arthrosis

The surfaces of the bones that form the joint are covered with a special, hyaline cartilage - smooth, providing the least frictional force during the motor skills of the joint surfaces. If osteoarthritis is diagnosed, it means that the cartilage is in the process of destruction.

As it progresses, the destructive process spreads to the bones and then to the joint capsule.

The disease has a universal code for microbes 10 - M15-M19, classifying it as a class of pathologies of musculoskeletal and connective tissue.

According to medical statistics, 12% of the world's population suffers from osteoarthritis, most of whom are elderly people over the age of 65. However, every year there is an alarming trend of increasing cases among young people.

The diagnosis is not fatal, but osteoarthritis is insidious with its recurrence and the threat of complete disability.

Mechanism of origin

The disease develops gradually, we can conditionally distinguish four stages:

1. Initially, a section of cartilage that is poorly supplied or damaged appears at the site of the cartilage. Gradually, in the presence of traumatic factors, the area does not recover, but, on the contrary, grows.
2. The body, trying to repair the collapsing cartilage, replaces the damaged areas with mineralized tissue that has no clear structure. Such tissue is generally a lower substitute for smooth, slippery and elastic hyaline cartilage.
3. Gradually the surface of the cartilage is covered with scars and bone growths - osteophytes.
4. Healthy areas from the load, increased several times, wear out very quickly and as a result, all the cartilage tissue becomes a big scar.

If the pathological process is not stopped, the joint will undergo the following adverse changes:

• bones are involved in the process of destruction;
• the synovial membrane becomes inflamed;
• the joint capsule becomes denser, loses its elasticity;
• the lumen of the joint space decreases rapidly;
• bones unable to withstand friction are deformed, as is the joint as a whole;
• the tissues of the joint are regenerated, thus there is a complete loss of the ability to move.

Types of osteoarthritis

This disease affects absolutely every joint surface! At the same time, despite the same mechanism of pathology, it is classified into several types.

So, depending on which joints are sick, they distinguish:

• osteoarthritis of the knee or patellofemoral osteoarthritis (abbreviated gonarthrosis);
• osteoarthritis of the hip (abbreviated as coxarthrosis);
• osteoarthritis of the shoulder joint;
• interphalangeal arthrosis;
• arthrosis of the ankle joint;
• osteoarthritis of the hands;
• cervical osteoarthritis;
• maxillary arthrosis;
• arthrosis of the metatarsophalangeal joint;
• arthrosis of the ilium;
• clavicular-acromial arthrosis;
• temporal arthrosis;
• arthrosis of the heels;
• arcuate osteoarthritis affecting the arcuate vertebrae (abbreviated as spondyloarthritis);
• arthrosis of the facet articulation of the joints of the spine;
• uncovertebral arthrosis;
• osteovertebral osteoarthritis;
• talonavicular arthrosis.

According to the specifics of the course of the pathological process in the cartilage tissue differ:

• deforming arthrosis is the name of a disease that has passed into a terminal (final) stage;
• arthrosis, - the presence of a classic inflammatory process is characteristic;
• chronic;
• acute osteoarthritis.

According to the causes of the pathology there are:

• dystrophic arthrosis of the joints associated with a critical metabolic disorder;
• osteoarthritis of the fracture caused by the respective injuries;
• post-traumatic osteoarthritis.

It is important to know! There is no arthrosis of the internal organs, for example, arthrosis of the heart is not a type of disease, but a consequence: a violation of cardiac activity due to destruction of cartilage in the chest.

There is another classification according to whether the disease is independent or caused by provoking factors:

• primary - occurs on completely healthy cartilage, another name - idiopathic osteoarthritis, or appears with age-related senile changes;
• secondary - caused by many reasons.

Symptoms of osteoarthritis

There are quite typical signs of osteoarthritis from all localizations, which depending on the degree of development of the pathology differ in severity:

• pain, pain syndrome aggravated by high humidity and hypothermia;
• reduced joint mobility;
• popping, squeaking and scraping sounds during movements of the joint surfaces;
• external changes in the contours of the joint;
• puffiness and swelling;
• redness of the skin.

pain

The most initial signs of disorders are felt by mild or moderate, short-term pain, which almost never occurs at night, but usually occurs only when the joint surface is loaded.

When the inflammatory processes pass into their final stage, the patient begins to feel unbearable, "biting" pain due to blood stasis and increased pressure in the joint bag. The pain is characterized by prolonged duration, at any time of day and whether the affected area is inat rest or on the move.

joint stiffness

This symptom is typical of a very advanced disease. At the same time, in the early stages, the patient still feels in the morning, after waking up, discomfort when moving in the form of a feeling of some stiffness.

As the destructive reactions progress, the patient notices:

• limiting the amplitude of normal movements;
• inability to change the position of the limbs at rest, even when trying to manually unfold the joint;
• strong fixation (contracture) in a certain position of the joint, which has long been in a state of lack of motor activity.

After all, in the fourth stage of the pathology, ankylosis is formed in the form of replacement of joint tissues with scars, with complete loss of functionality.

Sounds in the joint

Crunching can be accompanied by any dysfunction of the bones and cartilage, not just caused by osteoarthritis.

However, this disease is characterized by the sound:

• occurs only in the joint that hurts;
• accompanied by difficulty moving;
• tends to increase with the progression of the pathology and enters during the formation of ankylosis.

Changing the appearance of the joint

Noticeable changes appear in the later stages. So, the axis of the affected limb is bent, and the joint area itself is disfigured - it grows in size, the shape changes ugly.

All this indicates the irreversible destruction of the joint, inside which a new, without a specific structure, tissue has formed.

If such a disease occurs in the knee, then the load on the ankle and metatarsophalangeal joints will increase, which will damage them over time.

If the externally deformed part of the body is also swollen or swollen, this means inflammation of the synovial membrane, due to which synovial fluid accumulates in large quantities in the joint bag, causing severe pain.

Causes of osteoarthritis

The pathology can occur in one joint or spread to several. This disease rarely occurs at a young age - there is still enough vitality for self-healing of the body.

However, for all age groups, the reasons for their exposure are:

• internal - some diseases, bad habits, unbalanced diet, etc. ;
• external, - injuries, occupational factor.

Internal causes are factors that provoke a negative change in the joint in the form of inflammation of the joint. There are inflammations of various origins:

• infectious (E. coli and Koch's bacillus, viruses, chlamydia, staphylococci, Treponema pallidum, etc. );
• rheumatism;
• purulent arthritis;
• autoimmune nature;
• gout;
• psoriasis.

In addition, causes of internal exposure include congenital or acquired disorders of cartilage structure and malnutrition, which may be related to:

• genetic failures and mutations;
• abnormalities of intrauterine development, including perinatal trauma;
• old age;
• osteoporosis, ie "washing" of the constituent elements of bone tissue;
• hormonal disorders and overload, including menopause;
• disorders of normal metabolism;
• nutritional deficiencies of vitamins and minerals;
• diseases that cause muscle weakness;
• prolonged internal intoxication.

Exacerbation of many diseases of the musculoskeletal system also leads to degeneration of cartilage.

External causes of the disease are factors that damage the joint, such as:

• frequent hypothermia;
• sprains;
• strong blows;
• fractures;
• meniscus injury;
• strenuous physical activity (weightlifting, for example);
• professional sports;
• joint surgery.

Degrees of osteoarthritis

According to the clinical manifestations and the process of disease progression, four stages of arthrosis are distinguished:

1. 1st degree osteoarthritis, this is the initial stage of osteoarthritis, which is characterized by latent symptoms in the form of negative changes in the composition of synovial fluid and weakening of muscle fibers, if pain occurs, it is only during exercise;
2. 2nd degree arthrosis - this is already a feeling of pain due to bone breakdown and the formation of osteophytes, reflex neurotrophic regulation is disrupted and crunch occurs;
3. 3rd degree arthrosis is characterized by significant degenerative changes in the joint, its visible deformation with curvature of the limb axis, ligaments are shortened and the joint becomes pathologically mobile;
4. Grade 4 osteoarthritis is complete ankylosis, complete contracture and severe pain even at rest.

All four stages are uneven: abrupt exacerbations and moments of remission are possible during the pathological period.

Treatment of osteoarthritis

It has been clinically proven that treatment and prevention in the form of elimination of provoking factors of hyaline cartilage damage, although they do not alleviate the disease in the initial stage, stop its development and restore joint function.

In general, the disease of mild to moderate severity is treated with conservative methods. In case of severe destruction of the cartilage surface, which led to the destruction of the bones, surgical arthroplasty is indicated.

In this case, the main principles of treatment are:

• an integrated approach that involves the use of several therapeutic methods;
• purposefulness, ie concentrating efforts on eliminating disease-provoking factors and consequences.

Treatment with folk remedies

By treating it comprehensively, but at home, you can additionally resort to healing recipes of folk healers, offering effective treatment of health problems through herbs and bee products.

From plants use:

• bay leaf in the form of decoctions, tinctures of vodka and specially prepared oils used externally, directly on the area of inflammation;
• treatment of osteoarthritis with honey has established itself as a reliable topical drug that relieves inflammation in the form of friction and nourishes the skin, muscles and cartilage;
• cabbage leaf - better than white cabbage - knead it a little and wrap it around the sore spot, warm it with a woolen cloth on top and keep it overnight;
• aloe juice in the form of compresses and rubbing into the skin;

Burdock also helps treat osteoarthritis of the knee: the leaf is bandaged to the affected area, which is isolated overnight.

It is important to know! Using phytotherapy, it is necessary to enhance the effect, forget about bad habits and take care of proper nutrition.

Medicines for osteoarthritis

Drug treatment associated with the classical method of therapy is divided depending on the dosage form used:

• external use in the form of ointment for osteoarthritis, rubbing, lotions;
• injections;
• osteoarthritis pills;
• capsules.

Ointments

The pharmaceutical industry produces medical ointments based on natural, highly active ingredients:

• heparin ointment.

A remedy containing 1% diclofenac helps well: the gel is applied to the skin.

Injections

Injections have proven to be very good in treatment not only intravenously and intramuscularly, but also directly in the affected area, for example with non-steroidal drugs.

Thus, intra-articular injections are injected into damaged joint tissues:

• glucocorticoids, which improve the nutrition of cartilage tissue, relieve inflammation and increase elasticity;
• chondroprotectors and analogues of intra-articular fluid;
• hyaluronic acid as a lubricant and painkiller.

Preparations in the form of tablets and capsules

A special group in drug therapy are the so-called chondroprotectors for osteoarthritis, which contain the structural elements of hyaline cartilage and thus restore it.

These medicines are available as tablets and capsules for oral use in the gastrointestinal tract (orally).

In addition, patients are prescribed NSAIDs - anti-inflammatory drugs for osteoarthritis of the non-steroidal group, stopping acute pain and relieving exacerbations.

Analgesics are also used in the form of novocaine blockade.

In addition, complex vitamins are prescribed for osteoarthritis.

Of natural preparations with local action, medical bile is recommended, applied in the form of compresses on the skin.

Exercises for osteoarthritis

Special exercises and therapeutic gymnastics (LGG) have proven to be excellent, the complex of which gives physical activity to the unhealthy part of the body in a gentle, dosed way.

Dr. Bubnovski and Evdokimenko developed their own sets of therapeutic exercises.

It is important to know! Exercise is very effective in restoring health, but only if you resort to them at the very beginning of the disease!

Massage for osteoarthritis

Very beneficial effect on the treatment and therapeutic massage, which improves microcirculation and nutrition of deep tissues.

Diet for arthritis

In this condition, it is important to adhere to proper, rational nutrition to slightly improve the patient's condition. It is recommended to refrain from overeating, exclude animal fats and fried foods.

It is important to know! In addition, in the fight for healthy cartilage it is necessary to use physiotherapy in the form of magnetic therapy, electrophoresis, paraffin and therapeutic mud wraps.

Which doctor treats arthritis

First of all, with complaints of pain in the joints of the bones, you should go to the therapist. It is he who, after summarizing the patient's history and asking him in detail, will give direction to the necessary narrow specialist.

These may be, depending on the cause of the disease and its type, doctors of such profiles as:

• orthopedist;
• traumatologist;
• surgeon;
• rheumatologist.