Osteoarthritisis a chronic non-inflammatory disease of the joints or articular cartilage as well as the tissues surrounding them. Osteoarthritis is one of the most common diseases affecting 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 the factors that cause tissue degeneration and aging of the body can lead to the onset of this disease, therefore with age the onset of osteoarthritis is almost inevitable.
There are external and internal factors in the occurrence of this disease.The main external factors of osteoarthritis include humidity, hypothermia, unfavorable working conditions, functional overload of the joints with frequent microtraumas, as well as exposure to radiation energy and vibrations. The main and quite common cause of osteoarthritis is the inability of the cartilage to resist the added stress on the joints. Reasons for this manifestation can be impaired posture, long-term work, standing, and even some sports: lifting weights, running or jumping.
Internal factors that cause this disease include the following: hereditary predisposition to the occurrence of cartilage tissue diseases, impaired blood supply to the ankle, hormonal imbalance and metabolic disorders. The cause of osteoarthritis in women may be menopausal ovarian dysfunction. In addition, vascular processes with early development of atherosclerosis may 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 with severe pain and deformity of the joints, which leads to violation of their functions. With this disease, most often occurs damage to the load joints (joints of the hips and knees) and small joints of the hand. The back is also involved in the process. But more often the knee and hip joints are affected.
The most basic symptomswith osteoarthritis, there is severe pain in the area of the affected joints. These pains cause damage to bone, joints or periarticular tissue. Typically, such pain increases with exertion and decreases at rest. Night pains, swelling of the joints, as well as the appearance of a feeling of "gel viscosity" in the affected joint in the morning - all this indicates the appearance of osteoarthritis. The intensity of such pain depends on many reasons (atmospheric pressure, humidity and temperature changes). All of these factors begin to affect the pressure in the joint cavity, which causes these pains.
Another of the main symptoms of osteoarthritis is the appearance of a crack or crackling in the joints, not only when walking, but also during any movement. The appearance of such a crack or crackle is accompanied by 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 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.
- Deformative spondylosis.
- Intervertebral osteochondrosis.
GonarthrosisIt is a knee joint lesion in osteoarthritis. In this case, the pain in the knee joints while walking is pronounced and they are especially strong if you go down the stairs. The site 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 starts gradually, and the pain is increasing. With active and passive movements, a crackle can be heard. The pain begins to intensify and in many cases develops synovitis - an inflammation of the membrane of the joint capsule or tendon.
Coxarthrosis- This is a hip joint lesion. The initial pain of a thigh injury does not appear in the thigh area but in the knee, groin or buttocks. They increase with walking and sit at rest. These pains, which appear even with small changes on the radiograph, are accompanied by muscle spasms. With the loss of the hip joint, there is a gradual increase in mobility restriction in the joint. This disease is a consequence of trauma or arthritis. With coxarthrosis a "duck" gait is observed developing lameness, muscular hypotrophy of the buttocks and thighs. Also, there is pain on palpation in the femoral head area.
Osteoarthritis of the distal interphalangeal joints of the hand or Heberden joints. . . The appearance of such nodules is more often observed in women during menopause. They first appear on the first and third fingers of the hand. Over time, that is, after several months or even years, a symmetrical lesion is observed in the other distal interphalangeal joints. Such nodes are located on the dorsal-lateral surface of the joints.
Osteoarthritis of the proximal interphalangeal joints of the hands or Bouchard joints.Unlike Heberden joints, these joints appear on the lateral surface of the joint, resulting in lateral extension of the joint. As a result of this growth, the finger takes on a fusiform shape.
Deformative spondylosis- as a result of this disease in the region of the vertebrae appear marginal bone growth. This disease appears at the age of 20 years. Osteophytes (bone growth) look like swelling - edema occurs due to vascular compression. As a result, stiffening of the spine occurs and in some cases neurological disorders also appear.
Intervertebral osteochondrosisoccurs in combination with spinal curvature or deforming spondylosis. With this disease the disc degenerates and the nucleus comes out in different directions and this leads to spinal trauma. There is also an overgrowth of osteophytes and an increase in the surface of the joint. In this case, the ankle choroid 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- is primary or idiopathic (the causes of the disease have not been clarified) and secondary (the disease appears against the background of other diseases).
Primary osteoarthritislocalized when less than 3 keys are affected. Localized osteoarthritis affects the spine, joints of the hands and feet, knee joints, hip joints, and other joints.
There is also generalized osteoarthritis, when 3 or more joints are affected. In this case the large nodes and the distal interphalangeal nodes are affected. In addition, in the generalized form, corrosive osteoarthritis also appears.
Secondary osteoarthritiscan be post-traumatic. Also, secondary osteoarthritis can be caused by 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 pigmented cirrhosis, is an inherited disease in which there is a violation of iron metabolism and its accumulation in organs and tissues. Osteoarthritis can also be caused by diseases such as diabetes mellitus, hypothyroidism - decreased thyroid gland function, acromegaly - growth hormone hyperfunction. In addition to these diseases, osteoarthritis can also cause calcium deposition diseases, neuropathy and many other diseases.
What happens to osteoarthritis?
With this disease occurs intense aging of the articular cartilage. As a result, there is a loss of articular cartilage elasticity. Aside from the fact that the articular surfaces become rough, cracks still appear on them. In many cases, cartilage is consumed enough to expose the bone. All this leads to a decrease in the elasticity of the articular cartilage and causes rupture of the joints. Further, inflammation can join all the listed changes, due to which bone tissue growth occurs, and this leads to disease and deformity of the joints.
Diagnosis of osteoarthritis
The diagnosis of osteoarthritis in many cases does not cause great difficulty. But there are exceptions, for example, patients with a lesion of the shoulder joints and symptoms of joint inflammation. Difficulties may also appear in the diagnosis of primary and secondary osteoarthritis, the occurrence of which is associated with metabolic diseases or other diseases. On X-ray examination, signs of osteoarthritis are detected quickly (especially in the elderly) if clinical signs of osteoarthritis are present. To establish a definitive diagnosis, there is insufficient X-ray and laboratory data. To do this, it is necessary to conduct a series of additional studies to identify the exact cause of joint pain.
Treatment of osteoarthritis
To completely reduce or suppress pain, there are medication and non-drug methods, which include physical therapy and exercise therapy. To prescribe the right 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, as mechanical discharge 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, prolonged walking and long standing, as well as to exclude the transfer of weights that can lead to mechanical overload of the joints. If the disease is neglected, the patient is advised to walk on crutches or cane. With quite pronounced pain at the time of disease exacerbation, some patients are prescribed a half-bed regimen.
When treating osteoarthritis, it is recommended to follow a diet to reduce excess weight. This is especially true for those who have a knee joint lesion.
Also, in the treatment of this disease are used physiotherapeutic methods that not only reduce pain and inflammation, but positively affect metabolic processes in joint tissues 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. Furthermore, thermal procedures, the use of peat mud and paraffin wax are described.
Using therapeutic massage elements, patients should try to avoid mechanical irritation of the wrist capsule. Only in this case a decrease in painful muscle spasm is observed and the weakened muscle tone is also increased, as a result of which the patient's functional abilities are improved.
Medication 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).
Patients are also advised to head to the seaside spa treatment.
Prevention of osteoarthritisconsists in the daily performance of special exercises that help strengthen the musculoskeletal system. Removing excess weight, limiting weight bearing, as well as including on the menu dishes such as jelly, jelly meat or aspic are all osteoarthritis prevention measures. And, of course, getting involved in a sport such as swimming. It should be remembered that it is better to prevent any disease than to cure it. The same goes for diseases such as osteoarthritis. In order not to think in the future how to get rid of severe pain in osteoarthritis, as well as how to cure this disease, it is necessary today to take preventive measures, without delaying them for later.
Treatment of deforming osteoarthritis with different methods
High qualifications and accumulated experience in the use of shock wave therapy allows to achieve the maximum positive effect of treatment even in the advanced stages of the disease, avoiding in many cases surgical treatment.
Shock wave therapy is performed in a modern device:
- the course of treatment of arthritis, osteoarthritis with the UHT method consists of 5-7 sessions;
- the session is performed 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 joint tissues are released into the affected tissues. At the same time, blood flow to the damaged tissues 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 pain relief without analgesic;
- the possibility of use in the chronic phase of the disease and with its main manifestations;
- performed on an outpatient basis, does not require hospitalization, does not disrupt the normal rhythm of the patient's life.
Photodynamic therapy in orthopedicsIt is a two-component, non-invasive treatment method. To apply 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 a single oxygen, which toxically affects the energy complexes of the cell (mitochondria and the Golgi complex), destroying the latter and thus causing the irreversible process of apoptosis. At the same time, healthy cells are not damaged. Damaged pathological tissue is aseptically absorbed.
The photosensitizer is injected into the patient's body via transcutaneous (applications).
Elevation of PRP plasma- This orthopedic procedure is based on a patented method of processing the patient's blood using special biotechnological vacuum tubes and a special centrifugation method.
During the procedure, an injection form of autoplasm 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 wrist cavity. Autoplasm injections can reduce inflammation, relieve pain, and restore range of motion in the joints. The autoplasm treatment procedure minimizes the number of medications used or eliminates them altogether, thus reducing the toxic effect of the drugs on the patient's body. Also, autoplasm injections help reduce treatment time by 2-3 times.
Indications for the procedure (PRP plasmolifting):
- osteoarthritis;
- osteoarthritis;
- periarthritis;
- tendon tendopathies,
- ligament and muscle damage.
Thus, shock wave therapy, photodynamic therapy and plasma elevation (PRP) in orthopedics are the best choices for treating joint diseases. With the use of modern equipment and technologies and the experience of doctors, they allow you to achieve positive results.