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[骨关节炎:退行性改变还是适应性改变?基层医疗中的简短疼痛建议]

[Osteoarthritis: Degenerative changes or adaptive changes? Brief pain advice in primary care].

作者信息

Izquierdo Enríquez Gema, García Espinosa María Victoria, Prieto Checa Isabel, Fernández de Paúl María, Moreno Carrero Patricia, García Vila Silvia Fernanda

机构信息

Medicina Familiar y Comunitaria, Centro de Salud Villa de Vallecas, Madrid, España.

Medicina Familiar y Comunitaria, Centro de Salud Los Alpes, Madrid, España.

出版信息

Aten Primaria. 2025 Feb;57(2):103173. doi: 10.1016/j.aprim.2024.103173. Epub 2024 Dec 17.

Abstract

Osteoarthritis is a degenerative joint disease and is the most common joint problem worldwide. It is considered a serious disease due to the presence of pain and reduced functional capacity. Moreover, there are no disease-modifying drugs or curative treatment at present; the basic or first-line treatment is non-pharmacological, based on education and physical exercise. The presence of degenerative changes in imaging tests is present in a high percentage of the general asymptomatic population, i.e. in those who have no pain or functional limitation, and this percentage increases progressively with age. In short, osteoarthritis is part of the normal aging process of the population. As with low back pain, it is proposed to apply a salutogenic model of health, paying special attention to the terms used when informing and advising patients. It is proposed a review of the main causes, effectiveness and prognosis of osteoarthritis treatment, in order to provide brief educational advice to patients.

摘要

骨关节炎是一种退行性关节疾病,是全球最常见的关节问题。由于疼痛和功能能力下降,它被认为是一种严重的疾病。此外,目前尚无改善病情的药物或治愈性治疗方法;基础或一线治疗是非药物性的,基于教育和体育锻炼。影像学检查中出现的退行性改变在很大比例的一般无症状人群中存在,即在那些没有疼痛或功能受限的人群中,并且这个比例随着年龄的增长而逐渐增加。简而言之,骨关节炎是人群正常衰老过程的一部分。与腰痛一样,建议应用健康促进模式,特别注意在告知和建议患者时使用的术语。本文对骨关节炎治疗的主要原因、有效性和预后进行综述,以便为患者提供简短的教育建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aed7/11720430/76e88b416493/gr1.jpg

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