Arthrosis is a chronic disease of the joints, accompanied by pathological changes in the hyaline cartilage, and subsequently in the adjacent tissues, joint capsule and synovium.
The lesion is dystrophic and degenerative, which leads to a change in the structure of articular tissues, loss of their functionality. According to the same statistics, 12% of the total population of the planet is susceptible to arthrosis. From 62% to 65% of all episodes of the disease occur in people over the age of 60.
Another 30-35% of cases of joint damage with this pathology occur in patients aged 40-60 years. And about 3% are young people aged 20-40.
What is this?
In simple words, arthrosis is a chronic disease in which progressive degenerative-dystrophic changes develop in the joint due to metabolic disturbances. It is the most common joint pathology, diagnosed in 6-7% of the population. With age, the incidence increases dramatically.
The small joints of the hand (in women 10 times more often than in men), the big toe, the intervertebral joints of the thoracic and cervical spine, as well as the knee and hip joints are most often involved in the pathological process in arthrosis. Arthrosis of the knee and hip joints takes the leading place in terms of the severity of clinical manifestations and negative impact on the quality of life.
Arthrosis is characterized by a complex lesion of the articular and auxiliary apparatus:
- chondritis - inflammatory changes in the cartilage of the joint;
- osteitis - involvement of underlying bone structures in the pathological process;
- synovitis - inflammation of the inner membrane of the joint capsule;
- bursitis - damage to the periarticular bags;
- reactive inflammation of soft tissues (muscles, subcutaneous tissue, ligaments) located in the projection of the involved joint (periarticular inflammation).
The disease is diagnosed in 2% of people under 45 years old, in 30% - from 45 to 64 years old and in 65-85% - at the age of 65 years and older. Arthrosis of the large and medium joints of the extremities has the greatest clinical significance due to its negative impact on the standard of living and working capacity of patients.
Types of arthrosis
Depending on the cause of the pathological process inside the joint, primary arthrosis is distinguished, secondary and idiopathic.
Primary develops as an independent disease, secondary, as a result of an injury or infection, and the cause of the idiopathic form is not known. In addition to the classification of the disease, depending on the cause of the pathological process, arthrosis is distinguished according to the location of the destructive changes:
- Gonarthrosis is the most common type of pathology characterized by damage to the knee joints. Most often, gonarthrosis is detected in people who are overweight, with chronic metabolic diseases in the body, and weak immunity. Knee arthrosis progresses for a long time and gradually leads to a complete loss of motor function.
- Arthrosis of the shoulder joint - the main cause of degenerative processes in this area is congenital anomalies in the development of the shoulder joint or excessive stress on this area, for example, when carrying heavy luggage on the shoulders.
- Ankle arthrosis - the main reasons for the development of degenerative processes in the ankle joint are trauma, sprains, sprains, fractures. In some cases, the development of a pathological process can provoke an autoimmune disease - rheumatoid arthritis. Ankle arthrosis affects dancers, women wearing high heels, athletes.
- Uncoarthrosis or arthrosis of the cervical spine - the causes are neck injuries, progressive osteochondrosis, obesity, a sedentary lifestyle. At risk are people working at a computer in offices. In addition to severe pain in the neck, patients have pronounced dizziness, depression of consciousness, impaired memory and fatigue. These symptoms are caused by compression of the vertebral artery, through which nutrients and oxygen enter the brain.
- Coxarthrosis or arthrosis of the hip joint - the main cause of occurrence is age-related changes in the tissues of the joint. People over 45 are at risk.
- Osteoarthritis of fingers - develops for the same reason as spondyloarthrosis.
- Polyarthrosis is characterized by damage to multiple joints with progressive degenerative processes in them, while the pathological process involves ligaments, muscles and tissues surrounding the joint.
- Spondyloarthrosis - tissues of the spinal column, namely its lumbar region, are subject to destructive destruction. Women are at risk during the onset of menopause, as spondyloarthrosis progresses against the background of a deficiency of female sex hormones.
Causes of arthrosis
Two reasons contribute to the formation of arthrosis - stress and lack of adequate nutrition, which supplies vitamins and minerals for tissue repair. Every person's joints carry a load. For athletes and dancers, during physical work, the load on the legs is greater, which means that the bone joints wear out faster and require high-quality nutrition. With a quiet lifestyle, the support apparatus wears out more slowly, but also requires periodic tissue renewal.
Therefore, the main condition for the destruction and deformation of the joints is malnutrition, the indigestion of useful components, which often occurs with metabolic disorders.
Let's list the factors that contribute to the wear of the articular joints and metabolic disorders:
- Muscle weakness and abnormal loading of the joints. The weakening of one or more muscles increases the load on the joint and distributes it unevenly within the bone junction. Also, improper loading of muscles is formed with flat feet, scoliosis, therefore, with these "harmless" diseases, the cartilage tissues wear out with age, arthrosis appears.
The likelihood of arthrosis increases with strong physical exertion.
If the daily loads exceed the capacity of the bone tissues, microtrauma is formed in them. At the sites of injury, thickenings appear, which grow over time and deform the joint;
- Metabolic disorders (gastrointestinal diseases - stagnation of bile, dysbiosis, gastritis, cholecystitis, pancreatitis, metabolic disease - diabetes);
- Psychosomatic causes - psychosomatics of arthrosis confirms that a negative emotional state also becomes the cause of the disease. Stress forms muscle spasm, constant stress disrupts the nutrition of all tissues (internal organs, bones, joints);
- Heredity (the type of metabolism and its possible disorders are inherited, a tendency to muscle weakness or improper formation of the bone apparatus, to poor digestion - which is the basis for the development of arthrosis in old age).
Osteoarthritis is a disease of worn out joints that have lost a significant supply of minerals and the ability to resist stress and destruction. Therefore, with age, the predisposition to the disease increases. After 70 years, arthrosis is diagnosed in every second pensioner. Since the maximum load falls on the legs (a person moves - walks, stands, runs, jumps), it is here that the first signs of arthrosis form.
Mechanism of disease progression
When any of the reasons provoking a disease of the joint with arthrosis appears, pathological processes begin to develop in it. The mechanism of their progression is not fully understood, but the main stages of official medicine are known.
At the initial stage, there is a depletion of the structure of the cartilage tissue and abnormal changes in the synovial fluid. All this occurs due to metabolic disorders, in which the tissues of the joints do not receive the necessary components in sufficient quantities, or are deprived of some of them.
Further, the elasticity of collagen fibers and the flexibility of the cartilage are lost, due to the fact that in the body with a lack of nutrients, hyaluronic acid does not have time to be produced, which provides softness and flexibility of the structural composition of collagen fiber. The cartilage gradually dries out, becomes brittle and cracks. The fluid in the synovial capsule is gradually depleted and subsequently disappears completely.
Roughness and solid bone growths are formed on the cartilage tissue. At the same time, deformation of other tissues of the joint develops, their pathological degeneration, dystrophy and loss of physiological activity. For the patient, these changes mean the appearance of pain, lameness, joint stiffness.
Symptoms of arthrosis
Acute clinical picture is not typical for arthrosis, joint changes are progressive, slowly increasing, which is manifested by a gradual increase in symptoms:
- pain;
- intermittent crunching of the affected joint;
- joint deformity that appears and worsens as the disease progresses;
- stiffness;
- limitation of mobility (decrease in the volume of active and passive movements in the affected joint)
Pain in arthrosis is dull, transient, appears when moving, against a background of intense stress, towards the end of the day (it can be so intense that it does not allow the patient to fall asleep). The constant, non-mechanical nature of pain for arthrosis is uncharacteristic and indicates the presence of active inflammation (subchondral bone, synovium, ligamentous apparatus or periarticular muscles).
Most patients note the presence of so-called starting pains that occur in the morning after waking up or after a long period of inactivity and disappear in the course of physical activity. Many patients define this condition as the need to “develop a joint” or “disengage. ”
Arthrosis is characterized by morning stiffness, which has a clear localization and is of a short-term nature (no more than 30 minutes), sometimes it is perceived by patients as a "jelly feeling" in the joints. Feeling of wedging, stiffness is possible.
With the development of reactive synovitis, the main symptoms of arthrosis are joined by:
- soreness and local increase in temperature, determined by palpation of the affected joint;
- persistent pain;
- joint enlargement, soft tissue swelling;
- progressive decrease in range of motion.
Stages and degrees of arthrosis
In the course of the disease, medicine distinguishes between three stages, which differ in the signs of the disease, the intensity of the lesion and localization. At the same time, the differences in all three stages relate to the types of tissues undergoing pathological changes.
- The first stage of development of arthrosis of the joints is the initial phase of the disease. It is characterized by mild damage to the cartilage tissue and loss of physiological functions in collagen fibers. At the same time, at the first stage, minor morphological disorders of bone tissue and structural changes in synovial fluid are noted. The cartilage of the joint is covered with cracks, the patient has a slight soreness at the site of the pathology.
- Second degree - the development of arthrosis with increased dynamics. This stage is characterized by the appearance of stable pain, lameness. There are noticeable morphological and dystrophic changes in the cartilage; during the diagnosis, the growth of bone tissue is revealed. Osteophytes are formed - bone growths that are visible during a visual examination of the lesion site. At the same time, the processes of degenerative changes in the synovial capsule proceed, which leads to its structural depletion. The disease in this phase can often worsen and be regular. The pains gradually become constant.
- Third degree - active progression. At this stage, the synovial fluid is almost completely absent due to its degeneration, and the bone tissue is rubbed against each other. The joint mobility is almost completely absent, the pain becomes more palpable. Cartilage is also absent due to degenerative and atrophic changes. Treatment of the third degree of arthrosis of the joints is considered inappropriate.
In addition to these three degrees of development of pathology, there is a final stage - the irreversible destruction of all tissues of the joint. In this phase, it is impossible not only to conduct effective therapy, but even to relieve pain.
The inflammatory process usually begins in the second degree of the lesion, in rare cases, in the absence of medical intervention - in the first stage. Subsequently, it becomes more and more difficult to stop it, and this can lead to secondary pathologies, the development of pathogenic microflora in the place of localization of the disease.
To exclude severe consequences, treatment should be started from the first degree, and at the same time, intensive therapy methods should be applied. At the last stage, associated with the complete destruction of the cartilaginous tissue, only one technique is allowed to relieve the patient of pain and immobility of the joint - arthroplasty with complete or partial replacement of the component parts of the joint.
Consequences
The consequences of untimely treatment and advanced arthrosis of the joints are fraught with complications such as:
- disability;
- deformation beyond recovery;
- occurrence of vertebral hernias;
- joint stiffness or stiffness;
- decline in the quality and standard of living.
The chronic course, in addition to these complications, is accompanied by intense and frequent soreness, complete destruction of the structural components of the joint, discomfort, inability to perform physical work and play sports.
Diagnostics
Diagnosis of arthrosis is based on the assessment of anamnestic data, characteristic manifestations of the disease, the results of instrumental research methods. Indicative changes in general and biochemical blood tests are not typical for arthrosis, they appear only with the development of an active inflammatory process.
The main instrumental method for diagnosing arthrosis is radiography; in diagnostically unclear cases, computed or magnetic resonance imaging is recommended.
Arthrosis of the knee and hip joints takes the leading place in terms of the severity of clinical manifestations and negative impact on the quality of life.
Additional diagnostic methods:
- atraumatic arthroscopy;
- ultrasonography (assessment of the thickness of the articular cartilage, synovium, condition of the joint capsules, presence of fluid);
- scintigraphy (assessment of the state of the bone tissue of the heads of the bones that form the joint).
How to treat arthrosis?
It is better to treat arthrosis of the joints at an early stage, the treatment itself should be pathogenetic and complex. Its essence lies in removing the causes that contribute to the development of this disease, it is also necessary to eliminate inflammatory changes and restore functions that were previously lost.
The treatment of arthrosis is based on several basic principles:
- Oxygenation of the joint, or so-called intra-articular oxygen therapy.
- Drug therapy.
- Intraosseous blockages, as well as decompression of the metaepiphysis.
- Sustainable Diet.
- Damaged joints must be relieved of excessive stress. If possible, it should be kept to a minimum during treatment.
- Follow the established orthopedic regimen.
- Physiotherapy exercises.
- Taking a course of physiotherapy, which includes magneto and electrotherapy, shockwave, and laser therapy.
- Sanatorium treatment. To do this, it is necessary once a year, on the recommendation of a doctor, to undergo a course of treatment at specialized resorts.
Preparations for the treatment of arthrosis
Drug treatment is carried out in the phase of exacerbation of arthrosis, selected by a specialist. Self-medication is unacceptable due to possible side effects (for example, the negative effect of nonsteroidal anti-inflammatory drugs on the gastric mucosa).
Therapy includes the following drugs:
- Anti-inflammatory drugs. Starting therapy for arthrosis in a comprehensive manner, you can slow down the course of the disease and significantly improve the quality of life. It is worth dwelling in more detail on some points of treatment. In particular, drug therapy includes at the initial stage - this is the removal of pain syndrome, as well as the elimination of inflammatory processes occurring in the joints. For this, all doctors use non-steroidal anti-inflammatory drugs. Experienced doctors do not recommend their oral administration, as these drugs irritate the stomach wall to a large extent. Therefore, depending on the chosen drug, either intravenous or intramuscular administration is used. Sometimes, as auxiliary agents, NSAIDs are used in the form of ointments, but their absorption is extremely low, so a significant effect cannot be achieved.
- Hormonal corticosteroids. When arthrosis is at the stage of exacerbation, it is advisable to take hormonal corticosteroids. They are injected into the joint. Externally, you can use a special plaster, ointment or tincture, which are made on the basis of hot pepper.
- Chondroprotectors aimed at restoring cartilage and improving the qualitative composition of synovial fluid will not be superfluous. The course lasts a fairly long period of time, until the moment when there is an improvement. However, if the expected effect does not appear within six months of administration, the drugs should be canceled. Also intra-articular, along with chondroprotectors, it is advisable to use drugs made on the basis of hyaluronic acid. They contribute to the formation of the cell membrane responsible for the formation of joint cartilage.
Physiotherapy
To relieve pain, reduce inflammation, improve microcirculation and eliminate muscle spasms, a patient with arthrosis is referred for physiotherapy:
- In an aggravation phase. Prescribe laser therapy, magnetotherapy and ultraviolet radiation,
- In remission. Shown electrophoresis and phonophoresis.
In addition, thermal procedures, sulfide, radon and sea baths are used. To strengthen the muscles, electrical stimulation is performed. Gentle massage can also be used during remission.
Surgery
If the listed methods of exposure are ineffective, in the presence of complications, they resort to surgical treatment of arthrosis:
- Decompression of the metaepiphysis and prolonged intraosseous blockade (decrease in intraosseous pressure in the affected area);
- Corrective osteotomy;
- Endoprosthetics of joints.
In the early stages of the disease, mechanical, laser or cold plasma debridement is used (smoothing the surface of damaged cartilage, removing nonviable areas). This method effectively relieves pain, but has a temporary effect - 2-3 years.
Folk remedies
Most people these days don't want to take pills or injections. Therefore, they ask the question - how to cure arthrosis with the help of folk remedies? For the most part, such funds are aimed at increasing the tone of the body, improving blood circulation, relieving pain and increasing immunity.
Traditional medicine recipes are used to treat this disease:
- Egg solution is made from fresh egg yolk, which is mixed with turpentine and apple cider vinegar in a 1: 1: 1 ratio. The liquid must be thoroughly mixed and rubbed over the affected joint overnight. Then you need to wrap everything with a woolen scarf. It is recommended to rub for 1 month 2-3 times a week.
- Purchase elecampane root from the pharmacy. As a rule, it is packed in packs of 50 grams. To prepare the tincture, you will need half a pack of plant roots and 150 ml of high-quality vodka. The ingredients are mixed, placed in a dark bottle and infused for 12 days. Rubbing is done before bed, and if possible in the morning.
- The use of boiled oatmeal also gives good results. Take three to four tablespoons of oatmeal, pour boiling water over and cook over low heat for five to seven minutes. The amount of water used should provide a thick porridge, which should be cooled and used as a compress overnight. Use only freshly boiled flakes. Yesterday's porridge isn't good for a compress.
- Birch leaves, nettle leaves and calendula inflorescences are taken in equal parts. As a result, you need to get two tablespoons. We put the resulting crushed collection into a thermos, fill it with a liter of boiling water and leave it overnight. Starting the next morning, you need to take half a glass of the broth four to five times a day. The course of taking this prescription is two to three months.
Tinctures of bay leaves, horseradish, garlic and rye grains are also considered effective. Treatment of arthrosis with folk remedies will be most effective if combined with medication.
Nutrition for arthrosis
The basic principles of nutrition for arthrosis are reduced to the following points:
- Avoid heavy meals at night to avoid an attack of arthrosis.
- Eat fractionally.
- Constantly control weight, in order to avoid weight gain,
and, therefore, additional stress on sore joints. - When there is no aggravation of the disease, take a walk after eating.
- The menu needs to be balanced, drawn up with the attending physician.
There are absolutely no complaints about fish dishes - you can eat a lot of them, naturally, in reasonable quantities.
- Do not forget about the regular intake of vitamins from food. For patients with arthrosis, vitamins of group B are especially relevant
- Jellied meat plays an important role in the treatment of arthrosis. Such food will be a real storehouse of trace elements for sore joints. The most important component in aspic is naturally occurring collagen
- Vitamin B helps in the production of hemoglobin. It can be "obtained" by eating bananas, nuts, cabbage and potatoes. It is worth getting carried away with herbs and legumes. They will be the source of folic acid. Liver, mushrooms, dairy products, as well as eggs will be useful. They are rich in riboflavin.
Following the treatment regimen prescribed by the doctor, it is possible to achieve that the disease recedes, and the damaged tissue begins to regenerate.
Prevention
Prevention of arthrosis begins with proper nutrition. It is necessary to try to reduce the intake of salt, as well as food that can disrupt metabolism. These include legumes, fatty meats, and alcohol. Diet includes cabbage, greens and fish.
For the prevention of arthrosis, it is necessary to attend physical education classes, do warm-ups. If possible, it is better to walk a few kilometers. It is also important to monitor your weight and prevent weight gain, as this will put additional stress on sore joints. It is not recommended to take pills for the purpose of losing weight, as they can disrupt the metabolism in the body.
Forecast
The outlook for life is favorable. The favorableness of social and labor prognosis depends on the timeliness of diagnosis and initiation of treatment; it decreases when the decision on the issue of surgical treatment of the disease is delayed, if necessary.