When You Have RA…and Then OA

当OA独立发生时，它被认为是主要的，这是您祖母的形式 - 同时有10％的男性和60岁以上的女性中有18％的女性。但是，实际上有两种类型的OA。OA的次要形式发生在关节受伤或损坏后。”而且您非常了解关节的损害：类风湿关节炎。Sammut博士说：“在RA患者中，次级OA可以比初级OA早发生。”

The damage to your joints caused by RA makes you nearly three times more likely to develop OA than people without RA, according to alarge-scale, longitudinal studyout of Taiwan. “Our study demonstrated that RA was also one of the important risk factors for OA,” the authors wrote. What’s more, you can predict where OA might strike, says Dr. Sammut. If your RA affects, say, your wrists most severely, that’s where you are most at risk for developing secondary OA. If you have hypertension, too, your chances of an OA diagnosis increase by 1.21 times compared to people with RA who do not have high blood pressure, according to the study.

当您拥有RA时，您习惯了新的痛苦和不适，并且一直在弹出，并且很容易将它们写出，因为您必须忍受更多的RA废话。毕竟，谁有时间或精力进行其他医生的约会？德克萨斯州休斯敦的健康系统纪念系统纪念物赫尔曼（Memorial Hermann）的一名风湿病学家Rajat Bhatt，医学博士Rajat Bhatt说，这一点很重要。如果您通常的RA治疗方法也不会像以前那样抑制您的疼痛，或者与您的医生交谈。你可以有OA。

Keeping your RA well-managed can help prevent the kind of damage that might cause OA down the line. When the lining of the joint capsule, the synovium, becomes inflamed and swollen because of RA, “it leads to the destruction of the cartilage and bone,” says Dr. Sammut. And it’s that cartilage degradation that causes OA. So if you find your flares are getting worse or joint pain isn’t getting better, talk to your rheumatologist about increasing your current dosage, starting a new disease-modifying antirheumatic drug (DMARD), trying a short-term corticosteroid, or adding a nonsteroidal anti-inflammatory drug (NSAID) to your regimen.

尽管每个人都不一样，但两种形式的关节炎的典型一天可能看起来像：“您以RA的早晨关节僵硬和疼痛的特征醒来，” Bhatt博士说。几个小时后，这些症状便缓解了。在当天晚些时候，经过更多的活动，痛苦和僵硬又回来了，这是OA的经典MO。当您休息时，RA的疼痛往往会发生，而OA疼痛更有可能随着运动而发生。除了那些OA疼痛外，您还可能会发现使用特定关节时，骨头上的骨骼声音或声音。

好消息：有许多有效的方法来管理RA。Bhatt博士说，不太伟大的新闻：OA的治疗方法“不那么先进”。他们暂时缓解疼痛，但对长期有帮助。您的医生可能会建议每三到六个月直接注射到您的发炎的关节中，包括布洛芬和对乙酰氨基酚，或将皮质类固醇直接注射。医生还经常开处方杜洛西汀（Duloxetine），这是一种抑郁症药物，也被批准用于治疗OA疼痛。一种最近的研究, though, found that the drug had no effect in people with chronic knee or hip OA pain.

虽然OA可能没有魔术药，但有很多感觉可以让您自行缓解疼痛。许多self-care strategies we recommend for RA paincan be equally soothing for OA pain. What works: taking a hot bath, applying ice packs to the painful joints, meditating, gently massaging the area, wearing compression socks/gloves/braces to support your joints, and applying pain-relief creams. When it comes to creams, many people with OA and RA like生物冻结with menthol; others prefer the topical nonsteroidal anti-inflammatoryVoltaren Arthritis Pain Relieving Gel。

If you don’t already work with an occupational therapist (OT), start now. An OT will help you develop an energy-conservation plan: strategies that take some of the effort out of everyday activities so you don’t tire out as quickly. For example, push or pull or slide items rather than lifting. If you have to lift something, scoop it with both hands. Use a shower seat to save yourself standing time. Get what you need for the day—clothes, handbag, shoes—all at once to save yourself multiple trips to the closet. These may seem like tiny adjustments, but they can add up to make your day that much easier.

也向您的医生介绍了物理治疗师（PT），他们可以帮助改善受影响的关节运动并教您联合友好的锻炼。为什么这么重要：如果您超重或肥胖，那么额外的磅会给您的关节带来更大的压力，Sammut博士说。更多压力=更多的疼痛。但是，当搬家痛时，您如何运动呢？物理治疗师可以帮助制定一项锻炼计划，其中包括低影响力的有氧运动（开放，卧式骑自行车，步行，瑜伽），以及力量锻炼，使肌肉在关节周围增加肌肉而不承受重量。