[Column] Five rules for ‘proactive management’ of knee joint health
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St. Peter's Hospital 26-07-01 22:37Main content
Arthritis, which causes joint pain, stiffness and swelling, is a leading chronic condition that troubles daily life in later years. Osteoarthritis (degenerative arthritis) in particular is the most common type of arthritis.
Osteoarthritis occurs mainly in joints that are heavily used or bear a heavy load, including the knee, hip, spine and hand. Excessive use of and load on a joint bring about degenerative changes in the joint tissue and trigger an inflammatory response. When this results in an inflammatory response and deformity, osteoarthritis develops. This mechanism is why the proportion of osteoarthritis patients is high in later life.
Kang, Seung-Baik, an orthopedic specialist and Director of the Knee Joint Center at St. Peter's Hospital, said, “A considerable proportion of patients aged 60 and over who come to the hospital with knee or back problems are diagnosed with osteoarthritis,” adding, “Managing and treating the joints well on the basis of a correct understanding of osteoarthritis can determine the quality of life in old age.”
■ The cause is changes in joint structure, not ageing… early diagnosis determines how fast it progresses
The biggest misconception about osteoarthritis is the belief that it is a disease everyone naturally develops with age. Even now, many still regard it as an unavoidable wear-and-tear disease caused by aging.
However, it is not medically correct to see osteoarthritis as a simple consequence of aging. Studies over the past 20 years or so have shown that osteoarthritis develops through a combination of factors independent of aging, including changes and inflammation in the joint cartilage and structural changes in the bone beneath the cartilage. In fact, people with a history of joint injury or trauma, such as athletes, can develop osteoarthritis even at a young age.
Osteoarthritis causes pain, swelling, stiffness and limited joint movement. Symptoms generally progress slowly and gradually, but they can worsen rapidly if a fall or trauma damages the ligaments around the joint. As symptoms become severe, the joint may become unusable and pain may be felt even at rest
The knee in particular is the joint in which osteoarthritis occurs most often. This is because it bears a heavy load while also being used a great deal. WHO data likewise show that patients with knee osteoarthritis account for more than half of all cases. Typical symptoms of knee arthritis include pain or swelling in the knee after walking for a long time, difficulty going up and down stairs because of pain, and the knee failing to straighten properly or hurting when standing up after sitting. A sound from the knee when walking, or an abnormal gait caused by pain or other problems, are also counted among the suspicious symptoms.
What matters most is to slow the progression of cartilage damage as far as possible through early diagnosis, treatment and management. Kang, Seung-Baik, an orthopedics specialist and Director at the Knee Joint Center of St. Peter’s Hospital, said, “Degenerative arthritis may cause no more than intermittent pain in its early stages, but as time passes there is a strong likelihood that swelling and pain will worsen along with degenerative changes such as narrowing of the joint space, sclerosis and deformity,” adding, “Once degenerative changes have set in they cannot be reversed, so it is important to keep a careful eye on your knee health day to day and to go to a hospital as soon as any warning sign appears, in order to maintain joint health for as long as possible.”
■ Follow five key daily rules on weight control, exercise, posture and more
Degenerative arthritis of the knee is diagnosed mainly through a physical examination that checks the site and pattern of pain and the range of joint motion, together with X-ray imaging. When the pain is more severe than the plain X-ray findings suggest, or when other damage such as a meniscus tear or a microfracture is suspected, MRI may be used to reach an accurate diagnosis.
Treatment of degenerative arthritis varies with how far the disease has progressed and with the patient's condition. In the early stages of the disease, appropriate exercise and improvements in lifestyle habits come first. The next step is conservative treatment such as drug therapy, physiotherapy and exercise therapy. If the effect of treatment is minimal, pain and inflammation are controlled with medications such as non-steroidal anti-inflammatory drugs, while heat packs, electrical nerve stimulation and rehabilitative therapy are combined to maintain joint function. When pain is severe, injection therapy may also be considered depending on the patient's condition.
Surgical treatment is performed when the pain is severe enough to interfere with daily life or when conservative treatment does not produce a good response. Representative options include arthroscopic debridement, microfracture surgery to regenerate damaged areas of joint cartilage, and stem cell transplantation. These are effective when the cartilage lesion is small and joint deformity is minimal.
When cartilage damage or tearing is severe, or arthritis has progressed to an end stage, artificial joint replacement surgery is considered. The damaged portion is removed and the joint is replaced with ergonomically designed femoral and tibial implants. This can greatly reduce pain and is effective in restoring the function of a deformed joint.
The progression of degenerative arthritis can be slowed and its symptoms eased through weight control, exercise and other management. Director Kang, Seung-Baik recommends five key rules for knee joint health: ▲maintaining an appropriate weight and good eating habits ▲exercising regularly ▲avoiding everyday postures that are bad for the joints ▲giving up smoking and alcohol ▲managing the condition early when pain first appears and applying heat packs.
For the health of the knee joints, it is good to manage your weight with the load on the joints in mind and to avoid postures that strain particular areas, such as squatting, sitting cross-legged and crossing the legs. When sitting, it is advisable to use a chair or sofa rather than sitting on the floor, so as to minimize knee flexion. It also helps to avoid excessive caffeine and salt intake and to pay attention to a balanced diet. Eating foods that support joint function, such as those rich in antioxidants that suppress inflammation, can be helpful. It is also recommended to avoid smoking and weight gain, which lower bone density, as well as excessive drinking, which is a cause of conditions such as avascular necrosis of the femoral head.
What matters especially is appropriate exercise. Many people avoid exercise for fear of pain and of making their condition worse, but this is mistaken. Strengthening the muscles around a joint reduces the load on it while keeping it functioning smoothly. Moderate exercise — about 30 minutes a day of light walking on level ground, stretching, swimming or riding a stationary bicycle — is in fact a great help in strengthening the muscles around the joints and preventing stiffness. Quadriceps strengthening exercises in particular are highly effective for protecting the knee joint and building lower-body strength.
Director Kang, Seung-Baik said knee joint health is an important factor that goes beyond pain and is directly linked to healthy life expectancy in old age, adding that women aged 65 and over in particular should watch carefully for warning signs such as knee pain, swelling or difficulty walking and receive an accurate diagnosis and treatment early in order to maintain healthy joint function for as long as possible.
Source: Medworld News (http://www.medworld.co.kr)
Osteoarthritis occurs mainly in joints that are heavily used or bear a heavy load, including the knee, hip, spine and hand. Excessive use of and load on a joint bring about degenerative changes in the joint tissue and trigger an inflammatory response. When this results in an inflammatory response and deformity, osteoarthritis develops. This mechanism is why the proportion of osteoarthritis patients is high in later life.
Kang, Seung-Baik, an orthopedic specialist and Director of the Knee Joint Center at St. Peter's Hospital, said, “A considerable proportion of patients aged 60 and over who come to the hospital with knee or back problems are diagnosed with osteoarthritis,” adding, “Managing and treating the joints well on the basis of a correct understanding of osteoarthritis can determine the quality of life in old age.”
■ The cause is changes in joint structure, not ageing… early diagnosis determines how fast it progresses
The biggest misconception about osteoarthritis is the belief that it is a disease everyone naturally develops with age. Even now, many still regard it as an unavoidable wear-and-tear disease caused by aging.
However, it is not medically correct to see osteoarthritis as a simple consequence of aging. Studies over the past 20 years or so have shown that osteoarthritis develops through a combination of factors independent of aging, including changes and inflammation in the joint cartilage and structural changes in the bone beneath the cartilage. In fact, people with a history of joint injury or trauma, such as athletes, can develop osteoarthritis even at a young age.
Osteoarthritis causes pain, swelling, stiffness and limited joint movement. Symptoms generally progress slowly and gradually, but they can worsen rapidly if a fall or trauma damages the ligaments around the joint. As symptoms become severe, the joint may become unusable and pain may be felt even at rest
The knee in particular is the joint in which osteoarthritis occurs most often. This is because it bears a heavy load while also being used a great deal. WHO data likewise show that patients with knee osteoarthritis account for more than half of all cases. Typical symptoms of knee arthritis include pain or swelling in the knee after walking for a long time, difficulty going up and down stairs because of pain, and the knee failing to straighten properly or hurting when standing up after sitting. A sound from the knee when walking, or an abnormal gait caused by pain or other problems, are also counted among the suspicious symptoms.
What matters most is to slow the progression of cartilage damage as far as possible through early diagnosis, treatment and management. Kang, Seung-Baik, an orthopedics specialist and Director at the Knee Joint Center of St. Peter’s Hospital, said, “Degenerative arthritis may cause no more than intermittent pain in its early stages, but as time passes there is a strong likelihood that swelling and pain will worsen along with degenerative changes such as narrowing of the joint space, sclerosis and deformity,” adding, “Once degenerative changes have set in they cannot be reversed, so it is important to keep a careful eye on your knee health day to day and to go to a hospital as soon as any warning sign appears, in order to maintain joint health for as long as possible.”
■ Follow five key daily rules on weight control, exercise, posture and more
Degenerative arthritis of the knee is diagnosed mainly through a physical examination that checks the site and pattern of pain and the range of joint motion, together with X-ray imaging. When the pain is more severe than the plain X-ray findings suggest, or when other damage such as a meniscus tear or a microfracture is suspected, MRI may be used to reach an accurate diagnosis.
Treatment of degenerative arthritis varies with how far the disease has progressed and with the patient's condition. In the early stages of the disease, appropriate exercise and improvements in lifestyle habits come first. The next step is conservative treatment such as drug therapy, physiotherapy and exercise therapy. If the effect of treatment is minimal, pain and inflammation are controlled with medications such as non-steroidal anti-inflammatory drugs, while heat packs, electrical nerve stimulation and rehabilitative therapy are combined to maintain joint function. When pain is severe, injection therapy may also be considered depending on the patient's condition.
Surgical treatment is performed when the pain is severe enough to interfere with daily life or when conservative treatment does not produce a good response. Representative options include arthroscopic debridement, microfracture surgery to regenerate damaged areas of joint cartilage, and stem cell transplantation. These are effective when the cartilage lesion is small and joint deformity is minimal.
When cartilage damage or tearing is severe, or arthritis has progressed to an end stage, artificial joint replacement surgery is considered. The damaged portion is removed and the joint is replaced with ergonomically designed femoral and tibial implants. This can greatly reduce pain and is effective in restoring the function of a deformed joint.
The progression of degenerative arthritis can be slowed and its symptoms eased through weight control, exercise and other management. Director Kang, Seung-Baik recommends five key rules for knee joint health: ▲maintaining an appropriate weight and good eating habits ▲exercising regularly ▲avoiding everyday postures that are bad for the joints ▲giving up smoking and alcohol ▲managing the condition early when pain first appears and applying heat packs.
For the health of the knee joints, it is good to manage your weight with the load on the joints in mind and to avoid postures that strain particular areas, such as squatting, sitting cross-legged and crossing the legs. When sitting, it is advisable to use a chair or sofa rather than sitting on the floor, so as to minimize knee flexion. It also helps to avoid excessive caffeine and salt intake and to pay attention to a balanced diet. Eating foods that support joint function, such as those rich in antioxidants that suppress inflammation, can be helpful. It is also recommended to avoid smoking and weight gain, which lower bone density, as well as excessive drinking, which is a cause of conditions such as avascular necrosis of the femoral head.
What matters especially is appropriate exercise. Many people avoid exercise for fear of pain and of making their condition worse, but this is mistaken. Strengthening the muscles around a joint reduces the load on it while keeping it functioning smoothly. Moderate exercise — about 30 minutes a day of light walking on level ground, stretching, swimming or riding a stationary bicycle — is in fact a great help in strengthening the muscles around the joints and preventing stiffness. Quadriceps strengthening exercises in particular are highly effective for protecting the knee joint and building lower-body strength.
Director Kang, Seung-Baik said knee joint health is an important factor that goes beyond pain and is directly linked to healthy life expectancy in old age, adding that women aged 65 and over in particular should watch carefully for warning signs such as knee pain, swelling or difficulty walking and receive an accurate diagnosis and treatment early in order to maintain healthy joint function for as long as possible.
Source: Medworld News (http://www.medworld.co.kr)