Osteoarthritisit is 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 that affects 10-14% of the world population. Basically, this disease affects women aged 45 to 55 years. Osteoarthritis is the most common joint disease and accounts for almost 80% of all joint etiologies.
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 in the appearance of this disease.The main external factors of osteoarthritis include humidity, hypothermia, unfavorable working conditions, functional joint overload with frequent microtraumas, as well as exposure to radiation energy and vibration. The main and fairly common cause of osteoarthritis is the inability of the cartilage to withstand increased stress on the joints. The reasons for this manifestation can be alterations in posture, prolonged work, standing up and even some sports: lifting weights, running or jumping.
Internal factors that cause this disease include the following: hereditary predisposition to the onset of cartilage tissue diseases, impaired blood supply to the joint, hormonal imbalance, and metabolic disorders. The cause of osteoarthritis in women can be ovarian dysfunction at menopause. In addition, vascular processes with early development of atherosclerosis can also be the 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 clinical signs and symptoms of this disease?
The manifestation of osteoarthritis is expressed by severe pain and deformation of the joints, which leads to a violation of their functions. With this disease, damage to the load-bearing joints (hip and knee joints) and the small joints of the hand most often occurs. The spine is also involved in the process. But most of the time the knee and hip joints are affected.
The most basic symptomWith osteoarthritis, there is severe pain in the area of the affected joints. These pains cause damage to the bones, joints, or periarticular tissues. Generally, this pain increases with exertion and decreases with rest. Night pains, swelling of the joints, as well as the appearance of a sensation of "gel stickiness" in the affected joint in the morning - all this indicates the onset of osteoarthritis. The intensity of this pain depends on many reasons (atmospheric pressure, humidity and changes in temperature). All these factors begin to influence the pressure in the joint cavity, which causes these pains.
The next of the main symptoms of osteoarthritis is the appearance of a creaking or grinding sound in the joints, not only when walking, but even during any movement. The appearance of such a creaking or grinding noise is associated with a violation of the articular surfaces, which causes a restriction of mobility in this joint.
With osteoarthritis, there is an increase in the volume of the joints, which is a consequence of the appearance of edema 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.
GonarthrosisIt is an injury to the knee joint in osteoarthritis. In this case, pain is expressed in the knee joints when walking, and they are especially intense if you go down the stairs. The location of these pains is in the internal and frontal parts of the affected knee joint. Increased discomfort occurs when the knee is bent. Also, in many cases of knee osteoarthritis, there is a deviation of the knee joint. The disease begins gradually, and the pain increases. With active and passive movements, a crack can be heard. The pain begins to intensify and, in many cases, synovitis develops, an inflammation of the membrane of the joint capsule or tendon.
Coxarthrosis- This is a hip joint injury. The initial pain of a hip injury does not appear in the thigh area, but in the knee, groin, or buttock. They increase when walking and decrease when resting. These pains, which occur even with minor changes on the x-ray, are associated with muscle spasms. With the defeat of the hip joint, there is a gradual increase in the limitation of mobility in the joint. This disease is the result of trauma or arthritis. With coxarthrosis, there is a "duck" gait, development of lameness, muscular hypotrophy of the buttocks and thighs. In addition, there is tenderness in the area of the femoral head.
Osteoarthritis of the distal interphalangeal joints of the hand or Heberden's nodes. . . The appearance of such nodules is seen more often in women during menopause. Initially, they appear on the first and third fingers of the hand. Over time, that is, after several months or even years, a symmetrical lesion is seen in other distal interphalangeal joints. These nodules are found on the dorsal-lateral surface of the joints.
Osteoarthritis of the proximal interphalangeal joints of the hands or Bouchard's nodules. Unlike Heberden's nodules, these nodules appear on the lateral surface of the joint, causing a lateral enlargement of the joint. As a result of this increase, the finger acquires a fusiform shape.
Deforming spondylosis- As a result of this disease in the region of the vertebrae, marginal bone growths appear. This disease appears from the age of 20. Osteophytes (bone growths) look like swelling; edema appears due to vascular compression. As a result, spinal stiffness appears and, in some cases, neurological disorders appear.
Intervertebral osteochondrosisoccurs in combination with curvature of the spine or deforming spondylosis. With this disease, the disc degenerates and the nucleus protrudes in different directions, leading to trauma to the spine. There is also an overgrowth of osteophytes and an increase in the surface of the joint. In this case, the choroid of the joint suffers, as a result of which vasculitis occurs, an inflammation of the walls of small blood vessels. The pain syndrome is very pronounced and increases with physical exertion or hypothermia.
There are two main forms of osteoarthritis.- it is primary or idiopathic (the causes of the disease have not been clarified) and secondary (the disease occurs against the background of other diseases).
Primary osteoarthritisit is located when less than 3 joints are affected. With localized osteoarthritis, the spine, the joints of the hands and feet, the knee joints, the hip joints, and other joints are affected.
There is also generalized osteoarthritis, when 3 or more joints are affected. In this case, the large joints and the distal interphalangeal joints are affected. Furthermore, in the generalized form, erosive osteoarthritis also occurs.
Secondary osteoarthritisit can 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 also called, bronze diabetes or pigmentary cirrhosis, is a hereditary disease in which there is an alteration of iron metabolism and its accumulation in organs and tissues. Diseases such as diabetes mellitus, hypothyroidism, a decrease in the function of the thyroid gland, acromegaly, hyperfunction of growth hormone, can also be the causes of osteoarthritis. In addition to these diseases, osteoarthritis can also cause calcium deposit disease, neuropathy, and many other diseases.
What about osteoarthritis?
With this disease, intensive aging of the articular cartilage occurs. As a result, there is a loss of elasticity of the articular cartilage. In addition to the fact that the articular surfaces become rough, cracks still appear on them. In many cases, the cartilage is worn down enough to expose the bone. All this leads to a decrease in the elasticity of the articular cartilage and causes the joints to break. In addition, inflammation can join all the listed changes, which is why bone tissue growth occurs and this leads to disease and deformation of the joints.
Diagnosis of osteoarthritis
The diagnosis of osteoarthritis in many cases does not present great difficulties. But there are exceptions, for example, patients with an injury to the shoulder joint and symptoms of joint inflammation. Difficulties can also arise in the diagnosis of primary and secondary osteoarthritis, the occurrence of which is associated with metabolic or other diseases. On x-ray examination, signs of osteoarthritis are detected quickly (especially in the elderly) if there are clinical signs of osteoarthritis. To make a final diagnosis, there is not enough X-ray and laboratory data. To do this, a number of additional studies need to be conducted to identify the exact cause of joint pain.
Treatment of osteoarthritis
To reduce or completely suppress pain, there are drug and non-drug methods, including physical therapy and exercise therapy. To prescribe the correct treatment, an individual approach is required for each patient. In this case, the individual characteristics of the patient and the peculiarities of the course of this disease are necessarily taken into account.
In the treatment of osteoarthritis, first of all it is necessary to observe the regimen, since the 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 certain fixed position, a long walk and a prolonged position on the legs, as well as the exclusion of the transfer of weights that can lead to mechanical overload of the joints. If the disease is neglected, the patient is advised to walk with crutches or a cane. With quite pronounced pains at the time of exacerbation of the disease, some patients are prescribed a semi-bed regimen.
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 knee joint injury.
In addition, in the treatment of this disease, physiotherapeutic methods are used that not only reduce pain and inflammation, but also have a positive effect on metabolic processes in the tissues of the joints and improve microcirculation. Physiotherapy treatments include the use of electrical 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 therapeutic massage elements, patients should try to avoid mechanical irritation of the joint capsule. Only in this case there is a decrease in painful muscle spasm, and the tone of weakened muscles also increases, as a result of which the functional capabilities of the patient improve.
Drug treatment is prescribed depending on the form of the disease and the severity of its course. In the most severe cases, patients are prescribed surgical treatment (arthroplasty).
In addition, patients are advised to resort to spa treatments on the sea coast.
Prevention of osteoarthritis.It consists of the daily performance of special exercises that help to strengthen the muscle-ligament apparatus. Getting rid of excess weight, limiting the transport of weights, as well as the inclusion in the menu of dishes such as jelly, jellied meat or aspic are all preventive measures of osteoarthritis. And, of course, playing a sport like swimming. It must be remembered that it is better to prevent any disease than to cure it. The same applies to diseases like osteoarthritis. In order not to think ahead about 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 for later.
Treatment of deforming osteoarthritis by various methods.
The high qualification and accumulated experience in the use of shock wave therapy allows to achieve the maximum positive effect of the treatment even in advanced stages of the disease, avoiding surgical treatment in many cases.
Shock wave therapy is carried out in a modern apparatus:
- the course of treatment of arthritis, arthrosis by the UHT method consists of 5-7 sessions;
- the session takes place 1 time in 5-7 days.
Under the influence of a 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, the blood flow in the damaged tissue increases tenfold, which contributes to the reabsorption of calcium salts and areas of fibrosis.
Advantages of the SWT method:
- efficiency;
- good tolerance (does not require the use of anesthesia);
- reduces the need for other methods, especially surgical treatment;
- quick pain relief without pain relievers;
- the possibility of using in the chronic stage of the disease and with its primary manifestations;
- It is performed on an outpatient basis, does not require hospitalization, does not alter the patient's usual rhythm of life.
Photodynamic therapy in orthopedicsIt is a non-invasive and uncomplicated two-component treatment method. To implement the method, a photosensitizer and a laser radiation source approved for medical use with a wavelength of 660-670 nm are used.
Under the influence of a laser beam, a photosensitizer is excited by the release of singlet oxygen, which toxicly affects the energy complexes of the cell (mitochondria and Golgi complex), destroying the latter and thus triggering the irreversible process of apoptosis . At the same time, healthy cells are not damaged. Damaged pathological tissue is absorbed aseptically.
The photosensitizer is injected into the patient's body transcutaneously (applications).
PRP plasma lifting- This orthopedic procedure is based on a patented method of processing the patient's blood using special biotech vacuum tubes and a special centrifugation mode.
During the procedure, an injection form of platelet-containing autoplasma is isolated from the patient's blood, which is then injected into the soft tissues surrounding the joint and directly into the patient's joint cavity. Autoplasma injections can reduce inflammation, relieve pain, and restore range of motion in the joint. The autoplasma treatment procedure either minimizes the amount of drugs used or eliminates them entirely, thereby reducing the toxic effect of the drugs on the patient's body. Also, autoplasma injections help reduce treatment time by 2-3 times.
Indications for the procedure (plasmolifting PRP):
- osteoarthritis;
- osteoarthritis;
- periarthritis;
- Tendopathies of tendons,
- Damage to ligaments and muscles.
Therefore, shock wave therapy, photodynamic therapy and plasma lift (PRP) in orthopedics are the best options for the treatment of joint diseases. With the use of modern equipment and technologies and the experience of doctors, they allow you to achieve positive results.