An episode that will make Hollywood green with envy, was acted in my hospital, when two colleagues (retired Permanent Secretaries) came calling. I had just finished consultation with a middle-aged man. They overheard my last medical advise to him.”That everybody above 45 has arthritis, that the degree is the only variation”. One of them disagreed very vehemently. “Look doctor”, he blasted, “I am 62, and I don’t have arthritis”. After saying that, he jumped up twice, kicked out his right and left legs. Swang his right and left hands around. Then he bent down forward forcefully from his waist. Then in the process of getting up, he experienced a sharp excruciating back-pain, which he clutched with his two hands, shouting obscenities at no one in particular. We all had a very good laugh.
Yes, arthritis which results from degeneration in the joints is re-inforced by constant wear and tear, they receive through out life. Also injuries often accentuate and accelerate the disorder. Note that manifestation vary in individuals. Some are relatively mild, that they do not experience regular joint pains and movement limitations. Others are so pronounced that they regularly complain of back pain, waist pain, neck pain and leg pain. Wait a second. Have I defined “arthritis” for the uninitiated.
What is arthritis?
Arthritis is a term often used, to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling and decreased range of motion of the affected joint. In some types other organs are affected. Onset can be gradual or sudden, but usually becomes manifest after the age of 40. There are more tha 100 types of arthritis, but the most common are 1) osteoarthritis 2) rheumatoid arthritis 3) curvature arthritis 4) osteoporosis etc etc etc
Do you know that at every point in our lives, especially if we are above 40, we experience one form of pain or the other, especially in the mornings when we wake up. Some scientific analysis has attributed these pains and stiffness as arthritis resulting from the wear and tear of our joints. So what to do to ameliorate these discomforts and live a near normal live is the guiding principle of this write-up. Have you ever wondered, that sometimes when you get up from the bed, you experience back, waist, stomach, joint or other body pains which gradually wears off as the day progresses. For most of my patients, they want to live a better live, and so do you, but no body is arthritis free.
What is osteoarthritis?
This occurs to some degree in 80 to 90% of people over the age of 60, occurs in men more than women. It originates from loss of elasticity in the cartilage around the joint. The cartilage breaks up with the joint’s movement, and loose bits of cartilage are deposited in the joint itself.
These may grow and become calcified, increasing discomfort. The bone around the joint hardens, and cysts may develop, with spurs of bone around the joint edges. Treatment is to consult an orthopaedic for evaluation, meanwhile regular physiotherapy through massaging is recommended. Of course with Non-Steroidal-Anti-Inflammatory-Drug (NSAID), as recommended by your doctor.
What is rheumatoid arthritis?
This usually begins in middle age above 40, but its severity increases with age if neglected. It affects more women than men. The tissues of the joints thicken, so the cartilage becomes ulcerated and is eventually destroyed. There is over production of connective tissue, and ultimately the joint is swollen and may be fused solid. The muscles waste with disuse. Usually I do not allow my patients to reach this stage, I recommend them to the orthopaedic doctor for evaluation, with special exercises, and rest in serious cases, which are the main forms of treatment. Use of the steroid cortisone, is now thought to cause many problems, though it does give temporary relief. Please whenever in doubt consult your doctor.
What is curvature arthritis?
These are deformities of the joints due to shortening contraction of the surrounding muscles and ligaments. They are caused by arthritis or neurological disorders, or simply by prolonged inactivity, but because of our penchant for self-medication, we would neglect to consult a doctor, who would have detected the early contracture and shortening. The doctor would have referred you to an orthopaedic surgeon early, and the shortening muscle would have been lengthened through weight bearing mechanism, and you will not now, be walking with a limp, but due to negligence, one of your legs is now shorter than the other, left untreated, they become permanent and cause severe disablement. Treatment is with muscle-relaxing drugs, and physical manipulation.
What of osteoporosis?
This is increased porousness of the bone, usually from unknown causes, but sometimes due to severe nutritional deficiency of calcium salts. The skeleton becomes brittle and prone to fracture. The vertebrae are the bone most affected. They may collapse as they become weaker, and as they lose weight and size, the vertebral discs expand, producing increasing curvature of the spine. The condition may be triggered off by prolonged immobilisation in bed. It is more common in women than in men. This coul be prevented or corrected if detected early. So if you are above 40, please consult your doctor for any persistent back or neck pain, instead of resulting to self-medication and multiple consumption of analgesics.
What is our take this week?
If you are above 40, back, neck, shoulder, leg and waist pain are common, but if they become persistent and incapacitating please consult your doctor.
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