Arthritis Care Plan and Measures

The core nursing goal for arthritis patients has never been "complete cure", but to reduce the frequency of pain attacks by more than 30%, slow down the rate of joint function degradation by 50%, and reduce the rate of limitation of daily activities by 60% through personalized intervention. This is the consensus reached in the past 10 years of clinical follow-up data from domestic and foreign rheumatology and immunology departments and rehabilitation departments. All remaining nursing actions are personalized plans adapted around these three goals, and there is no universal "standard answer".

Speaking of which, when I was following up in the rehabilitation department in the past two years, I encountered too many patients who had gone astray: 52-year-old Aunt Zhang with knee arthritis. When she was first diagnosed, she went to health groups every day. Today she does squats to practice her legs, and tomorrow she puts on Internet-famous plasters. When it hurts, she takes ibuprofen. In less than half a year, her degenerative disease went from stage 2 to stage 3, and she almost needed an arthroscopy.； There is also Xiao Zhou, a 28-year-old programmer. He has wrist arthritis caused by long-term keyboarding. He heard people say that he should "move his joints more."

Let’s first talk about the care for acute attacks that everyone is most concerned about. Here we must first mention a point that is still controversial: Should we use hot compresses or cold compresses? The mainstream view of the Department of Rheumatology and Immunology in Western Medicine is that as long as there is obvious redness, swelling, heat and pain, cold compresses should be used first for 10-15 minutes each time. Wrap an ice pack in a towel and do not apply it directly to the skin. This can quickly reduce inflammatory exudation and relieve pain. ； However, the Department of Orthopedics and Traumatology of Traditional Chinese Medicine often recommends the external application of warm traditional Chinese medicine. As long as there is no local ulceration, warm stimulation can promote circulation and metabolism and speed up swelling. Nowadays, clinical standards are not strictly adhered to. Use whichever method makes you feel comfortable and will not aggravate the pain. The only thing to remind is not to rub the joint blindly. Repeatedly pressing and rubbing the joint during the acute edema period will aggravate the soft tissue damage and make the pain worse.

Oh, by the way, there are still many people who are afraid of side effects and refuse to take medicine. It is really unnecessary. The current clinical consensus is that if people with normal liver and kidney function take NSAIDs as needed, as long as they are not taken continuously for more than 7 days, there will be almost no serious side effects. Compared with letting inflammatory factors continue to erode joint cartilage, this risk is not worth mentioning at all. If you are worried about irritating your stomach, just take it after meals.

After the acute pain period, the focus of care is to put it bluntly: to "replenish strength" to the joints, but there is no fixed action template here. Straight leg raises and static squats often recommended by orthopedics are indeed useful, but now there is a new view in the rehabilitation department: you don’t have to force yourself to do movements you don’t like, you have to adjust them according to your own living habits. For example, if you usually like to climb mountains and stairs, practice standing on one leg more often to balance and enhance joint stability. ； If you often have to hold your baby and squat down to do housework, you should do more hip core exercises to reduce the compensatory pressure on your knees. ； For example, Xiao Zhou, who suffered from wrist arthritis, initially asked him to stretch his wrist joint every day because he found it troublesome. Later, he changed the plan. Every time he typed on the keyboard for 20 minutes, he held up a 500ml bottle of mineral water and shook it for 10 seconds. In less than 3 months, the number of pain attacks dropped from 4 times a week to 1 time a month, and the effect was even better.

Let me also mention the issue of protective gear: It is okay to wear supportive knee pads and wrist pads during an acute attack, which can help share the pressure on the joints, but do not wear them every day during the remission phase. If worn for a long time, the surrounding muscles will atrophy due to disuse, making them more susceptible to injury. Don’t buy the kind of Internet celebrity protective gear that costs hundreds of dollars. The OTC models that cost tens of dollars in ordinary pharmacies are enough to support you, and the price is all due to IQ tax.

There is another controversial point that is most frequently asked: Should we eat aminoglycosides? The latest European and American guidelines generally believe that ammonia sugar has no clear effect on moderate to severe arthritis and is not recommended for routine use. ； However, many domestic clinical follow-up data show that nearly 40% of patients with mild degenerative arthritis who eat aminoglucose for more than 3 months will experience significant reduction in pain. My suggestion is that you can first buy the cheapest domestic OTC amino sugar and try it for a month. If it works, continue taking it, and stop if it doesn’t. You don’t have to spend a lot of money to buy imported ones. The ingredients are not much different. As for health products such as chondroitin and collagen peptides, there is currently no clear clinical evidence to prove their effectiveness. If you have more money, you can buy them for peace of mind. If you have a limited budget, there is no need to spend them randomly.

Small details in daily life are actually more important than anything else. You don’t need to be scared to wear long pants in summer after hearing people say “arthritis is caused by cold”. However, wearing thin knee pads can indeed reduce muscle spasms when the weather is cold, and the probability of pain will be much lower. I have seen many little girls wearing ripped pants in winter, and the cold wind blows on their knees for half an hour, and the pain is so bad that they can’t get out of bed that night. There is really no need to hold it against yourself. If you are overweight, as long as your BMI can be reduced to less than 24, the joint load of patients with knee arthritis can be directly reduced by 30%, which is much more effective than taking aminoglucose for half a year. There are not so many taboos in diet. Unless you have gouty arthritis, you need to control purine. For ordinary degenerative arthritis, you don’t need to drink bone soup every day. High purine can’t supplement calcium. Eat more high-quality protein, fresh fruits and vegetables, which is better than anything else.

In fact, the core of arthritis care is "don't compete with yourself." When others use good methods, don't try too hard if it hurts. Rest when it hurts, and move appropriately when you feel comfortable. Don't always think about "cutting off the root". If you can go to work, play with your cat, and go to work without affecting the "root", it is already a perfect nursing effect.