Arthritis Care

There is no universal "magic prescription" for arthritis care. The core principle is a combination of "precise intervention by type + daily reduction of joint load + moderate function maintenance." It should be adjusted according to the type of arthritis, stage of onset, and personal physical condition. Blind calcium supplementation, pain relief, or excessive exercise/rest will aggravate symptoms.

Let’s talk about something I encountered in the outpatient clinic last week: 62-year-old Aunt Zhang has been suffering from knee pain for half a year. She heard from her neighbors that arthritis is caused by calcium deficiency plus cold. She applied hot compresses at home every day, drank high-calcium milk, and applied hundreds of yuan of blood-activating plaster. The pain was so painful that she even had to go downstairs to buy groceries. When she went for a check-up, she discovered that it was rheumatoid arthritis, which is not degenerative wear and tear at all. Calcium supplements for half a year have no effect at all, and have caused mild synovial hyperplasia.

Many people's understanding of arthritis is still limited to "senile disease, frozen disease, and calcium deficiency." In fact, there are several types of arthritis that are common clinically, and the focus of care varies greatly. The most common type of osteoarthritis is "wear and aging" caused by long-term use of the joints, just like the lubricating oil of the bearings. The focus of early and mid-term care is to reduce the load + appropriate cartilage repair. In the late stages, if the wear is too severe, replacement must be considered. ； Rheumatoid arthritis is caused by a disordered autoimmune system that "hits your own joints." The core of care is to take immune-controlling medicines on time. Don't use folk remedies blindly to delay the process. ； In addition, more and more young people are suffering from gouty arthritis. It is purely due to high uric acid deposits in the joints. Controlling diet to reduce uric acid is the fundamental.

Don't eat too much. Too many people are afraid to eat seafood and touch beef and mutton when they have arthritis, saying that these are "fat foods". In fact, except for gouty arthritis, which requires strict control of high-purine foods, ordinary patients with osteoarthritis should not eat seafood. Eating more deep-sea fish to supplement Omega-3 can also help fight inflammation. If you avoid these foods, you may be prone to nutritional deficiencies.

Controversy about ammonia sugar has indeed always existed. After 2019, the European and American Rheumatology Society does not recommend the use of ammonia sugar as a routine supplement for osteoarthritis. They feel that the clinical benefits are not obvious. However, many domestic orthopedics and rheumatology doctors I have contacted will still recommend that patients with early and mid-stage osteoarthritis take it for 3 months. After all, individual differences are too great. Some people do feel less sore and bloated after taking it, and they can just stop if it is not used. There are no side effects. There is no need to kill them all at once.

Let’s talk about a few pitfalls that ordinary people are most likely to step into. There was an old patient who was afraid of the cold in winter and wore a compression knee brace 24 hours a day. After wearing it for two months, he could not even walk steadily after taking it off, and his thigh muscles had atrophied. The knee brace was originally used for emergencies, such as when climbing stairs or walking long distances. Don't wear it every day. If the muscles are not used for a long time, it will make the joints more unstable. Some people believe that "climbing stairs 10,000 steps a day cures arthritis" on the Internet. The joints are already severely worn, and if you add weight to them every day, isn't this equivalent to adding a heavy workload to a bearing that is about to break? I met the most exaggerated old man who walked 30,000 steps a day. In the end, his knees swelled like steamed buns, and the fluid collected was light red.

Of course, that doesn’t mean you have to lie still if you have arthritis. I have seen a guy in his 30s who had knee pain and lay down at home for three months. He lost a lot of muscle mass. His joints wobbled after taking just two steps, which in turn caused them to wear out faster. As for whether you should move or stay still, there is really no standard answer: If you are overweight, don’t rush to exercise. Lower your weight first to reduce the weight-bearing pressure on your joints. ； If you don’t have enough muscle mass, start with non-weight-bearing muscle exercises such as silent squats and straight leg raises. Only when your muscles are strong can they help share the pressure on the joints. ； If the pain is severe during an acute attack, just rest and don't force yourself to exercise.

As for whether to apply heat or ice when a joint hurts, there is currently no unified standard in the industry: if the swelling is hot and the pain is excruciating during an acute attack, ice application should be given priority to calm the pain.； If you are usually afraid of cold and always feel that your joints are stiff and sore, apply hot compress if it feels comfortable. No one is right or wrong, just follow your body feeling.

After all, arthritis is a chronic disease tied to lifestyle, and no one can give you a permanent cure. Don't believe the nonsense on the Internet that "one action can cure arthritis". If it were such a good thing, our rheumatology department could close its doors. Whether your own joints are comfortable or not is always the first criterion. Don’t ignore the pain without seeing a doctor, and don’t buy a bunch of useless health care products. It’s better than anything else.