Osteoarthritis refers to diseases that affect the joints.As a result of dystrophic-degenerative processes, cartilage is gradually destroyed and replaced by growing bone tissue.The pathological process is accompanied by pain, limited joint mobility, disruption of its functions and severe deformation.Approximately 10-25% of the population suffers from osteoarthritis.After 80 years, almost every person has degenerative disorders of the musculoskeletal system.Most often, the disease affects the most mobile joints (fingers, hip, knee, neck).But sometimes degenerative processes develop in the ankle and shoulder joint.
Factors in the development of the disease
Various reasons trigger destructive processes in the body.The most important are congenital anomalies of the connective tissue.Regular microtraumas of the joints and acute joint diseases contribute to the appearance of arthrosis.Over time, the untreated disease enters a chronic stage with regular exacerbations.
The provoking factors that lead to the development of arthrosis are:
- excess weight;
- physical inactivity;
- hormonal disorders;
- atherosclerosis;
- venous insufficiency;
- endocrine disorders;
- genetic predisposition;
- regular, heavy loads on the joints (for example, in weight lifters or people whose profession involves lifting and moving heavy objects).
Under the influence of one or several provoking factors at once, the cells of the cartilage tissue begin to collapse.Gradually, the cartilage thins, becomes less elastic, then becomes covered with cracks and falls off.The bones in the joint begin to rub against each other.The body initiates a compensatory mechanism, as a result of which bone tissue grows on a crumbling surface.As a result, the joint becomes inactive and deformed.
Species
Osteoarthritis can be primary, appearing independently, and secondary, developing as a result of diseases, injuries and deformities of the joints.
Depending on the affected joint, the disease has its name:
- Gonarthrosis affects the knee joint.
- Coxarthrosis is a disease of the hip joint.
- Spondyloarthrosis affects the intervertebral discs of the lumbar, cervical and thoracic regions.
- Crocearthrosis involves the ankle in the pathological process.
If 3 or more joints are involved in the degenerative process, it is called a generalized form.If there are 1-2 joints it is local arthrosis.
Symptoms
Initially, the degenerative process occurs unnoticed.There are no nerve fibers in the cartilage, so in the initial stages of development the patient does not even know what destructive processes are occurring in his body.The first signs appear only several years after the onset of dystrophic-degenerative processes, when the periosteum under the cartilage is damaged or inflammation develops.
Initially, pain is felt in the limbs after intense effort.In the morning or after a long period of rest, a sensation of stiffness and dull, aching pain of not excessive intensity occurs.After a short warm-up or exercise, all painful symptoms disappear.Therefore, people do not go to the doctor, considering this to be a common occurrence.Meanwhile, it is at the initial stage that it is much easier to stop the progression of arthrosis.
Over time, all signs intensify.The pain becomes obsessive and constant, preventing you from sleeping at night.Pain, feeling of stiffness, inability to work fully or carry out household chores become increasingly bothersome.The aching, twisting pain in the joints and surrounding muscles intensifies in rainy weather.
Most often, arthrosis affects the joints of the lower extremities, so a person quickly gets tired of walking, it is difficult for him to climb stairs or any height, since stiffness of the joint is formed due to the destruction of cartilaginous tissue.An unsteady gait develops due to instability of the limbs.When you bend a joint, you hear an unpleasant creaking sound as the joint surfaces, which lack cartilage, rub against each other.Patients try to limit the mobility of the diseased joint, so over time, muscle atrophy develops.They decrease in volume and the gait becomes even more unstable.
If arthrosis develops in the joints of the upper extremities, this most often happens after injuries or as a result of chronic arthritis.In this case, bony growths appear on the fingers, and the hands become square in shape.
Clinical symptoms depend on the stage of development of arthrosis:
- Zero.
At stage zero, a person is sometimes bothered by slight discomfort.Radiographic examination does not reveal any degenerative changes. - Elementary.
When walking for a long time, a slight dull pain occurs.The x-ray shows the appearance of small areas of bone defects along the edges of the joint surfaces.When you bend the joint you will hear a creaking sound. - Easy.
In the morning there is pain and stiffness.X-rays show osteophytes (single bony growths) along the edges of the joints, narrowing of the joint space. - Moderate.
The moderate stage is considered degenerative.Bones and muscles constantly ache, especially at night.The joint swells slightly.X-ray examination shows even greater narrowing of the joint space, proliferation of bony growths, and increased bone density. - Heavy.
In the severe stage (deformation), aching, constant pain occurs, which intensifies with movement.When you try to bend the joint, you hear a loud crunch.The x-ray shows strong narrowing of the joint space;osteophytes have already grown so much that it leads to deformation of the joint and a change in its structure.
Diagnosis and treatment
An orthopedist, a rheumatologist and a surgeon are involved in determining the type and stage of degenerative-dystrophic processes in the joints.Diagnosis includes standard blood and urine tests.If necessary, an immunological analysis and an examination of intraarticular fluid for the presence of infection are performed.Instrumental studies are performed (MRI, ultrasound to identify changes in periarticular and joint soft tissues, CT, radiographs to determine changes in bone tissue).
Therapy
The disease cannot be completely stopped.Timely diagnosis and treatment allow you to maintain its mobility and prevent the progression of destruction.
Antispasmodics, NSAIDs, steroid blockers injected into the joint, chondroprotectors, muscle relaxants, vitamin and mineral complexes, drugs to improve the trophism of the affected tissues, inhibitors of proteolysis to slow down the destruction of cartilage and bone tissue are used as drugs in the treatment of arthrosis.
Patients with severe pain and an unstable joint are advised to wear tapes that fix the joint in a normal position using adhesive tapes, orthoses, elastic knee pads or elbow pads.Crutches or canes should be used for support.
Physiotherapy procedures including UHF, massage, ozone therapy, electrophoresis and phonophoresis with painkiller solution, magnetotherapy, acupuncture, electrical stimulation, darson evaluation, paraffin baths (in the absence of inflammation) should be prescribed.
In the later stages of arthrosis, when the tissues are already destroyed and the joints are severely deformed, the only solution is surgery:
- Arthroscopy with removal of bone growths, spines and partial replacement of damaged cartilage.
- Endoscopy.This involves the replacement of a joint (entirely or partially) with an artificial joint.
- Artodez.The joint is closed and fixed in a convenient position.Over time, the joint surfaces grow together.
Prevention
Since it is impossible to return your joint to a normal physiological state, it is necessary to take measures in advance to prevent this disease.It is especially important to do this if there is a family history of cases of this disease or if you reach the age of over 40.
Prevention includes maintaining a normal body mass index and regular exercise.Infectious pathologies and other joint diseases must be treated promptly, hypothermia and prolonged and sudden physical exertion must be avoided.People belonging to risk groups (by age, traumatic profession, poor heredity) must regularly examine their joints using X-rays.
Only timely and adequate treatment helps keep the joint healthy.