When joints give up

Humans have approximately 200-250 bones in the body, depending on their age. Joints - some immobile and others mobile - connect these bones. The joints are held in place and assisted by muscles and cartilage. They are lubricated with the jelly-like synovial fluid.

Over a lifetime, joints move hundreds and thousands of times. Some get used more than others. A labourer will use his shoulders and knees more. A desk job on a computer stresses the back and the joints of the fingers.

Repetitive movements wear out the joints, damaging them and making them painful. Pain can also be due to the deposition of crystals in the joint, inflammation, trauma or autoimmune diseases. Specific treatment may be required for these conditions.

To prevent stiffness, stretch the knees by extending them and also standing up after every hour of sitting. Chairs used for work should have a backrest and its height should be adjustable - whether a person is tall or short, the feet should rest comfortably on the floor. The top of the monitor should be at or slightly below eye level. It should be 50 to 65 centimetres from the eyes.

Inactivity makes weight creep up slowly. If your BMI is above 25, you can slow the onset of joint pain by losing weight. Every 4.5kg lost reduces pressure on the knee joints by 20 per cent.

Joint pain often starts as a niggling discomfort that makes you reluctant to exercise. Research has shown that regular exercise releases chemicals from muscles that nourish cartilage and also reduce pain and stiffness. With increasing age, high impact activities may worsen pain, but gentle exercise such as walking, swimming or cycling is beneficial. Stretching and strengthening the muscles around the joints helps cushion jolting impact and keep bones properly aligned.

Pain can be treated by local gel applications and ice packs. Pain killers, NSAIDs and even lubricants like glucosamine and chondroitin sulphate have a limited role. Higher doses may be needed to relieve the pain. Eventually, joints of the knee, hip and back may need reconstructive or replacement surgery. All treatment will eventually be unsuccessful if there is obesity, lack of an active lifestyle and lack of adequate sleep for rest and recovery.

The writer is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India. If you have any questions on health issues please write to yourhealthgm@yahoo.co.in

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