Osteoarthritis is a chronic degenerative disease that affects all parts of the joint: cartilage, joint membrane, ligaments, capsule, periarticular bones and periarticular muscles and ligaments.
According to European doctors, osteoarthritis is responsible for almost 70% of all rheumatological diseases. People aged between 40 and 60 years are more susceptible to joint osteoarthritis. This is facilitated by both lack of movement and prolonged overload, poor nutrition and, of course, injuries.
What is a joint?
Typically, a human joint consists of 2 or more connected bones. All working surfaces of the joint have a protective layer and are constantly lubricated with synovial fluid for better sliding. The joint cavity itself is hermetically sealed by the joint capsule.
In our body there are many joints that are "responsible" for certain types of movements, they can suffer different loads and have different safety margins.
The amount of movement in the joints depends on the structure of the joint, the ligamentous apparatus that limits and strengthens the joint, and the various muscles attached to the bones by tendons.
Causes of joint arthrosis
Normal functioning of joints is possible with constant self-renewal of cartilaginous tissue. At a young age, the rate of death of obsolete joint cells is equal to the rate of birth of new cells. Over the years, the cell renewal process slows down and the cartilaginous tissue begins to become thinner. Synovial fluid production also decreases. As a result, the articular cartilage begins to thin and break down, leading to osteoarthritis.
In addition, there are other causes of joint arthrosis:
- increased physical activity. Joint arthrosis is a frequent accompaniment of being overweight. As a result of overload, microtraumas form in the joints. Athletes develop joint damage due to increased loads on "unwarmed" joints;
- joint injuries;
- congenital or acquired deformities of the musculoskeletal system (rickets, kyphosis, scoliosis, inadequate bone fusion after injuries with the appearance of limb deformities: O- and X-shaped leg deformities).
Stages of osteoarthritis
Depending on the degree of destruction of the cartilaginous tissue, different stages or degrees of arthrosis can be distinguished.
Degrees and symptoms of osteoarthritis
- First-degree osteoarthritis is characterized by periodic joint pain, especially with increased physical activity. After rest, the pain usually disappears. The range of motion of the joint is not limited, the muscle strength of the injured limb is not changed. X-rays may show minimal signs of joint damage.
- 2nd degree arthrosis is manifested by painful sensations not only with intense physical stress, but also with small loads. Even during rest, joint pain may not subside. This degree is characterized by stiffness in movements and limited mobility in the joints. This ultimately leads to muscle atrophy. An x-ray may show deformation of the joint, a decrease in joint space and the appearance of bone growths near this gap.
- 3rd degree osteoarthritis - any movement causes a lot of pain in the person. Joint pain is present even at rest. Therefore, a person tries to move as little as possible so that the pain is minimal. In some cases, movement requires the use of crutches or a stretcher. Sometimes fusion of bones occurs - ankylosis (as in ankylosing spondylitis).
With deforming arthrosis, irreversible changes occur in the cartilaginous tissue of the joint and its functions and structure are completely disturbed. Deforming osteoarthritis of the joints is based on the appearance of dysfunctions in the formation of hyaline cartilage and synovial fluid.
Diagnosis of joint arthrosis
The main method for diagnosing joints is radiography. In osteoarthritis, changes in the joints, irregular joint surfaces and narrowing of the joint space can be observed.
Which joints are most likely to suffer from osteoarthritis?
The joints in the extremities most susceptible to osteoarthritis are the hips, knees, shoulders, elbows and hands.
With osteoarthritis of the hip joint, a person may first feel slight discomfort in the legs after running or walking. Over time, the pain intensifies, and there is limitation and stiffness in movement. In stage 3 of the disease, the patient protects his leg and tries, if possible, not to step on it.
Knee joint osteoarthritis manifests as pain in the knee joint after bending and straightening the legs. The most common cause of knee osteoarthritis is injuries sustained in the past. As a result of these injuries, the sliding of the articular surfaces is interrupted and their rapid wear occurs. In some cases, the joint may gradually lose its mobility.
Arthrosis of the ankle joint manifests itself in the form of swelling and pain in the ankle of the leg. The cause of arthrosis of the ankle joint can be: deformations, fractures of the ankle and talus, dislocations, flat feet, chronic injuries of the ankle joint in athletes and dancers. In fact, they often have osteoarthritis in the foot.
Arthrosis of the shoulder, elbow and wrist joints most often appears as a result of injuries, bruises, dislocations and intra-articular fractures. Osteoarthritis of the shoulder joint is characterized by intense, aching and dull pain that radiates to the forearm and hand. The pain appears more frequently at night. In hand osteoarthritis, pain is accompanied by hand dysfunction.
Osteoarthritis treatment
The main means of treating osteoarthritis are drug treatment, the use of physiotherapy and surgical treatment.
Drug treatment
The use of medications helps to improve blood circulation in damaged joints, restore the properties of cartilage and has an analgesic and anti-inflammatory effect.
Nonsteroidal anti-inflammatory drugs
With arthrosis, swelling of the joint may appear, the joint begins to hurt and the range of motion decreases. When taking anti-inflammatory drugs (NSAIDs), pain is reduced, the inflammatory chain reaction is stopped and the process of cartilage restoration is accelerated.
Medicines can be used in the form of tablets, rectal suppositories and powder. But remember that self-medication is unacceptable, the selection and dose of medication for arthrosis is carried out by a rheumatologist.
Centrally acting analgesics
Opioid medications lower a patient's pain threshold. These medicines can be taken strictly according to the prescription and only under the supervision of a doctor!
Chondoprotective drugs
Chondoprotective drugs are structural elements of the cartilage itself, therefore they actively restore this tissue and prevent its further destruction. Treatment is effective in the early stages of the disease. When the joint is completely destroyed, it is not possible to return the deformed bones to their original shape or develop new cartilage.
However, in stages 1-2 of arthrosis, chondroprotectors can bring significant relief to the patient. Combined preparations, which include glucosamine and chondroitin sulfate, provide better results compared to a single-component preparation.
Chondroitin Sulfate and Glucosamine Sulfate
These medications help slow the inflammatory response in tissues, help reduce cartilage damage, and help reduce pain. Most of the time, these 2 medications are used together in treatment, as they have a cumulative effect, but they must be taken for 3 to 6 months.
Hyaluronic acid
Provides viscosity and elasticity of synovial fluid. It helps the joints glide well. Therefore, doctors often prescribe injections of hyaluronic acid into the affected joint.
Physiotherapy treatments
Physiotherapy treatments may include:
- UHF therapy;
- magnetic therapy;
- low-intensity laser irradiation;
- drug electrophoresis;
- phonophoresis (using ultrasound to introduce medicine into the site of inflammation).
Surgery
Surgical treatment is used to restore and improve joint mobility, as well as to remove part of the damaged cartilage or meniscus.
Surgical treatment of osteoarthritis is used in extreme cases, when drug treatment is unsuccessful, when there is intense pain, partial or total immobility in the joints.
During arthroscopic surgery, it is possible to remove part of the cartilage affected by osteoarthritis, polish it to give a smooth surface, remove cartilage fragments and growths, and cut part of the damaged ligaments.
Knee replacement
With this operation, the articular surfaces of the knee joint are replaced with metal or combined prostheses. The prepared plates reproduce the surface of the articular cartilage. These prostheses are made of special alloys, do not cause a rejection reaction in patients, do not oxidize and do not read the surrounding tissues.
Hip surgery for osteoarthritis
During this operation, partial removal of the cartilage and bone tissue of the pelvis and femur is performed. Typically, the head of the femur and the articular surface of the pelvic bone are removed and replaced with a metal or metal-ceramic prosthesis.
Diet for osteoarthritis
Excess body weight is a great enemy of your joints. Most patients suffering from osteoarthritis of the hip and knee joints are overweight.
Therefore, for arthrosis, a properly selected diet is recommended. Jellied meat cooked in cartilage broth is believed to be beneficial for osteoarthritis. It contains a lot of collagen and structural components of cartilage, which help restore cartilage tissue.
Dairy products, proteins and calcium are beneficial. Animal protein is found in lean meats and fish, while vegetable protein is found in buckwheat porridge, beans and lentils. Boiled, stewed and steamed dishes are very healthy.
The best diet for joints is a diet with a slight predominance of carbohydrates (preferably complex carbohydrates), fruits and vegetables and a sufficient amount of protein and calcium.
Osteoarthritis prevention
The prevention of osteoarthritis, no matter how trivial it may be, lies in a healthy lifestyle. If possible, try to get fresh air, move around, walk barefoot on the sand, green grass and just the ground. This type of walking improves muscle function and increases blood circulation in the feet.
Using physical therapy with various arm and leg movements, twists and bends will provide viable support for the joints.
Patients often ask whether an alternative treatment for osteoarthritis is possible. Yes, folk remedies can help in the initial stages of the disease, reduce pain and improve the patient's general condition. But this does not replace following your doctor's instructions.