Which chondroprotectors for joints
are chosen At the heart of the pathogenesis of most degenerative and dystrophic diseases of the joints and spine is the destruction of the intraarticular cartilaginous tissue, the condition of which determines the stage of the disease and its symptoms. Modern medicine has found a method of therapeutic effect on intraarticular cartilage - it's chondroprotectors for joints.
These medications are designed to stop the progression of pathological changes and, if possible, to repair the damaged cartilage. It should be noted immediately that the effect of such treatment will be observed only in the case of the initial stage of the disease, in far-reaching cases of arthrosis, even the best chondroprotectors( CP) will be ineffective, since there is already nothing to restore in the joint( all cartilaginous tissue is already destroyed).
Mechanism of action of chondroprotectors
In order to understand how these medications help with joint diseases, at what pathology they will be effective, and at what treatment it is unsuccessful, it is necessary to understand how the joints of a person and what role of cartilaginous tissue are arranged.
At the heart of all arthrosis joints is the destruction of cartilaginous tissue
How are the cartilage of the joints arranged?
All articular surfaces of bones that form the joint are covered with cartilaginous tissue. It also includes intervertebral discs. The cartilage surface is smooth and constantly moistened due to a special intraarticular lubricant - synovial fluid. By the way, food for cartilage tissue is also due to the diffusion of substances from this liquid, since its cartilage does not have cartilage.
The main function of cartilage is to ensure smooth movements in the joint, in which the cartilage surfaces of bones slide one against the other, this process is also facilitated by intraarticular lubrication.
Structure of cartilaginous tissue:
- Cells( chondroblasts and chondrocytes).These are young and mature cells of cartilaginous tissue. They produce an intercellular substance, a matrix, which constitutes the bulk of the cartilage. There are much fewer cells here.
- The intercellular substance of the cartilage is characterized by high hydrophilic ability - binds water molecules, which constitute up to 80% of the matrix. The intercellular substance consists of collagen fibers and chondromucoid. It is the latter substance that is responsible for the integrity, strength, shape and function of the hyaline cartilage of the joint. In its composition has a substance such as chondroitin and glucosamines( structural units of cartilaginous tissue).
Cartilage destruction( regardless of the underlying cause) begins precisely with a decrease in the amount of glucosamines and chondroitin, which leads to the unfolding of the cartilaginous tissue, the appearance of a roughness on its surface, cracking and a decrease in the thickness of the cartilage. In connection with this, or in parallel, the production of synovial fluid rich in hyaluronic acid decreases, which further aggravates the condition.
The movements in the joint become painful, the articular surfaces of the bones become bare, which leads to the development of arthrosis and osteochondrosis with all the ensuing consequences.
Application point for chondroprotective agents
Chondroprotective drugs with a timely appointment can stop the destruction of the cartilaginous tissue and to some extent even repair the damaged cartilage structure. The fact that the basis of their composition are the above chondroitin and glucosamines, which, getting into the body, begin to "build in" the damaged cartilage, thus restoring their structure and function.
Action of the main components of chondroprotectors
Classification of chondroprotectors
Chondroprotectors can be divided into three features:
- by composition;
- on the generation of medicines;
- by the method of reception.
Types of chondroprotectors depending on the composition of
- CP, which contain chondroitin sulfate( Chondroxide, Mucosate, Chondrolon, Chondroitin, Structum, Arthron chondrex, Chondroitin-phytopharma).
- CP, which contain glucosamine( Arthron flex, Flexamin Glucosamine, Dona).
- Combined CP( chondroitin + glucosamine) - Arthron complex, Teraflex, Chondroitin complex.
- Combined CP( chondroitin and / or glucosamine + NPZP - ibuprofen, diclofenac) - Triac, Artron, Moveks, Advance, Artrodar.
- CP, which are an extract of cartilage and bone marrow of animals( Alflutop, Rumalon).
Kinds of chondroprotectors depending on the generation
- The first generation is not purified extracts from cartilage and bone marrow of animals. Currently, only Alflutop is used. Has a large number of allergic reactions.
- The second generation is mono-preparations based on glucosamine or chondroitin, which are indicated above.
- The third generation is a combination medicine.
- Separately it is necessary to allocate hyaluronic acid for intraarticular injections( Ostenil, Fermatron, Sinokrom, Viskosil, Suplazin, Synvisc).
Syncope is a preparation of hyaluronic acid for intraarticular administration, not for HP, but is a liquid transplant of synovial fluid
Types of chondroprotectors depending on the method of taking
- CP for oral administration( tablets, capsules) - Structum, Arthra, Teraflex. They are well tolerated by patients and practically do not cause side effects. The effectiveness of oral forms is low, since most of the active substance is lost during metabolic changes.
- CP in the form of injections( intramuscular and intraarticular) - Alflutop, Dona, all preparations of hyaluronic acid. More often cause allergic reactions, complications associated with injection, but their effectiveness is much higher.
- CP for external use( ointments, gels, creams) - Chondroxide. It is used only in complex treatment.
How to choose a drug?
To answer the question about how to choose a drug-chondroprotector for the treatment of joints, it's not so simple. Firstly, the assortment of such medicines in the modern pharmaceutical market is quite large. Secondly, the price of such treatment is very high, and given the need for a long course, which can reach a year or a half, for some patients the cost becomes prohibitive. Thirdly, the effect of chondroprotective therapy does not come immediately( the first positive signs can be noticed after 3-4 months of regular use).
Given all of the above, before you buy these medications, it is necessary to consult with a doctor who will determine whether there really is a need for such therapy and which drug will most suit your case.
Nevertheless, to somehow navigate the selection, it is necessary to evaluate the preparations-chondroprotectors according to the following criteria. A mono-drug or a combination?
With the above classification of HP, it can be seen that they can be single-component( mono-drugs) or combined. As a rule, the combination consists of two basic substances - chondroitin and glucosamine, while others do not. Some drugs in their composition have a non-steroidal anti-inflammatory drug( Ibuprofen or Diclofenac).And still we recommend reading: What are the tablets for gout?
It would seem that it is better to choose a medicine that contains both glucosamine and chondroitin, because both of these substances are equally important for the body. But in practice, there are some nuances of this choice: some sources of information claim that mono-drugs are more effective, while others are telling about the benefits of combined medicines.
Why are there so different opinions? First, chondroprotectors are "young" medicines( the experience of their use totals about 10-15 years).Secondly, the interest of pharmaceutical manufacturers of chondroprotectors plays an important role. It is known that in order to release one medicine to the market, billions of dollars are needed( the cost of clinical and other types of research, advertising campaign, etc.).Therefore, often the information that is received as a result of research sponsored by a certain company does not always correspond to the truth.
The recommendation is this: first of all, you need to address this question to a practicing arthrologist who, based on his experience with the use of these drugs and knowledge, will be able to advise a really effective HP.Also, excellent help will be provided by patients' opinions about this or that drug.
This is a very important criterion of choice, because a well-known and respected pharmaceutical company in the world can afford the most expensive and accurate equipment, modern manufacturing techniques, high purification of medicines and real clinical studies of the effectiveness of drugs, unlike no oneknown factories.
Buying branded drugs, not generics, you can be sure that for your money you will get only a high-quality medicine that will minimize all side effects, allergic reactions and inefficiency of therapy.
Artra is a combined chondroprotector with a large evidence base and a well-known manufacturer
Medical product or dietary supplements?
If the chondroprotector claims to be a medical product, then there must necessarily be clinical studies that confirm its effectiveness, composition, indications, contraindications, side effects, etc.
In the case of a dietary supplement it is not necessary. But you should understand that then there can not be a talk about the chemical purity of the drug, the amount of active substance that is in one pill( and it may not be there at all) and the effectiveness of such treatment.
The instruction for the drug is your main "weapon" - read it before buying it. There it is indicated whether the drug is a dietary supplement or a medicine.
Despite the fact that the Tooth Stone is a dietary supplement, many positive responses from
patients can be found about it.
disease stage As already mentioned, HP is effective only in the initial stage of the disease( stage 1 and 2 of arthrosis, osteochondrosis).If you have a pathological process already gone far( stages 3 and 4), then the expediency to take chondroprotectors is no longer, as the cartilage tissue is completely destroyed. And to resume its use these medicines are not able to
Indications and prohibitions to use
Indications for the use of chondroprotectors are:
- deforming osteoarthritis of 1-2 stages( including coxarthrosis, gonarthrosis);
- osteochondrosis of the spine in the initial stages;
- prophylaxis of articular degenerative diseases in persons at risk( age after age 50, athletes, people who have occupational hazards - heavy physical work or, conversely, prolonged stay in one position, overweight persons after a traumatic injury, people withanother disease of the musculoskeletal system, with endocrinological and metabolic disorders).
Contraindications to the appointment of CP are the individual intolerance of the components, pregnancy and lactation.
The list of the most effective chondroprotectors of
The following list of the most effective HP has been compiled taking into account the patients' feedback, the recommendations of the doctors-arthrologists, the clinical research data and the reputation of the manufacturer:
The most popular and effective chondroprotectors
- Dona. This is a mono-drug of glucosamine sulfate. There is in the form of powder for ingestion and ampoules for intraarticular or intramuscular injections. Produces this medicine Rottafarm( Italy).
- Artra. Complex chondroitin and glucosamine. Produce these tablets in the US.It is characterized by high efficiency with long-term intake and safety.
- Teraflex. Complex HP, which is available in the form of capsules and an external cream by the American company Sagmel.
- Structur. The drug chondroitin in capsules for oral administration, is produced by the French pharmaceutical company Sotex.
- Alflutop. This is HP in ampoules of the first generation. It is an extract of 4 species of Black Sea fish. It is used for intraarticular and intramuscular injections. A frequent side effect is an allergy.
- A toasting stone. This dietary supplement on a plant basis. There are capsules for internal administration and an ointment for external use.
Summing up, it can be noted that it's really hard to choose HP.Therefore, to get the maximum effect from the treatment and a minimum of side effects, this should be done by a specialist.
Chondroprotectors for joints. The best chondroprotectors. Chondroprotectors - reviews
As a result of heavy loads or any pathological changes in the human body, the structure of the cartilaginous tissue and the development of the synovial( intraarticular) fluid can be disrupted. This leads to painful changes in the joint, and sometimes to its immobilization.
In such cases, treatment with chondroprotectors is used - drugs that stimulate the restoration of articular cartilage and slow down its destruction. About what these medicines represent and how to choose the best of them, we'll talk in today's article.
What is included in the structure of chondroprotectors
At the heart of these medicinal preparations are biologically active components, which are structural elements of natural cartilage tissue. They alleviate the condition of the patient with arthrosis, mobility disorders of the joint, radiculitis, pain in the neck or lower back, osteochondrosis of the spine and some other pathologies.
Chondroprotectors for joints combine two important components of the cartilaginous tissue: glucosamine and chondroitin sulfate. As a rule, the lack of these substances reduces the mobility of the joint, causes painful movement and leads to arthrosis.
Features of the action of chondroprotectors
There are many diseases in the treatment of which these drugs are used. These include osteoarthritis, arthrosis and coxarthrosis, arthritis, dystrophic changes in articular cartilage, spondylosis, osteochondrosis and some other ailments.
But it should be noted at once that chondroprotectors for knee arthrosis of other listed pathologies are effective only in the early stages of the disease. In the same cases, when the destruction of cartilage has already occurred, these drugs are useless. This is due to the direction of the drug to restore the existing tissue, rather than the formation of a new one.
The features of these drugs include their slow influence on cartilage tissue. As a rule, to achieve a therapeutic effect from the beginning of taking the drug should take at least six months.
The active substance of the chondroprotector when absorbed into the body is absorbed into the blood, but its accumulation occurs precisely in the joint tissues, where the process of recovery takes place. True, some drugs are difficult to penetrate into cells of the cartilaginous tissue( this refers to the means containing chondroitin), in such cases additional components or physiotherapy are used in parallel with the main therapeutic agent.
Classification of chondroprotectors
Depending on the time of introduction into practice, it is customary in medicine to distinguish three generations of these drugs:
- Drugs "Rumalon" and "Alflutop" from the bone marrow and cartilage of animals.
- Preparations containing glucosamines, hyaluronic acid and chondroitin sulfate.
- Means with components in the form of chondroitin sulfate with hydrochloride.
All these products are released in the form of ointments, solutions for injections, gels, tablets and capsules.
How to choose chondroprotectorsWhen choosing the described means, one can not say that some of them are the best chondroprotectors with a wide field of application and suitable for absolutely everyone. For each patient who needs such drugs, they are selected strictly individually. What is unquestionably suitable for one patient may, for various reasons, prove to be useless for another. However, this can be said about all medicines.
Based on the above, it is clear that the choice of chondroprotector should be agreed with the physician-arthrologist( specialist in joint diseases).He will choose a suitable preparation in a specific case and will prompt the scheme of its application( in fact often the reception of such medicine is a component of complex therapy).
The most popular drugs-chondroprotectors for jointsAmong the most common drugs in the domestic medicine with the effect of restoring the affected cartilage tissue, several names can be distinguished. Here is a brief description of them.
- Chondroprotectors for joints "Rumalon" and "Alflutop".They are natural remedies derived from the bones and cartilage of fish and animals. Improve the metabolism in the cartilaginous tissue and have anti-inflammatory properties. They are used for deep intramuscular and intraarticular injections. But remember that these tools are effective only when systematically applied!
- Hyaluronic acid preparation "Hyaluron" is used internally. It is able to stimulate the restoration of solid cartilaginous tissues, thereby preventing their destruction. The drug is used in conjunction with chondroprotectors for internal use or ointments.
- The drug "Dona" not only restores tissue, but also removes inflammation. It is available as a powder for internal use and as an injection. Often this drug is prescribed simultaneously as an intramuscular and as an oral agent. The effect occurs two weeks after the start of the treatment.
- The preparation "Structum" is available in the form of gelatin capsules. It returns mobility to the affected joints, reduces pain and restores cartilage, helping to retain moisture in it, thereby enhancing its elasticity. The effect of taking the medication is preserved up to six months.
When using the described drugs, it is important to remember that they are not used during pregnancy and lactation. Chondroprotectors for joints are also contraindicated in the presence of allergic reactions to the components of these agents.
Some of these drugs are not used for diabetes, kidney failure, thrombophlebitis and bronchial asthma. Pay attention to the age of the patient. Particular care should be taken in patients with digestive system problems.
Chondroprotectors: reviews of doctors and patientsOpinions on the effectiveness of the described drugs are severely divided. There are various comments: from grateful and enthusiastic reviews of patients who are convinced that the chondroprotectors have returned to them the ability to move without pain and lead a full-fledged way of life, to the very skeptical remarks of those who consider treatment by this means simply a wasted time.
But with a detailed study of the problem doctors found that negative reviews belong to those who tried the drug only once. It was emphasized above that these drugs are referred to as long-acting drugs, the effect of which can be expected several months at a time. And two or three times inside or outside will not give anything. Only long-term therapy and often in combination with other therapeutic agents will allow to detect the positive effect of chondroprotectors on the patient's body!
Recommendations for use
Chondroprotectors for joints should be used, following certain rules that will improve the effectiveness of these drugs.
- Get rid of overweight, review your diet.
- Protect the patient's joint, trying to reduce the load on it.
- To engage in exercise therapy, which strengthens muscles around the diseased cartilage.
- Intermove motor activity with resting state. Every hour spent on the legs should end with ten minutes of rest in a lying or sitting position.
- Avoid overcooling.
- Remember that chondroprotectors are used for joints during remission. Acute condition is removed by analgesics and nonsteroidal drugs.
- In order to completely restore the joint, the patient requires at least six courses of treatment for three years( if the drug is used correctly, the effect is retained until the next course).
How many chondroprotectors
cost For chondroprotectors for joints, prices usually range from 1500 rubles.up to 4000 rubles.for the medicines needed to conduct a one-month course. As you can see, they can not be called cheap. But if the doctor permits you, then in some cases the cost of such treatment can be reduced, replacing the drugs with their components, which are produced separately.
So, the package of "Glucosamine" costs about 300 rubles. The same amount is worth the drug "Chondroitin".A chondroprotector "Dona"( which is based on glucosamine) is sold at a price of 990 rubles. So, as you guessed, you can pick up a replacement that will not be so painful for your wallet. But you can do this only by consulting with a doctor!
Remember that only an expert will help solve your problem. Do not self-medicate!
It is proved! Chondroprotectors are highly effective in the treatment of arthrosis of the knee jointIn a disease such as arthrosis or joint osteoarthrosis, for example, degenerative and degenerative joint changes occur, which is why they become limited in their mobility, aching and aching. That is why the basic treatment of patients with knee or other joint diseases should assume the restoration of cartilaginous tissue, because simply putting compresses is not an option. To do this, various medications are used in medicine, for example, chondroprotectors for the knee joint and special vitamins .
Experts have long argued about whether to practice treatment using such drugs, or not, because some patients who have osteoarthritis, say they clearly see an improvement in their health, and others do not feel any changes. The reason for their disagreement with each other is that many people simply do not know how to take such drugs correctly and hope for their quick effect, and in this case the treatment will not bring results. In fact, the minimum course of admission for the medical treatment of arthrosis of the knee joint, or in the diagnosis of osteoarthritis, for example, is at least 6 months and only after consulting a doctor. Independently choose their own medicine, medical products, even painkillers or compresses, it is undesirable, it is worth consulting with an orthopedic doctor.
Methods of treatment with chondroprotective agents
Almost all drugs with chondroprotectors and drugs contain the same substances that are part of the natural cartilage tissue. Such substances are glucosamine and chondroitin. Most types of chondroprotectors from cartilage and bone tissue of animals and fish are produced.
The following treatments are available:
1. Treatment with long courses of taking tablets or powders. The first results in patients diagnosed with osteoarthritis, for example, should be already 3-4 months after the first dose of the drug, and a stable and long-term effect occurs in 7-8 months. It is worth noting that the dosage, when taking the powder and tablets is significantly higher than necessary for treatment. This is because the molecules of chondroitin are not fully absorbed because they have a large mass.
2. Chondroprotectors for the knee joint, for example, can also be administered as injections, inside the joint bag. In acute inflammatory processes, the effect of injections is felt almost immediately, and in total 10 to 20 injections are required. After this, patients are prescribed a long-term use of tablets or other medication. The dose of chondroprotectors in this case is about 100 mg, which is quite enough for a persistent effect.
3. Anesthetic ointments and compresses. Their use brings tangible results in the period of remission, which is relevant for the knee joint or, if a person has osteoarthritis, for example. And it is also desirable to take oral chondroprotectors simultaneously with ointments.
What are chondroprotectors made of?
The most important components required for arthrosis are chondroitin and glucosamine. Chondroitin is a biologically active component that stimulates and restores the phosphoric-calcium process of metabolism in the cartilages of the knee or elbow.
By its nature chondroitin is a mucopolysaccharide, giving the cartilage elasticity and affecting the process of cartilage regeneration in arthrosis, as well as inhibiting the loss of calcium.
Glucosamine is also a BAS which stimulates the replenishment of hyaluronic acid, which gives the joint mobility. Glucosamine also helps the process of producing this acid by its own cartilage cells( chondrocytes).
Different drugs with chondroprotectors contain these two main components, which are combined in different amounts and dosages, and pharmacies also have preparations containing only one species.
Which chondroprotectors are most effective and popular?Medicamental treatment of arthrosis of the cervical spine or other joint diseases should start with the selection of its suitable drug. To date, the drug market is simply overcrowded with different generations of drugs. Chondroprotectors for the knee joint or helping with arthrosis, for example, are monocomponent and multicomponent( which include chondroitin and glucosamine).What to focus on when choosing? The following types have proved to be well:
1. Structum is a French medicine, available in the form of 250 and 500 mg capsules. In the composition of chondroitin sulfate, and the course of treatment is from 3 to 6 months.
2. Arthra is American manufacture. These are tablets, consisting of both the main components( chondroitin and glucosamine).Tablets with a dosage of 500 mg, the course of treatment is also from 3 months to six months.
3. Dona - Italian production, with glucosamine. This is either a solution for injections, or capsules. The injections are done for 2 weeks 2-3 times a year, and the capsules are taken for half a year.
4. Teraflex is an English medicine. Produced in the form of 400 or 500 milligram capsules. In the composition of chondroitin sulfate. The course of admission is 3-6 months for 3-4 capsules during the day.
It is worth considering that before receiving any drug and funds for arthrosis, even if it is a treatment for the elbow or knee joint, a competent specialist consultation is necessary. Only a doctor will be able to conduct a full examination of the patient and tell him what kind of treatment he needs, which chondroprotectors are more effective for taking in what doses and for how long, and what compresses are useful for his joints. If a patient is diagnosed with osteoarthritis, the symptoms and treatment may differ from those described by other patients, as this is very individual.
At the initial stages of the disease, almost all chondroprotectors have a noticeable effect on treatment due to direct effects on the cause of the disease. But in more severe cases with arthrosis, when the joint is badly damaged, chondroprotectors almost do not cause any changes in the body.
Do not rule out such diseases as arthrosis and osteoarthritis, therefore chondroprotectors in osteoarthritis are best taken together with other medicines, at the initial stages of the disease. If osteoarthritis in the severe stage, then only surgical intervention is already indicated, that is, the replacement of the joint.
Recommendations for admission
If a person is overweight and does not seek to reduce it - take chondroprotectors is useless. The extent to which the joint is abraded directly depends on those kilograms that put pressure on the joint. It is important to remember that eliminating the cause that caused, for example, osteoarthritis, is the first condition for effective treatment.
Affected and diseased joints must be carefully protected from heavy physical exertion. In the treatment of chondroprotectors, it is necessary to change the rhythm of one's life and reduce the physical effect on the joints.
But this does not mean that the joint should be left without movement. They need it, and regularly, since the immobility of the joint bag can cause deformation of the cartilage and reduce the metabolic processes in the joint. So, for example, if you are diagnosed with arthrosis or osteoarthritis, walking is just necessary, 4-5 km a day.
Also, in no case should you overcool the joints. And in the event that there is an infection, we must first remove it, and only then be treated with chondroprotectors. If a person has osteoarthritis, arthrosis and chronic infection, this means that the treatment will not be effective, because it can be the root cause of the disease.
In case the doctor prescribes the treatment to the patient. Including various types of chondroprotectors, and the person is already taking any medications - this must be told to the doctor.
How to choose chondroprotectors?
If you choose chondroprotectors for a sick joint or some means for joints, then the first thing to pay attention to the composition. Treatment is often based on the intake of either monocomponent drugs or multicomponent drugs. What kind of composition to take for each individual patient, in what form and for how long, should only the doctor decide.
Then you should see who is releasing this medicine. It is best not to allow treatment with a drug of some unknown firm, but take one that is manufactured by a well-known pharmaceutical company. And it is natural that the quality of the medicine directly affects its price.
After this, you must pay attention to the dosage. After all, in the market, in addition to medicines, there are also dietary supplements-chondroprotectors, that is, preparations that are less dosed. They do not have any negative effect, but given their composition, they should be taken a much longer time.
If a person has arthrosis or osteoarthritis, then one should not expect that it can be cured in two weeks - if the patient has started treatment, then he must be brought to the end, taking chondroprotectors as much as indicated by the doctor. Thus, treatment will be long, but effective. Only in this case there will be no negative results, because there are no miracles in the world, and it is impossible to cure severe arthrosis or osteoarthritis in a short period of time. It remains only to be reserved for time and patience, to take vitamins, to comply with all the prescriptions and recommendations of a specialist, and the result will not be long in coming.
Chondroprotectors of the new generation
Why the joints are destroyed
The mobility of our skeleton is ensured by the correct operation of its joints-joints. Despite significant differences in appearance, they all have a single outline of the structure - two or more articular surfaces of bones covered with hyaline cartilage, touching the bag with a cavity filled with synovial fluid. Hyaline cartilage has a high smoothness to reduce friction during movements. It does not have blood vessels in its composition, its nutrition is carried out through the synovial fluid.
This particular feature makes the cartilage particularly vulnerable. With various metabolic disorders or increased load on the joint, hyaline cartilage can be destroyed, and in the absence of normal supply, its recovery is extremely slow. Reducing the amount of hyaline cartilage leads to increased friction during joint movements, this accelerates the destruction of cartilage and stimulates inflammation. For a person, this manifests itself in the form of pain, impaired mobility. The extreme degree of this pathological process is the destruction of the cartilage and the proliferation of coarcting connective tissue that deforms the joint and makes movements in it impossible( ankylosis of the joint develops).
What drugs are used to treat
Because there are a number of interrelated pathological processes in the joint, it is possible to have a pharmacological effect on each of the links in this pathological process to relieve the patient's condition:
IMPORTANT TO KNOW!Doctors recommend! When back pain is needed. .. Read on - & gt;
- Nonsteroidal anti-inflammatory drugs - this group of drugs is able to significantly reduce the manifestations of inflammation. These include pain, swelling, proliferation of connective tissue. Therefore, NSAIDs are most often prescribed for lesions or osteochondrosis of joints.
- Vitamin and maintenance drugs - often the main factor that triggers the entire chain of pathological manifestations is a metabolic disorder. In order to correct it, polyvitaminic and mineral complexes are prescribed.
- Chondroprotectors are the most ambiguous group of drugs, about the effectiveness of which there are still disagreements. However, it directly affects the main manifestation of the disease - the destruction of hyaline cartilage.
There are combined and improved drugs that are used to fully implement complex treatment. For example, effective new generation chondroprotectors almost all contain additional vitamins or NSAIDs. What does the chondroprotectors consist of?
The main idea underlying the work of chondroprotectors in osteochondrosis is the delivery to the body of the compounds from which the hyaline cartilage consists - chondroitin-sulfate, hyaluronic acid, glycosamine. If they are present, the destruction of cartilage can be slowed down and even begin its recovery. Criticism of this concept is that these substances are referred to as macromolecules - a compound with a large molecular mass. The more the mass of any substance, the weaker and slower it is carried in the body, so the penetration of macromolecules into its area of action-into the joint-has long remained in doubt. But beneficial beneficial effect of chondroprotectors in osteochondrosis still have.
The use of these drugs slows down the destruction of the hyaline cartilage, stimulates the formation of the intra-articular( synovial) fluid, strengthens and compacts the structure of the hyaline cartilage. The best chondroprotectors for the spine of the new generation due to the content of additional active substances reduce the symptoms of inflammation, normalize the metabolism in the joint.
First generation chondroprotectors( Alflutop) are made from natural raw materials of bunches and bones of cattle, fish or shellfish. Ideal cleaning of active substances in this case is difficult to achieve, therefore they have a certain allergenicity. Subsequent groups of these medicines are already produced by chemical means, so people's hypersensitivity to them appears rarely. Like all macro-compounds, applied chondroprotectors for osteochondrosis, it is difficult to process the liver, sometimes causing its overload.
Which type of chondroprotector is better to choose
Despite the wide variety of this group of drugs, it is clearly impossible to determine which of them is unequivocally better - each of them has different effectiveness depending on the human body and the nature of its disease. This fact even found its peculiarity in the classification of chondroprotectors. According to one of them, they are divided by generations:
- The first generation( Alflutop, Rumalon) - consists of stretching ligaments and cartilage of animals. Relatively well absorbed by the body, but have an allergic effect.
- The second generation( Structum, Mukosat) - are already manufactured chemically, contain in their composition more easily assimilated forms of chondroitin and glycosamine.
- The third generation( Chondroitin Complex, Antron Complex) - is a combination of chondroprotector, vitamins and anti-inflammatory drugs. This combination was very successful - a person receives all the necessary treatment in a single tablet, not in a handful, reduces the toxicity of individual components.
There are drugs that are not included in this classification. A stone killer, a chondroprotector based on natural ingredients, refers to a new generation of medicines in its other characteristics. Slaughter stone shows results much higher than a number of other drugs of this group.
Another classification of chondroprotectors is the way they are introduced into the body, which determines the speed of the onset of the effect, the frequency of application, the dosage:
- Intra-articular administration is the most effective way of applying, providing a quick and stable effect. It is enough to do the injection procedure once or twice a year. The disadvantage is carrying out only in a hospital. Thus apply Gialgan, Adans.
- Intramuscular injection is a rather convenient method of using chondroprotectors, widely used for the administration of Alflutop, Elbona, Hondrolone.
- Tablets and capsules are convenient for self-administration, but it exerts an excessive load on the liver and to develop a noticeable improvement, so the drug should be used for at least six months.
- Ointments and lotions are the rarest type of application, as chondroitin and hyaluronic acid penetrate very badly through the skin. In combination with physiotherapeutic methods of administration( electrophoresis, magnetotherapy) permeability is significantly improved. So they use the already named toadstone, the new generation chondroprotector.
Features of chondroprotective injections
This group of medicines is actively used for a wide range of dystrophic joint diseases - arthritis, arthrosis, osteochondrosis of various localization. Especially relevant is the use of chondroprotectors in osteochondrosis of the spine - this pathology affects a huge number of people. The intake of these drugs should be prolonged due to their slow effects on hyaline cartilage. They only protect it, so in far-neglected cases with almost complete destruction of cartilage the reception of such a tool as a toadstone or another, is meaningless.
Chondroprotectors for osteochondrosis of the spine are recommended by most specialists to be administered intramuscularly. Drugs of Don, Alflutop have their own peculiarity - they are produced in ampoules of two types with different contents. Some contain powdered concentrate of the drug. In other ampoules a special solvent is produced - in ordinary water for injections, Don is not soluble. Despite such difficulties, the introduction of the drug intramuscularly has more vivid advantages over others. The course of treatment with the drug Don is about one and a half months, its effectiveness increases dramatically with the simultaneous oral administration of powder or capsules with the drug.
Efficacy and use of drugs in the form of capsules
Chondroprotectors for the spine can also be taken exclusively enteral way - an example of such a drug may be Teraflex, available in the form of capsules. He is prescribed three times a day, but the treatment is much more - at least two to three months because of low absorption. There are contraindications - pregnancy, allergy to the components of the drug. It is also necessary to consider the fact of taking other medications - Teraflex is able to greatly alter the absorption of antibiotics. Therefore, it is necessary to carefully study the instructions to the drug before using it.
Teraflex, Dona, Toad stone, Alflutop and other drugs can be of great help in osteochondrosis of the cervical, lumbar and other parts of the spine. But only if you start treatment at the earliest stages. Some doctors recommend all people after 35 years of age use ointments with chondroprotectors to prevent the destruction of cartilage. But with severe pathology, you should not believe the reviews on the Internet and contact a specialist to select the most appropriate means.
Chondroprotectors of the new generation for arthrosis: classification, mechanism of action, effectiveness
Chondroprotectors( verbally, in Latin, "protector cartilage") - drugs that inhibit the destruction of articular cartilage and increase the formation of lubricant - articular( synovial) fluid, withoutwhich the joint's work is impossible - a cartilaginous tissue.
Most of them consist of structural elements of cartilaginous tissue. Chondroprotectors of the new generation for arthrosis - one of the most effective means of its treatment.
Predisposition to the occurrence of arthrosis causes excessive body weight, a large load on the joints, metabolic disorders, including calcium deficiency in the body, joint injuries, as well as heredity and age.
If the cartilage is destroyed for any reason, the bone beneath it damages the articular cartilage that has still survived, this reduces the production of joint fluid, movements are difficult due to lack of lubrication, for the same reason, cartilage does not receive nutrition. As a result, the cartilaginous tissue becomes thinner, gradually dies, then disappears completely, the bony growths form in the joint, the tendons and the joint bag become weak.
Mechanism of action
The action of the chondroprotector consists in the restoration of the cartilaginous tissue. For this purpose, its structural elements chondroitin, glucosamine, and hyaluronic acid are introduced into the body.
Chondroitin is a structural material for the construction of cartilaginous tissue, it reduces its destruction with arthrosis, which ensures free sliding of joint surfaces, improvement of blood supply to joints and reduction of pain syndrome.
Glucosamine resumes the exchange in the cartilaginous tissue with the improvement of its elasticity, stimulates the synthesis of articular fluid, inhibits degenerative processes and also reduces pain.
Hyaluronic acid has viscous properties, acts as a lubricant or as a shock absorber, and participates in the construction of the cartilage itself.
Classification of chondroprotectors
Currently, the following classification of preparations is accepted:
- Chondroprotectors of 1st generation ( alflutope, rumalon, mukartrin).These include extracts from sea fish, extracts from cartilage and bone marrow of young animals. In modern medical practice, Alflutope and Rumalon are still used in injections. They have an analgesic and anti-inflammatory effect, contain either chondroitin( alflutope) or glycosamine( rumalon);
- The chondroprotectors of the 2nd generation are conventionally divided into aminosugars( glucosamine sulfate and hydrochloride) and polysaccharides( chondroitin sulfate analogs and hyaluronic acid preparations) that repair cartilage, normalize metabolism, reduce pain and inflammation of the joint:
- Arthron flex( tablets), Donapowders and ampoules), Artiflex, Elbon( ampoules) contain glycosamine derivatives;
- Arthron chondrex( tablets), Structum( capsules), Chondroxide( tablets, ointment, gel), Mucosate - contain chondroitin sulfate;
- Gialgan, Adant, Hualubriks, Ostenil, Fermatron, Crespin gel - preparations of hyaluronic acid, which are injected directly into the joint during treatment. They have an analgesic effect, serve as a synovial fluid, which stimulates the restoration of cartilage, and so improve the mobility of the joints, that behind them was called the "liquid prosthesis."
- Chondroprotectors 3 generations - complexes from chondroprotectors 2 generations. In addition, non-hormonal anti-inflammatory drugs( NSAIDs) or analgesics may be added to these complexes. This combination of funds complement their action and for a long time preserves the improvement of the patient's condition.
- glucosamine hydrochloride with chondroitin sulfate reduces pain in arthrosis of the knee: Teraflex, Arthron complex, chondroitin complex in tablets;
- chondroitin sulfate, glucosamine hydrochloride with methylsulfonyl methane, which contains sulfur, supports the elasticity of the connective tissue: Arthron, Triac( tablets);
- chondroitin sulfate and glucosamine sulfate with NSAIDs( ibuprofen, diclofenac) shows analgesic, antipyretic and anti-inflammatory effects: Teraflex, Advance, Moveks( tablets).This combination more effectively relieves pain, allows you to reduce the dose of analgesic by 2 times, which affects the reduction of side effects.
Widely used ointment chondroprotectors 3 generations. Of these, the most known are Chondroxide, Hondroflex, for their effectiveness they are called "needleless injectors."
- Preparations from other groups of : ginger extract, Piascladin( unsaponifiable soy and avocado compounds), diacerin, plant chondroprotectors( taraxacin and taraxacerin of dandelion root), etc. Their action effectively reduces inflammation and increases the anabolism( synthetic processes) of cartilage tissue.
Video: "The main groups and the mechanism of action of chondroprotectors"
What drugs can I trust?
With such a variety of drugs, the question always arises in patients: "Which chondroprotector is better?"
Because of their wide spectrum of action, third-generation drugs are considered a priority in the treatment of arthrosis. The intra-articular introduction of hyaluronic acid derivatives is actual, in which the effect persists for up to 1 year.
Attention when buying chondroprotector should pay:
- first, to the manufacturer. As a rule, a well-known name guarantees protection against forgery;
- secondly, the fact that the chondroprotector should be just a drug, not a dietary supplement. Do not be seduced by advertising: a food supplement does not guarantee a therapeutic effect!
- third, on the complexity of treatment, since the treatment with one chondroprotector is ineffective and should be combined with NSAIDs, physiotherapy, etc.
However, the choice of the drug for the appointment of treatment for arthrosis should be done by a doctor.
Contraindications and recommendations
In the announcement of the article, chondroprotectors are called "miraculous substances".In practice, most have no side effects, since they are based on analogues of the natural components of connective tissue, which facilitate the synthesis of cartilage. Individual selection of such drugs to draw up a treatment regimen should be performed by a doctor.
Side effects may include increased sensitivity to the components of medications. Chondroitin and glycosamine has contraindications and is not recommended for pregnancy and feeding of a child. Chondroitin sulfate is not used in the presence of bleeding in the patient, thrombophlebitis, glycosamine - in violation of the rhythm of cardiac activity and diabetes.
The reception of chondroprotectors is carried out for a long time, in several courses for 2-3 months, the drug should regularly enter the body in a certain dose. Prior to receiving a tangible effect of treatment, it can take 1-1.5 years, in some cases up to 3 years. This is due to the slow processes of regeneration of the cartilaginous tissue of the joints.The use of drugs makes sense only up to stage 3 of arthrosis: with complete destruction of cartilage with joint disability, it is impossible to get positive results of treatment, this patient is shown surgical treatment.
Effective method for arthrosis of knee joints are intraarticular injections, for which chondroprotectors are available in ampoules. Often the course of treatment begins with intra-articular and intramuscular injections, but continues with the administration of tablets and the use of ointments, gels, creams containing dimexide( chondroxide).
Joint fluid replacement( sodium hyaluronate) can slow the progress of the disease for a year, in some cases a long-term alternative to surgical joint replacement. With intraarticular administration, the effectiveness of other chondroprotectors is half that of hyaluronic acid. However, hyaluronate is rapidly destroyed in inflamed tissues, so intensive intra-articular injection requires intensive anti-inflammatory joint treatment.
Degenerative joint changes are widespread among the inhabitants of the planet, they suffer from 10-15% of the population. It is impossible to cure arthrosis, as well as old age, but, on time having addressed this problem to the doctor, you will prolong the working capacity and health of your joints.
Chondroprotectors for arthrosis: types, indications, contraindications
Chondroprotectors for arthrosis - drink or not drink?
Most likely, the reason for the disagreement is that many do not know the rules for taking chondroprotectors, each of which must be taken for a long time( at least 3-6 months) and only under medical supervision. Independent reception of the drug is undesirable, even if you saw an advertisement that talks about a good curative effect.
What are chondroprotectors? These are special substances that can protect the cartilaginous tissue. The main therapeutic effect on cartilage is the restoration of its structure and metabolic processes. Since with arthrosis, first of all, cartilaginous tissue suffers, it is desirable to take chondroprotectors for arthrosis in the very early stages of the disease, when there is no deformation of the joints.
Kinds of chondroprotectors
Almost all chondproprotectors contain substances that are part of the natural cartilage. One of them is chondroitin and glucosamine, which is a kind of precursor of chondroitin. Most chondroprotectors are made from bone and cartilage tissues of many animals, including fish.
Chondroprotective treatment is performed by the following methods:
- Chondroprotectors are taken in long courses in the form of tablets or in powder form( chondroprotective medications).Moreover, it was noted that patients begin to feel the first results only 3-4 months after the beginning of the admission, and a good and long-term therapeutic effect is observed not earlier than 6-8 months after continuous intake of drugs. Dosages when taking tablets or powder are higher( 2000 mg per day) than is necessary for treatment. This is due to the fact that the chondroitin molecule has a large molecular weight and therefore only a part of it is absorbed.
- Chondroprotectors can be injected inside the joint bag in the form of injections( injections of chondroprotectors).In acute processes, the therapeutic effect is felt after the first injection, only 10-20 injections are enough for the course of treatment. After that, the patients are prescribed tablets for a long time. The dosage of chondroprotectors in these cases is only 100 mg, which is sufficient to obtain the effect.
- 3. The use of ointments, which include chondroprotectors( ointment chondroprotectors).As a rule, such application brings a result in the period of remission or simultaneously with the intake of oral chondroprotectors.
For reception of more proof result reception хондропротекторов combine with reception of medicinal substances, improving a blood flow and a metabolism.
Treatment with chondroprotectors for arthrosis
Treatment of arthrosis, using even the best chondroprotectors, will not work if the underlying cause causing degenerative-dystrophic changes is not eliminated. As already mentioned, the components of chondroprotectors are chondroitin and glucosamine.
- Chondroitin is a biologically active substance that stimulates and restores the phosphorus-calcium metabolism in cartilage. By its nature, chondroitin is a high molecular weight mucopolysaccharide, which gives the cartilage elasticity, affects the process of its regeneration and inhibits calcium loss.
- Glucosamine is also a biologically active substance that stimulates the production of hyaluronic acid, which gives the joint mobility. Glucosamine also stimulates its own cartilage cells( chondrocytes) to produce hyaluronic acid. Hyaluronic acid stimulates the production of its own collagen and prevents its destruction.
In different medicinal chondroprotectors there is a combination of these two components, changing their dosages, and also there are preparations from this group that have only one component in their composition.
What chondroprotectors for arthrosis take?
To date, the market has more than one generation of drugs, which include chondroitin and glucosamine. What should I look for when choosing? The most effective chondroprotectors, which are most often used in the treatment of patients with arthrosis, are the following:
- Arthra is manufactured in the USA, it is available in the form of tablets, contains chondroitin sulfate and glucosamine. Tablets of 500 mg, take 2 pcs.per day, treatment course 3-6 months.
- Structum - production of France, is issued in the form of capsules of 250 and 500 mg. In the composition there is only chondroitin sulfate. The course of treatment is 3-6 months for 2 or 4 capsules per day.
- Dona - Italy production, the composition contains only glucosamine. It is available as a solution for injection, as well as in the form of capsules. The course of treatment with injections - 2 weeks 2-3 times a year, capsules 3-6 months for 4-6 capsules a day.
- Teraflex - UK production, available in capsules of 400 or 500 mg. In the composition there is only chondroitin sulfate. The course of treatment is 3-6 months for 2 or 4 capsules per day.
- Chondrolon - Russia production, is issued in the form of ampoules for injections of 100 mg. In the composition there is only chondroitin sulfate, the course of treatment is 25-30 injections 1-2 times a year.
- Chondroitin AKOS - Russia, is produced in capsules of 250 mg each. Contains only chondroitin sulfate. Take courses for 3-6 months for 2-4 capsules a day.
Before taking any of these drugs, you should consult your doctor who will perform the proper examination, establish the stage of the disease and determine which composition is best taken, for how long and at what dosages. For example, in the initial stages, all chondroprotectors are very effective, since they directly affect the cause of the disease. In later stages, especially if there is deformation of the joint, it is no longer possible to help, and the effect of chondroprotectors is neutral.
Coxarthrosis is not an exception, as chondroprotectors in coxarthrosis are better used together with other drugs, but at the initial stages of the disease. In the last stages of coxarthrosis, only surgical treatment is shown( replacement of the joint with an artificial one).This measure is necessary so that the patient does not become disabled.
Timely treatment of arthrosis with chondroprotectors can have the following effects:
- Providing the need for the affected joint in the necessary components for the restoration of cartilage tissue.
- Stimulation of hyaluronic acid production, which helps to restore the affected joint.
- No side effects and counteractions to other drugs used in the treatment of arthrosis.
Recommendations for the use of chondroprotectors
- It is useless to begin treatment if you have not taken measures to reduce excess weight. The abrasion of joints will directly depend on the number of kilograms that they have to "wear".Elimination of the cause of arthrosis is the first condition for successful treatment with chondroprotectors.
- Affected and diseased joints must be protected against the effects of increased physical exertion. Treatment with chondroprotectors should in no case be accompanied by previous physical exertion, if any.
- But affected joints at the same time need movement, and regular, as the immobility of the joints can cause deformation of the cartilage and slow down the metabolic processes in the joints. Therefore, walking on 4-5 km a day is what the patients who take chondroprotectors need.
- Patients with arthrosis can not supercool the joints.
- In case of infection, the infection must first be eliminated, and then the course of treatment with chondroprotectors should be continued. If the body has a hotbed of chronic infection, this means the treatment will not be effective, since the infection can be the cause of degenerative processes in the joints.
- If you take chondroprotectors and the doctor prescribed additional medications for you, you should inform the doctor that you are taking them( how many, which ones, who prescribes?)
. What should I look for when selecting chondroprotectors?
- The first thing you need to pay attention to is a mono-component or consists of two components? Which composition is better for you to take, only a specialist can decide. What form of drugs to take, only the arthrologist decides. Perhaps, it will be a complex application of ointments and tablets, for example.
- Who produces this drug? Of course, the best way is to buy a drug of a well-known pharmaceutical company that has modern technologies for production. Naturally, the quality of the drug will directly affect the price of the drug.
- Note the dosage of the constituent components. The fact is that in the market, besides medicines, there are dietary supplements, which differ not in the composition, but in the dosage of the components. Supplements do not have a bad effect, simply, given the dosage, take dietary supplements need longer.
In addition, decide for yourself once and for all - once you started a course of treatment, you need to bring it to the end. Only then will there be no negative results and negative emotions, because your health and you decide - to fight for it or not? And most importantly - do not wait for immediate results and miracles, which, as everyone knows, does not exist in the world. If you turned to the doctor on time, you correctly picked up the drug and you comply with all the recommendations prescribed above, you only need your patience, and the result is assured.
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