Osteoarthritis is a degenerative joint pathology, accompanied by processes of degeneration of cartilaginous tissue.As the disease progresses, the joint capsule, ligamentous apparatus, synovial membrane and nearby bone structures are also involved in the destructive process.
Prevalence of osteoarthritis
Among people with osteoarthritis, the majority are elderly.Disease after the age of 65 is not only the most frequently diagnosed joint pathology, but also the main cause of loss of working capacity with subsequent disability.Furthermore, in old age it is mainly the fair sex who get sick, but among young people the majority of those who get sick are men.
The incidence of osteoarthritis varies greatly between countries.It has not yet been possible to establish the reasons for the large dispersion of statistical data.
Causes and risk factors
Osteoarthritis is a disease that can be primary or secondary.If there are no objective reasons for the development of pathology, we speak of the primary type.If it is possible to identify the causes of osteoarthritis, we speak of a secondary type.
Secondary arthrosis can be provoked by the following negative factors:
- trauma to joints of various natures (frequent falls, sprains, bruises);
- chronic congenital tissue dysplasia;
- pathological changes in metabolic processes;
- various autoimmune pathologies;
- inflammatory processes of a nonspecific nature in the joint region;
- some pathologies of the endocrine system;
- processes of the degenerative-dystrophic type that occur chronically;
- various diseases accompanied by excessive joint mobility associated with a weak ligamentous apparatus;
- presence of hemophilia;
- inflammatory processes of a specific type.
In addition to the direct causes that lead to the development of osteoarthritis, there are also predisposing factors that do not cause the disease itself, but can increase the risk of its development.
These include:
- age over 55 years;
- the presence of excess weight, which increases the load on the joints;
- excessive load on any joint or group due to inadequate sports training, specific work that requires a long stay in the same position;
- history of surgical interventions on joints;
- heredity;
- hormonal changes in the female body during postmenopause;
- constant hypothermia;
- spinal pathologies that are not treated;
- insufficient intake of beneficial micro- and macroelements from food.
Development mechanism
The mechanism of osteoarthritis development is well known.The cartilage that ensures normal contact between two bones is smooth in nature, without protrusions or roughness, which helps maintain normal joint movement.When the disease occurs, the structure of the cartilage changes, it becomes rough and defects appear, reducing the effectiveness of natural gliding.
Due to the acquired unevenness, the cartilage is gradually damaged, in some points it begins to calcify and in others it begins to ossify.In this case, it is possible to separate small particles that end up in the joint fluid and can damage the surrounding tissues.
As the pathology worsens, the joint may enter a state of chronic subluxation, which will significantly impair its motor function.
Degrees
Doctors divide osteoarthritis into three main degrees:
- I graduated.Characterized by the absence of a clear clinical picture.The patient may have rare complaints of pain in the affected joint, but usually does not consult a doctor.In this case, changes in the ligamentous-muscular apparatus and joint fluid are observed, but there are still no visible deformations.
- II degree.The symptoms of osteoarthritis become more pronounced.The pain is characterized as tolerable but occurs regularly.The patient consults the doctor because he notices a decrease in quality of life.A characteristic crunching sound may be heard in the affected joint.Changes are observed in nearby muscular structures as nerve conduction is disrupted.
- III degree.Characterized by pronounced symptoms.The articular cartilage is very thin and cysts, foci of calcification or ossification can be found in it.The ligamentous apparatus becomes shorter, which leads to increased mobility in the affected area, which is accompanied by limitation due to a pronounced inflammatory process.The metabolism of surrounding tissues is impaired, which can lead to muscular dystrophy.
In any case, the patient will need clarification of the diagnosis from the attending physician.This is due to the specifics of the course of the disease, which is characterized by phases of remission and exacerbation, which alternately replace each other.
Pain due to illness
Pain due to osteoarthritis is the most common complaint that patients consult their doctor about.Its characteristic is the connection with the time of day, weather and physical activity.
In most patients, the pain worsens when walking, running, or other types of physical activity aimed at the affected joint.As soon as the load stops, the pain gradually subsides.Its development is explained by the fact that the cartilage is no longer capable of performing its shock-absorbing functions.
At night, discomfort most often occurs as a result of stagnation of blood in the veins.Another reason is the increase in intraosseous pressure during this period.
One of the main diagnostic criteria is the presence of so-called initial pain, which bothers the patient at the moment he begins active movement.The initial pain usually subsides if physical activity continues.Its occurrence is explained by the presence of joint deposits (debris), which irritate the nerve endings.Once these deposits move away from the nerves, the pain disappears.
Symptoms
In addition to pain, doctors identify other signs of osteoarthritis, which may indicate the presence of pathology.
These include:
- The appearance of a painful, crunchy sound.Pains appear mainly if a person has suffered from hypothermia.At first, the noise will be barely perceptible by ear, but as the disease progresses without therapy, it will become audible to those around you.
- Decreased ability to move.At the initial stage of development of the pathology, there is no decrease in mobility.However, the longer the disease remains untreated, the more serious the limitation of joint movement becomes.This is explained by the narrowing of the joint space and the spasm of nearby muscular structures.
- Joint deformity.It is characteristic of the late stage of arthrosis, but is also an important indicator of the course of the disease.During this period it is already very difficult to treat the disease.
Which doctor treats osteoarthritis?
Who treats osteoarthritis?In most cases, therapy is carried out by several specialists at the same time.First of all, an arthrologist is involved - a joint specialist.In addition, the patient will also need to consult an orthopedist.If the disease is a consequence of an inflammatory process, it is also recommended to consult a rheumatologist.
If necessary, other specialists can be involved during the treatment period.Most often it is necessary to resort to the services of traumatologists, physiotherapists, massage therapists and surgeons.
Diagnosis
Treatment of joint arthrosis begins only after the diagnosis has been confirmed and the degree of pathology has been established.First, the doctor interviews the patient in detail and performs an examination.The presence of characteristic complaints and deformities indicates the existence of the disease.
A mandatory way to confirm the diagnosis is an x-ray of the affected joint.If the disease has affected the knee, a photo of the knee is taken;If pathology is found in the hand, radiographic signs of the disease will be specifically looked for there.
X-ray diagnosis does not always provide sufficient results to diagnose the patient.In this case, he may be sent for an MRI scan (this will make it possible to assess the state of soft tissues and their involvement in the pathological process) or computed tomography (this will make it possible to draw conclusions about the state of bone and cartilaginous structures, the involvement of nearby anatomical formations in the pathological process).
Treatment
How to treat joint osteoarthritis?The choice of the appropriate therapeutic technique depends on the severity of the symptoms and the stage of the disease.
The doctor selects the treatment regimen after assessing the patient's general condition and the course of the disease.Conservative and surgical treatment methods can be used.
Medication
How to treat the disease if it is preferable not to have surgery, but to use medication?
Conservative therapy is suitable for patients only at an early stage of pathology formation and will include the use of three main groups of medications:
- glucocorticosteroids– hormonal drugs that effectively relieve the inflammatory process during an exacerbation are injected into the joint cavity;
- nonsteroidal anti-inflammatory medications,which are mainly used as injections and are injected into the muscles near the joint or directly into the vein.But doctors can also recommend tablets, although this option of taking NSAIDs is undesirable due to the negative effect on the gastrointestinal tract;
- chondroprotectors– medicines from this group can reduce the processes of destruction of cartilaginous tissue and increase regeneration;are especially effective in the early stages of disease formation.
Surgical
How to cure osteoarthritis if the disease has already advanced significantly?In this case, conservative therapy will be ineffective and doctors can only recommend surgical intervention to the patient.
Today, in most cases, endoprosthesis is performed.During the operation, the real joint is replaced by a prosthesis that has all the functions of a healthy joint.
In some cases, palliative treatment options are offered, the main objective of which is to reduce the load on the joint surfaces.
Exercise
In the early stages of the disease, treatment is not only done with medication, but also with physiotherapy.Physical exercise is an important stage of therapy, which helps maintain joint functionality and reduces the likelihood of disease progression.
Depending on the severity of the pathology and the individual characteristics of the patient, the set of exercises is selected individually.The doctor must take into account the location of the osteoarthritis, which allows for more effective treatment of the affected tissue.
Self-study without medical supervision is not recommended, especially at the initial stage.Exercises should be selected so that they are as smooth as possible, without sudden movements.
Physiotherapy classes are only effective if the patient devotes a little time to performing the recommended complex every day.
Traditional methods
Many people who suffer from osteoarthritis refuse to take medication or have surgery until the end.In this case, alternative medicines are used as substitutes for medicines.
The plants most used in therapy are:
- Kalanchoe;
- red-haired;
- horseradish;
- bay leaf;
- garlic;
- cinnamon;
- mackerel and others.
They are used in the form of tinctures, decoctions and poultices on the affected area.It is important to keep in mind that complete treatment of the disease with homemade recipes alone is impossible.It is best if traditional therapy is combined with traditional medicine.
Prevention
What to do to reduce the likelihood of developing osteoarthritis in old age?Simple preventative measures are available to anyone.
Recommended:
- daily moderate physical activity: walking, cycling, performing simple sets of exercises such as exercise and so on;
- adherence to the basic principles of a healthy diet: eating frequently, but little by little, avoiding fast food, overeating, heavy and fatty foods, eating a lot of seasonings;
- weight control: weight gain leads to increased stress on the joints, which can lead to the development of osteoarthritis;
- timely treatment of chronic diseases leading to metabolic disorders;
- the use of vitamin-mineral complexes if the amount of nutrients provided by food is considered insufficient.
The difference between arthritis and osteoarthritis
Many people, due to the sound similarity, confuse arthritis with arthrosis.However, these are completely different diseases.
Arthritis is not called dystrophy and degeneration of joint tissues, but rather any inflammatory reaction that can develop in the joint cavity, regardless of its cause.Inflammation most often affects not only the joint, but also the muscles closest to it, bone and ligament structures.Arthritis pain is not associated with physical activity;it can bother the patient even at rest and there is no compression on the joints.
In most cases, it is impossible to independently distinguish arthritis from arthrosis, since the main symptom is pain and patients rarely have any idea about its features in each of the pathologies.
It is better to entrust the attending physician with establishing an accurate diagnosis, so as not to be mistaken in the subsequent treatment and prevention of the disease.
Osteoarthritis is a serious pathology that can lead to disability if the patient does not consult a doctor in time.At the first signs of illness, it is recommended to contact a specialist so that he can confirm the diagnosis and select the most appropriate treatment.
If you manage to catch the disease at an early stage of development, you can probably do it even without surgical intervention, limiting yourself only to conservative treatment.