osteoarthritis

Throughout his life, a person is in constant movement.Thanks to this, it is possible to adapt quickly and effectively to changes in the environment, explore the world, move around and carry out daily activities.However, any movement of the body creates a certain load on the musculoskeletal system and can potentially become a traumatic situation, causing premature wear of the joints.This is how osteoarthritis of the joints 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 in the later stages.This can lead to serious health problems, including disability.A timely visit to a specialist will allow you to avoid these problems, because experienced doctors carry out a thorough diagnosis that allows you to identify pathological changes in the early stages.

Osteoarthritis is a joint disease of a degenerative-dystrophic nature with slow growth of the 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, 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 and prefer to self-medicate.It is this approach that significantly worsens the prognosis for recovery and also increases the chances 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.
• 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 who play traumatic sports).

Species

There are severalclassifications osteoarthritis: depending on the genesis, clinical forms and location.Each of them has its own clinical importance;Classification according to the location of the lesion is the most requested in practice.

Osteoarthritis of the lower extremities.

• Osteoarthritis of the hip joint- the most dangerous and serious type.Due to the anatomical features of the structure of this joint, it is here that the rapid development of degenerative-dystrophic disorders with damage to the musculoligamentous apparatus occurs.When inflammation occurs, the effect of total or partial immobility develops.Often, this pathology arises due to the presence of congenital dysplasias, dislocations and osteochondropathies.It manifests itself in the form of pain (at first it appears in the late afternoon and at night, but then 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 endure heavy loads every day.As a result, it is often injured, leading to degeneration.Ankle osteoarthritis usually presents 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 adequate and timely 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: patellofemoral and tibiofemoral.The first occurs after an injury to the patellofemoral joint.In the initial stages it is asymptomatic, since the joint has a large amount of cartilage responsible for shock absorption.Its presence prevents bone injury.Subsequently, the patient begins to notice pain in the knee after physical activity, which gradually becomes permanent (often intensifying with a change in weather).Synovitis, characterized by intense, almost unbearable pain, is often associated with the pathology.The tibiofemoral type is diagnosed very rarely and has a more favorable prognosis.It is characterized by pain sensations that radiate to the lower part of the body (usually the feet).
• Heel— After an injury or disease, degenerative-dystrophic changes can be observed in the area of the subtalar or talolocalcaneo-navicular joints.It also does not manifest itself clinically for a long time, but over time it begins to become painful and painful.

Osteoarthritis of the upper extremities.

suchlocation of the diseaseIt occurs less frequently than in the lower extremities.These are:

• Osteoarthritis of the shoulder joint.As a rule, it occurs after injury and against the background of microtrauma in professional athletes.It is sometimes diagnosed in people whose profession involves physically demanding work.The acromial type of disease results from injury and inflammation.Initially it goes unnoticed, but as it progresses, painful sensations appear in the area of the injured shoulder.Patients notice limited mobility, as well as a creaking 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 who work with vibrating tools.The symptomatic picture includes pain in the elbow when flexing and extending the upper limb and limited mobility.
• Osteoarthritis of the joints of the hand.As a rule, it is diagnosed in the carpometacarpal joint of the first finger (it is this joint that is most susceptible to injury in everyday life).It is characterized by a dull pain on the outer surface of the palm, which may radiate to the thumb.
• Osteoarthritis of the finger joints.It is most often found in people who do small jobs (embroidery, knitting, etc.).Excessive growth 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.Osteoarthritis is a disease that begins to manifest itself slowly against the background of congenital structural features of the connective tissue, previous diseases and microtrauma over a long period of time.Most chronic inflammations (arthritis), in one form or another, transform into a degenerative-dystrophic process with constant inflammatory relapses.The osteoarthritis age group deserves special attention, which represents the largest number of patients with this diagnosis.

Although there is no single genesis of this disease, there are several factors that predispose to suffering from 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 support such weight).
• Venous insufficiency.
• Related to professionwith constant foot, 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 inheritance.

Due to the influence of one or more of the factors listed above, the gradual destruction of the cartilaginous tissue that covers the articular surface of the bone begins.At first it becomes thinner, less elastic, and then cracks completely.The subchondral bone tissue comes into contact with the surface of the bone, causing its destruction 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 injury, even minor.Damaged cells actively synthesize anti-inflammatory cytokines, so the destruction of cartilage and bone is characterized by aseptic inflammation in the synovial membrane.Frequent relapses of the pathology cause a worsening of inflammation, as a result of which cells in hard tissues begin to die even more quickly, which contributes to the progression of the disease.

Symptoms

Osteoarthritis can occur for a long time without the slightest clinical sign.Patients live without even suspecting that active degenerative-dystrophic changes are occurring in their joints.As a rule, the first symptoms appear at the peak of the pathology or after inflammation occurs.There are several types of symptoms, depending on the time of appearance and the characteristics of manifestation.

First signs

A person begins to feel pain in the area of the damaged joint after doing physical activity (playing sports, jogging, walking without stopping, climbing stairs and much more).In the morning, after a long stay in a state of immobility, the first “sensations of initial pain” appear, combined with slight stiffness.To eliminate limited mobilityyou need to warm up for a certain time.The pain is aching or dull and is not very intense.Due to the lackluster clinical picture, patients rarely seek medical attention in the early stages.Many people begin to self-medicate and try different treatment methods, which can only make the current situation worse.However, it is in the early stages that this disease has the most favorable prognosis and a high probability of complete recovery without consequences.Therefore, it is highly 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 climate changes.They occur not only in the morning, but also persist throughout the day.Patients cannot sleep completely;many (especially in old age) notice bone pain and muscle pain.The pain will spread throughout the limb and radiate to surrounding areas.People with this problem tire quickly when walking even short distances and experience stiffness and difficult joint flexion.Many people notice instability of the damaged limb, which is why they develop an unsteady and smooth 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 movement, which leads to muscle atrophy.This, in turn, makes the gait even more unstable and cautious.Osteoarthritis of the upper extremities usually results from injury or chronic arthritis.The most notable deformation is observed in the interphalangeal joints of the hand.Bouchard and Heberden nodules form on the fingers and the hand itself becomes square.

Dangerous symptoms

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

• Swelling and constant pain in the extremities.- indicates active inflammation requiring urgent medical intervention.
• Joint deformity, so the gait changes or it is impossible to perform the usual movements.
• Myalgia and bone pain.
• Unstable gait, severe limitation of mobility during flexion and extension.
• The pain becomes constant, which does not decrease either in the afternoon or at night, radiating towards the surroundings.

Degrees

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

• Zero.A person does not feel any pain or discomfort when walking (even long distances).No pathological changes are detected in the X-ray image.
• Initial (doubtful).When walking for a long time, a moderate dull pain appears.Some patients notice 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 number of bone growths (osteophytes).
• Moderate (degenerative).Painful sensations occur not only in the morning, but also in the evening.Myalgia and bone pain occur.Patients sleep poorly and often notice swelling of the affected joint.X-rays reveal progression of joint space narrowing and osteophyte proliferation, as well as increased bone density.
• Heavy (deforming).The pain syndrome becomes permanent and is not always relieved with analgesics.The pain increases with any movement;A loud creak is heard when bending.Muscle atrophy and joint deformity also develop.An X-ray examination reveals a strong narrowing of the joint space and a significant growth of the edges of the articular surface, which caused deforming changes.

Exacerbation

All degenerative diseases are characterized by a slow, often asymptomatic course (especially in the early stages).An increase in pain is observed when weather conditions change (humidity, wind or drop in temperature) and when the inflammatory process begins.Inflammation is characterized by swelling, skin hyperemia, pain and swelling.Therefore, if signs of an inflammatory process appear, it is necessary to immediately seek qualified medical help.Provide independentfirst aidcan be done using the following methods:

1. Take some pain reliever medication.
2. Apply ointment or gel with anesthetic effect to the skin.
3. Keep the limbs in a stationary position (until the pain disappears).

Diagnosis

To make a diagnosis, highly accurate examination methods are used to identify even minor pathological changes.In the clinic, specialists conduct a thorough examination of the patient, which allows them to visually and palpably determine the current state of the joint (external signs of inflammation: swelling, redness of the skin, pain, hyperemia).After this, instrumental and laboratory diagnostics are prescribed, which makes it possible to obtain a complete picture of the extent of the lesion.Laboratory tests include:

• General, biochemical and immunological blood tests.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 infection and its sensitivity to antibiotics.

Instrumental diagnosis involves the following procedures:

1. Ultrasound and MRI of the joint.It allows detecting changes in articular and periarticular soft tissues.
2. X-ray and computed tomography.It is very informative when looking for changes in bone tissue.Today this is the preferred diagnostic method, essential for diagnosing osteoarthritis.
3. Arthroscopy.It is carried out if there are signs of the presence of inflammation.
4. Scintigraphy.It involves the administration of radiopharmaceuticals to evaluate the state of the bones and their metabolism.

Drug therapy

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

• Analgesics from the NSAID group.The doctor individually selects the type of medication, its form of release and dosage.The choice depends on the severity of the pain, age, sex 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.
• Muscle relaxants.They are necessary to relieve spasms of the periarticular muscles.In this way it is also possible to reduce pain and restore normal blood circulation in the joint.
• Neurotropic vitamins of group B.This is the social component of basic therapy.B vitamins help to normalize the functioning of the peripheral nervous system and also inhibit pain.
• Painkiller blocks.As a rule, they are used for severe acute pain that cannot be eliminated by taking the medications described above.In this case, solutions are used that are injected into the most painful places.

Osteoarthritis treatmentThe knee 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 drug is injected directly into the joint cavity, which ensures the fastest possible onset of the therapeutic effect.Its main objective is to improve the viscosity of the synodal fluid and prevent trauma to the articular surfaces of the bones.

Non-pharmacological therapy

It is important to understand thattaking medications- This is not a panacea nor the only way to recover.To eliminate pain, increase joint mobility and improve quality of life, it will be necessary to devote sufficient time to non-drug treatment methods.It is necessary to maintain the correct balance between adequate physical activity and adequate rest.You can achieve this result if you do daily workouts.To obtain 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 the pain intensifies during training, stop training.

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

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

1. Electrophoresis or phonophoresis with analgesic drug solutions.
2. Paraffin heating applications(carried out exclusively in the absence of an inflammatory process).
3. Darson validation- exposure to high and low frequency electrical currents to stimulate blood circulation and muscle relaxation.
4. Magnetotherapy and laser.
5. electrical stimulation.It is an effective physiotherapy aimed at recovering muscle volume and strength.

It is also possible to perform hirudotherapy, a treatment with 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 clean joint cavities.

Prevention

Treating osteoarthritis, as well as its consequences, is quite difficult.However, it is much easier to prevent it.To do this, just follow a few simple recommendations that will help protect healthy joints for many years.Among them:

• Active lifestyle.Even if your professional activity involves sitting or standing for long periods, it is necessary to reserve time (at least a few minutes a day) for a simple warm-up.
• Regular exercise or visit the pool..These are excellent general strengthening sports that will help maintain muscles and the musculoskeletal system in a healthy tone.
• Adequate and rational nutrition.It is extremely important to monitor your daily diet.It must include a sufficient amount of proteins, fats, carbohydrates, microelements and vitamins.It is advisable to increase the consumption of foods rich in omega-3 (fish, red game, avocado, walnuts, flaxseed, etc.) and collagen (jellies, rich soups, etc.).
• Monitor your body weight.It is necessary to maintain weight within normal limits, avoiding the development of obesity (for this it is also necessary to exercise and eat well).
• Wear comfortable shoes.
• stop doing sportsaccompanied by a high risk of injury.

Conclusion

Osteoarthritis of the joints.This 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 offers many therapeutic techniques aimed at improving the condition of patients and restoring their motor functions.However, it is important to remember that quality of life with osteoarthritis depends on the treatment time and compliance with medical recommendations.Early medical consultation allows the first degenerative changes to be identified and eliminated in a timely manner.Therefore, it is not necessary to self-medicate or postpone visiting the doctor.If you notice the first symptoms of joint disorders, you should immediately visit a doctor and undergo a thorough diagnosis.