Osteoarthritis refers to diseases that affect the joints.As a result of dystrophic-degenerative processes, cartilage is gradually destroyed and replaced by growing bone tissue.The pathological process is accompanied by pain, limited joint mobility, disruption of its functions and severe deformation.Approximately 10-25% of the population suffers from osteoarthritis.After 80 years, almost everyone has degenerative diseases of the musculoskeletal system.Most often, the disease affects the most mobile joints (fingers, hips, knees, neck).But sometimes degenerative processes develop in the ankle and shoulder joint.
Factors in the development of the disease
Various reasons trigger destructive processes in the body.The most important are congenital anomalies of connective tissue.Regular joint microtraumas and acute joint diseases contribute to the appearance of osteoarthritis.Over time, the untreated disease enters a chronic stage with regular exacerbations.
The provoking factors leading to the development of arthrosis are:
- overweight;
- physical inactivity;
- hormonal disorders;
- atherosclerosis;
- venous insufficiency;
- endocrine disorders;
- genetic predisposition;
- regular, heavy loads on the joints (for example, in weightlifters or people whose profession involves lifting and moving heavy objects).
Under the influence of one or several provoking factors at once, the cells of the cartilaginous tissue begin to collapse.Gradually, the cartilage becomes thinner, less elastic, then becomes covered with cracks and falls out.The bones in the joint begin to rub against each other.The body launches a compensatory mechanism, as a result of which bone tissue grows on the dilapidated 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 diseases, injuries and joint deformities.
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 in 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, we are talking about a generalized form.If there are 1-2 joints, this is local arthrosis.
Symptoms
At first, the degenerative process occurs unnoticed.There are no nerve fibers in the cartilage, therefore, in the initial stages 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 injured or inflammation occurs.
At first, there is pain in the limbs after great exertion.In the morning or after a long stay at rest, there is a sensation of stiffness and a dull pain of not very great intensity.After a short warm-up or exercise, all painful symptoms disappear.Therefore, people do not go to the doctor, considering this a common occurrence.However, it is in the initial phase that it is much easier to stop the progression of osteoarthritis.
Over time, all signs intensify.The pain becomes obsessive and constant, preventing you from sleeping at night.The pain, the feeling of stiffness, the inability to work fully or carry out household tasks become increasingly disturbing.The aching, tortuous pain in the joints and surrounding muscles intensifies in rainy weather.
Most often, osteoarthritis affects the joints of the lower extremities, which is why the person quickly gets tired of walking, has difficulty climbing stairs or any height, as with the destruction of the cartilaginous tissue, stiffness of the joint forms.An unsteady gait develops due to limb instability.When bending a joint, an unpleasant crunching sound is heard as the articular surfaces, devoid of cartilage, rub against each other.Patients try to limit the mobility of the diseased joint, so muscle atrophy develops over time.They decrease in volume and the gait becomes even more unstable.
If arthrosis develops in the joints of the upper extremities, it most often happens after injuries or as a result of chronic arthritis.In this case, bony protrusions appear on the fingers and the hands acquire a square shape.
Clinical symptoms depend on the stage of development of arthrosis:
- Zero.
At stage zero, a person is sometimes bothered by slight discomfort.Radiographic examination does not reveal any degenerative changes. - Elementary.
When walking for a long time, a slight dull pain occurs.Radiography shows the appearance of small areas of bone defects along the edges of the articular surfaces.When bending the joint, a crunching sound is heard. - 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 moderate stage is considered degenerative.Bones and muscles ache constantly, especially at night.The joint swells a little.X-ray examination shows an even greater narrowing of the joint space, proliferation of bone growths and an increase in bone density. - Heavy.
In the severe stage (deformation), constant pain occurs, intensifying with movement.When you try to bend the joint, you hear a harsh crack.The x-ray shows a marked narrowing of the joint space;the osteophytes have now grown so much that they have led to deformation of the joint and changes in its structure.
Diagnosis and treatment
An orthopedist, a rheumatologist and a surgeon are involved 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 examination of intra-articular fluid for the presence of infection are performed.Instrumental studies are carried out (magnetic resonance imaging, ultrasound to identify changes in periarticular and articular soft tissues, computed tomography, x-rays to determine changes in bone tissue).
Therapy
The disease cannot be completely stopped.Timely diagnosis and treatment allow you to maintain your mobility and prevent the progression of destruction.
Antispasmodics, NSAIDs, steroid blockades injected into the joint, chondroprotectors, muscle relaxants, vitamin and mineral complexes, medicines to improve trophism in affected tissues, proteolysis inhibitors to slow down the destruction of cartilage and bone tissue are used as medicines in the treatment of arthrosis.
It is recommended that patients with severe pain and an unstable joint use tapes that fix the joint in the normal position using adhesive tapes, orthoses, elastic knee pads or elbow pads.Crutches or canes should be used for support.
Physiotherapy procedures should be prescribed, which include UHF, massage, ozone therapy, electrophoresis and phonophoresis with an analgesic solution, magnetotherapy, 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 growths, pimples and partial replacement of damaged cartilage.
- Endoscopy.This involves replacing a joint (totally or partially) with an artificial joint.
- Artodez.The joint is closed and fixed in a comfortable position.Over time, the articular surfaces grow together.
Prevention
Since it is impossible to restore the normal physiological state of your own joint, 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 cases of this disease or if you are over 40 years old.
Prevention includes maintaining a normal body mass index and regular exercise.Infectious pathologies and other joint diseases must be treated promptly, avoiding hypothermia and prolonged and sudden physical exertion.People from risk groups (by age, traumatic profession, low heredity) need to regularly examine their joints using x-rays.
Only timely and adequate treatment helps keep the joint healthy.