Osteoarthritis

Throughout his life, a person is constantly in 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 daily activities.However, any movement of the body creates a certain load on the musculoskeletal system and can potentially become a traumatic situation, leading to premature wear and tear on 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 its danger, which is why they consult a doctor at a later stage.This can lead to serious health problems and even disability.A timely visit to specialists will allow you to avoid these problems, because experienced doctors carry out a thorough diagnosis, allowing 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 appears.According to official statistics, between 10 and 20% of people worldwide suffer from this pathology.These are quite significant indicators that increase every year.During the aging process, age-related changes occur in the musculoskeletal system, characteristic of most people over 80 years old.However, only a small proportion of them consult a doctor, preferring to treat themselves.It is this approach that significantly worsens the prognosis for recovery and also increases the risk of disability.

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

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

Species

There are severalrankings osteoarthritis: according to the genesis, clinical forms and location.Each of them has its own clinical significance;classification according to the location of the lesion is the most requested in practice.

Osteoarthritis of the lower limbs

• Osteoarthritis of the hip- 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 musculo-ligamentous apparatus occurs.When inflammation occurs, the effect of complete or partial immobility develops.This pathology is often due to the presence of congenital dysplasia, dislocations and osteochondropathy.It manifests itself in the form of pain (it first appears in the late afternoon and at night, but then becomes permanent, radiating towards the groin and gluteal region) and forced position of the lower limbs.
• Ankle- occurs quite often, because the ankle is forced to bear heavy loads every day.As a result, it is often injured, leading to degeneration.Ankle osteoarthritis often occurs without significant symptoms, but as it progresses, pain develops with 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 the others.There are several types: patellofemoral and patellofemoral.The first occurs after an injury to the patellofemoral joint.At first it is asymptomatic, because the joint has a large amount of cartilage responsible for shock absorption.Their presence prevents bone damage.Later, the patient begins to experience knee pain after physical activity, which gradually becomes permanent (often intensifies when the weather changes).Synovitis, characterized by intense, almost unbearable pain, is often associated with the pathology.The tibiofemoral type is extremely rarely diagnosed and has a more favorable prognosis.It is characterized by painful sensations radiating to the lower part of the body (usually towards the feet).
• Heel— degenerative-dystrophic changes can be observed in the subtalar or talocalcaneal-navicular joints after injury or disease.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 limbs

Suchlocation of the diseaseoccurs less frequently than in the lower limbs.These are :

• Osteoarthritis of the shoulder joint.As a rule, this occurs after injury and against the background of microtrauma in professional athletes.Sometimes diagnosed in people whose profession involves physically demanding work.Acromial type disease is a consequence of injury and inflammation.At first it goes unnoticed, but as it progresses, painful sensations appear in the injured shoulder.Patients note limited mobility, as well as a crunching noise when moving.If not treated promptly, 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 elbow pain during flexion and extension of the upper limb and limited mobility.
• Osteoarthritis of the hand joints.As a rule, it is diagnosed in the carpometacarpal joint of the 1st finger (it is this joint that is most susceptible to injuries in everyday life).It is characterized by dull pain on the outer surface of the palm, which can radiate to the thumb.
• Osteoarthritis of the finger joints.It is most often found in people doing small jobs (embroidery, knitting, etc.).A proliferation of bone tissue is observed, leading to the formation of Heberden's and Bouchard's lymph nodes.Patients rarely report joint pain (sometimes when the weather changes) and stiffness in movement.

Reasons

There is no single etiological factor leading to the development of this pathology.Osteoarthritis 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), in one way or another, turn into a degenerative-dystrophic process with constant inflammatory relapses.The osteoarthritis age group, 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 that predispose to it.The most clinically important of these are:

• Sedentary lifestyle(sedentary work, laziness and much more).
• Excessive physical activityphysically demanding work, professional sport (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 the professionwith a constant position, without any movement.
• Hormonal disorders and damage to the endocrine system(diabetes mellitus, atherosclerosis of blood vessels, obesity, etc.).
• Poor diet(insufficient daily intake of fats, proteins, carbohydrates, vitamins and microelements).
• Smoking and alcohol abuse.
• A burdened heredity.

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.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 joint edges), which significantly limits the mobility of the joint and leads to its deformation.

The cells of the joints have a particularity: they react quickly to any injury, even minor.Damaged cells actively synthesize anti-inflammatory cytokines, therefore the destruction of cartilage and bones is characterized by aseptic inflammation of the synovium.Frequent relapses of pathology lead to worsening inflammation, so hard tissue cells begin to die even faster, which contributes to the progression of the disease.

Symptoms

Osteoarthritis can occur for a long time without any 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 the appearance of inflammation.There are several types of symptoms, depending on the time of their appearance and the characteristics of their manifestation.

First signs

A person begins to feel 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 immobile, the first “initial painful sensations” appear, associated with slight stiffness.To eliminate limited mobilityyou need to warm up for a while.The pain is aching or dull and is not very intense.Due to the poor clinical picture, patients rarely consult a doctor at an early stage.Many people begin to self-medicate and try 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 great chances of complete recovery without consequences.It is therefore strongly recommended to make an appointment with a doctor if you notice sensations in your joints.

Obvious symptoms

The pain gradually increases, intensify with climate change.They occur not only in the morning, but also persist throughout the day.Patients cannot sleep completely;many (especially older people) note bone pain and aching 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 difficult bending and joint stiffness.Many people notice instability in the damaged limb, which is why they develop an uncertain and smooth gait.

Osteoarthritis of the knee is manifested by a characteristic tightening, formed as a result of rubbing of the joint surfaces against each other.The knee gradually begins to deform due to the growth of bone tissue along the edges.Patients try to limit their movements, which leads to muscle atrophy.This, in turn, makes the approach even more unstable and cautious.Osteoarthritis of the upper limbs is generally the result of an injury or chronic arthritis.The most visible deformation is observed at the level of the interphalangeal joints of the hand.Bouchard's and Heberden's knots 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, the appearance of clinical signs, even dangerous ones, 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 deformation, because of which the gait changes or it becomes impossible to perform the usual movements.
• Myalgia and bone pain.
• Unsteady gait, severe limitation of mobility during flexion and extension.
• The pain becomes constant, which does not subside either in the evening or at night, radiating to the surrounding areas.

Degrees

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

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

Exacerbation

All degenerative diseases are characterized by a slow, often asymptomatic progression (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, hyperemia of the skin, pain and swelling.Therefore, if signs of an inflammatory process appear, you should immediately consult a qualified doctor.Providing independent servicesFIRST AIDcan be achieved using the following methods:

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

Diagnosis

To make a diagnosis, high-precision examination methods are used to identify even minor pathological changes.In the clinic, specialists conduct a thorough examination of the patient, allowing them to visually and palpably determine the current state of the joint (external signs of inflammation: swelling, redness of the skin, pain, hyperemia).After that, laboratory and instrumental diagnostics are prescribed, which allows obtaining 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.
• Take intra-articular fluidto detect infection and its sensitivity to antibiotics.

Instrumental diagnostics involves the following procedures:

1. Ultrasound and MRI of the joint.Allows you to detect changes in articular and periarticular soft tissues.
2. X-ray and CT scan.It is very informative when looking for changes in bone tissue.Today, it is the preferred diagnostic method, fundamental for diagnosing osteoarthritis.
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 their metabolism.

Drug therapy

The prescription of medications is aimed at relieving pain, suppressing its progression and restoring joint function.To combat pain, we use:

• Analgesics from the NSAID group.The type of drug, its release form and dosage are selected individually by the doctor.The choice depends on the severity of the 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 relaxers.They are necessary to relieve spasms of periarticular muscles.In 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.
• Analgesic blockages.As a rule, they are used to treat severe acute pain that cannot be eliminated by taking the medications described above.In this case, we use solutions injected into the most painful places.

Treatment of osteoarthritisThe knee or any other joint cannot be treated without taking medications to help restore joint function.For this purpose are named:

• Chondroprotectors.Taking them restores cartilage tissue and improves blood circulation.It comes in the form of ointments, injections and tablets.
• Hyaluronic acid.The drug is injected directly into the joint cavity, ensuring the fastest possible onset of the therapeutic effect.Its main goal 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 thattake medicine- it is not a panacea nor the only way to recover.To eliminate pain, increase joint mobility and improve quality of life, you will need to devote sufficient time to non-drug treatment methods.It is necessary to maintain a balance between adequate physical activity and adequate rest.You can achieve this result by sticking to daily workouts.To achieve the desired result, you must adhere to the following training rules:

1. Classes must take place 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.), lifting weights (dumbbells, etc.), long periods of immobility.The best option in this case would be swimming, yoga (preferably with an instructor who is familiar with 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 solutions of analgesic drugs.
2. Warming applications with paraffin(performed exclusively in the absence of an inflammatory process).
3. Darsonvalidation- 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 expand blood vessels and normalize metabolic processes.In addition, it helps dissolve necrotic tissues and clean joint cavities.

Prevention

Coping with osteoarthritis, as well as its consequences, is quite difficult.However, it is much easier to prevent it.To do this, it is enough to 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 rest or rest, you should allow time (at least a few minutes per day) for a simple warm-up.
• Exercising regularly or going to the pool.These are great general strengthening sports that will help keep your muscles and musculoskeletal system healthy.
• Adequate and rational diet.It is extremely important to monitor your daily diet.It should contain a sufficient amount of proteins, fats, carbohydrates, microelements and vitamins.It is worth increasing the consumption of foods rich in omega-3 (fish, red game, avocado, nuts, flax seeds, etc.) and collagen (jelly, rich soups, etc.).
• Watch your body weight.It is necessary to maintain 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

Osteoarthritis of the jointsThis is a fairly serious disease that can lead to serious consequences and complications.However, you can fight it, live fully and accomplish 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 duration of treatment and compliance with medical recommendations.Early medical consultation allows you to identify the first degenerative changes and eliminate them in time.There is therefore no need to self-medicate or postpone a visit to the doctor.If you notice the first symptoms of joint disorders, you should immediately consult a doctor and undergo thorough diagnosis.