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September 2010
Arthritis in the Young
Dr Raju Vaishya
We usually do not associate arthritis with children and teenagers.The USA’s Centres for Disease Control and Prevention tears down this myth though, citing the statistics of three lakh children and young adults to have been diagnosed with arthritis.

It is likely there are thousands of unreported cases - of those who have not been to a doctor - and therefore, are not recognised in the statistics. The take home message is loud: age is not a factor for arthritis; it can affect the young and old alike.

Children and even teens might not be able to recognise and communicate their symptoms, which may lead to a delayed diagnosis. Parents, meanwhile, may attribute their children’s arthritis to ‘growing pains’ or even be guilty of dismissing them altogether.

5 Preventive Measures
As repeated till it became a clichÈ, prevention is indeed better than cure. Train up your child in the way he should go, and even when he is old he will not depart from it. And hopefully, not develop arthritis along the way, if these tips are adhered to.
  1. Obesity produces arthritis: Extra kilos are bad on the joints - they not just increase the burden on them, but also have a destructive metabolic effect. A chemical related to obesity upsets the balance between the build-up and breakdown of cartilage, the tough elastic†tissue that is mostly converted to bone in adults. This means that in obese children, the natural degradation of cartilage is faster than the renewal process that is supposed to restore it. This loss, over time, develops into osteoarthritis, the chronic breakdown of cartilage in the joints. So make plans to lose weight – or at least to stop gaining!
  2. Heavy exercise can damage the joints: Switch to lighter exercises, like low-impact biking, swimming, and even weightlifting, as long as it's not stressful. Walking is good, but ensure that you have comfortable walking shoes, don’t walk too fast, and choose relatively flat surfaces to walk – not steep inclines.
  3. Watch your biomechanics: How you lift and carry various objects, or perform physical tasks, including playing sports, can make a big difference to the health of your joints. The back is the most obvious part of the body that can be strained, but nearly all joints can be damaged by poor biomechanics. For instance, something as simple as gardening can put stress on joints, if you dig at the dirt with your fingers instead of using a proper tool. Proper mechanics while playing sports will do far more than improve your athletic performance. It also minimises strain on joints from head to toe that can manifest later as osteoarthritis.
  4. Prevent and treat injuries: Too many ankle sprains, or insufficient treatment following sprains, can put your ankles on the long grind to arthritis. The problem is, once you alter the mechanics of your ankles to compensate for the sprain, you can begin a process where the mechanics of other joints are also altered - through your knees up to your hips, etc. Remember, it’s all the same highway! So, take care of your injuries well, whether to the ankles, knees, or elsewhere.
  5. Taking supplements helps: The effect of supplements on reducing joint pain is still a touchy topic, but it is agreed upon that they can prevent deterioration of cartilage. Two drugs - Glucosamine and Chondroitin - both show evidence of helping cartilage avoid deterioration, at least to a degree.
Dr Raju Vaishya is Sr Consultant Orthopaedics and Joint Replacement Surgery at Apollo Indraprastha Hospitals, New Delhi

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