Decalogue for rheumatic patients in summer
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How to keep your defenses up
29 October, 2020
Osteoarthritis is the buzzword in Traumatology consultations. In the face of any joint pain there will always be someone who will tell you “that’s osteoarthritis”. They go to the consultation saying “my mother had osteoarthritis so I will have it too.” And there are even patients who come to consult me directly ”, what is osteoarthritis? Is shark cartilage good? I’m taking those powders from the drugstore … Collagen. Is it good?” And certainly, they are right.
What is it?
Osteoarthritis is a progressive and irreversible degenerative disease that can affect one or more joints. It’s characterized by progressive involvement of the articular cartilage, but other structures of joint such as the synovial membrane, joint capsule or subchondral bone are also involved.
Shelling out these terms a bit, to make it clearer: the fact that it is progressive and irreversible… speaks for itself. Note that it is not a career, but fortunately, except in cases of very rapid progression, from the first symptoms to the need to implant a prosthesis, many years pass. That opens a window to try to slow down its progression. It is true that the disease does not always progress at the same rate, and although there are times when a prosthesis must be put in within five years, there are also patients who have tolerable pain throughout their lives and do not need to undergo surgery.
How it affects?
Osteoarthritis is about PAIN and FUNCTIONAL LIMITATION and decreases your life quality because if your knee hurts and you can not climb stairs, but your greatest illusion is to go for a walk with you partner or to play a game, and you can not…. you are unhappy.
That’s why people come to the hospital, because they can’t lead with a normal life. This is where Medicine comes in. Our goal will be: relieve pain, regain mobility and if we can, try to slow down he profession.
Why we got osteoarthritis?
There is a type of osteoarthritis, secondary, which has a clearly identifiable cause: a fracture, high competition sport with repeated stress, dysplasias and other diseases. But in most cases, as in many other things, we do not know the cause.
What we do know is what happens in osteoarthritis, and that is a good start to act. We know that there is an affectation of the articular cartilage, which covers the bones, in such a way that it wears away until they are exposed. That is what hurts, the cartilage itself does not, since it lacks pain receptors. In addition, the synovial membrane that covers the joint becomes inflamed secondary to the alteration of the cartilage, causing more pain.
At this point, what remains for us is to act.
Treatment
There are two types of medication to treat osteoarthritis by mouth:
- analgesics
- SYSADOA (Symptomatic Slow Acting Drugs for Osteoarthritis).
When you are on an episode of acute inflammation, to relieve pain, we will first resort to analgesia: Paracetamol, NSAIDs (ibuprofen, dexketoprofen …) and minor opiates (tramadol). These drugs work quickly and are very effective. The problem appears when we have to take long-term painkillers. As we have said, osteoarthritis is a progressive and irreversible disease. These drugs prevent pain by eliminating inflammation but the moment we stop taking them, the pain will appear again. And although they are very good acutely, in the long term they present significant problems: liver toxicity, kidney toxicity and cardiovascular problems.
When it happens is where SYSADOAs come into play: Chondroitin and Glucosamine. The CHONDROPROTECTORS.
Chondroprotectores for osteoarthritis
Articular cartilage is a highly specialized tissue made up of 2% cells (chondrocytes) and 98% extracellular matrix (everything that surrounds cells and makes up cartilage) where we find collagen fibers and compounds called aggrecans formed by chondroitin and glucosamine among others.
We think that if what happened was that the articular cartilage was destroyed, why not supplement it orally with its fundamental components? Thus, studies were conducted where it was seen that these substances have an effect on the metabolism of chondrocytes and can help treat osteoarthritis. Specifically, the following mechanisms are postulated: anti-inflammatory activity, stimulation of the synthesis of proteoglycans and hyaluronic acid and a decrease in the catabolic activity of chondrocytes. In non-medical language: it seems that they help to synthesize the components that make up the extracellular matrix and that also inhibit its destruction. That is, they are drugs that would help to eliminate the symptoms of osteoarthritis and even slow it down.
But, as its name suggests, they are not medicinal that act immediately. The effect begins to be noticed after two or three weeks but with the advantage, unlike conventional analgesics, that its effect lasts 2-3 months after treatment.
And there is a great addition to all this … The CONDROPROTECTORS are very safe. To date, there are no known adverse reactions or damage to the body systems (kidney, liver, cardiocirculatory …), which makes them ideal for long-term consumption, because as we have already said, osteoarthritis is progressive.
There are studies that show that taking these CHONDROPROTECTORS slightly-moderately but significantly reduces pain and therefore functional limitation. There are also studies that state that it slightly but significantly slows the progression of osteoarthritis. And all this without side effects, unlike long-term NSAIDs or paracetamol. That is why the action before an arthritic outbreak would be to start with these analgesics (NSAIDs or paracetamol individualized per patient) to remove the acute pain and at the same time start with the CHONDROPROTECTORS so that they begin to take effect and to be able to discontinue the analgesics after two weeks.
In summary…
- Osteoarthritis is progressive. We can slow down its progression, and there will be cases that stagnate for a long time and do not need to do anything else, but unfortunately we do not know how to cure it. A prosthesis may finally have to be implanted, but let’s try to delay that moment with the highest quality of life possible!
- Dose and treatment schedule are always the doctor’s decision based on each patient.
- The effectiveness of CHONDROPROTECTORS depends a lot on their quality according to studies, so as far as possible, it is advisable to take quality pharmaceutical products.
- In short, the CONDROPROTECTORS are one more tool that we have to improve our quality of life in relation to the health of our joints
BLISScolágeno is the most complete and effective CHONDROPROTECTOR for the care of your joints:
Sara Moráis Rubio
Bachelor of Medicine and Specialist in Orthopedic Surgery and Traumatology