[Health Lecture] What to do if you have osteoarthritis? Physical therapists teach you tips for recovery

In order to ensure the scientific effect of learning health knowledge in the 3rd China Elderly Health Knowledge Competition, the organizers have collected various health science articles suitable for elderly people to learn from various hospitals. We will share them through the "Health Lecture Hall" column. Today we bring you an article about osteoarthritis from Ma Tingting of Beijing Boai Hospital, China Rehabilitation Research Center. Elderly friends are welcome to learn.

Aunt Li, a 65-year-old neighbor, has been feeling that her knee joints are rusty and she can't move them in the mornings recently. Her legs are also very painful. She has to wait for half a day and move slowly before she can get up. She went to the hospital for a checkup and found that she had osteoarthritis. After the diagnosis, Aunt Li was puzzled. She had been strong and healthy since she was young, and she has been exercising since retirement. How could she have osteoarthritis? What kind of disease is osteoarthritis?

Osteoarthritis is recognized worldwide as one of the most common disabling diseases and one of the most common elderly joint diseases in my country. It is a chronic joint disease, the main lesions of which are degenerative lesions of articular cartilage and secondary bone hyperplasia. Osteoarthritis is more common in middle-aged and elderly people over 50 years old, and is more common in women. It often occurs in the larger weight-bearing joints of the human body, such as the knees, hips, spine, and finger joints. In addition to osteoarthritis, it is also called osteoarthritis, degenerative arthritis, hyperplastic arthritis, senile arthritis or hypertrophic arthritis. Osteoarthritis has four typical symptoms.

The first symptom is joint pain, which gradually intensifies, getting worse during activity and getting better during rest. At the same time, the pain is also related to weather changes, and is more likely to occur in humid or low-temperature conditions.

The second symptom is joint stiffness, which is common when getting up in the morning or when not moving for a long time. Patients will feel that the joints are stuck and cannot move immediately. When moving slowly, the joints will make abnormal "crack, crack" sounds.

The third symptom is joint swelling, which is caused by cartilage and bone hyperplasia. In severe cases, it can also lead to joint deformation.

The fourth symptom is limited daily life activities. Patients will feel powerless when moving, and in severe cases, they will have difficulty bending the knee joint.

Osteoarthritis can have a significant impact on your daily quality of life. If you experience the above symptoms, you need to seek medical attention in a timely manner to prevent the condition from getting worse. In addition to taking medication on time as prescribed by the doctor to control the condition, physical therapy can also be used to treat osteoarthritis.

So, what is physical therapy? What symptoms can physical therapy help patients with osteoarthritis improve? Physical therapy (PT) is a profession that combines prevention, treatment and improvement of functional disorders caused by diseases and injuries. It aims to maximize the patient's function and maximize the patient's quality of life. It occupies an important position in modern medicine. As the executor of physical therapy, physical therapists mainly focus on pain management, strengthening muscle strength, increasing joint mobility, improving cardiopulmonary function, improving mobility and participation, etc. According to the results of professional physical therapy assessment, physical therapists develop a set of individualized intervention measures for patients, and can effectively assist and participate in specialized treatments such as orthopedics, neurology, cardiology, obstetrics and gynecology, and oncology; at the same time, physical therapists will also provide preventive education to patients so that they can establish a healthier lifestyle before the disease occurs. Physical therapists can complete their work in a variety of different places, including hospitals, private clinics, outpatient clinics, home health agencies, schools, sports and fitness institutions, workplaces, and nursing homes. For people with osteoarthritis, physical therapists can provide help to patients in the following aspects:

1. Control pain. First, in the acute stage of osteoarthritis, the pain is more obvious. At this time, patients should be advised to rest in bed and reduce activities. At the same time, cold therapy can be used to apply ice to the painful area to relieve pain. In the chronic stage, local heat therapy can be used for analgesia. Common methods include warm water showers, hot water baths, hot compresses, paraffin wraps, etc. In addition, physical therapy methods such as ultrasound, medium-frequency electrotherapy, and traditional Chinese medicine massage also have a certain effect on relieving pain.

2. Improve joint and muscle function. For joint stiffness and weak muscle, physical therapists will evaluate the joint and muscle status through professional physical therapy examinations, and select appropriate physical therapy methods for patients to improve function. For joints with limited mobility, passive stretching exercises are generally used to expand the range of joint motion. Taking the limited flexion of the hip and knee joints as an example, it is recommended that patients sit on the edge of the bed or on a fixed chair, hold the lower part of the knee joint on the side with limited mobility with both hands, and use slow and even force to pull the leg up toward the body. Pay attention to keeping the body upright as much as possible, stay for 10 seconds when pulling to the highest point without pain, then put down the leg and rest for 10 seconds, and then pull it up again. Repeat "pull up-put down" ten times as one training. Doing it 5-10 times a day can effectively improve the condition of joint restriction. For patients with low muscle strength, muscle strength training is recommended. Taking the quadriceps muscle strengthening as an example, let the patient sit upright on a chair with a backrest, place the feet flat on the ground with the width of the shoulders, and slowly and evenly lift the calf forward until it is level with the thigh and the knee joint is not overly stretched. Stop when it is raised to an angle that is not too tight, hold for 10-15 seconds, then slowly retract the calf, rest for 10 seconds and repeat the action. Repeat 10 times each time, and perform 3-5 training sessions a day. This training can effectively help osteoarthritis patients improve quadriceps muscle strength, thereby improving knee joint stability.

3. Control your weight. Obesity will increase joint damage for osteoarthritis patients, which is very detrimental to the recovery of the disease. Therefore, osteoarthritis patients are advised to control their weight to avoid excessive load on their joints. The Body Mass Index (BMI) can be used to calculate whether their weight is overweight. BMI is an internationally used standard for measuring the degree of fatness and health status of the human body. Its calculation formula is: BMI = weight ÷ height² (kg/㎡). Among the adult population in my country, a BMI value between 18.5-23.9 is in the normal range. A value below 18.5 is considered thin, and a value above 23.9 is considered obese. In physical therapy, osteoarthritis patients are generally advised to control their weight through a combination of a reasonable diet and aerobic exercise. In terms of diet, first of all, we should eat high-protein and high-calcium foods, such as eggs, milk, tofu, nuts, etc. High-protein foods will enhance the strength of muscles around joints, and calcium is a very important element for osteoarthritis. Drinking milk and sunbathing are both feasible ways to supplement calcium, which are beneficial to the recovery of osteoarthritis. Secondly, we should pay attention to a light diet, drink more water, eat more vegetables, and eat more fruits, which will help improve the metabolism around joints and promote the recovery of osteoarthritis. Finally, we should pay special attention to eating less high-oil and high-fat foods, which may increase the patient's weight, lead to obesity and increase joint load, thereby increasing the condition of osteoarthritis. In terms of exercise, it is recommended that patients choose their favorite aerobic exercises, such as walking, jogging, swimming, cycling, yoga, etc. These are all good ways to help osteoarthritis patients consume excess energy in the body. However, it should be noted that any exercise or exercise should be gradual to prevent excessive activity and loss of joints and avoid further damage to the joints. Therefore, be careful not to stand for a long time or walk a long way, and reduce activities such as climbing mountains and stairs.

4. Adopt a healthy lifestyle. In daily life, osteoarthritis patients should try to avoid frequent squatting, lifting heavy objects with bare hands, etc., and pay attention to protecting joints. When going out to buy things and need to lift heavy objects, you can replace your handbag with a cart; try to take the elevator to go up and down the stairs to avoid frequent weight bearing on the knee joints. If you must take the stairs, it is recommended to go down the stairs with your hands, walk backwards, or walk sideways, because these two methods mainly rely on the movement of the hip joint, and the load and pressure on the knee joint are significantly reduced, effectively reducing the wear of the articular surface cartilage, thereby effectively protecting the progression of knee osteoarthritis, which is very suitable for osteoarthritis patients with poor knee joint mobility.

About the Author:

Ma Tingting, deputy director and deputy chief technician of the first sports therapy department of Beijing Boai Hospital, China Rehabilitation Research Center; master of rehabilitation medicine and physical therapy; teaching officer and lecturer of PT teaching and research department of Capital Medical University School of Rehabilitation Medicine. Deputy leader of the Children's Rehabilitation Science Popularization Professional Group of the Science Popularization Health Education Working Committee of the Chinese Medical Education Association, member of the Children's Rehabilitation Committee of the Beijing Rehabilitation Medicine Association, and member of the CLASI International Sensory Integration Course (CLASI) certification.