Osteoarthritis

A person is in constant movement throughout his life.This makes it possible to quickly and effectively adapt to changes in the environment, explore the world, move and carry out everyday activities.However, any movement of the body places a certain strain on the musculoskeletal system and can potentially become a traumatic situation, leading to premature wear and tear of the joints.This is how arthrosis of the joints occurs - one of the most common diseases on the planet.Despite the widespread distribution, not everyone knows the primary manifestations and dangers, which is why they seek medical help in later stages.This can lead to serious health problems and even disability.A timely visit to a specialist allows you to avoid these problems, because experienced doctors carry out a thorough diagnosis and allow you to detect pathological changes in the early stages.

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

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

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

species

There are severalClassifications Osteoarthritis: depending on genesis, clinical forms and localization.Each of them has its own clinical significance;Classification according to the location of the lesion is the most popular in practice.

Osteoarthritis of the lower extremities

• Osteoarthritis of the hip joint- the most dangerous and heaviest type.Due to the anatomical features of the structure of this joint, degenerative-dystrophic diseases with damage to the musculoskeletal system quickly develop.When inflammation occurs, the effect of complete or partial immobility occurs.This pathology often occurs due to congenital dysplasia, dislocations and osteochondropathy.It manifests itself in the form of pain (at first it occurs in the late afternoon and at night, but later becomes permanent and radiates to the groin and buttocks) and in a forced posture of the lower extremities.
• ankle- is quite common because the ankle has to withstand heavy loads every day.As a result, it is often injured, leading to degeneration.Ankle osteoarthritis often occurs without any significant symptoms, but as it progresses, pain occurs during physical activity.Then the pain becomes constant, accompanied by stiffness of movement and complete immobility (rare if timely and appropriate treatment is not provided).
• Osteoarthritis of the knee joint- the most common variety.The knee bears the greatest load and is therefore more susceptible to injury than others.There are different types: patellefemoal and tibiofemoral.The first occurs after an injury to the patellofemoral joint.In the early stages it is asymptomatic because the joint has a large amount of cartilage that is responsible for shock absorption.Their presence prevents bone injuries.Later, after physical activity, the patient notices pain in the knee, which gradually becomes permanent (often worsening with changes in the weather).Synovitis is often associated with the pathology, which is characterized by severe, almost unbearable pain.The tibiofemoral type is diagnosed extremely 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— After injuries or illnesses, degenerative-dystrophic changes can be observed in the area of the subtalar or talocalcaneal-navicular joints.It also does not manifest itself clinically for a long time, but over time it begins to become painful and painful.

Osteoarthritis of the upper extremities

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

• Osteoarthritis of the shoulder joint.It usually occurs after injuries and against the background of microtrauma in professional athletes.Sometimes diagnosed in people whose jobs involve physically demanding work.Acromial disease is a result of injury and inflammation.At first it goes unnoticed, but as it progresses, painful sensations appear in the area of the injured shoulder.Patients notice limited mobility and a grinding noise when moving.Without timely treatment, partial ankylosis can occur.
• Elbow – much less commonly diagnosed.In most cases, this diagnosis is detected in certain professions: miners, blacksmiths and people who work with vibrating tools.The symptoms include pain in the elbow when bending and extending the upper extremity as well as limited mobility.
• Osteoarthritis of the wrists.As a rule, the diagnosis is made in the carpometacarpal joint of the 1st finger (this joint is most susceptible to injury in everyday life).It is characterized by a dull pain on the outer surface of the palm that can radiate to the thumb.
• Osteoarthritis of the finger joints.Most common in people who do small jobs (embroidery, knitting, etc.).Overgrowth of bone tissue is observed, leading to the formation of Heberden and Bouchard nodes.Patients rarely report joint pain (sometimes during weather changes) and stiffness of movement.

Reasons

There is no single etiological factor leading to the development of this pathology.Osteoarthritis is a disease that begins to manifest itself slowly over a long period of time against the background of congenital structural features of the connective tissue, previous illnesses and microtraumas.Most chronic inflammation (arthritis) one way or another turns into a degenerative-dystrophic process with constant inflammatory relapses.The arthrosis age group in which most patients are diagnosed with this diagnosis deserves special attention.

Although there is no clear origin of this disease, there are a number of predisposing factors.The clinically most important of these are:

• Sedentary lifestyle(sedentary work, laziness and much more).
• Excessive physical activityphysically difficult work, professional sports (sports injuries have a negative impact on health in all areas).
• Large body weight(The joints simply cannot withstand such weight).
• Venous insufficiency.
• Job relatedwith constant standing, without movement.
• Hormonal disorders and damage to the endocrine system(Diabetes mellitus, atherosclerosis of blood vessels, obesity, etc.).
• Poor diet(insufficient daily intake of fats, proteins, carbohydrates, vitamins and microelements).
• Smoking and alcohol abuse.
• Contaminated inheritance.

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

The cells in the joints have a special feature: they react quickly to even the smallest injury.Damaged cells actively synthesize anti-inflammatory cytokines, which is why the destruction of cartilage and bone is characterized by aseptic inflammation of the synovium.Frequent relapses of the pathology lead to an exacerbation of inflammation, so hard tissue cells begin to die even faster, which contributes to the progression of the disease.

Symptoms

Osteoarthritis can occur over a long period of time without the slightest clinical symptoms.Patients live without even suspecting that active degenerative-dystrophic changes are occurring in their joint.As a rule, the first symptoms appear at the peak of the pathology or after inflammation occurs.Depending on the time of occurrence and the characteristics of manifestation, there are different types of symptoms.

First signs

After physical activity (playing sports, jogging, continuous walking, climbing stairs and much more), pain occurs in the area of the damaged joint.In the morning, after a long period of immobility, the first “incipient pain sensations” appear, combined with a slight stiffness.To eliminate limited mobilityYou need to warm up for a certain amount of time.The pain is aching or dull in nature and not very intense.Due to the inconspicuous clinical picture, patients rarely seek medical advice in the early stages.Many people start self-medicating and trying different treatment methods, which can only worsen the current situation.However, this disease has the most favorable prognosis, especially in the early stages, and a high chance of a complete recovery without consequences.Therefore, it is strongly recommended that you make a doctor's appointment if you notice any discomfort in your joints.

Obvious symptoms

The pain gradually increases, increase with weather changes.They not only appear in the morning but also persist throughout the day.Patients cannot sleep fully;Many notice (especially as they age) sore bones and aching pains in the muscles.The pain spreads throughout the extremity and radiates to surrounding areas.People with this problem become tired quickly when walking even short distances and experience difficulty flexing and stiffness of the joints.Many people notice instability in the damaged limb, which is why they develop an unsteady and soft gait.

Knee osteoarthritis manifests itself in a characteristic crunch that occurs due to the friction of the joint surfaces against each other.Due to the growth of bone tissue around the edges, the knee gradually begins to deform.Patients try to restrict any movement, which leads to muscle loss.This in turn makes the gait even more unstable and cautious.Osteoarthritis of the upper extremities is usually a result of an injury or chronic arthritis.The most noticeable deformation is observed in the interphalangeal joints of the hand.Bouchard and Heberden nodes form on the fingers and the hand itself becomes square.

Dangerous symptoms

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

• Swelling and constant pain in the limbs- indicates active inflammation requiring urgent medical intervention.
• joint deformity, which changes gait or makes it impossible to perform normal movements.
• Myalgia and bone pain.
• Unsteady gait, severe limitation of mobility during flexion and extension.
• The pain becomes constant, which does not subside in the evening or at night and radiates into the surroundings.

Degrees

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

• Zero.When walking (even over long distances), people do not feel any pain or discomfort.No pathological changes are visible on the x-ray.
• Initially (doubtful).Moderate dull pain occurs with prolonged walking.Some patients notice a slight crunching sensation 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.
• Simply.The pain syndrome becomes more pronounced and occurs in the morning along with stiffness.The pain increases with movement.The x-ray shows a clear narrowing of the joint space and small bone growths (osteophytes).
• Moderate (degenerative).Painful sensations occur not only in the morning but also at night.Myalgia and pain in the bones occur.Patients sleep poorly and often notice swelling of the affected joint.X-rays show the progression of joint space narrowing and the proliferation of osteophytes as well as an increase in bone density.
• Heavy (deforming).The pain syndrome becomes permanent and cannot always be relieved by taking painkillers.The pain increases with every movement;A loud crunching sound can be heard when bending over.In addition, muscle atrophy develops and joint deformity occurs.An X-ray examination shows a strong narrowing of the joint space and a strong growth of the edges of the articular surface, which led to deforming changes.

aggravation

All degenerative diseases are characterized by a slow, often asymptomatic (especially in the initial stages) course.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 must immediately seek qualified medical help.Ensure independenceFirst aidcan be done using the following methods:

1. Take painkillers.
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).

diagnosis

Highly precise examination methods are used to make the diagnosis in order to detect even minor pathological changes.In the clinic, specialists carry out a thorough examination of the patient and can thus visually and tactilely determine the current condition of the joint (external signs of inflammation: swelling, redness of the skin, pain, hyperemia).Laboratory and instrumental diagnostics are then prescribed, which makes 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 and provide information about the cause of the disease (metabolic disorders, autoimmune reactions, etc.).
• C-reactive protein.
• Ingestion of intra-articular fluidto detect infections and their sensitivity to antibiotics.

Instrumental diagnostics includes the following procedures:

1. Ultrasound and MRI of the joint.Allows detection of changes in soft joint and periarticular tissue.
2. X-ray and CT.It is extremely informative in looking for changes in bone tissue.This is now the preferred diagnostic method and is fundamental in diagnosing osteoarthritis.
3. Arthroscopy.It is carried out if there is evidence of inflammation.
4. scintigraphy.Involves the administration of radiopharmaceuticals to assess the condition of bones and metabolism in them.

Drug therapy

Prescribing medications is aimed at relieving pain, suppressing its progression and restoring joint function.The following are used to combat pain:

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

Treatment of osteoarthritisKnees or other joints cannot be treated without taking medications to restore joint function.For this purpose the following are appointed:

• Chondroprotectors.Taking them restores cartilage tissue and improves blood circulation.It is taken in the form of ointments, injections and tablets.
• Hyaluronic acid.The medicine is injected directly into the joint cavity, which ensures 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-drug therapy

It's important to understand thisTaking medication- This is not a panacea and not the only way to recover.To eliminate pain, increase joint mobility and improve quality of life, you need to devote sufficient time to non-drug treatment methods.It is necessary to maintain the correct balance between sufficient physical activity and adequate rest.You can achieve this result by exercising daily.To achieve the desired result, you must adhere to the following training rules:

1. Classes must take place every day, regardless of health, mood, weather, living conditions and other factors.
2. All movements are carried out extremely gently and slowly.
3. If pain worsens during exercise, stop exercising.

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.), prolonged periods of immobility.The best option in this case would be swimming, yoga (preferably with a trainer who is familiar with joint problems) and Pilates.

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

1. Electrophoresis or phonophoresis with solutions of analgesics.
2. Heat applications with paraffin(carried out exclusively when there is no inflammatory process).
3. Darson validation- Exposure to high and low frequency electrical currents to stimulate blood circulation and muscle relaxation.
4. Magneto 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 - a treatment with leeches.The saliva of these animals contains a variety of enzymes that dilate blood vessels and normalize metabolic processes.In addition, it helps dissolve necrotic tissue and cleanse joint cavities.

Prevention

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

• Active lifestyle.Even if your job requires you to sit or stand still for long periods of time, you should take time (at least a few minutes a day) to simply warm up.
• Regular exercise or a visit to the swimming pool.These are excellent general strengthening sports that help keep your muscles and musculoskeletal system in a healthy tone.
• Proper and rational nutrition.It is extremely important to monitor your daily diet.It should contain a sufficient amount of proteins, fats, carbohydrates, microelements and vitamins.It is worth increasing the consumption of foods high in omega-3 (fish, deer, avocado, walnuts, flaxseed, etc.) and collagen (jelly, rich soups, etc.).
• Monitor your body weight.It is necessary to maintain your weight within normal limits in order to avoid the development of obesity (for this you also need to exercise and eat right).
• Wear comfortable shoes.
• Stop exercisingis associated with a high risk of injury.

Conclusion

Osteoarthritis of the jointsThis is a fairly serious disease that can have serious consequences and complications.However, you can fight it, live a fulfilling 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 timing of treatment and compliance with medical recommendations.Early medical advice allows you to detect the first degenerative changes and eliminate them in a timely manner.Therefore, there is no need to self-medicate or delay going to the doctor.If you notice the first symptoms of joint disease, you must immediately consult a doctor and undergo a thorough diagnosis.