Arthrosis

A person is constantly in motion throughout his life.Thanks to this, it is possible to quickly and effectively adapt 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 become a traumatic situation, resulting in premature wear of the joints.This is how arthrosis of the joints, one of the most common diseases on the planet, occurs.Despite its wide spread, not everyone knows its main manifestations and danger, so they consult a doctor in the later stages.This can lead to serious health problems, including disability.A timely visit to specialists will allow you to avoid these difficulties, because experienced doctors make a comprehensive diagnosis, which allows identifying pathological changes in the early stages.

Arthrosis is a degenerative-dystrophic joint disease with slow growth of the cartilage 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, from 10 to 20% of people in the world suffer from this pathology.These are quite significant indicators that are increasing every year.In the aging process, there are age-related changes in the musculoskeletal system that are characteristic of most people over the age of 80.However, only a small part of them prefers self-treatment by consulting a doctor.It is this approach that significantly worsens the prognosis of recovery and increases the chance of disability.

The disease occurs almost equally in both men and women.The risk group includes:

• Women over 50 and men over 40.
• Individuals with a history of endocrine diseases and chronic arthritis.
• People whose profession involves heavy physical labor or long periods of stationary work.
• Professional athletes (especially weightlifters and those involved in traumatic sports).

Species

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

Arthrosis of the lower extremities

• Osteoarthritis of the hip joint- the most dangerous and heavy type.Due to the anatomical features of the structure of this joint, the rapid development of degenerative-dystrophic disorders here occurs with damage to the musculo-ligamentous apparatus.When inflammation occurs, the effect of complete or partial immobility develops.Often this pathology occurs due to the presence of congenital dysplasias, dislocations and osteochondropathies.It manifests itself in the form of pain (at first it appears in the afternoon and at night, but later it becomes permanent, spreading to the groin and gluteal region) and the forced position of the lower limbs.
• Ankle- happens quite often, because the ankle has to withstand heavy loads every day.As a result, it is often injured and causes degeneration.Ankle arthrosis often occurs without significant symptoms, but as it progresses, pain appears during physical activity.Then the pain becomes stable, 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, so it is more susceptible to injury than others.There are several types: patellofemoral and tibiofemoral.The first occurs after damage to the patellofemoral joint.In the initial stages, it is asymptomatic, because the joint has a lot of cartilage responsible for shock absorption.Their presence prevents bone damage.Later, the patient begins to feel pain in the knee after physical activity, which gradually becomes permanent (often worsens when the weather changes).Synovitis, characterized by severe, almost unbearable pain, is often associated with pathology.The tibiofemoral type is rarely diagnosed and has a more favorable prognosis.It is characterized by pain sensations that radiate to the lower part of the body (usually the legs).
• Heel— after an injury or disease, degenerative-dystrophic changes can be observed in the area of the lower 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 in nature.

Arthrosis of the upper limbs

Solocalization of the diseaseit occurs less frequently than in the lower extremities.These are:

• Arthrosis of the shoulder joint.As a rule, it occurs after an injury and against the background of microtrauma in professional athletes.Sometimes it is diagnosed in people whose profession involves physically demanding work.The acromial type of disease is the 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 note limited mobility, as well as a creaking sound when moving.In the absence of timely treatment, partial ankylosis may occur.
• Elbow - diagnosed less often.In most cases, this diagnosis is found in certain professions: miners, blacksmiths and people who work with vibrating tools.The symptomatic picture includes elbow pain and limited mobility when bending and extending the upper limb.
• Arthrosis of hand joints.As a rule, it is diagnosed in the carpometacarpal joint of the 1st finger (this joint is the most susceptible to injuries in everyday life).It is characterized by a dull pain on the outer surface of the palm that can spread to the thumb.
• Arthrosis of the finger joints.It is most often found in people engaged in small jobs (embroidery, knitting, etc.).Overgrowth of bone tissue is observed, which leads to the formation of Heberden's and Bouchard's nodes.Patients rarely complain of joint pain (sometimes when the weather changes) and stiffness in movement.

Reasons

There is no single etiological factor that causes the development of this pathology.Arthrosis is a disease that slowly begins to manifest itself against the background of congenital structural features of connective tissue, previous diseases, as well as microtraumas over a long period of time.Most chronic inflammations (arthritis), in one way or another, turn into a degenerative-dystrophic process with constant inflammatory relapses.The age group of arthrosis, which makes up the majority of patients with this diagnosis, deserves special attention.

Although there is no single genesis of this disease, there are a number of factors that predispose to it.Among them, the most clinically important are:

• Sedentary lifestyle(sedentary work, laziness and more).
• Excessive physical activityphysical hard work, professional sports (sports injuries have a negative impact on health in all sectors).
• Large body weight(joints simply cannot cope with such weight).
• Venous insufficiency.
• Related to the professionwith a constant stop, without any action.
• Hormonal disorders and damage to the endocrine system(diabetes, atherosclerosis of blood vessels, obesity, etc.).
• Poor nutrition(insufficient daily intake of fats, proteins, carbohydrates, vitamins and trace elements).
• Smoking and alcohol abuse.
• Loaded heredity.

Under 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.At first it becomes thinner, less elastic, and then completely cracks.Subchondral bone tissue is in contact with the surface of the bone and causes its destruction due to friction.The protective reaction of the bone tissue is its spread (especially along the articular edges), which significantly limits the mobility of the joint and causes its deformation.

The cells of the joints have one feature - they quickly respond to any, even small, injuries.Damaged cells actively synthesize anti-inflammatory cytokines, so the destruction of cartilage and bones is characterized by aseptic inflammation in the synovium.Frequent repetition of the pathology causes the inflammation to worsen, so the hard tissue cells begin to die even faster, which contributes to the progression of the disease.

Symptoms

Arthrosis can occur for a long time without the slightest clinical signs.Patients live without suspecting that active degenerative-dystrophic changes have occurred in their joints.As a rule, the first symptoms appear at the height of the pathology or after inflammation occurs.There are several types of symptoms, depending on the time of occurrence and characteristics of manifestation.

First signs

A person begins to feel pain in the area of the damaged joint after physical activity (sports, running, walking without stopping, climbing stairs, etc.).In the morning, after a long period of immobility, the first "early pain sensations" appear with slight stiffness.To overcome limited mobilityyou need to warm up for a certain period of time.The pain is aching or dull and not very strong.Due to the poor clinical picture, patients rarely consult a doctor at an early stage.Many people begin to self-medicate and try different treatment methods, which can only worsen the existing condition.However, in the early stages, this disease has the most favorable prognosis and a high chance of complete recovery without consequences.Therefore, if you experience any sensations in your joints, it is strongly recommended that you consult a doctor.

Obvious symptoms

The pain gradually increases, intensified by weather changes.They do not occur only in the morning, but also continue throughout the day.Patients cannot sleep fully;many (especially in old age) report aching bones and aching pains in the muscles.The pain will spread all around and spread around.People with this problem tire quickly when walking even short distances, and suffer from difficult joint stiffness and stiffness.Many people report instability of the injured limb, so they develop an unsteady and soft gait.

Osteoarthritis of the knee is manifested by a characteristic crisis caused by friction of the articular surfaces against each other.The knee begins to deform gradually 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 extremities is usually the result of injury or chronic arthritis.The most noticeable deformation is observed in the interphalangeal joints of the hand.Bouchard and Heberden knots are formed in the fingers and the hand itself becomes square.

Dangerous symptoms

Thereforedegenerative-dystrophic changesdevelops gradually and over a long period of time, even the appearance of dangerous clinical signs may be overlooked.This significantly aggravates the current situation and worsens the prognosis of recovery.These symptoms are:

• Swelling and constant pain in the limbs- indicates active inflammation that requires immediate medical intervention.
• Joint deformation, due to which the gait changes or it becomes impossible to perform usual movements.
• Myalgia and bone pain.
• Unsteady gait, severe limitation of mobility during bending and stretching.
• The pain is constant, which does not go out in the evening or at night, radiates to 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.When walking (even over long distances), a person does not feel any pain or discomfort.No pathological changes are detected in the X-ray image.
• Primary (doubtful).Moderate dull pain appears when walking for a long time.Some patients note a slight creak when bending their limbs.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 is more pronounced and appears in the morning along with stiffness.Pain increases with movement.X-ray reveals a clear narrowing of the joint space and a small amount of bone growth (osteophytes).
• Medium (degenerative).Painful sensations occur not only in the morning, but also at night.Myalgia and pain occur in the bones.Patients sleep poorly and often notice swelling of the affected joint.X-rays show the progress of narrowing of the joint space and the proliferation of osteophytes, as well as an increase in bone density.
• Heavy (deforming).The pain syndrome is persistent and does not always go away with painkillers.Pain increases with any movement;a loud creaking sound is heard when bending.Muscle atrophy also develops, joint deformation develops.X-ray examination shows a strong narrowing of the joint space and a significant growth of the edges of the articular surface, which causes deforming changes.

Aggravation

All degenerative diseases are characterized by a slow, often asymptomatic (especially in the first stages) course.When the weather conditions change (humidity, wind or temperature drop) and the inflammatory process starts, pain increases.Inflammation is characterized by swelling, hyperemia of the skin, pain and swelling.Therefore, if signs of the inflammatory process appear, you should immediately seek qualified medical help.Provide independentfirst aidcan be done using the following methods:

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

Diagnostics

To make a diagnosis, high-precision examination methods are used to identify even small pathological changes.In the clinic, specialists conduct a comprehensive examination of the patient, which allows them to determine the current state of the joint visually and palpatively (external signs of inflammation: swelling, redness of the skin, pain, hyperemia).After that, laboratory and instrumental diagnostics are prescribed, which allows you to get 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 determine the cause of the disease (metabolic disorders, autoimmune reactions, etc.).
• C-reactive protein.
• Administration of intra-articular fluidto detect the infection and its susceptibility to antibiotics.

Instrumental diagnostics includes the following procedures:

1. Ultrasound and MRI of the joint.It allows detecting changes in soft joint and periarticular tissues.
2. X-ray and CT.It is very informative when looking for changes in bone tissue.Today, this is the preferred diagnostic method, which is the basis for the diagnosis of arthrosis.
3. Arthroscopy.It is performed when there are signs indicating the presence of inflammation.
4. Scintigraphy.It involves the administration of radiopharmaceuticals to assess bone health and metabolism.

Drug therapy

The purpose of prescribing drugs is to relieve pain, suppress its development and restore joint function.The following are used to combat pain:

• Painkillers from the NSAID group.The type of medicine, release form 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 include pain relievers.They are usually taken orally in tablet form, but injections or ointments can also be used.
• Muscle relaxants.They are necessary to eliminate spasm from 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 social component of basic therapy.B vitamins help to normalize the functioning of the peripheral nervous system and also inhibit pain.
• Pain relief blocks.As a rule, it is used for severe acute pain that cannot be relieved by taking the drugs described above.In this case, solutions injected into the most painful places are used.

Treatment of arthrosisknee or any other joint cannot be treated without taking drugs that help restore joint function.For this purpose, the following are set:

• Chondroprotectors.Their intake restores cartilage tissue and improves blood circulation there.It is taken in the form of ointment, injection and tablets.
• Hyaluronic acid.The drug is injected directly into the joint cavity, ensuring that the therapeutic effect starts as soon as possible.Its main purpose is to improve the viscosity of the synovial fluid and prevent damage to the articular surfaces of the bones.

Non-drug therapy

This is important to understandto take medicine- this is not a panacea and is not the only way to recover.You should devote enough time to non-drug treatment methods to relieve pain, increase joint mobility and improve quality of life.A proper balance must be maintained between adequate physical activity and proper rest.You can achieve this result by sticking to daily exercises.To get the desired result, you must follow the following training rules:

1. Classes should be held every day, regardless of health, mood, weather, living conditions and other factors.
2. All movements are performed extremely smoothly and slowly.
3. If the pain intensifies during the exercise, stop the exercise.

Regardless of the degree of arthrosis of the knee joint, the patient needs itstop running(especially for short distances at high speed), jumping, outdoor games (football, basketball, volleyball, etc.), weight lifting (barbell, etc.), long periods of immobility.In this case, the best options would be swimming, yoga (preferably with an instructor who knows joint problems) and Pilates.

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

1. Electrophoresis or phonophoresis with solutions of analgesics.
2. Paraffin warming applications(it is carried out only if there is no inflammatory process).
3. Darsonvalidation- exposure to high and low frequency electrical currents to stimulate blood circulation and muscle relaxation.
4. Magneto and laser therapy.
5. Electrical stimulation.It is an effective physiotherapy aimed at restoring muscle volume and strength.

Hirudotherapy - treatment using leeches is also possible.The saliva of these animals contains a large number of enzymes that expand blood vessels and normalize metabolic processes.In addition, it helps to dissolve necrotic tissue and clean joint spaces.

Prevention

It is quite difficult to fight arthrosis, as well as its consequences.But it is easier to avoid.To do this, follow simple recommendations that will help you maintain healthy joints for many years.Among them:

• Active lifestyle.Even if your professional activity involves long periods of sitting or standing, you should take time (at least a few minutes a day) for a simple warm-up.
• Regular exercise or visiting the pool.These are great general strengthening exercises that will help keep your muscles and musculoskeletal system in 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, trace elements and vitamins.It is worth increasing the consumption of foods high in omega-3 (fish, red game, avocado, walnuts, flax seeds, etc.) and collagen (jelly, rich soups, etc.).
• Track your body weight.Avoiding the development of obesity, it is necessary to maintain a normal weight (for this, you need to exercise and eat right).
• Wear comfortable shoes.
• Stop exercisingaccompanied by a high risk of injury.

The result

Arthrosis of the jointsThis is a rather serious disease that can cause serious consequences and complications.However, you can fight it, live a full life and go about your daily business.Modern medicine offers many therapeutic methods aimed at improving the condition of patients and restoring motor functions.However, it should be remembered that the quality of life with arthrosis depends on the treatment time and compliance with medical recommendations.Early medical consultation allows to identify the first degenerative changes and eliminate them in time.Therefore, it is not necessary to self-medicate or postpone going to the doctor.If you notice the first signs of joint disorders, you should immediately consult a doctor and undergo a comprehensive diagnosis.