A year ago I was diagnosed with arthrosis of my right knee. Since then, I have been taking anti-inflammatory drugs, as often the pain in the knee gets much worse. I understand, there are drugs called chondroprotectors that have been very effective in osteoarthritis. What do your experts think? Do these drugs help or not?
Slavka Hristova Marcheva, Dobrich
She completed specializations in sports medicine, ultrasound, toxicology, anesthesiology and resuscitation, he alth management.
He has many years of experience in the field of sports medicine, prevention, nutrition, weight loss, recovery and biostimulation.
Dr. Yanakieva, why are diseases of the musculoskeletal system the most common?
- The musculoskeletal system makes up 75% of our body. Therefore, its diseases are among the most common diseases. And of these, especially in middle and older age, arthrosis is the most common. Articular cartilage damage, accompanied by pain, stiffness and significant impairment of quality of life, is one of the epidemics of the 21st century. 10-12% of the population may suffer from this disease.
We know that the treatment of any disease must be started at an earlier stage to have an effect. But very often the patient returns to the doctor after some time with worsening condition. Why does it happen like this and how can we avoid the deterioration for as long as possible?
- According to data from the World He alth Organization, in chronic diseases requiring long-term treatment, half of the patients remain faithful to the prescribed therapy. The rest stop treatment or adjust their treatment at their own discretion without consulting a specialist. In arthrosis, frequent disorders are found that prevent a good effect from being achieved. The first of them is the continuous intake of painkillers.
The pain in the affected joint is so strong that the patients ask for only one thing - to give them something that will reduce it. And such drugs are prescribed all the time. Most often these are non-steroidal anti-inflammatory drugs (NSAIDs), less often - paracetamol. They are accepted in a course for 7-10 days at most, and then only as needed.
Unfortunately, in practice, this recommendation is not followed by the majority of patients, as is the case with your reader. NSAIDs act quickly, practically after 1-2 doses, improve self-esteem and the patient is in no hurry to stop them. Many people arbitrarily continue the course, and others start drinking them even for prevention. Finally, the opposite effect is reached - deterioration of the condition.
Why is it not recommended to take NSAIDs long term?
- NSAIDs are not harmless drugs. Some have a negative effect on the cardiovascular system, others on the gastric mucosa. The most important thing in this case is that they have a bad effect on cartilage tissue, accelerating its destruction. It turns out that there are no symptoms, but the disease progresses and over time the usual doses stop relieving the pain. And if, without consulting a doctor, you increase the doses yourself, the problems grow like a snowball. There comes a time when the only solution is to replace the joint with an artificial one. But not all joints have a replacement.
Of course, NSAIDs are necessary for arthrosis, especially in the first stages of treatment, there is nothing to replace them with, but we should not make them the only treatment.
What effect do chondroprotectors have on arthrosis, about which our reader asks?
- In the earlier stages of the disease, these preparations can slow down the development of the disease or even stop it for a while. The course of treatment with them is long, at least three months. But some patients stop it even after two weeks with the explanation that there is no visible result, why only take medicine.
The problem is that the effect of the chondroprotector is imperceptible at first, especially if it is compared to the rapid effect of NSAIDs. Therefore, it is recommended to drink them continuously. Over time, they give a good result: the cartilage becomes stronger, more elastic and moisturized, the metabolism normalizes.
Thanks to this, the mobility of the joint is improved, pain is reduced or even eliminated, therefore the need for painkillers with their side effects is reduced or eliminated. This result lasts from several months to half a year. Therefore, it is recommended to take the course with chondroprotectors twice a year.
But the main thing is that chondroprotectors are the only group of drugs that affect the cause of the disease, and not just reduce pain. They cannot restore the cartilage to a he althy state - no drug can, but they do not allow the disease to progress.
Is arthrosis only treated with drugs?
- It is a big mistake to rely only on drugs in the treatment of arthrosis. An important role in this disease is played by motor activity. Of course, some restrictions must be observed - the joints must be protected. You should not lift weights and run, you should avoid all sudden movements with a push in the joint, work with regular breaks. But immobilization is also not desirable.
Special gymnastics is needed, which will move the joint and ease the movement in it. At first, most people are happy to do the exercises. But when they feel a little better, they forget about gymnastics. Some lack the discipline to do the exercises, others feel that once the pain has subsided, there is no need for it and they can go about their lives as before. Unfortunately, this is not the case. Gymnastics is not only good for the joints, it also strengthens the muscles that surround and move them. If they are in good tone during movement, they compensate for part of the load. If they are relaxed and untrained, the load falls on the damaged cartilage. It wears out faster and self-esteem deteriorates.
Arthritis is a chronic disease that can worsen at any time. Therefore, gymnastics is needed not only for treatment, but also for the prevention of exacerbations. It should be done every day, whether there is pain or not.
Nordic walking is currently a very popular way of disease prevention and active recreation. Is it a good choice for people with arthritis?
- Walking with poles is very useful, it activates different muscle groups, increases endurance, activates the work of the heart and involves walking in the fresh air, where the beneficial effects of the sun and air are also added.
Virtually every beginner, regardless of age and level of training, notes that with the poles he can walk much longer, experiencing greater pleasure and without muscle aches afterwards from the unusual load.
This is because the load is not only on the back and legs as it is in normal walking. Leaning on the poles, a person distributes the load evenly throughout the body and makes a greater number of muscles work in the most optimal mode. This also consumes more energy. The excess load on the knee joints is reduced, the muscles of the neck, shoulders, arms, back and chest are additionally developed.
Increases resistance to rapid movement in the elderly, prone to vertigo and overweight. The technique is like cross-country skiing. You can walk anywhere, preferably on rugged and hilly terrain. The most important thing is that one feels comfortable.
To reach a good physical shape, start with 2-3 training sessions a week for 40-50 minutes. Gradually increase them to 4 workouts of 1 hour, increasing the pace as well. To check, try to say a 5-word sentence without stopping. If you're out of breath, you're in the right rhythm. It is properly selected Nordic walking, with sufficient duration and intensity of the load, that contributes to the burning of fat reserves. If you feel very tired, better take a short break. Overloading can do more harm than good.