Arthrosis is a joint disease, considered dystrophic and associated with the slow destruction of the cartilage within the joint.With arthrosis, for a long time, changes occur, restructuring the joint ends of the bone, inflammatory processes are underway and the degeneration of the periosyatic tissues occurs.Such a thing as “arthrosis” also includes a very large group of degenerative-inflammatory joint diseases, which have different causes and similar mechanisms of their development.
Arthrosis is considered the most common joint disease in the world, according to statistical data in one degree or another, up to 80% of the world's population suffers from arthrosis.The lessons of this type are very common and are third after oncology and cardiovascular disease.
The probability of developing arthrosis with age often increases.The disease also affects men and women, the exception is only arthrosis of interfalanx joints, since it is more often noticed in women.Arthrosis surpasses people of working age - 30 years and each year the number of sick people increases constantly and constantly.
The causes of arthrosis
Arthrosis develops due to metabolic disorders in the joint, which in turn leads to the fact that cartilage begins to lose elasticity.This can be facilitated by complete or partial loss of the composition of the proteoglycans cartilage, this happens, as a rule, due to very deep cracks in the cartilage itself.Loss of proteoglycans may occur for another reason: due to the failure of its production by joint cells.
The following reasons may affect the occurrence and development of arthrosis:
- Intended previous injuries.It can be dislocations, bruises, fractures, ligaments and other damage.
- Metabolic disorders.
- Excessive body weight, leading to additional loads at the joints.
- The inflammatory process in the joints is acute purulent arthritis.
- Elderly age.
- Low quality of power.
- Hypothermia.
- Autoimmune diseases - red lupus, rheumatoid arthritis.
- General body poisoning.
- Frequent colds.
- Specific inflammation - syphilis, tuberculosis, tick encephalitis, gonorrhea.
- Thyroid diseases.
- Blood coagulation violation (hemophilia).
- Perthine disease is a violation of blood supply to the femoral head.
In addition, at risk, in the near future, a disease such as arthrosis are people whose professions are: bricklayer, miner, fisherman, blacksmith, metallurgist - and other areas of activity related to increased physical work.
Arthrosis symptoms
Symptom of arthrosisThere is pain in the load in the joint, which disappears when the resting joint;Reducing joint mobility, crispness, a feeling of muscle tension in the joint.The articulation periodically affected by arthrosis may swell and, over time, is deformed.
Consider the 4 large groups following symptoms of arthrosis:
- Pain.The presence of pain is the first sign of articulation of the joints.It may be supposed that, with any damage, similar sensations occurs, but with arthrosis the pain has some characteristics.First, this is the occurrence of sudden pain or significant discomfort during the movements.It will be located where the painful joint is located.When a person for movement and enters a state of rest, the pain passes.At night, a person practically does not experience unpleasant sensations, unless during body blows, finding the ideal position - the patient falls asleep calmly.Pain appears during rest only in the disease progression phase, they have some resemblance to dental bastards when a person cannot fall asleep.They are closer to the morning - at 5 am.Therefore, at the beginning of the pain, there is virtually no pain, it can only be felt with load or palpation, over time a person's suffering is intensified and the joint requires more and more rest periods.Then life transforms completely into torture - hyaline cartilage is diminished, the bone is exposed, osteophytes begin to grow.The acute pain torments almost constantly, intensifying even more in bad weather and full moon.
- CRANCH.An equally indicative symptom of arthrosis is the presence of crispness.It becomes audible due to the fact that the softness of bone rotation in the joint is reduced, they rub as a result of which a characteristic sound arises.A crisis can be heard with other diseases and even when the joints are healthy.But it is precisely a crisis that is distinguished by its "dry" sound.The more the disease progresses, the brighter the sound becomes.Also, if a crisis is heard, the pain will be felt.This is what makes it possible to distinguish sound in conjunction with arthrosis with the harmless click.
- Reducing joint mobility is another characteristic symptom of arthrosis.In the early stage, this phenomenon does not bother the patient, but with the progression of arthrosis, the germination of bone neoplasms leads to the fact that the muscles are spasmodic and the joint gap disappears almost completely.This is the cause of members' immobility at destination.
- Joint deformation.Its modification is determined by the fact that osteophytes grow on the surface of bones and synovial fluid comes.Although deformation is one of the latest symptoms, when arthrosis reaches the articulation largely.
The course of the disease is characterized by the stages of exacerbation and stages of remission.This significantly complicates the independent diagnosis of arthrosis, depending only on their own sensations.Therefore, it is necessary to seek clarification of the diagnosis for the doctor.
Degree of arthrosis
Arthrosis is characterized by degenerative-distribution changes in the joints that will pursue a person in the form of a chronic disease.The result of such destruction is the defeat of the articulation of the cartilage, the pathological changes in its capsule and in the synovial shell, in ligaments and bone structures.
It is customary to distinguish between three degrees of arthrosis, which characterize the severity different from the course of the disease and have various symptoms.
1 degree of arthrosis
In the first stage of arthrosis development, no serious changes in joint morphology are observed.Only the composition of synovial fluid is disturbed.It provides articular fabric with worse nutrients, so cartilage loses its old resistance to family loads.This leads to the fact that cartilage tissues are inflamed, a person has pain.
The patient may complain of insignificant rigidity in the joints, but most of the time he does not pay attention to this feeling, attributing a violation of climate health changes, uncomfortable pose, etc.
Sometimes a weak crisis can be heard in the affected joint area.The pain can be sore.If the disease is diagnosed at this stage, it will be possible to deal with conservative methods.
2 degree of arthrosis
The second stage of arthrosis is accompanied by the destruction of the cartilage.Bone growths appear at the edges of the joint.The more intense the load, the stronger the tissue of the joint cartilage.
One person experiences constant pain to which he gets used to it.The inflammation now calms down and then aggravates again.
The muscles surrounding the joints will lose their previous functions, but most of the time these disorders are weak or moderate.Therefore, at this stage, a person can refuse to visit the doctor.
After a short load on the legs, a person may feel fatigue.At the same time, painful pain in the joints becomes acute.The crystal during movement intensifies, which is explained by bone growth.
It is in the second degree of arthrosis development in the joints that the deformation process begins, so you should definitely seek medical help.
3 degree of arthrosis
The third degree of arthrosis is the most serious.The joint cartilage of the affected joint is not only tuned, but it has also begun to collapse, and pathological outbreaks are already quite large.The joint is very deformed, which affects the normal axis of the limb.
The ligaments surrounding the joint previously lose their functional activity, are short, which affects the mobility of the arms or legs.
During this period, a person has contractures and subluxation.The muscles surrounding the joint are reduced and stretched, are difficult to contract.The articulation itself and nearby tissues suffer from insufficient nutrition.
A person is tormented by intense pain, acute and clear.Even at rest, the patient experiences significant discomfort.The third degree of arthrosis is associated with the risk of complete loss of human capacity.
Types of arthrosis
Depending on the cause of arthrosis, a disease is distinguished with a clear etiology, ie idiopathic arthrosis.Most of the time, it is diagnosed in people over 40.There are also secondary arthrosis, which occurs against the background of obvious causes (after injury, with joint inflammation, with endocrine diseases, etc.).
In addition to the fact that arthrosis is classified depending on the cause of its occurrence, the following varieties of the disease are distinguished:
- Knee arthrosis or gonarthrosis.This is the most common type of disease.At the same time, knee joints suffer.Pathology is diagnosed more often in people with overweight, against the background of metabolic impairment in the body, as well as due to stress.The disease develops over the years, in its late phase, the knee completely loses its mobility.
- Ankle arthrosis.In this type of disease, the ankle joint is affected.The disease develops against the background of the lesions, with the lengthening of ligaments due to available dysplasia, gout and diabetes.Sometimes the cause of pathology is rheumatoid arthritis.Most of the time, ankle arthrosis is diagnosed in people whose work is associated with excessive loads in this area: in dancers, athletes, women who wear high toela shoes.
- Shoulder arthrosis.The main reason for the pathology is considered congenital shoulder joint defects, or excessive loads.The risk group includes carriers, brilliants and people who are busy with hard manual work.This also includes elbow joint arthrosis.
- Hip joint arthrosis or thigh.This is one of the heavy varieties of pathology.The main reason is age -related changes in joint tissues.The risk group includes people over 40.
- Cervical arthrosis.The reasons that can lead to the development of this pathology: insufficient mobility of the cervical spine, obesity and injury.The risk group includes people involved in sedentary work.In addition to the main symptoms of arthrosis in the form of pain and restriction of joint mobility, patients have dizziness, headaches and sometimes even loss of consciousness.This is due to the involvement of the vertebral artery in the pathological process, which feeds the brain.
- Osteoarthritis of hands and fingers.In this case, the articulation of the wrist is damaged, the fingertips etc.Most of the time, women who entered during the menopause period suffer from pathology.
- Spondylartrosis in which the joints and the spine cartilage suffer.The disease develops more often in people at age after 65 years.Women suffer mainly from him, which is explained by a decrease in estrogen level after the climax that arrived.
- In polyothesis.This is a degenerative disease in which peripheral joints, ligaments and tendons suffer.The articulations of the spine may be involved in the pathology.
Arthrosis complications
If arthrosis does not provide adequate attention, it does not treat it in time and correctly, it can lead not only to the complete destruction of the sick joint, but also to a change in spine biomechanics, which is why hernias in intervertebral discs may appear and the development of arthrosis in other healthy articulations may begin.The complication of joint arthrosis is better not to allow.
The following pathologies are distinguished as the main complications of arthrosis:
- Destruction of the joint.
- Joint deformation.
- The impossibility of performing movements.
- Patient's disability.
- Vertebral spine biomechanics and other joints.
- Intervertebral disc hernias.
- Reducing the patient's standard of living.
Diagnosis of Arthrosis
To make a diagnosis, the doctor should interview and inspect the patient.Then he will name him an x -ray of the affected joints.
The X -Ray images are performed more often in 2 projections.The study allows you to visualize dystrophic changes in tissues, cartilage damage and adjacent bones.Articular gap in arthrosis patients is reduced, the bone site is deformed, bone growth, osteophytes can leave it.Sometimes the articulation itself loses stability, which leads to dislocations.
The first sign of arthrosis, which can be viewed in an X-ray, is the presence of osteophytes.First, the edges of the joint surface simply become clear.In the future, they thicken, and then freak out and peaks appear on them.The joint gap is already becoming as pathology advances.
Depending on the resulting radiological framework, the doctor can make the following diagnosis (the Kellgren-Lawrence classification is taken as a base):
- Arthrosis is doubtful.It is not possible to determine the degree of narrowing of the joint gap, but small osteophytes are visible.
- Soft arthrosis, in which osteophytes are well visualized, but there are doubts about the narrowing of the joint gap.
- Moderate arthrosis is diagnosed when joint gap is clearly reduced and osteophytes are clearly visible.Sometimes bone deformations are found.
- Severe arthrosis is accompanied by a significant narrowing of the joint gap and the formation of large osteophytes.The articulation will be deformed.
If the doctor needs more information about the condition of the joint, it may direct the patient to pass through the CT, arthroscopy or magnetic resonance imaging.To evaluate the quality of synovial fluid, joint puncture is performed.
Treatment Methods
It is better to treat painful joints at an early stage, the treatment itself should be pathogenic and complex.The essence of treatment is to remove the causes that contribute to the development of this disease, it is also necessary to eliminate inflammatory changes and restore the functions that were lost earlier.
The comprehensive treatment of arthrosis includes medications that have anti -inflammatory and analgesic properties, physiotherapeutic procedures should also be performed, which have an analgesic joint effect.If the treatment is performed on a spa resort, it consists of climatic conditions that act favorably in the joints, as well as the use of mineral waters and mud.
The treatment of arthrosis is based on several basic principles:
- Damaged joints should be eliminated from excessive load.If possible, during treatment, it should generally be reduced to a minimum.
- Following the established orthopedic regime.
- Physiotherapy exercises classes.
- The passage of physiotherapy, which includes a magnet and electrotherapy, shock wave and laser therapy.
- Sanatory treatment.To do this, it is necessary once a year, on the recommendation of a doctor, undergoes treatment of the course in specialized resorts.
- Articulation saturation with oxygen, or oxygenotherapy jointly in such a way.
- Drug therapy.
- Inside, the block of bones, as well as the decompression of metrophy.
- Rational approach to nutrition.
Physiotherapeutic treatment
You can deal with arthrosis using physiotherapeutic treatment methods.
These include:
- UVT.Shockwave therapy makes it possible to get rid of osteophytes, which are bone processes.They are the ones who become the main cause of pain.Waves soften these consequences and after a while are absorbed.At the same time, joint power improves, metabolic processes are normalized.This procedure is effective only in the early stages of disease development.In addition, only a doctor can name it, as it has many against -indications.
- Myostimulation.The method is based on muscle stimulation on electrical impulses.The procedure is shown for the treatment of bedridden patients who are forced to adhere to bed rest after injury.This method is not often prescribed for arthrosis, although it allows us to normalize blood flow in the problem area and increase muscle tone, which makes it possible to bring deadlines to restoration of joints.
- Phonophoresis.In this method of treatment, the articulation is exposed to waves and drugs by ultrasound.The effect of drugs increases as they will be delivered "exactly at destination," and cells will learn them better.
- Ozon therapy.This method involves the introduction of a gas mixture into the joint.The patient disappears, inflammation decreases, joint mobility is normalized and blood circulation improves.The treatment is performed in courses.Its duration depends on the severity of the pathology flow.
Surgical types of treatment
When it is not possible to deal with the disease with conservative methods, the patient is directed to the operation.
Surgical intervention methods include:
- Puncture performance.This is not only a therapeutic, but also a method of diagnosis.During its implementation, the needle is inserted in the joint, taking a small amount of liquid.In the future, it is sent for analysis.This method allows you to remove the load from the joint, as well as deliver medications to it, for example corticosteroids.
- Arthroscopy.At the same time, an arthroscope is introduced into the joint, for which several small cuts are made to the skin.This procedure makes it possible to evaluate the condition of the joint inside.During arthroscopy, the doctor can remove unnecessary cartilage, thus delivering a person out of pain.
- Close to articular osteotomy.The operation comes down to the fact that joint bones are slightly sawn and fixed in the correct position.This allows you to reduce load in the defeat zone, and save a person from pain.Although the procedure is effective enough, they rarely resort to it, as it is performed under anesthesia and requires a long period of recovery.
- Replacing your own articulation with a prosthesis.Endoprostrate is resorted if the joint is very deformed and cannot be restored.This is a difficult operation that costs a lot of money.The prosthesis itself is made of materials such as: metal, ceramic, plastic.After intervention, a person is restored for a long time, may suffer from pain.Although it is often impossible to help patients with other methods, otherwise a person can be completely immobilized.A high quality prosthesis is able to last 20 years.All this time, a person will have no problems with the movement.
Drug treatment
Let's consider the drug treatment in more detail:
- Anti -inflammatory drugs.Initial arthrosis therapy is comprehensive, you can slow down the course of the disease and widely improve quality of life.It is worth living in more detail at some points of treatment.In particular, drug therapy includes early stage - this is pain removal as well as the elimination of inflammatory processes that occur in the joints.
- Hormonal corticosteroids.When arthrosis is at the stage of exacerbation, hormonal corticosteroids are advisable.They are inserted in the joint.Externally, you can use a special patch, ointment or tincture, which are made based on burning pepper.
- Preparations designed to restore cartilage and improve the high quality composition of synovial fluid will not be superfluous.The course lasts a very long period so far until improvement.
If the case is especially difficult, ingestion of narcotic painkillers may be prescribed.But they are used extremely rarely when the rest of the means did not bring the desired effect.
Proper nutrition for arthrosis
Separately, it is worth living in nutrition during an exacerbation of the disease.There are also certain recommendations here - you cannot eat too much, as this will contribute to the accumulation of extra pounds, but it is impossible to starve, since the provision of cartilage with important elements will be broken.The priority task, which is facing the overweight patient, is their decrease.To do this, it is simply necessary to remove quick carbohydrates from the diet, they are contained in all products and flour sweets.Alcohol falls under the ban and, first and foremost, beer.
There is absolutely no complaint about fish dishes - they can be used a lot, of course, in reasonable amounts.But you should not lean on your very fat varieties, as they have many calories, which means extra pounds will not take too long.
An important role in the treatment of arthrosis is attributed to a cold plate.Surprisingly, it is this dish that is recommended to include all doctors in the diet.This food will be a real deposit of stroke elements for the painful joints.The most important component in this dish is a natural collagen.It is absorbed by the body quickly and is the basis of any connective tissue.Thanks to the regular consumption of jelly, good results can be achieved - the joints will become more mobile, the fabrics that line their tissues - elastic and cartilage and bones will gain strength.
Do not forget the regular intake of vitamins with food.For patients with arthrosis, vitamins B are especially relevant
Pyridoxin will help hemoglobin production."You can get it ”eating bananas, walnuts, cabbage and potatoes. It is worth being excited with vegetation and vegetables. They will become a source of folic acid. The liver, mushrooms, dairy products and eggs will be useful. They are rich in riboflavin.
Observing the physician's treatment regime, it can be achieved that the disease will retreat and damaged tissues will begin to recover.