Health Problems of the Elderly

A joint is where two bones meet. Arthritis refers to inflammation of the joint tissue which can be acute or chronic. In the elderly, the commonest type of arthritis is osteroarthritis, which is degenerative arthritis, most commonly affecting the knees.

Cause

As part of the aging process, joint fluid decreases. With wear and tear, the cartilage becomes thinner. If the muscles and tendon protecting the joint become weakened, if there is overweight, or if there is persistent abnormal posture or activities such as squatting or sitting on low stools, the condition would become worse.

Presentation

The commonest symptom is pain or discomfort, especially after walking, e.g. walking downstairs or carrying heavy load. Occasionally there may be redness, swelling and warmth. Chronic problems include stiffness and deformity.

Treatment

• The best treatment for pain is rest. Depending on the situation, heat or ice therapy and knee bandage may be used as advised.

• Medication for osteoarhritis can only reduce pain or inflammation. It cannot cure the disease. Common analgesia (e.g. panadol) and ointment (e.g. analgesic balm) are frequently useful. For more severe pain, non-steroidal anti-inflammatory drugs which have both analgesics and anti-inflammatory actions may be used. There are many kinds but invariably they have side-effects which can include gastro-intestinal discomfort or even bleeding, renal failure, etc. Therefore, they should be used with care and according to a doctor's advice.

• Injections of steroids into the joint can relieve pain but it would aggravate the arthritis. It should not be used unless absolutely necessary.

• Surgery may be required for certain severe cases of deformity. These include arthroplasty and knee replacement therapy.

Prevention and self-care

The degeneration of the knee joint cannot be reversed. However, with appropriate self-care and preventive measures, the process can be slowed, and it is possible to reduce pain and prevent relapse and deformity. To protect the knee joint, the most important is to reduce the wear and tear process:

• Minimize weight bearing of knee joint. For the obese, reduce weight.

• Avoid carrying heavy objects. Use a trolley.

• Avoid prolonged standing or walking. Use walking aid if required.

• Avoid putting the knee joint in one position for a long time e.g. sitting on low stool or squatting.

• Ensure proper balance between work and rest. Watch out for and be mindful of joint pain.

• Appropriate knee exercise and thigh muscle strengthening exercise can protect the knee joint. Consult a doctor or physiotherapist for advice.

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