Perhaps one of the surest signs of ageing is that sharp pain in the hips or knees, and that burning ache in the muscles and tendons around the joint. Almost like a rite of passage, you’ll know that you’ve crossed the line from middle age to your senior years when you develop difficulty with climbing stairs. And you’ll especially know it if you’ve also made a new friend: osteoarthritis.
The bane of elderly people around the world, osteoarthritis is a condition caused by the “wear and tear” of the joints as one ages. After a long, productive and energetic life, it’s inevitable that the weight bearing joints and the cartilage surrounding them get worn out, causing the exposed bones to grind against each other. Painfully.
That’s the all-too-familiar pain the elderly experience in the hips, knees and ankles when they perform tasks like walking or standing up.
The degenerative bone condition is estimated to affect 40 million Americans, and its incidence and prevalence increases steadily with age. While no studies have been done in Singapore, doctors estimate that about 10 to 20 % of the elderly here have osteoarthritis, especially of the knee.
Pain, pain, go away...
The problem with osteoarthritis is that it tends to hit more people as their age increases, and hits harder as they age.
In fact, in advanced cases of osteoarthritis the pain can be so disabling that knee and hip replacements are necessary.
Hip and knee replacement surgery has an excellent recovery rate when combined with a few months of rehabilitation and physiotherapy, with patients gaining a high quality of life after recovery.
But still, this may not the magic bullet for you. Some senior citizens may be unfit to be the recipients of a brand new joint due to severe heart disease, strokes or other chronic illnesses.
And the point about managing pain is never to let it get to the stage when you’re crying out for surgery.
The best studied medications for pain management from osteoarthritis are NSAIDs (non-steroidal anti-inflammatory drugs), which combat both the pain in the joints as well as the swelling that accompanies them.
If the pain is of the low-grade variety, hot and cold packs can offer effective, temporary relief, as will senior favourites like acupuncture and tuina.
On a day to day basis, clinical research suggests that daily supplements of glucosamine, chonroitin sulphate, and collagen may offer some solace to osteoarthritis sufferers – especially those in the early stages of the condition.
Because these compounds form the precursors of the material our body uses to make joint cartilage, the logic is that daily supplements should help the body to rebuild the cartilage lost to osteoarthritis, and hence beat back the march of condition.
One thing to note, though: even if these are just supplements, you should take them like medications. T supplements have to be taken every day, and in the recommended dosage – no half measures or skipping! Otherwise, the effectiveness of these supplements rapidly go down the drain.
Just work it out
Still, the most sure-fire way to combat osteoarthritis is just to work it out. An active lifestyle can keep the progression of osteoarthritis at bay: a healthy amount of physical exercise stimulates higher incidences of bone and cartilage formation, and also strengthens the muscles that are used to hold our creaking joints up.
But how exactly does one encourage a senior citizen to hit the road? As Prof Feng puts it, most elderly people associate exercise with blood, sweat, tears and pain – and people suffering from occasional joint pains may be loathe to subject themselves to the prospect of even more pain.
n reality, actual exercise should be pleasurable and natural part of the lifestyle, like eating or sleeping. While more public education needs to be done to persuade ailing seniors to take up exercise, you can and should still do your part: your parents are more open to exercise and an active lifestyle if accompanied by you and your kids.
Plus, the fact that bone loss begins after the age of 30 might be a good reason for you to work out with your parents or grandparents...
Growing old together
Generally, as seniors are no longer at the peak of their physical fitness, high impact sports are definitely out, and a different set of activities have to be devised for them.
You might want to get them started (and accompany them too!) on mild exercises like taichi, walking, and stretching at the frequency of three times a week, from half an hour to an hour of activity.
Morning taichi sessions are well-attended by many seniors, who will provide the bonding and numbers necessary to encourage your elderly family member to participate, while it pays to think of creative locations for a walk – try exploring different parts of the neighbourhood, or different parks and trails around the island!
While exercising together with your parent or grandparent provides a safety barrier, the usual precautions should still be taken. Seniors with medical conditions should seek advice from the doctor before embarking on the exercise programme, and it’s generally a bad idea to exercise if they’re having a cold, fever or feel generally unwell. If they develop chest pains, discomfort or shortness of breath, it’s important to stop immediately and go see a doctor.
And of course, remember the golden rule: remember that the senior is exercising to keep healthy, not to win a medal.
 Felson, D et al. 2000. “Osteoarthritis: New insights. Part 1: The disease and its risk factors”, in Annals of Internal Medicine 133(8):635-646.
 Christau S. et al, 2004. “Osteoarthritic patients with high cartilage turnover show increased responsiveness to the cartilage protecting effects of glucosamine sulphate” in Clin Exp Rheumatol. 2004 Jan-Feb;22(1):36-42.