Vietnamese youth struggle with degenerative joints

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Osteoarthritis, or degenerative joint disease, is usually thought to be connected with old ages, but doctors have warned that many Vietnamese young people are now struggling with the problem as well

The process when a healthy knee with complete cartilage (L), which covers the joint surfaces, gradually wears out (C) and is completely lost, causing friction between two bones. PHOTO: COMMONSENSEHEALTH.COM

Vu Cam Nhung, 33, a senior employee at a rolling door company in Hanoi, could feel her acute pain any time she ran or jumped, and she eventually began having difficulty just flexing her right leg late last year.

After trying several treatments like massage, painkillers and soaking her leg in hot salt water to no avail, she went to a doctor and was diagnosed with osteoarthritis a condition in which the cartilage covering the joint surface wears and tears in a faster pace than its repair on her right knee joint.

"How did I contract a disease that only old people get?" Nhung said.

Tuan Anh, an electrical engineer, had had knee injury playing soccer a few years ago and the pain dissipated in a few days. But years later he found himself struggling in constant knee pain, seemingly for no reason. He saw a doctor and was diagnosed with knee joint degeneration when he was only 30, which surprised him.

Many young Vietnamese are currently afflicted by severe degenerative joint disease, and they must undergo surgery to save them from disabilities, doctors say. Patients who need to undergo joint replacement have become younger over the last ten years, with their ages down from an average of around 60 to an average of 45-50, news website VnExpress has reported.

Growing up too fast

Normally, the disease appears when people are in their 40s and 50s and is more prevalent in even older people. However, many people in Vietnam struggle with it when they are around 35 or even younger, doctors say.

Dr. Le Anh Thu, deputy chairwoman of the Vietnam Rheumatology Association and head of Cho Ray Hospital's Musculoskeletal Department, said that 60 percent of people around 65 years old have osteoarthritis, while the figure for those around 80 was 85 percent.

Nearly a third of people around 35 years old also contract it, she said.

It is not uncommon that young patients have their joints replaced nowadays and the average cost for each new joint is around VND100 million (over US$4,700), Thu said. After 10-15 years of use, the replaced artificial joints again need changing at a cost twice as high as the first replacement.

However, only joints in positions like the femoral heads, knees and fingers are eligible for a replacement, she said.

Danger ignored

Dr. Tang Ha Nam Anh, head of the Ho Chi Minh City-based Nguyen Tri Phuong Hospital's Orthopedagogy Department, said: "Many young people have damaged joints and have no other choice but to undergo surgeries to save them from disabilities." 

Anh said the most common type of joint replacement surgery is that for the knee joints, which accounts for half of the total cases.

He said joint replacement surgeries are prescribed when patients have excruciating pain, lameness due to transfigured or bent joints, drug resistance, or are unable to exercise with physiotherapy. 

When the cartilage which coats the articular surfaces and prevents the bones from rubbing with each other wears away, causing disability and pain, patients need such replacements, Dr. Le Trong Phat, head of the FV Hospital's Orthopedics and Hand Surgery Department, told Vietweek.

Thu of the Vietnam Rheumatology Association said that though it is one of the top causes of human disability, osteoarthritis often starts with only mild symptoms such as intermittent pain in one or many joints, and a temporarily limited range of motion and transient morning stiffness.

Such symptoms are easy to get used to, and therefore patients rarely give themselves proper care early on.

When questioned by Vietweek as to why many young people are contracting osteoarthritis nowadays, Phat of the FV Hospital blamed traffic accidents or accidents in sports, saying that injuries in those situations will cause joints to wear out faster.

According to Anh of the Nguyen Tri Phuong Hospital, a small joint injury can lead to disability, but people tend to give them little attention.

"Without treatment, small injuries can become chronic problems and together with inflammation can destroy cartilage, which restricts patients' movements and can cause disabilities," Anh said.

Thu, however, said inactivity habit can also be among the causes of the disease among young people nowadays.

Anh said many people believe degeneration in knee joints cannot afflict office staff, who sit all day at work and put no pressure on their knee joints, but inactivity causes the cartilage to be less elastic. It also prevents synovial fluid from bringing nutrients to the cartilage, making it more vulnerable.

Doctors also say that those who abstain from eating can also expose themselves to joint degeneration as they do not provide the joints with sufficient nutrients. Obesity can also lead to the disease as the joints are burdened by heavy weight. 

Treatment and prevention

Phat said light cases can be treated with medication and physical therapy. Patients can undergo arthroscopic surgery in less serious cases, and when these methods cannot relieve the pain or restore the joint functions, a replacement of the joint surface with metal components is the solution.

Thu said people can prevent or delay the joint degeneration progress and reduce its seriousness with proper awareness.

People should eat well and have regular and reasonable exercise to help the cartilage absorb the nutrients.

They should not strain themselves in exercise, hunker, carry heavy loads or change positions suddenly.

Those who have joint pain, even light discomfort, should go to a good hospital or clinic for timely diagnosis and treatment, Anh said.

Undernatured type II collagen (UC-II) can be used to recover type II collagen in articular cartilage. Collagen is often damaged and lost during the aging process or due to excessive use or injuries.

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