‘TIS the season to be jolly!” Thus says the season’s song.
However, the season is also the season to be “wobbly.”
Just today, a 75-year-old patient came in, walking slowly with much difficulty due to severe right-knee and thigh pain. She has been suffering from rheumatoid arthritis for three years now. Normally, during the cold season, she complains of pain. Frequent attacks of arthritis when it is cold may be attributed to vascoconstriction of blood vessels, which leads to slow circulation and, hence, dryness of joints.
There are two kinds of arthritis, which affect older persons more frequently. Rheumatoid arthritis is an auto immune disease affecting the joints. For reasons not known to us, the immune system attacks its own tissues, including the synovium, which is a thin membrane lining the joints. This inflammation eventually destroys the cartilage and bone within the joint. The inflammation affects the surrounding muscles, ligaments and tendons which support and stabilize the joint. The attack causes fluid to build up, stopping the joint from working its normal way.
Osteoarthritis, which is the most common type, occurs when there is a breakdown of cartilage. This is a substance that provides cushion between two bones that meet at a joint. The much-needed cushion enables ease of movement. Without this cartilage, the bones begin to rub against one another, resulting in pain, swelling and stiffness. Osteoarthritis can affect any joint in the body. However, it generally involves joints in the hands, hips, knees, neck and lower back.
In some people, these inflammatory diseases are relatively mild and hardly affect day-to-day life. However, in others, it can be severely debilitating and may affect the quality of life. The pain can also cause depression and anxiety. Financially, the effect is felt due to loss of work ability and costs related to treatment.
During acute attacks, adequate pain management with the use of anti-inflammatory drugs may be needed to ensure quality of life. Aside from oral-pain relievers, there are a lot of topical agents now available in the market to help alleviate pain.