Strong Joints, Healthy Life

According to the Korea Institute for Health and Social Affairs’ “National Health and Nutrition Survey 2001” announced in December 2002, 350 out of 1000 Koreans are arthritis patients, the highest disease attack rate in the country.

There are about 100 kinds of arthritis. More than 80 percent of them are degenerative types. Arthritis is caused by worn out or damaged cartilage in a joint. Without a cartilage “buffer,” bones get rubbed against each other, causing inflammation or pain.

--Abominable pain

One of the most well known symptoms of arthritis is chronic pain. Even though you cannot stretch your joints well and feel stiff, you will not be diagnosed as suffering from degenerative arthritis unless you have pain.

Degenerative arthritis usually attacks knees, hip joints, the backbone, and the last knuckle of fingers. In particular, if you have aches in your knees and hip joints, which support your weight, you cannot walk well due to the pain. You feel more pain in the evening or at night, which even deprives you of sleep.

Hospitals will prescribe analgesic and anti-inflammatory drugs that relieve pain by restraining the reaction of the inflammation. However, a perfect cure is impossible to achieve. It is just to slow down or put a hold on the damage.

Recently, people use drugs with reduced side effects like stomachaches as well as the number of doses from two tablets a day to one. They include Vioxx (MSD), Celebrex (Pfizer), and Mobic (Boehringer Ingelheim). Transdermal plasters—KefenTech, Ketotop, Trast—are very effective since they stimulate joints directly. However, ordinary PAS reduces pain temporarily by stimulating the skin, but does not have long-term effects.

When a patient in the early stages of degenerative arthritis does not feel the efficacy of the drugs, he or she may get an injection of steroids or Hyaluron acid directly to the affected joint. However, there are disputes over the beneficial effects of such injections.

An operation is the last resort. Knee and hip joints are replaced with artificial joints. Recently, an operation to transplant cartilage from another organ has become popular.

--Cure it with exercise

The best way to prevent and cure arthritis is to exercise and prevent joints from becoming stiff and muscles from being contracted. If we do not move our body for more than two weeks, the body muscles become weak and bone density gets lower.

Walking backwards is best because the front foot hits the ground first to give knees less shock. Research has shown that we can alleviate pain by raising the temperature of the knee joints. We can get benefits from the balanced development of ankle and ligament muscles, which usually lean to the front side. Stretching for 5 to 10 minutes before walking is a necessity. Flat ground is better than a rugged or steep road.

In water, joints get almost no shock. Therefore, exercising in the water is good. You can just walk fast inside the water, even though you do not practice gymnastics or swim.

The appropriate amount of exercise is more than three times a week and 20 to 40 minutes per session. Moreover, late morning or early afternoon exercise is better since the joints are the softest at that time. Stair and mountain climbing, squatting, and lifting heavy objects give shock to the joints and should be avoided.

Obesity is the main cause of degenerative arthritis. Getting older  less exercise  reduced basal metabolism rate  and arthritis. There is no food that you should avoid, but eating too much, drinking or smoking, is forbidden.

If you gain weight, the pressure on your knees increases as much as four to seven times. Assuming that you gain 5 kg, you will give to your knees an additional load of 20 kg while walking on a flat road, and 35 kg while climbing stairs. It is better to change positions frequently. If you squat, you will get 3 to 8 times as much pressure as when you stand up. If possible, sit on a chair instead of the floor and use a toilet stool.

(Advice received from: In Joo-chul, president of the Korea Orthopedics Society and Kim Hee-joong, Professor of Orthopedic Surgery Department of Seoul National University Hospital.)

Sang-Hoon Kim corekim@donga.com