Arthritis care measures

There is no "once and for all cure" solution. The core goal of all measures is to Control pain attacks, delay joint degeneration, and maintain normal activity functions , specifically, it should be implemented in three directions: daily behavioral adjustment, standardized medical intervention, and individual adaptation. There is no need to pursue a "perfect solution", only the one that suits you is the most effective.

Let me first tell you about a case I encountered in the outpatient clinic last week. Aunt Li, 54, has suffered from osteoarthritis in both knees for three years. She heard an old sister in the community say, "Just walk more and wear off the bone spurs." She walked 8,000 steps a day despite the pain. As a result, her knees were swollen like a small steamed bun, and she couldn't even squat.

Regarding whether patients with arthritis can exercise, doctors from different departments have different priorities: Orthopedic surgeons generally recommend less weight-bearing and more rest in the acute phase to avoid repeated joint friction and aggravation of fluid accumulation.； But the point of view of the rehabilitation department is that even if the pain is so severe that you can't get off the ground, you should do non-weight-bearing muscle activation in bed, such as straight leg raises and ankle pump exercises. Otherwise, the thigh muscles will atrophy and the joint protection will be even worse. In fact, both of these statements are correct. Score: During the acute stage, when the pain is so painful that it is difficult to even step on the ground, just rest and do some static exercises on the bed at most. ； When the pain is almost gone, choose any exercise that puts less pressure on your joints, such as swimming, cycling, or walking slowly. Don't run a marathon, climb a tall building, or do weight-bearing square dancing. If you really want to climb a mountain, choose a gentle slope instead of rushing up the stairs.

Oh, by the way, there is also the question of knee pads and warmth that everyone asks the most, and it is not "the more coverings, the better". It is okay to wear knee pads when you go out in the winter or stay in an air-conditioned room when the temperature is low. This can prevent the joints from being irritated by cold and causing pain. However, it is best to take off the knee pads when the temperature is suitable at home or when you are doing muscle strength training. Long-term reliance on knee pads will make the muscles around the knee joint "lazy" and become weaker and more susceptible to injury. I used to have an old patient who wore fleece knee pads when it was over 30 degrees Celsius in summer. His knees felt cold when he took them off. In fact, the skin's tolerance to temperature decreased due to covering them for a long time. Later, he gradually reduced the thickness of the knee pads. Now he doesn't feel uncomfortable even if he doesn't wear them at normal room temperature.

As for being particular about diet, not everyone should “cut all foods”. It depends on what type of arthritis you have: the most common osteoarthritis patients actually have nothing they absolutely cannot eat. The most important thing to do is to control their weight. After all, for every 1 pound of weight gain, the knee joints bear 4 more pounds of pressure when walking. The effect of losing weight on relieving the pain of knee arthritis is sometimes more obvious than taking painkillers. If you have gouty arthritis, you really need to keep your mouth shut, and try to avoid high-purine foods such as beer, seafood, animal offal, and rich broth. Otherwise, the uric acid will rise and you will be in pain that makes you unable to get out of bed every minute. Patients with rheumatoid arthritis should avoid foods high in sugar and trans fatty acids. Studies have shown that such foods may aggravate the body's inflammatory response and increase the frequency of pain attacks.

Many people are very worried about taking medicine. They always feel that "the medicine is only three parts poisonous" and refuse to take painkillers because of the pain. In fact, non-steroidal anti-inflammatory drugs such as ibuprofen and celecoxib, which are commonly used in clinical practice, will basically not have any major side effects if they are taken according to the doctor's instructions and in the amount for 3-5 days when there is pain. Moreover, they not only relieve pain, but also eliminate local aseptic inflammation in the joints, which is much better than having the joints repeatedly swell and wear. Of course, some gastroenterologists will remind you not to take it on your own for a long time. If you have a bad stomach, you can choose a dosage form that is less irritating to the gastrointestinal tract. It is always right to ask your doctor before taking it. As for those folk remedies that promote "radical cure for arthritis" and the blood pricking programs in street massage parlors, be sure not to try them randomly. I have seen too many patients who applied folk remedies on their own so that their skin ulcerated, or who massaged their joints more severely and wore out their joint cartilage. Not only did they spend a lot of money, but they also suffered. Of course, rehabilitation physiotherapy in regular hospitals, such as ultra-short wave, medium-frequency electrotherapy, and joint mobilization performed by professional rehabilitation practitioners, can indeed relieve pain, and can be done if conditions permit.

Finally, to be honest, I have been in the orthopedic clinic for almost 7 years, and I have seen too many patients who always want to find a "universal prescription." In fact, arthritis care is to get along well with your joints, don't overdo it, and don't pamper it too much. You can try the methods that others say work well. If you use them and the pain becomes worse, stop immediately. After all, your feelings are the most accurate criterion. Oh, by the way, regular follow-up joint radiographs are taken every year to see the speed of degeneration. If it really reaches the point where conservative treatment is useless, surgery should be done. Now that joint replacement technology is very mature, there is no need to carry on and affect the quality of life.