Joint arthrosis is a chronic joint disease that develops as a result of metabolic disorders. As a result, degenerative, dystrophic changes and the destruction of cartilage tissue occur.
It occurs imperceptibly, but often develops very quickly. A person feels pain in the joints during movement, there is a decrease in stiffness and mobility, especially in the morning, while it is still "not opposite". If there are unpleasant sensations and periodic pain during awkward movements or loading, then it is very important to understand 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 limitations. The development of the disease is like an avalanche and the treatment is most often associated with unbearable pain, which is a clear sign of wear and tear on the joints.
The symptoms of arthrosis of the joints depend on how much the joint, cartilage tissue and nearby tissues are affected.
At the initial stage, arthrosis can be determined quite precisely, the treatment in this case is gentle and does not require serious intervention and expensive drugs for the treatment of arthrosis.
Types of arthrosis
Arthrosis of the joints is classified according to several criteria. Depending on the extent of the arthrotic changes in the cartilage tissue, 4 stages of arthrosis are distinguished. Arthritis is divided into primary and secondary. The cause of primary arthrosis is age-related changes. Secondary arthrosis develops as a result of injuries and joint diseases (for example, traumatic arthrosis or rheumatoid arthrosis). The disease can develop slowly over years or lead to the destruction of the joint over a few years (progressive arthrosis).
There is moreTypes of arthrosis depending on the affected area:
- – knee joint arthrosis – hip joint arthrosis
- Uncovertebral arthrosis - arthrosis of the cervical vertebrae
- Vertebral arthrosis - damage to the spine
- Patellofemoral arthrosis is a type of gonarthrosis in which the patella and part of the femur suffer.
The degree of the disease is determined by the degree of damage to the cartilage tissue.
degree of arthrosis - the cartilage tissue is slightly damaged, the person does not feel discomfort;
Arthrosis II degree - osteophytes appear, the space between the cartilages decreases, positional pain occurs with awkward movements;
III degree arthrosis - the cartilage tissue is destroyed in some places and exposes the bone tissue, the gap 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 cracking during movement and slight background pain;
- Limitation of joint mobility, discomfort during full physical activity;
- "Bouncing" blood pressure indicators;
- Headache and dizziness;
- Spasmodic syndrome and often muscle spasms;
- Visually observed deformity of the joint;
- Swelling of the skin surface, hyperthermia or redness over the diseased joint;
- Violation of motor function.
Why the disease appears
Arthrosis of the joints can manifest itself in any department, but patients most often come to us when arthrosis of the knee or hip joints makes itself felt. In the professional field, shoulder joint arthrosis can be observed in addition to the special, specific load of the hand.
The lesions are different in men and women.The strong half often suffers from temporomandibular, wrist, ankle and lumbar arthrosis. Women tend to complain about the chest and neck regions, as well as the joints of the hands and big toes.
The type of disease is determined by the location of the injury. The following types exist:
- 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);
- spine disease - 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.
Arthrosis can appear as an independent disease or as a consequence of an already ongoing disease, so it is important to know a person's medical 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 narrow the joint space is. MRI or arthroscopy may also be necessary, but only in particularly complex and ambiguous cases. Usually, an X-ray of the joints is sufficient to diagnose the disease.
In order to understand the presence and severity of the disease, as well as what disorders led to the disease, a comprehensive diagnosis must be made.
First, with helpx-ray in different viewsto get information about the degree of damage to the joint.
Tomography (magnetic resonance or computer) helpstumor processes are excluded.
Third, you need ittake teststo understand whether arthrosis is an independent disease or a complication, as well as determine the general condition of a person.
The complex of studies is the most informative and gives a clear picture of degenerative-dystrophic changes and helps to choose the optimal treatment plan.
Treatment of arthrosis
As discussed above, arthrosis can develop due to many factors, and the treatment plan is formed based on the understanding of the root causes, and the drugs for the treatment of arthrosis are selected accordingly.
The treatment must be developed individually, based on the results of the diagnosis. Be sure to take into account the person's condition and existing illnesses.
The restoration of the joint surface and cartilage tissue is not fast. They prescribe effective drugs that have side effects. In order to achieve the desired result, it takes up to 6 months to take the medication, so it is important to protect your health from side effects as much as possible.
Medical treatment of arthrosis
The main goal of such therapy is to remove the manifestations of arthrosis. Drug treatment of joint arthrosis includes:
- Nonsteroidal anti-inflammatory drugs. During arthrosis, a person experiences pain, the joint becomes inflamed. In order to eliminate unpleasant symptoms and stop inflammation, this group of drugs is prescribed.
- Hormonal injections into the joint. Corticosteroid drugs are most often administered 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 of hyaluronic acid. Hyaluronic acid preparations are similar to synovial fluid, which provides gliding and smooth free movement in the joint. In the case of arthrosis, the joint fluid is not secreted enough, so the orthopedist often prescribes a hyaluronic acid injection (injection into the joint in case of arthrosis).
- Biological therapy of arthrosis (PRP and cytokine therapy). It is a new innovative method of arthrosis therapy, which has entered practice recently, but is becoming more and more popular. This is the application of drugs based on the patient's platelet-enriched blood plasma. Thanks to the biological therapy, the blood supply to the joint is activated, the production of intra-articular fluid is activated, and the supply of nutrients to the cartilage tissue is activated.
Important!Drug treatment of arthrosis is effective in the early stages of the disease. Experts also emphasize that drug therapy cannot restore the damaged joint, but it makes it possible to eliminate symptoms and slow down the progression of arthrosis.
Physiotherapy and other conservative treatments 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, to strengthen muscles.
In addition, in case of arthrosis, you only need to make a few changes to your lifestyle:
- Avoid overloading – it's important to evenly distribute activity and take breaks to avoid overstressing the joint
- Take care of your diet and watch your weight - as excess weight only worsens joint problems, you need to review your diet and reduce your weight
- Remember to be careful and avoid injury if possible
- Use additional support for movement - in the later stages of arthrosis, independent movement becomes questionable, so you need to use a cane or crutches. In order to walk more comfortably, you can also use orthopedic insoles - they reduce the load on the joint.
There are also many folk recipes that "help defeat arthrosis. "However, treating arthrosis at home does not always bring results. In addition, the use of all kinds of self-made body lotions and ointments most often causes only allergic reactions and does not affect the health of the joint.
Surgical treatment of osteoarthritis
How to treat arthrosis if all of the above methods do not work? In this case, surgical treatment of osteoarthritis is prescribed. The type of operation is selected depending on the degree of damage to the joint and the individual characteristics of each patient.
Joint arthroscopy is a low-traumatic intervention, intra-articular surgery with several micropunctures in the joint. In the case of arthrosis, it is used as a temporary measure to "clean the joint": remove the cartilage parts, the growth of osteophytes, which interfere with free movement. Such treatment reduces joint pain, but does not provide a solution to the problem of arthrosis.
An osteotomy is an operation to adjust the axis of a joint. The fact is that in the case of arthrosis, one part of the joint usually suffers more (has a high 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 for treating arthrosis of the joints. The essence of the operation is to remove the joint destroyed by the disease and implant an artificial endoprosthesis in its place. The artificial joint is selected individually, it is ideal for each patient, and after a rehabilitation period it fully replaces the functions of the damaged joint.
Contraindications for arthrosis
What to pay attention to in arthrosis of the joints:
Joint loads- in case of arthrosis, you must abandon lifting weights and excessive static load. A stick can be used to relieve the joint. Shoes - Properly fitted shoes reduce the stress on the joint. It is advisable to avoid high-heeled shoes.
The weight- being 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.
Sportsmust also be reviewed. In the case of arthrosis, sharp jerking movements (contact sports, wrestling), long-distance running, and weight lifting should be excluded. But this does not mean that physical activity should be stopped completely. Moderate activity is only good for the joint.
Physiotherapy is actively used in addition to medical treatment. These are magnetotherapy, electrotherapy, heat therapy. In addition, physical therapy exercises are recommended to strengthen the muscles around the affected joint and improve blood supply.
The radical method of deforming arthrosis, which led to the deterioration of the quality of life, is often surgical intervention. In this case, either 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.
Endoprosthesis 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 cartilages, which anatomically fully correspond to human cartilages.
Treatment of the disease in the initial stage is high-quality nutrition of the cartilage tissue. For this purpose, the use of chondroprotectors, preferably of natural origin, flavonoids is recommended. Motor exercise 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, accompanied by pain, inflammation and the characteristic curvature of the limb ("wheel legs" or X-shaped deformation).
Causes of deforming arthrosis of the knee
Without adequate lubrication, the joint "dries out", cracks, loses height, so the bone heads become exposed. In this case, the closing plate of the articular surface of the bone remains unprotected; re-irritation of the many nerve endings in it causes pain and discomfort.
The following factors or their combination can cause deforming arthrosis of the knee:
- the presence of diseases of the joints (and especially the knees) in relatives;
- genetic disorders associated with the formation or accelerated death of abnormal, unstable cartilage cells;
- congenital and acquired disorders of the locomotor system (flat feet, joint hypermobility, dysplasia, scoliosis, kyphosis and others);
- excessive professional, household or sports load;
- microtraumas and injuries of the knee joint and meniscus, operations, 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, tendonitis, arthritis), incl. autoimmune nature (rheumatoid, psoriatic arthritis);
- metabolic disorders (gout, diabetes mellitus);
- age-related processes of joint aging and calcium leaching from bones;
- hormonal disorders and changes in the hormonal background (for example, in women, in connection with the lack of estrogen);
- 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 movement. Therefore, the range of permitted movements is very limited. An awkward turn can damage the periarticular tissues and cause joint changes - after all, the painful 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 during movement - for example, with a sharp straightening or bending of the leg, there is a feeling that "unfortunately, you stepped on the leg. "In the early stages, the pain can be episodic or so mild that it can be perceived as an unpleasant sensation. Then the pain increases after physical exertion or long stay in the same position. The skin also becomes painful - it reacts sensitively to every touch, e. g. and clothes.
There are 3 types of specific pain in deforming arthrosis of the knee joint:
- initiation (lasts 15-30 minutes after the joint emerges from a long resting state);
- mechanical (perceived during physical activity and disappears after rest);
- blockade (sharp pinching sensation in the knee).
Symptoms of deforming arthrosis of the knee usually develop slowly, as the disease is not characterized by rapid development. This is the insidiousness of arthrosis - it gradually gets 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, physiotherapy procedures and the use of orthopedic devices.
During the treatment, it is extremely important to alternate loading and unloading, and to prevent static loading of the knee. Orthopedic insoles, special shoes, canes, crutches, walkers, ergonomic chairs for work and rest help to slow down the disease. Orthoses with adjustable bracing are particularly effective, allowing modeling of the physiological axis of the foot and compensating for deformity.
In the early stages of deforming arthrosis of the knee, the goal of treatment is to restore the destroyed joint and ligament apparatus, relieve pain and increase the range of voluntary movements. Later - in alleviating the patient's condition. For this, sanatorium arthroscopy (washing with disinfectant) is performed when breaking off a piece of osteophyte, corrective osteotomy (correction of a bent bone), joint endoprosthesis (replacement).
In addition to the orthopedist, physiotherapists and chiropractors, specialists in exercise therapy and medical massage, as well as surgeons will tell you how to treat deforming arthrosis of the knee joint.
Physiotherapy
Among other physiotherapy methods for the treatment of deforming arthrosis of the knee joint, the following are used:
- laser and magnet therapy;
- microwave therapy;
- shock wave therapy;
- amplipulse;
- ultrasound therapy;
- electrophoresis with analgin, novocaine, chymotrypsin, etc. ;
- phonophoresis with glucocorticoids;
- paraffin and ozocerite applications;
- cryotherapy;
- acupuncture;
- joint traction and kinesitherapy;
- balneotherapy.
Massage for deforming arthrosis of the knee joint
The therapeutic and lymphatic drainage massage of the deforming arthrosis of the knee joint, as well as the manual therapy, is performed by a specialist after the arthritis subsides. For self-massage at home, stroking and rubbing are recommended, as well as movements aimed at stretching the muscles and ligaments, deep warm-up (last, after the warming effect). Self-massage goes well with topical irritants and essential oils. Remember that with deforming arthrosis of the knee joint, massage is performed on both joints, even if only one is affected.
Exercises for deforming arthrosis of the knee joints
Therapeutic gymnastics for deforming osteoarthritis of the knee joint (gym therapy) is performed in a sitting or lying position, water aerobics is also effective. An individual exercise series for deforming osteoarthritis of the knee joint is compiled by an instructor. Below we recommend a short warm-up to strengthen the leg muscles.
- Sit on the floor, legs straight, the emphasis is on the hands behind the back. Flex and extend your toes.
- The starting position is the same, slowly bend your legs, at the end of the movement rest your toes on the floor. Repeat with the leg behind the other leg.
- Continue in the same starting position, raising 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 your bent knee and try to lift the other leg off the floor.
- Sitting on the floor, spread your legs shoulder-width apart. Turn your foot so that the toe moves 180 degrees.
- Sitting on the floor with bent legs. Roll your feet from heels to toes and feel the work in the back of your thighs.
Excellent! Perform exercises for deforming osteoarthritis of the knee joint at least 3-6 times a day.
Medicines for deforming arthrosis of the knee
Drug treatment of deforming arthrosis of the knee joint enables a rapid cessation of acute pain, reduction of inflammation and swelling, and improvement of 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
Chondroprotectors in the form of tablets, capsules, sachets and injections are used to regenerate and maintain joint cartilage.
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 together with anesthetics, which are injected into the joint cavity as a block.
Anticonvulsants
Removal of the spasm is necessary for the patient to return to normal activity and tissue nutrition.
Angioprotectors
Preparations based on horse chestnut and others are used for deforming arthrosis of the knee joint.
Warming agents
Among the warming agents, it is worth highlighting preparations with natural ingredients: snake and bee venom, hot pepper, mustard.
All these drugs improve blood supply to tissues and distract from pain.
Nutrition for deforming arthrosis of the knee
A healthy diet for deforming arthrosis of the knee joint includes foods with reduced trans fat and "fast" carbohydrates. Preference should be given to lean meat and fish, seafood and vegetables, steamed, steamed in foil or under a lid. Fruits, berries and antioxidants are also useful. rich drinks - wild plants, blueberries, lingonberries, cranberries, high quality green tea and coffee. You can also eat whole grains, legumes.
But potatoes, white bread, sweets, ready meals, fast food and alcohol should be excluded.
If you are overweight with deforming osteoarthritis of the knee, consider a low-carb diet.