Osteoarthritis: Education and social support

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

Methods of teaching patients with osteoarthritis do not differ from those for other diseases. For this purpose, special methodological manuals for patients are usually published, video materials are prepared. In a popular presentation, patients receive information about the structure and function of joints, the nature of the disease, modern and promising methods of treatment and prevention. These materials, oriented not only to the patient himself, but also to his relatives, can be distributed individually (attending physicians, social workers), as well as in mutual aid groups, which are usually created at large specialized clinics. Patient education programs, such as the "Self-help Course for Arthritis", help patients reduce joint pain, maintain the function of the affected joints, reduce the number of visits to the doctor, and improve the quality of life. A comparative meta-analysis of controlled studies of the effectiveness of educational programs and the results of placebo-controlled studies of the effectiveness of NSAIDs showed that the former are only slightly inferior to the latter in terms of the effect on pain in osteoarthritis. Involving spouses increases the effectiveness of work with patients. J. Goeppinger and co-authors (1995) noted that self-help programs distributed by mail helped patients - joint pain decreased, and feelings of helplessness and depression disappeared.

An important part of the work within the framework of educational programs is the creation of a positive optimistic attitude towards their disease in patients due to the fact that in the minds of most patients, joint diseases are associated with the inevitability of loss of ability to work and a wheelchair.

The Arthrology Club is an example of a program for training and social support for patients. Despite the fact that the club's activities are focused on the general contingent of patients with rheumatological profiles, most of those attending the meetings are patients with joint diseases, in particular osteoarthrosis. Rheumatologists, exercise therapy methodologists, physiotherapists, and doctors of related specialties (orthopedists, etc.) give lectures at monthly meetings of the club members. The speeches emphasize simple self-help methods that patients can use at home. Methodological manuals on exercise therapy and memos for patients with osteoarthrosis are being prepared for distribution among the club members.

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Weight loss

It is known that overweight people have a higher risk of osteoarthritis progression than normal weight people. A 5 kg weight loss in women is associated with a 50% reduction in the risk of knee osteoarthritis. Weight loss in obese patients with osteoarthritis of large joints of the lower extremities is an important part of a non-drug treatment program. The results of a small clinical study of the effectiveness of anorexigenic drugs in patients with osteoarthritis of the knee and hip joints confirmed that a weight loss of 3-6 kg on average correlates with a decrease in the severity of symptoms of knee joint pathology, and to a lesser extent, of the hip joint.

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Diet food

Patients with osteoarthritis are recommended to follow a diet. 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 semi-fat cheeses, mayonnaise, pork, lamb, duck or goose meat. When preparing meals, use vegetable oil containing polyunsaturated fatty acids (corn, olive, sunflower, soybean, cottonseed, etc.), lean meats (veal, chicken, turkey, rabbit), fish (including fatty fish - salmon, tuna, herring, sardines, etc.), vegetables (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.

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