Arthrosis

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 and carry out daily activities.However, any movement of the body creates a certain load on the musculoskeletal system and can potentially turn into a traumatic situation, resulting in premature wear of the joints.This is how arthrosis of the joints occurs - one of the most common diseases on the planet.Despite its wide spread, not everyone knows its main manifestations and danger, 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, because experienced doctors conduct a thorough 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 cartilaginous 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 every year.During the aging process, age-related changes occur in the musculoskeletal system, which are characteristic of most people over the age of 80.However, only a small part of them consult a doctor, preferring self-medication.It is this approach that significantly worsens the prognosis for recovery and also increases the possibility of disability.

The disease manifests itself approximately equally in both 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 those who practice traumatic sports).

Species

There are severalclassifications arthrosis: depending on the genesis, clinical forms and localization.Each of them has its own clinical significance;in practice, classification based on the location of the lesion is more required.

Osteoarthritis of the lower limbs

• 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 system occurs.When inflammation occurs, the effect of complete 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 (first appearing in the late afternoon and at night, but then becoming permanent, radiating to the inguinal 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 often 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 injury than others.There are different types: patellofemoral and tibiofemoral.The first occurs after an injury to the patellofemoral joint.In the initial stages it is asymptomatic, since the joint has a large amount of cartilage responsible for shock absorption.Their presence prevents bone injuries.Subsequently, the patient begins to notice knee pain after physical activity, which gradually becomes permanent (often intensifies when the weather changes).Synovitis is often associated with the pathology, characterized by intense, almost unbearable pain.The tibiofemoral type is diagnosed very rarely and has a more favorable prognosis.It is characterized by pain sensations that radiate to the lower part of the body (usually the feet).
• Heel— degenerative-dystrophic changes may be observed in the area of the subtalar or talonavicular joints after an injury or disease.It also does not manifest itself clinically for a long time, but over time it starts to become painful and aching in nature.

Osteoarthritis of the upper limbs

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

• Osteoarthritis of the shoulder joint.As a rule, it occurs after an injury and against the background of microtraumas in professional athletes.Sometimes diagnosed in individuals whose profession involves physically demanding work.The acromial type of disease is a consequence of injury and inflammation.Initially it goes unnoticed, but as it progresses, painful sensations appear in the injured shoulder area.Patients notice limited mobility and a creaking sound during movement.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.The symptomatic picture includes elbow pain during flexion and extension of the upper limb and limited mobility.
• Arthritis 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 injury 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.It is most often found in people who do small jobs (embroidery, knitting, etc.).Excessive growth of bone tissue is observed, leading to the formation of Heberden's and Bouchard's nodes.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 and microtraumas over a long period of time.Most chronic inflammation (arthritis), one way or another, turns into a degenerative-dystrophic process with constant inflammatory relapses.The age group of arthritic subjects, which represents the largest number of patients with this diagnosis, deserves particular attention.

Although there is no single genesis of this disease, there are numerous factors that predispose it.Among these, the most important from a clinical point of view 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 areas).
• Large body weight(your joints simply can't handle that weight).
• Venous insufficiency.
• Related to the professionwith constant positionwithout any movement.
• Hormonal disorders and damage to the endocrine system(diabetes mellitus, atherosclerosis of blood vessels, obesity, etc.).
• Bad nutrition(insufficient daily intake of fats, proteins, carbohydrates, vitamins and microelements).
• Smoking and alcohol abuse.
• Encumbered inheritance.

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 it breaks down completely.The subchondral bone tissue comes into contact with the surface of the bone, causing its destruction by friction.The protective reaction of bone tissue is its proliferation (especially along the joint edges), which significantly limits the mobility of the joint and leads to its deformation.

Joint cells have a peculiarity: they give a rapid response to any injury, even minor ones.Damaged cells actively synthesize anti-inflammatory cytokines, which is why cartilage and bone destruction is characterized by aseptic inflammation in the synovium.Frequent relapses of the pathology lead to a worsening of inflammation, so the cells of hard tissues begin to die even faster, which contributes to the progression of the disease.

Symptoms

Osteoarthritis can occur for a long time without the slightest clinical sign.Patients live without even suspecting that active degenerative-dystrophic changes are occurring in their joint.As a rule, the first symptoms appear at the height of the pathology or after inflammation has occurred.There are different types of symptoms, depending on the time they occur and the characteristics of the manifestation.

First signs

A person begins to feel pain in the area of \u200b\u200bthe damaged joint after physical activity (playing sports, jogging, walking without stopping, climbing stairs and much more).In the morning, after a long stay in the immobile state, the first “initial sensations of pain” appear, combined with a slight stiffness.To eliminate limited mobilityyou have 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 attention in the early stages.Many people start to self-medicate and try different treatment methods, which can only make the current situation worse.However, it is in the early stages that this disease has the most favorable prognosis and a high probability of complete recovery without consequences.Therefore, it is strongly recommended that you make an appointment with a doctor if you notice sensations 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 are unable to sleep completely;many (especially in advanced age) notice bone pain and muscle pain.The pain will spread throughout the limb and radiate to surrounding areas.People with this problem tire quickly when walking even short distances and suffer from difficulty bending and stiffness in the joints.Many people notice instability in the damaged limb, which is why they develop an uncertain and gentle gait.

Knee arthrosis is manifested by a characteristic crunch, which is formed as a result of friction of the joint surfaces against each other.The knee gradually begins to deform due to the growth of bone tissue along the edges.Patients try to limit any movement, which leads to muscle atrophy.This, in turn, makes the gait even more unstable and cautious.Osteoarthritis of the upper limbs is usually a consequence of injury or chronic arthritis.The most obvious deformation is observed in the interphalangeal joints of the hand.Bouchard's and Heberden's nodes form on the fingers and the hand itself becomes square.

Dangerous symptoms

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

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

Degrees

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

• Zero.A person does not feel any pain or discomfort while walking (even for long distances).No pathological changes are detected on the X-ray image.
• Initial (doubtful).When walking for a long time, a moderate, dull pain appears.Some patients notice a slight creaking 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 along 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 obvious narrowing of the joint space and a small amount of bony growths (osteophytes).
• Moderate (degenerative).Painful sensations occur not only in the morning, but also at night.Myalgia and bone pain occur.Patients sleep poorly and often notice swelling of the affected joint.X-rays reveal progression of joint space narrowing and proliferation of osteophytes, as well as increased bone density.
• Heavy (deforming).The pain syndrome becomes permanent and is not always relieved by taking painkillers.The pain increases with any movement;when folding you will hear a loud creaking sound.Muscle atrophy and joint deformity also develops.An X-ray 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 independencefirst aidcan be done using the following methods:

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

Diagnostics

To make a diagnosis, high-precision examination methods are used to identify even small pathological changes.In the clinic, specialists carry out a thorough examination of the patient, allowing them to visually and palpably determine the current state of the joint (external signs of inflammation: swelling, redness of the skin, pain, hyperemia).Subsequently, laboratory and instrumental diagnostics are prescribed, which allows us 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.
• Intake of intraarticular fluidto detect the infection and its sensitivity to antibiotics.

Instrumental diagnostics involves the following procedures:

1. Ultrasound and magnetic resonance imaging of the joint.It allows you to detect changes in the articular and periarticular soft tissues.
2. X-ray and CT.It is highly informative when looking for changes in bone tissue.Today this is the diagnostic method of choice, fundamental for diagnosing arthrosis.
3. Arthroscopy.It is performed if there are indications indicating the presence of inflammation.
4. Scintigraphy.It involves the administration of radiopharmaceuticals to evaluate the condition of the bones and the metabolism in them.

Drug therapy

Prescription medications are aimed at relieving pain, suppressing its progression and restoring joint function.To combat pain, the following are used:

• Painkillers from the NSAID group.The type of drug, its form of release 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 painkillers.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.In 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.
• Pain relief blocks.As a rule, they are used for severe acute pain that cannot be eliminated by taking the drugs described above.In this case, solutions are used that are injected into the most painful places.

Treatment of osteoarthritisthe knee or any other joint cannot be treated without taking medications that help restore joint function.To this end, the following are appointed:

• Chondroprotectors.Taking them restores cartilaginous tissue and improves blood circulation within it.It is taken 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 purpose is to improve the viscosity of the synodal fluid and prevent trauma to the articular surfaces of the bones.

Non-pharmacological therapy

It's important to understand thistaking medications- this is not a panacea and is not the only way to recover.To eliminate pain, increase joint mobility and improve the quality of life, it will be necessary to devote a sufficient amount of 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 by sticking to daily workouts.To achieve the desired result, you must adhere to the following training rules:

1. Lessons must take place 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 arthrosis 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.

Physiotherapy is indicated for osteoarthritis.It helps improve well-being and fights possible complications of the disease.Physiotherapy procedures include:

1. Electrophoresis or phonophoresis with analgesic drug solutions.
2. Heating applications with paraffin(carried out exclusively in the absence of an inflammatory process).
3. Darsonvalidation- exposure to high and low frequency electric currents to stimulate blood circulation and muscle relaxation.
4. Magnetotherapy and laser therapy.
5. Electrical stimulation.This is an effective physiotherapy aimed at restoring muscle volume and strength.

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

Prevention

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

• Active lifestyle.Even if your professional activity involves long periods of sitting or standing still, it is necessary to dedicate time (at least a few minutes a day) to a simple warm-up.
• Regular exercise or visit the pool.These are excellent general strengthening sports that will help you keep your muscles and musculoskeletal system in a healthy tone.
• Correct 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 the consumption of foods rich in omega-3 (fish, red game, avocado, nuts, flax seeds, etc.) and collagen (gelatin, rich soups, etc.).
• Check your body weight.It is necessary to maintain 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

Arthritis of the jointsThis is a fairly 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 many 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 duration of treatment and compliance with medical recommendations.An early medical consultation allows you to identify the first degenerative changes and eliminate them promptly.Therefore there is no need to self-medicate or postpone a visit to the doctor.If you notice the first symptoms of joint disorders, you need to immediately visit a doctor and undergo a thorough diagnosis.