Spine arthrosis: types, symptoms and treatment
Our spine contains more than thirty vertebrae connected by facet joints. And this means that he, like any bone joint, is prone to joint diseases. Not passed him and such an attack as arthrosis of the spine .
The word "arthrosis" is consonant with the name of one more vertebral pathology - osteochondrosis .Such harmony is not without reason - the nature of both diseases is the same, with only one difference:
- Osteochondrosis destroys the cartilaginous tissue of the intervertebral disc
- Arthrosis - cartilage of the joints
Arthrosis of the spine( spondylarthrosis) is a degenerative degenerative process that results in cartilage articular tissue and is destroyed
Symptoms and Treatmentarthrosis of the spine
Arthrosis of the spine( spondylarthrosis) is a degenerative degenerative process, as a result of which the cartilaginous articular tissue undergoes an alterationeniya and destroyed
This disease is also another most severe form, in which not only destroys the cartilage, but also all the joint tissue -
- subchondral bone
- synovial membrane
- periarticular muscles
In osteoarthritis not only hiasche tissue is affected, but also the entire joint
. The nature of arthrosis is multilayered. Its causes are sometimes hidden deeply, and even may not be elucidated. Then it is called idiopathic .
This is considered an age-related disease that occurs after 60 years, but the disease can develop as a result of very many reasons.
Cause of arthrosis of the spine
- Most often it is traumatic joint damage .Trauma is the perfect soil for development after spinal arthrosis, as it is often complicated by inflammation, suppuration and internal metabolic disorders
- Congenital joint dysplasia leading to its incorrect biomechanics is the second most frequent cause of
- Inflammations of autoimmune character :
- rheumatoid arthritis
- ankylosing spondylitis ( second name: Bechterew's disease )
- Purulent and specific infections of ( staphylococcus aureus, miteGenetic factors :
The most important is the mutation ( collagen ), which provides elastic properties and durability of the cartilage and bone tissue.
Thus, arthrosis can be inherited
- Endocrine diseases( eg, estrogen deficiency during menopause in women)
- Disrupted internal metabolism
- Deficiency of important trace elements
Promotes the development of arthrosis of the spine, although not directly due to its causes, such factors :
- Too much weight( fat people almost always have joints)
- Constant hypothermia
- Living or working in an environment with poor ecology( availability of chemicaltoxic toxic substances, harmful fumes, gases, etc.)
- Operations performed on joints
- Low degree of physical activity
Stages of spinal arthrosis
Like osteochondrosis, which often develops in parallel( because the causes are the same)arthrosis passes several stages.
- The first is hardly visible:
Cartilaginous tissue thinned, softens and acquires a fibrous form
- The second stage leads the
- to cartilage damage and increased load on the articular area, resulting in the growth of osteophytes on its edges to the appearance of joint pain
- to the violation of muscular functions
- The third stage is already arthrosis in severe form:
- The joint base of the joint deforms so much that it leads to a change in the axis of the vertebra
- Joint ligamentsbut shorten, which leads to contractures of - severe limitation of motor capacity
- Muscular muscular disturbances arise:
Muscles shorten or stretch and lose ability to contract
The disease ends with the complete immobility of the joint .
Types of arthrosis
Arthrosis of the spine, depending on its location is divided into:
- Cervical( if the cervical region is affected)
- Dorsal( thoracic)
Common symptoms of arthrosis
- The first symptom of the disease is back pain, which first appearsas a result of great physical exertion. At rest, pain usually subsides
- . Then, when the disease progresses, rest does not help. Moreover, it starts to ache even at night
- There are such mechanical symptoms that indicate this pathology:
- morning stiffness
- pain intensification at the beginning of movement, attempts to change the position of
There are special test tables that allow to determine the severity of the disease by symptoms:
- Does it hurt at night
- How long does the morning stiffness last?
- How long does the pain persist when the position changes, etc.
Clinical symptoms when viewed
- presence thickenedand soreness at the edges of the joint slots
- joint swelling
- limited and painful movements
Arthrosis symptoms in different parts of the spine
The most common lesion is the cervical section, which often occurs because of the
- of prolonged sitting work, resulting in a very weak muscle strain
- physical activity
- unjustified physical exertion
The first symptoms of cervical arthrosis:
- The appearance of pain in the nape and neck:
- on awakening
- when trying toreturn or tilt the head
- Gradually the pains become chronic, aching
- All head movements are difficult with
- A serious complication can occur - unco-vertebral arthrosis , in which:
pains are very sharp, limiting not only the movement of the neck but also the hands of
- Serious neurologicaldisorders
Lumbar arthrosis is recognized by the following symptoms:
- Pain in the lumbar region that arise
- after physical labor
- when tiltedand the corners of the body
- in the morning when trying to get out of bed
After a while the pain passes
- As the disease deepens, the pain attacks increase, the night attacks begin
- There appears limited movement in the lumbosacral joint and hip joint
- Tension in the buttock muscles,pain, paresthesia phenomena and muscle weakness in the extremities
Diagnosis of the disease radiographically.
- pathological thickens in the joints
- narrowing of the gap between them
Treatment of arthrosis of the spine
Treatment for arthrosis is similar in many respects to the treatment of osteochondrosis: it is long and divided into several stages
Treatment of arthrosis begins with the elimination of pain that can be carried outdifferent conservative methods, and ends with sanatorium treatment
- Initially, in an acute period pain relief with non-steroidal remedies
- is introduced. The restriction regime onruzok
joint immobility for - death. There is a fast contracture, which is then very difficult to handle .
Therefore, the resting mode should be as short as possible, which does not fit with the instinctive desire of the patient to protect the joint from any loads.
- Treatment is prescribed by chondroprotectors, which are taken either inside or in the form of intraarticular injections.
Joints can also be injected into the joint when anesthetizing
- is administered. Such kinds of conservative treatment are applied:
- In the early stages of the disease, laser therapy
- is used for the treatment of pain and inflammation in arthrosis. In later cases joint decompression and bone blockage
- The method of radiofrequency anesthesia is very effective
- For muscular disorders, is used as a multichannel electrostimulation
- As a surgical treatment, is an endoprosthesis replacement of the patient's jointand spine
- Types of physical therapy:
- Ultrasound therapy
- Pulse magnetic
- diathermy Cryotherapy
- In order to slow down arthrosis and improve mobility during the recovery period, the following:
- exercise therapy
- water exercises
- gymnastics Qigong( Tai Chi)
- At the final stage of the recovery period, sanatorium treatment of the joints of the spine
is recommended. Health to you and the best!
Video: Radiofrequency analgesia for arthrosis of the intervertebral joints
Osteoarthritis - what are the types of this disease?
Osteoarthrosis, or deforming arthrosis - a pathology based on degenerative-dystrophic joint changes, which can be attributed to the damage to the cartilaginous tissue of the joint surface.
This disease is divided into two fairly large groups - primary and secondary. If during the examination the cause of the pathology was not established, it is customary to talk about primary arthrosis.
Secondary types of arthrosis have their own cause, to establish which does not constitute any difficulties. Most often, such a disease develops after traumatic joint damage, in the presence of endocrine diseases, in metabolic disorders. Also, secondary arthrosis can occur with rheumatoid arthritis, systemic lupus erythematosus or tuberculosis.
Secondary arthrosis of the knee, or gonarthrosis is a commonly diagnosed pathology, which is especially common in women after 45 years of age. In a risk group, you can include people with excessive body weight and suffered knee injuries. Gonarthrosis is diagnosed immediately on both legs, although the signs of the disease on them can be expressed in different ways - somewhere weaker, and somewhere on the contrary, very much.
The disease lasts for many years and can be expressed only in periodically arising painful sensations. But gradually the pathology passes into the second and the third stage, where the deformation of the knee occurs, and the pain sensations become literally intolerable. Joints in this case cease to perform their functions - knees do not bend, which greatly affects the ability to move.
Among all types of arthrosis, the most severe is the one that affects the thigh and is called such a pathology of coxarthrosis. The disease also occurs in three stages, at the very beginning the patients complain of periodic pain, which most often occurs after a load on the joint. After a short rest, it completely disappears.
In the second stage, the pains become intense and can appear not only when walking, but also at rest at night. With considerable strain, a person begins to limp. There is some restriction in the movement of the foot. On a radiographic study, it can be seen that the femoral head has already begun to deform.
Gradually coxarthrosis passes into the third stage. Here the pains become permanent, the patient can move with great difficulty, only with the help of a cane or crutches, the muscles begin to noticeably atrophy, the shortened limb shortens. Because of the change in the center of gravity of the body, the load on the affected joint sharply increases, which allows the disease to progress rapidly.
Uncovertereal form is a kind of arthrosis of the spine, in which joints of the same name are located between the cervical vertebrae. Normally, they should not be, so their appearance is an occasion to consult a doctor.
Among the symptoms, it is especially worth highlighting pain, vertebral artery syndrome and radicular syndrome. Pain occurs even with minimal head movement and is accompanied always by a crunch.
Manifestations of radicular syndrome depend on the level of lesion of the nerve roots. This can be numbness of hands, muscle weakness, pain in the neck, lumbago in the collarbone and shoulder blade and much more. When fusion of the artery that passes through the spine, develop symptoms of cerebral circulation disorders, which are expressed in headache, high blood pressure, hearing impairment.
Along with different types of arthrosis of the knee joint, there is primary and secondary arthrosis of the shoulder. As in all other cases, the disease begins with aching pain, which can worsen at night. The volume of movements in the first stage is not limited yet. To recognize the pathology in this case helps X-ray study.
Expressions begin in the second stage. The pain becomes very strong and constant, when you move your hand you can hear a crunch, the volume of movements is limited, there is an initial atrophy of muscles.
The third stage is not developed by everyone, as the disease can slow down its development as a result of timely treatment. However, those who continue to load the joint, risk being among those who will not bypass the third stage.
As for the treatment, non-steroidal anti-inflammatory drugs, pain relievers, and drugs that slow down the destruction of the cartilaginous tissue should be used. But the question of what kinds of calcium to drink from arthrosis can be said that calcium can be used only as an additional element in treatment, since the pathological process covers precisely the cartilaginous tissue, and not the bone.
Osteoarthritis symptoms, treatment, description
Joint disease that occurs as a result of degenerative processes in the cartilaginous tissue is called arthrosis. Osteoarthritis proceeds in the presence of severe pain and with progression of decreased mobility of the joint.
In case of arthrosis, bone tissue also becomes damaged, so this disease is often called osteoarthrosis. Untimely treatment can lead to disability.
Osteoarthritis is chronic, begins imperceptibly with rare not severe pains in the area of affected joints. As the degenerative processes develop in them, the pain intensifies. Especially acute they are felt in motion.
Development of arthrosis
Arthrosis is more likely to be affected by older people,with the years there is a decrease in activity and other violations of metabolic processes, endocrine disorders develop. As a result, the production of specific components in the cartilaginous tissue of the joints is reduced. There are changes in the interarticular cartilage, bones and soft tissues - the elasticity and the ability to amortize are lost.
Classification of arthrosis
There are several classifications of arthrosis, but its main indicators are causation and degree of joint damage.
Depending on the cause of the disease, primary and secondary arthrosis is isolated.
Primary arthrosis begins its destructive activity in the joints for no apparent reason, gradually hitting many joints. The exact causes of this type of arthrosis have not been revealed to date. It is assumed that one of the factors that provoke the disease is a genetic predisposition. Most often, the primary form of arthrosis manifests itself in the defeat of the joints with the muscular arm, which is determined in pronounced nodular deformations of phalanges. This form of arthrosis is characteristic for people older than 40 years of age.
Secondary form of arthrosis affects the joints regardless of the age of the person. The causes of its occurrence may be permanent increased stress on the joints, damage to the already aching joint with additional injuries of various types. In addition, the causes of arthrosis secondary form may be violations of endocrine and metabolic processes, various necrosis, inflammatory diseases, rheumatoid arthritis.
High loads, which lead to the development of arthrosis, are observed in obese people, runners, players, ballerinas, etc. Secondary arthrosis affects one or more joints of the spine and / or extremities.
The edges between primary and secondary arthrosis are very thin.
There are three degrees of progression of arthrosis, determined by the severity of the pathological process. There is also the fourth steppe, when there is a strong deformation of the affected joint, which can cause its complete immobility and development of disability.
In addition, there are classifications of arthrosis in place, form and kind of localization of the destructive process in the cartilaginous tissue.
Symptoms of arthrosis are pain, sometimes crunching in joints during movement, swelling, reaction to changing weather conditions. The pain appears not only in the joints, but also in the surrounding soft tissues.
Causes of deforming arthrosis
Deforming arthrosis, it is also osteoarthritis, the most common joint disease. With deforming arthrosis, there is a change in the metabolism and structure of the articular cartilage. There is a deformation, with changes in bone tissue. The elbow, knee and hip joints are most often affected by this disease.
The causes of deforming arthrosis are the same as secondary arthrosis - excess weight, increased stress, trauma. In addition, this type of arthrosis can occur against the background of varicose veins, weakness of muscles and ligaments in the joint area.
Primary cartilage damage, in conjunction with the inflammatory process, is also the cause of deforming arthrosis.
The disease occurs with severe pain and decreased motor ability.
Osteoarthritis of small joints of the hands
This type of disease is most typical for women. Many people do not pay attention to light tingling and burning in the fingers, but in vain. These tingling sensations are the first symptoms of arthrosis of small joints in the hands. In consequence, as the disease develops, the sensations disappear, but there is a persistent complication in the form of dense nodules on the joints of the fingers and a distorted phalanx. Often with arthrosis of small joints of the hands , the phalanges of the fingers become similar to the spindle. This complication is called a reactive synovitis.
This type of arthrosis is more typical for the primary form of the disease.
Treatment of arthrosis
Treatment of arthrosis is multifaceted and has a long character. The main principles of treatment of the disease include such measures as the restriction of the load, therapeutic exercise, medicinal relief of pain and inflammation.
Antibiotics for arthrosis are usually not used, except when it is necessary to remove the inflammatory process caused by infection of the body itself or the joint. Antibiotics for arthrosis are used, for example, in cases of disease as a consequence of rheumatoid arthritis.
Recently, in the treatment of arthrosis, chondroprotectors are widely used, allowing not only to suspend the process, but also to regenerate the joint tissues.
During periods of severe deterioration of the patient due to exacerbation of arthrosis hormonal drugs - hydrocortisone, dipisane, kenal intra-articular administration are used.
Shockwave therapy for arthrosis
In modern medical practice, the method of shock wave therapy for arthrosis has been successfully applied today.
The essence of the method is to use an acoustic wave of low frequency directed at the affected area. At the same time, there is a decrease in the pain syndrome, a flood of blood to the source of the lesion, and an improvement in overall well-being. There is an improvement in metabolism, removal of calcium deposits, an increase in the strength of tissues.
The procedure is painless and improvements are identified immediately after the first session.
But in the use of arthrosis shock wave therapy, it must be remembered that there are a number of contraindications to its use. This method is not recommended for pregnancy, brittleness of blood vessels, hemophilia, oncological diseases and in the presence of a pacemaker.
Exercises for the treatment of arthrosis
An indispensable condition in the treatment of arthrosis is the use of various types of exercises in order to prevent muscle atrophy and weakening of ligaments.
Exercises for the treatment of arthrosis are selected individually for each patient by the attending physician and a physiotherapist. The exercises are started only after relieving the exacerbation, but not later than 5-6 days after the pain syndrome is removed.
The objective of the exercises for the treatment of arthrosis is to restore joint mobility, aerobic training, increase strength and flexibility of muscles and joints.
Osteoarthritis is a serious disease. To prevent joint deformations, one must carefully take care of them - to eat rationally, engage in dynamic exercises, forget about bad habits and take vitamin and mineral complexes to support joints. With age, limit excessive loads.
In principle, arthrosis can have development on any of the joints of the body.
The onset and further development of joint arthrosis
The onset of arthrosis, as a rule, passes unnoticed for a person, as the pains of an easy nature that arise in the joints are given a minimal value. The beginning of origin can be considered strong infectious diseases or trauma - this is 70% is the beginning of the development of arthritis and arthrosis.
In the development of arthrosis( pathogenesis), three stages are distinguished, which occur sequentially.
- Osteoarthritis in the first stage characterizes the onset of changes in joint function, its lining functions between bone formations decrease, because of this there are weak periodic pains. The destruction of the joint tissue and the onset of deformities are not very pronounced.
- Arthrosis in the second stage is a gradual onset of destruction of the cartilaginous lining and the appearance of deformities. Deformations begin because of the growth of bone tissue, the so-called osteophyte. The pain syndrome becomes stronger and arises periodically due to weather changes and physical exertion. Peak pain occurs at night.
If at this stage there is no competent and systematic treatment, the disease will go to the second stage.
- Arthrosis in the third stage is characterized by very severe pain. Deformations and destruction of cartilaginous tissue have a strong character. The mobility of the joint is limited or disappears completely. There is a strong inflammation and swelling due to improper circulation of lymph.
The third stage does not have an effective therapeutic treatment, only surgical intervention.
It is also worth noting that the symptoms and treatment of arthrosis of the shoulder joint are similar to other joints. We will describe their symptoms below.
Symptoms of arthrosis
Osteoarthritis has its symptoms, based on its classification, but there is also a generalized list:
- is a pain syndrome that intensifies in wet weather and from freezing. The peak of pain is observed at dawn. Pain occurs in a state of rest and with tension;
- joint increases in volume due to deformities and osteophytes;
- the temperature of the skin around the affected joint increases. A general increase in temperature may be observed;
- because of pain changes gait;
- joint begins to swell, swelling and constriction are observed;
- with tension and work of the joint is heard and tangible crunching or creaking from the friction of the bone formations.
Diagnosis of arthrosis
Diagnosis of arthrosis is carried out using the following methods:
- medical examinations and feeling of damaged joints allows to identify and localize pain syndrome;
- X-ray and other methods of visualization of arthrosis allow to diagnose the level of deformation and the degree of destruction of cartilaginous tissue;
- probing of joint tissues, articular tissue extraction for revealing the internal composition of tissues. Thus, the presence of infectious lesions is diagnosed.
Treatment and prevention of
The most important preventive measure to avoid getting arthrosis is a lifestyle in which the proportionality of loads, proper nutrition and rest regime are observed.
Treatment of joints is divided into two groups:
- Reception of therapeutic preparations for the restoration of the joint tissue;
- Surgery and replacement of joints with prostheses
At the first stages of arthrosis, you can do without the use of drugs. The main methods are:
- Balance in nutrition and healthy lifestyle. In order for the disease to not progress, it is necessary to observe the normal mode of work and sleep;
- If arthrosis occurs, it is advisable to start attending courses on how to prevent the disease from developing and how to live with the initial stages of arthrosis;
- It is necessary to significantly reduce the loading of joints, for this it is necessary to monitor the body weight, sports and labor standards;Indications are swimming and walking on skis, as it is necessary to perform recumbent or sessile gymnastic exercises;
- It is very useful to apply heat to the affected area, hot wax applications, laser exposure, HC and electrical stimulation of the nerves;
- Use of various devices for unloading joints, for example, with arthrosis of the knee or ankle, a cane is used;
- Massage perfectly affects the mobility of joints, helps to remove swelling and swelling;
- Treatment in sanatoria and resorts has an excellent effect on the condition of the joints and the whole body. Health resorts should be supervised by specialists.
The intake of various pharmacological agents is the basis in the treatment of arthrosis. All medications prescribed by doctors can be divided into two therapeutic classes:
- Symptoms that affect the main striking factors - pain, inflammation, puffiness, temperature. Such drugs are considered to be glucocorticosteroid hormones. Their use is guaranteed to relieve pain and inflammation in a very short time. They are used for external exposure and are found inside.
- Chondroprotectors - drugs that effectively repair cartilage tissue, such drugs include glucosamine acids, the molecular composition of which is very similar to the composition of cartilage tissue and intraarticular fluid.
Symptomatic drugs are prescribed immediately, as they are used to remove the main symptoms of the initial stages, and chondroprotectors can significantly slow the progress of arthrosis.
As you know, pain is the main symptom of arthrosis at the beginning. In order to remove it, you must first remove the inflammation. For a short anesthetic and anti-inflammatory effect, ointments with anesthetic properties are actively used.
Ointments of nonsteroidal composition actively affect the affected joint, without disturbing the children and related tissues.
Typically, such drugs are used if therapy has not worked for 1-2 weeks, but to combine the two steroid drugs is unacceptable.
Used and means of steroid composition, for example, glucocorticosteroid hormones with internal input protect the tissue from destruction and relieve inflammation, but with prolonged exposure, steroids change the properties of synovitis fluid. Regular and prolonged use of hormones is unacceptable. Control of the doctor for the use of drugs is mandatory.
All medicines of this class positively influence the joint tissue, toning it, but it must be remembered that the effect of the course of taking is somewhat delayed. Positive impact is observed only after 3-5 weeks after the end of the course.
The diet allows you to control the body weight, which is very important for controlling the load on the joints. To the use of foods recommended with a high content of calcium( dairy products), vitamins and healthy fats, which are necessary for the construction of joints.
If the disease develops and the pains become intolerable, the joint is removed surgically. In its place, an implant is installed - an artificial prosthesis or an artificial construction that completely or partially replaces the properties of the lost joint. At present, a wide range of domestic and imported analog prostheses is used in medicine, which have proved themselves well. It must be remembered that the prosthesis is subject to wear and tear, therefore additional operations are performed to replace worn out prostheses.
And finally, we invite you to watch a video on the topic "what is arthrosis and the ways of its treatment".
To this end, the patient is assigned:
Non-steroidal anti-inflammatory drugs( NSAIDs).By suppressing the activity of inflammatory enzymes, such drugs help to remove soreness and swelling of the joints. They can be used either inside( in the form of injections, tablets, capsules), and externally( in the form of ointments, creams, gels and patches).Because of the toxic effect on the gastrointestinal tract, the administration of any NSAID is recommended to be limited to 2-3 weeks.
Restoration of mobility and inhibition of dystrophic changes
Drugs that improve microcirculation and metabolism in tissues. Stimulation of blood flow improves the delivery of nutrients and oxygen to the joint tissues, contributing to the active course of recovery processes in them. For treatment, both intramuscular injections and oral medications are used. The duration of the treatment course is determined individually.
Chondroprotectors. The main task of these drugs is to restore the destroyed cartilaginous tissues and stop the destruction of the joints. Medicinal forms of chondroprotectors are represented by injections, tablets and various external agents( gels, ointments, creams).The effect of the use of protective drugs develops slowly, so the course of treatment is always long - at least 3 months. Although Western medicine does not use hondoprotectors to such an extent, because of their studies, there is no significant effect on their use.
Glucocorticoids. They are used in the form of intraarticular injections with ineffectiveness of other therapies. Hormonal drugs quickly eliminate the symptoms of pain and inflammation, but they themselves have a destructive effect on cartilage, so they are not prescribed more than once a year and only in critical situations.
Nutrition in the treatment of arthrosis of the knee joint
The doctor rheumatologist-arthrologist Evdokimenko about arthrosis of the knee joint( theses from the video):
- recently the number of patients with knees became more than other joints;
- recently appeared atypical manifestations of diseases of the knees;
- is the cause of knee disease in the diet. Absolutely all modern products from the supermarket are filled with preservatives, especially smoked meat and sausages. Preservatives hold water( do not let the products dry up) due to the fact that they contain salts. These salts also accumulate in the knees;
- knee arthosis is treated more easily than arthrosis of the hip joint, just because it is treated with a diet. On the diet with gonarthrosis, you can learn from the video.
Surgical treatment is resorted to if neither medication nor physical therapy brings a noticeable relief to the patient. The following types of interventions are practiced:
Arthroscopy .This is the so-called "small" surgical operation, in which the surgeon conducts all manipulation through micro-punctures in the joint. During the procedure, fragments of cartilage, protein clumps and bony growths from the articular cavity are removed, which provoke inflammation. In the end, the joint is washed abundantly with saline solution. Absolute indications for arthroscopy are: damage to the cartilage, articular membranes, ligaments, tears of the meniscus. At the 3 stages of arthrosis, when most of the joint is already destroyed, this procedure is ineffective.
Periarticular osteotomy of the of the tibia and femur. During the operation, the doctor restores the natural axis of the lower limb, the displacement of which occurs due to deformation of the knee joint. This reduces the load on the affected knee and eliminates pain.
Endoprosthetics .Implies replacement of the damaged joint with an implant. The prosthesis can be complete or partial. The operation is indicated at stage 3 of arthrosis or persistent pain syndrome, which is not removed by drugs. The procedure is carried out under general anesthesia. The rehabilitation period takes an average of 2 months.
disease To reduce the risk of gonarthrosis, doctors advise patients:
- To lead an active lifestyle. For normal operation, the knee joints should receive a sufficient amount of nutrients that are supplied to them with blood. Motor activity can increase the intensity of blood supply.
- Avoid high stress on the joints. Do not lift weights. During physical work, you need to take breaks every 2 hours.
- Keep track of the weight. Excess body weight creates an additional burden on the legs. In the elderly, take food supplements based on chondroprotectors. Such drugs "nourish" cartilaginous tissue.
- Wear comfortable shoes. Every step is pressure on the joints. Comfortable footwear, performing a shock-absorbing function, reduces the load on the cartilage and prevents their premature wear.