Osteoarthritisis a chronic non-inflammatory disease of the joints or articular cartilage, as well as the tissues that surround them. Osteoarthritis is one of the most common diseases, affecting 10-14% of the world's population. In general, this disease affects women aged 45 to 55 years. Osteoarthritis is the most common joint disease and accounts for almost 80% of all joint etiology.
The etiology of this disease is currently unknown.. . . All the factors that cause tissue degeneration and aging of the body can lead to the appearance of this disease, therefore with age the appearance of osteoarthritis is almost inevitable.
There are external and internal factors for the occurrence of this disease.The main external factors of osteoarthritis are moisture, hypothermia, unfavorable working conditions, functional overload of the joints with frequent microtraumas, as well as exposure to radiation energy and vibration. The main and quite common cause of osteoarthritis is the inability of cartilage to withstand increased stress on the joints. The reasons for this manifestation can be impaired posture, prolonged work, standing and even some sports: weightlifting, running or jumping.
Internal factors that cause this disease include: hereditary predisposition to cartilage disease, impaired blood supply to the joint, hormonal imbalance and metabolic disorders. The cause of osteoarthritis in women may be ovarian dysfunction at menopause. In addition, vascular processes with early development of atherosclerosis can also be a cause of this disease.
Osteoarthritis also has a secondary development in diseases such as congenital dislocation, rheumatoid arthritis, intra-articular fractures and even alcoholism.
What are the symptoms and clinical signs of this disease?
The manifestation of osteoarthritis is expressed by severe pain and deformity of the joints, which leads to disruption of their functions. This disease most often causes damage to the loading joints (hips and knees) and small joints of the arm. The spine is also involved in the process. But the knee and hip joints are most often affected.
The most basic symptomin osteoarthritis there is severe pain in the affected joints. These pains cause damage to bones, joints or periarticular tissues. Usually such pain increases with exertion and decreases at rest. Night pains, swelling of the joints, as well as the appearance of a feeling of "gel viscosity" in the affected joint in the morning - all this indicates the appearance of osteoarthritis. The intensity of such pain depends on many reasons (atmospheric pressure, humidity and temperature changes). All these factors begin to affect the pressure in the joint cavity, which causes these pains.
The next one of the main symptoms of osteoarthritis is the appearance of crunch or squeak in the joints not only when walking, but even with every movement. The occurrence of such creaking or creaking is associated with a violation of the joint surfaces, which causes a restriction of mobility in this joint.
In osteoarthritis, there is an increase in the volume of the joints, which is a consequence of the appearance of swelling of the periarticular tissues. Swelling or fever in the affected joint is extremely rare.
Clinical forms of osteoarthritis:
- gonarthrosis.
- Coxarthrosis.
- Osteoarthritis of the distal interphalangeal joints of the hand.
- Osteoarthritis of the proximal interphalangeal joints of the hands.
- Deforming spondylosis.
- Intervertebral osteochondrosis.
gonarthrosisThis is a lesion of the knee joint in osteoarthritis. In this case, the pain in the knee joints when walking is pronounced and is especially intense if you go down the stairs. The location of these pains is in the inner and front part of the affected knee joint. Increased discomfort occurs when bending the knee. In addition, in many cases of gonarthrosis there is a deviation of the knee joint. The disease begins gradually and the pain increases. Creaking is heard during active and passive movements. The pain begins to intensify and in many cases develops synovitis - inflammation of the capsular membrane of the joint or tendon.
Coxarthrosis- This is a lesion of the hip joint. The initial pain of a thigh injury does not occur in the thigh area, but in the knee, groin or buttocks. They increase when walking and disappear at rest. These pains, which occur even with minor changes in the X-ray, are associated with muscle spasm. With the defeat of the hip joint, there is a gradual increase in the restriction of mobility in the joint. This disease is a consequence of trauma or arthritis. In coxarthrosis there is a "duck" gait, lameness, muscular hypotrophy of the buttocks and thighs. There is also pain on palpation in the area of the femoral head.
Osteoarthritis of the distal interphalangeal joints of the arm or Heberden's nodes. . . The appearance of such nodules is most often observed in women during menopause. They initially appear on the 1st and 3rd fingers of the hand. Over time, namely after a few months or even years, a symmetrical lesion is observed in other distal interphalangeal joints. Such nodes are located on the dorsal-lateral surface of the joints.
Osteoarthritis of the proximal interphalangeal joints of the hands or Bouchard's nodes. Unlike Heberden's nodules, these nodules appear on the lateral surface of the joint, leading to lateral enlargement of the joint. As a result of this increase, the finger acquires a spindle-shaped shape.
Deforming spondylosis- as a result of this disease in the area of the vertebrae appear marginal bone growths. This disease appears from the age of 20. Osteophytes (bone growths) look like swelling - swelling occurs due to vascular compression. As a result, stiffness of the spine occurs, and in some cases, neurological disorders appear.
Intervertebral osteochondrosisoccurs in combination with curvature of the spine or deforming spondylosis. In this disease, the disc degenerates and the nucleus protrudes in different directions, leading to trauma to the spine. Osteophyte overgrowth and increased joint surface area have also been reported. In this case, the choroid of the joint suffers, resulting in vasculitis - inflammation of the walls of small blood vessels. The pain syndrome is very pronounced and intensifies with exercise or hypothermia.
There are two main forms of osteoarthritis- it is primary or idiopathic (the causes of the disease are not clear) and secondary (the disease occurs against the background of other diseases).
Primary osteoarthritislocalized when less than 3 joints are affected. Localized osteoarthritis affects the spine, the joints of the arms and legs, the knee joints, the hips and other joints.
There is also generalized osteoarthritis when 3 or more joints are affected. In this case, large joints and distal interphalangeal joints are affected. In addition, erosive osteoarthritis occurs in the generalized form.
Secondary osteoarthritismay be post-traumatic. Also, the causes of secondary osteoarthritis can be metabolic diseases such as Gaucher disease, which is a genetic disease; Wilson's disease is a rare form of liver damage in which copper metabolism is impaired; hemochromatosis or, as this disease is called, bronze diabetes or pigmented cirrhosis, is an inherited disease in which there is a violation of iron metabolism and its accumulation in organs and tissues. Diseases such as diabetes, hypothyroidism - decreased thyroid function, acromegaly - hyperfunction of growth hormone, can also be causes of osteoarthritis. In addition to these diseases, osteoarthritis can also cause calcium deposition disease, neuropathy and many other diseases.
What happens to osteoarthritis?
In this disease there is an intensive aging of the articular cartilage. As a result, there is a loss of elasticity of the articular cartilage. In addition to the fact that the joint surfaces become rough, cracks still appear on them. In many cases, the cartilage is worn enough to expose the bone. All this leads to a decrease in the elasticity of the articular cartilage and causes the destruction of the joints. In addition, inflammation can accompany all of these changes, resulting in bone growth and leading to disease and deformity of the joints.
Diagnosis of osteoarthritis
Diagnosing osteoarthritis in many cases does not create great difficulties. But there are exceptions, such as patients with a shoulder lesion and symptoms of joint inflammation. Difficulties may also arise in diagnosing primary and secondary osteoarthritis, the occurrence of which is associated with metabolic or other diseases. X-rays show signs of osteoarthritis quickly (especially in the elderly) if there are clinical signs of osteoarthritis. There is not enough X-ray and laboratory data to make a definitive diagnosis. To do this, it is necessary to conduct a number of additional studies to determine the exact cause of joint pain.
Treatment of osteoarthritis
To reduce or completely suppress pain, there are both medicinal and non-medicinal methods, which include physical therapy and exercise. In order to prescribe the right treatment, an individual approach to each patient is needed. In this case, the individual characteristics of the patient and the peculiarities of the course of this disease must be taken into account.
In the treatment of osteoarthritis in the first place it is necessary to follow the regimen, as mechanical unloading of the joint is not only the main factor in reducing pain, but also plays an important role in the treatment of this disease. In this case, it is necessary to exclude a fairly long stay in a fixed position, prolonged walking and long standing, as well as excluding the transfer of weights, which can lead to mechanical overload of the joints. If the disease is neglected, the patient is advised to walk on crutches or a cane. Some patients are prescribed a semi-pulmonary regimen for severe pain during the exacerbation of the disease.
During the treatment of osteoarthritis, it is recommended to follow a diet to reduce excess weight. This is especially true for those who have a lesion of the knee joints.
Also, in the treatment of this disease are used physiotherapeutic methods that not only reduce pain and inflammation, but also have a positive effect on metabolic processes in joint tissues and improve microcirculation. Physiotherapy procedures include the use of electric currents, alternating magnetic currents, electrophoresis, as well as ultraviolet radiation and phonophoresis on the affected joints. In addition, thermal procedures, the use of peat mud and paraffin wax are prescribed.
Using elements of therapeutic massage, patients should try to avoid mechanical irritation of the joint capsule. Only in this case there is a reduction in painful muscle spasm, and the tone of weakened muscles also increases, resulting in improved functional capabilities of the patient.
Drug treatment is prescribed depending on the form of the disease and the severity of its course. In more severe cases, patients are prescribed surgical treatment (arthroplasty).
Patients are also advised to resort to spa treatment on the beach.
Prevention of osteoarthritisconsists of daily performance of special exercises that help strengthen the musculoskeletal system. Getting rid of excess weight, limiting weight loss, as well as including in the menu such dishes as jelly, jelly or aspic are preventive measures for osteoarthritis. And, of course, to engage in such a sport as swimming. It should be remembered that it is better to prevent any disease than to cure it. The same goes for diseases such as osteoarthritis. In order not to think in the future how to get rid of severe pain in osteoarthritis, as well as how to cure this disease, it is necessary to take preventive measures today without postponing them.
Treatment of deforming osteoarthritis by various methods
High qualification and accumulated experience in the use of shock wave therapy allow to achieve the maximum positive effect of the treatment even in the advanced stage of the disease, and in many cases surgical treatment is avoided.
Shock wave therapy is performed on a modern device:
- the course of treatment of arthritis, osteoarthritis by UHT method consists of 5-7 sessions;
- the session is held once every 5-7 days.
Under the influence of the shock wave, microcrystals of calcium salts and areas of fibrosis that form in the tissues of the joints loosen in the affected tissues. At the same time, blood flow to the damaged tissue increases tenfold, which contributes to the resorption of calcium salts and areas of fibrosis.
Advantages of the SWT method:
- efficiency;
- good tolerability (does not require the use of anesthesia);
- reduces the need for other methods, especially surgical treatment;
- rapid pain relief without analgesics;
- the possibility of use in the chronic stage of the disease and its primary manifestations;
- is performed on an outpatient basis, does not require hospitalization, does not disrupt the normal rhythm of life of the patient.
Photodynamic therapy in orthopedicsThis is a non-invasive two-component method of treatment without complications. A photosensitizer and a laser radiation source approved for medical use with a wavelength of 660-670 nm are used to apply the method.
Under the influence of a laser beam, a photosensitizer is excited with the release of singlet oxygen, which toxicly affects the energy complexes of the cell (mitochondria and the Golgi complex), destroying the latter and thus causing the irreversible process of apoptosis. At the same time, healthy cells are not damaged. Damaged pathological tissue is aseptically absorbed.
The photosensitizer is injected into the patient's body transcutaneously (applications).
PRP plasma lifting- This orthopedic procedure is based on a patented method for processing the patient's blood with the help of special vacuum biotechnological tubes and a special centrifugation mode.
During the procedure, an injectable form of platelet-containing autoplasma is isolated from the patient's blood, which is then injected into the soft tissues around the joint and directly into the patient's joint cavity. Autoplasmic injections can reduce inflammation, relieve pain and restore range of motion in the joint. The autoplasma treatment procedure minimizes or eliminates the number of drugs used, thus reducing the toxic effect of the drugs on the patient's body. Also, autoplasmic injections help reduce treatment time by 2-3 times.
Indications for the procedure (PRP plasmalifting):
- osteoarthritis;
- osteoarthritis;
- periarthritis;
- tendon tendopathies,
- damage to ligaments and muscles.
Thus, shock wave therapy, photodynamic therapy and plasma lifting (PRP) in orthopedics are the best choices for the treatment of joint diseases. With the use of modern equipment and technology and the experience of doctors, they allow you to achieve positive results.