Arthritis 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 occurs imperceptibly, but often develops very quickly. A person begins to feel pain in the joints when moving, there is stiffness and reduced mobility, especially in the morning, while it is still "not in conflict". If discomfort appears and periodic pain appears during uncomfortable movements or loading, then it is very importantunderstand that this will not go away and without intervention the situation will only get worse.
Symptoms of arthrosis
Arthrosis of large and medium joints seriously changes a person's lifestyle, impairs quality and imposes restrictions. The development of the disease is avalanche-like and the treatment is most often associated with unbearable pain, which is a clear sign of wear and tear of the joints.
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, the treatment in this case is gentle and does not require serious intervention and expensive drugs for the treatment of arthrosis.
Types of arthrosis
Arthritis of the joints is classified according to several criteria. Depending on the degree of arthrosis changes in the cartilage tissue, 4 stages of arthrosis are distinguished. Arthrosis is also divided into primary and secondary. The reason for the development of primary arthrosis is age-related changes. Secondary arthrosis occurs due to injuries and diseases of the joints (for example, traumatic arthrosis or rheumatoid arthrosis). The disease can develop slowly over years or lead to joint destruction in just a few years (progressive osteoarthritis).
There is alsotypes of arthrosis depending on the affected area:
- - arthrosis of the knee joint - arthrosis of the hip joint
- Uncovertebral arthrosis - arthrosis of the cervical vertebrae
- Vertebral arthrosis - damage to the spine
- Patellofemoral arthrosis is a type of gonarthrosis that affects the patella and part of the femur.
The degree of the disease is determined by the degree of damage to the cartilage tissue.
Arthrosis of the 1st degree - cartilage tissue is slightly damaged, a person does not feel discomfort;
Arthrosis II degree - osteophytes appear, the space between the cartilages decreases, situational pain occurs during uncomfortable movements;
Arthrosis III degree - the cartilage tissue is destroyed in places and exposes the bone tissue, the distance between the cartilages decreases, the pain is frequent and severe;
IV degree arthrosis - a significant part of the cartilage tissue is destroyed up to 60%, there is no gap between the bones, patients experience constant, severe pain, hyperthermia of the area above the joint occurs.
- Characteristic creaking during movement and slight pain in the background;
- Limitation of joint mobility, discomfort during full physical exertion;
- "Jumps" blood pressure indicators;
- Headache and dizziness;
- Convulsive syndrome and often muscle spasms;
- Visually observed deformation of the joint;
- Swelling, hyperthermia or redness of the skin over the affected joint;
- Impairment of motor function.
Why does the disease occur?
Arthrosis of the joints can occur in any of the departments, but most often patients turn when arthrosis of the knee or hip joint is felt. In the professional sphere, with a special, specific load on the hands, shoulder arthrosis can be observed.
Lesions differ in men and women.The strong half often suffers from temporomandibular, wrist, ankle and lumbar arthrosis. Women complain more about the chest and neck area, 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);
- disease of the spine - vertebral arthrosis;
- damage to the cervical spine - uncovertebral arthrosis.
The main reasons are:
- inflammatory process;
- professional sports;
- Overweight;
- professional non-standard load, for example, squatting or kneeling;
- previous joint injuries (post-traumatic);
- hypothermia;
- heredity;
- age changes.
Osteoarthritis can occur as a stand-alone disease or it can be the result of a pre-existing disease, so it is important to know a person's history.
Diagnosis of arthrosis of the joints
Arthrosis of the joints is detected by X-ray. The X-ray shows how the joint is deformed and how much the joint space narrows. You may also need to undergo MRI or arthroscopy, but only in particularly complex and ambiguous cases. Usually, x-rays of the joints are sufficient to diagnose the disease.
In order to understand the presence of the disease, its severity, as well as what disorders have led to the disease, a comprehensive diagnosis is carried out.
First, with helpx-ray in different projectionsreceive information about the degree of damage to the joint.
Tomography (magnetic resonance or computed tomography) helpsexclusion of 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 research complex is the most informative and gives a clear idea of the degenerative-dystrophic changes and helps to choose an optimal treatment plan.
Treatment of arthrosis
As discussed above, arthrosis can develop due to many factors and the treatment plan is developed based on understanding the underlying causes and arthrosis drugs are chosen accordingly.
Treatment should be developed individually, based on the results of the diagnosis. Do not forget to take into account the condition of the person, his existing diseases.
The restoration of the joint surface and cartilage tissue is not fast. Effective drugs that have side effects are prescribed. And taking drugs to achieve 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 arthrosis
The main goal of such therapy is to eliminate the manifestations of arthrosis. Medical treatment of arthrosis of the joints includes:
- Nonsteroidal anti-inflammatory drugs. With arthrosis, a person feels 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 prescribed in the acute stage of arthrosis.
- Chondroprotectors. The main task of these drugs is to stop the degenerative processes in the cartilage tissue to prevent its further destruction.
- Intra-articular injections with hyaluronic acid. Hyaluronic acid preparations are similar to synovial fluid, which provides gliding and smooth free movements in the joint. In arthrosis, the 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 for the treatment of arthrosis, which entered practice recently, but is gaining popularity. This is the use of drugs based on the patient's blood plasma enriched with platelets. Thanks to the biological therapy, the blood supply to the joint is activated, the production of intra-articular fluid is activated and the cartilage tissue is supplied with nutrients.
important!Drug treatment of arthrosis is effective in the early stages of the disease. Also, experts emphasize that drug therapy is not able to restore the damaged joint, but it will make it possible to eliminate the symptoms and slow down the progression of arthrosis.
Physiotherapy and other conservative methods for the treatment of arthrosis
Physiotherapy is also used in the fight against arthrosis. Various procedures (laser, phonophoresis, electrophoresis, magnetotherapy, UVT) and exercise therapy are prescribed to improve metabolic processes and blood circulation, strengthen muscles.
In addition, with arthrosis, you just need to make some adjustments in your lifestyle:
- Avoid overloading – it is important to evenly distribute activity and rest to avoid overloading the joint
- Take care of nutrition and monitor weight - since excess weight only exacerbates the joint problem, 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 arthrosis, independent movement becomes questionable, so you must use a cane or crutches. For more comfortable walking, you can also use orthopedic insoles - they will reduce the load on the joint.
There are also many folk recipes that "will help defeat arthrosis". However, treatment of arthrosis at home also does not always bring results. In addition, the use of any lotions and ointments from their own preparation most 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, the type of operation is selected.
Joint arthroscopy is a minimally traumatic intervention, an intra-articular operation through several micropunctures in the joint. In arthrosis, it is used as a temporary measure to "clean the joint": removing parts of cartilage, osteophytes, which interfere with free movement. Such treatment reduces pain in the joint, but is not a solution to the problem of arthrosis.
Osteotomy is an operation to align the joint axis. The fact is that with arthrosis, as a rule, one part of the joint suffers more (there is a large load). As a result of the osteotomy, the load on the joint is redistributed. It should be noted that arthrosis is a progressive disease of the joints. Therefore, osteotomy is a way to delay further treatment, but not to avoid it.
Joint arthroplasty is an effective, and in some cases, the only method of treating arthrosis 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, ideally suits each patient and fully restores the functions of the damaged joint after a period of rehabilitation.
Contraindications for arthrosis
What you should pay attention to in arthrosis of the joints:
Joint loads- with arthrosis, you should give up lifting weights, excessive static loads. A cane can be used to relieve the joint. Shoes – Properly fitted shoes reduce stress on the joint. It is recommended to avoid high-heeled shoes.
The weight- overweight is another factor in the progression of arthrosis. That's why it's important to maintain a healthy weight and eat a balanced diet.
Sportsshould also be reviewed. With arthrosis, it is necessary to exclude sharp sharp 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 drug treatment, physical therapy is actively used. These are magnetotherapy, electrotherapy, thermotherapy. In addition, physical therapy exercises are recommended to strengthen the muscles around the affected joint and improve blood supply.
A radical method of deforming arthrosis, which leads 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, upper layer of the joint is removed and a partial prosthesis is placed in its place. This allows you to get rid of pain and restore mobility.
Arthroplasty is the replacement of a joint with a prosthesis. It is suitable for severe destruction, when there is no point in saving the joint itself. The prosthesis has artificial cartilage, which anatomically fully corresponds to human cartilage.
The treatment of the disease in the initial stage is the provision of high-quality nutrition of the cartilage tissue. For this purpose, it is recommended to use chondroprotectors, preferably of natural origin, flavonoids. Motor load is also necessary to improve blood supply to the bones and perichondrium.
Deforming arthrosis of the knee
Deforming arthrosis of the knee joint(gonarthrosis, DAK) is a chronic progressive disease of the articular cartilage. It is characterized by the destruction of joint structures, which is accompanied by pain, inflammation and a characteristic curvature of the limb ("wheel leg" or X-shaped deformity).
Causes of deforming arthrosis of the knee
Without proper lubrication, the joint "dry 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 unprotected; repeated irritation of the numerous nerve endings that are in it causes pain and discomfort.
The following factors or their combination can become the cause of deforming arthrosis of the knee:
- the presence of diseases of the joints (and the knee - in particular) in relatives;
- genetic disorders associated with the formation of abnormal, 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, household or sports loads;
- microtraumas and injuries of the knee joint and meniscus, operations on it, leg fractures;
- circulatory disorders (varicose veins, atherosclerosis, thrombosis and other vascular diseases), their consequences (dissecting osteochondritis), as well as other causes of prolonged leg cramps;
- 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 aging of the joints and washing of calcium from the bones;
- hormonal disturbances and changes in the hormonal background (for example, related to the lack of estrogen in women);
- hypovitaminosis;
- overweight (observed in ⅔ of patients);
- physical inactivity.
But the main reason why deforming arthrosis of the knee is so common lies in its structure. The knee joint has only one axis (plane) of motion. Therefore, the range of permissible movements is very limited. An uncomfortable rotation can injure the periarticular tissues and cause arthrosis changes - after all, the affected knee will be subjected to daily stress.
Symptoms of deforming arthrosis of the knee joint
Gradually increasing pain in the area of the knee joint. At first, the pain is noticeable only when moving - for example, when suddenly straightening or bending the leg, there is a feeling that "unfortunately, you stepped on your foot. "In the early stages, the pain may be episodic or so weak that it is perceived as discomfort. Then, the pain intensifies after physical exertion or a long stay in the same position. The skin also becomes painful - reacts sensitively to any touch, incl. and clothes.
There are 3 types of specific pain in deforming arthrosis of the knee joint:
- onset (continues 15-30 minutes after the joint emerges from a long state of rest);
- mechanical (noticeable during physical activity and disappears after rest);
- block (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.
Treatment of deforming arthrosis of the knee joint
The treatment of deforming arthrosis of the knee joint consists of the complex use of drugs, dosed loading of the joint, physical therapy procedures and the use of orthopedic devices.
In the treatment process, it is extremely important to alternate loading and unloading to prevent static loading of the knee. Orthopedic insoles, specialized shoes, canes, crutches, walkers, ergonomic chairs for work and rest also help to slow down the disease. Orthoses with variable stiffness are particularly effective, allowing to model the physiological axis of the leg and compensate for the deformity.
In the early stages of deforming arthrosis of the knee, the goal of treatment is to restore the destroyed joint-ligament apparatus, relieve pain and increase the range of voluntary movements. In the later ones - to alleviate the patient's condition. For this, remedial arthroscopy (washing with antiseptics) is performed when part of the osteophyte is broken off, corrective osteotomy (correction of a curved bone), endoprosthetics (replacement) of the joint.
In addition to the orthopedist, physiotherapists and chiropractors, specialists in exercise therapy and therapeutic massage and surgeons will tell you how to treat deforming arthrosis of the knee joint.
Physiotherapy
Among other physiotherapeutic methods for the treatment of deforming arthrosis of the knee joint, the following are used:
- laser and magnetic therapy;
- microwave therapy;
- shock wave therapy;
- amplipulse;
- ultrasound therapy;
- electrophoresis with analgin, novocaine, chymotrypsin, etc. ;
- phonophoresis with glucocorticoids;
- applications with paraffin and ozokerite;
- cryotherapy;
- acupuncture;
- joint traction and kinesitherapy;
- balneotherapy.
Massage for deforming arthrosis of the knee joint
Therapeutic and lymphatic drainage massage for deforming arthrosis of the knee joint, as well as manual therapy, are performed by a specialist after the inflammation in the joint has subsided. For self-massage at home, stroking and rubbing, as well as movements aimed at stretching muscles and ligaments, deep warm-up (performed last, after a warming effect) are recommended. Self-massage combines well with topical irritants and essential oils. Remember that with deforming arthrosis of the knee joint, the massage is performed 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 arthrosis of the knee joint is carried out in a sitting or lying position, water aerobics is also effective. An individual complex of exercises for deforming arthrosis of the knee joint is compiled by an instructor. Below we offer a short warm-up aimed at strengthening the leg muscles.
- Sit on the floor, legs straight, hands behind the back. Flex and spread your toes.
- The starting position is the same, slowly bend your leg, resting your toe on the floor at the end of the movement. Repeat with the leg behind the other leg.
- Continue in the same starting position, raise the extended leg in front of you with toes towards you.
- Without changing the starting position, we pull our hands to the toes of the straight legs.
- Sitting on the floor, hug the bent knee and try to lift the other leg above the floor.
- Sitting on the floor, spread your feet shoulder-width apart. Rotate your feet in turn so that your toes move 180 degrees.
- Sitting on the floor, legs bent. Rotate your foot from the heel to the toes, feeling the work in the back of the thighs.
Excellent! Do knee osteoarthritis exercises at least 3-6 times a day.
Medicines for deforming arthrosis 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, the drugs are used at all stages of the disease and help to restore the mobility of the knee.
Chondroprotectors
To regenerate and maintain synovial cartilage, chondroprotectors are used in the form of tablets, capsules, sachets and injections.
Anti-inflammatory
Steroid and non-steroidal anti-inflammatory drugs are used to treat deforming arthrosis 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 along with anesthetics that are injected into the joint cavity as a block.
Antispasmodics
Removal of the spasm is necessary to return the patient to normal activities and the normal supply of nutrients to the tissues.
Angioprotectors
In case of deforming arthrosis of the knee joint, preparations based on horse chestnut, etc. are used.
Warming 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 the blood supply to the tissues and distract from the pain.
Nutrition in deforming arthrosis of the knee
A healthy diet for deforming arthrosis of the knee joint includes dishes with a reduced content of trans fats and "fast" carbohydrates. Preference should be given to lean meat and fish, seafood and vegetables cooked in steam, in foil or stewed under a lid. Alsofruits, berries and drinks rich in antioxidants are useful - wild plants, blueberries, cranberries, cranberries, high-quality green tea and coffee. You can also eat whole grains, legumes.
But potatoes, white bread, sweets, semi-finished products, fast food and alcohol should be excluded.
If you are overweight with degenerative knee osteoarthritis, consider low-carb diet options.