Osteoarthritis is a chronic disease of the joints accompanied by abnormal changes in the hyaline cartilage, and subsequently in the surrounding tissues, the joint capsule and the synovium.
The lesion is dystrophic and degenerative, leading to a change in the structure of arterial tissues, leading to their loss of function. According to the same statistics, 12% of the total population of the planet is susceptible to osteoarthritis. 62% to 65% of all episodes of the disease occur in people over the age of 60.
Another 30-35% of joint injury cases with this pathology occur between the ages of 40-60. And about 3% are young people aged 20-40.
What is this?
Simply put, osteoarthritis is a chronic disease in which progressive degenerative-dystrophic changes develop in the joint due to metabolic disorders. This is the most common joint pathology diagnosed in 6-7% of the population. With age, the intensity increases dramatically.
The small joints of the hand (10 times more common in women than in men), the intervertebral joints of the large ankle, chest, and cervical spine, as well as the knee and hip joints, are most often involved in osteoarthritis. Osteoarthritis of the knee and hip joints is a leading cause of severity of clinical manifestations and adverse effects on quality of life.
Arthrosis is characterized by severe damage to the articular and auxiliary apparatus:
- Qond Rit - Inflammatory changes in the cartilage of the joint;
- Osteitis - participation of bone root structures in the pathological process;
- Synovitis - inflammation of the inner membrane of the joint capsule;
- Bursitis - damage to the periarticular sacs;
Reactive inflammation of the soft tissues (muscles, subcutaneous tissue, ligamentous apparatus) located in the projection of the involved joint. > x / li>
The disease is diagnosed in 2% of people under the age of 45, in 30% - between the ages of 45 and 64, and in 65-85% - at the age of 65. Osteoarthritis of the large and medium joints of the limbs is of great clinical importance due to the negative impact on patients' standard of living and working capacity.
Types of osteoarthritis
Due to the causes of the pathological process inside the joint, primary arthrosis is distinguished, secondary and idiopathic.
Primary develops as an independent disease, secondary, as a result of injury or infection, and the cause of the idiopathic form is not known. In addition to classifying the disease based on the cause of the pathological process, arthrosis is characterized by the location of destructive changes:
- Gonarthrosis is the most common type of pathology characterized by damage to the knee joints. Most often, gonarthrosis is detected in people who have weight, chronic metabolic diseases in the body and weak immunity. Knee osteoarthritis progresses over a long period of time and gradually leads to complete loss of motor function.
Osteoarthritis of the shoulder joint - The main cause of degenerative processes in this side is congenital anomalies in the development of the shoulder joint or the development of excessive stress on this side, for example, while carrying heavy luggage on the shoulders.
Ankle arthrosis - The main causes of degenerative processes in the ankle joint are trauma, wrinkles, springs and fractures. In some cases, the development of an abnormal process can lead to an autoimmune disease - rheumatoid arthritis. Ankle osteoarthritis affects dancers, women wear high heels, athletes.
- Cervical spondylosis or arthrosis - causes of neck injuries, progressive osteochondrosis, obesity, seductive lifestyle. People working on computers in offices are at risk. In addition to severe neck pain, patients have pronounced dizziness, depression of consciousness, impaired memory, and fatigue. These symptoms are caused by compression of the vertebral artery, through which nutrients and oxygen enter the brain.
Coxarthrosis or arthrosis of the pelvic-femoral joint - the main cause of the seizure is age-related changes in the joint tissues. People over the age of 45 are at risk.
- Osteoarthritis of the fingers - develops for the same reason as spondyloarthritis.
- Polyarthritis is characterized by damage to many joints, including progressive degenerative processes, and the pathological process involves the muscles, muscles, and tissues around the joint.
- Spondyloarthritis - The tissues of the spinal column, in particular its lumbar region, are subject to destruction. Women are at risk at the onset of menopause because spondyloarthritis progresses against the background of female sex hormone deficiency.
Causes of osteoarthritis
Two causes contribute to osteoarthritis - stress and lack of adequate nutrition to provide vitamins and minerals for tissue repair. There is a load on all human joints. For athletes and dancers, during physical work, the load on the legs is greater, which means that the bone joints burn faster and require high-quality nutrition. With a quiet lifestyle, the support device washes more slowly, but also requires periodic tissue renewal.
Therefore, the main condition for the destruction and deformation of the joints is malnutrition, the absorption of useful components, which is often found in metabolic disorders.
Let us list the factors that contribute to the breakdown of intestinal joints and metabolic disorders:
Muscle weakness and abnormal joint loading. Weakening of one or more muscles increases the load on the joint and distributes it unevenly around the bone. Also, improper loading of the muscles is created by flat feet, scoliosis, therefore, with these "harmless" diseases, the cartilage tissues burn with age, arthrosis occurs.
The likelihood of osteoarthritis increases with the use of strong physical force.
If daily loads exceed the capacity of bone tissue, microtrauma is created in them. In areas of injury, thickening occurs which increases over time and the joint deforms;
- Metabolic disorders (gastrointestinal diseases - bile stagnation, dysbiosis, gastritis, cholecystitis, pancreatitis, metabolic disease - diabetes);
- Psychosomatic causes - The psychosomatics of osteoarthritis confirm that a negative emotional state also becomes the cause of the disease. Stress creates muscle spasm, constant stress disrupts the nutrition of all tissues (internal organs, bones, joints);
Heredity (type of metabolism and its possible disorders are hereditary, tendency to muscle weakness or improper formation of the skeletal system, poor digestion - this is the basis for the development of osteoarthritis in old age).
Osteoarthritis is a disease of worn joints that has lost a significant supply of minerals and resistance to stress and destruction. Therefore, with age, the susceptibility to the disease increases. After 70 years, osteoarthritis is diagnosed in every second retiree. After the maximum load falls on the legs (the person moves - walks, stands, runs, walks), this is where the first signs of osteoarthritis appear.
disease progression mechanism
When any cause of provoking joint disease with arthrosis appears, abnormal processes develop in it. The mechanism of their progression is not fully understood, but the basic stages of formal medicine are known.
In the initial stage, there is a decrease in the structure of cartilage tissue and abnormal changes in the synovial fluid. All of this happens due to metabolic disorders in which the tissues of the joints do not get the necessary components in sufficient quantities, or are deprived of some of them.
In addition, the elasticity and flexibility of collagen fibers are lost due to the lack of nutrients in the body, the production of hyaluronic acid does not have time, which provides the lightness and flexibility of the structural composition of collagen fibers. The cartilage gradually dries, becoming brittle and cracks. The fluid in the synovial capsule gradually dissolves and then disappears completely.
Cartilage and solid bone growth arise in cartilage tissue. At the same time, deformity of other tissues of the joint, their pathological degeneration, dystrophy and loss of physiological activity develop. For the patient, these changes involve pain, embarrassment, and heaviness in the joints.
Symptoms of osteoarthritis
Acute clinical picture is not typical for arthrosis, joint changes are progressive, slowly increasing, manifested by a gradual increase in symptoms:
- intermittent crushing of the affected joint;
- Joint deformity that appears and worsens with disease progression;
- Restriction of mobility (reduction of active and passive movements in the affected joint)
Pain in osteoarthritis has a dense transient nature, occurs during movement, against the background of intense stress, at the end of the day (it can be so intense that the patient does not sleep). The persistent, non-mechanical nature of the pain for osteoarthritis is non-articular in nature and indicates the presence of active inflammation (subcontrol bone, synovial membrane, ligament apparatus, or periarticular muscles).
Most patients report the presence of so-called primary pain that develops in the morning after waking up or after a long period of inactivity and passes during exercise. Many patients define this condition as the need for "joint" development or "disabling".
Arthrosis is characterized by morning stiffness that has a clear localization and is of a short-term nature (not more than 30 minutes), sometimes patients perceive it as a "jelly feeling" in the joints. Feeling married, firmness possible.
With the development of reactive synovitis, the main symptoms of osteoarthritis are joined by:
- Sensitivity and local increase in temperature due to palpation of the affected joint;
- constant pain;
- Joint enlargement, soft tissue swelling;
- Progressive reduction in range of motion.
Stages and degree of arthrosis
In disease, medicine distinguishes three stages that differ in the sign of the disease, the intensity of the lesion, and the localization. At the same time, the differences in all three stages relate to the pathological changes experienced by the tissue types.
The first stage in the development of osteoarthritis of the joints is the initial stage of the disease. Characterized by mild damage to cartilage tissue and loss of physiological functions in collagen fibers. At the same time, the first stage is marked by slight morphological disorders of bone tissue and structural changes in the synovial fluid. The cartilage membrane of the joint is covered with cracks, the patient has little pain at the site of pathology.
- Second degree - development of arthrosis with increased dynamics. This stage is characterized by the appearance of stable pain, anger. Morphological and dystrophic changes are noticeable in the cartilage; The diagnosis reveals an increase in bone tissue. Osteophytes are formed - the growth of bones that can be seen during a visual examination of the site of injury. At the same time, degenerative changes are taking place in the synovial capsule, leading to its structural degradation. The disease at this stage can often worsen and be regular. The pains occur gradually.
- Third degree - active advancement. At this point, the synovial fluid is almost non-existent due to its degeneration, and the bone tissue is washed against each other. The movement of the joint is almost not complete, the pain will become more noticeable. Cartilage is also absent due to degenerative and atrophic changes. Treatment of third degree arthrosis of the joints is considered inappropriate.
In addition to these three degrees of pathology development, there is a final stage - the irreversible destruction of all joint tissue. At this stage it is impossible not only to conduct effective therapy, but also to alleviate the pain.
Inflammatory process usually begins with the second degree of damage, in rare cases, in the absence of medical intervention - in the first stage. Subsequently, it becomes more and more difficult to stop it and this can lead to secondary pathologies, the development of pathogenic microflora at the site of disease localization.
In order to avoid severe consequences, treatment should start from the first degree, and intensive therapy methods should be used at the same time. In the last stage, associated with complete destruction of cartilage tissue, only one technique is allowed to relieve the patient from joint pain and immobility - arthroplasty, with complete or partial replacement of joint components.
The consequences of timely treatment of joints and advanced arthrosis are fraught with complications such as:
- Deformation beyond recovery;
- case of spinal hernia;
- joint strength or firmness;
- Decreased quality of life and standard.
Chronic course, in addition to this complication, is accompanied by intense and frequent pain, complete destruction of the structural components of the joint, discomfort, physical activity and sports.
The diagnosis of osteoarthritis is based on the evaluation of anamnestic data, the characteristic manifestations of the disease, the results of instrumental research methods. The changes indicated in the general and biochemical blood tests are not typical for arthrosis, they occur only with the development of an active inflammatory process.
The main instrumental method for the diagnosis of osteoarthritis is radiography; Computed tomography or magnetic resonance imaging is recommended in undiagnosed cases.
Osteoarthritis of the knee and hip joints is a leading cause of severity of clinical manifestations and adverse effects on quality of life.
Additional methods of diagnosis:
- Atraumatic arthroscopy;
- Ultrasonography (assessment of articular cartilage thickness, synovium, condition of joint capsules, presence of fluid);
- Scintography (assessment of the condition of the bone tissue of the bone heads that make up the joint).
How to treat osteoarthritis?
It is best to treat osteoarthritis of the joints at an early stage, the treatment itself should be pathogenetic and complex. Its essence lies in the removal of the causes that contribute to the development of this disease, it is also necessary to eliminate inflammatory changes and restore the functions that were previously lost.
Treatment of osteoarthritis is based on several basic principles:
- Oxygen of the joint, i. e. e. წ. Intracranial oxygen therapy.
- Drug therapy.
- Intraosseous blockades, as well as meteepiphyseal decompression.
- sustainable diet.
- Damaged joints should be relieved of unnecessary stress. If possible, treatment should be kept to a minimum.
- Follow the prescribed orthopedic regimen.
- Physiotherapeutic exercises.
Take a physiotherapy course that includes magnetic and electrotherapy, shock wave and laser therapy.
- Sanatorium treatment. For this it is necessary once a year, on the recommendation of a doctor, to undergo a course of treatment at specialized resorts.
Drug treatment is carried out in the arthrosis exacerbation phase, which is chosen by a specialist. Self-medication is not recommended due to possible side effects (eg, adverse effects of nonsteroidal anti-inflammatory drugs on gastric mucosa).
Therapy includes the following medications:
- Anti-inflammatory drugs. Primary therapy for osteoarthritis In a comprehensive way, you can stop the course of the disease and significantly improve the quality of life. It is worth talking in more detail about some of the points of treatment. In particular, drug therapy includes the initial stage - it is the removal of the pain syndrome, as well as the elimination of inflammatory processes in the joints. To do this, all doctors use nonsteroidal anti-inflammatory drugs. Experienced doctors do not recommend taking them orally as these drugs greatly irritate the stomach wall. Therefore, depending on the drug chosen, it is used intravenously or intramuscularly. Sometimes, as adjuvants, nonsteroidal anti-inflammatory drugs are used as ointments, but their absorption is very low, so it is impossible to achieve a significant effect.
- Hormonal corticosteroids. When osteoarthritis is in the exacerbation stage, it is recommended to take hormonal corticosteroids. They are inserted into the joint. Externally, you can use a special plaster, ointment or tincture made on the basis of hot pepper.
- Chondroprotectors aimed at restoring cartilage and improving the quality of synovial fluid will not be superfluous. The course lasts for quite a long period of time until there is a moment of improvement. However, if the expected effect does not appear within six months of taking it, the medication should be discontinued. Also intravenous, in combination with chondroprotectors, it is advisable to use preparations based on hyaluronic acid. They promote the formation of a cell membrane that is responsible for the formation of joint cartilage.
Physiotherapy<2 / h2>
To relieve pain, reduce inflammation, improve microcirculation and eliminate muscle spasms, a patient with osteoarthritis undergoes physiotherapy:
- At the aggravation stage. Prescribe laser therapy, magnetotherapy and ultraviolet radiation,
- in remission. Electrophoresis and phonophoresis are shown.
In addition, thermal procedures, sulfide, radon and sea baths are used. In order to strengthen the muscles, electrical stimulation is performed. Gentle massage can also be used during remission.
If the listed methods of exposure are ineffective, in case of complications, they resort to surgical treatment of osteoarthritis:
- metaphyseal decompression and prolongation of intraosseous blockade (decrease in intraosseous pressure in the affected area);
- Corrective osteotomy;
- Endoprosthesis of joints.
In the early stages of the disease, mechanical, laser, or cold plasma degradation is used (cleaning of the damaged cartilage surface, removal of non-avicadous areas). This method effectively relieves pain, but has a temporary effect - 2-3 years.
Most people these days do not want to take pills and injections. Therefore, they ask the question - how to cure osteoarthritis with the help of folk remedies? For the most part, such funds are aimed at increasing body tone, improving blood circulation, relieving pain, and boosting immunity.
Prescriptions of traditional medicine used to treat this disease:
- Egg solution is made from fresh egg yolk mixed with turpentine and apple cider vinegar in a 1: 1: 1 ratio. The liquid should be well mixed and flooded on the affected joint overnight. Then you have to wrap everything with a wool scarf. It is recommended to rub 2-3 times a week for 1 month.
- Buy Elecamane root from a pharmacy. It is usually packaged in a 50 gram package. To prepare the tincture you will need half a pack of plant roots and 150 ml of high-quality vodka. The ingredients are mixed, placed in a dark bottle and infused for 12 days. Garbage is done before bed, and if possible in the morning.
- Also using cooked oats also gives good results. Take three to four tablespoons of oatmeal, pour boiling water and cook on low heat for five to seven minutes. The amount of water used should provide a thick porridge that needs to be cooled and used as a compressor overnight. Use only freshly cooked flakes. Yesterday's porridge is not good for compresses.
- Birch leaves, nettle leaves and calendula flowers are taken in equal parts. As a result, you should get two tablespoons. The resulting crushed collect in a thermos, fill it with a liter of boiling water and leave it overnight. Starting the next morning, you should take half a cup of broth four to five times a day. The course of taking this recipe is two to three months.
Types of bay leaves, lentils, garlic and rye grains are also effective. Treatment of osteoarthritis with folk remedies will be most effective if it is combined with remedies >
The basic principles of nutrition for osteoarthritis are reduced to the following points:
- Avoid heavy meals at night to prevent an attack of osteoarthritis.
- Feed partially.
- Constantly control your weight to avoid weight gain,and therefore extra stress on the throat joints.
- When there is no aggravation of the disease, take a walk after eating.
- The menu should be balanced, compiled with the attending physician.
Complaints about fish dishes are not real - you can eat a lot of them, naturally in reasonable quantities.
- Do not forget to take food vitamins regularly. For patients with osteoarthritis, B vitamins are especially important
- Jelly meat plays an important role in the treatment of osteoarthritis. Such food will be trace elements for the wound. The most important component in aspic is naturally found in collagen
- Vitamin B helps produce hemoglobin. You can eat it with bananas, nuts, cabbage and potatoes. Worth planting with plants and legumes. They become a source of folic acid. Liver, mushrooms, dairy products, as well as eggs will be useful. They are rich in rigoflavin.
Following a doctor-prescribed treatment regimen, it is possible to achieve a recurrence of the disease, and damaged tissue begins to regenerate.
Prevention of osteoarthritis begins with proper nutrition. It is essential to try to reduce your salt intake as well as foods that can interfere with your metabolism. These include legumes, fatty meats and alcohol. The diet includes cabbage, herbs and fish.
To prevent osteoarthritis, it is necessary to attend physical education classes, do warm-ups. If possible, it is best to walk a few miles. It is also important to monitor your weight and prevent weight gain as this will put extra stress on the aching joints. It is not recommended to take pills for weight loss, as they can slow down the body's metabolism.
Life vision is favorable. Social and occupational prognosis depend on the time of diagnosis and initiation of treatment; This decreases when a decision on surgical treatment of the disease becomes necessary.