Osteoarthritis is a chronic joint disease, accompanied by pathological changes in the hyaline cartilage and subsequently in adjacent tissues, joint capsule and synovium.
The lesion is dystrophic and degenerative, which leads to a change in the structure of the joint tissues, loss of their functionality. 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 cases of joint damage with this pathology occur in patients aged 40 to 60 years. And about 3% are young people between the ages of 20 and 40.
What is this?
Put simply, osteoarthritis is a chronic disease in which progressive degenerative-dystrophic changes in the joint develop due to metabolic disturbances. It is the most common joint disease, diagnosed in 6-7% of the population. With age, the incidence increases significantly.
Very often, in osteoarthritis, the pathological process involves the small joints of the hand (in women 10 times more often than in men), the big toe, the intervertebral joints of the thoracic and cervical spine, as well as the knee jointsand hip. Osteoarthritis of the knee and hip joints takes first place in terms of severity of clinical manifestations and negative impact on quality of life.
Arthrosis is characterized by a complex lesion of the articular and auxiliary apparatus:
- chondritis - inflammatory changes in the cartilage of the joint;
- osteitis - involvement of underlying bone structures in the disease process;
- synovitis - inflammation of the inner membrane of the joint capsule;
- bursitis - damage to the periarticular bags;
- reactive soft tissue inflammation (muscle, subcutaneous tissue, ligament apparatus) localized in the projection of the affected joint (periarticular inflammation).
The disease is diagnosed in 2% of people under the age of 45, in 30% - from 45 to 64 years and in 65-85% - at the age of 65 and over. Osteoarthritis of the large and middle joints of the extremities has the greatest clinical significance due to its negative impact on patients' standard of living and working capacity.
Types of osteoarthritis
Depending on the cause of the pathological process within the joint, primary, secondary and idiopathic osteoarthritis is distinguished.
Primary develops as an independent, secondary disease following an injury or infection and the cause of the idiopathic form is unknown. In addition to the classification of the disease, depending on the cause of the pathological process, osteoarthritis is distinguished by the location of the destructive changes:
- Gonarthrosis is the most common type of disease characterized by damage to the knee joints. Most often, gonarthrosis is detected in overweight people, with chronic metabolic diseases in the body and weak immunity. Osteoarthritis of the knee progresses for a long time and gradually leads to complete loss of motor function.
- Osteoarthritis of the shoulder joint - the main cause of degenerative processes in this area are congenital anomalies in the development of the shoulder joint or excessive stress on this area, for example, when wearing heavy luggage on the shoulders.
- Arthrosis of the ankle - the main reasons for the development of degenerative processes in the ankle joint are trauma, sprains, sprains, fractures. In some cases, the development of a pathological process can provoke an autoimmune disease - rheumatoid arthritis. Osteoarthritis of the ankle affects dancers, women wearing high heels, athletes.
- Uncoarthrosis or arthrosis of the cervical spine - the causes are neck injuries, progressive osteochondrosis, obesity, a sedentary lifestyle. At risk are people who work on computers in offices. In addition to severe neck pain, patients have pronounced dizziness, depression of consciousness, memory impairment and fatigue. These symptoms are caused by compression of the vertebral artery, through which nutrients and oxygen enter the brain.
- Coxarthrosis or osteoarthritis of the hip joint: the main cause of onset is age-related changes in the tissues of the joint. People over 45 are at risk.
- Osteoarthritis of the fingers - develops for the same reason as spondyloarthrosis.
- Polyarthrosis is characterized by damage to multiple joints with progressive degenerative processes in them, while the pathological process involves ligaments, muscles and tissues surrounding the joint.
- Spondyloarthrosis: the tissues of the spinal column, namely its lumbar region, are subject to destructive destruction. Women are at risk during the onset of menopause, as spondyloarthrosis progresses against the background of a deficiency of female sex hormones.
Causes of arthrosis
Two reasons contribute to the formation of osteoarthritis: stress and lack of adequate nutrition, which provides vitamins and minerals for tissue repair. The joints of each person carry a load. For athletes and dancers, during physical work, the load on the legs is greater, which means that the bone joints wear out faster and require high-quality nutrition. With a quiet lifestyle, the support apparatus wears out more slowly, but also requires periodic renewal of tissues.
Therefore, the main condition for the destruction and deformation of the joints is malnutrition, indigestion of useful components, which often occurs with metabolic disorders.
We list the factors that contribute to joint wear and metabolic disorders:
- Muscle weakness and abnormal load on the joints. Weakening of one or more muscles increases the load on the joint and distributes it unevenly within the bone junction. In addition, the incorrect loading of the muscles is formed with flat feet, scoliosis, therefore, with these "harmless" diseases with age, cartilage tissues wear out, arthrosis appears.
The probability of osteoarthritis increases with severe physical exertion.
If the daily loads exceed the capacity of the bone tissues, microtraumas are formed in them. At the lesion sites, thickenings appear that grow over time and deform the joint;
- Metabolic disorders (gastrointestinal diseases - stagnation of bile, dysbiosis, gastritis, cholecystitis, pancreatitis, metabolic disease - diabetes);
- Psychosomatic causes: the psychosomatic of arthrosis confirms that even a negative emotional state becomes the cause of the disease. Stress forms muscle spasms, constant stress interrupts the nutrition of all tissues (internal organs, bones, joints);
- Heredity (the type of metabolism and its possible disorders are hereditary, tendency to muscle weakness or improper formation of the bone system, to indigestion - which is the basis of the development of arthrosis in old age).
Osteoarthritis is a disease of worn-out joints that have lost a significant supply of minerals and the ability to withstand stress and destruction. Therefore, with age, the predisposition to the disease increases. After 70 years, osteoarthritis is diagnosed in every second retiree. Since the maximum load falls on the legs (a person moves - walks, gets up, runs, jumps), this is where the first signs of arthrosis are formed.
Mechanism of disease progression
When one of the reasons that provoke a disease of the joint with arthrosis appears, pathological processes begin to develop. The mechanism of their progression is not fully understood, but the main stages of mainstream medicine are known.
In the initial stage, there is a depletion of the structure of the cartilage tissue and abnormal changes in the synovial fluid. All this occurs due to metabolic disorders, in which the tissues of the joints do not receive the necessary components in sufficient quantities, or are deprived of some of them.
In addition, the elasticity of collagen fibers and the flexibility of cartilage are lost, due to the fact that in the body with a lack of nutrients, hyaluronic acid does not have time to produce, which provides softness and flexibility of the compositionstructure of the collagen fiber. Cartilage gradually dries up, becomes brittle and cracks. The fluid in the synovial capsule gradually drains and subsequently disappears completely.
Roughness and solid bone growth are formed on the cartilage tissue. At the same time, deformation of other tissues of the joint develops, their pathological degeneration, dystrophy and loss of physiological activity. For the patient, these changes mean the appearance of pain, lameness, joint stiffness.
Symptoms of osteoarthritis
The acute clinical picture is not typical of osteoarthritis, joint changes are progressive, slowly increasing, which is manifested by a gradual increase in symptoms:
- pain;
- intermittent creaking of the affected joint;
- joint deformity which appears and worsens as the disease progresses;
- stiffness;
- limitation of mobility (decrease in the volume of active and passive movements in the affected joint)
The pain in osteoarthritis is dull, transient, appears when moving, against a background of intense stress, towards the end of the day (it can be so intense that it does not allow the patient to fall asleep). The constant, non-mechanical nature of osteoarthritis pain is not characteristic and indicates the presence of active inflammation (subchondral bone, synovium, ligamentous apparatus or periarticular muscles).
Most patients notice so-called initial pains that appear in the morning after waking up or after a long period of inactivity and disappear during physical activity. Many patients define this condition as the need to "develop a joint" or "disengage".
Osteoarthritis is characterized by morning stiffness, which has a clear localization and is of a short nature (no more than 30 minutes), is sometimes perceived by patients as a "jelly sensation" in the joints. Feeling of wedging, possible stiffness.
With the development of reactive synovitis, the main symptoms of osteoarthritis are added:
- soreness and local increase in temperature, caused by palpation of the affected joint;
- persistent pain;
- joint enlargement, soft tissue swelling;
- progressive decrease in range of motion.
Phases and degrees of osteoarthritis
In the course of the disease, medicine distinguishes between three stages, which differ in the signs of the disease, the intensity of the lesion and the localization. At the same time, the differences in all three stages relate to the types of tissues that undergo pathological changes.
- The first stage of development of osteoarthritis of the joints is the initial stage of the disease. It is characterized by minor damage to cartilage tissue and loss of physiological functions in collagen fibers. At the same time, in the first stage, minor morphological disorders of the bone tissue and structural changes in the synovial fluid are noted. The cartilage of the joint is covered with cracks, the patient has a slight pain at the site of the pathology.
- Second degree: the development of osteoarthritis with greater dynamics. This stage is characterized by the appearance of stable pain, lameness. There are notable morphological and dystrophic changes in the cartilage; during the diagnosis, the growth of bone tissue is revealed. Osteophytes are formed - bone growths visible during a visual examination of the lesion site. At the same time, the processes of degenerative changes in the synovial capsule proceed, which leads to its structural exhaustion. The disease at this stage can often worsen and be regular. The pains gradually become constant.
- Third degree - active progression. At this stage, the synovial fluid is almost completely absent due to its degeneration, and the bone tissue is rubbed against each other. Joint mobility is almost completely absent, the pain becomes more palpable. Cartilage is also absent due to degenerative and atrophic changes. Treatment of the third degree of arthrosis of the joints is considered inappropriate.
In addition to these three degrees of development of the pathology, there is a final stage: the irreversible destruction of all tissues of the joint. At this stage, it is impossible not only to conduct effective therapy, but also to relieve pain.
The inflammatory process usually begins in the second degree of the injury, in rare cases, in the absence of medical intervention - in the first stage. Subsequently, it becomes increasingly difficult to stop it, and this can lead to secondary pathologies, the development of pathogenic microflora in the place of the localization of the disease.
To exclude serious consequences, treatment should be started from the first degree and, at the same time, intensive care methods should be applied. In the last phase, associated with the complete destruction of the cartilage tissue, only one technique is allowed to relieve the patient from pain and immobility of the joint - arthroplasty with complete or partial replacement of the component parts of the joint.
Consequences
The consequences of inappropriate treatment and advanced arthrosis of the joints are fraught with complications such as:
- disability;
- deformation beyond recovery;
- appearance of vertebral hernias;
- joint stiffness or stiffness;
- decline in quality and standard of living.
The chronic course, in addition to these complications, is accompanied by intense and frequent soreness, complete destruction of the structural components of the joint, discomfort, inability to perform physical work and play sports.
Diagnostics
Diagnosis of arthrosis is based on the evaluation of anamnestic data, characteristic manifestations of the disease, results of instrumental research methods. Indicative changes in general and biochemical blood tests are not typical for osteoarthritis, they appear only with the development of an active inflammatory process.
The main instrumental method for the diagnosis of osteoarthritis is radiography; in diagnosically unclear cases, magnetic or computerized resonance imaging is recommended.
Osteoarthritis of the knee and hip joints takes first place in terms of severity of clinical manifestations and negative impact on quality of life.
Additional diagnostic methods:
- atraumatic arthroscopy;
- ultrasound (assessment of the thickness of the articular cartilage, synovium, condition of the joint capsules, presence of fluid);
- scintigraphy (assessment of the state of the bone tissue of the heads of the bones that form 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 removing the causes that contribute to the development of this disease, it is also necessary to eliminate inflammatory changes and restore functions that were previously lost.
The treatment of osteoarthritis is based on several basic principles:
- Oxygenation of the joint, or so-called intra-articular oxygen therapy.
- Pharmacological therapy.
- Intraosseous blocks as well as decompression of the metaepiphysis.
- Sustainable diet.
- Damaged joints need to be relieved of excessive stress. If possible, it should be minimized during treatment.
- Follow established orthopedic regimen.
- Physiotherapy exercises.
- Attending a physiotherapy course, which includes magneto and electrotherapy, shockwaves, and laser therapy.
- Treatment in the sanatorium. To do this, it is necessary once a year, on the recommendation of a doctor, to undergo a course of treatment at specialized resorts.
Preparations for the treatment of osteoarthritis
Drug treatment is carried out in the phase of exacerbation of arthrosis, selected by a specialist. Self-medication is unacceptable due to possible side effects (for example, the negative effect of non-steroidal anti-inflammatory drugs on the gastric mucosa).
Therapy includes the following drugs:
- Anti-inflammatory drugs. By starting osteoarthritis therapy comprehensively, you can slow down the course of the disease and significantly improve the quality of life. It is worth dwelling in more detail on some points of the treatment. In particular, drug therapy includes in the initial stage - this is the removal of pain, as well as the elimination of inflammatory processes that occur in the joints. For this, all doctors use non-steroidal anti-inflammatory drugs. Experienced doctors do not recommend their oral administration, as these drugs irritate the stomach wall to a large extent. Therefore, depending on the chosen drug, intravenous or intramuscular administration is used. Sometimes, as auxiliary agents, NSAIDs are used in the form of ointments, but their absorption is extremely low, so it is not possible to achieve a significant effect.
- Hormonal corticosteroids. When osteoarthritis is at the stage of exacerbation, it is advisable to take hormonal corticosteroids. They are injected into the joint. Externally, you can use a special patch, ointment or tincture, which are made on the basis of hot pepper.
- Chondroprotectors aimed at restoring cartilage and improving the qualitative composition of the synovial fluid will not be superfluous. The course lasts for a fairly long period of time, until the moment when improvement occurs. However, if the expected effect does not manifest itself within six months of administration, the drugs should be canceled. Also intra-articular, together with chondroprotectors, it is recommended to use drugs based on hyaluronic acid. They contribute to the formation of the cell membrane responsible for the formation of joint cartilage.
Physiotherapy
To relieve pain, reduce inflammation, improve microcirculation and eliminate muscle spasms, a patient with osteoarthritis is referred to physiotherapy:
- In a phase of aggravation. Prescribe laser therapy, magnetotherapy and ultraviolet radiation,
- In remission. Show electrophoresis and phonophoresis.
In addition, thermal procedures, sulfide, radon and sea baths are used. To strengthen the muscles, electrical stimulation is performed. A gentle massage can also be used during remission.
Surgery
If the listed exposure methods are ineffective, in the presence of complications, surgical treatment of osteoarthritis is used:
- Decompression of the metaepiphysis and prolonged intraosseous block (decrease in intraosseous pressure in the affected area);
- Corrective osteotomy;
- Joint endoprosthesis.
In the early stages of the disease, mechanical debridement, laser or cold plasma is used (smoothing the surface of damaged cartilage, removing non-viable areas). This method effectively relieves pain, but has a temporary effect - 2-3 years.
Folk remedies
Most people these days don't want to take pills or injections. Therefore, they ask the question: how to cure arthrosis with the help of folk remedies? For the most part, such funds are aimed at increasing the tone of the body, improving blood circulation, relieving pain and increasing immunity.
Traditional medicine recipes are used to treat this disease:
- The egg solution consists of fresh egg yolk, which is mixed with turpentine and apple cider vinegar in a 1: 1: 1 ratio. The liquid should be thoroughly mixed and rubbed into the jointaffected at night. Then you need to wrap everything with a wool scarf. It is recommended to rub for 1 month 2-3 times a week.
- Buy elecampane root from the pharmacy. It is usually packaged in packs of 50 grams. 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. Rubbing is done before going to bed and, if possible, in the morning.
- The use of boiled oatmeal also gives good results. Take three or four tablespoons of oatmeal, pour boiling water over it and cook over low heat for 5-7 minutes. The amount of water used should provide a thick porridge, which should be cooled and used as a compress overnight. Use only freshly boiled flakes. Yesterday's porridge is not good for a compress.
- Birch leaves, nettle leaves and marigold inflorescences are taken in equal parts. Accordingly, you need to take two tablespoons. We put the resulting crushed collection in a thermos, fill it with a liter of boiling water and leave it overnight. Starting the next morning, it is necessary to take half a glass of broth four to five times a day. The course of taking this prescription is two to three months.
Tinctures of bay, horseradish, garlic and rye grains are also considered effective. Treatment of arthrosis with folk remedies will be most effective when combined with drugs.
Nutrition for osteoarthritis
The basic principles of nutrition for osteoarthritis are reduced to the following points:
- Avoid heavy meals in the evening to avoid an attack of osteoarthritis.
- Eat fractionally.
- Constantly monitors weight, in order to avoid weight gain,
and, therefore, further stress on sore joints. - When there is no aggravation of the disease, take a walk after eating.
- The menu must be balanced, drawn up with the attending physician.
There are absolutely no complaints about fish dishes - you can eat a lot of them, of course, in reasonable quantities.
- Don't forget your regular intake of vitamins from food. For patients with osteoarthritis, B vitamins are particularly relevant
- Meat in jelly plays an important role in the treatment of osteoarthritis. Such food will be a real storehouse of trace elements for sore joints. The most important component in aspic is the natural collagen
- Vitamin B helps in the production of hemoglobin. It can be "obtained" by eating bananas, nuts, cabbage and potatoes. It is worth getting carried away by herbs and legumes. They will be the source of folic acid. Liver, mushrooms, dairy products and eggs will be useful. They are rich in riboflavin.
By following the treatment regimen prescribed by the doctor, it is possible to achieve that the disease regresses and the damaged tissue begins to regenerate.
Prevention
Prevention of osteoarthritis begins with proper nutrition. It is necessary to try to reduce salt intake, as well as food which can disrupt the metabolism. These include legumes, fatty meats, and alcohol. The diet includes cabbage, vegetables and fish.
For the prevention of osteoarthritis, it is necessary to attend physical education courses, warm up. If possible, it is best to walk a few kilometers. It is also important to monitor weight and prevent weight gain, as this will increase the stress on sore joints. It is not recommended to take weight loss pills, as they can disrupt the body's metabolism.
Forecast
The outlook for life is favorable. Facilitating the social and occupational prognosis depends on the timeliness of diagnosis and the initiation of treatment; decreases when the decision on the question of surgical treatment of the disease is delayed, if necessary.