Arthrosis

Throughout his life, a person is in constant motion.Thanks to this, it is possible to quickly and effectively adapt to changes in the environment, explore the world, move around and carry out everyday activities.However, any movement of the body creates a certain load on the musculoskeletal system and can potentially become a traumatic situation, resulting in premature wear of the joints.This is how arthrosis of the joints occurs - one of the most common diseases on the planet.Despite its widespread prevalence, not everyone knows its primary manifestations and danger, which is why they seek medical help in the later stages.This can lead to severe health problems, including disability.A timely visit to specialists will allow you to avoid these troubles, because experienced doctors conduct a thorough diagnosis, allowing you to identify pathological changes in the early stages.

Arthrosis is a joint disease of a degenerative-dystrophic nature with a slow growth of the cartilage structure and the 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.These are quite significant indicators that increase annually.During the aging process, age-related changes occur in the musculoskeletal system, characteristic of most people over 80 years of age.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.

The disease occurs approximately equally in both men and women.The risk group includes:

• Women over 50 years old and men over 40 years old.
• Persons with a history of endocrine disorders and chronic arthritis.
• People whose profession involves heavy physical labor or the need to remain in a stationary position for a long time.
• Professional athletes (especially weightlifters and those who engage in traumatic sports).

Species

There are severalclassifications arthrosis: depending on genesis, clinical forms and localization.Each of them has its own clinical significance; the classification according to the location of the lesion is most in demand in practice.

Arthrosis of the lower extremities

• Osteoarthritis of the hip joint- the most dangerous and severe type.Due to the anatomical features of the structure of this joint, 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 dysplasias, dislocations and osteochondropathy.It manifests itself in the form of pain (at first it appears in the late afternoon and night, but later it becomes permanent, radiating to the groin and gluteal region) and forced position of the lower extremities.
• Ankle- occurs quite often, since the ankle is forced to withstand heavy loads every day.As a result, it is often injured, leading to degeneration.Ankle arthrosis often occurs without significant symptoms, but as it progresses, pain appears during physical activity.Then the pain becomes constant, stiffness of movements and complete immobility are added (rarely, in the absence of timely and adequate treatment).
• Osteoarthritis of the knee joint- the most common variety.It is the knee that bears the greatest load, which is why it is more susceptible to injury than others.There are several types: patellefemooal and tibiofemoral.The first occurs after injury to the patellofemoral joint.At the initial stages, it is asymptomatic, since the joint has a large amount of cartilage responsible for shock absorption.Their presence prevents bone injury.Later, the patient begins to notice pain in the knee after physical activity, which gradually becomes permanent (often intensifies when the weather changes).Synovitis, characterized by severe, almost unbearable pain, is often associated with the pathology.The tibiofemoral type is diagnosed extremely rarely and has a more favorable prognosis.It is characterized by pain sensations radiating to the lower part of the body (usually to the feet).
• Heel— degenerative-dystrophic changes can be observed in the area of the subtalar or talocalcaneal-navicular joints after injury or illness.It also does not manifest itself clinically for a long time, but over time it begins to become painful and aching in nature.

Arthrosis of the upper extremities

Suchlocalization of the diseaseoccurs less frequently than in the lower extremities.This:

• 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.The acromial type of disease is a consequence of injury and inflammation.Initially it goes unnoticed, but as it progresses, painful sensations appear in the area of the injured shoulder.Patients note limited mobility, as well as a crunching sound when moving.In the absence of timely treatment, partial ankylosis may occur.
• Elbow - diagnosed much less frequently.In most cases, this diagnosis is detected in certain professions: miners, blacksmiths and people working with vibrating tools.The symptomatic picture includes pain in the elbow when flexing and extending the upper limb and limited mobility.
• Arthrosis of the joints of the hand.As a rule, it is diagnosed in the carpometacarpal joint of the 1st finger (it is this joint that is most susceptible to injury in everyday life).It is characterized by a dull pain in the outer surface of the palm, which can radiate to the thumb.
• Arthrosis of the finger joints.Most often found in people doing small work (embroidery, knitting, etc.).Overgrowth of bone tissue is observed, leading to the formation of Heberden's and Bouchard's nodes.Patients rarely report joint pain (sometimes when the weather changes) and stiffness in movement.

Reasons

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 features of connective tissue, previous diseases, as well as microtrauma over a long period of time.Most chronic inflammations (arthritis), one way or another, transform into a degenerative-dystrophic process with constant inflammatory relapses.The age group of arthrosis, 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 a number of factors predisposing to it.The most clinically important among them are:

• Sedentary lifestyle(sedentary work, laziness and much more).
• Excessive physical activityphysically hard work, professional sports (sports injuries have a negative impact on health in all sectors).
• Large body weight(the joints simply cannot cope with such weight).
• Venous insufficiency.
• Profession relatedwith constant standing, 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 fats, proteins, carbohydrates, vitamins and microelements).
• Smoking and alcohol abuse.
• Burdened heredity.

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 completely cracks.The subchondral bone tissue comes into contact with the surface of the bone, 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.

The cells of the joints 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 bones is characterized by aseptic inflammation in the synovium.Frequent relapses of the pathology lead to worsening inflammation, so hard tissue cells begin to die even more rapidly, which contributes to the progression of the disease.

Symptoms

Arthrosis can occur for a long time without the slightest clinical signs.Patients live without even suspecting that active degenerative-dystrophic changes are occurring in their joint.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 characteristics of manifestation.

First signs

A person begins to experience pain in the area of the damaged joint after physical activity (playing sports, jogging, walking without stopping, climbing stairs, and much more).In the morning, after a long stay in a motionless state, the first “starting pain sensations” appear, combined with slight stiffness.To eliminate limited mobilityyou need to warm up for a certain time.The pain is aching or dull in nature and is not very intense.Due to the lackluster clinical picture, patients rarely seek medical advice in the early stages.Many people begin to self-medicate and try out different treatment methods, which can only worsen the current situation.However, it is in the early stages that this disease has the most favorable prognosis and a high chance of a full recovery without consequences.Therefore, it is strongly recommended that you make an appointment with a doctor if you notice any sensations in your joints.

Obvious symptoms

The pain gradually increases, intensify with weather changes.They occur not only in the morning, but also persist throughout the day.Patients cannot sleep fully; many (especially in old age) note aching bones and aching pain in the muscles.The pain will spread throughout the entire limb and radiate to the surrounding areas.People with this problem quickly get tired when walking even short distances, and suffer from difficult joint flexion and stiffness.Many people note instability of the damaged limb, which is why they develop an uncertain and gentle gait.

Osteoarthritis of the knee is manifested by a characteristic crunch, which is formed as a result of friction of the articular surfaces against each other.The knee gradually begins to deform due to the growth of bone tissue along the edges.Patients try to limit any movements, which leads to muscle atrophy.This, in turn, makes the gait even more unstable and cautious.Osteoarthritis of the upper extremities is usually a consequence of injury or chronic arthritis.The most noticeable deformation is observed in the interphalangeal joints of the hand.Bouchard's and Heberden's nodes form on the fingers, and the hand itself becomes square.

Dangerous symptoms

Due to the fact thatdegenerative-dystrophic changesdevelops gradually and over a long period of time, the appearance of even dangerous clinical signs may go unnoticed.This significantly aggravates the current situation and worsens the prognosis for recovery.These symptoms are:

• Swelling and constant pain in the limbs- indicates active inflammation requiring urgent medical intervention.
• Joint deformity, due to which the gait changes or it becomes impossible to perform usual movements.
• Myalgia and bone pain.
• Unsteady gait, severe limitation of mobility during flexion and extension.
• The pain becomes constant, which does not subside in the evening or at night, radiating into the surrounding areas.

Degrees

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

• Zero.A person does not experience any pain or discomfort while walking (not even long distances).No pathological changes are detected on the X-ray image.
• Initial (doubtful).When walking for a long time, moderate dull pain appears.Some patients note a slight crunch when bending the limb.An 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.The pain increases with movement.An x-ray reveals a clear narrowing of the joint space and a small amount of bone growths (osteophytes).
• Moderate (degenerative).Painful sensations occur not only in the morning, but also at night.Myalgia and pain in the bones occur.Patients sleep poorly and often notice swelling of the affected joint.X-rays reveal the progression of narrowing of the joint space and the proliferation of osteophytes, as well as an increase in bone density.
• Heavy (deforming).The pain syndrome becomes permanent and is not always relieved by taking painkillers.The pain increases with any movement; a strong crunching sound is heard when bending.Muscle atrophy also develops, and joint deformity develops.An X-ray examination reveals a strong narrowing of the joint space and significant growth of the edges of the articular surface, which caused deforming changes.

Exacerbation

All degenerative diseases are characterized by a slow, often asymptomatic (especially in the first stages) course.An increase in pain is observed when weather conditions change (dampness, wind or drop in temperature) 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 independentfirst aidcan be done using the following methods:

1. Take any painkiller medication.
2. Apply ointment or gel with an anesthetic effect to the skin.
3. Keep the limbs in a stationary position (until the pain is eliminated).

Diagnostics

To make a diagnosis, high-precision examination methods are used to identify even minor pathological changes.At the clinic, specialists conduct a thorough examination of the patient, allowing them to visually and palpably determine the current condition 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 obtain a complete picture of the extent of the lesion.Laboratory tests include:

• General, biochemical and immunological blood test.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.
• Taking intra-articular fluidto detect infection and its sensitivity to antibiotics.

Instrumental diagnostics involves the following procedures:

1. Ultrasound and MRI of the joint.Makes it possible to detect changes in soft articular and periarticular tissues.
2. X-ray and CT.It is highly informative when searching for changes in bone tissue.Today this is the preferred diagnostic method, which is fundamental for diagnosing arthrosis.
3. Arthroscopy.It is carried out if there are indications indicating the presence of inflammation.
4. Scintigraphy.Involves the administration of radiopharmaceuticals to assess the condition of bones and metabolism in them.

Drug therapy

The prescription of medications is aimed at relieving pain, suppressing its progression and restoring joint function.To combat pain, the following are used:

• Painkillers from the NSAID group.The type of medication, its release form and dosage are selected by the doctor individually.The choice depends on the severity of pain, age, gender and other factors.The most commonly prescribed medications contain painkillers. They are usually taken orally in tablet form, but injections or ointments can also be used.
• Muscle relaxants.They are necessary to relieve spasm from the periarticular muscles.This way it is also possible to reduce pain and restore normal blood circulation in the joint.
• Neurotropic B vitamins.This is the sociable component of basic therapy.B vitamins help normalize the functioning of the peripheral nervous system and also inhibit pain.
• Painkiller blockades.As a rule, they are used for severe acute pain that cannot be eliminated by taking the drugs described above.In this case, solutions are used that are injected into the most painful places.

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

• Chondroprotectors.Taking them restores cartilage tissue and improves blood circulation in it.It is taken in the form of ointments, injections and tablets.
• Hyaluronic acid.The medicine is injected directly into the joint cavity, ensuring the fastest possible onset of the therapeutic effect.Its main purpose is to improve the viscosity of the synodal fluid and prevent trauma to the articular surfaces of the bones.

Non-drug therapy

It is important to understand thattaking medications- this is not a panacea and not the only way to recover.To eliminate pain, increase joint mobility and improve quality of life, you will need to devote a sufficient amount of time to non-drug treatment methods.It is necessary to maintain the correct balance between adequate physical activity and proper rest.You can achieve this result by sticking to daily workouts.To get the desired result, you must adhere to the following training rules:

1. Classes must be held every day, regardless of health, mood, weather, life circumstances and other factors.
2. All movements are performed extremely smoothly and slowly.
3. If pain intensifies during training, then stop training.

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

For arthrosis, physiotherapy is indicated.It helps improve well-being and fights possible complications of the disease.Physiotherapeutic procedures include:

1. Electrophoresis or phonophoresis with solutions of analgesic drugs.
2. Warming applications with paraffin(carried out exclusively in the absence of an inflammatory process).
3. Darsonvalidization- exposure to high and low frequency electrical 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 number of enzymes that dilate blood vessels and normalize metabolic processes.In addition, it helps to dissolve necrotic tissue and cleanse joint cavities.

Prevention

Dealing with arthrosis, as well as its consequences, is quite difficult.However, it is much easier to prevent it.To do this, just 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 need to make time (at least a few minutes a day) for a simple warm-up.
• Regular exercise or visiting the pool.These are excellent general strengthening sports that will help keep your muscles and musculoskeletal system in healthy tone.
• Proper and rational nutrition.It is extremely important to monitor your daily diet.It should include a sufficient amount of proteins, fats, carbohydrates, microelements and vitamins.It is worth increasing the consumption of foods high in omega-3 (fish, red game, avocado, walnuts, flaxseeds, etc.) and collagen (jelly, rich soups, etc.).
• Monitor your body weight.It is necessary to keep your weight within normal limits, avoiding the development of obesity (for this you also need to exercise and eat right).
• Wear comfortable shoes.
• Stop playing sportsaccompanied by a high risk of injury.

Conclusion

Arthrosis of the jointsThis is a fairly 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 condition of patients and restoring their motor functions.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 a timely manner.Therefore, there is no need to self-medicate or put off going to the doctor.If you notice the first symptoms of joint disorders, you must immediately visit a doctor and undergo a thorough diagnosis.