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Arthrosis of the joints

Arthrosis is a disease characterized by the gradual destruction of the joint due to the development of dystrophic changes in the tissues.According to WHO, every tenth resident of the planet is faced with this problem.After 50 years, the risk of the occurrence of the disease is about 30%, and by 70 years reaches 80-90%.

Healthy joint and affected by arthrosis

General information

Arthrosis is a chronic, long -term process that affects not only joints.As it progresses, dystrophic and degenerative changes are also amazing the auxiliary apparatus.In the process, the patient is faced with inflammation of the cartilage and bone tissue, the capsule of the joint and the periosemantial bag, as well as the muscles, ligaments and subcutaneous tissue contacting with them.

Regardless of localization, the pathological process passes according to a single scheme.First, in the thickness of the fabric, the balance between the processes of growth and destruction of the cartilage is disturbed, and the balance is shifted in favor of dystrophy and reverse development (degeneration).At this time, the changes invisible to the eye in the microstructure of the cartilage occur, which leads to its thinning and cracking.

As the disease progresses, the joint loses its elasticity and becomes more dense.This reduces its ability to depreciate, the rate of tissue damage is constantly increasing due to vibration and microtrauma during movements.The thinning of the cartilaginous layer provokes the active growth of bone structures, as a result of which spikes and ledges appear on the smooth surface of the joint - osteoarthrosis develops.Movements become increasingly limited and painful.Spasms of muscles surrounding the affected area develop, which exacerbates the pain and deforms the limb.

Stages of the disease

The arthrosis of the joints develops gradually and in the process three sequential stages that determine the severity of the disease:

  • Stage 1: pathology is not detected on an X -ray or ultrasound, but the destruction processes have already been launched;The composition of the joint fluid changes, as a result of which the tissues are obtained less than nutritious creatures and become more sensitive;The increased load on the area of damage causes inflammation (arthritis) and pain;
  • The 2nd stage is characterized by the active destruction of cartilage fabric, and bone spikes and growths appear along the edges of the joint platform (area of contact of surfaces);At this time, the pain becomes familiar, and inflammatory processes go stronger or weaker;spasms associated with the joint of muscles are periodically noted;
  • Stage 3: the areas of destruction affect almost the entire surface of the cartilage, the joint platform is deformed, the injured limb deviates from its axis;The volume of movements is reduced, and the ligaments are weakening and become short.

Some experts also distinguish the IV stage of development of arthrosis.It is characterized by almost complete immobility of the joint.

Types

Depending on the cause of the disease, primary and secondary arthrosis are distinguished.In the first case, pathology arises independently against the background of a comprehensive effect of predisposing factors.The secondary form is the result of other diseases and is divided into the following groups:

  • damage to the joints that occurred due to metabolic disorders or endocrine diseases (gout, diabetes mellitus, acromegaly, hyperparathyroidism);
  • Destruction associated with congenital pathologies (Pedget's disease, congenital lip dislocation, scoliosis, hemophilia, etc.);
  • Post -traumatic arthrosis, which arose against the background of fractures, cracks, necrotic processes or surgical operations, as well as arising due to the features of the profession.

The most in demand is the classification of osteoarthritis, depending on the localization of the pathological process:

  • Gonartrosis: the lesion of the knee, one of the varieties of which is pallet -pemorary arthrosis - the destruction of the joint between the femoral bone and the patella;
  • Arthrosis of the ankle joint: occurs against the background of a large load and frequent injuries;
  • Arthrosis of the joints of the foot: the thumb most often suffers at the junction with the foot;defeat develops against the background of gout or valgus deformation;
  • shoulder arthrosis is characterized by damage to the shoulder and is often found at a young age against a background of increased physical activity (movers, athletes, builders);
  • Coksartrosis: damage to the hip joint;Maybe both one -sided and bilateral and is one of the frequent causes of disability in people over 50;
  • Vertebral arthrosis: the destruction of the cartilaginous discs between the vertebrae, most often affects the cervical and lumbar spine;
  • Arthrosis of the joints of the brush: the joints of the fingers are most often affected, the pathologies are especially susceptible to women in menopause;
  • arthrosis of the temporomandibular joint: it is quite rare, most often against the background of chronic inflammation due to bite disorders or improper prosthetics;
  • Arthrosis of the elbow joint: a rare form of the disease, most often associated with injuries of this area.

The reasons for the development

The main factor in the development of arthrosis is the mismatch between the test and the joint ability of the joint to withstand this load.Acute or chronic, this process inevitably leads to the destruction of tissues.

The list of causes that increase the risk of arthrosis of any localization includes:

  • heredity;
  • endocrine pathology (diabetes);
  • injuries of the articular apparatus: bruises, dislocations, fractures or cracks of bones inside the joint bag, full or partial breaks of ligaments that penetrate wounds;
  • regular increased joint load associated with the profession;
  • obesity;
  • hypothermia;
  • Transferred inflammatory joint diseases: acute arthritis, tuberculosis, etc.;
  • blood diseases in which hemorrhages often occur in the joint (hemophilia);
  • sharp changes in the hormonal background (pregnancy, menopause);
  • local circulatory disorders in connection with atherosclerosis, varicose veins, thrombophlebitis, etc.;
  • autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, etc.);
  • Dyplasia of connective tissue (congenital pathology, accompanied, including excessive mobility of the joints);
  • congenital pathologies of the musculoskeletal system (flat feet, dysplasia or congenital dislocation of the hip joint, etc.);
  • age over 45-50 years (risk increase is associated with a decrease in collagen synthesis);
  • osteoporosis (bone vacuum);
  • chronic intoxication of the body (including salts of heavy metals, drugs, alcohol);
  • Surgical interventions on the joints.

Symptoms

Symptoms of arthrosis practically independent of its cause and localization, since changes in the joints go according to the same scenario.The disease develops gradually and begins to manifest itself, already when the cartilage is quite seriously damaged.

One of the first signs of dysfunction is the crunch in the problem area during movement.Most often, it occurs when the knee or shoulder is damaged.At the same time, a person can feel a slight decrease in mobility after prolonged inaction, for example, in the morning.

When asked what symptoms appeared with arthrosis, most patients first call pain.At first, insignificant and weak, gradually it gains strength, preventing it from moving normally.Depending on the stage and localization of pathology, a person may feel:

  • Starting pains: occur during the first movements after prolonged inaction of the joint and are associated with the formation on the surface of the cartilage of thin film from the destroyed fabric;After the start of work, the film shifts, and discomfort disappears;
  • Pain with prolonged physical exertion (standing, walking, running, etc.): appear due to a decrease in the shock -absorbing properties of the joint;
  • Weather pain: provoked by low temperature, humidity, atmospheric pressure changes;
  • Night pain: associated with venous stagnation and increased blood pressure inside the bones;
  • Joint blockade: sharp, severe pain associated with infringement of a piece of cartilage or bone located in the joint cavity.

As arthrosis develops, the symptoms become more noticeable, the patient notes the following signs:

  • an increase in morning stiffness;
  • strengthening and increasing the duration of pain;
  • decrease in mobility;
  • joint deformation due to bone growths;
  • Deformation of bones and surrounding tissues: the process is well noticeable on the limbs and fingers of the hands, which become noticeably curved.

When inflammation is attached, the affected area swells, blushes and becomes hot to the touch.Pressing on it causes a sharp increase in pain.

Joint pain in arthrosis

Analyzes and diagnostics

The diagnostics of arthrosis is engaged in the orthopedic doctor.He conducts a detailed survey of the patient to identify complaints and anamnesis.The doctor in detail about the time of the appearance of the first signs and the speed of their development, the injuries and diseases, the presence of similar problems in relatives.

A general blood test allows you to identify an inflammatory process, which often accompanies arthrosis.

The main method of diagnosis is radiography.In the picture, the following signs are clearly visualized:

  • narrowing of the joint gap;
  • Changing the contours of the contacting bones;
  • disturbed bone structure in the affected area;
  • bone growths (osteophytes);
  • curvature of the axis of the limb or finger;
  • subluxation of the joint.

For more detailed diagnostics, they can be prescribed:

  • computed tomography (CT);
  • magnetic resonance imaging (MRI);
  • Ultrasound of the joint;
  • arthroscopy (internal examination of the joint cavity using a camera introduced through a small puncture);
  • Scintigraphy (assessment of the state of bones and metabolism in them by the introduction of radiopharmaceutical drugs).

In case of suspicion of the secondary nature of the disease, appropriate tests and consultations of narrow specialists are prescribed.

Treatment of arthrosis of the joints

The choice of the methodology for the treatment of arthrosis of the joints depends on the cause of the disease, its stages and symptoms.In the arsenal of doctors there are:

  • drugs;
  • non -drug treatment;
  • Surgical methods.

In addition, the patient needs to strictly observe a diet and adjust his lifestyle in order to minimize further damage to the joints.

Drug treatment

The appointment of drugs for arthrosis pursues two main goals:

  • removal of pain and inflammation;
  • restoration of cartilage fabric or, at least, stop further degeneration.

To facilitate the condition of the patient, various types of drugs are used:

  • non -steroidal anti -inflammatory drugs in the form of tablets, injections, ointments or candles;They relieve pain and inflammation well;
  • Hormones (corticosteroids): shown in severe pains and, most often, are introduced directly into the joint cavity;
  • Other analgesics, for example, antispasmodic action: help reduce the level of pain by relaxing muscles;

It is important to remember: all types of painkillers are used only to facilitate the condition of the patient.They do not affect the condition of the cartilage, and with prolonged use they accelerate its destruction and cause serious side effects.

The main preparations for the restoration of joints today are chondroprotectors.They contribute to the saturation of cartilage with nutrients, stop the monument and start cell growth processes.Means have an effect only at the early and average stage of the development of the disease and subject to regular long -term use.

Preparations that improve microcirculation in tissues and anti -meanings help to enhance the effect of chondroprotectors.The former provide good supply of the affected area with oxygen and nutrients, and the latter slows down the processes of tissue destruction.

The selection of specific drugs, their dosage and the administration regimen is engaged in the doctor.

Non -drug treatment

Non -drug treatment includes the following methods:

  • physiotherapy:
    • Shock wave therapy: destroys bone growths and stimulates blood circulation due to the effects of ultrasound;
    • Automated electromiostimulation: exposure to electrical impulses to stimulate muscle contraction;
    • Ultrafonophoresis: the effect of ultrasound in combination using drugs;
    • Ozonotherapy: the introduction of a special gas mixture into the joint capsule;
  • physiotherapy physical education;
  • mechanotherapy: exercise therapy using simulators;
  • Joint traffic to reduce the load;
  • massage.

Surgical treatment

Most often, the help of a surgeon is required at the severe stages of the disease.Depending on the localization of the pathological process and the degree of lesion, it can be prescribed:

  • Puncture: a puncture of the joint with the removal of a part of the fluid and, according to indications, the administration of drugs;
  • Corrective osteotomy: removal of part of the bone, followed by fixation from a different angle to remove the load from the joint;
  • Endoprosthetics: replacing the damaged joint with a prosthesis;Used in extremely neglected cases.

Arthrosis in children

Arthrosis is considered a disease of the elderly, but it can also be found in children.The most common cause of pathology is:

  • congenital pathology of connective tissue;
  • severe injuries;
  • heredity;
  • metabolic disorders and the work of the glands of internal secretion;
  • orthopedic disorders (flat feet, scoliosis, etc.);
  • overweight.

Children's arthrosis is rarely accompanied by pronounced symptoms: the pain is aching, and there is practically no stiffness and limitation of the function.Monothetic changes are detected on an X -ray, MRI and ultrasound.In the process of treatment, the same products are used as in adults.Maximum attention is paid to exercise therapy and physiotherapy, since at a young age they are especially effective.Without treatment, the disease sooner or later passes into the advanced stage with a complete loss of mobility.

Diet

Diet is one of the most important factors in the treatment of arthrosis.In the presence of excess weight, it is necessary to reduce it to reduce the load on the joints.In this case, a balanced diet with calories deficiency is prescribed.Regardless of the body mass index, doctors recommend completely abandoning:

  • quick carbohydrates (sugar, desserts, flour);
  • alcohol;
  • spices;
  • legumes;
  • strong tea and coffee;
  • Excessively fatty and sharp dishes.

Canned and offal are not excluded, but significantly limited, as well as salt.Ideal nutrition for osteoarthritis includes:

  • low -fat varieties of meat;
  • fish and seafood;
  • eggs;
  • dairy products;
  • linseed and olive vegetable oils;
  • vegetables and fruits, a large amount of greens;
  • Moderate cereals, pasta from hard -wrap pasta;
  • Products with a high content of collagen (jelly, pouring, jelly).

Prevention

Arthrosis is easier to warn than to treat.To maintain joint health for many years, it is recommended:

  • lead an active lifestyle;
  • regularly exercise and visit the pool;
  • eat properly, use enough omega-3 and collagen;
  • prevent the exceeding of the BMI;
  • Wear comfortable shoes.

If the disease is diagnosed at an early stage, it is recommended to regularly undergo spa treatment, as well as exclude professional risk factors: long-term stay on the legs, lifting severity, vibration.

Consequences and complications

Arthrosis progresses very slowly.When performing a doctor’s prescription, his current slows down significantly, which allows you to maintain joint mobility much longer.Unreversible consequences develop without treatment:

  • pronounced joint deformation;
  • decrease in mobility up to its complete loss (ankylosis);
  • shortening of the limb (with damage to the knee or femoral joint);
  • Deformation of bones, curvature of the limbs and fingers.

Forecast

The prognosis for arthrosis depends on the form of the disease, its degree and quality of treatment.Pathology is one of the frequent causes of disability, and in advanced cases, the ability to move and self -service.In severe forms of damage to the knee and hip joints, the patient receives the first or second disability group (depending on the stage and volume of damage).