Prevention of osteoarthritis should be as harmful as hypertension and coronary heart disease as early as possible.
In the golden autumn, many elderly people will go out to play, and for the elderly with osteoarthritis, there is no need to "stay at home". Experts suggest that moderate exercise therapy for patients with osteoarthritis can relieve pain, improve physical function, improve quality of life and walking ability, and reduce the risk of falling.
Xu Jun issued by Xinhua News Agency
Osteoarthritis is the most common disease among people over 60 years old, and it is also the fourth most disabling disease in the world. However, nowadays, the patients with osteoarthritis have begun to change and extend to young people. This often has nothing to do with age. Joint trauma and joint overuse can cause secondary osteoarthritis. Therefore, osteoarthritis is closely related to each of us and should be paid attention to. Experts remind that arthritis should be prevented, diagnosed and treated early.
The harm is not lower than hypertension and coronary heart disease.
Osteoarthritis is a chronic joint disease characterized by articular cartilage degeneration and secondary hyperosteogeny. Normal human joints are composed of joint cavity, joint capsule and joint surface, and the surface of bones is covered with a layer of cartilage. These cartilage and synovial cells of joint capsule can secrete mucus and play a role in lubrication.
With the increase of age and the aging of human body, the cartilage of some joints, especially the weight-bearing joints such as knees and hip joints, is worn, and the local lubrication function is reduced. The severe wear of cartilage exposes subchondral bone, which leads to bone hyperplasia. Wear particles stimulate synovium, causing pain and swelling. For example, the bearing of the machine keeps running under heavy load, aging and wearing, the surface becomes pitted, and the lubricating oil is not enough.
Osteoarthritis begins in youth and develops slowly. Although it is not fatal, it is no less harmful than hypertension and coronary heart disease. Professor Weng Xisheng, deputy director of the Orthopedic Branch of the Chinese Medical Association and chief physician of the Orthopedic Department of Peking Union Medical College Hospital, said that although it is regarded as "geriatric disease", the early occurrence of symptoms such as joint discomfort is concentrated in middle age.
A few days ago, it focused on the research report on the health status and diagnosis and treatment habits of bone and joint — — Patient-centered — — A new understanding of bone and joint health management (referred to as "report") was released. It is revealed that the incidence of patients’ conscious joint discomfort increases with age, and the first time is from 40 to mdash; 54 years old, at 45— At the age of 49, it began to rise significantly. In 2017, the total number of patients with osteoarthritis in China has reached 61.2 million.
Experts call for paying attention to basic treatment, integrating public education, health care policies and osteoarthritis prevention strategies into the management of regular chronic diseases, implementing appropriate osteoarthritis prevention strategies, and timely using sports therapy, physical therapy, mobility assistance and other means to move the "treatment opportunity window" forward and delay the progress of the disease.
Women are more frequent than men.
Osteoarthritis is more common in women than in men, and both the prevalence rate and the average number of uncomfortable joints are higher than in men. Geographically, the prevalence rates in southwest, northwest, Guangdong and Heilongjiang are generally high.
There are many causes of osteoarthritis. Besides age, sex and other factors, occupational influence and bad living habits are also important causes of osteoarthritis. The above report pointed out that excessive or insufficient exercise, long standing or sedentary work habits are easy to induce osteoarthritis. Osteoarthritis will affect all weight-bearing joints of the whole body, among which knee joint discomfort is the most common, followed by cervical and lumbar vertebrae.
With the progress of the disease, patients are often accompanied by symptoms such as joint pain, soreness, bone friction, rigidity and dysfunction, which not only seriously hinders the normal life of patients, but also causes huge psychological burden.
Behind the huge patient population, there is still a huge unmet need for diagnosis and treatment. Based on the big data of Ping An Doctor’s consultation platform, the most common medical problems mainly focus on three aspects: treatment expectation, disease management and treatment cost. Respondents expect to improve their quality of life, control their medical burden, and are willing to learn more about diseases to help themselves or their families better cope with diseases.
90% of patients lack understanding of the disease.
As a degenerative disease, osteoarthritis progresses relatively slowly, and its harm will not bring sudden and fatal effects to patients, which is extremely hidden and easily overlooked by patients. Although with the popularization of bone health education, the public’s awareness of osteoporosis prevention and calcium supplementation has improved, but the awareness of cartilage health management, another important aspect of bone health, is still generally lacking.
According to the report, nearly 90% of patients with osteoarthritis lack knowledge about arthritis, and even have a serious lack of understanding or mistakes about the end point of diseases such as disability. Patients often don’t realize that they are "diseases" at the time of onset, which leads to missing the earliest treatment opportunity.
In addition, for patients, even if they seek medical treatment, their attitude towards diagnosis and treatment is not positive enough, and their compliance with treatment is not strong. According to the report, 23% patients have a negative attitude towards the diagnosis and treatment of diseases, and think that this is a natural phenomenon of "aging process", and no measures have been taken to reduce joint discomfort. Among people over the age of 65, the proportion of patients who choose to "accept their fate" and give up treatment has further increased to nearly 40%.
For the choice of treatment methods, most moderate and severe patients wait until their illness is serious before looking for intervention measures, and give priority to basic treatments such as exercise and massage, and have low awareness of treatment methods such as drugs and surgery. Weng Xisheng said that the management of osteoarthritis, a chronic disease, focuses on early diagnosis and treatment, early intervention, and the use of step-by-step and personalized treatment strategies. Therefore, the construction of "basic treatment — Drug therapy — "Surgical treatment" should be an important development direction of the current bone and joint health management model, which guides patients at different stages to adopt targeted treatment according to the progress of the disease.
Promote patient-centered whole-course disease management.
Professor Lin Jianhao, director of the Department of Osteoarthrosis of Peking University People’s Hospital, said: "In view of the irreversible nature of osteoarthrosis, self-management of patients is very important. For patients with early and middle osteoarthritis, besides maintaining proper weight and adjusting lifestyle, scientific exercise therapy is one of the core means of the whole disease management of osteoarthritis. Targeted and personalized exercise therapy can effectively help patients achieve the goals of relieving pain, improving knee joint function and quality of life. "
In addition, for the drug treatment of osteoarthritis, the report emphasizes that individualized treatment strategies should be adopted, not only for the right medicine, but also for people. If the pain symptoms are obvious, non-steroidal anti-inflammatory drugs can be given to relieve the pain; On the basis of disease education and exercise therapy, patients with joint swelling in the acute stage can be injected with a small amount of hormones in the joint cavity as appropriate according to the condition to relieve the symptoms, but it should be noted that the injection in the joint cavity should not exceed 4 times in one year, and strict aseptic operation is needed to avoid infection. In addition, crystalline glucosamine sulfate and other chondroprotective agents can be used as background therapy for a long time to relieve pain, repair cartilage and delay the progress of the disease.
Experts stressed that under the guidance of the Healthy China Strategy, the special action of healthy bones is gradually becoming a reality under the impetus of many parties. Osteoarthritis should be included in the long-term plan of national chronic disease management together with chronic diseases such as cardiovascular and cerebrovascular diseases and diabetes. It is imperative to promote patient-centered whole-course disease management.
To this end, the report puts forward the "three-comprehensive" strategy for the prevention and treatment of osteoarthritis, that is, by strengthening the popular science work in the whole society to improve national cognition, advocating the active participation and promotion of osteoarthritis prevention and control by the whole people, and constructing the whole process management concept of step-by-step treatment of joint diseases.
interlinkage
How do young people prevent arthritis?
Avoid carrying heavy objects on your back.
Avoid standing and walking for a long time, and sit and rest in the middle. Try to sit in the toilet and squat less when defecating. Do not take iron or iron-containing multivitamins. Because iron is associated with pain, swelling and joint injury. Alkaloids in Solanum vegetables, such as tomatoes, potatoes, eggplant, peppers and tobacco, can aggravate arthritis symptoms.
lose weight
Obese people suffer from osteoarthritis significantly more than others. Losing weight to reduce the pressure and wear of joints can effectively prevent the occurrence of osteoarthritis.
Change the unreasonable way of exercise
Tai Ji Chuan’s semi-squat or squat exercise exerts great pressure on the joints of lower limbs and should be avoided as much as possible. Climbing mountains and stairs increases the pressure on the joints of lower limbs and should be avoided as much as possible. With the increase of age, we should gradually adjust the exercise mode, focusing on swimming, cycling and walking, and reducing the exercise mode with large amount of exercise.
Avoid joint injuries
Pay attention to the safety of sports venues and sports equipment to avoid injury. Warm up before exercise, and the amount of exercise will gradually increase from small to large. Do not take part in heavy-load exercise at the beginning. Relax after a lot of exercise. Old people should avoid falling when walking.