Dear Readers,

D. Swaby is a 72-year-old gentleman who writes Lifeline from a Red Hills Road address. He suffers with high blood pressure, but this is not troubling him at this time. His complaint is his painful knees. So much pain and recurring swelling to his knee joints ! Mr Swaby says that at this time every year his knees hurt, but it is so much worse this year.

He wonders why he has to feel so much pain; he can only hobble around with a walker at this time. The painkillers give some moderate relief, but as soon as they wear out he is under the pain again. He wonders if life is worthwhile when he has to feel such pain. He visits the clinic doctor every three months and gets medication, but he is hopeful that Lifeline can suggest some further means of dealing with the arthritis pain.

Osteoarthritis is the leading chronic disorder reported by elderly people and its occurrence is on the increase. How to deal with this problem depends on its staging. That is whether it is mild, moderate or advanced. Coping with osteoarthritis involves the person having adequate knowledge of the disease and how it manifests and what precautions to take when it is acting up, as well as lifestyle modifications, physical therapy and medication.

It is as yet unclear what triggers osteoarthritis to really develop and cause pain. A common and straightforward belief is that the wear and tear on the knee joints with age makes it more vulnerable to injury and subsequent inflammatory changes with the release of localised chemicals resulting in painful swollen joints which are difficult to move. Osteoarthritic joints are not always painful and some people who manifest joint changes typical of severe osteoarthritis are pain free. In other individuals, even minor changes in the joints are associated with a great deal of pain.

With osteoarthritis, the suffering individual needs to take charge of their own care to a greater extent, because education about osteoarthritis is very important.

Exercise is very important for joints and the person with osteoarthritis should remain as active as is possible. Exercise should involve low-impact activities such as cycling and swimming where possible, as high-impact exercise such as jogging tends to worsen the wear and tear on the knee joints.

Weight loss is also critical when a person is overweight as the heavy weight of obesity burdens the already damaged and weak knees and may send a person into use of a walker or a wheelchair! One study showed that a five-pound weight loss in overweight women resulted in a 50% decrease in knee symptoms !

In the home, adjustments such as raising the levels on regular seats and toilet seats can make a big difference to comfort and avoiding falls and other accidents and help alleviate symptoms. Guard railing on beds and on walls to help support the osteoarthritic individual as they move about the house also makes life more comfortable when it can be afforded.

Physical therapy with the use of heat, ultrasound and hydrotherapy also work to relieve pain and range-of-motion exercises prevent contractures and keep the joints supple. Strengthening exercises which seek to strengthen the muscles around the joints are particularly important as they seek to stabilise the knee joint and prevent further deterioration of the knee cartilage. Exercise, both in the form of at-home cycling or swimming and physical therapy, help reduce knee pain and pain to the other joints also and should be considered a necessary part of therapy.