Arthritis pain harming ageing population


Osteoarthritis, or degenerative joint disease is characterised by the gradual wearing away of cartilage that cushions joints throughout the body. This causes bones to rub together, leading to pain, swelling and joint stiffness. 


This devastating condition is often associated with ageing, injury and obesity.  It will most likely affect the joints that have been continually stressed throughout the years including the hand, wrist, neck, back, knee and hip. Osteoarthritis sufferers often experience pain and stiffness in the morning that improves as the day goes on. 


Osteoarthritis is already one of the ten most disabling diseases in the country. The prevalence of osteoarthritis is increasing with extended life expectancy, with the greatest disease burden where access to therapies is not readily available. 


To address this growing burden, the Osteoarthritis Research Society International has recently published new guidelines in the journal Osteoarthritis and Cartilage. The new guidelines highlight the non-surgical management of knee osteoarthritis and the importance of biomechanical interventions, exercise and weight management strategies. 


Depending on the severity of the condition, common treatment approaches usually involve over-the-counter and prescription medications. However, these approaches can have side effects that can range from a nuisance to life threatening. 


According to the Arthritis Foundation, “staying physically active and maintaining a healthy weight are the keys to living well with osteoarthritis. Too little movement can lead to stiffness and weak joints. Losing one pound can take four pounds of pressure off your knee joints.” 


Locally, inactivity levels are high with more than half of adults being insufficiently active. Urbanisation and rapidly growing cities has resulted in increasingly popular sedentary pastimes such as watching television. 


Some people with osteoarthritis tend to avoid exercise if they’re in pain, or out of fear of worsening the cartilage loss. But research shows that exercise is an integral part of prevention, maintenance and treatment of osteoarthritis. 


The World Health Organization (WHO) recommends adults aged 65 and above do at least 150 minutes of moderate-intensity aerobic physical activity or do at least 75 minutes of vigorous-intensity aerobic physical activity or an equivalent combination of moderate- and vigorous-intensity activity throughout the week.


Exercise is also an effective weight control mechanism, which can help prevent osteoarthritis from developing in the joints. Strengthening exercises help reduce stress and pain by building muscles and keeping joints flexible and mobile.  


Combining regular exercise with a healthy diet can assist weight loss, reduce joint stress, and provide the body with required nutrients for health and healing. Researchers have found vitamins A, C and E to have antioxidant properties that have potential benefits to osteoarthritis sufferers. 


According to WHO, there is a threefold increase risk of progression of osteoarthritis for people in the lower decile of vitamin C and D blood levels. 


Citrus fruits are excellent sources of vitamin C but there are many non-citrus sources as well. Examples include papaya, strawberries, pineapple, kiwifruit, cantaloupe, raspberries, blueberries and watermelon. 


To get enough vitamin D, it is important to get frequent, short exposures of direct sunlight. Regular short exposures have been found to be much more effective and safer than intermittent longer ones. 


As a general rule, older people need more vitamin D than younger people, larger people need more that smaller people, and dark-skinned people need more than fair skinned people. 


Dr Cory Couillard is an international health columnist that works in collaboration with the World Health Organization’s goals of disease prevention and control. Views do not necessarily reflect endorsement. 

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