arthrosis

Throughout his life, a person is in constant motion.Thanks to this, it is possible to quickly and effectively adapt to changes in the environment, explore the world, move and perform daily activities.However, every 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 joint arthrosis happens - one of the most common diseases on the planet.Despite its wide spread, not everyone knows the primary manifestations and danger, therefore 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 troubles, because experienced doctors perform a complete diagnosis, allowing you to identify pathological changes in the early stages.

Arthrosis is an articular disease of a degenerative-dystrophic nature 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 appears.According to official statistics, from 10 to 20% of people in the world suffer from this pathology.These are quite significant indicators that grow every year.During the aging process, age-related changes occur in the musculoskeletal system, characteristic of most people over 80 years old.However, only a small part of them consult a doctor, preferring to self-medicate.It is this approach that significantly worsens the prognosis for recovery and also increases the possibility of disability.

The disease occurs 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 stay in a stationary position for a long time.
• Professional athletes (especially weightlifters and those involved in traumatic sports).

The types

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

Arthrosis 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, it is here that the rapid development of degenerative-dystrophic disorders 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 osteochondropathy.It appears in the form of pain (at first it appears in the late afternoon and at night, but later it becomes permanent, radiating to the groin and gluteal region) and forced position of the lower extremities.
• the ankle- happens quite often, as the ankle is forced to withstand heavy loads every day.As a result, it is often injured, leading to degeneration.Ankle arthrosis 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 increase (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, therefore it is more susceptible to injury than others.There are several types: patellofemoral and tibiofemoral.The first occurs after injury to the patellofemoral joint.In the initial stages, it is asymptomatic, as the joint has a large amount of cartilage responsible for shock absorption.Their presence prevents bone damage.Later, the patient begins to notice pain in the knee after physical activity, which gradually becomes permanent (often intensifies when the weather changes).Synovitis, characterized by severe, almost unbearable pain, is often associated with the pathology.Tibiofemoral tibia 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 in the legs).
• HEEL— Degenerative-dystrophic changes can be observed in the area of the subtalar or talocalcaneal-navicular joints after injury or disease.It also does not appear clinically for a long time, but over time it begins to become painful and painful in nature.

Arthrosis of the upper extremities

Suchlocalization of the diseaseit occurs less often than in the lower extremities.These are:

• Osteoarthritis of the shoulder joint.As a rule, it occurs after injury and against the background of microtrauma in professional athletes.It is sometimes diagnosed in individuals whose profession involves hard physical work.The acromial type of the disease is a consequence of injury and inflammation.Initially, it goes unnoticed, but as it progresses, painful sensations appear in the area of the injured shoulder.Patients notice limited mobility, as well as a cracking noise when moving.In the absence of timely treatment, partial ankylosis may occur.
• Elbow - diagnosed much less often.In most cases, this diagnosis is detected in certain professions: miners, blacksmiths and people who work with vibrating tools.The symptomatic picture includes pain in the elbow during flexion and extension of the upper limbs and limited mobility.
• Arthrosis of the wrists.As a rule, it is diagnosed in the carpometacarpal joint of the first 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.
• Arthrosis of 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.

reason

There is no single etiological factor that leads to the development of this pathology.Arthrosis is a disease that begins to appear slowly against the background of congenital structural features of the 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 arthrosis age group, which accounts for the largest number of patients with this diagnosis, deserves special attention.

Despite the fact that there is no single genesis of this disease, there are a number of factors that predispose it.The most clinically important of them 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 sectors).
• Heavy body weight(joints simply cannot withstand such weight).
• Venous insufficiency.
• Regarding the professionwith continuous standing, without any movement.
• Hormonal disorders and damage to the endocrine system(diabetes mellitus, atherosclerosis of blood vessels, obesity, etc.).
• Poor nutrition(insufficient daily intake of fats, proteins, carbohydrates, vitamins and trace elements).
• Smoking and alcohol abuse.
• Heavy 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 completely cracks.Subchondral bone tissue comes into contact with the surface of the bone, causing it to be destroyed by 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 leads to its deformation.

Nodal cells have a peculiarity - they give a quick response to any damage, even small.Damaged cells actively synthesize anti-inflammatory cytokines, which is why the destruction of cartilage and bone is characterized by aseptic inflammation in the synovium.Frequent relapses of the pathology lead to worsening of inflammation, so the cells of the hard tissues 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 even suspecting that active degenerative-dystrophic changes are occurring in their joints.As a rule, the first symptoms appear at the peak of the pathology or after the appearance of inflammation.There are several types of symptoms, depending on the time of appearance and the characteristics of the manifestation.

The first signs

A person begins to experience pain in the area of the damaged joint after physical activity (playing sports, running, walking without stopping, climbing stairs and much more).In the morning, after a long stay in a stationary state, the "first feelings of initial pain" appear, combined with light stiffness.To eliminate limited mobilityyou have to warm up for a certain amount of time.The pain is aching or dull in nature and is not very intense.Because of the poor clinical picture, patients rarely seek medical advice in the early stages.Many people begin to self-medicate and try different treatment methods, which can only worsen the current situation.However, it is in the early stages that this disease has the most favorable prognosis and a high chance of a full recovery without consequences.Therefore, it is strongly recommended that you make an appointment with a doctor if you notice any sensation in your joints.

Visible symptoms

The pain gradually increases, intensify with weather changes.They occur not only in the morning, but also continue throughout the day.Patients cannot sleep completely;many (especially in old age) notice bone pain and muscle pain.The pain will spread throughout the limb and radiate to the surrounding areas.People with this problem tire quickly when walking even short distances, and suffer from difficult joint bending and stiffness.Many people notice instability of the injured limbs, therefore they develop an unsteady and soft gait.

Osteoarthritis of the knee is manifested by a characteristic crackle, which is formed as a result of the friction of the articular surfaces with 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 walking even more unstable and cautious.Osteoarthritis of the upper extremities is usually the result of injury or chronic arthritis.The most obvious deformation is observed in the interphalangeal joints of the hand.Bouchard's and Heberden's joints are formed in the fingers, and the hand itself becomes square.

Dangerous symptoms

Because of the fact thatdegenerative-dystrophic changesit develops gradually and for a long period of time, the appearance of even dangerous clinical signs can go unnoticed.This significantly worsens the current situation and worsens the prognosis for recovery.These symptoms are:

• Swelling and constant pain in the limb- indicates active inflammation that requires urgent medical intervention.
• Deformation of joints, due to which the gait changes or it becomes impossible to perform the usual movements.
• Myalgia and bone pain.
• Unsteady gait, severe limitation of mobility during bending and stretching.
• The pain becomes constant, which does not sit in the evening or at night, radiating to the surrounding areas.

Diplomas

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

• Zero.A person does not experience any pain or discomfort while walking (even over long distances).No pathological changes are detected in the X-ray image.
• Beginner (doubtful).When you walk for a long time, moderate dull pain appears.Some patients notice a slight creaking when they bend 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 a clear 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 badly and often notice swelling of the affected joint.X-rays reveal progression of joint space narrowing and proliferation of osteophytes, as well as an increase in bone density.
• Heavy (distorting).The pain syndrome becomes permanent and is not always relieved by taking painkillers.The pain increases with every movement;a loud clicking noise is heard during bending.Muscle atrophy also develops and joint deformation develops.An X-ray examination reveals a strong narrowing of the joint space and significant enlargement of the edges of the articular surface, which caused deforming changes.

worsening

All degenerative diseases are characterized by a slow progress, often asymptomatic (especially in the first stages).An increase in pain is observed when weather conditions change (humidity, wind or temperature drop) 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 independentfirst aidcan be done using the following methods:

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

Diagnosing

To establish a diagnosis, high-precision examination methods are used to identify even small pathological changes.In the clinic, specialists perform a complete examination of the patient, allowing them to visually and tangibly determine the current state of the joint (external signs of inflammation: swelling, redness of the skin, pain, hyperemia).After that, laboratory and instrumental diagnostics are described, which allows one 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.
• Taking intra-articular fluidsto detect the infection and its sensitivity to antibiotics.

Instrumental diagnostics includes the following procedures:

1. Ultrasound and MRI of the joint.It makes it possible to detect changes in the articular and periarticular soft 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 fundamental for the diagnosis of arthrosis.
3. Arthroscopy.It is performed if there are indications that indicate the presence of inflammation.
4. Scintigraphy.It involves the administration of radiopharmaceuticals to assess bone health and metabolism.

Drug therapy

The prescription of drugs is aimed at relieving pain, suppressing its progression and restoring joint function.To combat pain, the following tools are used:

• Painkillers from the NSAID group.The type of medication, the form of its release and the dose are chosen by the doctor individually.The choice depends on the severity of the pain, age, gender and other factors.The most commonly prescribed medications contain pain relievers.They are usually taken orally in tablet form, but injections or ointments can also be used.
• Muscle relaxants.They are necessary for the relief of spasm from 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 social component of basic therapy.B vitamins help normalize the functioning of the peripheral nervous system and also inhibit pain.
• Blockade against pain.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 arthrosisthe knee or any other joint cannot be treated without taking medications to help restore joint function.For this purpose, the following are designated:

• Chondroprotectors.Taking them restores cartilage tissue and improves blood circulation in it.It is taken in the form of ointments, injections and tablets.
• Hyaluronic acid.The drug is injected directly into the joint cavity, ensuring the fastest onset of the therapeutic effect.Its main purpose is to improve the viscosity of the synovial fluid and prevent trauma to the articular surfaces of the bones.

Non-drug therapy

It is important to understand thattaking medications- this is not a medicine and not the only way to heal.To eliminate pain, increase joint mobility and improve quality of life, you will need to devote sufficient time to non-drug treatment methods.It is necessary to maintain the right balance between adequate physical activity and adequate rest.You can achieve this result by sticking to daily exercises.To get the desired result, you must adhere to the following training rules:

1. Classes should be held 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 exercise, then stop the exercise.

Regardless of the degree of arthrosis of the knee joint, the patient needsstop running(especially short distances at high speed), jumping, outdoor games (football, basketball, volleyball, etc.), weight lifting (barbells, 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.

For arthrosis, physiotherapy is indicated.It helps to improve well-being and fights possible complications of the disease.Physiotherapy procedures include:

1. Electrophoresis or phonophoresis with solutions of analgesic drugs.
2. Paraffin heating applications(performed exclusively in the absence of an 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.This is an effective physiotherapy aimed at restoring muscle volume and strength.

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

Preventing

Coping with arthrosis, as well as its consequences, is quite difficult.However, it is much easier to prevent it.To do this, it is enough to follow simple recommendations that will help protect healthy joints for many years.Among them:

• An active lifestyle.Even if your professional activity involves long periods of sitting or standing, you should find time (at least a few minutes a day) for a simple warm-up.
• Regular exercise or visits to the pool.These are great sports for general strengthening that will help keep your muscles and musculoskeletal system in healthy tone.
• Proper and rational food.It is extremely important to monitor your daily diet.It should include a sufficient amount of proteins, fats, carbohydrates, trace elements and vitamins.It is worth increasing the consumption of foods with a high omega-3 content (fish, red game, avocado, nuts, flax seeds, etc.) and collagen (jelly, rich soups, etc.).
• Monitor your body weight.It is necessary to keep your weight within normal limits, avoiding the development of obesity (for this you also need to exercise and eat properly).
• Wear comfortable shoes.
• Stop playing sportsaccompanied by a high risk of injury.

CONCLUSION

Arthrosis of jointsThis is a very serious disease that can lead to serious consequences and complications.However, you can fight it, live a full life and go about your day job.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 arthrosis depends on the time of treatment and compliance with medical recommendations.Early medical consultation allows you to identify the first degenerative changes and eliminate them in time.Therefore, there is no need to self-medicate or postpone going to the doctor.If you notice the first symptoms of joint disorders, you should immediately visit a doctor and undergo a complete diagnosis.