Most people will suffer from osteoarthritis, how to prevent it?

Author: Li Jianmin, Chief Physician, Beijing Jishuitan Hospital

Reviewer: Li Jun, Chief Physician, Peking University First Hospital

According to statistics, among the elderly population, sixty to seventy percent will suffer from arthritis in various joints.

That is to say, as we get older, each of us has more than a 50% chance of developing osteoarthritis. For some people, it may be limited to one or two joints, while for others, it may occur in joints throughout the body. This is related to the wear and tear of the joints.

1. What is osteoarthritis?

Strictly speaking, osteoarthritis is caused by the degeneration of articular cartilage.

The joint is composed of a cartilage between two bones, which is a cushion. Osteoarthritis is the degeneration of the cartilage cushion, which mainly causes cartilage thinning, cartilage fragmentation, and cartilage degeneration, resulting in the narrowing of the entire joint space of the cartilage.

The cartilage is worn down and thinned, resulting in cystic changes and increased density of the subchondral bone tissue. The main symptoms are joint swelling, pain and limited movement.

Figure 1 Original copyright image, no permission to reprint

Therefore, the essence of this disease is that it is a disease caused by the degeneration of articular cartilage, which leads to joint swelling and pain.

2. At what age is one likely to develop osteoarthritis?

Under normal circumstances and at a normal weight, osteoarthritis generally does not occur until after the age of 40.

Osteoarthritis mainly occurs in the joints of the lower limbs. Because the lower limb joints have to bear weight, such as the knee joints, ankle joints and hip joints, they will gradually develop symptoms of osteoarthritis, including joint pain, swelling, and wear of the joint cartilage.

As for the upper limbs, such as the wrists and finger joints, degenerative changes usually appear after the age of 50 or 60.

Of course, because osteoarthritis is caused by joint wear, if a single joint or individual joints are used very frequently, excessive use will also cause joint wear, so we can also see osteoarthritis in young people.

3. Where is osteoarthritis likely to occur?

Because osteoarthritis is caused by the wear and tear of articular cartilage, joints that are used frequently are more likely to experience articular cartilage degeneration, leading to joint swelling, pain, and osteoarthritis.

Generally speaking, it occurs more frequently in the joints of the lower limbs, such as the knee joints and ankle joints on both sides. Some people even have the hip joints on both sides affected. It can occur in any of the three major joints of the lower limbs.

Figure 2 Original copyright image, no permission to reprint

Some people walk a lot, which causes wear and tear of the articular cartilage in the small joints of the feet and the tarsometatarsal joints.

Some people work a lot and often do housework or manual labor. Their fingers are exposed to cold water for a long time, which causes wear and tear of the articular cartilage in the interphalangeal joints and they are more likely to suffer from arthritis.

There are also some people who engage in physical labor all year round, such as bricklayers and fitters. Their elbow joints are used quite a lot, especially for stonemasons, who were more common in the past. They often use heavier hammers to hammer stones. Over time, the elbow joints will also experience wear and tear.

Therefore, osteoarthritis basically affects the lower limbs more than the upper limbs, and the joints with more mobility are more common than the joints with less mobility.

4. Can osteoarthritis occur in the spine?

Yes, it happens, most commonly in the waist and the small joints of the lumbar spine.

Because there is an intervertebral disc connecting the vertebrae of the lumbar spine, and an upper articular process and a lower articular process connecting the posterior part of the vertebrae, a small joint is formed.

Figure 3 Original copyright image, no permission to reprint

When the lumbar spine moves a lot, the lumbar facet joints degenerate and the articular cartilage degenerates, leading to the formation of osteophytes, or bone spurs, in the facet joints. In this case, lumbar osteoarthritis will develop, causing pain in the lower back and limited movement.

Generally, simple osteoarthritis is less common in the thoracic and cervical vertebrae.

5. Will osteoarthritis cause disability?

There are still cases of disability caused by osteoarthritis.

Because osteoarthritis mostly occurs in the joints of the lower limbs, causing swelling and pain in the joints and narrowing of the joint spaces. If this condition develops more seriously and persists for a long time, complete wear of the articular cartilage may occur.

As the saying goes, when the articular cartilage is worn away, there is no gap between the two bones. In this case, if the patient's physical condition allows, an artificial joint replacement can be performed. In this case, after the artificial joint is replaced, his joint function will be restored and he will not be disabled.

However, some patients are special. For example, they have underlying diseases that prevent them from undergoing surgery, and their joints are severely worn. There are no conditions to restore joint function, which will lead to disability.

6. How to prevent osteoarthritis?

To prevent osteoarthritis, we must first avoid joint injuries. Because osteoarthritis is caused by joint degeneration, injured joints are prone to degeneration of articular cartilage, so avoiding joint injuries is a major aspect.

Second, avoid overuse of joints, which can lead to wear of joint cartilage and osteoarthritis.

Third, you should avoid getting your joints cold, because many patients with osteoarthritis in the interphalangeal joints do not actually move very much in their daily lives. They just do a lot of housework and often use cold water. The stimulation of cold water can also cause cartilage degeneration in the joints.

Therefore, to prevent osteoarthritis, you need to avoid injuries, fatigue, and colds.