Masaki Ohta writes:
Yoko Kashiwagi is a 42-year-old media executive, working in Tsukiji downtown area, living in Denenchofu. She was a marathon runner during her Keio university days and continued to run and exercise regularly into her 30s. But for the last five years she has been too busy to get enough exercise because of her increased business responsibilities, and over the last two years she has stopped exercising completely, has gained 7 or 8 kilos. She also has began smoking cigarettes at this time. And at the same period, she has noticed it increasingly more difficult to move her left knee which she had injured during her running practice in university. Now she feels more and more fatigued, and the crackling and stiffness in her left knee sometimes is very painful. In addition, her left knee gets swollen and red, especially when she has to work late into the night. She is thinking she might have rheumatoid arthritis or some other kind of arthritis, and is afraid of ACL reconstruction surgery from the last year*s case of her father who was also an athlete.
Although the term arthritis refers to more than 100 different diseases that affect the joints and, sometimes, muscles and other tissues around the joints, these diseases could be classified into two categories. One is degenerative arthritis or osteoarthritis results from the breakdown of cartilage. That is the most common form of arthritis. The other is inflammatory arthritis results from inflammation (redness, warmth, and swelling) in the joints. Rheumatoid arthritis is a type of it. The treatments for them differ considerably, so it is important to know which type of arthritis you have. In general, a diagnosis of arthritis is based on information you provide, your medical history, a physical examination, X-rays, test of a sample of your blood or fluid withdrawn from inside the affected joints. To make an accurate diagnosis, I need as much information as you can provide. So I will ask you some more questions. Where does it hurts exactly in your left knee and when in the day is your pain most severe ? How long does your pain continue and at what level is it? These are important to determine the type of arthritis you have and the cause. When do you first noticed the pain? This information can help me determine if your arthritis is caused by an injury. Is there any swelling? If the swelling is caused by inflammation, you may have rheumatoid arthritis or another type of inflammatory arthritis. If the swelling is caused by growths of bone (bone spurs), you probably have osteoarthritis. Do you feel pain other than in your left knee? Osteoarthritis usually affects only one or two major joints (usually in the legs). Rheumatoid arthritis affects multiple joints simultaneously. Which daily tasks are hard to do? Do you have another family members who have arthritis other than your father? Do you take medications or do you have allergies to any medications?
You must realize that arthritis cannot be cured, but it can be only treated. Beginning treatment as early as possible can help reduce longterm damage to your joints and bones. The goal of every treatment for arthritis is only to reduce pain and stiffness, allow for greater movement, and slow the progression of the disease. Were it proved that you might have osteoarthritis, there would be several general types of treatment. Weight loss and exercise might be usually the first recommended treatments. Losing weight can help relieve the pressure and strain on your joints, reducing the wear and tear that can cause damage to the tissues inside the joint. It can also help reduce the pain and stiffness in the affected joints. Sometimes balanced dietary may help you to reduce your weight, low in fat and high in fiber, such as fruits, vegetables, whole grains, and legumes (dried beans, peas, and lentils). Stop smoking. It may be the cause of osteoarthritis, and other diseases.
Regular exercise is known to be very effective for relieving the pain and stiffness of osteoarthritis and may help slow the progression of the disease. Exercise also helps you reach or maintain a healthy weight, which reduces the stress on your joints. Stretching exercises, which are also called range-of-motion exercises, are good for helping to reduce stiffness in your joints and improve their flexibility. Stretching exercises include anything that requires regular movement of a joint to its fullest capacity. Strengthening exercises help maintain or build the muscles around your joints, which helps keep the joints stable. Stronger muscles also improve the joint's movement. Fitness exercises, also called aerobic exercises, increase your endurance, strengthen your heart and lungs, and give you energy. Try to exercise aerobically for at least 60 to 90 minutes each week. Brisk walking, swimming, and bicycling are good fitness exercises. Exercise also helps relieve stress and depression, which many people with osteoarthritis experience occasionally. If you have arthritis the use of heat and cold might be time-honored techniques for relieving the pain, stiffness, and occasional swelling that can result from it. But do not combine either heat or cold with rubbing or the use of creams. This combination can cause burns. Onsen, a hot spring, treatment might be helpful to your left knee.
Medication is usually recommended only after weight loss and exercise have not been effective in relieving symptoms. Because of the potential side effects, drugs are used at later stage in treating. Arthritis medications generally are used to reduce pain and tenderness in the joints. No drugs are available that can actually stop the progression of the disease or cure it. Doctors often first recommend an analgesic (pain reliever) called acetaminophen for people who have osteoarthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs) are also often used for relieving the pain of osteoarthritis. The most frequently used NSAIDs are aspirin, ibuprofen, and naproxen. They may reduce inflammation as well. Corticosteroids, man-made substances that are related to cortisone, are used to reduce pain and inflammation. In some cases, doctors will give them by injection directly into the affected joint. Although the shot cannot stop the progression of osteoarthritis, it may help relieve the symptoms for many months. But corticosteroids are strong drugs that can cause serious side effects, such as damage to bones and cartilage. Kanpo, a traditional Chinese medication or acupuncture treatment also might be one of your choice.
Surgery is usually done only in severe, disabling cases of arthritis for which other treatments have failed. In fact, most people who have osteoarthritis will never need to have surgery. But when surgery is necessary, it may be done to prevent the joint from becoming deformed, to correct a deformity, to remove bonelike material from around the joint to allow for greater movement, or to replace a damaged joint with an artificial one. Osteotomy (which means "cutting of a bone") is most often done to repair a joint that arthritis has damaged unevenly. This uneven damage can put more stress on the cartilage and cause further damage. Arthroscopy is a procedure that is being used increasingly to diagnose and sometimes repair joints. For arthroscopy, a doctor uses a long viewing tube called an arthroscope that he or she inserts through a small incision in the skin over the affected joint. The arthroscope, which has a light and a tiny video camera at its tip, can be inserted directly into the fluid-filled space in the joint. Whatever your treatment will be, it will be most effective if you are actively involved.
Most people with osteoarthritis live full, active lives. Following an active lifestyle is often the most effective treatment for osteoarthritis. So now I will give you some advice to get well along with osteoarthritis. First, learn about osteoarthritis and its effects and treatment. The more you know about your illness, the more control you will have over it and the more successful your treatment is likely to be. You can get life-enhancing payoffs from learning as much as you can about causes, effects, and treatments. Continuing the recommended treatment is minimal. Second, contact your local chapter of national and local organizations, such as the Arthritis Foundation which offer services, help with daily activities, or classes. And then, ask for help when you need It. Your family members and friends can play a critical role in helping you learn to live with osteoarthritis. Find activities you enjoy or can do with friends. Walking, swimming, slow dancing, and water exercises are especially beneficial for people with osteoarthritis. And the most important thing of all is to be optimistic. One powerful weapon against arthritis is maintaining a positive attitude. And if so do you, you might look more vigorous and younger than you really are and will also be successful in your business.
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