ground. I rested my elbows on the armrests just enough to bear the weight of my upper body. I also set an alarm clock and stood up and walked for 2 minutes every hour. I practiced straight leg raises twice when I had nothing to do. I basically haven’t had any pain in the past six months. If you usually like to squat on the ground and wipe the floor, carry more than ten kilograms of vegetables up stairs, or sit on a low bench to pick vegetables, change these habits as soon as possible. Every time you bear extra weight, you are wearing down your already scanty joint cartilage.

After all, arthritis itself is a chronic disease that requires long-term management. Don’t always try to find a once-and-for-all solution. The care methods that work well for others may not work for you. After all, everyone’s arthritis type, severity, and physical fitness are different. Finding a reliable attending doctor, working with a rehabilitation practitioner to come up with a plan that suits you, and adjusting slowly is better than any miracle drug of unknown origin.