Niggling pain in your joint? Play safe, see a doctor

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Degenerative joint disease is more widely prevalent in Vietnam than normally thought, and its victims are getting younger, doctors say.

They caution that improper or lack of treatment for the problem can leave one permanently disabled.

So it is advisable that the small, almost insignificant pains in any joints are not ignored until they assume serious proportions.

The Vietnam Rheumatology Association estimates that degenerative joint disease affects 85 percent of Vietnamese citizens above 80, 60 percent of those above 65 and also 30 percent of those above 35.

Dr. Le Anh Thu, vice chairwoman of the association, said the average age of patients needing joint replacement has fallen from 60 a decade ago to between 45 and 50, news website VnExpress reported.

Thu said the procedure, which replaces the arthritic or dysfunctional joint surface with an orthopedic prosthesis, costs VND100 million (US$4,760) and can only be performed at certain places such as knees, hips, and fingers.

Doctors say 27 million adults in the US suffer from degenerative joint disease and more than $42 billion is spent on the replacement surgery every year.

But the procedure is not affordable for average people in a developing country like Vietnam, and the artificial joints need to be replaced every ten or 15 years, at a much higher cost than the first.

Dr. Tang Ha Nam Anh, head of the Orthopedics Department at Nguyen Tri Phuong Hospital in Ho Chi Minh City, said the replacement becomes necessary when the patients suffer a lot and are in constant pain, their body resists medication, or do not have the conditions to continue other therapies, or are unable to walk due to the joints being deformed.

He said 50 percent of the procedures in Vietnam are performed on the knees and many of the patients are not very old.

Wrong actions

One patient, Tuyet Mai, 39, was advised the surgery after around ten years of failing to receive proper treatment for her rheumatoid arthritis, which is an autoimmune disease that results in a chronic, systemic inflammatory disorder, typically in the joints.

Doctors at the hospital said Mai had received medication from different facilities, and not adopted protective measures for the joints like immobilization, or taken necessary nutrition.

Another patient named Quang Thanh, 54, had to have replacements of both knees as the deformation was so severe that his legs formed an O shape when standing.

He ignored his pain for a long time, continuing his work, which involved carrying heavy things, till a time came when he could not walk.

Doctors say degenerative joint disease is a leading cause of disability, but it starts with very mild pains that patients typically choose to suffer or simply get used to.

It ranks as the second most common joint condition seen over the past ten years at Cho Ray, a leading hospital in Ho Chi Minh City that has treated many emergency cases.

Dr. Nguyen Hoang Bac, deputy director of the Ho Chi Minh City Medical University Hospital, estimates, based on patients seen at his hospital, that around 20 percent of the population suffer from degenerative joint disease, and twice as many women as men are afflicted.

The disease comes along with osteoporosis, which happens after menopause causes the bone to become porous.

Doctors say the disease typically comes with old age, and to those indulging in heavy labor. It also happens after a minor damage to the joints becomes chronic, and, combined with inflammation, destroys cartilages, hindering physical activities and damaging the joints permanently.

Thu said patients should neither ignore the pains nor treat the condition themselves because it would worsen the condition and bring on other complications including damage to other organs due to medication's side effects. 

"When one has a proper understanding of the degeneration, we can prevent it or limit the chances for it to happen, slow down its development and reduce the impacts," she said.

Doctors say that like aging, there is no going back from degenerative joint disease, but people can make it less severe.

Patients can use medication including painkillers orally, take injections into the joints to supply nutrition to the cartilages, and creams for external use to make the muscles flexible.

But these treatments should ideally go along with non-medication treatments like reflexology and exercises.

Doctors also say that once people are diagnosed with degenerative joint disease, they should control their weight as one extra kilogram means five times the burden on the joints.

Patients should indulge in moderate physical activity to give time for the cartilages to recover.

Too much squatting or sudden changes of positions can also affect the joints, they say.

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