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 that affects 10-14% of the world's 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 articular etiology.
The etiology of this disease is currently unknown.. . . All factors that cause tissue degeneration and aging of the body can lead to the occurrence of this disease, therefore, with age, the appearance of osteoarthritis is almost inevitable.
There are external and internal factors in the onset of this disease.The main external factors of osteoarthritis include dampness, hypothermia, unfavorable working conditions, functional overload of joints 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 resist the increased stress on the joints. The reasons for this manifestation can be impaired posture, long-term work, standing on their feet, and even some sports: lifting weights, running or jumping.
The internal factors that cause this disease include the following: hereditary predisposition to the occurrence of diseases of the cartilage tissue, impaired blood supply to the joint, hormonal imbalance and metabolic disorders. The cause of osteoarthritis in women may be ovarian dysfunction in 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 with alcoholism.
What are the symptoms and clinical signs 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, the most often occurs damage to the load joints (hip and knee joints) and small joints of the hand. The spine is also involved in the process. But most often the knee and hip joints are affected.
The most basic symptomwith osteoarthritis, there are severe pains in the area of the affected joints. These pains cause damage to the bones, joints, or periarticular tissues. Typically, such pain increases with exertion and decreases at rest. Night pains, joint swelling, as well as the appearance of a feeling of "gel viscosity" in the affected joint in the morning - all this indicates the occurrence of osteoarthritis. The intensity of such pain depends on many reasons (atmospheric pressure, humidity and temperature changes). All these factors begin to influence the pressure in the joint cavity, which causes these pains.
The next one of the main symptoms of osteoarthritis is the appearance of a crunch or squeak in the joints, not only when walking, but even during any movement. The appearance of such a crunch or squeak is associated with a violation of the articular surfaces, which causes a restriction of mobility in this joint.
With osteoarthritis, an increase in the volume of joints occurs, 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.
- Spondylosis deformans.
- Intervertebral osteochondrosis.
GonarthrosisIs a lesion of the knee joint in osteoarthritis. In this case, pain in the knee joints when walking is expressed, and they are especially intense if you go down the stairs. The place of localization of these pains is in the inner and front parts of the affected knee joint. An increase in discomfort occurs when the knee is bent. In addition, in many cases of gonarthrosis, there is a deviation of the knee joint. The disease begins gradually, and the pain is growing. With active and passive movements, a crunch can be heard. The pain begins to intensify, and in many cases synovitis develops - an inflammation of the capsule membrane of the joint or tendon.
Coxarthrosis- This is a lesion of the hip joint. The initial pain of a hip injury does not appear in the thigh area, but in the knee, groin, or buttock. They increase with walking, and subside at rest. These pains, which occur even with minor changes on the x-ray, are associated with muscle spasm. With the defeat of the hip joint, there is a gradual increase in the limitation of mobility in the joint. This disease is a consequence of trauma or arthritis. With coxarthrosis, there is a "duck" gait, developing lameness, muscle 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 hand or Heberden's nodules. . . The appearance of such nodules is most often observed in women during menopause. Initially, they appear on the 1st and 3rd fingers of the hand. Over time, namely after several months or even years, a symmetrical lesion is observed in other distal interphalangeal joints. Such nodules are located 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, resulting in lateral enlargement of the joint. As a result of this increase, the finger acquires a fusiform shape.
Spondylosis deformans- 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, and this leads 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 localized when fewer than 3 joints are affected. With localized osteoarthritis, the spine, joints of the hands and feet, knee joints, hip joints and other joints are affected.
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, in the generalized form, erosive osteoarthritis also occurs.
Secondary osteoarthritiscan 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 a violation 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 deposition disease, neuropathy, and many other diseases.
What does happen with 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 out enough to expose the bone. All this leads to a decrease in the elasticity of the articular cartilage and causes disruption of the joints. Further, inflammation can join all the listed changes, due to which the growth of bone tissue occurs, and this leads to disease and deformation of the joints.
Diagnosis of osteoarthritis
Diagnosis of osteoarthritis in many cases does not cause great difficulties. But there are exceptions, for example, patients with a lesion of the shoulder joint and symptoms of joint inflammation. Difficulties may 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 clinical signs of osteoarthritis are present. In order to make a final diagnosis, there is not enough X-ray and laboratory data. To do this, it is necessary to conduct a number of additional studies in order to identify the exact cause of the pain in the joints.
Osteoarthritis treatment
In order to reduce or completely suppress pain, there are both drug and non-drug methods, which include physical therapy and exercise therapy. To prescribe the correct treatment, an individual approach to each patient is required. 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, it is first of all necessary to observe the regimen, since 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 rather long stay in a certain fixed position, prolonged walking and long standing 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 rather pronounced pains at the time of exacerbation of the disease, some patients are prescribed a semi-bed regime.
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, 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 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 decrease in painful muscle spasm, and the tone of the weakened muscles also increases, as a result of which the patient's functional abilities improve.
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).
Also, patients are advised to resort to spa treatment on the coast of the sea.
Prevention of osteoarthritisconsists in the daily performance of special exercises that help to strengthen the musculo-ligamentous apparatus. Getting rid of excess weight, limiting the carrying of weights, as well as the inclusion in the menu of such dishes as jelly, jellied meat or aspic are all preventive measures of osteoarthritis. And, of course, going in for such a sport as swimming. It must be remembered that it is better to prevent any disease than to cure it. The same applies to diseases such as osteoarthritis. In order not to think in the future 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 until later.
Treatment of deforming osteoarthritis by various methods
High qualifications and accumulated experience in the use of shock wave therapy allows achieving the maximum positive effect of treatment even in advanced stages of the disease, avoiding surgical treatment in many cases.
Shock wave therapy is carried out on a modern apparatus:
- the course of treatment of arthritis, arthrosis by the UHT method consists of 5-7 sessions;
- the session is carried out 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 are loosened in the affected tissues. At the same time, blood flow in the damaged tissue increases tenfold, which contributes to the resorption 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;
- rapid relief of pain without analgesics;
- the possibility of using at the chronic stage of the disease and with its primary manifestations;
- performed on an outpatient basis, does not require hospitalization, does not disrupt the patient's usual rhythm of life.
Photodynamic therapy in orthopedicsIs a non-invasive, complication-free 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 with the release of singlet oxygen, which toxicly affects the energy complexes of the cell (mitochondria and the Golgi complex), destroying the latter and thereby triggering the irreversible process of apoptosis. At the same time, healthy cells are not damaged. The damaged pathological tissue is aseptically absorbed.
The photosensitizer is injected into the patient's body by transcutaneous (applications).
PRP plasma lifting- This orthopedic procedure is based on a patented method of processing the patient's blood using special vacuum biotechnological tubes and a special centrifugation mode.
During the procedure, an injection form of autoplasma containing platelets 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 minimizes the number of medications used or eliminates them altogether, thereby reducing the toxic effect of drugs on the patient's body. Also, autoplasma injections help to reduce the treatment time by 2-3 times.
Indications for the procedure (PRP plasmolifting):
- 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 technologies and the experience of doctors, they allow you to achieve positive results.