Arthrosis of the joints is a chronic joint disease that develops due to metabolic disorders. As a result, degenerative, dystrophic changes and destruction of cartilage tissue occur.
It happens unnoticeably, but often develops very quickly. A person begins to feel pain in the joints when moving, there is stiffness and decreased mobility, especially in the morning, when he is not yet "disarmed". If discomfort appears and periodic pain occurs during uncomfortable movements or loads, it is very important to understand that this will not go away, and without intervention the situation will only worsen.
Osteoarthritis symptoms
Arthrosis of large and medium joints seriously changes a person's lifestyle, worsens quality and imposes restrictions. The development of the disease is like an avalanche, and treatment is most often associated with excruciating pain, and this is a clear sign of joint wear.
The symptoms of osteoarthritis of the joints depend on how much the joint, cartilage tissue, and nearby tissues are affected.
In the initial stages, arthrosis can be determined quite accurately, treatment in this case is moderate and does not require serious intervention and expensive drugs for the treatment of arthrosis.
Types of osteoarthritis
Arthrosis of the joints is classified according to several criteria. Depending on the degree of arthritic changes in the cartilage tissue, 4 stages of arthrosis are distinguished. Osteoarthritis is also divided into primary and secondary. The cause of the development of primary arthrosis is age-related changes. Secondary osteoarthritis occurs due to injuries and diseases of the joints (for example, traumatic osteoarthritis or rheumatoid osteoarthritis). The disease can also develop slowly over years or lead to destruction of the joint within a few years (progressive osteoarthritis).
There's alsoTypes of osteoarthritis according to the affected area:
- – osteoarthritis of the knee joint – osteoarthritis of the hip joint
- Uncovertebral osteoarthritis - osteoarthritis of the cervical vertebrae
- Spinal osteoarthritis - damage to the spine
- Patellofemoral osteoarthritis is a type of gonarthrosis in which the patella and part of the femur suffer.
The degree of disease is determined by the degree of damage to the cartilage tissue.
Arthrosis of the first degree - the cartilage tissue is slightly damaged, the person does not feel discomfort;
Arthrosis grade II: osteophytes appear, the space between the cartilages decreases, situational pain occurs with uncomfortable movements;
Grade III arthrosis - cartilage tissue is destroyed in places and exposes bone tissue, the gap between the cartilages decreases, the pain is frequent and severe;
IV degree arthrosis - a significant part of the cartilage tissue is destroyed by up to 60%, there is no gap between the bones, patients experience constant severe pain, hyperthermia of the area above the joint occurs.
- A characteristic crunch during movements and a slight background pain;
- Limitation of joint mobility, discomfort during full physical activity;
- "jumping" blood pressure indicators;
- Headache and dizziness;
- convulsive syndrome and often muscle spasms;
- Visually observed joint deformity;
- Swelling, hyperthermia, or redness of the skin area over the diseased joint;
- Violation of motor function.
Why does the disease appear?
Arthrosis of the joints can manifest itself in any of the departments, but most often patients turn when arthrosis of the knee or hip joint is felt. In the professional field, with a special and specific load on the hands, shoulder arthrosis can be observed.
The lesions differ in men and women.The strong half often suffers from temporomandibular, wrist, ankle and lumbar arthrosis. Women complain more of the thoracic and cervical regions, as well as the joints of the fingers and toes.
The type of disease is determined by the location of the lesion. There are the following types:
- arthrosis of the hip joint - coxarthrosis;
- arthrosis of the knee joint - gonarthrosis;
- damage to the patella and part of the femur - patellofemoral arthrosis (a type of gonarthrosis);
- spinal disease - vertebral osteoarthritis;
- damage to the cervical spine - uncovertebral arthrosis.
The main reasons are:
- inflammatory process;
- professional sports;
- over weight;
- non-standard professional load, for example, squatting or kneeling;
- previous (post-traumatic) joint injuries;
- hypothermia;
- inheritance;
- age changes.
Osteoarthritis can appear as an independent disease, or it can be the result of an already ongoing disease, so it is important to know a person's history.
Diagnosis of osteoarthritis of the joints.
Arthrosis of the joints is detected by X-ray. The X-ray image shows how the joint is deformed and how much the joint space is narrowed. It may also be necessary to undergo an MRI or an arthroscopy, but only in particularly complex and ambiguous cases. X-rays of the joints are usually sufficient to diagnose the disease.
To understand the presence of the disease, its severity and the disorders that provoked it, a comprehensive diagnosis is made.
First, with the helpx-rays in different projectionsreceive information about the degree of damage to the joint.
Tomography (MRI or CT) helpsexclude tumor processes.
Third, you needtake teststo understand whether arthrosis is an independent disease or a complication, as well as to determine the general condition of a person.
The complex of studies is the most informative and gives a clear picture of degenerative-dystrophic changes and helps to choose the optimal treatment plan.
Treatment of osteoarthritis
As discussed above, osteoarthritis can develop due to many factors, and the treatment plan is developed based on an understanding of the underlying causes and medications for the treatment of osteoarthritis are selected accordingly.
Treatment should be developed individually, based on the results of the diagnosis. Be sure to take into account the person's condition, his existing diseases.
Restoration of the articular surface and cartilage tissue is not rapid. Effective drugs that have side effects are prescribed. And taking drugs to get the desired result lasts up to 6 months. Therefore, it is important to protect your health as much as possible from side effects.
Medical treatment of osteoarthritis
The main goal of such therapy is to eliminate the manifestations of arthrosis. Pharmacological treatment of arthrosis of the joints includes:
- Non-steroidal anti-inflammatory drugs. With arthrosis, a person experiences pain, the joint becomes inflamed. To eliminate unpleasant symptoms and stop inflammation, this group of drugs is prescribed.
- Hormonal injections into the joint. Corticosteroid drugs are most often given in the acute stage of osteoarthritis.
- Chondroprotectors. The main task of these drugs is to stop the degenerative processes in the cartilage tissue to prevent further destruction.
- Intra-articular injections of hyaluronic acid. Hyaluronic acid preparations are similar to synovial fluid, providing smooth, free movement and gliding in the joint. With arthrosis, synovial fluid is not secreted enough, so orthopedists often prescribe injections of hyaluronic acid (injections into the joint with arthrosis).
- Biological therapy of osteoarthritis (PRP and cytokine therapy). A new innovative method of treating arthrosis, which has recently come into practice, but is gaining popularity. This is the use of drugs based on the patient's blood plasma enriched with platelets. Thanks to biological therapy, the blood supply to the joint is activated, the production of intra-articular fluid is activated and nutrients are supplied to the cartilaginous tissue.
Important!Pharmacological treatment of osteoarthritis is effective in the early stages of the disease. Also, experts emphasize that drug therapy is not able to restore a damaged joint, but it will allow to eliminate symptoms and slow down the progression of arthrosis.
Physiotherapy and other conservative treatments for osteoarthritis
In the fight against arthrosis, physiotherapy is also used. Various procedures (laser, phonophoresis, electrophoresis, magnetotherapy, UVT) and exercise therapy are prescribed to improve metabolic processes and blood circulation, strengthen muscles.
Also, with osteoarthritis, you just need to make a few adjustments to your lifestyle:
- Avoid overload: It is important to evenly distribute the activity and take breaks so as not to overload the joint.
- Take care of nutrition and control weight: Since being overweight only exacerbates the problem with the joints, you should review your diet and reduce body weight
- Remember to be careful and avoid injury as much as possible.
- Use additional support for movement: In the later stages of osteoarthritis, independent movement becomes questionable, so you must use a cane or crutches. To make walking more comfortable, you can also wear orthopedic insoles - they will reduce the load on the joint.
There are also many folk recipes that "will help to beat arthrosis. "However, treating osteoarthritis at home does not always give results either. In addition, the use of all kinds of self-prepared lotions and ointments often only provokes allergic reactions and does not affect the health of the joint.
Surgical treatment of osteoarthritis
How to treat arthrosis if all the above methods do not work? In this case, surgical treatment of arthrosis is prescribed. Depending on the degree of damage to the joint, the individual characteristics of each patient, a type of operation is selected.
Joint arthroscopy is a minimally traumatic intervention, an intra-articular operation through several micro-punctures in the joint. With arthrosis, it is used as a temporary measure to "clean the joint" - remove parts of cartilage, osteophyte growths that interfere with free movement. Such treatment reduces pain in the joint, but it is not a solution to the problem of osteoarthritis.
Osteotomy is an operation to align the axis of the joint. The fact is that with arthrosis, as a rule, one part of the joint suffers more (has a large load). As a result of the osteotomy, the load on the joint is redistributed. It should be noted that osteoarthritis is a progressive disease of the joints. Therefore, osteotomy is a way to delay further treatment, but not to prevent it.
Joint arthroplasty is effective and, in some cases, the only method of treating osteoarthritis of the joints. The essence of the operation is the removal of a joint destroyed by the disease and the implantation of an artificial endoprosthesis in its place. The artificial joint is selected individually, it is ideal for each patient and fully restores the functions of the damaged joint after a period of rehabilitation.
Contraindications for osteoarthritis
What you should pay attention to in arthrosis of the joints:
joint loads- with arthrosis, you need to abandon weightlifting, excessive static loads. A cane can be used to unload the joint. Shoes: Properly fitted shoes reduce stress on the joint. It is advisable to avoid high-heeled shoes.
The weight- Being overweight is another factor in the progression of osteoarthritis. Therefore, it is important to maintain a healthy weight and eat a balanced diet.
Sportsmust also be checked. With arthrosis, it is necessary to exclude sudden jerky movements (contact sports, wrestling), running long distances, lifting weights. But this does not mean that physical activity should be stopped completely. Moderate activity will only benefit the joint.
In addition to medical treatment, physiotherapy is actively used. These are magnetotherapy, electrotherapy, thermotherapy. Also, physical therapy exercises are recommended to strengthen the muscles around the affected joint and improve blood supply.
A radical method of deforming arthrosis, which led to a deterioration in the quality of life, is often surgical intervention. In this case, arthroscopy or arthroplasty is performed.
Arthroscopy is a procedure in which the worn top layer of a joint is removed and a partial denture is placed in its place. This allows you to get rid of pain and restore mobility.
An endoprosthesis is the replacement of a joint with a prosthesis. It is appropriate for severe destruction, when the joint itself does not make sense to save. The prosthesis has artificial cartilage, which anatomically fully corresponds to humans.
Treatment of the disease at the initial stage is the provision of high-quality nutrition for cartilage tissue. For this, the use of chondroprotectors, preferably of natural origin, flavonoids, is recommended. Motor load is also necessary to improve blood supply to the bones and perichondrium.
Deforming osteoarthritis of the knee
Deforming osteoarthritis of the knee joint.(gonarthrosis, DAK) is a chronic progressive disease of the joint cartilage. It is characterized by the destruction of joint structures, which is accompanied by pain, swelling and a characteristic curvature of the limb ("wheel legs" or X-shaped deformation).
Causes of deforming osteoarthritis of the knee.
Without proper lubrication, the joint "dries out, " cracks, and loses height, exposing the heads of the bones. In this case, the closing plate of the articular surface of the bone remains defenseless; re-irritation of the numerous nerve endings found in it causes pain and discomfort.
The following factors or their combination can become the cause of deforming osteoarthritis of the knee:
- the presence of diseases of the joints (and of the knee, in particular) in relatives;
- genetic disorders associated with the formation of abnormal and unstable cartilage cells or their accelerated death;
- congenital and acquired malformations of the musculoskeletal system (flat feet, joint hypermobility, dysplasia, scoliosis, kyphosis and others);
- excessive professional, domestic or sports loads;
- microtraumas and injuries of the knee joint and meniscus, operations on it, fractures of the legs;
- circulatory disorders (varicose veins, atherosclerosis, thrombosis and other vascular diseases), their consequences (osteochondritis dissecans), as well as other causes of prolonged spasms in the legs;
- inflammatory diseases of the joints and periarticular tissues (synovitis, bursitis, tendinitis, arthritis), incl. autoimmune nature (rheumatoid, psoriatic arthritis);
- metabolic disorders (gout, diabetes mellitus);
- age-related processes of joint aging and calcium leaching from bone;
- hormonal disorders and changes in the hormonal background (for example, associated with a lack of estrogen in women);
- hypovitaminosis;
- excess weight (observed in ⅔ of patients);
- physical inactivity.
But the main reason deforming osteoarthritis of the knee is so common lies in its structure. The knee joint has only one axis (plane) of motion. Therefore, the scope of permitted movements is very limited. An uncomfortable twist can injure the periarticular tissues and trigger osteoarthritic changes; after all, the sore knee will be subjected to daily stress.
The causes of the development of deforming arthrosis of the knee can be a large number of factors.
Symptoms of deforming arthrosis of the knee joint.
Gradual increase in pain in the area of the knee joint. At first, the pain is only noticeable when you move; for example, when sharply stretching or bending the leg, there is a feeling that "unfortunately stepped on the foot. "In the early stages, the pain may be episodic or so mild that it is perceived as a nuisance. Then the pain intensifies after physical exertion or a long stay in the same position. The skin also becomes painful - it reacts sensitively to any touch, including. and clothes.
There are 3 types of specific pain in deforming osteoarthritis of the knee joint:
- onset (lasts 15-30 minutes after the joint comes out of a long state of rest);
- mechanical (noticeable during physical activity and disappears after rest);
- locking (sensation of a sharp pinch in the knee).
Symptoms of deforming arthrosis of the knee, as a rule, grow slowly due to the fact that the disease is not characterized by rapid progress. This is the insidiousness of arthrosis: gradually getting used to the discomfort of the disease, the patient "gets used" to the pain, does not notice the deterioration and postpones the visit to the doctor.
Knowing the main symptoms of deforming osteoarthritis of the knee will help to recognize the disease in time.
Treatment of deforming osteoarthritis of the knee joint.
Treatment of deforming arthrosis of the knee joint consists of the complex use of drugs, a dosed load on the joint, physiotherapy procedures, and the use of orthopedic devices.
In the treatment process, it is extremely important to alternate loading and unloading to avoid static loading of the knee. Orthopedic insoles, specialized shoes, canes, crutches, walkers, ergonomic chairs for work and rest also help curb the disease. Particularly effective are orthoses with variable reinforcement, which make it possible to model the physiological axis of the leg and compensate for deformity.
In the early stages of deforming osteoarthritis of the knee, the goal of treatment is to restore the destroyed joint and ligamentous apparatus, relieve pain, and increase the range of voluntary movements. In the last - in alleviating the patient's condition. For this, healing arthroscopy (washing with antiseptics) is performed when a piece of osteophyte is broken, corrective osteotomy (correction of a curved bone), endoprosthesis (reposition) of the joint.
In addition to the orthopedist, physiotherapists and chiropractors, specialists in physiotherapy and therapeutic massage, and surgeons will tell you how to treat deforming osteoarthritis of the knee joint.
The treatment of deforming osteoarthritis of the joints is a long and complex process that requires an integrated approach.
Physiotherapy
Among other physiotherapeutic methods for the treatment of deforming arthrosis of the knee joint, the following are used:
- laser and magnetotherapy;
- microwave therapy;
- shock wave therapy;
- amplipulse;
- ultrasound therapy;
- electrophoresis with analgin, novocaine, chymotrypsin, etc. ;
- glucocorticoid phonophoresis;
- paraffin and ozokerite applications;
- cryotherapy;
- acupuncture;
- joint traction and kinesitherapy;
- balneotherapy.
Massage for deforming osteoarthritis of the knee joint.
Therapeutic and lymphatic drainage massage for deforming osteoarthritis of the knee joint, as well as manual therapy, are performed by a specialist after the inflammation in the joint has been relieved. For self-massage at home, stroking and rubbing are recommended, as well as movements aimed at stretching muscles and ligaments, deep heating (performed last, after a heating effect). Self-massage goes well with local irritants and essential oils. Remember that with deforming arthrosis of the knee joint, massage is carried out on both joints, even if only one of them is affected.
Exercises for deforming arthrosis of the knee joints.
Therapeutic gymnastics (exercise therapy) for deforming osteoarthritis of the knee joint is carried out sitting or lying down, water aerobics are also effective. An instructor compiles an individual set of exercises for deforming osteoarthritis of the knee joint. Here's a brief warm-up designed to strengthen your leg muscles.
- Sit on the floor, legs straight, emphasis on the hands behind the back. Bend and unbend your toes.
- The starting position is the same, slowly bend your leg, at the end of the movement rest your toes on the ground. Repeat with the foot behind the other foot.
- Staying in the same starting position, raise your leg straight out in front of you, toe toward you.
- Without changing the starting position, we bring our hands to the tip of our straight legs.
- Sitting on the floor, hug your bent knee and try to lift the other leg off the floor.
- Sitting on the floor, spread your legs shoulder-width apart. Rotate the legs in turn so that the toe moves 180 degrees.
- Sitting on the floor, legs bent. Roll your foot from heel to toe, feeling the work on the backs of your thighs.
Excellent! Perform exercises to deform osteoarthritis of the knee joint at least 3-6 times a day.
Drugs for deforming osteoarthritis of the knee.
Drug treatment of deforming arthrosis of the knee joint allows you to quickly stop acute pain, reduce inflammation and swelling, and improve nutrition of the joint. Therefore, drugs are used at all stages of the disease and help restore knee mobility.
Chondroprotectors
Chondroprotectors in the form of tablets, capsules, sachets and injections are used to regenerate and maintain synovial cartilage.
anti-inflammatory
Steroidal and nonsteroidal anti-inflammatory drugs are used to treat deforming osteoarthritis of the knee joint. They are prescribed in the form of tablets, injections, sachets, creams, ointments and other products for external and internal use.
Anti-inflammatory drugs can be used in conjunction with anesthetics, which are injected into the joint cavity as a blockade.
antispasmodics
Elimination of the spasm is necessary for the patient to return to normal activities and the normal supply of nutrients to the tissues.
angioprotectors
For deforming arthrosis of the knee joint, preparations based on horse chestnut and others are used.
heating agents
Among the warming agents, it is worth highlighting preparations based on natural ingredients: snake and bee venom, hot pepper, mustard.
All these drugs improve blood supply to tissues and distract pain.
Nutrition for deforming osteoarthritis of the knee.
A healthy diet for deforming osteoarthritis of the knee joint includes dishes that are low in trans fat and "fast" carbohydrates. Preference should be given to lean meat and fish, seafood and vegetables, steamed, in foil or stewed under a lid. Fruits, berries and drinks rich in antioxidants are also useful: wild plants, blueberries, lingonberries, blueberries, high-quality green tea and coffee. You can also eat whole grains, legumes.
But potatoes, white bread, sweets, convenience foods, fast food and alcohol should be excluded.
If you are overweight with deforming osteoarthritis of the knee, consider low-carbohydrate diet options.