Osteoarthritis refers to diseases that affect the joints.As a result of dystrophic-degenerative processes, cartilage is gradually destroyed and its place is replaced by growing bone tissue.Pathological process is accompanied by pain, limitation of movement of joints, violation of its functions and severe deformation.Approximately 10-25% of the population suffers from arthrosis.After the age of 80, almost all people have degenerative disorders of the musculoskeletal system.Most often, the disease affects the most mobile joints (fingers, hip, knee, neck).But sometimes degenerative processes develop in the ankle and shoulder joints.
Factors of disease development
Various reasons cause destructive processes in the body.Congenital connective tissue disorders are the most important.Regular microtrauma of the joints and acute joint diseases contribute to the occurrence of arthrosis.Over time, an untreated disease turns into a chronic stage with regular exacerbations.
Factors causing the development of arthrosis are:
- overweight;
- physical inactivity;
- hormonal disorders;
- atherosclerosis;
- venous insufficiency;
- endocrine disorders;
- genetic predisposition;
- Regular and heavy loads on the joints (for example, in weightlifters or people whose profession involves lifting and moving heavy objects).
Under the influence of a provoking factor or several influences at the same time, cartilage tissue cells begin to collapse.Gradually, the cartilage thins, becomes less elastic, then becomes covered with cracks and falls off.The bones of the joint begin to touch each other.The body begins a compensatory mechanism, as a result of which bone tissue grows on the destroyed surface.As a result, the joint becomes inactive and deformed.
species
Arthrosis can be primary, which appears independently, and secondary, which develops as a result of joint diseases, injuries and deformations.
Depending on the affected joint, the disease has its name:
- Gonarthrosis affects the knee joint.
- Coxarthrosis is a disease of the hip joint.
- Spondyloarthrosis affects the intervertebral discs of the lumbar, cervical and thoracic regions.
- Crusarthrosis involves the ankle in the pathological process.
If 3 or more joints are involved in the degenerative process, it is a generalized form.If there are 1-2 joints, it is local arthrosis.
symptoms
At first, the degenerative process is imperceptible.There are no nerve fibers in the cartilage, so at the initial stage of development, the patient does not even know what destructive processes are taking place in his body.The first signs appear only a few years after the onset of dystrophic-degenerative processes, when the periosteum under the cartilage is damaged or inflammation develops.
At first, pain appears in the limbs after a heavy load.In the morning or after a long rest, there is stiffness and a dull aching pain of not too great intensity.After a short warm-up or exercise, all painful symptoms disappear.That's why people don't go to the doctor because it's a common occurrence.At the same time, it is much easier to stop the progression of arthrosis at the initial stage.
All signs get stronger over time.The pain becomes obsessive and constant, preventing sleep at night.Pains, heaviness, inability to do full work or household chores become more and more bothersome.Aching, twisting pain in the joints and surrounding muscles worsens in rainy weather.
Most often, arthrosis affects the joints of the lower limbs, so a person quickly gets tired of walking, it is difficult for him to climb stairs or any height, because the destruction of cartilage tissue causes joint stiffness.Unsteady gait develops due to limb instability.An unpleasant crunching sound is heard when the joint is bent, when the articular surfaces devoid of cartilage rub against each other.Patients try to limit the mobility of the affected joint, so muscle atrophy develops over time.They decrease in volume and walking becomes even more unstable.
If arthrosis develops in the joints of the upper limbs, it happens most often after injuries or as a result of chronic arthritis.In this case, bony protrusions appear on the fingers, and the hands become square.
Clinical symptoms depend on the stage of arthrosis development:
- zero.
At the zero stage, a person sometimes feels a little discomfort.X-ray examination does not reveal degenerative changes. - Elementary.
A mild dull pain occurs when walking for a long time.X-rays show small areas of bone defects along the edges of the articular surfaces.A creaking sound is heard when bending the joint. - it's easy
In the morning there is pain and stiffness.X-rays show osteophytes (single bone growths) along the edges of the joints, narrowing the joint space. - Moderate.
The middle stage is considered degenerative.My bones and muscles hurt all the time, especially at night.The joint is slightly swollen.X-ray examination shows further narrowing of the joint space, proliferation of bone formations and increased bone density. - heavy.
In the severe stage (deformation), constant aching pain appears, which is aggravated by movement.When you try to bend the joint, a harsh crunch is heard.X-ray shows a sharp narrowing of the joint space;Osteophytes have already grown to such an extent that it has caused deformation of the joint and changes in its structure.
diagnosis and treatment
An orthopedist, a rheumatologist and a surgeon participate in determining the type and stage of degenerative-dystrophic processes in the joints.Diagnosis includes standard blood and urine tests.If necessary, an immunological analysis and an examination of the intra-articular fluid for the presence of infection are carried out.Instrumental studies are conducted (MRI, ultrasound to determine changes in soft periarticular and articular tissues, CT, X-ray to determine changes in bone tissue).
therapy
It is impossible to completely stop the disease.Timely diagnosis and treatment allow you to maintain its mobility and prevent the progression of destruction.
Antispasmodics, non-steroidal anti-inflammatory drugs, steroid blockade injected into the joint, chondroprotectors, muscle relaxants, vitamin and mineral complexes, drugs to improve trophism in the affected tissues, proteolysis inhibitors to slow down the destruction of cartilage and bone tissue are used for the treatment of arthrosis.
Patients with severe pain and an unstable joint are recommended to wear tapes that hold the joint in its normal position using adhesive tapes, orthoses, elastic knee pads or elbow pads.Crutches or crutches should be used for support.
Physiotherapy procedures should be prescribed, which include UHF, massage, ozone therapy, electrophoresis and phonophoresis with analgesic solutions, magnetic therapy, acupuncture, electrical stimulation, darsonvalization, paraffin baths (in the absence of inflammation).
In the later stages of arthrosis, when the tissues are already destroyed and the joints are severely deformed, the only way is surgical intervention:
- Arthroscopy with removal of bone formations, vertebrae and partial replacement of damaged cartilage.
- Endoscopy.It is the replacement of a joint (in whole or only part) with an artificial joint.
- Artodesis.The joint is closed and fixed in a comfortable position.Over time, the articular surfaces grow together.
Prevention
Since it is impossible to restore one's own joint to a normal physiological state, it is necessary to take measures in advance to prevent this disease.It is especially important to do this if there is a family history of the disease or if you reach the age of 40.
Prevention includes maintaining a normal body mass index and regular exercise.Infectious pathologies and other joint diseases should be treated in time, hypothermia and prolonged and sudden physical exertion should be avoided.People in the risk group (according to age, with a traumatic profession, poor heredity) should regularly examine the joints using X-ray.
Only timely and adequate treatment helps joint health.