How to treat rheumatism?

Many people misunderstand arthritis as "rheumatism". In fact, this understanding is wrong. Because there are many diseases with arthritis. Common diseases are as follows: rheumatoid arthritis; Osteoarthritis; Systemic lupus erythematosus; Ankylosing spondylitis; Gout; Rheumatic fever and so on.

Arthralgia is not necessarily arthritis. Osteoarthritis, rheumatoid arthritis and gout are three common causes of joint pain.

The concept of arthritis

Arthritis generally refers to inflammatory diseases that occur in human joints and their surrounding tissues and are caused by inflammation, infection, degeneration, trauma or other factors, and can be divided into dozens. There are more than 65438+ billion arthritis patients in China, and the number is increasing. The clinical manifestations are redness, swelling, heat, pain, dysfunction and joint deformity of joints, which in severe cases lead to joint disability and affect the quality of life of patients. According to statistics, half of people over 50 years old in China suffer from osteoarthritis, and 90% of women and 80% of men over 65 years old suffer from osteoarthritis. The prevalence rate in China is 0.34% ~ 0.36%, and the life expectancy of severe patients is shortened by about 10 ~ 15 years.

English name arthritis Clinic: orthopedics; Common causes: caused by inflammation, infection, degeneration, trauma or other factors; Common symptoms: joint redness, swelling, heat, pain, dysfunction and joint deformity.

The cause of disease

The etiology of arthritis is complex, which is mainly related to autoimmune reaction, infection, metabolic disorder, trauma, degenerative diseases and other factors. According to the etiology, arthritis can be divided into osteoarthritis, rheumatoid arthritis, ankylosing arthritis, reactive arthritis, gouty arthritis, rheumatic arthritis, suppurative arthritis and so on.

classify

Many diseases can cause arthritis. The common arthritis in clinic is as follows:

1. Osteoarthritis

Also known as degenerative arthropathy, osteoarthrosis. Bone hyperplasia is closely related to human aging. Most elderly people may be accompanied by hyperosteogeny and naturally get osteoarthritis. Clinical data show that the prevalence rate of osteoarthritis in people under 45 years old is only 2%, while the prevalence rate in people over 65 years old is as high as 68%. According to doctors, people will suffer from different degrees of osteoarthritis when they are old.

2. Rheumatoid arthritis

The disease often manifests as pain in small joints (knuckles, wrists, etc.). ), and the joints are symmetrical. 80% of patients with rheumatoid arthritis are between 35 and 50 years old, but the elderly and children can also get sick. Because its etiology has a complicated relationship with heredity, infection, environment and immunity, it can not be completely cured in clinic. Only drug treatment can control the disease and maintain joint function.

3. Ankylosing spondylitis

Most of them are axial joint diseases such as spine and sacroiliac joint. The etiology is still unclear, and it is generally believed that genetic factors and environmental factors interact. The disease is more common in men, and the onset age is mostly before 40 years old. In severe cases, it can lead to deformity of spine and joints and affect daily life.

4. Reactive arthritis

Inflammatory joint diseases caused by extra-articular infection factors such as intestinal system and urinary system. Reduce infection rate, improve immunity, and have certain preventive and therapeutic effects.

5. Gouty arthritis

Arthritis caused by urate crystallization and deposition. The onset is mostly acute unilateral arthritis, with sudden swelling and pain of the big toe as the main symptom. When it hurts, it is "pain". The course of the disease lasts about a week and can be relieved, and it passes like a gust of wind, so it is called "gout", but it is easy to recur. The preventive method is to effectively resist oxidation and prevent the oxidative decomposition of nucleic acid, thus reducing the production of endogenous purine (accounting for 80%) and then reducing the production of uric acid. At the same time, we should change our living and eating habits and eat less exogenous purines such as animal viscera, seafood, beer and liquor to reduce the production of uric acid.

clinical picture

Most arthritis has a long course of disease and is difficult to heal, so it is quite difficult to treat. Therefore, early detection, early diagnosis and early treatment are beneficial to prevent the progress of arthritis and improve the prognosis of patients.

1. Joint pain

Is the main manifestation of arthritis. Different types of arthritis will show different pain characteristics.

2. Joint swelling

Swelling is a common manifestation of joint inflammation, and it is also the result of inflammation progress, which is not necessarily related to the degree of joint pain. Generally proportional to the disease.

3. Joint dysfunction

Joint pain and inflammation cause edema of tissues around the joint, protective spasm of muscles around the joint, and destruction of joint structure, which leads to limited joint activity. Patients with chronic arthritis may suffer from permanent joint function loss due to long-term limited joint activity.

4. Symbols

Different types of arthritis have different signs, such as erythema, deformity, soft tissue swelling, joint swelling, exudation, bone swelling, bone friction, tenderness, muscle atrophy or weakness, limited joint range of motion, nerve root compression and so on.

cheque

1. Laboratory inspection

(1) Routine tests such as blood routine, urine routine, erythrocyte sedimentation rate, C-reactive protein, biochemistry (liver and kidney function, A/G), immunoglobulin, protein electrophoresis and complement. Blood routine, protein electrophoresis, immune complex and serum complement are generally in the normal range. Patients with synovitis may have a slight increase in C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Patients with secondary arthritis may have abnormal laboratory tests related to the primary disease.

(2) Autoantibodies such as rheumatoid factor, anti-cyclic citrulline antibody, rheumatoid factor IgG and IgA, anti-perinuclear factor and anti-keratin antibody, as well as antinuclear antibody and anti-ENA antibody.

(3) Genetic markers HLA-DR4 and HLA-DR 1 subtype.

2. Image inspection

(1)X-ray examination X-ray film of joint showed swelling of soft tissue, osteoporosis and subchondral sclerosis after the lesion progressed, and/or cystic degeneration of articular surface, invasive bone destruction, blurred articular surface, asymmetric stenosis of joint space, joint fusion and dislocation. Hyperplasia of joint margin, osteophyte formation or joint effusion in different degrees, and loose bodies or joint deformation can be seen in some joints.

(2)CT examination includes joint CT and chest CT examination.

(3) MRI examination of joints MRI examination is very helpful for early detection of joint lesions in patients with rheumatoid arthritis.

(4) Ultrasonic joint ultrasound is a simple and non-invasive examination, which has differential significance for synovitis, joint effusion and joint destruction.

3. Special inspection

(1) Joint Puncture For joints with joint cavity effusion, the examination of joint fluid includes: joint fluid culture, rheumatoid factor detection, etc. Polarized light detection of urate crystals used to identify gout.

(2) Arthroscopy and synovial biopsy are of great value in the diagnosis and differential diagnosis of arthritis.

diagnose

1 rheumatoid arthritis

It is a common acute or chronic connective tissue inflammation. It can recur and involve the heart. The clinical manifestations are joint and muscle wandering pain. This is an allergic disease. It is one of the main manifestations of rheumatic fever, which usually begins with acute fever and joint pain. Typical manifestations are mild to moderate fever, wandering polyarthritis, and most of the joints involved are knee, ankle, shoulder, elbow and wrist, which are often transferred from one joint to another. The focus is red, swollen and burning, and some patients also have several joints at the same time. Atypical patients only have joint pain and no other inflammatory manifestations. Acute inflammation usually subsides in 2 ~ 4 weeks, leaving no sequelae, but it often recurs. If rheumatic activities affect the heart, myocarditis may occur, and even heart valve lesions may be left behind.

2. Rheumatoid arthritis

This disease is one of the most common chronic arthritis. It is related to heredity, bacterial and viral infections and environmental factors including smoking. It can occur at any age, but it is more common in women aged 40 ~ 60. 1987 Diagnostic conditions of the classification standard of rheumatoid arthritis revised by American Rheumatology Association (≥4 items can be diagnosed);

(1) morning stiffness lasts at least 1 hour (≥6 weeks).

(2) involving three or more joints (≥6 weeks).

(3) Hand joint (wrist joint, metacarpophalangeal joint or proximal interphalangeal joint) is involved (≥6 weeks).

(4) Symmetric arthritis (≥6 weeks).

(5) There are rheumatoid nodules under the skin.

(6) X-ray changes of hand joints (osteoporosis or obvious decalcification of joints and their adjacent areas, narrowing of joint space).

(7) Serum rheumatoid factor positive (titer >; 1:32)。

3. Osteoarthritis

It is more common in middle-aged and elderly people, and the onset process is more slow. Hand, knee, hip and spine joints are easy to be involved, while palms, fingers and wrists are less involved. The disease usually worsens with activity or decreases with rest. The morning stiffness time is generally less than half an hour. When both hands are involved, Hubbard's tubercle and bouchard's tubercle can be seen in physical examination, and the knee joint can feel friction. There were no extraarticular manifestations such as subcutaneous nodules and vasculitis. Most rheumatoid factors are negative, and a few elderly patients may have low titer positive.

4. Gouty arthritis

Gout is a metabolic disease caused by abnormal purine metabolism and increased uric acid synthesis. When the renal function is abnormal, the uric acid level will also increase because the uric acid clearance rate of the kidney is reduced. The uric acid in plasma is saturated, which leads to the crystal deposition of monosodium urate, which is relatively lacking in blood vessels in the tissues around the distal joint. The appearance of this crystal can lead to acute inflammatory synovitis of a single joint or multiple joints. Gout is more common in men, and the big toe is the most common affected part. Most gout patients will have the first metatarsophalangeal joint involvement at some point in their lives. Other foot areas that may be affected are the instep, heel and ankle.

5. Ankylosing spondylitis

Young men are more frequent and have obvious family onset tendency. It mainly involves sacroiliac joints, spinal joints and other axial joints, and peripheral joints can also be involved, but most of them are large joints of lower limbs, showing asymmetric swelling and pain, often accompanied by pain at the attachment points of tendons and ligaments such as spinous process, greater trochanter, achilles tendon and spinal costal joint. When the lesion is serious, the spine may be stiff, and the activities of cervical, lumbar and thoracic vertebrae are limited, resulting in "humpback", which seriously affects the daily life of patients. The extraarticular manifestations were iridocyclitis, cardiac conduction block and aortic valve insufficiency. X-ray film shows that sacroiliac joint is invaded, destroyed or fused. More than 90% patients are positive for HLA-B27, but negative for rheumatoid factor.

6. Reactive arthritis

The onset is acute, and there is often a history of intestinal or urinary tract infection before the onset. Asymmetry mainly involves large joints (especially lower limb joints), and generally involves small joints such as interphalangeal joints and wrist joints near asymmetric fingers. May be accompanied by ophthalmia, urethritis, balanitis and fever. HLA-B27 can be positive and rheumatoid factor negative, and patients may have X-ray changes of asymmetric sacroiliitis.

7. Infectious arthritis

Related to bacterial infection. Common pathogens include Staphylococcus aureus, Pneumococcus, Meningococcus, Neisseria gonorrhoeae, Streptococcus and Mycobacterium tuberculosis. Pathogenesis includes direct bacterial infection and the release of toxins or metabolites by bacteria in the process of infection, including subacute bacterial endocarditis and post-scarlet fever arthritis. Arthritis caused by direct bacterial infection is characterized by joint swelling, fever and pain and joint dysfunction. Asymmetric involvement of weight-bearing joints of lower limbs. It often involves large joints, such as hip and knee joints. Joint cavity puncture fluid often shows purulent changes. Bacteria can be found by smear or culture. Arthritis infected by mycobacterium tuberculosis is common in young people, and there are also evidence of tuberculosis in other parts, including pulmonary or lymph node tuberculosis. There may be erythema nodosum with negative serum rheumatoid factor. The tuberculin test was positive. Arthritis caused by bacterial metabolites or toxins can heal itself in 1 ~ 2 weeks, and joint symptoms linger.

8. Others

Such as traumatic arthritis, psoriatic arthritis and enteropathy arthritis. Autoimmune diseases, such as systemic lupus erythematosus, Sjogren's syndrome, scleroderma and tumor, often manifest as arthritis in the course of disease occurrence and development.

treat cordially

1. drug therapy

According to the types, symptoms and accompanying diseases of arthritis, choose appropriate therapeutic drugs. The principle of treatment is early diagnosis and rational combination of drugs as soon as possible. Commonly used anti-rheumatic drugs are as follows:

(1) Non-steroidal anti-inflammatory drugs can inhibit the synthesis of prostaglandin, rapidly produce anti-inflammatory and analgesic effects, and have a good effect on relieving pain, which can relieve headache and muscle pain, including joint pain related to osteoarthritis. These drugs take effect quickly and metabolize quickly in the body. Once the metabolism is completed, the pain starts again and lasts for a short time. Can't change the course of disease. Ibuprofen, penicillamine, diclofenac, aspirin and indomethacin are commonly used in clinic.

(2) Glucosamine sulfate and other chondroprotective agents can promote cartilage synthesis, inhibit the decomposition of articular cartilage, and also have anti-inflammatory effects. Sulfuric acid rich in glucosamine sulfate is also one of the essential components for synthesizing cartilage matrix. Taking these drugs for a long time (more than 2 years) can relieve pain symptoms, improve joint function and delay the destruction of joint structure. Glucosamine sulfate takes effect slowly, but its drug safety is good, so it is suitable for long-term use as a basic therapeutic drug.

(3) Slow-acting antirheumatic drugs are mostly used for rheumatoid arthritis and seronegative spondyloarthropathy. It can control the disease to some extent, but the effect is slow. Commonly used are gold mixture (intramuscular injection or oral administration), penicillamine, sulfasalazine, chloroquine and so on.

(4) Cytotoxic drugs produce immunosuppression through different channels. Commonly used are cyclophosphamide, methotrexate and chlordecone. They are usually second-line drugs for systemic lupus erythematosus, rheumatoid arthritis and vasculitis. Although the side effects are getting more and more serious, they play a great role in improving the prognosis of these diseases.

(5) Adrenal cortical hormone is an anti-inflammatory and antiallergic drug, which can obviously improve the prognosis of connective tissue diseases such as systemic lupus erythematosus, but can't radically cure these diseases. Many of its side effects increase with the increase of dose and the extension of treatment. If used for a long time, it will aggravate the damage of articular cartilage and aggravate the symptoms of osteoarthritis. Therefore, its efficacy and side effects should be measured and carefully selected in application.

(6) Streptococcal infections such as antibiotics can cause arthritis manifestations of rheumatic fever. Penicillin is the most effective drug to control acute streptococcal infection. Patients with acute rheumatic fever receive long-term antibiotic treatment to prevent the occurrence of long-term rheumatic carditis. Prevention for adults should not be less than 5 years, and children should be at least 18 years old. Tuberculous arthritis and fungal arthritis need active and effective anti-tuberculosis or antifungal drugs.

(7) The treatment of gouty arthritis includes drug therapy in acute phase, including high-dose non-steroidal anti-inflammatory drugs or colchicine and uric acid reduction in remission phase. The drugs for reducing uric acid mainly include allopurinol which inhibits uric acid production and benzbromarone which promotes uric acid excretion.

(8) Chinese medicine treatment. Traditional Chinese medicine theory of arthritis treatment holds that "wind-cold-dampness evil blocks meridians, making them impassable, thus causing pain", so traditional Chinese medicine treatment generally aims at expelling wind and cold, relieving spasm and dredging collaterals, promoting blood circulation and removing blood stasis. It can relax stiff joint muscles, relieve muscle spasm, dredge meridians, reduce swelling and relieve pain. Dulcimer Tang Jie has been used clinically for more than 30 years, mainly for treating various neck, shoulder, lumbocrural pain, muscle and joint pain, numbness, heaviness, unfavorable flexion and extension, joint swelling and so on. It is especially suitable for the "old cold legs" of the elderly with stiff joints in the morning. EMS Express can be delivered to the north and south of China within three to five days.

2. Surgical treatment

Surgical treatment mainly includes joint cavity puncture, synovial resection, joint replacement, joint orthopedic, joint fusion and so on.

3. Bone marrow transplantation

The treatment of rheumatoid arthritis does have a significant effect. Autologous bone marrow transplantation promotes the recovery of patients by restoring the function of immune system, and has achieved good results in the treatment of rheumatoid arthritis in children.

4. Immunization and biotherapy

This kind of treatment is aimed at the onset of arthritis and the main links that lead to disease progress, such as targeted molecular therapy of cytokines, plasma exchange, immune purification, immune reconstruction, mesenchymal stem cell transplantation and so on. It is mainly used for other patients with severe arthritis that is ineffective, rapid and refractory, mainly rheumatoid arthritis.

5. Other treatments

Including physical, rehabilitation, vocational training, psychological and other treatment. Physical therapy mainly includes the following types: direct current therapy and drug iontophoresis, low-frequency pulse electrotherapy, medium-frequency current therapy, high-frequency electrotherapy, magnetic field therapy, ultrasonic therapy, acupuncture and phototherapy, that is, infrared ray, ultraviolet ray and cold therapy. Rehabilitation and vocational training focus on functional exercise and lifestyle adjustment. Conditional hospitals should carry out functional exercise under the guidance of rehabilitation experts.

prognosis

The etiology, course of disease, individual differences and treatment methods of arthritis are different, and their prognosis is also different. The course of most patients with reactive arthritis is self-limited, and usually subsides in 3 ~ 5 months. In recent ten years, with the early combined use of slow-acting anti-rheumatic drugs, the treatment of extra-articular lesions and the emergence of new therapies, the prognosis of rheumatoid arthritis has been significantly improved. The condition of most patients with rheumatoid arthritis can be well controlled or even completely relieved.

prevent

1. Avoid environmental factors that induce arthritis.

Humid environment is conducive to the growth of some pathogenic bacteria and has a certain relationship with the onset of arthritis. Therefore, we should pay attention to hygiene at ordinary times, keep indoor ventilation well, prevent moisture and keep warm, and avoid the spread of pathogenic bacteria, especially streptococcus. In addition, other environmental factors, such as ultraviolet rays and exposure to certain chemicals, may lead to abnormal immune response in some susceptible people, leading to different arthritis. Susceptible people should avoid exposure to strong ultraviolet rays and certain chemicals.

2. Eat a reasonable diet and maintain a good lifestyle.

Nutritional deficiency can aggravate arthritis, while overnutrition and obesity can induce or aggravate gouty arthritis and osteoarthritis. Therefore, a scientific and reasonable diet is a measure to prevent certain arthritis, such as reducing the intake of purine-rich foods such as animal viscera, seafood, poultry and beans, which can effectively prevent gouty arthritis. The probability of smokers suffering from rheumatoid arthritis has obviously increased, and quitting smoking has become one of the preventive measures for rheumatoid arthritis.

3. Exercise moderately, keep happy and improve immunity.

The stability of the immune system is related to emotions. Clinically, many patients develop autoimmune diseases after experiencing adverse life events. Therefore, maintaining an optimistic and stable attitude is conducive to preventing arthritis caused by autoimmune diseases.

Treatment of arthritis

1. Main causes of joint pain: Osteoarthritis, rheumatoid arthritis and gout are three common causes of joint pain. Osteoarthritis is a degenerative disease of local joints, characterized by progressive damage to articular cartilage of synovial joints. Rheumatoid arthritis is a chronic systemic disease with unknown etiology, which is characterized by persistent inflammation of synovium around joints. Gout is an inflammatory disease caused by uric acid deposition in joint tissues. These diseases are usually chronic and persistent pain, and patients have a certain degree of tolerance, but in acute attacks, the pain is often unbearable or even impossible to move at all.

2. Therapeutic purpose of arthritis: Pain is a manifestation of disease, and the key to treating pain is to treat the primary disease. However, when pain is the main manifestation of some diseases, and the disease itself is difficult to cure, the treatment of pain is particularly important, and controlling pain has become the most important part of arthritis treatment. In view of the importance of joints to patients' mobility, restoring or maintaining joint function is one of the most important goals in the treatment of joint pain. Treatment should focus on the overall situation and always pay attention to the protection of function. When the pain cannot be controlled by systemic therapy, surgical treatment can be considered according to the patient's condition. In fact, a major purpose of joint replacement is to relieve pain. The purpose of systematic therapy is: to relieve pain and joint stiffness; Increase joint mobility; Control inflammation; Restore joint function as much as possible; Prevent or correct deformities. For patients with osteoarthritis, it can delay the progress of the disease. For patients with rheumatoid arthritis, because there is no cure, it is important to restore their functions and improve their quality of life.

Traditional Chinese medicine theory of arthritis treatment holds that "wind-cold-dampness evil blocks meridians, making them impassable, thus causing pain", so traditional Chinese medicine treatment generally aims at expelling wind and cold, relieving spasm and dredging collaterals, promoting blood circulation and removing blood stasis. It can relax stiff joint muscles, relieve muscle spasm, dredge meridians, reduce swelling and relieve pain. Dulcimer Tang Jie has been used clinically for more than 30 years, mainly for treating various neck, shoulder, lumbocrural pain, muscle and joint pain, numbness, heaviness, unfavorable flexion and extension, joint swelling and so on. It is especially suitable for the "old cold legs" of the elderly with stiff joints in the morning. EMS Express can be delivered to the north and south of China within three to five days.

3. Treatment principle of arthritis pain: The treatment of arthritis pain should follow the principles of treating the primary disease, relieving the progress of the disease, evaluating the pain state and grading treatment. There are three kinds of commonly used painkillers, simple painkillers-only simple analgesic effect, no anti-inflammatory effect; Non-steroidal anti-inflammatory drugs-both anti-inflammatory and analgesic, suitable for inflammatory pain, are divided into traditional (NSAIDs) and new (COX-2 inhibitors) painkillers; Opioid drugs, powerful preparations include morphine, fentanyl and so on. The weak preparations include tramadol, and the synthetic preparations include acetaminophen and oxycodone. These three kinds are basically divided into three levels, the severity of pain is different, and the drugs used are different. If it is joint pain caused by osteoarthritis and rheumatoid arthritis, it is recommended to use non-steroidal anti-inflammatory drugs. There are many kinds of drugs with similar efficacy, and the same patient may have different sensitivities to different drugs. COX-2 inhibitor, a new non-steroidal anti-inflammatory drug, can be used when suffering from gastric ulcer or risk factors. Its biggest advantage is that it can reduce the occurrence of gastrointestinal adverse reactions, which is obviously superior to other drugs in this respect. These drugs are expensive, so other traditional NSAIDs and acid inhibitors can be used together to achieve similar effects. Acetaminophen (alias: Baifuning; Biliton; Acetaminophen; Paracetamol; Tylenol analgesic tablets), the drug has few adverse reactions, convenient purchase, low price and less economic pressure caused by long-term treatment.

When patients with severe arthritis can't control the use of non-steroidal anti-inflammatory drugs, opioids are recommended. Opioids are often called anesthetics, but opioids are addictive and should not be used for a long time. Therefore, it is generally believed that when the pain can only be controlled by opioids, artificial joint replacement should be performed. It is best to do it before deformity and serious deterioration of muscle function.

4. Other adjuvant therapies (drugs for nourishing cartilage, lubricant injected into joint cavity, etc.). For osteoarthritis, drugs that nourish cartilage can relieve the disease at the early stage, and glucosamine is one of the important components that human body can synthesize cartilage by itself. With the increase of age, joint degeneration and cartilage wear occur, and the self-synthesized glucosamine is gradually insufficient to repair, which will accelerate the progress of the disease. Supplementing glucosamine products similar to human cartilage extracted from crab shells and shrimp shells can help cartilage repair and relieve pain to some extent. Local injection of hormone into joint cavity to fight acute inflammation can effectively relieve pain symptoms. Most of them are used in small doses for a short time, which is not suitable for whole body use. Topical ointment or plaster, ointment, emulsion and gel, including mint, salicylic acid and diclofenac salt, can temporarily relieve joint pain. However, long-term application may produce tolerance to this therapy, and the effect will gradually decline. Hyaluronic acid injected into joint cavity is an important component of joint fluid extracted by biochemical technology. Just like injecting lubricating oil into an automobile engine, pumping hyaluronic acid directly into the joint cavity can increase the lubricity and viscosity of joint fluid, reduce pressure and cartilage wear, and improve the nutritional status of articular cartilage, thus helping to repair diseased cartilage. It is a direct and effective method in conservative treatment at present. Physical therapy, including local hot compress, electrotherapy, traction, hydrotherapy, training lower limb muscles, etc. Hyperthermia and electrotherapy can promote joint blood circulation, improve stiffness, diminish inflammation and relieve pain. It should be noted that the function of hyperthermia is mainly to relieve symptoms and make patients feel "comfortable". Overheating will aggravate joint synovitis, which is not conducive to controlling the progress of the disease. When arthritis affects activities, knee pads, elbow pads or brackets should be used to relieve joint pressure. Walking sticks and walkers can reduce joint pressure, make gait stable, and avoid joint deformation caused by improper force.

5. Exercise therapy Reasonable exercise is the most long-term and effective method to improve joint function and slow down the progress of the disease. Exercise can increase bone density, enhance muscle strength and softness, help stabilize joints, relieve joint stiffness symptoms when getting up in the morning, improve balance and endurance, and control weight. More importantly, exercise can improve the functions of other systems in the whole body, such as cardiovascular system, respiratory system and digestive system. "Life lies in sports". If you are too painful to go out to exercise, don't forget to do some soft stretching exercises. After the pain is relieved or the condition is stable, gradually increase the amount of exercise.