The problem occurs more often after menopause. Reducing overweight is the first strategy to protect all joints
Women are much more often affected by osteoarthritis than men. This is confirmed by the most recent epidemiological data: over 60 per cent of those affected, after the age of 50-55, are female. “In reality, it can be said that the whole chapter of rheumatological diseases concerns above all women: patients represent the great majority of our clients”, confirms Carlo Selmi, head of Rheumatology and Clinical Immunology at the IRCCS Humanitas Clinical Institute in Rozzano (Milan) and professor of Humanitas University.
The precise reasons for this “predilection” still elude, but certainly ba part of the blame is ascribed to the metabolic and hormonal dynamics that take place in her organism at different stages of life. “Until at menopause, the protection ensured by estrogen, the female sex hormones, dominates, acting as a tonic elixir not only on blood vessels and the heart, but also on the immune system and joint tissues “ Selmi explains. And when this protection wanes with the loss of fertility, the cartilage of the joints is found fragile and less efficient at parrying the blows of wear and tear. “So much so that in women already with osteoarthritis it is common experience to find a marked worsening of pain after menopause” specifies the expert. On this predisposing biological terrain (the recurrence of arthrosis in the family also counts), other factors then intervene, first of all body weight.
Osteoarthritis and arthritis
«Overweight and obesity are conditions that favor osteoarthritis degeneration“. “The surprising aspect”, adds the rheumatologist, “is that the excess kilos affect the joints already used to supporting loads, such as knees, hips and feet, but also on those of the hands“. Distinctions A clarification is necessary in order not to fall into a very frequent misunderstanding: “arthrosis” is quite another matter than “arthritis“. That ending, “dare”, indicates that the cartilage arranged like a carpet on the bone heads of the joint is consumed by a slow degenerative process, “but without those inflammatory phenomena that characterize arthritis”, explains Selmi. The result is however a pain that is defined as “mechanical” because the skeletal segments, no longer protected and spaced apart by the cartilage cushions, touch and rub against each other causing suffering, especially during use and less at rest.
«By far the most affected site is the spine, especially the cervical and lumbar tracts. Followed by the knee, the hip and the base of the thumb, a localization that limits the use of the first finger, making it difficult even to open a bottle of water ». A commonplace is widespread: that against this degeneration we can only stand by and watch. In reality, even if there is no real cure, much can be done to mitigate the d
isagi. “The primary goal is to stem the pain to safeguard the quality of life.” But the weapon is not cortisone. “Absolutely not,” emphasizes the expert. «Yes, instead anti-inflammatory drugs, in moderation and as needed. And paracetamol is undoubtedly the first choice and the safest ».
diet and movement
But the joints will thank you if two more steps are taken: a low-calorie diet (so as not to burden the skeletal scaffold with excessive weight) and then un therapeutic exercise plan that helps strengthen muscles, for example in front of the abdominals and behind the paravertebrals, because if we compare the spine to a shabby pillar it is as if we were supporting it with two poles, one in front and the other at the back.
“They reduce pain, especially in large joints, the infiltration of hyaluronic acid, a lubricant capable of mitigating cartilage suffering,” he explains. Surgery And speaking of the knee: if conservative treatments don’t work, the final chance is the prosthesis, whose implant can now be piloted through special robotic platforms assisted by artificial intelligence, specifically designed for this joint, which calculates the best positioning based on the anatomical characteristics of each patient.
Swimming, cycling and Tai-chi
Sport: friend or foe of arthrosis? “I confess: I am a runner, who grinds between 50 and 70 kilometers a week,” says Professor Carlo Selmi. «Passion leads me to recommend running to almost all my patients, even to lose weight: if you are able to deal with this physical exercise, why not? The important thing, however, is that thecommitment is always sustainable, moderate, otherwise there is a risk of a worsening of pain“. And Selmi adds: «Of course, the swimming and cycling are the most suitable sporting practices“. One of the most effective activities in domesticating the painful symptoms of arthrosis can then be the Chinese martial art of Tai-chi. The soft movements, slow and circular, at the base of this discipline, in fact help to dissolve stiffness and tone the muscles around the joints.
December 6, 2021 (change December 6, 2021 | 18:27)
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