Five common misunderstandings about osteoarthritis that must be clarified!

Author: Zhang Guangwu, Chief Physician, Peking University Shougang Hospital

Reviewer: Li Jun, deputy chief physician, Peking University First Hospital

As age increases, the probability of osteoarthritis occurring after the age of 45 increases.

Someone has done statistics and found that 45% of people over 60 years old have osteoarthritis; after 80 years old, almost 100% of them have osteoarthritis, but some people have more severe symptoms and some people have milder symptoms.

Osteoarthritis is caused by a variety of factors, including degenerative changes, weight, trauma, deformity, etc., which act on the joints and cause changes in the joint structure, resulting in joint dysfunction, including joint stiffness, pain, swelling, difficulty in flexion and extension, muscle atrophy, etc.

Osteoarthritis often occurs in weight-bearing joints, most commonly in the joints of the lower limbs, such as the knees, hips, and ankles, but it can also occur in the cervical, thoracic, and lumbar vertebrae.

Figure 1 Original copyright image, no permission to reprint

There are many misunderstandings about osteoarthritis and its treatment. Let’s talk about some of the more common misunderstandings and see if you have any of them.

1. Does osteoarthritis require treatment?

uncertain.

For degenerative arthritis, see if there are symptoms. If there are symptoms, treat them. If there are no symptoms, my advice to the public is to ignore it. For middle-aged and elderly people, it is a degenerative change and an objective existence. We can live with it peacefully without special treatment.

2. Are injections and medications a panacea for treating osteoarthritis?

This is a misconception.

Osteoarthritis is related to age and joint aging. This process is irreversible and cannot be intervened. What we can intervene is to relieve the symptoms of pain and swelling and make the patient feel more comfortable. This is something that can be done.

There are many treatments available now, including medication and injections, all of which focus on alleviating symptoms rather than reversing the aging process of joints. These methods cannot cure osteoarthritis, so everyone must have a correct understanding of this.

Figure 2 Original copyright image, no permission to reprint

3. Are antibiotics necessary to treat osteoarthritis?

This is also a misunderstanding.

There are two main types of inflammation. One is inflammation caused by bacterial infection, which is characterized by redness, swelling, heat and pain, and elevated white blood cell count in blood tests. This bacterial inflammation needs to be treated with antibiotics.

There is also a type of inflammation called aseptic inflammation, which is inflammation that has nothing to do with bacteria. Osteoarthritis is a type of aseptic inflammation, so osteoarthritis does not need to be treated with antibiotics.

Many people take antibiotics to reduce inflammation when they hear the word "inflammation". This is completely wrong and very dangerous. Antibiotics are chemical drugs that can cause varying degrees of liver and kidney damage, as well as other toxic side effects. Antibiotics must be used purposefully under the guidance of a doctor and should not be abused. Abuse of antibiotics will eventually cause bacterial resistance, and when you get sick, the antibiotics will be useless, which is a very scary thing.

4. Can patients with osteoarthritis take painkillers for a long time?

Analgesics are the first choice for treating osteoarthritis, and this view is the same both abroad and in China. Different patients have different degrees of pain, and doctors decide which analgesics to use based on comprehensive considerations of the specific situation.

For osteoarthritis, although analgesics are the first choice, long-term use is not recommended. My advice to patients is: use it when it hurts, and don't use it when it doesn't hurt.

Currently, analgesics have several major side effects. The first major side effect is gastrointestinal reaction. After taking them, you will feel stomach discomfort, acid reflux, nausea, and even vomiting. The most serious ones can cause gastrointestinal perforation. There are also effects on the cardiovascular and blood systems. Therefore, you must know when to stop taking them and stop taking them immediately after the pain is relieved. This is the most important principle.

In addition, analgesics must be used under the guidance of a doctor. For example, some patients also have gastric ulcers and stomach problems. When choosing analgesics, doctors will consider these factors to minimize damage to the gastrointestinal tract. It is very important not to buy some over-the-counter analgesics at the pharmacy and use them casually.

5. Is it better for patients with osteoarthritis to exercise more?

This is another misunderstanding.

Some people suggest that walking a certain number of steps a day is good, and they think running is simple. In fact, running also requires skills, and incorrect exercise will damage joints. For some people, walking this many steps is good for the body, while for others, walking this many steps may cause damage to the joints.

The occurrence of osteoarthritis is related to stress, and the most important reason for stress is exercise, part of which is sports and part of which is walking. Protecting joints is a particularly important measure to reduce the occurrence of osteoarthritis. My view is that it varies from person to person, and the amount of exercise must be determined according to one's own situation.

In addition, preventing osteoarthritis starts with choosing the correct way to exercise. When doing sports such as running, playing basketball, and playing table tennis, the body is standing and the weight is on the joints, which can easily cause joint injuries.

If you swim, this problem will not exist. When swimming, the body is in a horizontal position and the pressure on the joints is zero. This can effectively protect the joints while achieving the purpose of exercise. Therefore, it is important to choose the right exercise method.

Many people think that they can wear off bone spurs through strenuous exercise, which is impossible. The mechanism of bone spurs is excessive stress on the joints. A lot of exercise will definitely increase the pressure. Excessive exercise will make bone hyperplasia and bone spurs more obvious. Of course, bone spurs and bone hyperplasia have limits. When they reach a certain level, the strength of the joints reaches a balance and they will not proliferate indefinitely.