Arthritis care guidance and measures

There is no universal "one-size-fits-all solution" for arthritis care. The core principle is to first clarify the type of arthritis, avoid triggering factors, carry out targeted functional maintenance, follow medication instructions, and refuse to blindly follow popular folk remedies or "Internet celebrity exercise methods", so that pain can be relieved to the greatest extent and joint degeneration can be delayed.

Last week I met a 62-year-old Aunt Zhang at the outpatient clinic. She wanted to "exercise more to maintain her joints" after retirement, so she climbed the 12th floor three times a day with the community fitness team, and also practiced 20 squats. In less than half a month, her left knee was so swollen that she couldn't even put on thick jeans. She was limping when she came in. An MRI found that the amount of effusion in the joint cavity had tripled, and a small piece of patellar cartilage had been worn away.

In fact, there are a lot of people like Aunt Zhang who fall into the trap. The most controversial topic on the Internet about arthritis care now is "should I move or take care of myself?" There is actually nothing wrong with both sides, but the applicable scenarios are completely different. Most doctors in the sports medicine department recommend moderate activities. This is for patients in the stable stage of degenerative osteoarthritis. Only when the strength of the thigh muscles increases can they help the joints share at least 30% of the pressure and reduce wear and tear. ； But if you catch up with the acute stage of rheumatoid arthritis or gout attack, the rheumatology and immunology doctor will definitely tell you to move less immediately. At this time, the joint surface is already inflammatory, and moving around will only aggravate the wear and tear, and the inflammation will subside more slowly.

Another common misconception is to use hot compresses whenever there is pain, or even go for high-temperature moxibustion or sweat steaming, saying that it is necessary to "force the cold air out of the joints." Don't try it blindly. If it's just a dull soreness after catching a cold, and the joints are not red, swollen or hot, hot compress can indeed relax the muscles, promote circulation, and make you feel more comfortable. ； But if the joint is swollen and shiny, hot to the touch, or painful when touched, whether it is an acute attack of gout or an acute synovitis, hot compresses will only dilate the blood vessels, causing more tissue leakage and greater swelling. Two months ago, I encountered an uncle who had a gout attack. I applied a hot water bottle at home for three days. Initially, it was just ankle pain. In the end, I couldn't even get off the ground. When I arrived, my feet were swollen bigger than my fist, and I couldn't even fit a size 45 slipper into it.

Small details in daily life are actually more effective than blind exercise. For example, when wearing shoes, don't listen to people saying "soft-soled shoes are good for joints" and just buy those old Beijing cloth shoes that can be twisted into twists. It is best to choose shoes with a heel height of 2-3 centimeters, shoes that can bend at 1/3 of the forefoot, and a certain degree of support at the back heel. Regular jogging shoes are much more suitable than soft-soled cloth shoes. There are also knee pads. Don’t buy the kind of tight elastic sleeves that you wear every day. If you wear them for a long time, your thigh muscles will become “lazy” and slowly shrink, which will make them less able to protect the joints. Knee pads can only be worn when you climb stairs, carry heavy objects, or walk long distances. You don’t need to wear them at all when you walk normally at home.

People always go to extremes when it comes to medication. They either think that "painkillers are all side effects and they hurt you so much that they won't take them." Or if they feel pain, they just buy ibuprofen and take it for half a month. In fact, there is really no need to be so extreme. If the pain is very mild, just occasional soreness and swelling, and it does not affect eating and sleeping, you don’t need to eat at all. Putting on a mild pain-relieving patch and baking it with a baking lamp for ten minutes can relieve the pain. ； But if the pain is so severe that you can't turn over or get out of bed at night, and you can't rest without taking medicine, it's not good to carry it. The inflammation will disappear slowly and may become chronic. However, it is best to find a doctor to prescribe selective COX-2 inhibitors, which have much fewer gastrointestinal side effects than ordinary ibuprofen. Don't buy analgesics and take them randomly. Taking them for a long time can easily cause gastric bleeding.

By the way, the care priorities for different types of arthritis are very different, so don’t generalize. For example, the core of gouty arthritis is to control uric acid. Don't drink soup, beer, eat too much seafood and animal offal, drink more warm water at ordinary times, and don't touch hot water during the attack. ； Patients with rheumatoid arthritis should also check their immune indicators regularly. Don’t stop taking anti-rheumatic drugs casually. Pay attention to keeping your joints warm when the weather gets cold. ； Post-traumatic arthritis is common among young people. The key is to correct previous bad exercise habits. Don't always do squats, running and jumping, which have a great impact on the joints. Instead, practice more strength training that does not wear the joints, such as silent squats and straight-leg raises.

To be honest, I have come into contact with so many patients with arthritis, and I found that those who are most likely to have problems are those who "follow others when they say it works." For others, practicing squats may help, but your cartilage may be thin, but practicing it will make it worse. People may take traditional Chinese medicine, but you may have gout, but drinking it will increase your uric acid. The best care is actually to find a doctor to find out what kind of arthritis you have and how far it has degenerated, and then tailor a plan, which is more effective than reading ten health posts.