Osteoarthritis: Training and social support

The algorithm for treating patients with osteoarthritis has its own peculiarities. If the overwhelming majority of diseases, including non-rheumatic diseases, are preceded by an outpatient or inpatient treatment of osteoarthritis, then the osteoarthrosis looks different in the case of osteoarthritis: rehabilitation - outpatient (less often - inpatient) treatment - rehabilitation. The use of pharmacotherapy in patients with osteoarthritis is recommended only if the rehabilitation measures are ineffective.

Methods of teaching patients with osteoarthritis do not differ from those in other diseases. For this purpose, they usually publish special methodological manuals for patients, prepare video materials. In a popular presentation, patients receive information about the structure and function of the joints, the nature of the disease, modern and promising methods of treatment and prevention. These materials, targeted not only to the patient himself, but also to his relatives, can be distributed individually (treating doctors, social workers), as well as in self-help groups, which are usually created at large specialized clinics. Training programs for patients, for example, "Self-help course for arthritis," help patients to reduce joint pain, support the function of affected joints, reduce visits to the doctor, and improve the quality of life. A comparative meta-analysis of controlled studies of the effectiveness of training programs and the results of placebo-controlled trials of the effectiveness of NSAIDs showed that the former are only slightly inferior to the second in terms of the effect on the pain syndrome in osteoarthritis. Involvement of spouses increases the effectiveness of working with patients. J. Goeppinger and co-authors (1995) noted that self-help self-help programs spread by mail helped patients - joint pain decreased, helplessness, depression disappeared.

An important part of the work within the framework of training programs is to create positive optimistic attitude towards their disease in patients, because in the minds of the majority of patients joint diseases are associated with the inevitability of disability and a wheelchair.

The arthrological club is an example of a training program and social support for patients. Despite the fact that the activity of the club is focused on the general contingent of rheumatological patients, most of the attending sessions are patients with joint diseases, in particular osteoarthrosis. At monthly meetings of the club participants lectures are given by rheumatologists, methodologists on curative physical training, physiotherapists, doctors of related specialties (orthopedists, etc.). The speeches focus on simple ways of self-help, which patients can use at home. To disseminate among the members of the club, methodical manuals on curative physical training, memoirs for patients with osteoarthritis are prepared.

[1], [2]

Decreased body weight

It is known that with excessive body weight, there is a higher risk of progression of osteoarthritis than with normal weight. Reducing the body weight by 5 kg in women is associated with a 50% reduction in the risk of osteoarthritis of the knee joints. Reducing the body weight in obese patients with osteoarthrosis of large joints of the lower extremities is an important part of the program of non-drug treatment. The results of a small clinical study of the efficacy of anorectic drugs in patients with osteoarthritis of the knee and hip joints confirmed that a decrease in body weight on average by 3-6 kg correlates with a decrease in the severity of the symptoms of the pathology of the knee joint, to a lesser extent - the hip joint.

[3], [4], [5], [6], [7], [8], [9], [10], [11], [12]

Dietary food

Patients with osteoarthritis are recommended diet food. It is necessary to exclude animal fats, easily digestible carbohydrates (sugar, chocolate, confectionery, white bread), fatty milk and kefir, cream, sour cream, condensed milk, fatty and bold cheeses, mayonnaise, pork, mutton, duck or goose meat. When cooking, use vegetable oil containing polyunsaturated fatty acids (corn, olive, sunflower, soybean, cotton, etc.), low-fat varieties of meat (veal, chicken, turkey, rabbit), fish (including fatty varieties - salmon , tuna, herring, sardines, etc.), vegetables (to limit the consumption of potatoes) and fruits, skim milk and kefir, low-fat cheeses. In complex therapy, patients can be recommended food supplements containing chondroitin and glucosamine sulfates.

[13], [14], [15]