This is osteoarthritis .
Osteoarthritis (A Simple Guide to Osteoarthritis) is a joint disease which occur mostly in people above 50 years old although there are cases of people having the illness at 35 years old.
It was caused by wear and tear of the cartilage of the joints as well as loss of joint fluid and swelling of bones. The frequent strain exerted on the bones of the joints over a period of time cause inflammation of the joints or arthritis.
It was a common disease in the 1970s and is still very common today. Part of the reason was the high rise living where people have to climb stairs unlike in the kampong (rural village) which is built on flat grounds.
In those days other than the specialist orthopedic surgeons there were very few general practitioners who knew how to do intra-articular injections. I was one of the few family doctors who knew how to inject into joints effectively.
One of my first patient was an old lady who shared her provision shop with a Chinese medicine shop. She had pain in both knees for some time now but Western and Chinese medicine and treatment could not help her. I was able to give an intra-articular injections into her knees which relieved her pain for several years.
Because of this she and the proprietor of the Chinese medicine shop would recommend customers to see me when the Chinese medicines did not help to relieve the pain. It was through them that I develop a reputation for treating joint pains.
I always tell my patients that there was no 'cure' but temporary relief.
There was a patient of 35 years old who had knee joints pain after doing some taichi exercises. After the injections she recovered and after my advice on avoiding climbing stairs and practicing taichi she did not have any problems with her knees up to today.
It was very important that the patient realized that the injection is not a cure and that they have to help themselves in order to get well:
1. lose weight if obese. The heavier you are the greater strain on the hips, knees and ankles.
2. avoid carrying heavy things
3. avoid over straining the joints by climbing steep stairs
4. avoid wearing high heels which cause more strains on the legs and back
Rheumatoid arthritis( A Simple Guide to Rheumatoid Arthritis) is an even more severe condition than osteoarthritis. I had a young woman in the 1970s who had just graduated from Nanyang University who developed this severe and swollen joint pains. After x-rays and blood tests it was confirmed that she had Rheumatoid arthritis.
She was referred to Tan Tock Seng Hospital for treatment. She was given steroids and painkillers.
Sometimes the pain was so bad that she had to call me for house calls to relieve her pain.
It was depressing to see her becoming worse by the year with deformities of he wrists and ankles.
Finally she had to be admitted to hospital for a new anti-cancer medicines which did relieve her pain. Unfortunately the deformities could not be remedied. It was sad to see a young woman ready for work become a recluse with deformities unable to work or help herself.
Gouty arthritis ( A Simple Guide to Gout) was one of the most painful arthritis.
I had a patient who would limped into my clinic every time after a night out drinking alcohol. I would give him an injection into the most painful joint and an uricosuric drug( to pass out the uric acid from the body through the urine) and pain killer.
He would be well until the next episode of gouty arthritis.
Some other patient will have the same problem after taking peanuts, soya beans, seafood and internal organs.
Prevention was to avoid the above food, drink lots of water to dilute the uric acid in the blood and take a drug called allopurinol which help to turn the uric acid to urea.
One of the danger of this drug was a severe allergic reaction called Steven Johnson Syndrome.
Arthritis is a one of the most common medical condition which is why I first wrote about Osteoarthritis in my blog " A Simple Guide to Medical Conditions". This is particularly so with an increasing population of elderly people.
I still get an occasional referral for treatment of arthritis cases.
I had to tell them that the injection I gave them was not a 'cure' but temporary relief. Health education and prevention was better than cure.
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