Stages of arthrosis: symptomatology and treatment
Arthrosis, or osteoarthritis - is a pathology leading to the destruction of the cartilage plate of bones that form the joint. There are 3 stages of arthrosis. The initial stage is well treatable. But in the future, if you do not seek help from a doctor, the disease progresses very quickly. Usually arthrosis of the last degree requires surgical intervention.
Osteoarthritis: the nature of the problem and the symptoms of
Osteoarthritis is a process of joint destruction. Most often the knee and hip joints are affected. Symptoms of arthrosis in each case will differ, so it is advisable to consider the signs of arthrosis of each group of joints separately.
- Osteoarthrosis of the hip joint.
The initial stage of arthrosis of this joint begins with the fact that a person feels discomfort in the joint. At first an unpleasant sensation appears after physical exertion( running, walking) or by the end of the day, but then, if the problem is ignored, arthrosis begins to progress, and discomfortable sensations become more and more alarming, gradually turning into painful ones. Then a feeling of stiffness appears in the joint. The next stage of the development of the disease is accompanied by already sharp pain sensations, because of which a person can not even be in a certain position. At the last stages, a person deliberately protects that leg, from which the joint is struck, tries not to step on it, keeps it at rest and once again does not subject the joint to movements and stresses.
- Osteoarthritis of the knee joint.
The disease begins with the same discomfort, but already in the knee area. Particularly painful aching person aching pain, which usually appear after prolonged exertion on the legs( to provoke the pain can even unhurried, but a long walk).Outwardly, the disease does not manifest itself in any way: there are no changes in the joint area, inflammatory process and other disorders, since the wear of the cartilaginous tissue of the joint is a purely internal and deep process. If the disease is not treated, the symptomatology is aggravated: pain becomes stronger, stiffness and immobility of the joint appear. The disease in one case can not disturb a person for decades, and in another, on the contrary, it is rapidly progressing.
Joint pathology: causes and stages of arthrosis
It is accepted to distinguish 3 stages of the disease, although sometimes 4 stages are also isolated. Disease begins with the fact that a person notices a barely noticeable crunch during movement, aching pain, tingling in the affected area. Each stage of the disease has its own symptomatology.
- The first stage.
In the first stage, affected joints remain mobile, but only in one direction. Thus the person feels some discomfort, and in the further and painful sensations, especially after excessive loading. In a state of rest, these sensations pass. Muscle mass in the diseased limb remains the same. There are no serious violations at this stage of the development of the disease, so even an X-ray image will not show anything. However, the examination of the affected area can enable the physician to identify already existing disorders in the form of irregularities or curing.
- The second stage.
At this stage, the condition begins to worsen: the pains arise regardless of whether there were loads or not, that is, even inessential movements cause pain. A person tries to keep a sick limb in a state of rest, but this does not always give the desired effect - the pain may not stop. Movement becomes constrained, mobility is limited. It is logical that a person keeps a sick limb, tries not to load it, does not even step on it. Over time, this leads to muscle tissue atrophy. At this stage, the x-ray already makes it possible to diagnose arthrosis: it is evident that the joint is deformed, the articular cleft is narrowed, bone growths, irregularities, etc. are observed.
- The third( according to some sources, the fourth) stage.
The condition of the patient becomes even worse. Now the pain in the affected area becomes simply unbearable, and it can also occur in a state of complete rest. Man even more immobilizes a sick limb, is in constant search for a pose, in which the pain is not so acute. The mobility of the joint is further restricted, and at the last stage ankylosis occurs, that is, a complete fusion of the articular surfaces of the bones.
Causes of development of arthrosis
There are many reasons that trigger the development of the disease. The most common of these are the following:
- Increased physical activity( especially in professional athletes and obese people);
- Injuries, curvature of the spine as scoliosis or kyphosis, rickets, deformities of the lower extremities in the O or X type, incorrectly fused after fractures of the bone;
- Imbalance of the hormonal sphere, violation of the circulatory system;
- Violation of the process of formation and secretion of synovial fluid in the joint, which leads to its deterioration.
Methods of treatment of the disease
Methods of treatment depend on the stage of the disease. The course of treatment and therapeutic measures is prescribed only by a doctor. Do not self-medicate yourself and choose methods of treatment yourself. It is best to see a doctor who will prescribe a correct and effective course of therapy. Modern medicine solves the problem of osteoarthritis in the following ways:
- Medication approach.
Drug treatment is aimed at improving blood circulation in affected areas, accelerating the process of recovery of affected cartilage, eliminating the inflammatory process and anesthesia. To this end, doctors prescribe the drugs of the following groups: non-steroidal anti-inflammatory drugs( they reduce the swelling of the cartilaginous tissue, thereby reducing pain);painkillers( usually opioids);chondroprotectors( these drugs accelerate the process of restoration of cartilaginous tissue, since they are structural elements of the cartilage itself);drugs that increase the concentration of synovial fluid in the affected joint( very effective are injections of hyaluronic acid).
- Surgical intervention.
If treatment has not been started on time, it is often necessary to resort to an operative intervention, as a result of which the mobility of the joint improves, and in some cases, is restored. This removes parts of the cartilaginous tissue or the entire cartilaginous surface. The operation is prescribed when medication failed to produce results, the damaged joint causes acute pain or is immobilized.
Usually, one of two types of operations is performed: arthroscopic surgery or prosthetics. The first approach is not highly traumatic and consists in removing part of the affected cartilage or ligaments, irregularities, etc. In this case, micro cuts are made, through which tools and an arthroscope are introduced, which transmits information about the progress of the operation to the monitor.
Prosthetics is a more complex and extensive intervention. During the operation, the patient's joint is replaced by a metal or combined prosthesis. Modern implants are made of very high-quality materials, which exclude cases of rejection, discomfort, trauma, etc. The choice of the type of operation is always left for the doctor and depends on the general health of the patient, the degree and severity of the disease, the qualification of the surgeon.
The progression of the disease: the recommendations of
If the disease has only manifested itself, the most correct thing to do is to make every effort to ensure that it does not progress further. Methods of traditional medicine may well have a positive effect:
- Completely abandon the use of alcohol;
- Eat right.
Special diet is an excellent additional measure in the fight against the disease. Especially it is shown to those who have excess weight. Refusal of heavy, fried food, flour will help to reduce weight, and hence, reduce the burden on the joints.
- Limit physical activity.
On the one hand, you should avoid long walking, running, etc., but, on the other hand, you need to do exercises every morning. It should be short( 10 minutes is enough), easy. At the same time, avoid such exercises as running and squats.
These measures may well help in the first stage of the disease and stop its progression.
In the second stage, these measures will not be enough. If the patient at the beginning of the disease did not seek medical help from a doctor, then the second degree is the time to do it immediately. Only folk medicine in this case is already powerless, therefore it is necessary to resort to other measures:
- The intake of medications prescribed by a doctor.
- Therapeutic gymnastics, which you can learn to do in the room of physiotherapy at the clinic, and then perform regularly at home.
- Strongly not walk for a long time, stand for a long time in one place, lift weights.
The third( fourth) stage of the disease requires comprehensive treatment. In addition to drugs, it includes the following physiotherapy procedures:
- Resonance-microwave therapy;
- Magnetic wave therapy;
- Laser Therapy.
All these procedures are able to reduce pain, from which patients suffer at this stage of the disease. If the intensive care measures do not help, then the last option remains - prosthetics.
What are the degrees of arthrosis and what causes the disease
The degree of arthrosis shows the severity of the disease. There are only 4 stages. Each of them is characterized by its symptoms and, accordingly, methods of treatment. To treat arthrosis 1, 2 degrees is always easier, rather than in the last two stages. Arthrosis of the 2nd degree does not refer to serious illnesses. Therefore, the army takes young people with a diagnosis of flat foot 2 degrees, with arthrosis 1 degree. That is, if you have a flat foot 2 degrees and arthrosis, then this does not guarantee the cancellation of military service. Treatment of the first degree and the second of this disease consists in regular gymnastics and the use of folk remedies. It does not require medication or surgery. However, the degrees progress from one to the other.
Degrees of arthrosis in medicine have their own characteristics. For example, people with type 1 arthrosis have a metabolic disorder, grade 2 is accompanied by traumas and infectious diseases, 3 and 4 - deformation and destruction of joints.
Osteoarthritis occurs due to injuries of various kinds or mechanical overloads. They arise against the background of excessive loads on the joints. Lifting heavy things or uneven physical exercise negatively affects your health.
Arthrosis 1 degree
As a rule, patients with arthrosis do not feel any special signs of the disease .At times you may feel a tingling or crunching in the affected area, but intense pain does not occur.1 degree can not be determined by X-ray: the disease has only begun to develop, so there have been no noticeable changes. However, to see the hardened places, affected by pathology, it is possible. Since the stage passes without obvious signs of discomfort( no fever, no swelling), you do not pay attention to minor symptoms, and the disease will progress further. Thus, the disease passes into the 2nd stage of the disease.
Treatment of arthrosis 1 degree is at home. It is recommended that you exercise regularly, but you do not want to walk for a long time. Do not overwork your body. Use ointments from horseradish or propolis, they will stop the development of pathology. Do not drink alcohol at all, it will aggravate the situation. You need to make a mode of the day, which includes charging, rest, work, food. In the diet, by the way, you need to include vitamins. They will support the body and strengthen immunity. Eat more fresh fruits and vegetables, forget about bad habits.
Second degree of disease
From arthrosis 2 degrees will not be cured easily. The intervention of the doctor is required, since traditional medicine will be powerless. What symptoms characterize the 2 stage of degenerative-dystrophic joint disease? This is the onset of pain, which is aggravated by stress. In addition, there is a slight deformation, which is accompanied by a crunch of bones. It becomes difficult for you to stay long in one position, which affects your activity. Despite the early stage, arthrosis is treated with medications, anesthetics and anesthetics. If the treatment is not started on time, the disease will go to stage 3, the course of recovery takes much longer.
People with arthrosis 2 degrees are not recommended to walk much, do excessive work. It is recommended to have more rest and exercise.
The third degree of the disease
This stage is accompanied by strong pain, stiffness of movement, and sometimes complete disability. A person becomes dependent on weather conditions: the pain subsides, then intensifies. Sometimes the joints refuse to work, or when they work, there is a crunch and aching pain. This stage is not conclusive, but leads to the surgical table. If the process of joint destruction is not stopped, then the operation is the only way out. You should not bring your health to such a state, it is better to turn to a specialist.
Treatment of grade 3 arthrosis should be comprehensive. It includes the use of medications, various procedures( laser therapy, electrophoresis, UHF, magnetotherapy and others), gymnastics and a special diet.
Fourth degree of arthrosis
Stage 4 of arthrosis is characterized by persistent pain in the area of the affected joint. The person loses mobility. Anesthetics stop helping. To treat arthrosis with medications and physiotherapy is already useless. Thus, a patient with arthrosis is forced to resort to surgery. It lasts no more than 3 hours and is the removal of the destroyed part of the joint. Instead, an endoprosthesis is inserted, which serves up to 25 years. Such a prosthesis will be more suitable for older people, since their mobility is limited. Young people move much more, which will complicate their lives after the operation. Moreover, the process of rehabilitation takes a lot of time, so it is better to stop the disease in the early stages.
Severity, symptoms and treatment of arthrosis of the knee
Pathology is caused by the destruction of the knee or its deformation. The occurrence of arthrosis of the knee joint can occur for various reasons: age, trauma, genetic predisposition. There are many reasons, but the outcome is one.
How does the disease manifest itself? By stages, you can identify complications, and the symptoms of the disease itself.
Arthrosis of the knee joint also 4:
- Osteoarthritis of the first degree is characterized by pain that occurs when the knees or legs are stressed. With prolonged movement, you begin to feel tired, but there is no particular discomfort. The first degree of arthrosis is not observed on X-ray images, but an alarming signal can be increased fatigue of the legs with daily loads. Treatment of this stage is outpatient. It is recommended to do exercises in the morning, eat properly and do not allow the lifting of heavy objects.
- Stage 2 presents a different picture: the pain appears not only with the load, but also at rest. And it can be long and aching, but quickly passing. Here, you can benefit from ointments, tinctures and home-made creams that lubricate the knee joint. Painkillers are prescribed for the doctor's prescription.
- Stage 3 arthrosis of the knee joint in rare cases leads to surgical intervention. You begin to notice that the pains are more intense than before. You are now difficult to move, as the legs hurt and give to the knee. To treat arthritis of this degree, you should consult a doctor and follow all his instructions exactly.
- To 4 degrees, the cartilage tissue is destroyed. You stop moving, you suffer constant pain. If you allowed the development of the disease before the final stage, then you will have to operate. Conservative methods are powerless, you need to remove the affected part.
Degrees of arthrosis of foot
Arthrosis of the foot is a common disease that spares no one. With this pathology, the joints of the toes are destroyed. The disease can be observed with another pathology, which is called flat feet. Most often this is observed flat foot 2 degrees.
People with arthrosis who are overweight or engaged in activities that require a long stay on their feet .Also, the disease provokes heredity, improper diet, curvature of the spine.
Articular tissues are affected depending on the severity of the disease.
- Arthrosis of the foot of the 1st degree is characterized by periodic pains in the anterior part of the foot, which occur when the legs are stressed.
- In the second stage, the bones noticeably thicken, the foot becomes limited in mobility. The pain manifests itself more often and becomes prolonged.
- The third degree is caused by deformation of the foot and considerable difficulty in movement.
A person who suffers from arthritis, is characterized by a limping gait. It rests on the outer part of the foot, and movements of a constrained character. On the affected area there is swelling.
Treatment includes long-term use of nonsteroidal drugs, painkillers, physiotherapy, the use of chondroprotectors and compliance with a certain diet.
Interested in the classification of osteoarthritis? Types and stages of arthrosis hereArthrosis - one of the most common joint diseases in modern man. Different specialists differentiate the stages of arthrosis. As a rule, they give 3 or 4 degrees of arthrosis. In this article, we will consider a more detailed classification of osteoarthritis, consisting of four stages. Types of arthrosis can be different, but the symptoms that determine the stage of the disease are mostly similar.
The emergence of the disease
Before considering the degree of osteoarthrosis separately, let us turn to the reasons provoking the development of this disease.
In most cases, the cause of the first stage is the violation of any metabolic processes in the body, the cause of the second is nonspecific infections and injuries, and the third and fourth are characterized by changes in the structure of the affected joints.
Often often, osteoarthritis occurs due to functional or mechanical overload of joints, a decrease in their recovery function caused by trauma, arthritis, endocrine disorders and problems with metabolism in the tissues of articular cartilage.
The prerequisites for the development of this arthrosis lie in the violation of the functioning of articular cartilage, leading to a decrease in their elasticity, thinning. As a result of the influence of pathological processes, the surface of the cartilage becomes rough, which leads to a disruption in the sliding of bones and the growth of osteophytes. In this condition, the joints become more vulnerable to injury. When arthrosis progresses, the lesions become more serious, the joint synovial membranes, ligaments, tissues, tendons and muscles located near the diseased joint begin to degenerate.
There are different classifications of arthrosis, for example, in the form of localization:
- localized( in one joint);
- generalized( in many joints), otherwise called polyarthrosis.
Polyarthrosis is much less common than with localized arthrosis.
Basically, the causes of osteoarthritis are:
- various injuries;
- lack of mobility( hypodynamia);
- inflammation in the joints;
- excessive physical activity;
- deficiency in the body of minerals;
- flat feet;
- hereditary factors.
And now consider the degree of arthrosis more.
Onset of the disease: first degreeAt the first degree of osteoarthritis joints still retain their natural mobility, however only in one direction. At this stage, with the help of radiography, it is practically impossible to determine the seriousness of the disease, since at first in the picture any joint damage will not be visible. Detection of the disease is possible if you notice cured or uneven surfaces in one or another location of the joints.
The onset of development of osteoarthritis does not seem to be apparent in outward appearance. The body temperature does not increase, the color of the skin around the joints does not change, puffiness is also absent. What can signal about starting arthrosis? First, a feeling of fatigue, tingling in the joint area or a slight aching pain. Secondly, a barely audible crunching in the affected joint during the movement. In most cases, people simply ignore these symptoms, since they practically do not reduce the quality of life. However, if you pay attention to them in time, you can avoid very serious health problems.
At this stage, compresses from horseradish broth, ointments with propolis, horseradish and wax, as well as a diet for joint osteoarthritis, can be cured. Nutrition should be balanced so that the body receives the necessary nutrients, and include a source of collagen, helping the restoration of joints. It can be found in jelly and mousse based on gelatin and holed of beef, pork or chicken legs. If you need to lose weight, the diet should be discussed with your doctor.
In the treatment of the first degree of arthrosis, it is necessary to perform daily exercises that strengthen the periarticular muscles and ligaments. Moderate physical activity improves the nutrition of the cartilage tissue of the joints. It is advisable to refuse from prolonged physical exertion, so as not to overload the joint. Operation at the initial stage is not appointed.
Development of the disease: second degree
If the initial stage is not treated, the disease can develop up to 2 stages. At this stage, treatment becomes impossible without a doctor. Diagnosis of the second degree is quite simple, as the joint disorders become obvious, although still quite curable.
Symptoms of the second stage are much more obvious than the first. The patient experiences constant slight fatigue, a feeling of pressure in the joints that appears after intense physical exertion. Even with minor movements, the patient feels acute pain in the joints, accompanied by a clearly audible crunch. Bending / unbending in the joints is becoming increasingly difficult.
The danger of the second stage of arthrosis is the beginning of deforming of the joints. If you do not start treatment at this stage, it becomes almost impossible to stop the development of the disease.
Already at this stage, the treatment is hampered by many factors, therefore it is already useless to use folk remedies, it is necessary to resort to the help of traditional medicine. To combat arthrosis prescribe vasodilator medications, chondroprotectors, restoring cartilaginous joints, as well as physiotherapy exercises and physiotherapy. In addition, in some cases, the use of painkillers and anti-inflammatory drugs. To avoid overloading the joints, patients should not stand too long in one place and walk. Also heavy lifting and strong physical activity are forbidden.
Initiated arthrosis: third degree
This stage of the disease is very painful, as painful sensations persecute the patient not only during movement, but even when he rests. The joints become very meteosensitive. Many patients say that before the weather changes, "joints twist".At this stage of development of arthrosis, the affected joint can completely refuse, leading to a patient's incapacity. This applies to all major joints, for example, when arthrosis of the knee joint of the third degree is diagnosed.
The third stage requires complex treatment. In addition to taking medication, which must necessarily be prescribed by a doctor, you need to attend physiotherapy sessions. For the treatment of arthrosis at this stage apply: diadynamic therapy, UHF, electrophoresis, magnetotherapy, resonant microwave therapy, laser therapy and electrosleep.
Only operation: fourth degree
In the classification of arthrosis and the degrees of their development, many physicians unite the third and fourth stages, while others share them.
The fourth stage is characterized by extremely intense pain in the joints affected by osteoarthritis. Such pain can not be removed with the help of even the most powerful anesthetics and intensive physiotherapy. The only way out is surgery for endoprosthetics. This operation is the replacement of the affected joint with an endoprosthesis. For today it is the most progressive and effective method of treatment of arthrosis, which has reached the last stage. Thanks to the installation of the prosthesis, the mobility of the joint is restored, which allows the patient to live actively again.
During the operation of endoprosthetics, the damaged joint is removed, and in its place an artificial joint made of special plastic or metal alloy is installed. As a rule, the joint is replaced entirely, although in some cases, a partial replacement of any joint elements is possible. In most cases, such an operation is done by the elderly, as young wear out the prosthesis relatively quickly( in about 20 years it becomes unfit for use).The duration of the surgical intervention is from one to three hours, depending on the complexity. The operation of endoprosthetics is performed under general or spinal anesthesia.
Regardless of how doctors classify arthrosis, their opinions converge in one: all diseases of the joints need to be treated in a timely manner. Treatment of tendonosis of the knee joint or arthrosis, or any other disease must begin when the first signs appear. This will not only save health problems in the future, but also save a significant amount of money.
Osteoarthritis Osteoarthritis is a chronic degenerative-dystrophic joint disease, as a result of which cartilage is destroyed, pathological changes occur in the capsule, synovial membrane, ligamentous apparatus and adjacent bone structures. The main cause of the disease is the violation of metabolic processes. At the same time, traumas, congenital malformations, inflammatory diseases of the joints, excessive load, excessive weight and a number of other factors play a certain role. Arthrosis is manifested by pain, morning stiffness and restriction of mobility. Characteristic gradual progression of symptoms, however, the rate of development of the disease can be different. Diagnosis is made on the basis of anamnesis, clinical examination and radiographic findings. Treatment of arthrosis is usually conservative: exercise therapy, anti-inflammatory drugs, physiotherapy, blockade, etc. When the joint surfaces are destroyed, endoprosthetics are performed.
Osteoarthritis is a chronic disease in which joint degenerative-dystrophic changes develop in the joint due to metabolic disturbances. At the root of the disease is the damage to the articular cartilage, however, the pathological process with arthrosis captures not only cartilage, but also neighboring anatomical formations: capsule, ligaments, synovial membrane, cartilage under the cartilage and periarticular muscles.
Prevalence of arthrosis
Arthrosis is the most common joint disease. According to the American physicians, in the United States this disease is observed in about 7% of the population. Russian specialists sound almost the same numbers - according to data of large-scale studies of arthrosis, 6.43% of Russians suffer. Men and women suffer from arthrosis equally often, but among young patients there is a slight predominance of men, and among the elderly, women. An exception to the general picture is arthrosis of interphalangeal joints, which develops in women 10 times more often than in men.
With age, the incidence increases dramatically. So, according to the research of American doctors, arthrosis is detected in 2% of people under 45, in 30% of people from 45 to 64 years and in 65-85% in people aged 65 years and over. The first place in the prevalence is occupied by arthrosis of small joints of the hand, the first metatarsophalangeal joint, the lumbar and cervical spine, as well as the hip and knee joints. However, due to their negative impact on the standard of living and the patients' ability to work, the greatest clinical importance is arthrosis of the knee, hip, shoulder and ankle joints.
Causes and risk factors for the development of arthrosisIn a number of cases, the disease occurs for no apparent reason, such arthrosis is called idiopathic or primary. There is also a secondary arthrosis - developed as a result of some pathological process. The most common causes of secondary arthrosis:
- Injuries( fractures, meniscus lesions, ligament ruptures, dislocations, etc.).
- Dysplasia( congenital disorders of joint development).
- Metabolic disorders.
- Autoimmune diseases( rheumatoid arthritis, systemic lupus erythematosus).
- Nonspecific inflammation( acute purulent arthritis).
- Specific inflammation( tuberculosis, tick-borne encephalitis, gonorrhea, syphilis).
- Some endocrine diseases.
- Degenerative-dystrophic processes( Perthes disease, dissecting osteochondritis).
- Diseases and conditions in which there is increased mobility of the joints and weakness of the ligamentous apparatus.
- Hemophilia( arthrosis develops as a result of frequent hemarthrosis).
- Elderly age.
- Excess weight( due to increased load the joint is constantly overloaded, joint surfaces prematurely "wear out").Excessive strain on joints or a certain joint. It can be caused by working conditions, incorrect organization of training( especially if there is a history of joint injuries), certain diseases, as well as the consequences of diseases and injuries( for example, lameness, which increases the load on the healthy leg, and when using the cane - andhand).
- Operative interventions on the joint, especially high-traumatic operations with the removal of a large number of tissues, resulting in the articular surfaces become incongruent, and the load on them increases.
- Hereditary predisposition( presence of arthrosis in immediate relatives).
- Disorder of endocrine balance in postmenopause in women. Micronutrient Deficiency.
- Neurodystrophic disorders in the cervical or lumbar spine( humerus arteriosclerosis, lumbosacral muscle syndrome).
- Exposure to toxic substances.
- Unfavorable ecological situation.
- Repetitive microtrauma of the joint.
Mechanism of arthrosis development
Osteoarthritis is a polyethiologic disease, which is based on the violation of normal formation and restoration of cells of cartilaginous tissue, regardless of specific causes.
Normally the articular cartilage is smooth, elastic. This allows the articular surfaces to move freely relative to each other, provides the necessary cushioning and, thereby, reduces the load on adjacent structures( bones, ligaments, muscles and capsule).With arthrosis, the cartilage becomes rough, the articular surfaces begin to "cling" to each other during movements. The cartilage becomes more and more fractured. It separates small pieces that fall into the joint cavity and move freely in the joint fluid, traumatizing the synovial membrane. In the surface zones of the cartilage there are small foci of calcification. In the deep layers there are sites of ossification. In the central zone, cysts are formed, communicating with the joint cavity, around which, due to the pressure of the intra-articular fluid, ossification zones also form.
Because of the constant traumatization, the capsule and synovial membrane of the joint with arthrosis thicken. On the synovial membrane there are villi, in the capsule formed foci of fibrous degeneration. Over time, due to the thinning and disruption of the normal shape and function of the cartilage, the adjacent bone surfaces are deformed, and bone protrusions appear at their edges. Because of the increased load in the ligaments and muscles, there are foci of fibrous degeneration. The probability of damage to the musculoskeletal system( stretching, tears, tears) increases, sometimes the joint "leaves" in a state of subluxation. With a significant destruction of the cartilage, the movement is sharply limited, possibly the formation of ankylosis.
Stages of arthrosis
There are three stages of arthrosis:
- The first stage of arthrosis - marked morphological changes are absent, only the composition of the synovial fluid is disturbed. The fluid worse supplies cartilage tissue with nutrients, cartilage resistance to normal loads decreases. Because of the overload of articular surfaces, inflammation occurs, pains appear.
- The second stage of arthrosis - articular cartilage begins to collapse, there are marginal bony expansions along the edges of the joint site. Pains become permanent, habitual, inflammatory process that calms down, then becomes aggravated. There is a slight or moderate disruption of the function of the periarticular muscles.
- The third stage of arthrosis - articular cartilage is thinned, there are extensive foci of destruction. There is a significant deformation of the articular area with a change in the axis of the limb. Because of the disruption of the normal relationship between the anatomical structures of the joint and the extensive pathological changes in the connective tissue, the ligaments become inadequate and shorten, resulting in the development of pathological mobility of the joint in conjunction with the restriction of the natural volume of movements. There are contractures and subluxations. Periarticular muscles are stretched or shortened, the ability to contract is weakened. The nutrition of the joint and surrounding tissues is disturbed.
Pain in arthrosis
Pain is the most common symptom of arthrosis. The most striking signs of pain in arthrosis are the connection with exercise and weather, night pain, starting pain and sudden sharp pains in combination with joint blockade. A certain rhythm of pain in arthrosis is directly related to the load on the joint. With prolonged exercise( walking, running, standing), the pain intensifies, and at rest subsides. This is due to a decrease in the ability of the cartilage to provide shock absorption during movements. The cause of night pain with arthrosis is venous congestion, as well as increased intraosseous blood pressure. The pains also increase under the influence of unfavorable weather factors: high humidity, low temperature and high atmospheric pressure.
The most characteristic sign of arthrosis is the starting pain - the pain that occurs during the first movements after a state of rest and passing while maintaining the motor activity. The cause of starting pain in arthrosis becomes detritus - a film of components of the destroyed cartilaginous tissue, which settles on articular surfaces. As a result of movements, detritus moves from the cartilage to the twists of the articular bags, so the pain disappears. Blockades are sudden sharp pains and the inability to perform movements in the joint. Their cause is the infringement of the articular mouse - a piece of cartilage or bone, lying freely in the joint cavity. In addition to these types of pain, with the development of reactive synovitis in patients with arthrosis, there may be other pain - a constant, noisy, bursting, independent of movements.
Symptoms of arthrosis
Arthrosis develops gradually, gradually. At the beginning, patients are concerned about weak, short-term pains without clear localization, which increase with physical activity. In some cases, the first symptom becomes a crunch when moving. Many patients with arthrosis note the feeling of discomfort in the joint and transient stiffness at the first movements after a period of rest. In the future, the clinical picture is supplemented by night pains and pains "on the weather."Over time, the pain becomes more pronounced, there is a noticeable limitation of movement. Because of the increased load, the joint from the opposite side begins to hurt.
Periods of exacerbations alternate with remissions. Exacerbations of arthrosis often occur against a background of increased stress, with exacerbations develop synovitis. Because of pain, limb muscles reflex spasm, muscle contractures can be formed. The crunch in the joint becomes more and more permanent. At rest there are muscle cramps and unpleasant sensations in the muscles and joint. Due to the increasing deformation of the joint and severe pain syndrome, lameness occurs. In the late stages of arthrosis deformation becomes even more pronounced, the joint is bent, movements in it are significantly limited or absent. The support is difficult, when moving to a patient with arthrosis, one must use a cane or crutches.
At visual examination of the patient with arthrosis in the early stages of visual changes are not detected. Joint of normal shape, slight edema is possible. When palpation is determined by inconspicuous or moderate soreness. Movement is almost in full. Later, the deformation becomes more and more noticeable, palpation reveals pronounced soreness, and the patient, as a rule, clearly marks the most painful points. At the edge of the joint slit, thickening is defined. Movement is limited, instability in the joint is detected. The curvature of the limb axis can be detected. With the development of reactive synovitis, the joint is enlarged in volume, has a spherical appearance, palpation is determined by fluctuation.
Diagnosis of arthrosis
Diagnosis is made on the basis of characteristic clinical signs and radiographic pattern of arthrosis. Shoots of the patient joint( usually in two projections) are performed: with gonarthrosis - the radiography of the knee joint, coxarthrosis - radiography of the hip joint, etc. The radiographic picture of arthrosis consists of signs of dystrophic changes in the articular cartilage and adjacent bone. The joint gap is narrowed, the bony area is deformed and flattened, cyst formations, subchondral osteosclerosis and osteophytes are revealed. In some cases, arthrosis shows signs of joint instability: curvature of the limb axis, subluxation.
The brightness of clinical manifestations of arthrosis does not always correlate with the severity of the radiographic signs of the disease. However, certain regularities still exist. Thus, osteophytes arise in the early stages of the disease and are usually the first roentgenologic sign of arthrosis. Initially, the edges of the articular surfaces are sharpened, as the disease progresses, they thicken more and more, eventually forming bone spines and outgrowths. The narrowing of the joint gap appears later. In this case, due to the instability of the joint, the gap can take the form of a wedge. Approximately at the same time, osteosclerosis develops in the subchondral bone zone, and cysts form in the bone tissue adjacent to the joint.
In view of radiologic signs, specialists in orthopedics and traumatology distinguish the following stages of arthrosis( classification of Kellgren-Lawrence):
- 1 stage ( doubtful arthrosis) - suspicion of narrowing of the joint space, osteophytes absent or present in small quantities.
- Stage 2 ( mild arthrosis) is a suspected narrowing of the joint space, osteophytes are clearly defined.
- Stage 3 ( moderate arthrosis) - an obvious narrowing of the joint gap, there are clearly defined osteophytes, bone deformations are possible.
- Stage 4 ( severe arthrosis) - marked narrowing of the joint gap, large osteophytes, pronounced bone deformities and osteosclerosis.
Sometimes X-rays are not enough to accurately assess the joint condition. To study bone structures perform CT of the joint, to assess the state of soft tissue - MRI of the joint. If there is a suspicion of having a chronic disease that caused secondary arthrosis, the orthopedist prescribes consultations of the appropriate specialists: endocrinologist, hematologist, gynecologist, etc. If necessary, a differential diagnosis of arthrosis with rheumatoid diseases is sent to a rheumatologist for consultation.
Treatment of arthrosis
The main goal of treating patients with arthrosis is to prevent further destruction of the cartilage and preserve the function of the joint. Therapy is long, complex, includes both local and general activities. One of the most important tasks for arthrosis is the optimization of the load on the joint. It is necessary to exclude long walking, repeated stereotyped movements, long stay on legs, long stay in a fixed position and carrying heavy loads. A huge role in minimizing the load on the joint surfaces is the decrease in body weight for obesity.
During the remission of the patient, arthrosis is directed to therapeutic physical training. The complex of exercises depends on the stage of arthrosis. In the initial stages, swimming and cycling are allowed, with arthrosis expressed, a specially designed set of exercises should be performed in the supine or sitting position. In the period of exacerbation of arthrosis, a semi-post regimen is prescribed. In the later stages walking with crutches or walking stick is recommended.
Medication in the phase of exacerbation of arthrosis includes the appointment of non-steroidal anti-inflammatory drugs( voltaren, diclofenac, orthophen), sometimes in combination with sedatives and muscle relaxants. The dose of NSAIDs is selected individually, taking into account contraindications. Along with drugs for oral administration, intramuscular injections and rectal suppositories are prescribed. In the phase of remission of arthrosis, NSAIDs are not recommended because of their negative effects on the gastrointestinal tract and cartilage metabolism. In reactive synovitis, joint punctures are performed followed by the administration of glucocorticosteroids( diprospan, Kenalog, hydrocortisone).At the same time, the number of SCS injections should not exceed 4 times a year.
Long-term agents for arthrosis include chondroprotectors( Structum, glucosamine sulfate, Ostenil, Synvisc), which are injected into the joint cavity according to a certain scheme. For topical use, warming and anti-inflammatory ointments are used. For relief of pain syndrome, reduce inflammation, improve microcirculation and eliminate muscle spasms, the patient with arthrosis is directed to physiotherapy. In the acute phase, laser therapy, magnetic fields and ultraviolet irradiation are prescribed, in the phase of remission, electrophoresis with dimexide, trimecaine or novocaine, phonophoresis with hydrocortisone, inductothermy, thermal procedures( ozocerite, paraffin), sulfide, radon and sea baths. Electro-stimulation is performed to strengthen the muscles. In the phase of remission with arthrosis, a gentle massage can also be prescribed.
When articular surfaces are destroyed with pronounced impaired joint function, endoprosthetics are performed. In some cases, palliative operations are performed to relieve the joint: with coxarthrosis, osteotomy and fenestration of the broad fascia of the thigh; in case of gonarthrosis, arthrotomy with the removal of nonviable areas of the joint surfaces in combination with osteotomy and correction of the shank axis.
Description of degrees of arthrosis( 1,2,3 and 4 degrees)
Arthrosis, as a rule, is divided by physicians into four separate stages. Since this disease affects quite a lot of people, determining the degree of arthrosis is a fairly simple task provided knowledge of the relevant symptoms.
The first stage is accompanied by a violation of metabolic processes in the body, the second occurs due to injuries and nonspecific infectious diseases, and in the third and fourth stages, changes and disorders in the joints are observed.Usually, the cause of arthrosis is mechanical or functional overload of joints, reduction in their recovery function due to injuries, arthritis, disruption of the endocrine system, metabolism in the cartilage tissues.
A prerequisite for the onset of this disease is a disruption in the functioning of the cartilage, resulting in a decrease in its elasticity, it becomes thinner, and the surface of the cartilaginous tissue becomes rough. As a consequence, the processes of slipping of bones are violated, a person becomes vulnerable to injury, osteophytes develop. During the progression of arthrosis, synovial joints of the joints, tissues, ligaments, muscles and tendons located in proximity to the affected area are also damaged.
In most cases, arthrosis progresses in one joint, but sometimes there are situations where several joints are affected simultaneously.
Common causes of this disease are trauma, low mobility, hypothermia, inflammatory processes in the joints, high physical stress, lack of minerals in the human body, excess of its own weight, heredity, and also flat feet.
The site has a detailed article on arthrosis of the knee joint. Read also here an article on arthrosis of the toes.
On the first degree of arthrosis, the joints of a person do not lose their mobility, but only in one direction. Determine how serious the disease with an X-ray is virtually impossible, since it does not reflect any joint disorders at the initial stage. You can detect the disease by seeing uneven or hardened surfaces of that part of the body where the joints are located.
The onset of development of arthrosis is not accompanied by an increase in body temperature, the appearance of swelling in the affected areas, a change in the color of the skin in the region of the joints. The patient can only feel a barely audible crunch, tingling or aching pain in the affected joint. Most people do not attach much importance to these symptoms, since they do not bring any significant trouble. However, it is recommended that you carefully monitor the condition of your joints, take appropriate measures in time.
At the first stages of osteoarthritis, lotion from horseradish broth, use of special ointments with wax, propolis or horseradish can help. It is strictly forbidden to drink alcohol. It is recommended to balance the food and do daily exercises. Gentle diet is a very effective method for the treatment of arthrosis in the first stage, because it helps to reduce weight and, as a consequence, reduce the mechanical stress on the joints. The patient needs to eat a maximum of natural products with a high content of vitamins, to diversify their diet. It is advisable to limit yourself to prolonged walking or other prolonged physical exertion. At the first stage, surgical treatment of arthrosis is not prescribed.to content ^
If the time is not taken to deal with the treatment of arthrosis, then after a while it can go to the second degree. In this case, you can not do without the help of a doctor. It is not difficult to determine the development of arthrosis of the second degree, since violations in the joints are already becoming obvious, despite the fact that this is only a warning before going on to the next stages. In the second stage, the symptoms of the disease are more pronounced. There is a constant slight fatigue, a feeling of pressure in the affected joints, especially after strong physical exertion. In the joints, acute pain is felt even with the smallest movements, which is accompanied by an audible crunch. To bend or to unbend a limb with each passing day becomes more difficult.The second degree of arthrosis carries a danger, as the joints are already beginning to partially deform. If the appropriate treatment measures are not taken in a timely manner, the progression of the disease will be very difficult to stop.
Treatment of arthrosis of the second degree already carries certain difficulties. The use of traditional medicine does not have a positive effect, therefore, it is necessary to treat arthrosis only in traditional ways. Doctors prescribe the use of chondroprotectors, medical drugs that expand the vessels, physiotherapy and gymnastics. In addition, sometimes patients are prescribed anti-inflammatory drugs, anesthetics and pain medications. It is forbidden to walk or stand for a long time in one place, to subject the joints to prolonged and strong physical exertion, to lift heavy objects.to content ^
The third degree of arthrosis is a very painful stage of the development of this disease. Patients feel a sharp pain in the joints, even being in complete rest, not to mention the movement. The sensitivity of affected areas varies with the change in weather conditions. Sometimes joints are completely denied, and a person becomes incompetent.
Treatment of the third degree of arthrosis must necessarily be complex. The patient, in addition to receiving prescribed medicines, must attend various special procedures, such as UHF, diadynamic therapy, resonant microwave therapy, electrophoresis, laser therapy, magnetotherapy, and electrosleep.to content ^
Fourth degree of
The fourth degree of arthrosis is accompanied by unbearable pain in the joints, which can not quench even strong analgesics and intensive physiotherapy. In this case, the only solution is to replace the affected joint with an endoprosthesis by surgical intervention. At the moment this method is the most effective and progressive, so endoprosthetics is becoming an increasingly popular method for treating arthrosis of the fourth degree. The prosthesis significantly improves the mobility of the joint, allows the patient to resume active life.
In the process of endoprosthetics, the damaged parts of the joint are removed, and in their place plastic or metal parts of similar shape are placed. In most cases, the joint changes completely, partial replacement is very rare. As a rule, the endoprosthesis is put to the elderly, as young people with their active and mobile way of life wear out the artificial joint quickly enough( for 20 years).The operation itself to replace the joint takes 1-3 hours. It is performed under spinal or general anesthesia.
All doctors have a common opinion that it is better to cure arthrosis in the early stages of development in time than to resort to immediate surgical intervention.it is not only a waste of money, but also a torment for many days. Therefore, delay treatment of arthrosis in any case impossible.
- Arthrosis of the foot Arthrosis of the foot( deforming osteoarthritis) is a chronic disease characterized by degenerative-dystrophic disorders in the cartilaginous tissues. Cartilage destruction and inflammatory processes in the soft tissues of the foot are caused by impaired metabolism
- Arthrosis of the toes Arthrosis of the toes is a degenerative joint disease that manifests itself in the inflammation of the soft tissues around the joint and the immediate destruction of the cartilage. The reason for such changes is for sure
- Arthrosis of the joints of the fingers of hands Quite often people experience pain in the hands, namely in the joints of the fingers. In most cases, this is due to the development of arthrosis.then the disease leads to a limitation of
- Arthrosis of the shoulder joint. Shoulder arthrosis is a chronic pathology in which the articular cartilage and the adjacent bone tissue degrade, wear out and collapse. If you carelessly treat this
- : 10.04.2015
I do not know, we can say that I have a first degree, but the doctor said that there is a suspicion of arthrosis. I, very much became frightened and that God forbid, did not go further this disease began to be engaged in itself. First, she went on a diet, began to walk every evening, and in any weather and no indulgence. Plute began to take the drug Don, he for such a disease is simply an unskillful thing. Now there are pills, but the doctor said there are injections. And it's very good that the bones with sea salt do not hurt. That's what I managed to learn and try for a while, while I'm treating my arthrosis. Do you have any methods to combat it?
First degree of arthrosis
What is the first degree picture is not difficult to imagine, but it will be problematic to recognize. Mobility in the joints of a person is not disturbed, pain or slight stiffness may appear, but this can easily be attributed, as we usually do, to weather change, an uncomfortable position during sleep, and a bunch of other excuses. Even if you undergo a medical examination using an X-ray, the disease will not immediately reveal. Only experienced doctors, with palpation and full inspection, will be able to see small changes in the form of an uneven surface in the place of the affected joint.
The erroneous opinion that the formation of arthrosis is accompanied by some common signs of in the form of fever, swelling, redness, etc. Arthrosis of 1 degree is determined only by the appearance of a crunch in the joint, but there may be slight tingling in the affected area or aching pain. All these minor changes do not cause the person to react properly, because this is the first signal that you need to take any action, see a doctor, drink a course of vitamins for cartilage, and carry out prevention.
Often people who watch their health, at the first sign of turning to folk medicine and this is the right decision, in the first stages of the disease is given to non-traditional treatment. You can make various lotions, apply burdock leaves, cabbage, apply certain ointments, resort to massage procedures, drink herbal preparations and you must definitely give up alcohol. To these processes it is necessary to add therapeutic gymnastics and the condition will noticeably improve.
Second degree of arthrosis
If the first signs were not accepted treatment, the disease passes into the second phase. Arthrosis of the 2nd degree already has pathological changes, cartilage begins to deteriorate, especially under heavy loads. During this period, traditional medicine is powerless, it can be a good addition to the treatment that the doctor will prescribe. At the second stage the disease manifests itself clearly, there are noticeable symptoms. After short actions, walks at the person weariness is observed, joints any more nojut, in them the acute pain and there are already enough loud crunches. Motions are shackled, it is already impossible to conduct any actions.
Non-treatment leads to deformation of the joints, to abrasion of the cartilaginous tissue. At this stage, doctors prescribe medications that contain special proteins that help restore the cartilaginous structure, physiotherapy procedures and compulsory physical education. All prescriptions of physicians should be carried out unconditionally, regularly and even if a person's condition improves, one should not forget about prevention and repeat all the procedures that have been passed at least once a year.
The third degree of
It also happens that after obvious changes that occur in a person, he still does not take any measures, launching a mechanism working against him. From the second degree to the third is not so much time, so negligent attitude to their health will soon lead to serious consequences. In the joint there is a strong pain, regardless of whether it is in peace or not, it can intensify together with the change of weather and other phenomena. In some situations, the joints are completely immobilized, preventing the person from doing anything at all.
Arthrosis of the 3rd degree requires complex treatment, it usually includes taking medications, physiotherapy, massage, manual therapy, exercises. Sometimes the third degree is divided into the fourth, when in the joint there is a strong, unbearable soreness, and therapeutic procedures even in complex do not help. There remains only one option - to carry out the operation, replacing the patient joint with a prosthesis. To avoid such problems, you need to be more careful about health, and if you find even the most innocuous symptoms, it is best to seek help from specialists. Osteoarthritis is an insidious disease, no matter what the degree of arthrosis, they do not tolerate delay in treatment.