Arthritis care routine

To quickly relieve discomfort during acute attacks, slow down joint degeneration, and preserve normal mobility as much as possible, all nursing actions must be adjusted based on the type of arthritis (osseous/rheumatoid/gouty/reactive, etc.) and the stage of the disease. There is no "standard operation" that applies to everyone.

When many people are first diagnosed with arthritis, the first question they ask is, “Will I never be able to move again?” ”, this is actually a point of great controversy in academic circles now - the "rest school" believes that the joints have been worn out, and walking and squatting are extra consumption, and they should not move if they can. ； “Sports people think that joints can be better protected only when muscle strength increases, and the more you lie down, the worse it will be. In fact, there is nothing wrong with what both sides said, but they did not clearly explain the applicable scenarios. Last week, I met a 62-year-old patient with knee arthritis in the outpatient clinic. I heard someone said that walking can wear down bone spurs. He walked 5 kilometers around the park every day, and his knees were swollen like steamed buns. When he came, he cried and asked if he was going to have his leg amputated. ； There is also a 30-year-old rheumatoid patient. After experiencing pain once, he did not even dare to hold a cup of water. Over the past six months, his muscles atrophied and his joint mobility became worse and worse. To put it bluntly, during an acute attack, when the joints are red, swollen, hot and sore that you can’t touch them, just rest quietly and don’t insist on doing rehabilitation. When the inflammation subsides and the pain subsides, you can slowly build muscle strength. For example, patients with knee arthritis can practice silent squats and ankle pumps, and patients with shoulder arthritis can do wall-climbing movements. These are all very cost-effective movements according to our clinical experience. The premise is that you don’t increase the amount blindly and stop when it hurts.

What is more confusing than moving or not is whether to apply cold or hot compresses. Many people have a stereotype: when their joints hurt, they apply hot towels or electric heating lamps. The hotter the joints, the more comfortable they will be. But if you have an acute attack of gout, could you try applying a hot towel? It will make you jump in pain on the spot. There is no standard answer here: as long as the joints feel hot to the touch and red and swollen when the attack occurs, give priority to cold compresses within 72 hours. Just wrap an ice pack in two layers of towels and apply it for 15 minutes. Do not apply it directly to the skin for frostbite. ； If it's just a dull soreness after catching a cold and no signs of redness, swelling or heat, then you can use hot compresses, baking lamps, or baby warmers, whatever makes you feel better. There are also support-type knee pads with added steel plates. Don’t wear them every day when walking. If you wear them for a long time, your muscles will become lazy and shrink. You can only wear them when walking long distances or climbing stairs. For daily warmth, choose loose cashmere knee pads.

There are even more pitfalls with medication. Many people think that "painkillers hurt the stomach" and they are so painful that they can even break into cold sweats. In fact, the gastrointestinal side effects of the commonly used selective COX-2 inhibitors are much smaller than those of the old-fashioned ibuprofen. It is perfectly fine to take them for three to five days as directed by the doctor. Instead, the inflammation spreads and is more likely to become chronic pain. There is also glucosamine, which has been touted to be amazing, but there is no unified conclusion in the academic community. Some studies say it has a relieving effect on mild to moderate osteoarthritis, and some say it is as effective as a placebo. My suggestion is that you can try taking it for three months. If you feel the pain is less, continue taking it. If you don’t feel anything after taking it for three months, don’t spend so much money on imported health products, they are useless.

Don't underestimate the small details in life, sometimes they are more effective than taking medicine. I once had an old patient who suffered from knee arthritis pain for five or six years. He wore flat-soled old Beijing cloth shoes every day. Later, I heard that he changed to a pair of soft-soled shoes with a 1.5cm heel. The pain when going up and down stairs was reduced by half. There are also many aunts who like to kneel down to wipe the floor and squat on the ground to choose vegetables. The wear and tear on the knee joints is three times greater than normal walking. Don’t squat if you can sit on a small bench. ； Don’t carry anything more than 5kg, and try to use a backpack. Carrying it on one shoulder for a long time can easily lead to shoulder arthritis. If you have gouty arthritis, the core is to control uric acid. Don’t be greedy for beer and seafood. It’s better than any other care. ； People with rheumatoid arthritis must take anti-rheumatic drugs on time, and don't stop taking them without permission. Otherwise, the joints will become damaged after a recurrence, and eventually become deformed and irreversible.

In fact, arthritis is a chronic disease that will stay with you for a lifetime. Care does not need to be like completing KPIs. There is no need to copy other people's experience, and there is no need to read what the Internet says cannot be done and then dare not do anything. Pay more attention to your body's reaction, rest when it hurts, move appropriately when you feel comfortable, and check with the doctor regularly to check the progress. It is more effective than any dogmatic routine.