As the saying goes, "old legs first old", many people to a certain age will appear joint pain, joint stiffness and limited activity and other phenomena, they often think that this is due to "osteoporosis" or "lack of exercise" caused by joint pain, and even think that it is a normal phenomenon after increasing age. But in fact, the "culprit" that causes most elderly joint pain is osteoarthritis.

1. What is osteoarthritis?

Osteoarthritis is one of the most common joint diseases which mainly involves the damage of articular cartilage and the whole joint tissue, and eventually causes the degeneration of articular cartilage, fibrosis, fracture, ulcer and the damage of the entire articular surface. The disease is most common in middle-aged and elderly people, mainly knee, hip, hand and other joints, the main risk factors include genetic susceptibility, female, aging, obesity or overweight, joint force line disorders, metabolic syndrome, trauma and so on. Due to the accelerating aging of the global population, increasing obesity and increasing joint damage, the prevalence of osteoarthritis is increasing, resulting in reduced physical function, quality of life and social participation.

2. Clinical manifestations of osteoarthritis

Osteoarthritis generally begins insidiously and progresses slowly. The main manifestations are pain, tenderness, stiffness, bone hypertrophy and limited mobility of the affected joint and its surroundings. Pain is the earliest symptom of the vast majority of patients with osteoarthritis, mostly after activity, rest can be relieved. With the progression of the disease, the pain time is gradually prolonged, and pain can also occur at rest. Pain can affect the daily activities of the elderly, such as going up and down stairs, squatting and other joint bending movements, and even affect walking on flat ground; Some patients have severe and persistent pain, accompanied by paresthesia, often accompanied by anxiety and depression. In addition, there will be different degrees of limited joint movement, joint stiffness, and there can be a bounce or friction sound when the joint is active.

    

3. How is osteoarthritis treated

Elderly friends feel joint discomfort, should go to the regular hospital orthopedic treatment. The purpose of osteoarthritis treatment is to relieve joint pain, improve joint function, prevent or slow down structural changes in joints, and improve patients' quality of life. As far as possible, the doctor will develop an individualized treatment plan based on the results of the disease assessment, and take different steps of treatment.

4. Prevention of osteoarthritis

① Control weight and reduce joint pressure

The hip and knee joints are under heavy load during weight-bearing activities, and maintaining an ideal body weight is important to protect joint structure and improve symptoms. Studies have shown that the percentage of weight change has a dose-effect relationship with the improvement of joint symptoms, and the improvement of symptoms is more obvious when the weight is reduced by more than 10%, and only weight loss can reduce the symptoms of knee arthritis by 25% to 50%. Weight loss method is recommended to limit dietary calories combined with physical exercise, the daily diet should be low-fat, less salt, less sugar as the principle, it should be noted that calorie restriction may lead to fat weight loss and weakened muscle strength, especially the elderly, so muscle strength training should be carried out at the same time.

② Suitable for exercise, pay attention to warm

People often "exercise leads to increased joint wear and tear, once suffering from osteoarthritis can not exercise" misunderstanding. However, numerous studies have also confirmed that exercise can effectively treat osteoarthritis. Cartilage has no blood supply and needs to get nutrition from joint fluid through exercise. People who do not exercise for a long time are more prone to degeneration of articular cartilage. Exercise is good for the whole body organs such as heart, brain, lungs, etc. And exercise itself is an important measure of weight management. It is generally recommended to carry out low-intensity aerobic exercise (such as walking, Taijiquan, Baduanjin, low-impact aerobic dance, etc.), the use of correct and reasonable aerobic exercise can improve joint function and relieve pain. The strength training of the muscles around the joint can improve the stability of the joint and promote local blood circulation. At the same time, it is necessary to keep the joints warm and add clothes in time when the temperature drops.

References:

[1] Joint Surgery Group, Orthopaedic Branch of the Chinese Medical Association, Osteoarthritis Group, Orthopaedic Branch of the Chinese Medical Doctor Association, National Clinical Medical Research Center for Geriatric Diseases, etc. Chinese Guidelines for the Diagnosis and Treatment of osteoarthritis (2021 edition) [J/OL]. Chinese Journal of Orthopaedics, 201,41(18):1291-1314.

[2] Tong Sihan, Huang Yigang, Zhang Changqing, et al. Mechanism of pain in senile degenerative arthritis [J]. Journal of Practical Geriatrics, 2019,37(10):989-994. (in Chinese)

[3]MARTEL-PELLETIER J, BARR A J, CICUTTINI F M, et al. Osteoarthritis[J/OL]. Nature Reviews. Disease Primers, 2016, 2:16072.

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