May you grow old and decrepit?
If you answered amen to that prayer, then you already know and agree with my title, that arthritis is one of the gifts that come with old age. Arthritis is God’s prescription and must be taken by everyone. It is akin to slow death into old age. Old age comes with its own baggage of poor eye sight, poor hearing, weak heart and weak bones. As we age, we slowly fall apart and become frail. The bones degenerate, lose their supporting ligaments and rub together (arthritis). This degeneration is what can then lead to the pain and swelling around joints of the body. It leads to neck pains, back pains, hip pains and knee pains. Depending on your body status, usage and of course occupation, the symptoms can be none, mild, moderate or severe.
Anyway, forgive my sanctimonious ramblings and let us talk about prevention of arthritis.
Arthritis starts from about 20 years of age in most people. Soon as we finish growing, we start to deteriorate which is what happens with arthritis. The best treatment for arthritis is prevention. The very best way to prevent arthritis is to die young. But, we do not want to do that! So the next best way is to ensure you live a lifestyle free of obesity, constant body trauma from occupations that cause repetitive injuries, punishing sporting activities and smoking.
Cervical is the medical term for neck. Spondylosis is a term referring to degenerative arthritis of the joints between the bones. Therefore cervical spondylosis is arthritis of the neck. The neck supports the head and when the neck is injured, you can feel like the ‘weight of the world is on your shoulders’. It can cause pain in the neck, radiating into the head, pain shooting down the arms and pain down the spine. It can lead to pressure on the nerves or the spinal cord. This can then cause numbness in the hands, legs and difficulty with walking. It can be so bad as to make a patient completely disabled.
The causes of common neck pains are as follows
· Poor posture at home or at work leading to neck strain and muscle spasms
· Cradling the phone between your neck and shoulder (without using your hand)
· Neck injuries such as whiplash
· Lying on your stomach to read for long periods
· Degenerative diseases causing disc prolapse and arthritis
Lumbar is the medical term for the lower back. Spondylosis is again the term referring to degenerative arthritis of the joints between the bones. Therefore, lumbar spondylosis is arthritis of the back. The back supports the body and helps keep us upright. It is therefore affected by the weight of the body especially when standing, sitting and walking. Pain in the back can radiate to the hips, the legs and the private parts. With pressure on the nerves, it can lead to numbness in the legs and weakness causing difficulty in walking. It can be so bad as to cause problems with passing urine and stool. It can also affect sexual function.
The causes of common back pain are as follows:
· Poor posture
· Improper lifting techniques
· Back injury such as muscle sprains
· Bone and muscle disease
· Stress, anxiety and depression
· Degenerative conditions such as osteoporosis and arthritis
Other joints such as hips and knees can be affected in arthritis and can lead to a miserable life. The treatment for arthritis in general is prevention and exercises. You must keep active and mobile as sedentary living causes the joints to stiffen up and lead to worsening of the condition. Do some physical activity, if possible, and consider others such as breathing exercises, physiotherapy, massage, acupuncture, and aerobics therapy. Apart from improving physical health, other benefits include stress relief, improving sleep and the additional benefits from socialising with other people.
Drugs can help to reduce the pain so making it easy for the patient to exercise. The commoner drugs used are Paracetamol, Ibuprofen and Diclofenac. There are other drugs such as Amitriptyline, Carbamazepine, Pregabalin and Gabapentin which are however not often used to the maximum dose before being substituted. Drug combinations should take into consideration, the mode of action and duration of action of the drug. This means that different types of drugs that work through different mechanisms should be used. We also have an irrational fear of the pretty strong pain killers due to ‘possible’ complications. The fear of complications causes many doctors to avoid good drugs.
Surgery for arthritis
Surgery for arthritis of the spine depends on the cause and the condition. It may be simple or complex involving the use of implants to hold the spine together. For arthritis of the hips and knees, a new hip or knee may be required. Those who cannot be operated upon or who do not need an operation can also be helped by injections, physical therapy and advice.
However, patients need to know that arthritis is not curable. It is treatable and manageable but cannot be cured. Because like I said before, it is God’s own prescription. Prayers can help but prevention by healthy living is very important to avoid ending up in pains and requiring surgery.
Dr Biodun Ogungbo , MBBS, FRCS, FRCSEd, MSc is a Consultant Neurosurgeon, Abuja. He can be reached at: firstname.lastname@example.org