• Osteoarthritis results from wear and tear on bones and joint capsules.
• Five million Germans suffer from the consequences.
• Briefly explained: which osteoarthritis treatment helps whom?

If the joints hurt, it is usually osteoarthritis : it is the most common of all joint diseases. About five million Germans suffer from it. Osteoarthritis occurs when bones, ligaments, tendons and joint capsules wear out.

This is important to differentiate the disease from rheumatoid arthritis. Inflammation is the cause here.

This is important for osteoarthritis treatment

“Arthrosis is a disease that runs in waves,” explains Johannes Flechtenmacher, President of the Professional Association of Orthopedists and Trauma Surgeons. Less painful phases alternate with those that torment those affected.

The aim of the treatment is to relieve the pain on the one hand and to maintain or restore the ability to move on the other.

Osteoarthritis needs combination treatments

Ideally, the doctor combines non-drug treatments such as physiotherapy, nutritional recommendations, and hot or cold applications with medication. These are mainly used in the acute pain phase.

“In the less painful episodes, patients should try to avoid medication,” explains Flechtenmacher. In principle, movement in particular is an important component of therapy. His motto: “Move a lot, load little.”

Five osteoarthritis treatments put to the test:

1. NSAIDs: cortisone-free pain relievers

This is how the drug works: The non-steroidal anti-inflammatory drugs (NSAIDs) are the classic all-rounders in pain relief. They have both anti-inflammatory and analgesic effects, but do not contain cortisone.

Medicines include ibuprofen, diclofenac, or naproxen. They block two important enzymes that play a role in the sensation of pain: Cyclooxygenase (COX) isoenzymes I and II.

The so-called Cox II inhibitors are therefore well suited to treat acute joint pain associated with osteoarthritis.

NSAIDs also have an antipyretic effect.

Side effects: Gastrointestinal complaints and an increased risk of cardiovascular diseases are among the risks of NSAIDs. “That is why it is particularly important to tailor the osteoarthritis treatment to the patient,” explains orthopedist Flechtenmacher.

For example, ibuprofen is not suitable for patients with kidney problems, and diclofenac hits the liver. Both drugs also have a negative effect on the cardiovascular system. Naproxin is therefore better suited for heart disease patients with osteoarthritis.

2. Opioids

This is how the drug works: Opioids are effective remedies that are used against severe joint pain. By attacking the opioid receptors, they prevent pain from developing and being transmitted.

Tramadol is one of the morphine-like drugs. “Morphines are not suitable for treating acute phases of pain in osteoarthritis,” says Flechtenmacher. This is especially true for plasters. Morphine should only be used for chronic treatment if no other therapy is helping the patient.

Side effects: Many sufferers suffer from the exhaustion caused by morphine. Especially in older people, opioids aggravate many age problems. These include, for example, constipation and dizziness. This also increases the risk of frail patients falling.

3. Hyaluronic acid

In addition to drugs that directly combat pain, there are active ingredients that intervene in the mechanism of the disease. A typical representative is hyluronic acid.

This is how the drug works: Doctors inject hyaluronic acid into the joint to treat osteoarthritis. That’s the only way it works. “In contrast, it is pointless in tablet form, as is sometimes offered,” explains Flechtenmacher. Only in the joint does the drug help the knees or fingers move more smoothly.

With regard to evidence-based studies, hyaluronic acid should be viewed critically, adds the doctor. For example, the relief of osteoarthritis on knock knees or bow legs, where it is biomechanically induced, works less well than on straight legs.

Side effects: As a rule, osteoarthritis patients tolerate hyaluronic acid very well. Since it is injected directly into the joint, there is the usual risk of infection from the method.

4. Natural medicine

This is how the treatment works: Natural active ingredients such as nettle leaves, willow bark or devil’s claw should also relieve pain. The latter contains, among other things, harpagoside. Similar to the non-steroidal anti-inflammatory drugs, they are supposed to inhibit the formation of the pain messenger prostaglandin.

“So far, however, nothing has been identified in evidence-based studies that proves the effectiveness of the natural active ingredients,” explains Flechtenmacher.

Side effects: They are dependent on the natural medicine product. The instruction leaflet of the devil’s claw, for example, warns of possible gastrointestinal complaints such as diarrhea, nausea, flatulence, vomiting as well as dizziness and headaches or rashes.

5. Acupuncture

This is how the treatment works: As with natural active ingredients, evidence of how acupuncture works for osteoarthritis has not yet been provided in scientific studies.

On the contrary. An Australian study looked at the effects of acupuncture. The results published in the “JAMA” magazine showed: Acupuncture with needles or laser has no relevant effect on pain and function in patients over 50 with knee osteoarthritis and moderate or severe chronic pain.

However, acupuncture helps some osteoarthritis sufferers. Johannes Flechtenmacher, for example, relies on the alternative form of treatment

• light and irregular pain
• when many illnesses in the affected person rule out other drugs.

In addition, there are many patients who benefit from the doctor’s attention and empathy alone.

Side effects: The symptoms can get worse at first, writes the German Pain Society on acupuncture . And adds: “Occasionally there are slight bruises or bruises, and brief circulatory reactions can also occur during acupuncture treatment.”

In any case, those affected should not treat their joint pain independently, but should always have it checked out by a specialist.

Surveys by the Federal Statistical Office show that Germany’s men are getting fatter year after year: If the body mass index is used as a benchmark, 62 percent of men are currently overweight (BMI over 25) and 18 percent are obese (BMI over 30) . And while only a third of the 20 to 25 year olds are overweight, the proportion among the over 50 year olds rises to more than 70 percent. Among women, 43 percent carry too many pounds around – but the proportion of people who are overweight shrinks slightly every year.

Visceral belly fat is a health risk

But while many of the overweight women have the word “lose weight” at least in the back of their minds, the term “diet” bounces off most men. Somehow, around 30, they gradually lose their firm body, but they feel comfortable with their figure, which they do not find too fat at all. Men seem to be more tolerant of their paunch than women of their love handles.

This has nothing to do with reason, because it is now known that so-called visceral belly fat in particular poses a health risk. The metabolically active tissue releases inflammatory substances and increases the risk of cardiovascular diseases, diabetes and erectile dysfunction.

The traditional image of the man promotes obesity

Papa gets the biggest piece of meat because a man has to eat properly – this age-old belief persists in Germany. And so men eat an average of 1.1 kilograms of meat every week. That is twice as much as for women and twice as much as recommended for a healthy diet. In addition, there are plenty of carbohydrates in the form of pasta, potatoes or white bread, sausage, butter and cheese – and the plates are often scooped up on the “all-you-can-eat” principle.

Many men get fat because they eat and drink too much of the wrong things, for example six times as much beer as women. And they stay fat because it is very difficult to change established eating habits.

Men need a lot of motivation to diet

Doctors and nutritionists find time and again that men rarely lose weight because they find themselves too fat. It almost always takes an external spark for the average man to change something in his lifestyle, for example when the doctor diagnoses diabetes or a heart problem, or when a relationship breaks up.

This was also the result of an evaluation of two major diet programs by the British health authority NHS. And there were even more men-specific issues on the subjectLose weight:

• Only ten percent of men had received a referral from their doctor for the programs.
• But: Once men start with such a measure, they develop ambition to lose weight and get out less often than women.
• Men are more likely to respond to programs that avoid the word “diet” and place great emphasis on exercise.

Proper diet and exercise

Weight loss results mainly from diet changes. However, if men also expand their muscle cushion in the process, the effect is increased because of the high energy requirements of the muscles. Men should exercise all muscle groups in the body and not just squint at the fast-growing biceps.

A sporting program that includes a mix of strength and endurance is often better accepted by men than women. Sport should be fun in any case, because after actively losing weight, exercise can stabilize the desired weight – without the man having to constantly watch the calories.

What men should eat for weight loss is no different from a diet for women:

1. less red / fatty meat, sausage and animal fat

2. more vegetables

3. less white flour and sugar (carbohydrates)

4. more white / lean meat, tofu, or legumes (protein)

5. no alcohol

Intermittent fasting – as invented for men

Intermittent fasting is a suitable diet method for those who like it simple and uncomplicated. With the simple principle, there are time windows for food intake, which alternate with fasting episodes. The fat metabolism is activated, excess pounds can melt – especially if you keep an eye on the calories.

• The popular “16: 8” method is suitable as a permanent nutritional principle: During the day, people eat in an 8-hour window, two to three meals without snacks in between. The nocturnal eating break is extended to 16 hours – ideal for men who do not like breakfast.
• The “5: 2” interval fasting allows you to eat normally on five days, then there are a maximum of 500 calories on two days.
• The “1: 1” method is considered to be the most difficult to stick to: alternately eat one day and one fast.

For men (and women), the combination of two protein shakes and a normal meal a day is a good start to losing weight. US presenter and comedian Jimmy Kimmel lost over twelve kilos before he switched to intermittent fasting “5: 2”.

The man’s body is the best weapon against obesity

Once men have decided to lose weight, they enjoy a great advantage over women. Men are taller, heavier and have more muscles – as a result, their bodies burn more energy even when they are resting.

If they also save calories, they lose more weight and lose weight faster than women. This was shown by a study with 2000 male and female participants who had exactly the same general conditions. After eight weeks, the men saw 16 percent more weight loss. Their bodies cling less to fat deposits, which in women are a stubborn reservoir for pregnancy and breastfeeding.