Osteoarthritis refers to diseases that affect the joints.As a result of dystrophic-degenerative processes, the cartilages gradually die and their place is taken by the growing bone tissue.The pathological process is accompanied by pain, limited joint mobility, disruption of its functions and severe deformation.About 10-25% of the population suffers from arthrosis.After 80 years, almost all people have degenerative disorders in the musculoskeletal system.Most often, the disease affects the most mobile joints (fingers, hips, knees, neck).But sometimes degenerative processes develop in the ankle and shoulder joints.
Factors affecting the development of the disease
Various causes initiate destructive processes in the body.The most important are congenital disorders 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.
Provocative factors leading to the development of arthrosis are as follows:
- overweight;
- physical inactivity;
- hormonal disorders;
- arteriosclerosis;
- venous insufficiency;
- endocrine disorders;
- genetic predisposition;
- regular and heavy loading of the joints (for example, in weightlifters or people whose profession involves lifting and moving heavy objects).
Under the influence of a provoking factor or several at the same time, the cells of the cartilage tissue begin to collapse.Gradually, the cartilage thins, becomes less flexible, then becomes covered with cracks and falls off.The bones at the joint begin to rub against each other.The body starts a compensatory mechanism, as a result of which the bone tissue grows on the damaged surface.As a result, the joint becomes inactive and deformed.
Species
Arthrosis can be primary, which occurs independently, and secondary, which develops as a result of diseases, injuries and joint deformities.
Depending on the affected joint, the name of the disease is:
- 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.
- Crusarthrosis involves the ankle in the pathological process.
If 3 or more joints are involved in the degenerative process, we speak of a generalized form.If there are 1-2 joints, then this is local arthrosis.
Symptoms
At first, the degenerative process goes 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 taking place in his body.The first signs appear only a few years after the start of the dystrophic-degenerative processes, when the bone membrane under the cartilage is damaged or inflammation develops.
At first, after strong exertion, there are pains in the limbs.In the morning or after a long period of rest, a feeling of stiffness and a dull aching pain of not too high intensity appear.After a short warm-up or exercise, all painful symptoms disappear.That's why people don't go to the doctor because it's a common phenomenon.Meanwhile, it is much easier to stop the progression of arthrosis at the initial stage.
Over time, all signals become stronger.The pain becomes obsessive and constant, preventing sleep at night.Pains, feelings of stiffness, inability to complete work or household tasks are more and more disturbing.The aching, twisting pain of the joints and surrounding muscles intensifies in rainy weather.
Most often, arthrosis affects the joints of the lower limbs, so a person gets tired quickly when walking, it is difficult to climb the stairs or any height, because the stiffness of the joint is formed due to the destruction of the cartilage tissue.Unsteady gait develops due to the instability of the limb.An unpleasant cracking sound can be heard when the joint is bent, as the cartilage-free joint surfaces rub against each other.Patients try to limit the mobility of the diseased joint, so muscle atrophy develops over time.The volume decreases and the gait becomes even more unstable.
If arthrosis develops in the joints of the upper limbs, it most often occurs after injuries or as a result of chronic arthritis.In this case, bony outgrowths appear on the fingers and the hands become square.
Clinical symptoms depend on the stage of development of arthrosis:
- Zero.
In the zero stage, a person is sometimes disturbed by a slight discomfort.The X-ray examination does not reveal any degenerative changes. - Basic.
A slight dull pain occurs when walking for a long time.X-rays show the appearance of small bone defects along the edges of the joint surfaces.A creaking sound can be heard when the joint is bent. - Easily.
Pain and stiffness in the morning.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 ache constantly, especially at night.The joint will be slightly swollen.The X-ray examination shows an even greater narrowing of the joint space, the proliferation of bone growths, and an increase in bone density. - Difficult.
In the severe stage (deforming), constant aching pain occurs, which increases with movement.When you try to bend the joint, you hear a harsh crack.The X-ray shows a sharp narrowing of the joint space;the osteophytes have already grown so much that it has led to deformation of the joint and changes in its structure.
Diagnosis and treatment
Orthopedist, rheumatologist and surgeon are involved in determining the type and stage of degenerative-dystrophic processes of the joints.Diagnosis includes the usual blood and urine tests.If necessary, we perform an immunological analysis and an examination of the intra-articular fluid for the presence of infection.Instrumental tests are performed (MRI, ultrasound to identify changes in soft periarticular and joint tissues, CT, X-ray to determine changes in bone tissue).
Therapy
The disease cannot be completely stopped.Timely diagnosis and treatment make it possible to maintain mobility and prevent the progression of destruction.
In the treatment of arthrosis, anticonvulsants, NSAIDs, steroid blockades injected into the joint, chondroprotectors, muscle relaxants, vitamin and mineral complexes, drugs that improve the trophism of the affected tissues, and proteolysis inhibitors that slow down the destruction of cartilage and bone tissue are used as medicines.
Patients with severe pain and an unstable joint are recommended to wear tapes that fix the joint in a normal position with tape, orthosis, flexible knee pads or elbow pads.Crutches or sticks should be used for support.
Physiotherapy procedures should be prescribed, which include UHF, massage, ozone therapy, electrophoresis and phonophoresis with an analgesic solution, magnetic therapy, acupuncture, electrical stimulation, darsonvalization, paraffin baths (in the absence of inflammation).
In the later stages of arthrosis, when the tissues are already destroyed and the joints are severely deformed, the only way is surgical intervention:
- Arthroscopy with removal of bone growths, spines and partial replacement of damaged cartilage.
- Endoscopy.It is the replacement of a joint (completely or only a part) with an artificial joint.
- Artodez.The joint is closed and fixed in a comfortable position.Over time, the joint surfaces grow together.
Prevention
Since it is impossible to restore one's own joint to its normal physiological state, preliminary measures must be taken to prevent the disease.It is especially important to do this if you have a family history of this disease or if you reach the age of 40.
Prevention includes maintaining a normal body mass index and regular exercise.Infectious pathologies and other joint diseases should be treated immediately, hypothermia and prolonged and sudden physical exertion should be avoided.Those belonging to the risk group (age, people with a traumatic profession, people with bad heredity) should regularly examine their joints with the help of X-rays.
Only timely and appropriate treatment helps to preserve the health of the joint.