This week’s Tuck Talk program will discuss common issues that you should be careful about: osteoarthritis and joint damage. It’s not just a disease of the elderly! It can happen to people of all ages. We’ll reveal small, regular behaviors to prevent long-term osteoarthritis and joint damage, along with a 10-second method for checking for osteoarthritis, with Dr. Punch Woraphon, an orthopedic surgeon and preventative medicine specialist.
Is it true that younger people are starting to experience knee and joint pain these days and wonder if it’s osteoarthritis or just inflammation?
Dr. Punch: Now, since I started examining 5-6 years ago, people’s behavior has changed a lot, causing a lot of knee pain. More and more 18-19 year olds are coming to see the doctor. Most knee pain is caused by behavior, 70-80% from various uses. For example, now children, if they are teenagers, come to see the doctor if they have knee pain, most of them are caused by their behavior, using the exercise, liking to play hard, intensely, having fun, liking to exercise loudly, now it’s marathon running.
Young people come from exercise behavior?
Dr. Punch: Mostly it’s like that.
So what causes working-age people to become ill?
Dr. Punch: We’ve started exercising less, but it’s still a part of our daily life. Lifting, bending, bending, sitting cross-legged, and our daily routine, if we use the wrong posture, can also lead to knee pain.
What habits or behaviors cause knee joint damage?
Dr. Punch: A common habit that Thai people encounter is squatting, sitting with their legs folded, or sitting cross-legged. Having to sit on the floor and bend your knees a lot will cause more force to act on your knees.
Do shoes matter?
Dr. Punch: It’s very effective. There’s research that says if we walk, let’s say 50 kg. If we take one or two steps, the knees will bear 2-4 times the weight of the body. When we walk normally, it means that 50 kg. One knee has to bear 200 kg. When we walk, there will be a constant impact on the ground, reflecting up to the feet and knees. If the shoes don’t provide good enough support, there’s a chance that the force will be transmitted to the knees and could result in injury.
Besides shoes, weight loss also has an effect?
Dr. Punch: It’s very important. It’s practically a worldwide guideline that if you’re looking to prevent or treat osteoarthritis, the best thing to do is lose weight. Not too much, but not too little. I like to tell my patients that I don’t want them to lose weight, but rather maintain a healthy weight. Too little increases the risk of osteoporosis, and too much increases the risk of osteoporosis. It has to be just right.
Heavy weight causes knees to deteriorate and wear out faster. How does it increase the pressure?
Dr. Punch: Suppose a Thai person weighs 50 kg. If they stand on one leg, the weight will be on one knee. If they stand on the same leg, they will share it halfway. If we walk, the weight will increase from 50 kg. It will become 2-4 times that, which is 200 kg. Walking is equivalent to one knee bearing 200 kg. If our weight increases by 1 kg, that means one knee will have to bear an additional 4 kg of weight per step. Suppose 10,000 steps increase by 4 kg on each side. From our weight increasing by 1 kg, that means the weight our knees will have to bear increases by 40,000 kg per day.
Does this mean that walking will cause our knees to deteriorate?
Dr. Punch: Not exactly. Exercise is good if you’re prepared and walking with proper posture. If you walk with proper posture, train the muscles around your knees to support the weight you’re exercising, and stretch your muscles appropriately, it’ll benefit both your heart and your muscles. You need to stretch and strengthen your muscles in tandem.
What standing and sitting positions are bad for your knees?
Dr. Punch: It must be said that every position is bad for your joints, even sitting. If several people sit in chairs that aren’t optimal, the ideal sitting position is when the soles of your feet are flat on the floor, pointing forward together. The chair height should be at a level where your knees are at about 90 degrees, or slightly extended, to allow for good blood flow. When the chair is low and you bend your knees a lot, the blood vessels that supply blood to the lower back are bent, reducing blood flow. This increases the chance of numbness and cramps at night.
Is sitting cross-legged bad?
Dr. Punch: It’s really not good. Try observing that if you sit with your legs crossed for no more than 15-20 minutes, your body will start to feel numb because the blood vessels are compressed and blood isn’t flowing to them, so it becomes numb.
Do I have to sit close to the chair?
Dr. Punch: It’s best to have your back close to the chair, your butt close to the chair, and sit halfway. The advantage is that we can move around easily and flexibly. People will sit like this, but if it’s suitable for symptoms like no back pain, no pain in the lower back, you have to sit close together. It’s like when driving, I tell my patients if they have back pain. Try the first thing when driving. Observe when sitting, do you like to slide? Your body slides and your butt floats. After a while, it will hurt. Always remember to keep your butt close to the seat at all times.
What symptoms do people often overlook? If you do it often, your joints will start to break down?
Dr. Punch: The most common type of osteoarthritis is knee joints. This includes lots of sitting and standing, not just squats, but also floor sitting, knee-bending, lifting heavy weights, and walking, climbing and descending stairs. Research has shown that walking increases your weight by 2-3 times. If you’re climbing and descending stairs, your knees have to bear 4-5 times the weight.
In the average elderly group, at what age do joints and knees begin to deteriorate?
Dr. Punch: Research says the average age is around 55 years.
What symptoms will there be?
Dr. Punch: Symptoms begin with a sharp pain in the knee. I noticed that it often happens when going up and down stairs. Another symptom is waking up in the morning and feeling like the knee is stiff. Patients will say that the knee will be stiff for about half an hour when they wake up. This is a symptom that indicates knee degeneration. They will feel like they are stretching and bending, and it will feel tight and not move smoothly.
How can you tell if pain is caused by arthritis or gout?
Dr. Punch: If osteoarthritis is the most common condition, note that it’s caused by behavior. For example, if you start to feel pain while walking up stairs for a long time, but it improves after resting, that’s osteoarthritis. It’s caused by overuse, which causes pain whenever you use it. If it’s gout, the pain is unbearable. It usually affects the big toe joint first. When the pain is unbearable, it becomes swollen, red, and hot, and you can’t even touch it. That’s gout.
As we age, is it true that taking calcium supplements can help slow down bone deterioration?
Dr. Punch: Calcium helps strengthen bones and prevents osteoporosis. However, sometimes patients ask if calcium is good for knee pain and osteoarthritis. I must say that it’s not directly related to osteoarthritis because calcium is a component of bones, not joints.
Are there any foods or nutrients that can help slow down joint degeneration or reduce inflammation?
Dr. Punch: There’s no food that can help prevent osteoarthritis. If I were to recommend a meal, I’d recommend eating a complete diet of all five food groups. The most important thing is to maintain proper overall health, not overweight or underweight, and to exercise regularly and correctly. Foods that can reduce inflammation include good fats like Omega-3 and deep-sea fish, which can help somewhat. But taking care of your health is the most important thing.
If I have joint pain and knee pain, how will the doctor treat it?
Dr. Punch: We need to discuss lifestyle behaviors that could worsen knee pain and whether there’s a risk of osteoarthritis. If we discuss these findings and find something inappropriate, adjustments must be made. The most important factor is behavior modification. In most cases, surgery is recommended as a last resort. If things don’t improve, then surgery is the answer. When it’s interfering with your daily life and making you unhappy, then surgery should be discussed. Treatment begins with behavior modification, muscle strengthening exercises, and stretching exercises. If there’s no improvement, then medication is recommended. Paracetamol and anti-inflammatory medications can help. If you don’t like taking medication, topical medications and patches can help. These can be very effective, and surgery may not even be necessary.
For those who are experiencing knee and joint pain, after watching this clip, what are the 3 things the doctor would recommend you do?
Dr. Punch: 1. Behavior modification: Anything that has the potential to injure your knees must be stopped. Your weight must be kept appropriate. 2. You must train the muscles around your knees to absorb impact appropriately because you will be using this knee for the rest of your life. Finally, 3. Don’t be afraid to see a doctor. If you experience pain, see a doctor first. At least you’ll get a diagnosis so you can get the correct treatment. Don’t let it become chronic, because minor injuries will cause you to develop osteoarthritis in the future.
