Regular disinfection and monitoring of chlorine and pH levels are key to preventing infections.

Swimming is one of the healthiest physical activities – it cools you down, engages your whole body, and relaxes your mind. But even though pool water often looks clean, experts warn: behind the apparent clarity, many microorganisms may lurk that pose a health risk, especially if the water isn’t properly maintained, reports Slobodna Dalmacija.

Regular disinfection and monitoring of chlorine and pH levels are key to preventing infections. The most at-risk groups include children, pregnant women, people with weakened immune systems, and anyone who spends a lot of time in the water.

Water that looks clean

Bacteria, viruses, and parasites can spread by swallowing contaminated water, skin contact, or inhaling droplets that float above the surface. That’s why pools must be regularly treated with chemicals like chlorine and bromine.

One of the most common pool-related illnesses is diarrhea. Even the smallest amount of contaminated water can cause infection, especially if someone who is currently ill or recovering from an intestinal infection is in the water.

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Cryptosporidiosis

The parasite Cryptosporidium is one of the most common causes of diarrhea outbreaks in pools because it can survive even in water treated with standard amounts of chlorine. For this reason, most public pools require users to shower before entering, and people who have recently been ill should avoid swimming.

Health experts warn that untreated diarrhea can last up to two weeks and cause severe dehydration, especially in children. Medical help should be sought if there is black stool, blood in the stool, severe abdominal pain, fever, dehydration, or diarrhea lasting more than two days.

Hot tub rash and swimmer’s ear

If hot tub water isn’t properly disinfected, it can cause a rash from the bacterium Pseudomonas aeruginosa. This red rash can appear a few hours after leaving the water.

The problem is more common in hot tubs because heat speeds up chlorine breakdown, allowing bacteria to multiply faster.

Another common complaint among swimmers is swimmer’s ear – an infection of the outer ear canal that happens when water gets trapped in the ear. It most often affects children, with symptoms like pain, itching, swelling, and sometimes pus discharge.

Prevention includes thoroughly drying the ears, and special drops that dry out the ear canal can also be used – but only after consulting a doctor.

Steam can be dangerous

The bacterium Legionella, which causes Legionnaires’ disease, can also spread by inhaling steam or mist from hot tubs and pools.

This respiratory infection is especially dangerous for older adults, smokers, and people with chronic illnesses. Symptoms include cough, chest pain, fever, muscle aches, and digestive problems.

Although the disease can be successfully treated with antibiotics, early detection is key to recovery.

Test the water

To prevent infections, pool water can be periodically tested using readily available home test strips. But experts’ most important advice remains the same: don’t go into the water if you’re sick, always shower before swimming, and shower and change clothes as soon as possible after getting out.

The drop in estrogen lowers resting metabolism, burns fewer calories, increases muscle loss and fat storage.

Eating disorders are slowly but steadily gaining ground among women in middle and older age.

Doctors and experts notice a significant increase in problems among women aged between 40 and 70 who seek help. Since they don’t fit the stereotype of someone with an eating disorder – that is, they’re not teenage girls – their diagnosis is often missed or treatment is delayed, reports net.hr.

“There’s nothing worse than being told by a doctor you’re too old for an eating disorder,” says Cynthia Bulik, founder of the University of North Carolina’s Center of Excellence for Eating Disorders.

“Yet countless women in menopause report exactly that.”

The most common types: binge eating, bulimia, and laxative abuse

Research shows that between two and 13 percent of women over 40 have an eating disorder, and experts think up to 30 percent of middle-aged women may have symptoms, with a noticeable rise, according to Elizabeth Wassenaar, certified eating disorder specialist and regional medical director at the Eating Recovery Center in Colorado.

Binge eating is the most common disorder in mature women, followed by bulimia, and Jason Nagata, a physician specializing in eating disorders at UCSF Benioff Children's Hospital in San Francisco, also notes an increase in laxative abuse in this age group.

Middle-aged women may also experience anorexia and orthorexia – a disorder involving obsessive exercise and “healthy” eating, often tied to perimenopause, which can lead to malnutrition.

Symptoms of perimenopause and menopause are key in the development of eating disorders due to complex physiological and psychological changes.

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Ways these conditions increase a woman's risk of developing eating disorders include:

Hormones that change body composition

Menopause can trigger eating disorders much like puberty affects teenage girls.

During puberty and menopause, estrogen fluctuates, affecting serotonin production, mood, happiness, confidence, and physical health.

“During perimenopause and menopause, women often experience an increase in overall body fat, especially around the abdomen,” explains Nagata.

As he points out, this mostly happens due to the drop in estrogen, which affects fat storage and regulates appetite and mood.

The drop in estrogen lowers resting metabolism, burns fewer calories, increases muscle loss and fat storage, lowers energy, activity, and increases body dissatisfaction.

Regaining lost sense of control

Besides hormonal changes, menopause often comes alongside major life shifts like children leaving home, marital issues or divorce, job changes, and aging parents needing care – all of which strongly impact eating habits.

Additionally, “middle-aged women carry much of the family burden,” says Robyn Kievit, registered nurse and certified eating disorder specialist from Massachusetts.

Under such pressures, eating disorders may develop as a way to “regain a lost sense of control,” says Wassenaar.

“The desire for control is a powerful psychological driver of eating disorders at any age, but especially in midlife,” Nagata emphasizes.

One patient in 2009 said that controlling food was the way she managed her life.

Pressure to stay slim

Women in midlife face pressure to remain slim and youthful as their bodies naturally change, leading to weight dissatisfaction in 73 percent of them – a situation worsened by trendy weight-loss drugs like Ozempic and harmful #SkinniTok trends.

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Why was everyone so slim in the ’60s: Did we eat differently or move more?
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May 19
“Asking a woman aged 45 to 55 to look like she did at 15, 20, or even 30 is unfair,” says Kievit.

Bulik notes that women in perimenopause and menopause experience body changes that often cause feelings of disconnection from themselves, which worsen eating disorders as a coping strategy.

History of eating disorders, anxiety, and depression
Women who developed eating disorders in youth are at the highest risk of relapse during menopause.

“Research shows many women with midlife eating disorders didn’t experience these issues for the first time,” says Nagata.

Jennifer Wildes, director of the Eating Disorders Program at the University of Chicago Medical Center, says she’s seen this in her patients.

“Some were never treated or had symptoms fade only to return with menopause,” she says.

How to recognize and recover from eating disorders

The main challenge in treating women in perimenopause and menopause is helping them recognize their eating disorder, which is often masked by diets, health trends, or aging itself.

Signs weight loss is out of control include preoccupation with food or weight, frequent detoxing, severe restrictions, social food avoidance, and compensatory behaviors like excessive exercise, laxative use, reducing or skipping meals.

Recognizing signs is key because “eating disorders treated in the first six months have the best chance for full recovery,” says Kievit.

The good news is that when recognized and diagnosed, evidence-based treatments – including proven psychotherapy – can be highly effective.

Women struggling with eating disorders in midlife can seek help from trained therapists, nutritionists, doctors, and organizations.

No matter where they turn for help, Wassenaar stresses the importance of doing so before it’s too late, writes National Geographic.

“It’s never too late to seek help for an eating disorder and build a peaceful relationship with your body,” she says, adding, “Whether you’ve developed eating disorders for the first time or lived with them for decades, now is the time to seek and receive help.”

Emotions guide us. They help us decide whether to start something, continue, change, or stop – depending on our current physical state, environment, and the meaning we assign to it.

In this way, emotions act as an internal compass – showing us what matters or warning us when something is wrong, writes psychologist Theo Causidis for Psychology Today.

Throughout the day, we experience a wide range of emotions. Most pass unnoticed. But there are three emotions that have the power to completely take over our brain – bypassing thought, blocking logic, and leading us to impulsive, often harmful actions, reports N1.

When these emotions overwhelm us, we lose emotional balance. We act on autopilot. The thinking part of the brain shuts down, and emotions take command. The longer they remain unchecked, the stronger they become – pulling us further away from what truly matters to us.

It's important to stress that these emotions are not "bad." No emotion is inherently bad. They are messengers, not enemies. They are here to deliver a message and serve a purpose – to help us survive, connect, and find meaning.

These emotions share common traits:

They narrow our focus solely to what triggered them. They create a strong internal pressure to be "released." They pull us away from core priorities – often without us realizing it.

The first two are fear and anger.

They are loud, quick, and familiar. But the third is less obvious – craving. Craving doesn’t shout. It whispers. And that’s precisely why it can just as powerfully hijack the mind.

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Fear: Brain in Survival Mode

As soon as we face something that even slightly scares us, the brain registers it as a threat. Whether it’s a growling dog or a hostile look, the "fight or flight" response is triggered.

In that moment, everything non-essential is paused. Focus locks onto the threat and a possible response. Should we avoid it? Confront it? Freeze and hope it goes away?

The threat doesn’t even have to be real. Imagined fear is enough. For example? Stage fright – heart racing, mind blanking, body wanting to flee. That’s fear taking over.

When fear dominates, focus narrows, the body prepares for defense, and long-term planning disappears. Instead of strategy – survival.

This mechanism once saved our lives, but today it often holds us back – we avoid important conversations, miss opportunities, and shut down when we should open up.

Anger: Fast and Furious Reaction

While fear responds to threats, anger responds to insults. Insults don’t have to be words – they can be the feeling of being ignored, misunderstood, disrespected, or attacked.

When anger overtakes us, focus locks on what insulted us – and the person responsible. Instinctively, we strike back.

Our tone rises, body language becomes defensive or aggressive, words get sharper. We criticize others’ flaws, mistakes, and weaknesses. Reason and reflection vanish. The part of the brain that might say, “Maybe don’t post that now” – doesn’t function.

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Anger hits like a wave – forcefully, until it throws us onto the shore. Sometimes unharmed, but often with consequences.

The same applies when we are the source of our own anger. Self-criticism can be just as ruthless. Instead of understanding – attack.

Think of the last heated argument with someone you love. Did you tell them how much you appreciate them? Or did you reach for “vinegar” instead of “honey”?

Craving: The Silent Saboteur

Craving is a universal emotion, but rarely spoken about openly. Even in therapy, it’s often avoided. It’s intimate. Private territory. But like fear and anger, it too can completely hijack our brain.

Craving isn’t just sexual. It includes longing for excitement, reward, fulfillment. When unchecked, it leads to obsessive thoughts, poor choices, and emotional detachment.

In extreme cases, it contributes to sexual or porn addictions, pathological jealousy, idealizing a partner, even self-degradation.

Craving focuses attention, narrows awareness, and shuts off judgment – quietly but persistently. It doesn’t shout – it whispers.

Scientific research shows that during sexual arousal, the brain areas responsible for reward and motivation become more active, while those for self-control and critical thinking diminish. Hormones like dopamine, testosterone, and oxytocin flood the system. Essentially – the entire brain is in action.

And interestingly – the object of desire doesn’t even have to be real. Fantasies and mental scenarios are enough. Just as imagined threats paralyze us with fear, imagined closeness sustains craving.

What Can We Do?

The goal is not to suppress these emotions. They are not enemies. But we can slow them down and activate the rational part of the brain.

This is where emotional regulation comes in – the ability to recognize what we’re feeling, understand how it affects us, and choose behavior that aligns with our values and goals.

One effective tool is the LAPS strategy:

Label

“I feel fear/anger/craving.”

By naming the emotion, we activate the awareness center and engage the rational part of the brain.

Allow

“It’s okay to feel this.”

Emotions are human. We shouldn’t demonize them.

Pause

“I won’t react yet.”

Create space between feeling and action. The wave will pass.

Shift

“What else can I do now?”

Redirect attention to something calming or mentally engaging. Activate the mind.

Fear, anger, and craving are part of the human experience. But if we give them too much space – they’ll take us where we didn’t want to go. Understanding how they work doesn’t make us cold – it makes us aware.

And awareness is the first step to regaining control over our own mind.

Talking about digestive issues may be uncomfortable, but paying attention to certain symptoms is crucial for your health.

A group of doctors shared with the portal Eating Well eight symptoms related to digestive health that deserve attention.

Rectal Bleeding

Gastroenterologist Dr. Michael Schopis states that “although there are many causes of rectal bleeding, including harmless hemorrhoids, it’s important to have an exam to rule out more serious and potentially life-threatening conditions such as colorectal cancer or inflammatory bowel disease.”

Prolonged Diarrhea

“In the case of diarrhea lasting two weeks or more, you should visit a gastroenterologist to rule out possible causes such as inflammatory bowel disease, celiac disease, thyroid disorders, persistent infections, and so on,” adds Schopis, advising to monitor soft or watery stools lasting longer than a few days, reports Eating Well.

Severe Abdominal Pain

Another symptom may be abdominal pain, notes gastroenterologist and professor of medicine Dr. James Cox. “Abdominal pain can be deceptive because it sometimes feels like a simple stomachache. But it can be caused by organs outside the digestive system,” he explains.

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While occasional stomach pain may be harmless, if it is intense or persistent, you should consult a doctor. “Prolonged or debilitating pain may be a sign of a serious condition,” the doctor emphasizes.

Bloating Issues

Gastroenterologist Dr. Kenneth Brown believes that “new evidence shows bloating may be an early sign of inflammation in the intestines which, if untreated, can lead to chronic health problems. If you constantly feel bloated, especially if accompanied by other symptoms, consult a doctor.”

Bloating may indicate an imbalance in gut flora and lead to conditions such as inflammatory bowel disease, irritable bowel syndrome, or metabolic disorders like diabetes. Other symptoms can include abdominal pain, changes in bowel movements, unexplained weight loss, or vomiting.

Unintentional Weight Loss

People often experience weight changes, but if you’re losing weight without changes in diet or physical activity, it may be time to visit a gastroenterologist.

“Typically, this means sudden loss of more than four to five kilograms without any change in habits,” says Cox. This could indicate a condition affecting nutrient absorption or appetite, such as celiac disease or inflammatory bowel disease, reports Eating Well.

Changes in Bowel Habits

Changes in the color, consistency, or shape of stools may signal it’s time for an exam. “People often notice changes if they pay attention: the color, texture, or frequency of bowel movements can change significantly,” says Cox. If you notice this, schedule a doctor’s appointment.

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Frequent Heartburn

“Chronic heartburn can be confusing because people sometimes experience it as common digestive trouble. But if you feel a burning sensation in your chest, especially near the breastbone, it’s heartburn, not just indigestion,” says Cox. It could be a sign of a hiatal hernia or gastroesophageal reflux disease (GERD), so a thorough evaluation is important.

Difficulty Swallowing

Cox identifies difficulty swallowing as another symptom to pay attention to. “Swallowing difficulties may appear in different forms, such as food coming back up into the throat or a sensation of something being stuck in the throat or chest,” explains the doctor for Eating Well.

Persistent pain while swallowing is also a reason for an exam. Schopis notes that a doctor might recommend an endoscopy to examine the digestive system with a camera, reports Index.hr.

Major life events – accidents, divorces, and serious traumas – often occur in the years immediately preceding the onset of various types of cancer.

Given that stress levels are rising and that the number of people expected to get sick will increase by one third – up to four million by 2030 – some experts now say that new evidence on stress's impact on the body suggests it would not be surprising if there is a link between stress and cancer.

The Impact of Stress Hormones on Cancer

Professor Melanie Flint from the University of Brighton, who studies the impact of stress hormones on cancer, says:

"There has been a lot of progress in this field, and I don’t think we can rule out stress as a contributor to the development of cancer. My opinion is that stress really contributes – both to the onset of cancer and to its spread once it appears – but it is a contributing factor, not necessarily a direct cause."

It seems that some studies following large populations over time support this idea.

One study of 10,000 women in Finland, conducted over 15 years, found that those who experienced deep grief were more likely to develop breast cancer within five years.

Workplace stress has been linked to a higher risk of prostate cancer in men under the age of 65, and – although to a lesser extent – to breast cancer in women, reports Avaz.ba.

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It Can Suppress the Immune System

Other similar studies, however – including analyses of the highest-quality evidence – show no connection. Part of the problem, according to Professor Trevor Graham, director of the Centre for Evolution and Cancer at the Institute of Cancer Research, is that stress often goes hand in hand with other behaviors that also increase cancer risk.

"A stressful life is often associated with many other cancer risk factors, such as smoking, excessive alcohol consumption, physical inactivity, and unhealthy diet, so it’s hard to separate what the real cause is," he explains.

It’s well known that stress causes a number of effects on the body – especially if it’s chronic.

"Stress causes the release of the stress hormone cortisol. Stress and cortisol can suppress the immune system," says Professor Flint.

Scientists have also tried to replicate the effect of stress on cells in the lab, showing that stress can damage DNA and cause changes in cells which, if replicated, could develop into cancer.

However, since it is difficult to faithfully replicate stress in laboratory conditions, this may not be a reliable indicator of what actually happens in the human body, emphasizes Professor Graham, according to the "Daily Mail".

False and misinterpreted information about sun protection and skin cancer is circulating on social media. Do sunscreens protect against melanoma, or do they actually increase the risk of skin cancer?

Warnings are currently spreading on social media about an alleged risk of skin cancer caused by sunscreens. Although ultraviolet rays are the main cause of melanoma and sunscreens block those rays, some advise against their use and portray sunscreens as a potential danger.

Is There Any Truth to These Claims?

Claim: "It is an indisputable fact that countries with the highest sunscreen usage also have the highest rates of skin cancer. The more sunscreen is used, the more skin cancer spreads," wrote a U.S.-based X platform user with 58,000 followers at the end of June.

On TikTok, too, videos can be found warning about the alleged skin cancer risk linked to sunscreen use.

DW Fact Check: False

These warnings are unfounded.

"There is no scientific evidence suggesting a link between increased cancer risk and the use of sunscreens," said Brittany Schaefer from the Connecticut Department of Public Health in a statement to DW.

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The X platform user cited the Connecticut Tumor Registry as a source in their post. Spokeswoman Schaefer explained that the claim is incorrect:

"The original cancer incidence data likely came from the CTR — the tumor registry from several decades ago — but the added commentary about sunscreen is not part of that data. We don’t know the source of the current graphic, but it did not come from CTR or the Connecticut Department of Health."

More Sunscreen, More Melanoma?

So why is the number of skin cancer cases rising globally, despite the increasing use of sunscreen? An international study by scientists from the U.S., Switzerland, Germany, and Hungary, published in December 2023, proposed five hypotheses to explain the contradiction.

According to the Basel study, reasons for the misconceptions and myths about sunscreen and cancer risk include:

increased diagnostics
improved treatment methods
outdated scientific studies
irregular and improper use of sunscreen
climate change

High Incidence in Australia

Growing awareness among patients and doctors has led to more reporting and recording of skin cancer cases. Despite rising incidence, the global skin cancer mortality rate is declining thanks to better treatments, according to the International Agency for Research on Cancer.

According to the World Cancer Research Fund data from 2022, Australia had the highest age-standardized incidence rate of new skin cancer cases: 37 per 100,000 people annually, followed by Denmark (31.1), Norway (30.6), New Zealand (29.8), and Sweden (27.4).

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In terms of total skin cancer cases in 2022, the U.S. ranked first with 101,388 cases, while Germany, with the same incidence rate of 16.5, had 21,976 cases, placing it second.

Regarding deaths, the U.S. again ranked first in 2022 with 7,368 deaths, and Germany was fourth with 3,303 cases, behind China and Russia. This data shows that high incidence doesn’t necessarily mean high mortality.

Outdated Studies

Another possible reason for the rising number of skin cancer cases is that more people are spending time in the sun. Even when they use sunscreen, it doesn’t mean they use it correctly.

The lack of modern scientific studies contributes to outdated narratives. The U.S. Food and Drug Administration (FDA) began regulating sunscreens only in 2011. Earlier studies likely involved sunscreens with much lower protection levels than those available today.

Sunscreens – a Lucrative Market
But do people in countries with the highest skin cancer rates (New Zealand, Australia, Sweden, Norway, Canada, and the U.S.) actually use sunscreen more often, as claimed online?

It’s true that global sales of sunscreen are increasing. According to manufacturers, the market is expected to reach a value of USD 13.553 billion by 2028. The largest market is the U.S., followed by China and South Korea.

How sunscreen is actually used in practice is another matter. According to Australia’s Bureau of Statistics, 38 percent of people aged 15 and older use sunscreen regularly.

However, nearly 7 percent of respondents reported sunburns in the week before the survey. Among those aged 15 to 24, the figure was as high as 15 percent.

Sunscreen Only on Vacation

In the U.S., a Talker Research study from May this year showed that fewer than 41 percent of 2,000 respondents use sunscreen more than 60 days per year. Thirteen percent said they never use it.

In Germany, a country with high skin cancer rates, an online survey from August 2024 found that about 51 percent of people use sunscreen only in summer or when directly exposed to sunlight.

Sybille Kohlstädt, spokeswoman for the German Cancer Research Center (DKFZ) in Heidelberg, warns that due to a lack of reliable data, one should not draw incorrect conclusions:

"Unlike the available data showing the global increase in skin cancer, there are no national statistics that precisely track sunscreen usage and correlate it with cancer incidence."

In recent years, cortisol has increasingly been mentioned as the cause of numerous issues – from chronic fatigue and insomnia to the accumulation of fat tissue. Although it often has a negative connotation, this hormone plays a key role in the normal functioning of the body.

“Cortisol regulates the body's response to stress, blood sugar levels, metabolism, inflammatory processes, and even the sleep-wake cycle,” explains Dr. Erika Armstrong for Eating Well.

What Is Cortisol and Why Is It Important?

Cortisol is a hormone secreted by the adrenal glands, and its levels naturally vary throughout the day – it is highest about 30 minutes after waking up and lowest at night. In stressful situations, cortisol levels rise rapidly to help the body react quickly – heart rate increases, blood sugar levels rise, and the body prepares for “fight or flight.”

The problem arises when cortisol remains constantly elevated, even without a real physical threat. Chronically elevated cortisol levels can seriously damage your health. According to Eating Well, it increases the risk of heart disease, stroke, type 2 diabetes, and other inflammatory conditions.

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According to Dr. Armstrong, the only sure way to know if you have high cortisol is through laboratory testing. However, there are symptoms that may indicate a problem, reports Sombor.info.

Most Common Symptoms of Elevated Cortisol

1. Sleep Problems

If you have trouble falling asleep or wake up in the middle of the night, cortisol might be the cause. “Cortisol should be low at night, but stress or a drop in blood sugar can increase it and wake you up,” says Armstrong. Research shows that higher cortisol levels in the evening worsen sleep quality.

2. Fat Accumulation Around the Abdomen

If you notice you're gaining weight in the abdominal area without changes in your diet or physical activity, a hormonal imbalance might be the cause. “Cortisol promotes fat storage around the stomach as a form of protection,” says the doctor.

3. Fatigue and Irritability

When cortisol is chronically high, you may feel mentally tense even when physically exhausted. “Cortisol can keep us alert while we feel completely drained,” Armstrong explains. In the long term, this condition can impair memory, concentration, and other cognitive functions.

How to Naturally Lower Cortisol and Reduce Inflammation?

Reducing cortisol helps regulate inflammation and lowers the risk of chronic diseases. Here are some scientifically proven tips:

Anti-inflammatory diet: Eat foods rich in omega-3 fatty acids, a variety of fruits and vegetables, and dietary fiber.
Blood sugar stabilization: Eat regular meals with protein, healthy fats, and fiber – this prevents cortisol spikes.
Stress management: Meditation, mindfulness techniques, and regular rest help reduce stress.
Healthy sleep: Maintain a consistent sleep schedule and relaxing bedtime routines.
Gut health: A balanced gut microbiome boosts immunity and reduces inflammation.

Nearly 60% of people have knee cartilage damage without any symptoms, which is usually discovered by accident.

The knee is the largest joint in the human body. It consists of the articular ends of the femur and tibia, which are covered with cartilage, articular bodies – menisci, ligaments, joint capsules, and surrounding muscles and tendons.

It is often exposed to injuries, both in athletes and recreational individuals, as well as in traffic accidents and various falls.

As a result of repeated minor injuries or injuries to the meniscus and/or cruciate ligaments of the knee, cartilage damage may occur over time, and in older people, it may even lead to the complete loss of cartilage. This can cause varying degrees of pain and knee deformity.

What Is Articular Cartilage?

It is a specially structured cartilage, called hyaline cartilage. Healthy cartilage is:

• shiny, whitish, smooth, elastic,
• allows smooth joint movements,
• acts as a shock absorber during walking, running, and jumping.

Like a sponge, it retains joint fluid, which is squeezed into the joint space during activity and enables smooth joint movement.

The knee essentially consists of two joints. One is between the femur and patella (patellofemoral joint), and the other is between the femur and tibia (tibiofemoral joint).

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How to Know If Your Knee Cartilage Is Damaged?

Studies show that nearly 60% of people have knee cartilage damage without any symptoms, which is often discovered accidentally during an MRI performed for another reason. Major contributing factors to cartilage damage include:

• genetic factors,
• living and working conditions,
• injuries,
• inflammatory joint diseases.

"Once damaged, cartilage begins to deteriorate irreversibly. It is a slow and long-lasting process and can remain unnoticed for a long time," says orthopedic surgeon Dr. Vaso Kecojević for Stetoskop.

First signs that may indicate cartilage problems are:

• pain during movement,
• morning stiffness,
• audible sensations like clicking, creaking, scraping,
• difficulty straightening the knee after prolonged driving or sitting,
• trouble climbing stairs,
• difficulty squatting,
• joint effusion (swelling).

In later, untreated stages, knee deformity may occur, in the form of O- or X-shaped legs.

"Your orthopedist may suggest additional tests after the examination, such as X-rays or knee MRI," explains Dr. Kecojević.

How Does Knee Cartilage Deteriorate – Stages?

Knee cartilage deterioration happens gradually. In the first stage, softening occurs; in the second, cracks appear on the smooth surface; in the third, the cartilage thins; and in the fourth, full-thickness cartilage defects expose the underlying bone. This may be accompanied by:

• severe pain,
• joint effusion,
• limited movement.

"If your doctor diagnoses cartilage damage, treatment depends on the stage of deterioration," emphasizes Dr. Kecojević.

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How Is Damaged Knee Cartilage Treated?

Treatment usually starts with pain-relief medications, such as:

• nonsteroidal anti-inflammatory drugs (NSAIDs),
• chondroprotectors – drugs that block the enzymes responsible for pain, retain fluid in the cartilage and microscopic collagen fibers, and inhibit cartilage-degrading enzymes,
• various physical therapy procedures,
• injections into the knee containing structural substances (like hyaluronic acid).

"Excellent results in the first three stages have been shown by treatment with autologous conditioned blood plasma – Orthokine," highlights Dr. Kecojević.

Surgical techniques also exist for filling cartilage defects using grafts from o