Arthrosis

Throughout his life, a person is always on the move.Thanks to this, it is possible to quickly and effectively adapt to changes in the environment, explore the world, move and carry out daily activities.However, any body movement produces a certain load on the musculoskeletal system and can potentially be a traumatic situation, resulting in premature wear and tear on the joints.This is how joint arthrosis occurs - one of the most common diseases on the planet.Despite its widespread prevalence, not everyone knows its main manifestations and dangers, which is why they seek medical help at a later stage.This can lead to serious health problems, including disability.A timely visit to a specialist will allow you to avoid this problem, because an experienced doctor carries out a comprehensive diagnosis, allowing you to identify pathological changes at an early stage.

Arthrosis is a degenerative-dystrophic joint disease with slow growth of 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 occurs.According to official statistics, from 10 to 20% of people in the world suffer from this pathology.This is a fairly significant indicator that increases every year.During the aging process, age-related changes occur in the musculoskeletal system, characteristic of most people over the age of 80.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 chance of disability.

This disease occurs approximately equally in men and women.Risk groups include:

• Women aged 50 and over and men aged 40 and over.
• 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 traumatic sports).

Species

There are severalclassification arthrosis: depending on genesis, clinical form and localization.Each of them has its own clinical significance;classification by lesion location is of most interest in practice.

Arthrosis in the lower leg

• Osteoarthritis of the hip joint- the most dangerous and severe type.Due to the anatomical features of this joint structure, 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 dysplasia, dislocation and osteochondropathy.It manifests itself in the form of pain (at first it appears in the late afternoon and night, but then it becomes permanent, radiating to the groin and gluteal area) and a forced position on the lower part of the leg.
• ankle- happens quite often, because the ankle has to withstand heavy loads every day.As a result, it is often injured, which leads to degeneration.Ankle arthrosis often occurs without significant symptoms, but when it progresses, pain appears during physical activity.Then the pain becomes constant, stiffness of movement and complete immobility are added (rarely, if there is no timely and adequate treatment).
• Osteoarthritis of the knee joint- the most common variety.The knee bears the greatest load, which is why it is more prone to injury than others.There are several types: patellefemoal and tibiofemoral.The first occurs after an injury to the patellofemoral joint.In the early 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, which is characterized by severe, almost unbearable pain, is often associated with pathology.The tibiofemoral type is diagnosed very rarely and has a better prognosis.It is characterized by pain that radiates to the lower part of the body (usually to the legs).
• Heels— Degenerative-dystrophic changes can be observed in the subtalar or talocalcaneal-navicular joint area after injury or disease.It also does not manifest itself clinically for a long time, but over time it begins to become painful and painful in nature.

Arthrosis of the upper extremity

solocalization of diseaseoccurs less often than in the lower leg.These are:

• Arthrosis of the shoulder joint.As a rule, it occurs after injury and against the background of microtrauma in professional athletes.Sometimes diagnosed in individuals whose profession involves physically demanding work.This type of acromial disease is the result of injury and inflammation.At first it goes unnoticed, but as it progresses, a painful sensation appears in the injured shoulder area.The patient noted limited movement, as well as a pulsating sound when moving.If there is no timely treatment, partial ankylosis may occur.
• Elbow - diagnosed 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 when flexing and extending the upper limb and limited mobility.
• Arthrosis of the hand joint.As a rule, it is diagnosed in the carpometacarpal joint of the first finger (this joint is the most susceptible to injury in everyday life).It is characterized by a dull pain on the outer surface of the palm, which can radiate to the thumb.
• Arthrosis of the finger joints.Often found in people who do small jobs (embroidery, knitting, etc.).Excessive growth of bone tissue is observed, which leads to the formation of Heberden and Bouchard 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 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 inflammation (arthritis), one way or another, turns into a degenerative-dystrophic process with constant recurrent inflammation.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 several factors that influence it.The most clinically important among them are:

• Sedentary lifestyle(sedentary work, lazy and more).
• Excessive physical activityhard physical work, professional sports (sports injuries have a negative impact on health in all sectors).
• Heavy weight(joints cannot support such weight).
• Venous insufficiency.
• related to the professionby standing still, 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 fat, protein, carbohydrates, vitamins and microelements).
• Smoking and alcohol abuse.
• Descendants burdened.

Due to the influence of one or more of the factors listed 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 cracks completely.Subchondral bone tissue is in contact with the bone surface, causing it to be destroyed by friction.The protective reaction of bone tissue is its proliferation (especially along the articular edges), which significantly limits the mobility of the joint and leads to its deformation.

Joint cells have a peculiarity - they give a quick response to any, even minor injuries.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 recurrence of pathology leads to worsening inflammation, so the cells of hard tissue begin to die faster, which contributes to the development of the disease.

symptoms

Arthrosis can occur for a long time without any clinical signs.Patients live without suspecting that active degenerative-dystrophic changes are occurring in their joints.As a rule, the first symptoms appear at the height of the pathology or after inflammation occurs.There are several types of symptoms, depending on the time of occurrence 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 (sports, jogging, non-stop walking, climbing stairs, and more).In the morning, after a long stay in motion, the first "starting pain sensation" appears, combined with a slight stiffness.To eliminate limited mobilityyou need to warm up for a certain time.Pain is aching or dull in nature and not very strong.Due to 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, in the early stages of this disease has the best prognosis and a high chance of full recovery without consequences.Therefore, it is highly recommended that you make an appointment with a doctor if you notice any sensation in your joints.

Clear symptoms

The pain gradually increased, exacerbated by weather changes.They occur not only in the morning, but also continue throughout the day.The patient cannot sleep completely;many (especially in old age) notice bone pain and muscle pain.The pain will spread throughout the body and creep into the surrounding area.People with this problem tire quickly when walking even short distances, and experience difficulty bending and joint stiffness.Many people are aware of the instability of the damaged limb, which is why they experience an erratic and soft gait.

Osteoarthritis of the knee is manifested by characteristic irritation, which is formed due to the friction of the articular surfaces against each other.The knee gradually begins to change shape 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 the gait more unstable and cautious.Osteoarthritis of the upper extremity is usually due to injury or chronic arthritis.The most significant deformation is observed in the interphalangeal joint of the hand.Bouchard and Heberden nodes are formed on the fingers, and the hand itself becomes square.

Dangerous symptoms

Due to that factdegenerative-dystrophic changesdevelops gradually and over a long period of time, the appearance of dangerous clinical signs may 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 defects, due to a change in gait or becoming impossible to perform normal movements.
• Myalgia and bone pain.
• An erratic gait, severe limitation of mobility during flexion and extension.
• The pain becomes constant, which does not recede in the evening or night, radiates into the surrounding area.

Degree

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

• Zero.One does not experience any pain or discomfort while walking (even over long distances).No pathological changes were detected on X-ray images.
• Beginning (doubtful).When walking for a long time, moderate dull pain appears.Some patients note slight stiffness when bending the limbs.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.Pain increases with movement.X-rays reveal clear narrowing of the joint space and a small number 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 less and often see swelling in the affected joints.X-ray reveals the development of joint space narrowing and osteophyte proliferation, as well as increased bone density.
• Weight (deformation).The pain syndrome becomes permanent and is not always relieved by taking painkillers.Pain increases with any movement;a loud buzzing sound is heard when bending over.Muscle atrophy also develops, and joint deformities develop.X-ray examination revealed a strong narrowing of the joint space and a significant growth on the edge of the articular surface, which caused deformational changes.

Severity

All degenerative diseases are characterized by a slow course, often without symptoms (especially in the first stage).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 must immediately seek qualified medical help.Provide freefirst aidcan be done using the following methods:

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

Diagnostics

To make a diagnosis, high-precision examination methods are used to identify even small pathological changes.In the clinic, specialists carry out a thorough examination of the patient, allowing them to visually and clearly determine the current state of the joint (external signs of inflammation: swelling, redness of the skin, pain, hyperemia).After this, laboratory and instrumental diagnostics are prescribed, which allows one to get a complete picture of the extent of the lesion.Laboratory tests include:

• General blood tests, biochemical and immunological.Changes in the blood can confirm the presence of inflammation, as well as establish the cause of the disease (metabolic disorders, autoimmune reactions, etc.).
• C-reactive protein.
• Take intra-articular fluidto detect the infection and its sensitivity to antibiotics.

Instrumental diagnostics involves the following procedures:

1. Ultrasound and MRI of joints.Allows to detect changes in soft articular and periarticular tissues.
2. X-rays and CT scans.It is very informative when looking for changes in bone tissue.Today this is the diagnostic method of choice, which is the basis for diagnosing arthrosis.
3. Arthroscopy.It is carried out if there are signs indicating the presence of inflammation.
4. Scintigraphy.Involves the administration of radiopharmaceuticals to assess the condition of the bones and the metabolism therein.

Drug therapy

Prescription drugs aim to relieve pain, suppress its progression and restore joint function.To combat pain, the following are used:

• Painkillers from the NSAID group.The type of medicine, form of release and dosage are selected 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.
• Relax the muscles.They are necessary to relieve spasms from the periarticular muscles.This way can also reduce pain and restore normal blood circulation in the joints.
• Neurotrophic B vitamins.This is a basic therapy component that is easy to get along with.Vitamin B helps normalize the function of the peripheral nervous system and also prevents pain.
• Restriction of painkillers.As a rule, they are used for severe acute pain that cannot be eliminated by taking the drugs described above.In this case, a solution is used that is injected into the most painful place.

Treatment of arthrosisknee or any other joint cannot be treated without taking medication to help restore joint function.For this purpose, the following are appointed:

• Chondroprotectors.Taking it 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 increase the viscosity of the synovial fluid and prevent trauma to the articular surface of the bone.

Therapy is not medicine

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

1. Classes must be held every day, regardless of health, mood, weather, living conditions and other factors.
2. All movements are done very smoothly and slowly.
3. If the pain increases during exercise, then stop the exercise.

Regardless of the degree of arthrosis of the knee joint, the patient's needsstop running(especially in short distances at high speeds), jumping, outdoor games (football, basketball, volleyball, etc.), lifting weights (barbell, etc.), long periods of immobility.The best options in this case are swimming, yoga (preferably with an instructor who will know about problems with joints) and Pilates.

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

1. Electrophoresis or phonophoresis with a solution of analgesic drugs.
2. Application of heating with paraffin(carried out exclusively if there is no inflammatory process).
3. Darson's confirmation- 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 using leeches.The saliva of these animals contains a large amount of enzymes that dilate blood vessels and normalize metabolic processes.In addition, it helps dissolve necrotic tissue and cleans the joint cavity.

Prevention

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

• Active lifestyle.Even if your professional activity involves long periods of sitting or standing still, you should take time (at least a few minutes a day) for a simple warm-up.
• Regular exercise or visiting the pool.This is an excellent general strengthening sport that will help keep your muscles and musculoskeletal system in a healthy tone.
• Proper and rational nutrition.It is very important to monitor your daily diet.It should contain a sufficient amount of protein, fat, carbohydrates, microelements and vitamins.It is worth increasing the consumption of foods high in omega-3 (fish, red game, avocados, walnuts, flax seeds, etc.) and collagen (jelly, rich soups, etc.).
• Monitor your weight.It is necessary to maintain your body 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

Arthritis 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 provides many therapeutic techniques aimed at improving the patient's condition and restoring their motor function.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 delay going to the doctor.If you see the first symptoms of joint disorders, you must immediately visit a doctor and undergo a comprehensive diagnosis.