Osteoarthritis

Throughout his life, a person is in constant movement.Thanks to this, it is possible to adapt quickly and effectively to changes in the environment, explore the world, move around and carry out everyday activities.However, any movement of the body creates a certain load on the musculoskeletal system and can potentially become a traumatic situation, resulting in premature wear and tear on the joints.This is how joint arthrosis occurs - one of the most common diseases on the planet.Despite its wide prevalence, not everyone is aware of its primary manifestations and dangers, which is why they seek medical help in the later stages.This can lead to serious health problems, including disability.A timely visit to specialists will allow you to avoid these problems, as experienced doctors carry out a complete diagnosis, allowing you to identify pathological changes in the early stages.

Osteoarthritis is a joint disease of a degenerative-dystrophic nature, with slow growth of the cartilage structure and proliferation of bone tissue.As a result of these pathological changes, deformation of the affected joint occurs, its mobility is impaired and severe pain occurs.According to official statistics, 10 to 20% of people in the world suffer from this pathology.These are quite significant indicators that increase annually.During the aging process, age-related changes in the musculoskeletal system occur, which are characteristic of most people over 80 years of age.However, only a small proportion of them consult a doctor, preferring to self-medicate.It is this approach that significantly worsens the recovery prognosis and also increases the chance of disability.

The disease occurs approximately equally in men and women.The risk group includes:

• Women over 50 and men over 40.
• People with a history of endocrine disorders and chronic arthritis.
• People whose profession involves heavy physical work or the need to remain in a stationary position for a long time.
• Professional athletes (especially weightlifters and trauma sports practitioners).

Species

There are severalratings arthrosis: depending on the genesis, clinical forms and location.Each of them has its own clinical significance;classification according to the location of the lesion is the most sought after in practice.

Arthrosis of the lower extremities

• Osteoarthritis of the hip joint- the most dangerous and serious type.Due to the anatomical features of the structure of this joint, it is here that the rapid development of degenerative-dystrophic disorders with damage to the musculo-ligamentous apparatus occurs.When inflammation occurs, the effect of total or partial immobility develops.This pathology often occurs due to the presence of congenital dysplasias, dislocations and osteochondropathy.It manifests itself in the form of pain (at first it appears in the late afternoon and at night, but then becomes permanent, radiating to the groin and gluteal region) and forced position of the lower limbs.
• Ankle- occurs quite often, as the ankle is forced to bear heavy loads every day.As a result, it is often injured, leading to degeneration.Ankle osteoarthritis usually occurs without significant symptoms, but as it progresses, pain appears during physical activity.Then the pain becomes constant, stiffness of movements and complete immobility are added (rarely, in the absence of timely and adequate treatment).
• Osteoarthritis of the knee joint- the most common variety.It is the knee that bears the greatest load, which is why it is more susceptible to injuries than the others.There are several types: patellefemooal and tibiofemoral.The first occurs after injury to the patellofemoral joint.In the initial stages it is asymptomatic, as the joint has a large amount of cartilage responsible for absorbing shocks.Its presence prevents bone injuries.Later, the patient begins to experience knee pain after physical activity, which gradually becomes permanent (often intensifying when the weather changes).Synovitis, characterized by intense and almost unbearable pain, is often associated with pathology.The tibiofemoral type is diagnosed extremely rarely and has a more favorable prognosis.It is characterized by painful sensations that radiate to the lower part of the body (usually the feet).
• Jump— degenerative-dystrophic changes may be observed in the area of the subtalar or talocalcaneo-navicular joints following injury or disease.It also does not manifest itself clinically for a long time, but over time it starts to become painful and painful in nature.

Osteoarthritis of the upper extremities

Suchlocation of the diseaseoccurs less frequently than in the lower extremities.These are:

• Arthrosis of the shoulder joint.As a rule, it occurs after injury and against the background of microtrauma in professional athletes.Sometimes diagnosed in individuals whose profession involves physically demanding work.The acromial type of the disease is a consequence of injury and inflammation.Initially it goes unnoticed, but as it progresses, painful sensations appear in the area of the injured shoulder.Patients note limited mobility, as well as a crunching sound when moving.In the absence of timely treatment, partial ankylosis may occur.
• Elbow - diagnosed much less frequently.In most cases, this diagnosis is detected in certain professions: miners, blacksmiths and people who work with vibrating tools.Symptoms include pain in the elbow when flexing and extending the upper limb and difficulty moving.
• Arthrosis of the hand joints.As a rule, it is diagnosed in the carpometacarpal joint of the 1st finger (it is this joint that is most susceptible to injuries in everyday life).It is characterized by a dull pain on the outer surface of the palm, which may radiate to the thumb.
• Osteoarthritis of the finger joints.Most often found in people who perform small jobs (embroidery, knitting, etc.).Excessive growth of bone tissue is observed, leading to the formation of Heberden's and Bouchard's nodules.Patients rarely report joint pain (sometimes when the weather changes) and stiffness in movement.

Reasons

There is no single etiological factor that leads to the development of this pathology.Arthrosis is a disease that begins to manifest itself slowly against the background of congenital structural features of connective tissue, previous diseases, as well as microtraumas over a long period of time.Most chronic inflammations (arthritis), one way or another, turn into a degenerative-dystrophic process with constant inflammatory relapses.The osteoarthritis age group, which concentrates the largest number of patients with this diagnosis, deserves special attention.

Although there is no single genesis for this disease, there are several factors that predispose it.The most clinically important among them are:

• Sedentary lifestyle(sedentary work, laziness and much more).
• Excessive physical activityphysically hard work, professional sport (sports injuries have a negative impact on health in all sectors).
• Large body weight(the joints simply can't support that much weight).
• Venous insufficiency.
• Related to the professionwith constant foot, without any movement.
• Hormonal disorders and damage to the endocrine system(diabetes mellitus, atherosclerosis of blood vessels, obesity, etc.).
• Poor nutrition(insufficient daily intake of fats, proteins, carbohydrates, vitamins and microelements).
• Smoking and alcohol abuse.
• Overloaded heredity.

Due to the influence of one or more of the factors listed above, the gradual destruction of the cartilaginous tissue covering the articular surface of the bone begins.First, it becomes thinner, less elastic and then completely cracks.The subchondral bone tissue comes into contact with the surface of the bone, causing its destruction through friction.The protective reaction of bone tissue is its proliferation (especially along the articular edges), which significantly limits the mobility of the joint and leads to its deformation.

Joint cells have a peculiarity - they quickly respond to any, even mild, injury.Damaged cells actively synthesize anti-inflammatory cytokines, which is why the destruction of cartilage and bones is characterized by aseptic inflammation in the synovium.Frequent relapses of the pathology lead to an aggravation of inflammation, so that hard tissue cells begin to die even faster, which contributes to the progression of the disease.

Symptoms

Arthrosis can occur for a long time without the slightest clinical signs.Patients live without even suspecting that active degenerative-dystrophic changes are occurring in their joints.As a rule, the first symptoms appear at the height of the pathology or after the onset of inflammation.There are several types of symptoms, depending on the time of occurrence and the characteristics of manifestation.

First signs

A person begins to feel pain in the damaged joint area after physical activity (playing sports, running, walking without stopping, climbing stairs and much more).In the morning, after a long stay in a motionless state, the first “initial painful sensations” appear, combined with slight stiffness.To eliminate limited mobilityyou need to warm up for a certain time.The pain is aching or dull in nature and is not very intense.Due to the lackluster clinical picture, patients rarely seek medical advice in the initial stages.Many people begin to self-medicate and try different treatment methods, which can only worsen the current situation.However, it is in the initial stages that this disease presents a more favorable prognosis and a high probability of full recovery without consequences.Therefore, it is highly recommended that you make an appointment with a doctor if you notice any sensation in your joints.

Obvious symptoms

The pain gradually increases, intensify with climate change.They occur not only in the morning, but also persist throughout the day.Patients cannot sleep completely;many (especially in old age) notice pain in the bones and muscles.The pain will spread throughout the limb and radiate to the surrounding areas.People with this problem get tired quickly when walking, even short distances, and suffer from difficulty bending and stiff joints.Many people notice instability of the injured limb, which is why they develop an insecure and smooth gait.

Knee osteoarthritis is manifested by a characteristic crunch, which is formed as a result of the articular surfaces rubbing against each other.The knee gradually begins to deform due to the growth of bone tissue at the edges.Patients try to limit any movements, which leads to muscle atrophy.This, in turn, makes walking even more unstable and cautious.Osteoarthritis of the upper extremities is usually the result of injury or chronic arthritis.The most notable deformation is seen in the interphalangeal joints of the hand.Bouchard's and Heberden's knots form on the fingers and the hand itself becomes square.

Dangerous symptoms

Due to the fact thatdegenerative dystrophic changesdevelops gradually and over a long period of time, the appearance of even dangerous clinical signs may go unnoticed.This significantly worsens the current situation and worsens the recovery prognosis.These symptoms are:

• Swelling and constant pain in the limbs- indicates active inflammation requiring urgent medical intervention.
• Joint deformity, due to which the gait changes or it becomes impossible to perform the usual movements.
• Myalgia and bone pain.
• Unstable gait, severe limitation of mobility during flexion and extension.
• The pain becomes constant, which does not diminish at dusk or at night, radiating into the surrounding areas.

Degrees

In orthopedic practice, it is customary to distinguish clinical and radiological degrees of arthrosis according to the Kellgren-Lawrence classification:

• Zero.A person does not feel any pain or discomfort when walking (not even long distances).No pathological changes are detected on the X-ray image.
• Initial (doubtful).When walking for a long time, moderate and dull pain appears.Some patients notice a slight clicking sound when bending the limb.An X-ray examination reveals the first signs of pathology: narrowing of the joint space and small areas of bone defects at the edges.
• Easy.The pain syndrome becomes more pronounced and appears in the morning along with stiffness.The pain increases with movement.An x-ray reveals a clear narrowing of the joint space and a small amount of bone growths (osteophytes).
• Moderate (degenerative).Painful sensations occur not only in the morning, but also in the evening.Myalgia and bone pain occur.Patients sleep poorly and often notice swelling in the affected joint.Radiographs reveal the progression of joint space narrowing and the proliferation of osteophytes, as well as an increase in bone density.
• Heavy (deformed).The pain syndrome becomes permanent and is not always relieved by the use of analgesics.The pain increases with any movement;a strong crunching sound is heard when bending.Muscle atrophy also develops and joint deformity develops.Radiographic examination reveals a strong narrowing of the joint space and significant growth of the edges of the articular surface, which caused deforming changes.

Exacerbation

All degenerative diseases are characterized by a slow, often asymptomatic course (especially in the early stages).An increase in pain is observed when weather conditions change (humidity, wind or drop in temperature) and when the inflammatory process begins.Inflammation is characterized by swelling, hyperemia of the skin, pain and swelling.Therefore, if signs of an inflammatory process appear, you should immediately seek qualified medical help.Provide independentFirst aidcan be done using the following methods:

1. Take any pain medication.
2. Apply ointment or gel with an anesthetic effect to the skin.
3. Keep the limbs in a stationary position (until the pain disappears).

Diagnosis

To make a diagnosis, high-precision examination methods are used that make it possible to identify even minor pathological changes.In the clinic, specialists carry out a thorough examination of the patient, allowing you to visually and palpably determine the current state of the joint (external signs of inflammation: swelling, redness of the skin, pain, hyperemia).After that, laboratory and instrumental diagnostics are prescribed, which make it possible to obtain a complete picture of the extent of the lesion.Laboratory tests include:

• General, biochemical and immunological blood test.Changes in the blood can confirm the presence of inflammation, as well as establish the cause of the disease (metabolic disorders, autoimmune reactions, etc.).
• C-reactive protein.
• Taking intra-articular fluidto detect infection and its sensitivity to antibiotics.

Instrumental diagnosis involves the following procedures:

1. Ultrasound and magnetic resonance imaging of the joint.It allows detecting changes in articular and periarticular soft tissues.
2. X-ray and computed tomography.It is highly informative in searching for changes in bone tissue.Today this is the preferred diagnostic method, fundamental for diagnosing osteoarthritis.
3. Arthroscopy.It is performed if there is evidence of the presence of inflammation.
4. Scintigraphy.It involves the administration of radiopharmaceuticals to assess the condition of the bones and their metabolism.

Drug therapy

Prescribing medications aims to alleviate pain, suppress its progression and restore joint function.To combat pain, the following are used:

• Analgesics from the NSAID group.The type of medicine, its release form and dosage are selected individually by the doctor.The choice depends on the severity of the pain, age, gender and other factors.The most commonly prescribed medications contain pain relievers.They are usually taken orally in tablet form, but injections or ointments can also be used.
• Muscle relaxants.They are necessary to relieve spasm of the periarticular muscles.This way it is also possible to reduce pain and restore normal blood circulation in the joint.
• Neurotropic B vitamins.This is the sociable component of basic therapy.B vitamins help normalize the functioning of the peripheral nervous system and also inhibit pain.
• Analgesic blocks.As a rule, they are used for severe acute pain that cannot be eliminated by using the medications described above.In this case, solutions are used that are injected into the most painful places.

Osteoarthritis treatmentknee or any other joint cannot be treated without taking medications to help restore joint function.To this end, the following are appointed:

• Chondroprotectors.Taking them restores cartilaginous tissue and improves blood circulation in it.It is administered in the form of ointments, injections and tablets.
• Hyaluronic acid.The medicine is injected directly into the joint cavity, ensuring the fastest possible onset of the therapeutic effect.Its main objective is to improve the viscosity of the synodal fluid and prevent trauma to the articular surfaces of the bones.

Non-drug therapy

It is important to understand thattaking medications- this is not a panacea and is not the only way of recovery.To eliminate pain, increase joint mobility and improve quality of life, it will be necessary to devote sufficient time to non-drug treatment methods.It is necessary to maintain the correct balance between adequate physical activity and adequate rest.You can achieve this result by following daily exercises.To obtain the desired result, you must adhere to the following training rules:

1. Classes must be held every day, regardless of health, mood, weather, life circumstances and other factors.
2. All movements are performed extremely smoothly and slowly.
3. If the pain intensifies during training, stop training.

Regardless of the degree of osteoarthritis of the knee joint, the patient needsstop running(especially over short distances at high speed), jumping, outdoor games (football, basketball, volleyball, etc.), weight lifting (barbell, etc.), long periods of immobility.The best option in this case would be swimming, yoga (preferably with an instructor who knows about joint problems) and Pilates.

For osteoarthritis, physiotherapy is indicated.It helps improve well-being and combats possible complications of the disease.Physiotherapeutic procedures include:

1. Electrophoresis or phonophoresis with analgesic solutions.
2. Heating applications with paraffin(carried out exclusively in the absence of an inflammatory process).
3. Darsonvalidization- exposure to high and low frequency electrical currents to stimulate blood circulation and muscle relaxation.
4. Magnetic and laser therapy.
5. Electrical stimulation.This is an effective physical therapy that aims to restore muscle volume and strength.

It is also possible to carry out hirudotherapy - treatment with leeches.The saliva of these animals contains a large number of enzymes that dilate blood vessels and normalize metabolic processes.Additionally, it helps dissolve necrotic tissue and clean joint cavities.

Prevention

Dealing with osteoarthritis, as well as its consequences, is quite difficult.However, it is much easier to avoid it.To do this, just follow simple recommendations that will help protect healthy joints for many years.Among them:

• Active lifestyle.Even if your professional activity involves long periods of sitting or standing still, you need to set aside time (at least a few minutes a day) for a simple warm-up.
• Regular exercise or visiting the pool.These are excellent general strengthening sports that will help keep your muscles and musculoskeletal system in good shape.
• Adequate and rational nutrition.It is extremely important to monitor your daily diet.It should include a sufficient amount of proteins, fats, carbohydrates, microelements and vitamins.It is worth increasing your consumption of foods rich in omega 3 (fish, red game, avocado, nuts, flaxseed, etc.) and collagen (jellies, rich soups, etc.).
• Monitor your body weight.It is necessary to keep your weight within normal limits, avoiding the development of obesity (for this you also need to exercise and eat well).
• Wear comfortable shoes.
• Stop playing sportsaccompanied by a high risk of injury.

Conclusion

Osteoarthritis of the jointsThis is a rather serious disease that can lead to serious consequences and complications.However, you can fight it, live a full life and do your daily work.Modern medicine offers various therapeutic techniques aimed at improving the condition of patients and restoring their motor functions.However, it is important to remember that the quality of life with osteoarthritis depends on the length of treatment and compliance with medical recommendations.Early medical consultation allows you to identify the first degenerative changes and eliminate them in a timely manner.Therefore, there is no need to self-medicate or postpone going to the doctor.If you notice the first symptoms of joint disorders, you should immediately consult a doctor and undergo a full diagnosis.