Osteoarthritis is a degenerative joint pathology, accompanied by degeneration processes of cartilage tissue.As the disease progresses, the joint capsule, ligamentous apparatus, synovial membrane and nearby bone structures also participate in the destructive process.
Prevalence of osteoarthritis
Among people with osteoarthritis, the majority are older people.The disease after the age of 65 is not only the most frequently diagnosed joint pathology, but also the main cause of loss of the ability to work with subsequent disability.Moreover, in old age, it is mainly the fair sex who get sick, but among young people, most of those who get sick are men.
The incidence of osteoarthritis varies greatly between countries.It has not yet been possible to determine the reasons for the wide dispersion of statistical data.
Causes and risk factors.
Osteoarthritis is a disease that can be primary or secondary.If there are no objective reasons for the development of pathology, we speak of the primary type.If it is possible to identify the causes of osteoarthritis, it is called secondary type.
Secondary osteoarthritis can be caused by the following negative factors:
- traumatization of joints of various nature (frequent falls, sprains, bruises);
- chronic congenital tissue dysplasia;
- pathological changes in metabolic processes;
- various autoimmune pathologies;
- inflammatory processes of a nonspecific nature in the joint area;
- some pathologies of the endocrine system;
- degenerative-dystrophic type processes that occur chronically;
- various diseases accompanied by excessive joint mobility along with a weak ligamentous apparatus;
- presence of hemophilia;
- Inflammatory processes of a specific type.
In addition to the direct causes that lead to the development of osteoarthritis, there are also predisposing factors that do not cause the disease itself, but can increase the risk of its development.
These include:
- age over 55 years;
- the presence of excess weight, due to which the load on the joints increases;
- excessive load on any joint or group due to inadequate sports training, specific work requiring prolonged stay in one position;
- history of surgical interventions on the joints;
- inheritance;
- hormonal changes in the female body during postmenopause;
- constant hypothermia;
- spinal pathologies that are not treated;
- insufficient intake of beneficial micro- and macroelements from food.
Development mechanism
The mechanism of development of osteoarthritis is quite well known.The cartilage that ensures normal contact between two bones is smooth in nature, without protuberances or roughness, which helps maintain normal movement of the joints.When the disease occurs, the structure of the cartilage changes, it becomes rough and defects appear that reduce the effectiveness of natural sliding.
Due to the acquired unevenness, the cartilage is gradually injured, in some places it begins to calcify and in others it begins to ossify.In this case, small particles are separated that end up in the joint fluid and can damage the surrounding tissues.
As the pathology worsens, the joint can enter a state of chronic subluxation, which will significantly affect its motor function.
Degrees
Doctors divide osteoarthritis into three main degrees:
- I graduate.Characterized by the absence of a clear clinical picture.The patient may have rare complaints of pain in the affected joint, but usually does not consult a doctor.In this case, changes are observed in the ligamentous-muscular apparatus and in the joint fluid, but there are still no visible deformations.
- II degree.The symptoms of osteoarthritis become more pronounced.The pain is characterized as tolerable, but occurs regularly.The patient consults a doctor because he or she notices a decrease in quality of life.A characteristic cracking sound can be heard in the affected joint.Changes are observed in nearby muscle structures, as nerve conduction is altered.
- III degree.Characterized by pronounced symptoms.The articular cartilage is very thin and cysts, foci of calcification or ossification can be found in it.The ligamentous apparatus is shortened, which leads to increased mobility in the affected area, which is accompanied by limitation due to a pronounced inflammatory process.The metabolism of surrounding tissues is affected, which can lead to muscular dystrophy.
In any case, the patient will need the treating doctor to clarify the diagnosis.This is due to the specifics of the course of the disease, which is characterized by stages of remission and exacerbation, which alternately replace each other.
Pain due to illness
Pain due to osteoarthritis is the most common complaint for which patients consult a doctor.Its characteristic feature is its connection with the time of day, weather and physical activity.
In most patients, the pain worsens when walking, running, or other physical activity directed at the affected joint.As soon as the load stops, the pain gradually subsides.Its development is explained by the fact that cartilage can no longer perform its shock absorption functions.
At night, discomfort occurs most often as a result of stagnation of blood in the veins.Another reason is the increase in intraosseous pressure during this period.
One of the main diagnostic criteria is the presence of the so-called initial pains, which bother the patient at the moment when active movement has just begun.The initial pain usually disappears if physical activity continues.Its appearance is explained by the presence of joint deposits (debris) that irritate the nerve endings.Once these deposits move away from the nerves, the pain disappears.
Symptoms
In addition to pain, doctors identify other signs of osteoarthritis, which may indicate the presence of pathology.
These include:
- The appearance of a painful, crunching sound.The pain appears mainly if a person has suffered hypothermia.At first, the crackling will be barely audible to the ear, but as the disease progresses without treatment, people around you will hear it.
- Decreased ability to move..At an early stage of the development of pathology, there is no decrease in mobility.However, the longer the disease remains untreated, the more severe the limitation of joint movement will be.This is explained by a narrowing of the joint space and spasms of nearby muscle structures.
- Joint deformity.It is characteristic of the last stage of osteoarthritis, but is also an important indicator of the course of the disease.During this period it is already very difficult to treat the disease.
What doctor treats osteoarthritis?
Who treats osteoarthritis?In most cases, therapy is carried out by several specialists at once.First, an arthrologist, a joint specialist, intervenes.Additionally, the patient will also need to visit an orthopedist.If the disease is a consequence of an inflammatory process, it is also recommended to visit a rheumatologist.
If necessary, other specialists may be involved during the treatment period.Most of the time you have to resort to the services of traumatologists, physiotherapists, masseuses and surgeons.
Diagnosis
Treatment of joint osteoarthritis begins only after the diagnosis is confirmed and the degree of pathology is established.First, the doctor interviews the patient in detail and performs an examination.The presence of characteristic complaints and deformities indicates that the disease exists.
A mandatory way to confirm the diagnosis is x-ray of the affected joint.If the disease has affected the knee, a photograph of the knee is taken;If the pathology is located on the hand, then radiological signs of the disease are specifically looked for there.
Diagnosis by radiography does not always provide sufficient results to diagnose the patient.In this case, you can be sent for an MRI (this will allow you to assess the state of the soft tissues and their involvement in the pathological process) or a CT scan (this will allow you to draw conclusions about the state of bone and cartilaginous structures, the involvement of nearby anatomical formations in the pathological process).
Treatment
How to treat osteoarthritis of the joints?The choice of the appropriate therapeutic technique depends on the severity of the symptoms and the stage of the disease.
The doctor selects the treatment regimen after assessing the general condition of the patient and the course of the disease.Both conservative and surgical treatment methods can be used.
medication
How to treat the disease if it is preferable not to undergo surgery, but rather to use medication?
Conservative therapy is suitable only for patients at an early stage of pathology formation and will include the use of three main groups of drugs:
- glucocorticosteroids– hormonal drugs are injected into the joint cavity, which effectively relieve the inflammatory process during an exacerbation;
- non-steroidal anti-inflammatory drugs,They are mainly used as injections and are injected into the muscles near the joint or directly into a vein.But doctors can also recommend pills, although this option of taking NSAIDs is undesirable due to the negative effect on the gastrointestinal tract;
- chondroprotectors– drugs of this group can reduce the processes of destruction of cartilage tissue and improve regeneration;They are especially effective in the initial stages of disease formation.
Surgical
How to cure osteoarthritis if the disease has already gone quite far?In this case, conservative therapy will be ineffective and doctors will only be able to recommend surgical intervention to the patient.
Nowadays, endoprostheses are performed in most cases.During the operation, the actual joint is replaced with a prosthesis that has all the functions of a healthy joint.
In some cases, palliative treatment options are provided, the main goal of which is to reduce the load on the articular surfaces.
exercise
In the early stages of the disease, it is treated not only with medications, but also with physiotherapy.Physical exercise is an important stage of therapy, which helps maintain the functionality of the joint and reduces the likelihood of further progression of the disease.
Depending on the severity of the pathology and the individual characteristics of the patient, the set of exercises is selected individually.The doctor must take into account the location of the osteoarthritis, which allows the most effective treatment of the affected tissue.
Self-study without medical supervision is not recommended, especially in the initial stage.Exercises should be selected so that they are as gentle as possible, without sudden movements.
Physiotherapy classes are effective only if the patient spends a little time performing the recommended complex every day.
Traditional methods
Many people who suffer from osteoarthritis refuse to use medication or undergo surgery until the end.In this case, alternative medicines are used as substitutes for medications.
The plants most used in therapy are:
- Kalanchoe;
- ginger;
- horseradish;
- bay leaf;
- garlic;
- cinnamon;
- horsetail and others.
They are used in the form of tinctures, decoctions and poultices on the affected area.It is important to keep in mind that a complete treatment of the disease is impossible using only home recipes.It is better if traditional therapy is combined with traditional medicine.
Prevention
What can be done to reduce the probability of developing osteoarthritis in old age?Simple preventive measures are within everyone's reach.
Recommended:
- daily moderate physical activity: walking, cycling, performing simple sets of exercises as exercise, etc.;
- adherence to the basic principles of a healthy diet: eat frequently, but little by little, avoid fast food, overeating, heavy and fatty foods, eat a lot of spices;
- weight control: weight gain increases stress on the joints, which can lead to the development of osteoarthritis;
- timely treatment of chronic diseases that cause metabolic disorders;
- the use of vitamin and mineral complexes if the amount of nutrients provided by food is considered insufficient.
The difference between arthritis and osteoarthritis.
Many people, due to the similarity of the sound, confuse arthritis and osteoarthritis.However, these are completely different diseases.
Arthritis is not called dystrophy and degeneration of joint tissues, but any inflammatory reaction that can develop in the joint cavity, regardless of its cause.Inflammation most often affects not only the joint, but also the muscles closest to it, bone and ligamentous structures.Arthritis pain is not associated with physical activity;It may bother the patient even at rest and there is no cracking in the joints.
In most cases, it is impossible to independently distinguish arthritis from osteoarthritis, since the main symptom is pain and patients rarely have an idea of its characteristics in each of the pathologies.
It is better to entrust the establishment of an accurate diagnosis to the attending physician, so as not to make mistakes in further treatment and prevention of the disease.
Osteoarthritis is a serious pathology that can cause disability if the patient does not consult a doctor in time.At the first signs of the disease, it is recommended to contact a specialist so that he can confirm the diagnosis and select the most optimal treatment.
If you manage to detect the disease at an early stage of development, you will probably be able to do it even without surgical intervention, limiting yourself only to conservative treatment.