National Bone and Joint Day | Bone and joint problems in obese

Dr G K Sudhakar Reddy
August 4, 2020

Being overweight or obese is now recognised as a serious cause of ill health and disability. There is a significant positive association between orthopaedic disorders and the level of obesity causing pain, deformity and difficulty in walking.

Excess body weight accumulation increases pressure on joints, particularly the hips, knees and ankles.

Here are a few type of  arthritis:

Osteoarthritis

It is a condition of damage/ wear and tear of the joint lining or cartilage. Obesity triggers this by loading excessive weight on the weight bearing joints like the knee and the hip. 

Knee Osteoarthritis

This is the most common arthritis especially in the Indian subcontinent.

While walking, an individual exerts 3 to 6 times pressure that of the body weight on the weight-bearing knee joint, which means in an obese with excess body weight, larger forces are exerted, which lead to higher risk of deterioration of cartilage.

In addition, there are excessive fat tissues that produce hormones and other factors that affect the joint cartilage metabolism and cause inflammation of the joints giving rise to joint pathology.  Leptin is one of the hormones causing knee osteoarthritis. 

Hip osteoarthritis

The force exerted across the hip is 3 times that of body weight. Hip osteoarthritis is caused by factors such as joint injury, increasing age and being overweight.    

Hand osteoarthritis

The observation that obese individual has a higher risk in having hand osteoarthritis has led to a hypothesis that the metabolic effect produced by fat tissue is the underlying factor. 

Osteoporosis

It is a progressive bone condition of decrease in bone mass and density (Bone Mineral Density or BMD) which can lead to an increased risk of fracture. Recent research suggests that obesity may accelerate bone loss. It is the amount of muscle mass which is seen in an active person, which accounts for bone strengthening effects and not due to the fat seen in a heavy person.

Low back pain

Low back pain from degenerative disc disease of the lumbar spine is one of the most disabling conditions in the community and overweight and obesity have the strongest association with seeking care for low back pain.

Managing Hip and Knee Osteoarthritis

Life style changes

If one is overweight, try to lose weight by doing more physical activity and eating a healthier diet. Regular exercise keeps you active and mobile and builds up muscle, thereby strengthening the joints and can improve symptoms. 

Pain Killers

Painkillers help with pain and stiffness for short term. They don’t affect the arthritis itself and won’t repair the damage to your joint. Creams and gels can be applied directly onto painful joints.

Nutritional Supplements

Glucosamine and chondroitin are nutritional supplements. Animal studies have found that glucosamine can both delay the breakdown of and repair damaged cartilage. However, there is insufficient evidence to support the use of glucosamine in humans and one can expect only a mild-to-moderate reduction in pain

Joint injections

If pain from osteoarthritis is severe joint steroid injections are injected into the joints that can reduces swelling and pain. The injections can start working within a day or so and may improve pain for several weeks or months. 

Hyaluronic acid injections, which help to lubricate your knee joint also give short term relief. In early stages. Stem cell treatment or cartilage regeneration procedures are being tried in young people with small defects, however it is still experimental and lacks long term evidence.

Surgery

May be recommended if you have severe pain or mobility problems.

Arthroscopy

If one has frequent painful locking/stiffening episodes especially in the knee joint, an operation to wash out loose fragments of bone and other tissue as joint can be performed by a minimally invasive key hole procedure called Arthroscopy.

Arthrodesis

If hip or knee replacement is not suitable, especially in young people who do heavy manual work, one can consider an operation known as an arthrodesis, which fuses your joint in a permanent position. This means that your joint will be stronger and much less painful, although you will no longer be able to move it.

Osteotomy

In young, active people in whom a knee joint replacement would fail due to excessive use one can consider an operation called an osteotomy. This involves adding or removing a small section of bone either above or below your knee joint.  This helps realign your knee so your weight is no longer focused on the damaged part of your knee. An osteotomy can relieve your symptoms of osteoarthritis, although you may still need knee replacement surgery eventually as you grow old

Joint replacement surgery

Joint replacement therapy is most commonly carried out to replace hip and knee joints. It involves replacing a damaged, worn or diseased joint with an artificial joint made of special plastics and metal.

For most people, a replacement hip or knee will last for at least 20 years, especially if it is cared for properly and not put under too much strain.

Dr G K Sudhakar Reddy is a Sr Consultant Orthopaedic Surgeon at Citizens Speciality Hospitals, Hyderabad

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Agencies
May 19,2020

New York, May 19: Cigarette smoke spurs the lungs to make more of the receptor protein which the novel coronavirus uses to enter human cells, according to a study which suggests that quitting smoking might reduce the risk of a severe coronavirus infection.

The findings, published in the journal Developmental Cell, may explain why smokers appear to be particularly vulnerable to severe COVID-19 disease.

"Our results provide a clue as to why smokers who develop COVID-19 tend to have poor clinical outcomes," said study senior author Jason Sheltzer, a cancer geneticist at Cold Spring Harbor Laboratory in the US.

"We found that smoking caused a significant increase in the expression of ACE2, the protein that SARS-CoV-2 uses to enter human cells," Sheltzer said.

According to the scientists, quitting smoking might reduce the risk of a severe coronavirus infection.

They said most individuals infected with the virus suffer only mild illness, if they experience any at all.

However, some require intensive care when the sometimes-fatal virus attacks, the researchers said.

In particular, they said three groups have been significantly more likely than others to develop severe illness -- men, the elderly, and smokers.

Turning to previously published data for possible explanations for these disparities, the scientists assessed if vulnerable groups share some key features related to the human proteins that the coronavirus relies on for infection.

First, they said, they focused on comparing gene activity in the lungs across different ages, between the sexes, and between smokers and nonsmokers.

The scientists said both mice that had been exposed to smoke in a laboratory, and humans who were current smokers had significant upregulation of ACE2.

According to Sheltzer, smokers produced 30-55 per cent more ACE2 than their non-smoking counterparts.

While the researchers found no evidence that age or sex impacts ACE2 levels in the lungs, they said the influence of smoke exposure was surprisingly strong.

However, they said, the change seemed to be temporary.

According to the data, the level of the receptors ACE2 in the lungs of people who had quit smoking was similar to that of non-smokers.

The study noted that the most prolific producers of ACE2 in the airways are mucus-producing cells called goblet cells.

Smoking is known to increase the prevalence of such cells, the scientists said.

"Goblet cells produce mucous to protect the respiratory tract from inhaled irritants. Thus, the increased expression of ACE2 in smokers' lungs could be a byproduct of smoking-induced secretory cell hyperplasia," Sheltzer explained.

However, Sheltzer said other studies on the effects of cigarette smoke have shown mixed results.

"Cigarette smoke contains hundreds of different chemicals. It's possible that certain ingredients like nicotine have a different effect than whole smoke does," he said.

The researchers cautioned that the actual ACE2 protein may be regulated in ways not addressed in the current study.

"One could imagine that having more cells that express ACE2 could make it easier for SARS-CoV-2 to spread in someone's lungs, but there is still a lot more we need to explore," Sheltzer said.

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Agencies
June 10,2020

Early treatment with the antiviral drug remdesivir has been found to reduce viral load and prevent lung disease in macaques infected with SARS-CoV-2 that causes COVID-19, according to a study.

The findings, published in the journal Nature on Tuesday, support the early use of remdesivir treatment in patients with COVID-19 to prevent progression to pneumonia.

Researchers from the National Institutes of Health in the US noted that remdesivir has broad antiviral activity and has been shown to be effective against infections with SARS-CoV and MERS-CoV in animal models.

The drug is being tested in human clinical trials for the treatment of COVID-19, they said.

Researcher Emmie de Wit and colleagues investigated the effects of remdesivir treatment in rhesus macaques, a recently established model of SARS-CoV-2 infection.

Two sets of six macaques were inoculated with SARS-CoV-2.

One group was treated with remdesivir 12 hours later -- close to the peak of virus reproduction in the lungs -- and these macaques received treatment every 24 hours until six days after inoculation.

In contrast to the control group, the researchers found that macaques that received remdesivir did not show signs of respiratory disease, and had reduced damage to the lungs.

Viral loads in the lower respiratory tract were also reduced in the treated animals; viral levels were around 100 times lower in the lower-respiratory tract of remdesivir-treated macaques 12 hours after the first dose, they said.

The researchers said that infectious virus could no longer be detected in the treatment group three days after initial infection, but was still detectable in four out of six control animals.

Despite this virus reduction in the lower respiratory tract, no reduction in virus shedding was observed, which indicates that clinical improvement may not equate to a lack of infectiousness, they said.

Dosing of remdesivir in the rhesus macaques is equivalent to that used in humans, the researchers noted.

They cautioned that it is difficult to directly translate the timing of treatment used in corresponding disease stages in humans, because rhesus macaques normally develop only mild disease.

However, researchers said the results indicate that remdesivir treatment of COVID-19 should be initiated as early as possible to achieve the maximum treatment effect.

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Agencies
April 25,2020

An uncertain prognosis, severe shortage of resources and the imposition of unfamiliar public health measures that infringe on personal freedoms along with large and growing financial losses are undoubtedly contributing to the widespread psychological and emotional distress associated with COVID-19.

The COVID-19 pandemic has forced millions of people to work from home world-wide. Today, due to constant exposure to increasing numbers, an intense fear of contamination have a massive psychological impact on people who are working from home.

Kuhoo Gupta, Healer and Founder of The K Junction talks about wellness during work from home as the situation is resulting in people being vulnerable to severe mental illnesses. Staying positive and optimistic while working from home during pandemic can be heavily challenging.

Gupta states its critical to maintain your mental well-being and immune system, as people with mental upheavals are prone and susceptible to various flu or inflammations. Your bodies immune system reacts abnormally which diminishes the capability of it's function.

The only key to manifesting a wonderful well-being is to try and calm one's mind and focus on constructive and wellness activities, to find a path towards making ourselves more resilient while working from home. Gupta shares 5 tips you can start doing today to improve and enhance your positive outlook.

Remember! Your workplace should be a sacred space where you are able to find a sense of comfort in your work environment. It should help you feel positive, healthier and happier, more like a protective zone.

Fabricating a Positive Workstation

There should be a separate workstation so that one can concentrate while working from home. It would be great if the work desk is stationed somewhere near a window or a balcony door so that one can welcome sunlight, fresh air and a view of plants & birds during the day. Try to have an ergonomic setting of your table and chair so that you keep your posture right while working the whole day. Keeping one or two indoor plants near your work desk will help to make it interesting.

Keep your laptop charger wires and other stuff neatly on your desk to avoid overwhelming yourself. Motivation quotes around you will help to make you overall positive. Keep your notes diary and pen handy at your desk. It will always helps to keep some colorful artifacts around you to make the atmosphere a little cheerful.

Declutter Your Workstation

Avoid the pilling up files and unnecessary stationery at your workstation. Clutter is responsible for the confusion and problems all around and it leads to distraction; thus, a clean desk reflects power which enhances positivity and creates a tranquil workspace that will help your mind focus on productivity. It is important to declutter your work desk once in a few days because physical clutter translates to mental clutter.

Gratitude Notes in workstation and how to manifest

It is a great morning practice to write at least five things you are grateful for. It helps to shift the focus from negative to positive, from scarcity to abundance. One can write gratitude statements on Post it notes and put them at the work daily. This will raise the vibrations and help you stay grounded and positive. You can also compile affirmations and prayers that you resonate. Whenever you take work breaks, it is a good idea to read these.

Crystals to imbibe positivity at workstation

Selenite is a great crystal to spread light and positivity around. Black tourmaline absorbs negativity and is great to shield you from it during lockdown. Shungite is a great crystal to reduce the effects of electromagnetic radiations around you. You can place it near your wifi router, laptop and other devices to reduce the EMF pollution effects on you and your family. Clear quartz is great for energizing you after a tiring meeting. Just hold it in your left hand with eyes closed for five minutes and visualise beautiful energy entering your body and soul.

You can combine this exercise by holding black tourmaline in your right hand and visualize all the tiredness and unwanted energy draining into the black tourmaline. Tiger eye is very effective in eliminating the scattered brain and it allows us to make confident decisions. Green Aventurine neutralizes stress and anxiety from work, allowing us to keep calm.

Lepidolite is known as the Peace Stone, making it one of the best crystals for peace. It improves our overall mood, calms us, soothes us, and reduces our anxiety with a peaceful sense of happiness.

Sodalite is a great crystal for peace because it turns fear and stress into peaceful feelings. It also helps in better communication and can help while making crucial presentations & meetings.

Fluorite is great for healing and rejuvenating the mind and body. You can close your eyes and sit quietly with Fluorite while imagining your body being filled with an incredible energy that puts you at ease with yourself and the world.

Pyrite, also known as abundance stone, is great to put over your business card to manifest abundance at work.

Don't forget to clean your crystals regularly to harness their maximum energy.

Meditate, Do Pranayam and Stay Hydrated!

It is important to take short breaks to maintain productivity at work. Being summer, it is a good idea to get up for a water break once in 30 minutes at least. Even if you keep a water bottle alongside you, walking to the kitchen for water will help your physical body get some much needed movement.

Few iterations of square breathing once in two hours is a great way to boost your mind and body. Square breathing is basically the sequence of inhalation - holding breath - exhalation - holding breath - all for equal time spans. So you can count mentally 1 to 4 in inhalations, then again counting 1 to 4 as you hold your breath, and so on and so forth.

You can also chant any mantra while taking a work break for 1 or 2 minutes. While attending online meetings, where there is nothing much your hands are doing, you can utilize that time to do Yoga Hast/Hand Mudras and harness their energies. Pran Mudra is one of the best options to practice while attending meetings or reading articles, where your hands are free essentially.

You can Also -

Dress up like you would do while going to office so as to feel good in general

Go out on your terrace/balcony once or twice a day to get some fresh air, sunlight and hear birds chirping

Say yes to distractions rather than getting irritated from them, because you cannot avoid them while working from home, like the kids, TV sounds, kitchen sounds etc.

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