Features of peripheral joint osteoarthritis
Diseases of the musculoskeletal system are of great social importance. This is due to the fact that in most cases such a pathology disrupts the normal operation of the musculoskeletal system, which leads to temporary or permanent loss of ability to work. Osteoarthritis is a collective concept that includes a group of diseases with similar symptoms. It should be noted that osteoarthritis can affect both the central joints( femoral) and peripheral ones. Osteoarthritis of peripheral joints is widespread worldwide. In both cases, not only the joint itself is affected, but also the periarticular space, including connective tissue.
Of great importance is the fact that with the damage of large joints and small joints, various complications can develop, up to ankylosis. Ankylosis is a complete destruction of the joint and its immobility. An interesting fact is that osteoarthritis is a synonym for osteoarthritis in foreign sources, since inflammation plays an important role in the development of pathology. Let us consider in more detail what the etiology, clinic and treatment of this disease are.
Definition and classification of
Osteoarthritis is a disease having a chronic course characterized by degenerative-dystrophic joint changes. This is due to the defeat of cartilaginous tissue. As already mentioned above, osteoarthritis is a group of diseases. At the same time, they all have different etiology, but a single mechanism of development. Osteoarthritis is divided into 2 large groups: primary and secondary. Primary osteoarthritis is also called idiopathic. It can affect both large joints, and small( peripheral).
The secondary form is characterized by the fact that peripheral joints are involved in the process against the backdrop of some pathology of the body. These can be traumatic injuries, metabolic diseases, endemic diseases, congenital diseases. Among the diseases of metabolism, Wilson-Konovalov's disease, Gaucher's disease, hemochromatosis and some others are of particular importance. The defeat of small joints is observed against the background of endocrine pathology. It can be diabetes, acromegaly, hypothyroidism. Secondary osteoarthritis of large joints and small ones can develop with neuropathy, increased deposition of calcium salts.
Prevalence of arthrosis of peripheral joints
In peripheral osteoarthritis, various joints of the hands, feet and other parts of the body can be involved in the pathological process. The defeat of small joints in most cases is detected in persons older than 40 years. It is also interesting that the incidence is steadily increasing with age. In elderly people at the age of 55 years, osteoarthritis is diagnosed in about one in two. It is established that the lesion of small joints of the hands is developing more often in women than in men. Thus, the risk factor for the development of osteoarthritis can be sex.
To the risk factors for the involvement of the joints of the hands, the stop is the defect associated with the synthesis of type 2 collagen. Of no small importance is the congenital pathology of the musculoskeletal system. Of great importance are the acquired risk factors. These include increased body weight, previous surgical interventions, and advanced age. It must be remembered that depending on the etiology, one joint as well as many can be affected. In the first case, there is a localized form of the disease, in the second - generalized form.
Pathogenesis of the disease
Always defeat peripheral joints with osteoarthritis accompanied by bone deformation. The most important is that osteoarthritis is characterized by degenerative and dystrophic processes in tissues. This is observed as a result of the primary damage to cartilage, which soon leads to its inflammation. With osteoarthritis of joints, catabolism prevails, not anabolism. This means that the tissue is gradually destroyed. In this case they are not restored in a natural way. With the disease of the peripheral joints of the hands, feet and other parts of the body, a disturbance in the production of mediators and enzymes occurs.
The so-called cytokines that have a pro-inflammatory effect are produced. All this eventually leads to the degradation of collagen, so necessary for the normal functioning of the cartilage. An important place in the pathogenesis is the inflammatory reaction. Its presence is indicated by the detection in the synovial membrane of cellular infiltration. Progression of the disease is characterized by an increase in the concentration of C-reactive protein.
Causes of development of osteoarthrosis
Polyosteoarthrosis or lesion of any one peripheral joint can occur for various reasons. The most important are various kinds of trauma, which contribute to joint damage and impairment of its function. Slightly more rare cause are congenital disorders. They are associated with dysplasia. As for the secondary form of the disease, here the leading place in the etiology is inflammation. Polyostoarthrosis can be a consequence of autoimmune diseases. Often the importance is also acquired by infectious diseases caused by various microorganisms.
Important for it is hypodynamia, excessive body weight. In this situation, oxygen starvation of the joint tissues can be observed, which leads to its pathology. Less important is the disease, like arteriosclerosis of blood vessels. Polyostoarthrosis very often develops as a result of disturbances in metabolic processes. A similar state appears with age. This can occur even in middle-aged people. The joints of the hands, feet and other parts of the body do not get all the nutrients to the full, which results in the joints being worn out.
Clinical manifestations of
Polyostoarthrosis has a poor symptomatology. Very often, patients do not pay attention to the appearance of the first symptoms. In this case, osteoarthritis can occur without bright manifestations for a very long period. The main signs of pathology include the following:
- violation of mobility of the joint or several joints at once;
- pain syndrome;
There are other signs that can be pronounced. This appearance of thickening in the region of the joint joint edge, a feeling of tension in the affected area, tenderness when moving, there may be signs of inflammation. When lesions of peripheral joints are often found crepitation. She remembers the crunch. Another important feature is the increase in the size of the joint. In some cases, it is caused by swelling. If peripheral joints are affected, nodules may appear. This is typical when involving interphalangeal joints of hands or feet. As for such manifestations as swelling or a rise in temperature in the area of the lesion, they are not characteristic.
Pain syndrome in osteoarthritis of peripheral joints
As in the case of lesions of large joints, in this situation the main symptom is pain. There are several types of pain. The first is mechanical pain. It appears more after physical exertion, while in the rest period( at night) it subsides. Some people have pain at night. At the same time, it has a stupid character. The pain syndrome is permanent. The mechanism of its appearance is associated with stagnation of venous blood. This factor contributes to increased intraosseous pressure.
If the pain in the joints of the hands, legs is permanent, the cause may be hidden in the development of synovitis. Muscular spasm is of great importance in the appearance of pain. Another type of pain is characterized by a brief appearance. Their duration is about half an hour or even less. The peculiarity is that they appear after rest and pass after the motor activity. It is important that soreness is a consequence of the damage not to the cartilage itself, but to the bone, because the cartilaginous tissue is devoid of nerves. In the bone tissue develop microinfarctions, osteophytes.
Osteoarthritis of various joints
Osteoarthritis can develop in the area of the metacarpal joint. It is manifested by the fact that the movement of the thumb is disturbed. There is crepitation. The pain is localized at the inner surface. Such a joint injury is more common in women than in men. Osteoarthritis can appear in the ankle. This deformation occurs. The main etiologic factor is trauma. Osteoarthritis can affect the shoulder joint.
A typical symptom of involvement of the shoulder joint is a pain in the lead. It is important that the joint is not deformed. As in previous cases, there may be a crunch. Osteoarthrosis of the shoulder joint is almost never the primary one. It develops as a consequence of a disease. In medical practice, you can find not only osteoarthritis of the joints of the hands, but also the feet. An example is the defeat of the first metatarsophalangeal joint.
The reason for its development is flatfoot, traumatic injury. The main symptoms: deviation of the affected finger to the side, pain, impaired motor activity. Roentgen shows the narrowing of the joint gap, signs of the inflammatory process, osteosclerosis. In the event that the function of several joints is disrupted, there is a polyosteoarthrosis. Polyostoarthritis is not uncommon.
Diagnosis and treatment measures
With simple osteoarthritis or joint polyostoarthrosis, diagnostics are always performed. It includes the collection of an anamnesis of the disease and complaints of the patient. Of no small importance are the instrumental methods of investigation. Polyostoarthrosis can be detected by X-ray diagnostics of peripheral joints. X-ray is able to detect dystrophic changes, in particular, narrowing of the joint gap. If thickened or cysts are detected, this indicates a lesion of the bone tissue. In the early stages of the disease, the presence of osteophytes is of great diagnostic value. Osteoarthritis or polyostearthrosis differs from arthritis in that all clinical and diagnostic criteria develop gradually over many years.
Treatment of arthrosis of the hands, feet and other parts of the body can be conservative and operative. Conservative treatment means prescription of anesthetics, electrophoresis, ultraphonophoresis. Laser irradiation is used. An important factor is the restriction of the load on the joint. Folk remedies are not always effective, but can be applied. A large role is played by exercise therapy, sanatorium-and-spa treatment. Of the drugs used chondroprotectors, NSAIDs and other means. The choice of method of treatment depends on the stage of the disease. When complications develop, surgical intervention is performed.
Thus, arthrosis or polyostoarthrosis is a serious pathology that can significantly worsen the quality of life and reduce the ability to work. When the first signs of pathology appear, it is recommended to consult a doctor. It is not necessary to be treated independently.
How to treat osteoarthritis?
Characteristics of the disease
Osteoarthritis is the most common joint disease. To date, every tenth person of working age has complaints of pain in the joints and spine. With age, this trend is increasing. This is due to the progressive development of hypodynamia, obesity, an increase in the number of infectious and endocrine diseases among the population, and a general deterioration of the ecological situation in the world. But to mitigate the manifestations of the disease or even completely cure it by everyone. It is enough only to want it. It is able to overcome such a complex disease as osteoarthritis treatment timely and stubborn, active life position, readiness to change the habitual way of life to a more complete and correct way, to follow the recommendations of specialists. Let us consider in more detail ways to combat osteoarthritis.
To begin with, we will understand the main signs of the disease in order to recognize the presence of this ailment and to seek medical help on time. For osteoarthritis, the following symptoms are typical:
- pain in the area of large joints, arising in the morning, after a load or an unusual position of the body;
- morning joint stiffness;
- movement restrictions, crunching in the joints;
- gradual increase of pain syndrome as the disease develops.
When painful joints appear, you can see on the radiographic image a characteristic compaction of bone tissue right under the articular cartilage. Later, bone growths( osteophytes) appear at the edges of large joints. Thus, osteoarthritis can be diagnosed at the earliest stage of its development, begin timely treatment and prevent the development of severe consequences, often leading to disability.
Pain can remind itself of the most common actions of
So, how to treat osteoarthritis?
Use of pain medication. The main cause of the patient's treatment to the doctor with osteoarthritis is pain syndrome. Pain in the progressing stage of the disease can occur even from the slightest physical exertion or prolonged stay in one position of the body. This is a very worrisome patient. To eliminate severe soreness, analgesics of the central action( opioid preparations) are used. These drugs are equated to psychotropic narcotic substances, so they are released strictly according to the doctor's prescription. To prevent the development of synovitis( inflammation of the synovial membrane of the joint) and to relieve acute pain intra-articularly injected corticosteroid hormones.
Use of non-steroidal anti-inflammatory drugs( diclofenac, ibuprofen).This group of drugs has in addition to the analgesic effect also pronounced anti-inflammatory properties. The course of admission is short-lived, since similar medications have a harmful effect on the mucosa of the gastrointestinal tract, causing the formation of erosions and stomach ulcers.
The use of chondroprotectors( chondroitin sulfate, hyaluronic acid, glucosamine sulphate).These drugs are used for long courses - for a year or more. Some patients use them constantly. Normally, chondrocytes( cartilage cells) are synthesized and form a special intercellular substance, from which a cartilaginous tissue is formed. With osteoarthritis, the function of chondrocytes weakens and the cartilaginous tissue begins to break down. Chondroprotectors prevent the destruction of joints and have a strengthening effect on them.
Use of intraarticular oxygen therapy
Oxygen deficiency of the joint provokes an increase in the glycolysis of the cartilaginous tissue and the accumulation of under-oxidized metabolic products in it. For their oxidation requires additional oxygen, which, moreover, is also capable of stretching the joint capsule, forming a discharge pillow. For this purpose, intraarticular administration of oxygen is used. Through a puncture in the joint, ozone, exposed to laser light( singlet oxygen), is introduced. As a rule, 4 such procedures are done, with an interval between them not less than two days.
Treatment of osteoarthritis with laser irradiation has long proved itself on the positive side. Laser therapy has anti-inflammatory, disinfecting, analgesic and stimulating effects.
Treatment of osteoarthrosis with laser
After the removal of acute inflammation in the joint and the elimination of the pain syndrome, the application of physiotherapy and massage is shown.
When osteoarthritis is performed self-massage before exercise physical therapy to increase blood circulation, increase muscle tone and make exercises more comfortable and painless. It is possible to use point massage, which affects the biologically active points of the body.
Therapeutic physical training. LFK in osteoarthritis is performed in a sitting or lying position. The purpose of such exercises is to give a light load on the joint without overloading it. Do not experiment with exercises that cause pain. All movements should be smooth, with a gradual increase in amplitude. Therapeutic exercise strengthens blood circulation and nutrition of cartilaginous tissue, prevents the appearance of stagnant phenomena and development of contractures, reduces pain and strengthens muscles.
Use of thermal procedures, paraffin applications on sick joints.
Ultrasound treatment, electrophoresis. These techniques effectively eliminate pain and relieve the inflammatory process in the joints.
Local Barotherapy. Effectively improves circulation in the cartilaginous tissue of the joint.
Sanatorium treatment, application of mud baths.
Day regimen, diet and physical activity
Patients with osteoarthritis are forbidden to stand for a long time, to carry weights, to make sharp movements of limbs. In the acute phase of the disease, bed rest can be prescribed. If you need to lift a heavy object, you must evenly distribute the load on both hands. It is recommended to wear special orthopedic shoes and use comfortable furniture at work and at home so that you can easily stand up and do not accidentally get injured.
Excess weight gives additional strain on the joints. With obesity, it is necessary to struggle in a complex way: to review the diet, to increase physical activity, to be examined by an endocrinologist( often the cause of excess weight is endocrinological disorders).
In osteoarthritis shows the motor mode. Joints need moderate physical activity. During the movement, the cartilage tissue is fed. Physical exercises develop joints, do not allow them to "overgrow", contribute to strengthening the muscular framework that protects the spine from injuries. In the initial stage of the disease shows excellent results swimming in the pool: patients note a decrease in pain, a decrease in muscle tension and stiffness of the joints.
Interview about joint disease and osteoarthritis. The presenter speaks Ukrainian( and quite a bit), and the doctor - in Russian, and so simply and clearly explains what's what:
- Apitherapy. Treatment with bee venom of patients with joints is quite common. The poison of bees( apitoxin) contains a mass of biologically active substances, which have a pronounced analgesic, anti-inflammatory effect. In addition, it improves the metabolism, promotes the restoration of joint mobility and the relief of pain syndrome. Biting by bees is carried out for two weeks. This method is contraindicated in the presence of allergies to bee products and bee stings.
- Hirudotherapy. It is carried out with the use of special medical leeches( river can not be used - they can be contagious), the salivary glands of which secrete a special substance hirudin, which has anti-edema, analgesic and anti-inflammatory effect. In addition, the leech affects the biologically active points of the body, stimulating them and improving the trophism of tissues. Contraindications for the use of hirudotherapy are: pregnancy, hemophilia, anemia, hypotension, allergic reactions to hirudin, low blood coagulability.
Treatment with stings of bees is not a panacea, but it helps with many diseases.
If the above methods are ineffective, surgical treatment and arthroplasty are used. The earlier a patient seeks medical help, the higher his chances of a full recovery.
Osteoarthrosis - Wikipedia
The term "osteoarthrosis" unites a group of diseases of different etiology, but with similar biological, morphological and clinical outcomes, in which not only the articular cartilage but the entire joint is involved in the pathological process, including the subchondral bone, ligaments, capsule, synovial membrane and periarticular muscles.
The main clinical symptoms of osteoarthritis are joint pain and deformity, leading to functional deficiency.
At the heart of degenerative dystrophic changes in arthrosis is the primary cartilage damage followed by an inflammatory reaction, so often arthrosis is called arthrosis-arthritis .Osteoarthritis is always associated with deformation of the bone tissue, which is why it is also called osteoarthritis or deforming arthrosis .
Terminological definitions - osteoarthrosis, arthrosis, osteoarthritis, arthrosis deformans - are currently listed as synonyms in the X International Classification of Diseases.
Most often, the term "osteoarthrosis" is used to refer to a chronic progressive disease of synovial joints.
Isolate localized( with lesion of one joint) and generalized forms of osteoarthritis( polyostearosis ).Some common types of osteoarthritis have been given separate names. In particular, the term "gonarthrosis"( from other Greek-γόνυ-knee) is used to refer to arthrosis of the knee joint, "coxarthrosis"( from Latin coxa - thigh) - for arthrosis of the hip joint.Years of life, adjusted for incapacity for work for osteoarthritis per 100 000 population in 2004.no data ≤ 200 200-220 220-240 240-260 260-280 280-300 300-320 320-340 340-360 360-380 380-400 ≥ 400 Frequency and severity of joint disease in osteoarthritis
Osteoarthritis is the most common form of lesionjoints and one of the main causes of disability, causing a deterioration in quality of life and significant financial costs, especially in the elderly.
There is osteoarthritis everywhere. In the US, he suffers from 21 million people( about 7% of the population).A large-scale study in 7 cities of the former USSR revealed a manifest( accompanied by clinical symptoms) osteoarthritis in 6.43% of the examined( 41,348 people over 15 years old).
In general, the prevalence and incidence of osteoarthritis varies widely in different countries of the world. For example, the prevalence of osteoarthritis in Ukraine is 2515.7 per 100 thousand population, the incidence is 497.0 per 100 thousand population. As established by population studies, these rates are slightly lower than in the US, and significantly higher than in the UK.
The incidence of osteoarthritis sharply increases with age, reaching a third of the population in the elderly and senile ages. Among patients with osteoarthritis at a young age, men predominate, and in the elderly, women. In the United States, osteoarthritis occurs in 2% of the population under the age of 45, 30% at the age of 45-64 years and 63-85% older than 65 years.
At the same time in Sweden, the manifest osteoarthritis of peripheral joints was found only in 5.8% of the population aged 50-70 years.
Most often, osteoarthritis affects the joints of the hand, the first metatarsophalangeal joint of the foot, the joints of the cervical and lumbar spine, knee and hip joints. However, the severity of the disability of the musculoskeletal system is dominated by the hip, knee and ankle joints, as well as the shoulder joint.
ThiologyBasic etiological factors of osteoarthrosis
Osteoarthritis is a consequence of mechanical and biological causes that disrupt the formation of cells of articular cartilage and subchondral bone. It can be initiated by many causes, including hereditary, evolutionary, metabolic and traumatic.
Osteoarthritis affects all joint tissues. The disease is manifested by morphological, biochemical, molecular and biomechanical changes in cells and matrix that lead to softening, deflation, ulceration and decrease in the thickness of articular cartilage, as well as to osteosclerosis with sharp thickening and densification of the cortical layer of the subchondral bone, the formation of osteophytes and development of subchondral cysts.
Clinically, osteoarthritis is manifested by arthralgia, pain and movement limitation, recurrent synovitis, local inflammation in various joint tissues.
Primary and secondary osteoarthrosis
Osteoarthritis is primary and secondary.
If the cause of the development of the disease is not established, then such an arthrosis is usually called primary, or idiopathic( from other.-Greek.ἴδιος - a peculiar, special, unusual and πάθος - disease).
The main causes of
Osteoarthritis is a multifactorial poly-ioiologic disease. The three main causes of the degenerative-dystrophic process in the joint: trauma, dysplasia and inflammation.
Joint trauma is the most common cause of arthrosis. In the second place is dysplasia of the joint - congenital features that are accompanied by poor biomechanics of the joint.
Inflammation also often causes damage to joint tissues and the development of secondary arthrosis. Most often this is the result of autoimmune diseases( for example, rheumatoid arthritis), less often - the infectious process( for example, acute purulent inflammation of the joint caused by staphylococcus or another specific infection( in gonorrhea, syphilis, tick-borne encephalitis)).it is also a very common complication in chronic hemarthrosis( Hemophilia).
Risk factors for
Risk factors for primary osteoarthritis are: hereditary predisposition, overweight, elderly age, specific occupations. In addition, the incidence of osteoarthritis depends on sex and race / ethnicity.
Genetic factors include: hereditary disorders and mutations of type II collagen, other hereditary diseases of bones and joints, congenital disorders of joint development( dysplasia).
Non-genetic( non-hereditary) multiple factors, such as:
- age, osteoporosis, affect the development and progression of osteoarthrosis;
- metabolic disorders in the body;
- deficiency in the body of microelements;
- developmental disorders( dysplasia) and acquired diseases of bones and joints;
- neurodystrophic manifestations of the pathological process in the lumbosacral( lumbosacral muscle syndrome), or in the cervical spine( shoulder-scapular periarthritis);
The following risk factors for osteoarthritis are environmental factors:
- action of chemical toxins;
- joint injury, repetitive microtrauma;
- operations on the joints( eg, meniscectomy);
- occupation and physical activity at work.
Stages of the diseaseStages of arthrosis
Regardless of the cause, there are 3 stages of arthrosis. At the first or the initial stage of arthrosis there are no pronounced morphological disturbances of the joint tissues. The changes refer only to the function of the synovial membrane, to the biochemical composition of the synovial fluid, which, through diffusion, nourishes the cartilage and menisci of the joint. The joint loses its ability to withstand the usual load for it, and the joint overload is accompanied by inflammation and pain syndrome.
In the second stage of the disease, we see the beginning destruction of articular cartilage and meniscus. Bone reacts to the load of the articular area with edge growths - osteophytes.
The second stage inevitably goes to the third stage of severe arthrosis. Its signs are pronounced bone deformation of the joint support site, which changes the axis of the limb. Insolvency, shortening of ligaments of the joint leads to pathological mobility of the joint or in combination with the stiffness of the joint bag - to a sharp restriction of natural movements - contractures. Chronic inflammation and chronic pain syndrome usually accompany 2 and 3 stage.
In the initial stage of the disease, the muscles that perform movements in the joint are weakened, but, in general, are not changed. In the second stage there is a violation of muscle function due to violation of reflex neuro-trophic regulation. In the third stage of the disease, joint loading and motor activity are severely disrupted, due to contractures and limb axis disorders, the amplitude of muscle contraction changes, normal attachment points of the muscular-tendon complex change.then it is accompanied by a shortening or stretching of the muscle, a decrease in the ability to fully reduce. Trophic disorders in the joint disease affect not only the muscles, but all limb tissues.
Pathogenesis ofStructure of cartilage
The pathogenesis of this disease is caused by a violation of the function and structure of the cartilage of the joint. Articular cartilage is a highly specialized tissue consisting of a matrix and chondrocytes immersed in it. Matrix contains two main macromolecules, glycosamines( proteoglycans) and collagen. The high concentration of proteoglycans in the cartilage keeps the collagen network energized, thereby promoting a uniform distribution of the load that affects the cartilage, and ensuring the restoration of the shape after the termination of the load. With the loss of even a small amount of glycosamin, the resistance of the cartilage matrix to physical stress is reduced, and the surface of the cartilage becomes sensitive to damage. In the earliest stages of arthrosis, the cartilage becomes thicker than normal, but with progression it becomes thinner. The cartilage becomes soft and friable, on it there are deep ulcers, usually only in the most loaded part of the joint.
Normally, with periodic loads, for example walking, the cartilage plate deforms and returns to its original form, performing the function of a peculiar pump that provides for the expulsion of the decay products and the "absorption" of nutrients and building material. Compression and restoration of the form under loading is the main condition for the regeneration of damaged cartilaginous tissue. However, excessive or prolonged loading of the joint adversely affects the function of the articular cartilage and increases the flow of arthrosis.
The cartilage and meniscus joints are powered only by synovial fluid. The "health" of the sliding and damping structures of the joint depends on the quantity and quality of the fluid secreted by the synovial membrane.
Synovial membrane performs an important function of filtering the building material of cartilage - hyaluronic acid, it protects the elution of the latter from the joint cavity. Violation of the biochemical composition of synovial fluid in case of trauma or inflammation of the joint actually leads to the development of a disease called osteoarthritis.
The effectiveness of the circulation and diffusion of the synovial fluid is directly related to movement in the joint and joint loading. Movement in the joint is necessary for the metabolism in the cartilage. In itself, prolonged restriction of movements in the joint leads to a deterioration in the supply of cartilage.
In arthrosis, the equilibrium between the formation of a new building material for the restoration of cartilage and its destruction is disturbed. The cartilage of a firm, elastic structure turns into a dry, thin with a rough surface. The underlying bone becomes thicker and grows apart from the cartilage, which limits movement and causes deformity of the joints. The joint capsule thickens - is fibrotic, and also inflames. The joint is filled with an inflammatory fluid that stretches the capsule and ligaments of the joint. Pain, and later deformation of articular surfaces with arthrosis leads to joint stiffness and joint contractures. Morning and starting pain, as well as stiffness in the joint in patients with deforming arthrosis itself is due to the low elasticity of the cartilage and the need for starting movements to restore sufficient elasticity of the cartilage.it creates a feeling of pain and stiffness.
In inflammation, the joint assumes a resting position or a physiological position. In this position, the maximal spreading of the ligaments and the capsule of the joint is ensured. In this position, the pain in the joint is minimal. A major influence on the course of the pathological process is the condition of the so-called muscle corset of the joint, that is, a system of muscles that not only moves in the joint but also stabilizes the joint, absorbing powerful inertial impulses during movement. Thus, the internal broad muscle in the quadriceps femur protects the knee from lateral instability at the moment of landing on the heel while walking, and the middle gluteal muscle on the side of the support leg limits the pelvic inclination at the time of transfer, which protects the hip joint from overload.
Outcome of the diseaseOutcome of arthrosis of the knee and hip joint
The outcome of arthrosis is the complete destruction of the joint with the formation of ankylosis - complete immobility of the joint or neoarthrosis with unnatural mobility.then it is accompanied by a severe disability of the limb. Recently, without waiting for the outcome of the disease, more and more often special operations are used to replace the joint with a prosthesis - joint replacement. The figure depicts the varus deformity of the knee typical for the terminal stage of knee arthrosis in combination with lateral pathological instability of the knee joint. Osteoarthritis of the block-shaped or globular joint, such as the hip joint, ends with ankylosing. In this case, the closure of the joint usually occurs in the nonphysiological( vicious) position of the limb. In this case, we see the hip in the position of flexion and reduction, in which the leg is shortened, and the limb axis and biomechanics of the locomotor system are significantly impaired.
Clinical course and diagnosis
If at the onset of the disease the pain occurs only periodically, after considerable physical exertion, and quickly passes at rest, then as the disease progresses, the intensity of pain increases, it does not disappear after rest and appears at night.
In the context of evidence-based medicine, a number of standard tests for assessing osteoarthritis have been developed. To assess joint pain and morning stiffness, a ten-point visual analogue scale is used. To characterize gonarthrosis and coxarthrosis, the Leken index is widely used.
Osteoarthrosis and its treatment: classical and folk remedies for the disease
- Physical exercises
In the modern world, osteoarthritis is very common: its treatment, unfortunately, gives almost 100% results only in the very initial stage. Without therapy, it has been slowly but irreversibly developing for decades. And according to statistics, by the age of 40, it is already reaching the stage when recovery has a small chance.IMPORTANT TO KNOW!A new means of restoring joints in 99% of subjects. The pain goes away 100%!Read more here - & gt;
To the question: "How to cure osteoarthritis?" - there is no single answer. The initial cause of joint deformation is the degradation of the articular cartilage. Therefore, the main task is to treat the primary causes of its destruction and stop further cracking. At later stages - elimination of consequences in the form of pains and inflammatory processes.
Traditional treatment of
In case of confirmation of the diagnosis of osteoarthritis, the treatment of joints is recommended to begin immediately. The earlier the adequate therapy is conducted, the more chances are that the disease will recede. The general principles of the treatment of ailment are:
- improving cartilage nutrition and stopping the negative process;
- removal or reduction of pain;
- treatment of secondary reactive diseases.
The solution of a problem than treating an osteoarthritis depends on the degree of joint destruction and the tasks that the doctor is facing. At the initial stages( 1-2) pharmacology has a rather wide variety of medicines for healing from the disease. The basic therapy is the use of chondroprotectors - drugs that improve the state of cartilage and the quality of synovial fluid.
Methods of taking medications for cartilage restoration:
- means for ingestion are issued in the form of capsules and powders( Don, Arthra, Teraflex, Structum, Formula-C).The use of such drugs is prolonged: from 4 months to 1.5 years with interruptions, but the effect in the form of cessation of pain lasts up to six months;
- intramuscular injections( Noltrex, Alflutop, Elbona, Hondrolone, Adgelon) are more rapid in terms of effect. The course of treatment is from 10 to 20 injections;
- introduction to the joint of hyaluronic acid( replacement of intraarticular fluid): Fermatron, Sinocrome, Ostenil. Injections require special precision, so the most appropriate use for knee joints. In the hip joint, injections are done only under computer control. But the result of such manipulations comes already after 1-5 sessions and lasts six months.
Other drugs are used as symptomatic treatment. The most used pharmaceuticals as analgesics: a group of NSAIDs and hormonal drugs( with severe pain syndrome and inflammation).The injection form is most effective, especially intraarticular blockades. In addition, muscle relaxants are used to relieve spasmodic pain and substances that improve blood circulation.
In the diagnosis of osteoarthritis of 1 degree, treatment with topical agents is quite effective. There are ointments and creams that have chondroprotective, analgesic, anti-inflammatory, warming, blood flow improving.
Therapeutic gymnastics for osteoarthritis is such an important method that it can be put into the plan of therapeutic measures first. Correctly selected and regularly performed exercises can replace almost all other means to combat the disease.
There are cases when even at the last stages with the help of movements people significantly improved their condition. Problems solved by the exercise therapy:
- strengthening the muscles around the affected joint and creating a muscle carapace;
- improving blood circulation and cartilage nutrition, fighting stagnant phenomena;
- development of movements of the affected limb;
- reduction in excess weight and load on the joint.
Surgical treatment of
With minor damage to the cartilage and joint to the stage of development, osteoarthritis of grade 2 treatment means all types of conservative therapy. Radiographic stages 3 and 4 are characterized by such deformation of the joint that the function of the limb is usually completely disturbed and the person suffers constant pain. The only way to improve the quality of life of the patient remains surgical intervention:
- arthroscopy is a modern and virtually bloodless surgical method that allows all manipulations inside the joint with the help of two small incisions;
- arthrodesis is a form of palliative surgery in far-advanced stages, aimed at rigid fixation of the joint in the most optimal way to eliminate pain;
- endoprosthetics - a "new life" of the limb, an artificial alternative with complete restoration of functions.
Contraindication to the installation of the implant is osteoporosis. To treat it, use biophosphonates, which are similar to bone minerals. They accumulate in places of destruction and remain there for a year.
Features treatment depending on the location of the
The treatment plan for arthrosis is individually compiled , because the severity of the flow, the variety of therapeutic methods and the possibility of prediction are largely dependent on the location of the compound that is affected.
The most easy to overcome is considered to be a musculoskeletal osteoarthritis, the most severe is the generalized cervical spine and large joints.
Osteoarthrosis of large joints
This location of arthrosis is the most disabling and difficult to treat, as one of the most important human functions - the ability to walk - is disrupted. In addition, the joints of the lower extremities carry the greatest burden, especially with excess weight and work associated with lifting weights.
In the early stages with proper therapy, a complete cure of the joints is possible. At later emphasis is on symptomatic and surgical methods, as well as exercise therapy. Very important is the use of orthopedic means: canes, crutches, orthoses, specially designed shoes.
Osteoarthritis of the hands
In this case, the cartilage is destroyed most of the joints of the hand. With the diagnosis of osteoarthritis of the hands, the treatment is the same as for other types of lesions. Along with the basic therapy, local anesthesia is applied, treatment of concomitant inflammatory processes.
Lesion of the joints of the hands is rarely accompanied by a complete loss of functions, usually does not lead to disability, so the problem of how to treat osteoarthritis of the hands with the help of surgical methods, most often does not arise.
Osteoarthritis of the fingers of the hands
The peculiarity of affection of the cartilage of the joints of the fingers is that it is rarely accompanied by a strong pain syndrome - in most cases a tingling sensation is felt in the nodules. But the treatment of osteoarthrosis of the fingers is more aimed at fighting the constant inflammatory complications of arthrosis. Very well proven physioprocedures and traditional methods of treatment in the form of compresses with mushrooms with bischofite or bile.
In addition, with the diagnosis of osteoarthritis of the joints of the fingers, treatment and prevention in the early stages can be a very important factor for those people whose professional activity is associated with fine motor skills( pianists, seamstresses, artists).If the disease starts, then such patients are often forced to change their profession.
Also in the case of osteoarthrosis of the fingers, treatment with anti-rheumatic drugs, such as Plakvenil, is preferably performed with the presence of the initial inflammatory joint damage - rheumatoid arthritis.
Osteoarthrosis of wrist joint
The wrist joint is one of the most complex on the upper limb. It consists of a large number of elements, since the human hand can perform very complex functions and perform precise movements.
Permanent strong overload or joint trauma creates the prerequisites for cartilage degradation, gradual development of severe pain syndrome and stiffness.
In the treatment of osteoarthritis of the wrist joint, the treatment is directed, first of all, to the immobilization of the joint by means of gypsum, orthosis or elastic bandage, and secondly, to taking painkillers. Surgery may be needed in extremely neglected cases and only with a palliative purpose - to reduce pain due to arthrodesis.
Osteoarthritis of the cervical spine
The degenerative disease of the cartilaginous and bony structures of the cervical spine is one of the most dangerous lesions, as it is in the immediate vicinity of the spinal cord.
A squeezing or damage to this body can lead to disability. That is why when diagnosing osteoarthritis of the cervical spine, treatment is required as early as possible.
Methods of therapy for this type of osteoarthritis include wearing an orthopedic collar, taking pain medications, muscle relaxants, exercise therapy. With the development of complications of the CNS, immediate surgical intervention is prescribed. The less the spinal cord suffered, the better the prognosis of further rehabilitation.
Temporomandibular osteoarthritis of the temporomandibular joint( TMJ)
Temporomandibular joint is small in size, but a disturbance of its correct functioning affects other functions: chewing and motor. With the disease, osteoarthritis of the TMJ treatment is aimed at eliminating pain and limiting mobility, relaxing the affected muscles. In this form of arthrosis, drug blockades, physio- and manual therapy are good.
When arthrosis develops into its most severe form - generalized osteoarthritis - the treatment is symptomatic. With this kind of disease affects more than three joints, which indicates the systemic nature of the disease, therefore, the original cause( for example, disturbance of metabolic processes) is eliminated. If the process does not stop, all the measures available in the arsenal are taken to improve the patient's condition.
Folk methods of treatment
Treatment of osteoarthritis with folk remedies implies the solution of the same problems as in traditional medicine: cartilage restoration, pain relief, treatment of concomitant inflammation. Healers for centuries accumulated their knowledge, intuitively and practically, finding useful effects in certain plants or natural products.
Moreover, the healers never shared the body and soul of man. What they noticed in ancient times is confirmed by modern research. Indeed, under stress substances that weaken the human immune system, as well as destroying cartilage tissue, are secreted. Therefore, in the case of osteoarthritis, treatment with folk remedies, first of all, means taking into account the state of mind of a person. And only after working out these factors are taken for the patient.
In the framework of an unconventional approach called folk medicine, the treatment of osteoarthritis and restoration of cartilage tissue was suggested by the herbalist Raphael Slotin. To do this, you need to collect lilac flowers and leaves( always after flowering), dry, rub into powder, add olive oil and gum. Ointment should be used regularly. It also has an analgesic effect.
In the arsenal of healers, quite a lot of different recipes for ointments, lotions, compresses, which have analgesic effect. All of them are selected for patients individually, taking into account the possibilities and contraindications. Known and time-tested folk remedies for osteoarthritis, which relieve pain:
- compresses: take 1 tbsp.a spoonful of soda, salt, honey and mustard, mix. Use at night. Spread the knee, cover it with polyethylene, wadded and bandage, wash it off in the morning. The course of treatment - from 4 procedures;
- ointment: 1 egg( or yolk) and 1 tbsp are mixed.l.vegetable oil, 1 tsp is added.turpentine gum( purified) and 2 tbsp.l.vinegar. The mixture is applied to the tissue and applied to the sore spot, on top - polyethylene, woolen shawl, well wrapped;
- rubbing: tincture on vodka or alcohol of walnut partitions;
- "natural doctor": fresh leaves of plantain pribintovyvayutsya at night, after drying should be replaced.
Means for inflammation of
In the case of osteoarthritis, folk methods of treating primary and secondary inflammatory processes are quite extensive. For example, such recipes are popular:
- 100 g. Powder of white clay, previously dried for several hours under the sun, mix with any butter to the type of sour cream. The joint should be carefully mixed with a mixture in case of acute inflammation, it is more possible to do it with chronic arthritis;
- rub the roots of horseradish and( or) radish, gruel used for compresses or rubbing - until the signs of inflammation disappear.
Many folk methods of treating osteortrosis with motion and massage have already been adopted by representatives of traditional medicine. The methods of manual therapy, kinesiology, PIRM, which are borrowed from ancient oriental healers, are now used with great success for the treatment of osteoarthritis.
For example, one simple method for pain in the back and joints: roll the affected area over a plastic bottle filled with warm water for 15 minutes every day.
Mankind has many centuries and even millennia in the search for methods of treating affected joints. Unfortunately, no means have been found yet, which once and for all would solve the problem of the restoration of cartilage and, accordingly, the complete cure of deforming arthrosis in the late stages. However, has already done a lot to cure osteoarthritis in the early stages of and complete recovery of functions with endoprosthetics.
Osteoarthritis of the hand - the beginning of joint osteoarthritis |Portal of your health ZdravoE
Osteoarthritis of the hand - is caused by a metabolic disorder in the cartilaginous tissue. The disease leads to cartilage damage and restriction of movement. In addition, it deforms the appearance of the hands, in the region of the joints appear outgrowths.
How does the osteoarthritis of the hand develop?
Osteoarthritis of the hand is one of the types of joint osteoarthritis ─ a common disease of the musculoskeletal system.
Osteoarthrosis of the hand is caused by metabolic disturbances in bones and cartilages, joint capsules and ligaments. The disease develops due to disruption of the processes of restoration and destruction of the cartilage and the bone to it. Cartilage triples the ability to retain moisture, loses elasticity, elasticity, crackles and collapses.
Pain in osteoarthritis of the hand is caused by the fact that the cartilage is excessively "rubed" against each other because of the destruction of cartilage, which acts as a shock absorber. If this process is not stopped, they can form "spines" - osteophytes.
Osteoarthritis of the hand is aggravated by lack of physical activity( hypodynamia), monotonous movements, developing muscle weakness, as well as sharp loads. Risk factors for the development of the disease: age, sex, nutrition, heredity. Osteoarthritis of the hand can also be caused by professional, sports injuries, obesity, can develop against the background of arthritis or gout.
How is the osteoarthritis of the hand manifested?
Most people older than 55 years experience changes in the radiograph that indicate changes in the cartilaginous tissue of the joints of the hand.
However, only one in five people make complaints, which are typical for osteoarthrosis of the brush.
For osteoarthrosis of the brush is characterized by the formation of nodules in the region of the joints of the fingers( phalanges, which are located closer to the nail plate, suffer more often than others).They are called knots( Heberden and Bushard).By their nature they represent the growth of bone tissue. Nodules are located on the back and side surfaces of the fingers. They are dense and at the same time practically painless.
The peculiarity of these nodules is their constancy: once appearing, they no longer disappear. In this case, both hands often suffer, the changes are symmetrical, and the index and middle finger is affected by the process of osteoarthrosis of the brush in the first place. In this case, the fingers may be slightly curved.
These changes are not found on the thumb of the brush.
Sometimes their appearance is accompanied by a slight tingling. However, people rarely pay attention to this symptom of an osteoarthritis of a brush.
Anxiety arises only when changes in the joints of the hand affect the activity of the movements. The increase in nodules on the joints of the hand can limit the ability to work so much that the fingers practically cease to "obey" and the small movements of the hands become difficult.
Changes in bone tissue over time affect the joint tissue.
The movements of the thumb cause a crunch and pain along the radial edge of the wrist at the junction of the first metacarpal and trapezoidal bones. In addition, there may be a restriction of the movements of the thumb, causing a violation of the function of the hand, and at a late stage - a characteristic deformation of the affected joint, which gives the brush a square shape( "square brush").
The disease also leads to a limitation of joint mobility( varying degrees), up to a decrease in ability to work. Sometimes an osteorarthrosis of the hand may not allow performing elementary movements. The hardest are movements directed at compression, and requiring precision.
At the same time this type of osteoarthritis often causes disability of people whose work requires the accuracy of the finger movement. And just an elementary possession of the pen when writing!
When the osteoarthrosis of the hand progresses, a crunch occurs during movements, pain points around the joint appear, stiffness( up to 30 minutes after rest) in the affected joint.
Prolonged osteoarthritis of the hands leads to the appearance of radiographic signs( in the picture osteophytes are visible).But at the initial stages of the disease, symptoms are often absent at all, so it is difficult to diagnose.
Treatment of osteoarthritis of the hand and osteoarthrosis of the joints
Osteoarthrosis of the hand is difficult to cure quickly: it is required to "return" the cartilage ability to retain moisture, and this ability depends on the renewal of the cartilage tissue that occurs for several months. To this end, chondroprotectors are used - literally, "cartilage protectors".
Of this series of drugs, Structum is a French-made product that contains special chondroitin sulfate 4 and 6 types.
Unlike other chondroprotectors, chondroitin sulfate, which is part of Structum, has the highest degree of sulfation. Sulfation characterizes the property of the substance to attract and retain water. Due to the maximum sulfate content( 100% active ingredient), Structum contributes more to moistening cartilage, retaining moisture in the cartilage, improving the elasticity and elasticity of the cartilage more than other preparations. Chondroitin sulfate in the structure of Structum has a special composition and structure of chondroitin. It is obtained from the trachea of young chickens. At the same time, science absolutely accurately confirms that this type of chondroitin is type 4 and 6, most closely by the biological nature of the composition and structure of human cartilage.(The comparison was made with chondroitin derived from cartilage of fish and other animals.)
In addition, the lowest of all such preparations, the molecular weight of chondroitin, allows Structum to penetrate more deeply into the joint through the synovial membrane and be used by cartilaginous cells for self renewal and recovery. Cartilage tissue as a result restores its properties, the load on the spine is amortized to a greater extent. Due to the high quality of chondroitin sulfate and such unique properties against the background of the use of Structum, unlike other chondroprotectors, the clinical effect is much faster and more pronounced. Pain in the joints decreases markedly, which makes it possible to significantly reduce or completely abolish pain medication. This helps to avoid such side effects of painkillers( nonsteroidal anti-inflammatory drugs) such as: exacerbations of stomach and duodenal ulcers, bleeding from the stomach and duodenum, toxic effects on the liver and kidneys, on hematopoiesis and even heart attacks and strokes. Most patients note that using the Structum, joint movements are more pronounced, And having woken up in the morning, there is already no such stiffness in the joints, puffiness of the joint, you can button up the buttons yourself without the help of relatives, turn the water tap easily, turn the key in the lock. Those.feel freer and less dependent on others. This is what in the West is called to get a higher quality of life.
Today, there are various hondprotectors, but with osteoarthritis of the joints of the hands only one chondroprotector - chondroitin sulfate( Structum) - has evidence of efficacy. In addition, Structum has evidence of effectiveness in lesions and other joints - both the knee and hip. Therefore, applying the Structum, the healing effect will "feel" all the joints of
simultaneously. It should be remembered that the effect does not come immediately, but in a few weeks. But very important is the time of manifestation of the clinical effect - a significant reduction in pain and stiffness, marked improvement in mobility in the joints - against the background of the drug Structum persists even after the end of treatment. The duration of preservation of the effect even after the termination of therapy by Structum is considered to be the longest in comparison with other hondprotectors.
So after the completion of a 6-month course of treatment, pain reduction persists for another 4-5 months, depending on the severity and localization of osteoarthritis. On average, the effect of aftereffect lasts almost as long as the reception of Structum
. But the removal of the pain symptom is not a key point in the treatment of joint osteoarthritis. Structum as a chondroprotector( protector of cartilage) slows down degenerative processes in the cartilage - stops the progression of osteoarthritis of the joints and osteochondrosis. And this means preventing the transition of the disease to a more severe stage, Structum allows to reduce the risk of disability, to postpone the need for joint endoprosthetics.
Side effects are very rare, as chondroitin sulfate Structum has a high degree of purification and French production does not allow any impurities, which often give allergic reactions in other drugs.
Dosage regimen The structure is very simple: 1 capsule( 500 mg of chondroitin sulfate) 2 times a day. Those.only 2 capsules per day. Capsules are swallowed whole and washed down with a large glass of water. The duration of the course is from 3 to 6 months. The drug does not increase blood sugar, which is very important for long-term use in patients with diabetes or a predisposition to it.
Before using Structum, read the instructions for use carefully and do not hesitate to seek advice from your doctor!