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Jang
Jiong
PREVENTION AND
TREATMENT
OF
OSTEO.
ARTHRITIS
IN
THE
ELDERLY
Osteo-arthritis or
degenerative
arthritis occurs
in
the elderly
but
there
is also
a tendency
to
affect younger
populations. Joints
like
the
neck,
the low
back and the knees that are
most ac-
tive or
over-burdened (from obesity) are
commonly afiected. The joint pain
oc-
curs
in
the
morning
and gets
less with
mild exercises but gets worse
upon
heavy
joint
activities; later, pain gets
worse
and the
joint, swollen and
even
deformed.
The
COL2A1 gene
that
is
related
to
Collagen
ll
production,
is
incriminated. Early changes
of
osteo-
arthritis are deformity or even crushing
and dislodging of fragments
of
the car-
tilage in
the
joints;
bony
spines
(osteophytes)
that
abuts onto
the
nerves may also form,
then,
inflamma-
tion
of the
joint
covering
and
related
muscles occur.
The
transforming
growth factor-beta (TGF-beta) seems
important as
it
can suppress the forma-
tion
of an
intederon
(lL-1)
that
reduces
the formation of
collagen ll, lll
-
the ba-
sic
mechanism. Reduce stress
to
all
joints, e.9.,
go downstairs carefully
would preserve the
knee
joints;
main-
tain
correct posture; take
moderate
exercises,
e.9., swimming,
tai-chi,
etc.
Treatment
is
usually conservative, e.9.,
pain
killers
(local
and/or
ingested),
physiotherapy,
acupuncture,
acupressure,
or
even micro-current
therapy etc. However, local injections
to the
affected
joints
may
have
complications. Operative procedures
are
the
last resort.
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