Arthrosis of the joints

Arthrosis is a disease characterized by the gradual destruction of the joint due to the development of dystrophic changes in the tissues.According to the WHO, every tenth resident of the planet faces this problem.After 50 years, the risk of the disease is about 30%, and by 70 years it reaches 80-90%.

General information

Arthrosis is a chronic, long -term process that affects not only the joints.With this progress, dystrophic and degenerative changes are also incredible, the auxiliary apparatus.In the process, the patient is faced with inflammation of the cartilage and bone tissue, the capsule of the joint and the per -semantial sac, as well as the muscles, ligaments and subcutaneous tissue contact with them.

Regardless of the location, the pathological process passes according to one scheme.First, in the thickness of the tissue, the balance between the processes of growth and destruction of the cartilage is disturbed and the balance is shifted in favor of dystrophy and reverse development (degeneration).The changes that invisible to the eye in the microstructure of the cartilage are currently emerging, which leads to its thinning and cracking.

As the disease progresses, the joint loses its elasticity and becomes more dense.This reduces its ability to depreciate, the rate of tissue damage is constantly increasing due to vibration and micro -trauma during movements.The thinning of the cartilage layer provokes the active growth of bone structures, resulting in spikes and sills on the smooth surface of the joint - osteoarthrosis develops.Movements are becoming increasingly restricted and painful.Muscle spasms are developing, surrounding the affected area, which exacerbates the pain and deforms the limb.

Stages of the disease

The arthrosis of the joints develops gradually and in the process three consecutive stages that determine the severity of the disease:

• Stage 1: Pathology is not detected on X -Ray or ultrasound, but the destruction processes have already been started;The composition of the joint fluid changes, as a result of which the tissues are obtained less than the nutritional beings and become more sensitive;Increased loading of the area of damage causes inflammation (arthritis) and pain;
• The second stage is characterized by the active destruction of cartilage tissue, and bone spines and growths appear at the edges of the joint platform (area of contact of surfaces);At that time, the pain became familiar and the inflammatory processes became stronger or more loud;Muscle joint spasms are periodically noted;
• Stage 3: the destruction areas affect almost the entire surface of the cartilage, the joint platform is deformed, the injured limb deviates from its axis;The volume of movements is reduced and the connections weaken and become short.

Some experts also distinguish the IV stage of arthrosis development.It is characterized by almost complete immobility of the joint.

Types

Depending on the cause of the disease, primary and secondary arthrosis are distinguished.In the first case, the pathology occurs independently against the background of the overall effect of predisposing factors.The secondary form is the result of other diseases and is divided into the following groups:

• damage to the joints caused by metabolic disorders or endocrine diseases (gout, diabetes mellitus, acromegaly, hyperparathyroidism);
• Destruction associated with congenital pathologies (Pedget disease, congenital dislocation of the lips, scoliosis, hemophilia, etc.);
• Post -traumatic arthrosis occurring against the background of fractures, cracks, necrotic processes or surgery, as well as occurring due to the characteristics of the profession.

The most in demand is the classification of osteoarthritis, depending on the location of the pathological process:

• Gonarthrosis: the lesion of the knee, one of the varieties of which is a pallet - pepper arthrosis - the destruction of the joint between the bone and the patella;
• Ankle arthrosis: occurs against the background of high load and frequent injuries;
• The arthrosis of the joints of the foot: the thumb most often suffers at the intersection with the foot;The lesion develops against the background of gout or valgus deformation;
• Raming arthrosis is characterized by shoulder damage and is common at a young age against the background of increased physical activity (hamal, athletes, builders);
• Coxarthrosis: damage to the hip joint;Perhaps both bilateral and is one of the common causes of disability in people over 50;
• Vertebrae arthrosis: the destruction of cartilage discs between the vertebrae, most often affects the cervical and lumbar spine;
• Brush arthrosis: finger joints are most often affected, pathologies are particularly susceptible to menopausal women;
• Temporomandibular arthrosis: this is quite rare, most often against the background of chronic inflammation due to bite disorders or improper prosthesis;
• Elbow arthrosis: a rare form of the disease, most often associated with injuries to this area.

The reasons for the development

The main factor in the development of arthrosis is the mismatch between the test and the ability of the joint to withstand this load.Acute or chronic, this process inevitably leads to the destruction of the tissues.

The list of causes that increase the risk of arthrosis at any localization includes:

• heredity;
• Endocrine pathology (diabetes);
• Injuries to the joint: bruises, dislocations, fractures or bone cracks inside the joint, full or partial fractures of ligaments that penetrate the wounds;
• regularly increased joint workload related to the profession;
• obesity;
• hypothermia;
• Transferred inflammatory joint diseases: acute arthritis, tuberculosis, etc.;
• Blood disorders in which hemorrhages often occur (hemophilia);
• Acute changes in hormonal background (pregnancy, menopause);
• local blood disorders in connection with atherosclerosis, varicose veins, thrombophlebitis, etc.;
• autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, etc.);
• Connective tissue diplasia (congenital pathology, accompanied, including excessive joint mobility);
• congenital pathologies of the musculoskeletal system (flat legs, dysplasia or congenital dislocation of the hip joint, etc.);
• age over 45-50 years (increase in risk is associated with a decrease in collagen synthesis);
• osteoporosis (bone vacuum);
• chronic intoxication of the body (including salts of heavy metals, medicines, alcohol);
• Surgical interventions of the joints.

Symptoms

Symptoms of arthrosis, practically independent of its cause and localization, as changes in the joints are underway according to the same scenario.The disease develops gradually and begins to manifest itself, when cartilage is quite seriously damaged.

One of the first signs of dysfunction is crunching in the problem area during movement.Most often it occurs when the knee or shoulder is damaged.At the same time, one may feel a slight reduction in mobility after prolonged inaction, such as in the morning.

When asked what symptoms occur with arthrosis, most patients first call pain.At first, insignificant and weak, gradually gain strength, preventing it from moving normally.Depending on the scene and the location of the pathology, one can feel:

• Starting pain: occur during the first movements after prolonged inaction of the joint and are associated with the formation of the cartilage surface of a thin film of the destroyed tissue;After the start of the work, the film moves and the discomfort disappears;
• Pain with prolonged physical activity (standing, walking, running, etc.): Appears due to a decrease in the properties of shock -absorbent properties of the joint;
• Time pain: provoked by low temperature, humidity, changes in atmospheric pressure;
• Night pain: associated with venous stagnation and high blood pressure inside the bones;
• Joint blockade: acute, severe pain associated with a disorder of a piece of cartilage or bone located in the joint cavity.

With the development of arthrosis symptoms become more noticeable, the patient notes the following signs:

• increase in morning stiffness;
• strengthening and increasing the duration of pain;
• reduction of mobility;
• Deformity of the joint due to bone growth;
• Deformation of bones and surrounding tissues: The process is well noticeable to the limbs and fingers, which become noticeably curved.

When inflammation is attached, the affected area swells, blushes and becomes hot to touch.Pressing it causes a sharp increase in pain.

Analyzes and diagnostics

The diagnosis of arthrosis is engaged with the orthopedic physician.He conducts a detailed study of the patient to identify complaints and history.The doctor in detail about the onset of the first signs and the rate of their development, injuries and diseases, the presence of similar problems in relatives.

The overall blood test allows you to identify an inflammatory process that often accompanies arthrosis.

The main method of diagnosis is radiography.In the photo, the following characters are clearly visualized:

• narrowing of the gap of joints;
• Change of contact bone contours;
• impaired bone structure in the affected area;
• Bone growth (osteophytes);
• curvature of the axis of the limb or finger;
• Subluxation of the joint.

For a more detailed diagnosis, they can be prescribed:

• Computed tomography (CT);
• Magnetic resonance imaging (MRI);
• Ultrasound of the joint;
• Arthroscopy (internal examination of the joint cavity using a camera introduced by a small puncture);
• Scintigraphy (evaluation of bone condition and metabolism in them by introducing radiopharmaceutical drugs).

In case of suspicion of the secondary nature of the disease, appropriate tests and consultations of narrow specialists are prescribed.

Treatment of arthrosis of the joints

The choice of methodology for the treatment of arthrosis of the joints depends on the cause of the disease, its stages and symptoms.There are: in the arsenal of doctors:

• medicines;
• treatment without medicine;
• Surgical methods.

In addition, the patient should strictly monitor a diet and adjust his lifestyle in order to minimize the further damage to the joints.

Medication

The appointment of arthrosis drugs pursues two main goals:

• elimination of pain and inflammation;
• Restoration of cartilage tissue or, at least, stop the more current degeneration.

Different types of medicines are used to facilitate the patient's condition:

• non -steroidal anti -inflammatory drugs in the form of tablets, injections, ointments or candles;They relieve pain and inflammation well;
• Hormones (corticosteroids): shown in severe pain and are most often introduced directly into the joint cavity;
• Other analgesics, for example, antispasmodic action: Help reduce the level of pain by relaxing the muscles;

It is important to remember: all types of painkillers are only used to facilitate the patient's condition.They do not affect the condition of the cartilage and with prolonged use accelerate its destruction and cause serious side effects.

The main preparations for joint restoration today are chondroprotectors.They contribute to the saturation of cartilage with nutrients, stop the monument and begin the processes of cell growth.The agents have the effect only in the early and middle stages of the development of the disease and are subject to regular long -term use.

Preparations that improve microcirculation in tissues and antimainets help to enhance the effect of chondroprotectors.The former provides a good supply of the affected area with oxygen and nutrients, and the second slows down the processes of tissue destruction.

The choice of specific drugs, their dose and administration regimen is engaged with the doctor.

Without medicine

Drug -free treatment includes the following methods:

• Physiotherapy:
  • Shock wave therapy: destroys bone growths and stimulates blood circulation due to the effects of ultrasound;
  • Automated electromostimulation: Exposure to Electric Impulses to Stimulate Muscle Contraction;
  • Ultraphonophoresis: the effect of ultrasound in combination with the help of medicines;
  • Ozone therapy: introducing a special gas mixture into the joint capsule;
• Physiotherapy Physical Education;
• Mechanotherapy: exercise therapy using simulators;
• Joint traffic to reduce load;
• Massage.

Surgical treatment

Most often, the help of a surgeon is required at the severe stages of the disease.Depending on the location of the pathological process and the degree of lesion, it may be prescribed:

• Drilling: drilling the joint with the removal of part of the fluid and according to indications of medication;
• Corrective osteotomy: removal of part of the bone, followed by fixing from a different angle for removing the load from the joint;
• Endoprothetics: replacement of the damaged joint with a prosthesis;Used in extremely neglected cases.

Arthrosis in children

Arthrosis is considered a disease of the elderly, but can also be found in children.The most common cause of pathology is:

• Congenital connective tissue pathology;
• severe injuries;
• heredity;
• metabolic disorders and the functioning of the endocrine glands;
• orthopedic disorders (flat legs, scoliosis, etc.);
• Overweight.

Child arthrosis is rarely accompanied by pronounced symptoms: the pain is sick and practically no stiffness and limitation of function.Monothetic changes are detected on X -ray, MRI and ultrasound.The same products are used in the process of treatment.Maximum attention is paid to exercise and physiotherapy therapy, as they are particularly effective at a young age.Without treatment, the disease sooner or later goes to the advanced stage with complete loss of mobility.

Diet

Diet is one of the most important factors in the treatment of arthrosis.In the presence of excess weight, it is necessary to reduce it to reduce the load on the joints.In this case, a balanced calorie deficiency diet is prescribed.Regardless of the body mass index, doctors recommend a completely abandonment:

• fast carbohydrates (sugar, desserts, flour);
• alcohol;
• spices;
• legumes;
• strong tea and coffee;
• Excessively fatty and sharp dishes.

Canned and quarantines are not excluded but significantly limited, as well as salt.The ideal eating for osteoarthritis includes:

• low -fat varieties of meat;
• fish and seafood;
• eggs;
• dairy products;
• linen and olive vegetable oils;
• vegetables and fruits, large amounts of greenery;
• Moderate cereals, hard dough paste;
• Products high in collagen (jelly, pouring, jelly).

Prevention

Arthrosis is easier to warn than for treatment.To maintain joint health for many years, it is recommended:

• Lead an active lifestyle;
• Exercise and visit the pool regularly;
• Eat properly, use enough omega-3 and collagen;
• prevent exceeding BMI;
• Wear comfortable shoes.

If the disease is diagnosed at an early stage, it is recommended to regularly undergo spa treatment, as well as to exclude professional risk factors: long -term leg stay, weight lifting, vibration.

Consequences and complications

Arthrosis progresses very slowly.When performing a doctor's prescription, his current one slows down significantly, allowing you to keep the mobility much longer.Non -versitive consequences develop without treatment:

• pronounced deformity of the joints;
• reducing mobility to its full loss (ankylosis);
• shortening of the limb (with knee damage or femoral joint);
• Bone deformity, curvature of the limbs and fingers.

Forecast

The prognosis for arthrosis depends on the form of the disease, its degree and quality of treatment.Pathology is one of the common causes of damage and in advanced cases the ability to move and self -serve.In severe forms of damage to the knee and hip joints, the patient receives the first or second disability group (depending on the stage and volume of damage).