We have talked recently about what arthritis is. Today we will talk about how we treat arthritis. Wang Xu Feng was a 60-year-old man who lived in a large city in south China. He retired from his work 5 years before primarily because of pain in his knees and joints in his hands. He just was not able to do his work. He had worked in a factory for 30 years standing and using his hands all day. The first year or two was much better however, he realized, his joints just never got back to normal. He had noticed about 3-4 years before he had retired, i.e. when he was about 52 years or so, his joints had started hurting. He had gone to see his doctor and was given some medicines which helped some but never resolved the pain or discomfort in his joints. He had retired primarily because his doctor said he should and he was getting where he could not do his work very well. At 60 he noticed his knees got to where he was having trouble walking. He returned to his doctor. X-rays showed that his knees had a lot of damage. He asked his doctor how he could repair his knees. Wang Xu Feng’s doctor said that there was not much to do except to totally replace his knee. Wang Xu Feng was shocked.
The story of Wang Xu Feng is not uncommon either in China or other countries. It illustrates several important points about arthritis. Prevention is much better than cure, once severe damage is done there is little that can be done except for major surgery. Third and finally, medicines up till now only really help pain and discomfort. They don’t prevent progression of disease.
Let us talk about the first point first. That is prevention. Prevention is the most important aspect of treatment with osteoarthritis or degenerative arthritis. However, in rheumatoid arthritis there is little that can be done to prevent this type of arthritis. In a certain way there is little that can be done to prevent the onset and development of osteoarthritis. Yet, we know that exercise does a lot to strengthen the muscles around the joint of say the knee so that when arthritis does start the joint itself will not be as weak as it otherwise would be. Thus though in a strict sense exercise does not prevent arthritis, it does have a very strong role in preventing arthritis from progressing as faster than it otherwise would.
There was a study of many men and women recently regarding the progression of osteoarthritis. These men and women had some of them exercise for many years and some of them not exercise. Those who exercised could walk more without as much pain compared with those who did not exercise. This study clearly showed the great importance of exercise in preventing the onset and progression of osteoarthritis.
However, what is the difference between Wang Xu Feng’s work and exercise? The difference is daily and long hours of the same repetitive motions. This is what can cause significant degeneration of joints and destruction. Thirty minutes daily or walking, biking, running or swimming is enough to help but too much to cause hurt. This is very important. Dr. Luke has seen many patients who everyday worked very hard dong the same job over and over for years. It is when these people start developing consistent pain in the joint they are using that they need to stop or they will have permanent damage in those joints. Daily exercises of thirty minutes strengthen the joints and muscles while daily repetitive exercises all day destroy joints.
Thus Wang Xu Feng should have stopped exercising when he first started having problems in his knees and hands. What else could he have done? There are medicines called anti-inflammatory agents, which are medicines which can help with the pain and discomfort of osteoarthritis. They do not cure or prevent but they help with the discomfort. However, the use of these medicines should always be given in association with exercise. Further if these medicines are used long term then it is important for a person to have their doctor check their liver and kidneys as these medicines can have adverse effects on the liver and kidney if used long term.
Thus prevention is so important in arthritis. The same can be said for our spiritual lives. How many of us do things each day, which are destructive to our lives. We do things to people in our families or to our friends we wish we had never done. But what about our thoughts? All of us have thoughts which we are glad are not made public. However, these thoughts can be destructive to friends and relations. The Bible says that is out of the heart that our thoughts proceed and give way to actions. Another way of saying this is that what we think, in time we will do. Isn’t this correct? This is true whether we admit it or not.
The Bible says it like this, ‘There is no one righteous, not even one; there is no one who understands, no one who seeks God. All have turned away, they have together become worthless; there is no one who does good, not even one. Their throats are open graves; their tongues practice deceit. The poison of vipers is on their lips. Their mouths are full of cursing and bitterness. Their feet are swift to shed blood; ruin and misery mark their ways, and the way of peace they do not know. There is no fear of God before their eyes (Romans 3.10-18).’ This is a very dramatic passage from the Bible written to the people in Rome around 60AD. However, this passage is a testimony to the history of mankind as well as the history of each of our lives, even though no one would like to admit this.
Also can we prevent others or ourselves from thinking bad thoughts about people? This is very hard and in fact if we are honest we all fail in this. The Bible actually says this a little more directly in book written to the people of Rome about 60AD. Each of us is capable of doing very bad things and thinking very bad thoughts. How can we over come this? Another question is do we want to think other than bad thoughts about other people?
The Bible says that Jesus Christ is the power for salvation. We have no power to either save ourselves or change our actions or thoughts. It is only as Jesus saves us from these actions, thoughts and sins can we overcome our desire to do them. This is so very important in each of our lives.
Let us go back to talk about the treatment of arthritis. What happens to people who already have fairly serious arthritis? This all depends on what type of arthritis. The most important thing is not to do activities, which will make the arthritis worse. For example, as we mentioned above with Wang Xu Feng, he continued his work even when he had bad pain in his joints. This is the wrong thing to do.
Second, there are anti-inflammatory medicines, which work well. Many different types are available in China and probably can be found in all major cities and in many county hospitals. These medicines work very well in relieving pain and stiffness. They do have side effects in that they can cause kidney and liver disease. Thus they need to be taken carefully. If taken for more than a week they need to be taken under the direction of a doctor’ supervision. Many patients take these medications for years without significant side effects.
Third is doing limited exercises every day for about thirty minutes. Actually the single best exercise is swimming. Why is this? First, when we are in the water our weight is about one eighth of what it is on land. This is important for arthritis in that there is less weight placed on joints with exercise compared with say walking or running. Thus one can do a lot of exercise without putting stress and wear and tear on joints. Also, in the water, there is slight passive resistance, which is going on. This slight passive resistance we do not have as much with walking. This passive resistance is very important for arthritis. Again why? Because this passive resistance slowly builds up our muscles around the joints. It is this build up of muscles which helps delay the onset of arthritis and when arthritis develops then it will not advance so rapidly. This is very important. In fact there is no more important aspect of preventing and treating arthritis than exercise. And, as we have just discussed swimming is the single best exercise, which can be done.
The fourth aspect of treating arthritis is surgery on the joints. This aspect of arthritis treatment is very important and has been revolutionized over the past 10-20 years. In fact this is one of the greatest advances in medicine in the past 10-20 years. The main aspect of surgery on the joints with arthritis is replacing the total joints. This is done with an artificial joint. The creation and development of the artificial is nothing short of a miracle. This is taking the old joint, which has been destroyed by arthritis, and totally replacing the old joint. The orthopedic surgeon does this. Around the world in the past 10-20 years there have been literally millions of old joints replaced by new artificial joints. The primary joints being replaced are the hips and knees, so some rare shoulder and elbows have been done. Further, most of these artificial joint replacements have been done in the elderly, that is people 60-70 and older. Many older people who simply could not walk with their arthritis or whose joints had become unstable and were falling down have had their knees and hips replaced. Now they can walk well. There are some side effects and some people’s joint replacements do not do well. However, in the hands of an experienced orthopedic surgeon most of these hip and knee replacements do very well.
Many people ask, ‘when should I get a knee or hip joint artificial replacement?’ There are two indications. First is pain in the joint, which the patient cannot bear. Second is instability, which makes the patient unable to walk well or increases the chance that they will fall. If a patient has one or both of these complaints then they should talk with their orthopedic surgeon about having a joint replacement. It is important that the patient ask the surgeon if they have done quite a number of these before they have this procedure done.
This procedure as we have said is literally a miracle, i.e. helping people who almost literally cannot walk and allowing them to walk well. There is a story in the Bible just like this. It is in the book called Acts which was written around 60AD and describes the events of Jesus Christ’s followers just after Jesus Christ rose from the dead and ascended to heaven. The account of the story goes like this.
“One day Peter and John (two of Jesus’ followers) were going up to the temple at the time of prayer-at three in the afternoon. Now a man crippled from birth was being carried to the temple gate called Beautiful, where he was put everyday to beg from those going into the temple courts. When he saw Peter and John about to enter, he asked them for money. Peter looked straight at him, as did John. The Peter said, ‘Look at us!’ So the man gave them his attention, expecting to get something from them. Then Peter said, ‘Silver or gold I do not have, but what I have I give you. In the name of Jesus Christ of Nazareth, walk.’ Taking him by the right hand, he helped him up, and instantly the man’s feet and ankles became strong. He jumped to his feet and began to walk. Then he went with them into the temple courts, walking and jumping, and praising God. When all the people saw him walking and praising God, they recognized him as the same man who used to sit begging at the temple gate called Beautiful, and they were filled with wonder and amazement at what had happened to him (Acts 3.1-10).’
What an incredible story. Jesus Christ and his name have enormous power. Even power to heal those who cannot walk. However, not being able to walk is not the worst thing in the world. The worst thing is not being able to know God and worship God both now and for eternity. Jesus Christ wants us to not only know the power to heal us physically but also spiritually, or our sins, which cause us to say and do bad, and wrong actions. How can you know that healing? You can know that by placing your trust in Jesus Christ. Here is how it can be done.
Please pray the following prayer with me: ‘Dear Jesus, I know I have sinned and done wrong. I believe that Jesus Christ died for my sins on the Cross and took my sins on himself on the Cross. I believe that after he died he was buried and three days later arose from the dead so that I might have new life today. I ask you to come into my life now to save me from my sins.’ If you have prayed this prayer and believe it then you are now a child of God both now and forever more. Congratulations.