Arthrosis

Man is in constant motion throughout his life.Thanks to this, it is possible to quickly and efficiently 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 occurs - one of the most common diseases on the planet.Despite its widespread distribution, not everyone knows its primary manifestations and danger, which is why 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 carry out a thorough diagnosis, which allows you to identify 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, the affected joint is deformed, its mobility is reduced and there is severe pain.According to official statistics, from 10 to 20% of people in the world suffer from this pathology.These are quite significant indicators that increase from year to year.During the aging process, age-related changes occur in the musculoskeletal system, characteristic of most people over 80 years of age.However, only a small part of them consult a doctor, preferring to self-medicate.This approach significantly worsens the prognosis of recovery and increases the possibility of disability.

The disease occurs approximately equally in 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 remain in a stationary position for a long time.
• Professional athletes (especially weightlifters and those involved in trauma sports).

Species

There are several of themclassification arthrosis: depending on the genesis, clinical forms and localization.Each of them has its own clinical significance;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 difficult type.Due to the anatomical characteristics of the structure of this joint, the rapid development of degenerative-dystrophic disorders with damage to the muscle-ligament apparatus occurs here.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 manifests itself in the form of pain (initially occurs in the late afternoon and night hours, and later becomes permanent, radiating to the groin and gluteal region) and a forced position of the lower extremities.
• Ankle- occurs quite often, because the ankle joint is forced to withstand heavy loads every day.As a result, it is often injured, which leads to degeneration.Osteoarthritis of the ankle joint often occurs without significant symptoms, but as it progresses, pain occurs during physical activity.Then the pain becomes constant, 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.The knee is the one that bears the greatest load, which is why it is more susceptible to injury than the others.There are several types: patellofemoral and tibiofemoral.The first occurs after an injury to the patellofemoral joint.In the initial stages, it is asymptomatic, because the joint has a large amount of cartilage responsible for shock absorption.Their presence prevents bone injuries.Later, the patient begins to notice pain in the knee after physical activity, which gradually becomes permanent (often increases when the weather changes).Synovitis, characterized by severe, almost unbearable pain, is often associated with pathology.The tibiofemoral type is diagnosed extremely rarely and has a more favorable prognosis.It is characterized by feelings of pain radiating to the lower part of the body (usually the feet).
• Heel— degenerative-dystrophic changes in the area of the subtalar or talocal-navicular joints can be observed after injury or disease.It also does not manifest itself clinically for a long time, but over time it begins to be painful and painful in nature.

Arthrosis of the upper extremities

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

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

Reasons

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

Despite the fact that there is no single genesis of this disease, there are a number of factors that predispose to it.Clinically the most important among them are:

• Sedentary lifestyle(sedentary work, laziness and more).
• Excessive physical activityphysical hard work, professional sports (sports injuries negatively affect health in all sectors).
• High body weight(joints just can't handle that kind of weight).
• Venous insufficiency.
• Related to the professionwith constant 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 microelements).
• Smoking and alcohol abuse.
• Loaded heredity.

Due to the influence of one or more of the factors mentioned above, the gradual destruction of the cartilage tissue that covers 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 its destruction by friction.The protective reaction of the bone tissue is its proliferation (especially along the joint edges), which significantly limits the mobility of the joint and leads to its deformation.

Joint cells have a special feature - they give a quick reaction to any, even minor injuries.Damaged cells actively synthesize anti-inflammatory cytokines, which is why the destruction of cartilage and bones is characterized by aseptic inflammation in the synovium.Frequent relapses of the pathology lead to worsening of inflammation, so the hard tissue cells begin to die even faster, which contributes to the progression of the disease.

Symptoms

Arthrosis can appear for a long time without the slightest clinical signs.Patients live without 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 the onset of inflammation.There are several types of symptoms, depending on the time of occurrence and the characteristics of the manifestation.

First signs

A person begins to feel pain in the area of the damaged joint after physical activity (playing sports, running, walking without stopping, climbing stairs and more).In the morning, after a long stay in a stationary state, the first "initial feelings of pain" appear, combined with light 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 unclear clinical picture, patients rarely seek medical advice in the early stages.Many people begin to self-medicate and try different methods of treatment, which can only worsen the current situation.However, it is precisely in the early stages that this disease has the most favorable prognosis and great chances for a full recovery without consequences.Therefore, it is recommended to make an appointment with a doctor if you notice any sensations in your joints.

Obvious symptoms

The pain gradually increases, intensify with weather changes.They occur not only in the morning, but also last 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 spread to the surrounding areas.People with this problem get tired quickly when walking even short distances, suffer from difficult bending and joint stiffness.Many people notice the instability of the damaged limb, due to which they develop an uncertain and soft gait.

Osteoarthritis of the knee is manifested by characteristic crunching, which occurs as a result of the friction of joint surfaces against each other.The knee gradually begins to deform due to the growth of bone tissue along the edges.Patients try to limit any movements, 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 was observed in the interphalangeal joints of the hand.Bouchard's and Heberden's nodes form on the fingers, and the hand itself becomes square.

Dangerous symptoms

Due to the fact thatdegenerative-dystrophic changesdevelops gradually and over 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 limbs- indicates active inflammation that requires immediate medical intervention.
• Joint deformity, due to which the gait changes or it becomes 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, radiating to the surrounding areas.

Degrees

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 feel pain or discomfort while walking (even for long distances).No pathological changes were detected on the X-ray.
• Initial (doubtful).A moderate dull pain occurs when walking for a long time.Some patients notice a slight creak when bending the limb.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 occurs in the morning with stiffness.The pain increases with movement.The X-ray reveals a clear narrowing of the joint space and a small amount of bone growths (osteophytes).
• Moderate (degenerative).Painful sensations occur not only in the morning, but also at night.Myalgia and bone pain occur.Patients sleep poorly and often notice swelling of the affected joint.X-rays reveal the progression of narrowing of the joint space and the proliferation of osteophytes, as well as an increase in bone density.
• Heavy (deforming).The pain syndrome becomes permanent and cannot always be alleviated by taking painkillers.The pain increases with every movement;there is a loud creaking sound when bending.Muscle atrophy also develops, and joint deformity develops.An X-ray examination shows a strong narrowing of the joint space and a significant growth of the edges of the joint surface, which caused deformational changes.

Exacerbation

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

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

Diagnostics

To establish a diagnosis, high-precision examination methods are used to identify even minor pathological changes.In the clinic, specialists conduct a thorough 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 prescribed, which provide 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 fluidto detect infection and its sensitivity to antibiotics.

Instrumental diagnostics includes the following procedures:

1. Ultrasound and MRI of the joint.It enables detection of changes in soft articular 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 fundamental for diagnosing arthrosis.
3. Arthroscopy.It is carried out if there are indications indicating the presence of inflammation.
4. Scintigraphy.It includes the administration of radiopharmaceuticals to assess the state of the bones and their metabolism.

Drug therapy

Prescribing medication is aimed at alleviating pain, preventing its progression and restoring joint function.The following are used to combat pain:

• Painkillers from the NSAID group.The type of medicine, form of its release and dose 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 relieve spasms 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 normalize the functioning of the peripheral nervous system and also inhibit pain.
• Pain block.As a rule, they are used for severe acute pain that cannot be eliminated by taking the above-described medicines.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 medication to help restore joint function.For this purpose, the following were appointed:

• 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 possible 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.

Therapy without drugs

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

1. Classes must 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 increases during training, stop the training.

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 (weights, 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.

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

1. Electrophoresis or phonophoresis with analgesic solutions.
2. Warming applications with paraffin(performed exclusively in the absence of an inflammatory process).
3. Darson validation- exposure to high and low frequency electric 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 - treatment with leeches.The saliva of these animals contains a large number of enzymes that expand blood vessels and normalize metabolic processes.In addition, it helps dissolve necrotic tissue and clean joint cavities.

Prevention

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

• Active lifestyle.Even if your professional activity involves long periods of sitting or standing, you must take time (at least a few minutes a day) for a simple warm-up.
• Regular exercise or a visit to the pool.These are excellent general strengthening sports that will help you keep your muscles and musculoskeletal system in a healthy tone.
• Proper and rational nutrition.It is extremely important to monitor the daily diet.It should contain a sufficient amount of protein, fat, carbohydrates, microelements and vitamins.It is worth increasing the consumption of foods rich in omega-3 (fish, red game, avocado, walnuts, flax seeds, etc.) and collagen (jellies, rich soups, etc.).
• Monitor your weight.It is necessary to maintain 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 the jointsThis is a rather serious disease that can lead to serious consequences and complications.However, you can fight it, live a full 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 arthrosis depends on the time of treatment and compliance with medical recommendations.An early medical consultation allows you to recognize the first degenerative changes and to remove them in time.Therefore, there is no need to self-medicate or delay going to the doctor.If you notice the first symptoms of joint disorders, you must immediately visit a doctor and undergo a thorough diagnosis.