Osteoarthritis is a chronic degenerative disease that affects all parts of the joint: cartilage, joint membrane, ligaments, capsule, periarticular bones, muscles and periarticular ligaments.
According to European doctors, arthrosis represents almost 70% of all rheumatological diseases. People between the ages of 40 and 60 are more susceptible to joint osteoarthritis. This is facilitated by both lack of movement and prolonged overload, poor nutrition and, of course, injuries.
What is a joint?
Typically, a human joint consists of 2 or more connected bones. All working surfaces of the joint have a protective coating and are constantly lubricated with synovial fluid for better sliding. The joint cavity itself is hermetically sealed by the joint capsule.
In our body there are many joints that are "responsible" for certain types of movements, can withstand different loads and have different safety margins.
The amount of movement in the joints depends on the structure of the joint, the ligament system that limits and strengthens the joint, and the various muscles attached to the bones via tendons.
Causes of joint arthrosis
The normal functioning of the joints is possible with the constant automatic renewal of cartilage tissue. At a young age, the rate of death of obsolete joint cells is equal to the rate of birth of new cells. Over the years, the cell renewal process slows down and the cartilage tissue begins to thin. The production of synovial fluid also decreases. As a result, the joint cartilage begins to thin and break down, leading to osteoarthritis.
In addition, there are other causes of joint arthrosis:
- increase in physical activity. Osteoarthritis of the joints is a frequent accompaniment of excess weight. Due to overload, microtraumas form in the joints. Athletes develop joint damage due to increased loads on "unheated" joints;
- joint injuries;
- congenital or acquired deformities of the musculoskeletal system (rickets, kyphosis, scoliosis, improper fusion of bones after injuries with the appearance of deformities of the limbs: O-shaped and X-shaped deformities of the legs).
Stages of osteoarthritis
Depending on the degree of destruction of the cartilage tissue, different stages or degrees of arthrosis can be distinguished.
Degrees and symptoms of osteoarthritis
- 1st degree arthrosis is characterized by periodic pain in the joints, especially with increased physical activity. After rest, the pain usually goes away. The range of motion of the joint is not limited, the muscle strength of the injured limb is not changed. X-rays may show minimal signs of joint damage.
- 2nd degree arthrosis is manifested by painful sensations not only with intense physical stress, but also with minor loads. Even while resting, joint pain may not decrease. This grade is characterized by stiffness in movements and limited mobility of the joints. This ultimately leads to muscle atrophy. An x-ray may show deformation of the joint, a decrease in the joint space and the appearance of bony growths near this space.
- 3rd degree arthrosis - any movement causes great pain to a person. Joint pain is present even at rest. Therefore, a person tries to move as little as possible so that the pain is minimal. In some cases, moving requires the use of crutches or a stretcher. Sometimes fusion of bones occurs: ankylosis (as in ankylosing spondylitis).
With deforming arthrosis, irreversible changes occur in the cartilaginous tissue of the joint, and its functions and structure are completely disrupted. Deforming arthrosis of the joints is based on the appearance of dysfunctions in the formation of hyaline cartilage and synovial fluid.
Diagnosis of joint arthrosis
The main method for diagnosing joints is x-ray. In osteoarthritis, changes in the joints, uneven joint surfaces and narrowing of the joint space can be observed.
Which joints are most likely to suffer from osteoarthritis?
The extremity joints most susceptible to osteoarthritis are the hips, knees, shoulders, elbows and hands.
With arthrosis of the hip joint, a person may initially feel slight discomfort in the legs after running or walking. Over time, the pain intensifies, limitations and stiffness in movement appear. With stage 3 disease, the patient protects his leg and tries, if possible, not to step on it.
Osteoarthritis of the knee joint manifests itself as pain in the knee joint after bending and straightening the legs. The most common cause of knee osteoarthritis is injuries sustained in the past. As a result of these injuries, the sliding of the joint surfaces is disrupted and rapid wear occurs. In some cases, the joint may gradually lose its mobility.
Osteoarthritis of the ankle joint manifests itself in the form of swelling and pain in the ankle of the leg. The cause of arthrosis of the ankle joint can be: deformations, fractures of the ankles and talus, dislocations, flat feet, chronic injuries of the ankle joint in athletes and ballerinas. By the way, they often suffer from arthrosis of the foot.
Osteoarthritis of the shoulder, elbow and wrist joints most often appears due to injuries, bruises, dislocations and intra-articular fractures. Osteoarthritis of the shoulder joint is characterized by a pressing, aching, dull pain that radiates to the forearm and hand. The pain appears more often at night. With arthrosis of the hands, pain is accompanied by dysfunction of the hand.
Treatment of osteoarthritis
The main means of treating arthrosis are drug treatment, the use of physiotherapy and surgical treatment.
Pharmacological treatment
The use of drugs helps to improve blood circulation in damaged joints, restore the properties of cartilage and has an analgesic and anti-inflammatory effect.
Non-steroidal anti-inflammatory drugs
With osteoarthritis, swelling of the joint may appear, the joint begins to hurt and the range of motion decreases. When taking anti-inflammatory drugs (NSAIDs), pain decreases, the inflammatory chain reaction is stopped and the process of cartilage restoration is accelerated.
The drugs can be used in the form of tablets, rectal suppositories and powder. But remember that self-medication is unacceptable, the selection and dose of drugs for arthrosis is carried out by a rheumatologist.
Centrally acting painkillers
Opioid drugs reduce the patient's pain threshold. Such drugs can be taken strictly according to prescription and only under the supervision of a doctor!
Chondoprotective drugs
Chondoprotective drugs are structural elements of the cartilage itself, so they actively restore this tissue and prevent its further destruction. Treatment is effective in the early stages of the disease. When the joint is already completely destroyed, it is not possible to restore the original shape of the deformed bones or grow new cartilage.
However, in stages 1-2 of osteoarthritis, chondroprotectors can bring significant relief to the patient. Combined preparations, which include both glucosamine and chondroitin sulfate, give better results than a single-component preparation.
Chondroitin sulfate and glucosamine sulfate
These drugs help slow the inflammatory response in tissues, help reduce cartilage damage, and reduce pain. Most often, these 2 drugs are used together in treatment, as they have a cumulative effect, but they need to be taken for 3-6 months.
Hyaluronic acid
Provides viscosity and elasticity of synovial fluid. Helps the smooth movement of the joints. Therefore, doctors often prescribe hyaluronic acid injections into the affected joint.
Physiotherapy treatments
Physiotherapy treatments may include:
- UHF therapy;
- magnetotherapy;
- low intensity laser irradiation;
- electrophoresis with drugs;
- phonophoresis (using ultrasound to introduce a drug to the site of inflammation).
Surgery
Surgical treatment is used to restore and improve joint mobility, as well as remove some of the damaged cartilage or menisci.
Surgical treatment of arthrosis is resorted to in extreme cases, when pharmacological treatment does not produce results, when severe pain, partial or complete immobility of the joints occurs.
During arthroscopic surgery, it is possible to remove part of the cartilage affected by arthrosis, polish it to obtain a smooth surface, remove cartilage fragments and growths, and cut part of the damaged ligaments.
Knee replacement
With this operation the articular surfaces of the knee joint are replaced with metal or combined prostheses. The prepared plates replicate the surface of the articular cartilage. These prostheses are made of special alloys, do not cause a rejection reaction in patients, do not oxidize and do not damage the surrounding tissues.
Hip surgery for osteoarthritis
During this operation, partial removal of the cartilage and bone tissue of the pelvis and femur is performed. Typically, the head of the femur and the articular surface of the pelvic bone are removed and replaced with a metal or metal-ceramic prosthesis.
Diet for osteoarthritis
Excess body weight is a great enemy of the joints. Most patients with osteoarthritis of the hip and knee joints are overweight.
Therefore, for arthrosis, a properly selected diet is recommended. It is believed that jellied meat cooked in cartilage broth is beneficial for arthrosis. It contains a lot of collagen and structural components of cartilage, which help restore cartilage tissue.
Dairy products, proteins and calcium are helpful. Animal proteins are found in lean meat and fish, while plant proteins are found in buckwheat porridge, beans and lentils. Boiled, stewed and steamed dishes are very healthy.
The best diet for joints is a diet with a slight predominance of carbohydrates (preferably complex), fruits and vegetables and a sufficient amount of proteins and calcium.
Prevention of osteoarthritis
The prevention of osteoarthritis, however trivial it may be, lies in a healthy lifestyle. If possible, try to be in the fresh air, move, walk barefoot on sand, green grass and just on the ground. This type of walking improves muscle function and increases blood circulation in the feet.
The use of physical therapy with various arm and leg swings, twists and bends will provide feasible support for the joints.
Patients often ask if an alternative treatment for osteoarthritis is possible. Yes, folk remedies can help in the initial stages of the disease, reduce pain and improve the general condition of the patient. But it does not replace following your doctor's instructions.