Preparations for the treatment of joints

List of modern medicines and joint preparations

NVVC: first aid to joints - pros and cons

ibuprofen

Non-steroidal anti-inflammatory drugs ( NSAID) is the most common group of drugs used for pain and inflammation of any organs.

best-known representatives are:

  • aspirin

  • indomethacin

  • diclofenac

  • ibuprofen

  • nimesulide

  • diflunisal

  • lizinmonoatsetilsalitsilat

  • sulindac

  • atseklofenak

  • etodolac

  • lornoxicam

  • ketoprofen

  • flurbiprofen

  • nabumetone

mechanism of action

wide popularity due to the rapid elimination of symptoms due to the triple effect of this groupmedicines:

  • anti-inflammatory;

  • analgesic;

  • antipyretic.

The anti-inflammatory effect is due to other mechanisms than hormonal drugs, which is emphasized in the name - non-steroid agents. Maximum it is expressed in indomethacin, flurbiprofen and diclofenac, and minimal anti-inflammatory effect should be expected from ibuprofen, amidopyrine and aspirin.

These drugs block prostaglandins - mediators of inflammation, which are released when tissue is damaged. As a result, all the symptoms of inflammation decrease: redness, swelling, pain, fever and disruption of function.

Pain syndrome better eliminates ketorolac, ketoprofen, diclofenac and indomethacin. Less analgesic activity is possessed by aspirin, ibuprofen and naproxen.

The strength of different drugs depends on the structure of the molecule. However, individual sensitivity to different drugs can not be ruled out.

Unwanted reactions

Prolonged use of NSAIDs necessary for the treatment of gonarthrosis is limited to the development of dangerous undesirable reactions, most often from the digestive tract and kidneys.

Because the anti-inflammatory effect is blocked by prostaglandins, a side effect is a decrease in the protective factors of the stomach. Most of the members of this group of medicines are acids, so they additionally irritate the gastric mucosa.

The result can be NSAIDs-gastropathies: erosive or ulcerative defects of the gastrointestinal mucosa, the most severe manifestation of which is gastrointestinal bleeding.

It is believed that indomethacin, ketoprofen, piroxicam are more aggressive in this respect. Rarely, such complications develop when taking small doses of ibuprofen and diclofenac.

How to avoid side effects from the gastrointestinal tract:

  • With a high gastric acidity, gastritis and a history of an ulcer, severe concomitant pathology, in elderly people the probability of occurrence of gastrointestinal bleeding increases. In such situations, the use of selective drugs( meloxicam, nimesulide, celecoxib) that do not reduce the protective factors of gastric mucus is more justified and can be used for a long time.

  • It is possible to use drugs that reduce gastric acidity( proton pump inhibitors), however long-term therapy is estimated as economically unprofitable.

Side effects of NSAIDs are often manifested by the development of cardiovascular complications in the form of strokes, heart attacks and thromboses. More safe in this regard are naproxen and ibuprofen. The use of diclofenac significantly increases the risk of heart and vascular disease.

The development of arterial hypertension, heart failure, acute renal failure may be a consequence of decreased blood flow in the kidney vessels due to inhibition of prostaglandin synthesis.

Possible development of aspirin bronchial asthma, Ray syndrome( bleeding) and many other side effects.

Such formidable unwanted reactions do not allow self-treatment and dictate certain rules of application:

  • NSAIDs should not be taken for a long time. They are used as an "ambulance", quickly and effectively eliminating the symptoms of arthrosis of the knee joint.

  • The use of anti-inflammatory drugs masks the picture of the disease, without eliminating its cause, which often causes a belated address to the doctor.

  • The choice of drugs is broad both in strength of action and in side effects. The physician will be able to select the optimal drug in a safe dosage and prescribe the necessary studies to prevent the development of complications.


Chondroprotectors: is it possible to restore cartilaginous tissue?

Chondroprotectors

Because arthrosis of the knee joint is caused by damage to the cartilage of articular surfaces, the ideal drug should be able to restore them. Such hope appeared in the allocation of a group of chondroprotectors( CP), the most studied of which were glucosamine( HA) and chondroitin sulfate( cholesterol).

The last 25 years of conducting numerous studies have accumulated a vast base, both confirming the effectiveness of HP, and refuting it. As much as contradictory reviews on the use of drugs.

You should not expect a speedy recovery on the background of taking chondroprotectors: minimal results should be evaluated not earlier than after 6 months of therapy. Reducing the dosage of NSAIDs in the treatment of arthrosis of the knee joint is the first symptomatic effect of CP administration. These drugs are most effective at stages 1 and 2 of arthrosis.

Glucosamine and chondroitin, like nonsteroidal drugs, have anti-inflammatory effects by suppressing "inflammation cells"( interleukins and prostaglandins).However, unlike NSAIDs, chondroprotectors have excellent tolerability.

Preventing the progress of the disease( on the roentgenogram - slowing down the rate of narrowing of the joint space) is also an important effect of this group of medicines.

Initially, HA and XC were used in isolation and in the form of injection forms, which limited their use. Then oral forms of release were developed. Here is an example of several drugs with chondroprotective effect.

Drugs containing chondroitin sulfate

  • Chondrolon( Russian company "Microgen") - available in the form of ampoules of a dry substance for intramuscular injection.

  • Chondroitin AKOS( Sintez, Russia) - capsules for oral administration of 250 mg and ointment for topical application. In a day you need to take 4 capsules.

  • Structum( "Pierre Fabre", France) - capsules of 250 and 500 mg. The daily dosage is 1000 mg.

Drugs containing glucosamine

A study in Belgium showed a greater efficacy of glucosamine in arthrosis of the knee than CS.

  • Elbona( CJSC "Moscow Pharmaceutical Factory") is a preparation for intramuscular injection of 400 mg of active substance in an ampoule.

  • Dona( "Rottapharm") - is available in the form of powder and capsules for oral administration, as well as a solution for intramuscular injection. In 1 sachet powder contains 1500 mg of active substance, and in one capsule - 250 mg.

Drugs containing HA and CS

Numerous studies have shown that the efficacy of the two components improves the treatment outcome by 60% and the monotherapy by 30.

Arthra( Unifarm, USA) and Teraflex( Bayer, Germany) - complex preparations containing both chondroprotectors, differ somewhat by the dosages of the incoming components: 500 mg of HA and XC in the first and 500 mg of HA and 400 XC in the second.


Means for insertion into the joint cavity

Hydrocortisone

In severe pain syndrome, the doctor can recommend the introduction of the medicine directly into the joint cavity.

As drugs that quickly eliminate symptoms of inflammation, glucocorticosteroids are most commonly used:

  • Hydrocortisone

  • Diprospan

  • Kenalog

  • celeston

Chondroprotectors, which are called "liquid prosthesis", are optimally optimized. Sodium hyaluronate in preparations:

  • Duralan

  • Ostenil

  • Fermatron

  • Synvisc

They practically replace articular fluid, improving nutrition of cartilaginous surfaces. However, these medicines are not yet available to everyone at a cost.


Topical medications

Drugs for local therapy are additional methods for the treatment of arthrosis of the knee joint. Usually the active substance is an NSAID, such as in the preparations Voltaren-gel, Fastum-gel, Menovazine, diclofenac ointment, indomethacin and butadione. Medical compresses with bischofite( an oil derivative), dimexidom( anti-inflammatory drugs), medical bile expand the range of therapeutic measures for gonarthrosis.

Absorption of the drug with local treatment is no more than 7-8%, so monotherapy is rarely effective.

As the course of the disease is accompanied by periods of exacerbation and remission, it is important to combine different methods of treatment, to apply effective physiotherapy procedures, sanatorium treatment, possibly traditional medicine.

The doctor will help with recommendations at any stage of the disease!


Innovative BAA for joints

Dietary supplements

Food supplements are not medicines, but biologically active substances( food additives), which consist of natural components and are considered to complement the basic therapy.

For the treatment of joint diseases, all companies - the world leaders in the manufacture of dietary supplements( such as NSP, Vision, Vitaline Inc) and Russian manufacturers - offer a huge number of complexes.

They may contain components that have different effects:

  • herbs with anti-inflammatory activity;

  • vitamins and minerals for the activation of metabolic processes;

  • calcium, vitamin D, collagen to strengthen bone tissue.

There are even components that improve blood circulation, and detoxicants( for example, Dectox in Vision).

Innovative drugs for the treatment of inflammatory-degenerative diseases of the joints are chondroprotectors, which protect against inflammation and repair cartilage tissue.

Before their appearance in joint diseases it was possible to carry out only symptomatic therapy, that is, the elimination of pain syndrome. The era of chondroprotectors marked the possibility of influencing the cause of the disease - cartilaginous tissue.

Glucosamine and Chondroitin were the first to use this group. They have been actively studied in official medicine for more than 40 years. Recent years of use have accumulated numerous evidence of the effectiveness of chondroprotectors in the pathology of both large and small joints. For example, a study in Belgium showed that patients taking chondroprotectors for 1 to 3 years were less likely to need joint replacement for arthrosis of the hip joints by 60% less than those taking a placebo( a substance-free pill).

In 2014, they entered the mandatory algorithm for the treatment of residual arthritis, recommended by the European Society of ESCEO.

Most manufacturers of dietary supplements have in their arsenal Chondroitin and Glucosamine in the form of 100% natural product of high purity.

Chondroitin

Chondroitin sulfate( ChS) is a specific component of cartilage, it is a natural mucopolysaccharide. In patients with joint diseases, its concentration in the synovial fluid is reduced. It is found in cartilages, ligaments of animals, fish.

Chondroitin sulfate has regenerative( regenerative) activity:

  • is involved in the process of calcium deposition in the bones, preventing the development of osteoporosis;

  • increases the synthesis of collagen, strengthening ligaments, tendons, cartilage;

  • retains the cellular structure of the cartilage, which increases the strength of bones;

  • increases the production of intra-articular fluid, which prevents cartilage friction;

  • slows the narrowing of the joint gap in gonarthrosis;

  • reduces the destruction of chondrocytes( cells of the cartilaginous tissue), making them resistant to the action of inflammatory enzymes.

In addition, chondroitin sulfate has an anti-inflammatory effect by suppressing the activity of "inflammation cells" - the enzymes and mediators involved in the cascade of inflammatory reactions. Due to this, soreness in the joint decreases, and its mobility increases.

Supplements Chondroitin sulfate is usually available in capsules of 250-350 mg( 50-60 pieces per pack).It is more often recommended to take 1-2 capsules a day. Note that the drugs have a much higher dosage: 500-1500 mg 3 times a day.

The cost per month of treatment varies considerably, depending on the manufacturer, and is 300-2500 rubles.

Contraindications for use are increased bleeding of blood vessels and individual intolerance, pregnancy and lactation.

Glucosamine

Glucosamine( HA) is a component of chondroitin and a precursor of glycosaminoglycan, the main component of cartilage. It is isolated from chitin( a substance that is part of the shell of crustaceans).

GA has similar effects with chondroitin: symptomatic( reduction of soreness in movements and improvement of joint function) and regenerative( restoration of cartilage tissue with prolonged use).

In addition, Glucosamine has some differences from chondroitin:

  • has better results and the highest level of evidence in the treatment of arthrosis of the knee joints( cholesterol showed the best effect with arthrosis of the hip joints);

  • is a more preferred building material for the formation of glycosaminoglycans in the human body( in particular, hyaluronic acid).

Often used association that Glucosamine in the structure of the cartilage is a brick, and chondroitin - cement.

Supplements Glucosamine is also available in capsules, the cost varies depending on the manufacturer in approximately the same range as chondroitin.

Contraindications to use are similar to those of cholesterol.

Both drugs are very well tolerated, no side effects are reported.

Due to the peculiarities of the action of glucosamine and chondroitin sulfate, complexes appeared containing both preparations. In 1999, a convincing study was carried out, which showed that, when combined, cartilage cells began to produce twice as many glycosaminoglycans, and in the case of single drug therapy, only one-third.

The combination of two drugs costs on average the same as one drug. For example, Doppelgerz asset offers a complex at a budget price - 250-300 rubles per month of treatment. It contains 700 mg of glucosamine and 100 mg of chondroitin sulfate in a capsule.

Different manufacturers try to improve the complexes with other components. So, Glucosamine Forte - BAA, containing, in addition to HS and HA, the grass root "Devil's Claw" and shark cartilage ecstasy( Santegra, USA)."SOLGAR Glucosamine-Chondroitin Plus" has additional components in the form of vitamin C and manganese.

Thanks to the latest research in medicine, it can be said that the best joint supplements combine the 4th component: Glucosamine, Chondroitin, Methylsulfonylmethane and Celadrin.

Methylsulfonyl methane

Methylsulfonylmethane

Methylsulfonyl methane( MSM, DMSO2, dimethyl sulfone) - is called the "third whale" in the treatment of joint diseases. This organic compound contains sulfur and is present in all tissues of the body. MSM improves the supply of nutrients through the cell membrane. With its deficiency, trophic tissue disorders are formed.

Sulfur is the fourth mineral in the human body by mass fraction, which has many positive effects: antioxidant, antihistamine, analgesic and anti-inflammatory. It is the latter two effects that are used in the treatment of inflammatory joint diseases. Sulfur is found in many foods: vegetables, fruits, cereals, milk, meat, but is destroyed when cooked. With age, the need for it increases.

MSM promotes faster muscle recovery after exercise, so it has long been used as a sports nutrition in Ice Power Plus, Bone Boost from SAN, Animal Flex from Universal Nutrition and others.

The use of MSM with chondroitin and glucosamine has become the next step in the treatment of joint diseases. It turned out that it enhances the effect of both drugs.

The French company Arkofarma developed such a complex preparation and named it "Inzhoy Enti"( Vision).The composition of BAA includes Glucosamine, Chondroitin, Methylsulfonylmethane and Bamboo Extract, rich in silicon.

To avoid allergic reactions associated with the release of a preparation from bovine protein, glucosamine and chondroitin are of marine origin. To maximize the preservation of useful properties of components in the production process, cryocorrelation technology is used.

The drug is available in capsules of 30 pieces per pack, take 1 capsule per day. The month of treatment "Inzhoy Enti" will cost 2300-2500 rubles.

Supplements "Glucosamine Chondroitin Super Formula" is characterized by a higher content of 3 specified components than analogues. It also includes selenium, magnesium and vitamin E.

"Glucosamine chondroitin MSM"( Doctor's Best) contains additionally sodium and potassium.

The latest effective compound for the treatment of joint diseases is Celadrin.

Celadrin

Celadrin is a special complex of fatty acids( LC), isolated from bovine fat. LCs are part of the lipid of cell membranes responsible for transporting nutrients into the cell and the products of decay from it.

Celadrin has a whole complex of unique effects:

  • When exposed to negative factors, including inflammatory mediators, on the cell membrane, it quickly restores its integrity.

  • Oppresses the production of "inflammatory cells" in the development of autoimmune and pathological inflammatory processes.

  • Improves the composition of the joint fluid, as a result of which the amplitude of movements in the joints increases, the friction of cartilage is not allowed.

Due to the listed properties, Celadrin improves the flexibility of the ligament apparatus, reduces pain, restores the volume of movement in the joint.

Celadrin 525 from the company Solgar( USA) is available in the form of capsules( 60 pieces per pack), a day is recommended to take 1-2 pieces. The cost of treatment will average 2100-2300 rubles.for 1-2 months.

New Celadrin &MSM from Now contains Celadrin and MSM.It is recommended to apply a daily dose of 3 capsules, a 20-day course of treatment will cost about 600-700 rubles.

The Agel FLX( Agel Enterprises, USA) is the group of drugs containing the four most important components for the restoration of joint function.

It is available in the form of a gel with a taste of fruit( 21g) and contains active ingredients in an increased amount: Chondroitin sulfate 1200 mg, Glucosamine sulfate 1500 mg, MSM 400 mg and Celadrin 750 mg. The monthly course of treatment with an innovative drug is about 3000 rubles.

There is no information on large meta-analyzes confirming the effectiveness of Agel FLX, however, the drug is considered very promising. A three-year study conducted at the Department of Traumatology and Orthopedics of the St. Petersburg State Medical University named after. I.P.Pavlova, in which 134 patients participated, demonstrated a significant reduction in the pain syndrome and an increase in the amplitude of the movements.


What is important to remember the patient when using dietary supplements?

important to remember
  1. Does the doctor help?

    The doctor can not prescribe dietary supplements officially, since they do not belong to the group of medicines. However, he can advise them as an additional method of prevention and treatment. The doctor may have experience in the application of dietary supplements to other patients with a similar pathology and long-term observations of the dynamics of the disease.

  2. Can I treat food supplements as a waste of money?

    It is possible, except that 35% of the world's dietary supplements are consumed in the US, where the economic justification for spending each dollar is taken into account. On the second place - Europe( 32% of the market), on the third - Japan( the country of long-livers).It is important to choose the right manufacturer and full ownership of information that dietary supplements do not act quickly!

  3. When to wait for the result?

    When taking dietary supplements, it is important to follow the admission rules( multiplicity and timing of application), but do not treat them as medications that should help instantly( eg, NSAIDs).A group of chondroprotectors are drugs with a delayed effect( the minimum course is 3 months).Supplements act more gently, the result often has to wait longer than when taking medications.

  4. How to evaluate the result?

    The result can be assessed objectively by reducing the intake of NSAIDs not earlier than six months after the beginning of the application of dietary supplements. This indicates a reduction in pain syndrome, stiffness, and improved joint function. BADy for joint disease use for life, treatment is carried out by courses.

  5. Side effects and contraindications

    The tolerance of dietary supplements is usually good, no side effects are described. This is due to the fact that the basis - 100% natural substance without preservatives, additives and dyes. Seldom can be an individual intolerance. Contraindications in dietary supplements are usually very small: pregnancy and lactation. There is no danger of addiction and overdose.

There are references both to the ineffectiveness of applying BADs and chondroprotectors. The reason for them is most often the discrepancy between expectations and reality: the patients suggest that after 1-3 months of application the cartilage tissue should be restored, and the pain syndrome should be left for good.

In fact, the correct approach to taking dietary supplements is this: use them as an additional method of therapy for a long time. BADs, like chondroprotectors, will work more effectively in the early stages of the disease. The very first result can be considered a reduction in the dose of NSAIDs, which indicates a decrease in the pain syndrome. About other effects in relation to cartilaginous tissue can be said no earlier than 1.5-2 years after admission. To suspend the course of the disease is already a huge result!

Author of the article: Alekseeva Maria Y., physician-therapist

ayzdorov.ru

Preparations chondroprotectors for the treatment of joints

Long-term chronic joint diseases are always associated with dystrophic changes in articular cartilage - its condition determines the form and stage of the disease. To stop the destruction of cartilaginous tissue and restore its structure, chondroprotectors are used successfully - drugs whose action is directed to nutrition and the formation of new cells of cartilaginous tissue, as well as to the production of synovial fluid - joint lubrication.

chondrotin-acos chondroprotektor

Chondroprotectors are one of the main medicines for the treatment of joints.

Chondroprotectors: application point

To better understand the role of cartilage, we will consider the structure of the joint. The joint surfaces of the bones are lined with a smooth and always moistened layer of cartilaginous tissue. The role of lubrication is synovial fluid, which is produced by cartilage cells. An important condition for its development is movement in the joint: the more actively the joint works, the more liquid is produced. Synovial grease, in addition, also nourishes the cartilage.

If, for one reason or another, the cartilage begins to deteriorate, the underlying bone is exposed, the surface of which is coarse and rough. The opposite cartilage, when in contact with the bone, is also damaged. Because of this defect, the development of the synovial fluid is disrupted: the joint does not receive lubrication, and the cartilage does not receive nutrition. As a result, the cartilage tissue gradually dies, and the joint loses its functions.

Chondroprotectors hamper the development of this process. Their use reduces pain and to some extent helps to relieve inflammation. The composition of these drugs include substances that are normally produced in the human body and are necessary for the formation of synovial fluid.

The active substances of chondroprotectors are chondroitin sulfate and glucosamine. The drugs are available in various dosage forms:

  • injection solutions;
  • tablets, capsules and powders for oral administration;
  • ointments, creams and gels.

How to take chondroprotectors?

It should be noted that can only be restored to cartilage, which has not yet been completely destroyed, therefore the use of chondroprotectors is most effective in the early stages of the disease. When the total death of cartilage cells has already occurred - the medicines are completely useless. Also important is the lengthy course. Doctors recommend not to be limited to 1 to 2 courses, since this is clearly not enough for a complete regeneration of the cartilage.

Restorative processes in the cartilaginous tissue are rather slow, so do not wait for quick results. For joints, chondroprotectors become, as it were, a source of permanent make-up. If you stop treatment before the time - the cartilage will start to break up again. The average time of course therapy lasts from six months to one and a half years - during this period, a lasting long-term effect is achieved. In some cases, the reception is extended to 2 - 3 years. The daily dose and duration of the course is determined by the doctor.

Chondroprotectors are easily tolerated by patients and have virtually no side effects( in some cases, intestinal disorders may occur).With care appoint these drugs to people with diabetes, because the glucose contained in them should be compensated for by increasing the dose of insulin. Contraindication to the use of drugs will be allergic intolerance, pregnancy and early childhood.

chondroprotectors table: comparison of chondroitin and glucosamine

Comparison of chondroitin and glucosamine. Click on the picture to enlarge

The choice of the drug

The choice of preparations of this group is quite wide, and it is not easy for everyone to understand what exactly suits him. Given that the price of chondroprotectors can be very high, and the effect does not come immediately - before buying it is worth to consult with a doctor and together with him choose the most suitable medicine.

Often the course of treatment begins with intraarticular or intramuscular injections, gradually moving to the reception of tablets and capsules. At the same time, ointments, creams and gels with chondroitin and glucosamine are used.

According to arthrologists, the following drugs have proved themselves well:

  • Arthra is a tablet manufactured in the USA.Contain glucosamine and chondroitin, are well absorbed, easily tolerated. Produced in packages of 30 - 100 tablets, the price, depending on the size of the package 500 - 2000 rubles.
  • Dona - glucosamine powder for oral administration and injection. Produced in Italy( Rottafarm).The cost of packing of 6 ampoules or 20 doses of powder is 900 - 1500 rubles.
  • Teraflex is a complex preparation of Sagmel( USA), contains chondroitin and glucosamine, is available in capsules and as a cream. The package contains from 30 to 120 capsules, the price of packing 450 - 1500 rubles. Simultaneously with taking capsules inside to strengthen the effect, it is recommended to use Teraflex cream.
  • Chondrolon is an ampoule solution of chondroitin sulfate of Russian origin. The package contains 10 ampoules. Price 1000 - 1300 rubles per packing.
  • Structum is a French preparation of chondroitin sulfate in capsules manufactured by Sotex. Produced in packages of 60 capsules in two different dosages( 250 and 500 mg).The cost of the 1st package is 500 - 1300 rubles.
  • Elbona is a Russian-made product from Ellara, a solution of glucosamine for intramuscular injection. The package contains 6 ampoules. The price is from 900 rubles.

The group of chondroprotectors is referred to as drugs, the effectiveness of which is clinically proven, and food additives that may not contain the active substance at all, since they are not subject to mandatory testing. Therefore, always buy only proven drugs and on the advice of your doctor.

SustavZdorov.ru

Preparations for the treatment of joints


In recent decades, the incidence of musculoskeletal system in the population of many countries increased. Arthroses and arthritis affect people of young age and have a tendency to a chronic progressive course. Stop the development of the disease can be with a timely call to the doctor. Otherwise, the risk of irreversible changes, loss of ability to work and a decrease in the quality of life is great.

The main role in the treatment of joint diseases is medication, the dosage and duration of reception of which is established by a specialist after a diagnostic examination and determining the severity of the course of the pathology.

The main goal of conservative therapy is to eliminate pain, reduce inflammation, restore normal volume and amplitude of movements. Some medications affect the symptoms of the disease, others can eliminate its cause. A comprehensive approach increases the effectiveness of treatment and helps achieve lasting positive results.

Non-steroidal anti-inflammatory drugs( NSAIDs)

NSAIDs are drugs that have antipyretic, analgesic, anti-inflammatory effects on the body. They are prescribed as a symptomatic remedy for arthrosis of joints and arthritis. The medicines of this group relieve the signs of inflammation in the pathology of the musculoskeletal system of any nature and are prescribed in the acute period of the disease. Non-steroidal drugs have a non-hormonal origin, but have a pronounced analgesic effect. They are divided into two main groups, which differ selectively influence on mediators of inflammation.

Non-selective NSAIDs inhibit the production of enzymes COX-1 and COX-2, which causes side effects from the digestive tract. The enzyme cyclooxygenase is involved in the synthesis of inflammatory mediators, called prostaglandins. In this case, COX-1 has protective functions for the gastric mucosa, and COX-2 is released when the joints become inflamed. The inhibition of the production of two fractions of the enzyme leads to a good anti-inflammatory effect and a persistent elimination of pain. However, it often causes side effects associated with the formation of ulcers of the mucosa of the digestive tract and bleeding. Therefore, the drugs are prescribed short courses for 10-14 days against the background of taking funds to protect the gastric mucosa, for example, omeprozole.

Ibuprofen
ibuprofen-based preparations refer to non-selective NSAIDs

Non-selective NSAIDs:

  • diclofenac( voltaren, diclovite, orthophene, naproxen);
  • ibuprofen( bolinet, advill, dolgite, mothrin);
  • indomethacin( indowene, indocid, moovide, methindole);
  • ketoprofen( arthrosilene, ketonal);
  • lornoxicam( xsefokam);
  • piroxicam( pyrox, tonsillin, erazon, pyrox).

Selective NSAIDs refer to the new generation of drugs. They block the synthesis of only COX-2, thereby selectively acting on the inflammation focus in the affected joint. In this case they have a somewhat less analgesic effect, but do not cause irritation of the mucous membrane of the stomach and intestines.

Selective NSAIDs:

  • arkoxy;
  • nimesulide( aponyl, nise, kokstral, nymphast);
  • meloxicam( melox, arthrosan, movalis, lem);
  • celecoxib( ranseleks, phlogoxib).
Movalis
Movalis is an effective anti-inflammatory drug with a selective action of

Selective drugs can be administered for several months under the supervision of a physician. It should be borne in mind that repeated courses of treatment of NSAIDs worsen metabolic processes in the cartilage and should be used with caution in joint arthrosis. Pharmacological industry NSAIDs are available in tablets, injections, rectal suppositories and ointments.

Hormones

For the treatment of arthritis, which are accompanied by inflammatory reaction and pain syndrome of high intensity, steroid hormones are used. They are prescribed in tablets( prednisolone, hydrocortisone), intraarticular injections and are substances synthesized by the adrenal cortex. Hormonal therapy is usually used in cases when NSAIDs do not have the necessary clinical effect. In addition, the drugs are recommended for the appearance of synovitis - inflammation of the periarticular soft tissues( ligaments, tendons, muscles).To treat diseases of the musculoskeletal system, intraarticular injections are recommended:

  • Kenalog,
  • metopred,
  • flosteron,
  • depot-medrol,
  • diprospan,
  • celeston.
Kenalog
Kenalog is used for insertion into the joint cavity

The therapeutic course is 1-3 injections, which are carried out at intervals of 5-10 days. Hormonal therapy is prescribed in the acute period of the disease under the strict supervision of the attending physician. The introduction of steroid drugs into the joint is associated with the risk of complications( infection, blockage of the joint, trauma of the soft tissue structures) and requires a highly qualified approach. Therapy is recommended for inflammation of the elbow, hip, knee joint in the event of persistent pain that does not lend itself to cupping by other methods.

Chondroprotectors

Chondroprotekotry is prescribed for degenerative-dystrophic joint diseases - arthrosis, which is accompanied by destruction of intraarticular cartilage. Preparations of this group contain two main components, presented chondroitin sulfate and glycazamine. They contribute to the restoration of the normal structure of the cartilaginous tissue, block the work of enzymes involved in inflammation, reduce the intensity of pain.

Chondroitin sulfate is an important component of cartilage, it normalizes the water content in it and provides elasticity. Glycazamine is the precursor of honroitin. It promotes the normal synthesis of synovial fluid - lubricant for the smooth and painless movement of intraarticular sections of bones. As the tissues age and when exposed to adverse factors at a young age, the body does not sufficiently synthesize these substances, which requires their additional introduction in the composition of medications. Otherwise there is destruction of cartilage, pain during movement and complete cessation of functioning of affected joints, which leads to disability. Medicines also strengthen the ligaments, tendons, muscles that support the anatomically correct structure of the joint.

We also recommend reading: Pain in the knee joint Joint aches

The pharmacological industry produces chondroprotectors containing only glycazamine or chondroitin sulfate, and also combined agents that are considered more effective in the therapy of arthrosis. The following medicines are most popular in medical practice:

  • preparations with chondroitin sulfate( mucosate, structum, chondrolone, chondroxide);
  • preparations with glycazamine( elbon, altron-flex, don, yunium);
  • combined agents containing glycosamine and chondroitin sulfate( chonda, arthroflex, arthron complex, teraflex, chondro, arthra).

In addition, chondroprotectors can be taken in the composition of dietary supplements( BAA).They include not only the main components for the restoration of cartilage, but also additional ingredients that improve the regenerative and protective properties of the joint tissues. The most effective for the health of the musculoskeletal system Methylsulfanylmethane( contains sulfur) and Celadrin( includes a complex of fatty acids).They are part of Glucasamine Chondroitin Super Formula, Chondroitin Glucasamine MSM, Millenium Neo, Celadrin 525, New Celadrin & MSM, Agel FLX, which are considered to be the best homeopathic remedies for cartilage repair. It should be remembered that chondroprotectors in the composition of drugs and dietary supplements are slowly accumulating in the body, therefore they are prescribed repeated courses for 4-6 months for several years.

Structum
Structum is a monopreparation with the chondroprotective effect of

. The achievements of modern medicine made it possible to insert joint joint prostheses inside the joint, which are hyaluronic acid preparations:

  • dewrolan,
  • ostanil,
  • pharmatron.

They prevent the friction of the articular surfaces of bones, forming a protective film on the cartilage. This contributes to the elimination of pain, the activation of metabolism in the pathology site, and the normalization of the motor activity of the joints. The course of treatment is prescribed 5-10 injections, depending on the severity of the disease. In addition, chondroprotectors such as chondrolon, aflutop, T. T are introduced into the joint. The price of therapy with this group of drugs is quite high, but they affect not only the symptoms, but also the cause of arthrosis, which helps to eliminate the pathological process.

Remicade
Remicade effectively removes inflammation of the joints of the autoimmune nature

Basic remedies

For autoimmune diseases of the musculoskeletal system, basic medicines are used. They are aimed at eliminating the inflammatory response of connective tissue, which is caused by the damaging effect of antibodies in violation of the normal functioning of the immune system. These drugs affect the cause of the pathological process and are prescribed in conjunction with NSAIDs and steroid hormones in the acute phase of the disease. Baseline therapy is represented by the following means:

  • azathioprine,
  • arava,
  • sulfasalazine,
  • remicade,
  • gold preparations,
  • cyclophosphamide,
  • methotrexate.

Drugs are prescribed for rheumatoid, psoriatic, reactive arthritis and other autoimmune pathology of the musculoskeletal system with long courses from 6 months to several years.

For the treatment and strengthening of joints, in addition to the main groups of drugs, medicines are used that increase the effectiveness of the therapy. Vasodilators( trental) improve the blood flow in articulations, the supply of nutrients and medicinal substances inside the joint.

Muscle relaxants( midolgamma) relieve muscle spasm in the area of ​​inflammation, thus providing an analgesic effect. Local application of ointments, gels, solutions with irritating components( finalgon, apizatron, dimexide) reflexively improves trophism and metabolism, affecting the nerve receptors of the skin. The main condition for recovery is complex therapy under the supervision of a doctor. In neglected cases it is necessary to resort to an operation that often requires joint prosthetics, leads to loss of ability to work, and limits the freedom of movement.

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What drugs are used to treat arthrosis of the knee joint?

What is arthrosis of the knee joint?

Osteoarthritis of the knee joint( or, as it is also called, gonarthrosis) is a disease of the knee joint, accompanied by pains, impaired motor functions and deformation of the cartilage cartilage of the knee joints. Usually it appears in people of an age prone to fattening - and women suffer from gonarthrosis more often than men. It is accepted to divide this disease on a stage, each of which intensifies and complicates the coping and treatment of the disease.

Osteoarthritis of the knee joint, treatment and preparations for which it is necessary to select with the mind is a disease, a frequent problem now, especially in the elderly. The first stage of arthrosis of the knee joints is almost not detected by ordinary residents, since the pain is episodic, not particularly strong, joint deformities do not occur. It can last very long - from several months to several years in a row. Usually, pains persecute people after the beginning of active activity, in the process of heavy physical labor and some time after it, after which they disappear to the following significant loads.

Sometimes this is accompanied by a so-called Baker cyst - an abnormal accumulation of articular fluid in the back of the knee. She usually descends after taking a course of anti-inflammatory drugs - to operate Baker's cyst in any case is not worth it, since it is not associated with cancer.

The second stage is much heavier. The pains appear at the beginning of walking, the joints begin to crack painfully and click, the leg with difficulties bends at an angle of less than 90 degrees. A person with the second stage of gonarthrosis becomes difficult to get up on his feet, many types of physical activity become inaccessible: the pains become too strong. Abnormal accumulation of articular fluid manifests itself in more than half the cases. There is an initial deformation of the osseous cartilaginous tissues of the knee joints, they are "flattened", becoming wider.

Osteoarthrosis

The third stage is the most severe for a patient with gonarthrosis. Pain in the knees does not recede for a minute, even at rest it is difficult to find a position in which it would become tolerable. The knee can not be bent at an angle of less than 90 degrees and it is very painful to straighten the leg completely. The bones and cartilages of the knee joint are subject to noticeable erosion, and physical loads are simply impossible. This is truly the end of a healthy human life.

How to deal with arthrosis of knee joints and are there any means to treat it?

The first thing you need to remember a person who showed signs of at least the first stage of gonarthrosis is to consult with a specialist in the nearest hospital. It is necessary to avoid excessive loads on the affected joints, to lose excess weight to facilitate walking and functioning of the lower extremities. Also, knee joint injuries should not be tolerated - they significantly increase the risk of arthrosis symptoms.

If you are already exposed to the later stages of this unpleasant illness, then it must be treated. Fortunately, this is possible.

First of all, under the strict supervision of your doctor, you need to buy NSAIDs( non-steroidal anti-inflammatory drugs for arthrosis).They will stop the spread of excess articular fluid, remove possible edema and reduce pain when working joints. It should be remembered that this is only the beginning of treatment, the removal of only some of the symptoms, and not the very cause of gonarthrosis. Do not be deceived - it is still very far from the true cure.

It is also necessary to take chondroprotektorov - drugs that help the body to repair damaged cartilage tissue and eliminate the effects of joint deformation. Unfortunately, they work slowly and can not be cured for a cure - at the third stage of arthrosis, when the cartilage is subjected to almost total entropy, these drugs will be powerless. However, the less that chondroprotectors can do is to stop the patient's condition, restore minor cartilage damage and normalize the production of articular fluid, restoring the necessary lubricating properties( which, of course, will prevent further deterioration of knee joints).

Ointments help to relieve pain

Do not forget about the presence of ointments and creams from pain in the joints and muscles. They, although they do not have any curative effect, quite well restore the circulatory system( especially - warming ointments), which contributes to the early restoration of the joint and the rehabilitation of the surrounding muscles. In general, treatment of gonarthrosis with ointments helps patients to relieve pain in the knees and accelerate the recovery process - this should not be discounted, limited only to chondroprotectors and NSAIDs.

Like ointments, compresses work. Experts in this matter advise them much more than warming ointments: the effect of using compresses is similar, but much stronger and versatile. Of these medicines, medical bile, bischofite and dimexide are especially prominent.

We recommend reading: knee osteoarthritis Osteoarthritis of the knee joint of the 1st degree

All these agents not only produce an external warming effect, but also are able to soak through the skin, acting directly on the foci of the disease from the inside( unlike the advertised gels and ointments of all colors,external warming effect).When using any medicine, be sure to consult a specialist who is treating you.

Also have the right to life intraarticular injections. They differ in their types and uses and have the greatest number of restrictions to use and contraindications. Many modern doctors make the grossest mistakes in the use of these drugs, which is quite unfortunate for the patients.

The injections do not work at once - between injections it is necessary to take a break in the area of ​​two weeks, and no more than five injections into one joint for a course of treatment. Hormonal injections relieve inflammatory processes without producing any other positive effects. Preparations with arthrosis on hyaluronic acid envelop the damaged joint surfaces, preventing further erosion of bone-cartilaginous tissues. Unfortunately, for all its high efficiency, hyaluronic injections are very expensive;The treatment course will cost you no less than a thousand dollars. However, this is one of the most effective methods of treatment of gonarthrosis without surgical intervention.

Do not forget about manual therapy of knee joints. When treating the initial stages of arthrosis of the knee joints, it has a truly miraculous effect. Already after a small number of procedures, the overwhelming majority of patients feel tremendous relief and improvement of the situation with the diseased knees. Experienced specialists of manual therapy raised to their feet a huge number of patients with gonarthrosis, which otherwise were subject to surgery.

Remember the benefits of using exercises of therapeutic gymnastics and the use of walking canes in everyday life. Exercise individually, according to your situation and stage of the disease, after consulting with an experienced doctor. The walking stick should be chosen taking into account the distance from the floor to the wrist of your hand, stretched down. A cane is worn in the hand opposite the leg with a diseased knee joint( say, the left leg is susceptible to gonarthrosis, and in the right you wear a cane).At each step on a sick leg, transfer your center of gravity to the cane: this helps to reduce the load when walking.

What does this need to be done?

It is necessary to understand the danger of diseases of the knee joints, including arthrosis. Preparations for the treatment of joint arthrosis should be chosen carefully, taking into account all the nuances. At the first signs of pain in the knees, try to find an experienced doctor who can give you the correct and effective instructions for the prevention of this problem. Remember: in the initial stages of gonarthrosis is much more treatable than late. If you want to live your life without pain and unnecessary complications, keep an eye on your health and the health of your knees.

MoyaSpina.ru

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