What are the drugs used for osteoarthritis?
Osteoarthritis is a chronic disease in which the cartilage of the joint, along with the adjacent bone, undergoes degenerative changes. With this disease, joints become inactive, pain appears. Osteoarthritis affects not only cartilaginous, but also all other tissues of the joint. At the same time, changes in cells gradually lead to a decrease in cartilage, to its softening and breaking down into fibers. There may be a thickening of the cortical layer and the formation of cones and outgrowths. This makes the movements more painful and ultimately can lead to their complete restriction. Currently, there is a huge number of drugs for osteoarthritis, which should be taken only according to the prescribing physician.
Causes of osteoarthritis and its symptoms
This joint disease is primary and secondary. If there is an unidentified reason for the development of osteoarthritis, it is called primary, and for an obvious reason, after which the disease began to develop, it is secondary. There are three main causes of the disease. This is a trauma, inflammation or dysplasia. Among the risk factors are overweight, age, postmenopause, micronutrient deficiency, hypothermia, chemical toxins, joint operations, high physical activity, poor ecology.
There are three stages of the disease. At the first there can be no pronounced symptoms. There are no tissue disorders in the joint. Only the synovium and its biochemical composition change. There is pain and inflammation in joint overload.
In the second stage, the destruction of the cartilage starts, the growths appear on the edge of the articular area. The pain becomes a constant companion during movement, and the joints look enlarged and swollen. There is a muscle disorder in the affected joint.
In the third stage, pronounced external changes in the joint will be observed. There is a change in the limb axis, deformation of the supporting area. Movement becomes limited, muscles reduce their ability to contract and changes the point of attachment of the complex of muscles and tendons. During the treatment of osteoarthritis drugs are used whose action is based on protection, reducing inflammation and pain relief. We need the right rhythm of life and constant tracking of weight, as excess kilograms increase the burden on sick and damaged joints.
Pain and inflammation remedies
These include non-steroidal anti-inflammatory drugs( NSAIDs) and analgesics. They will help reduce the pain syndrome and relieve inflammation, which will ease the patient's condition and make him more mobile. NSAIDs suppress the activity of prostaglandin biosynthesis and reduce cyclooxygenase. This leads to a reduction in inflammation and the appearance of an analgesic effect. Use of these drugs can only be recommended by a doctor, since tablets can lead to serious adverse reactions.
This is especially true for older people who have other diseases, such as diabetes, peptic ulcers, hypertension. It must be remembered that by taking these medicines without the advice of a doctor, you can get an ulcer or poisoning with toxins. After all, with age, the weight of the liver decreases slightly, the rate of renal filtration slows down, the blood flow also becomes slower, and the body weight may increase. This is what leads to more difficult work of the blood cleansing organs, to their accumulation in the body and to poisoning them. For the elderly, this is fraught with very serious consequences.
NSAIDs are not recommended for taking on an ongoing basis. Although they relieve pain, but because of this, patients are more active and do not spare joints at all, which aggravates their situation. Preparations of the last generation are safer, but you should not overdo with them, either. Analgesics of central action will act on the receptors that are in the brain. They are appointed only in the event that from the NSAID already there is no help or with their side effects. Basically, they are appointed at the last stage and sold only on prescription. They can be combined with NSAID preparations.
Prescribe drugs only individually and with all the characteristics of the patient. Therefore, even if two patients have the same symptoms and stages of the disease, they can get completely different drugs. The doctor is primarily based on the individualities of osteoporosis and accompanying diseases. Do not forget that in the late stages of osteoarthritis, when the deformities of the joints occurred and the growths appeared in them, painkillers will at least relieve the pain, but make the joint moveable, as before the appearance of growths, will not work. It will take an operating intervention.
If the above-described drugs were aimed at relieving pain, the chondroprotectors will protect and fill the cartilage with the necessary material, which is synthesized in the body in insufficient quantities. These drugs are used for osteoarthritis for a long time. This may be about a year, but, of course, only according to the doctor's prescription. The medicine consists of the structural components of the cartilage. Most often used drugs that include glucosamine sulfate or chondroitin sulfate.
They are produced by different manufacturers under different brand names. They can be called a kind of building material that will help the joints with a shortage of their synthesized material. These are slow-acting drugs, but, despite their slowness, their action after the passed course does not immediately fade. In doing so, they improve cartilaginous tissue, and degeneration processes slow down significantly. They can be used throughout life on an ongoing basis. Glucosamine sulfate is found in the human body and is a component of cartilage.
At its reception the preparation favorably influences structure of a joint, showing structurally-modifying action. He can relieve pain and reduce immobility of the joint. This is due to his ability to suppress enzymes that destroy cartilage, inhibit the formation of radicals, promote the accumulation of a normal amount of calcium in the bones of the body. Absorbed in the intestine of this drug almost completely, and with intravenous injection quickly enters the articular cartilage.
Chondroitin sulfate is most often used with glucosamine, but it can be taken separately. This drug is necessary for the body. It will increase the strength of ligaments and cartilaginous tissue. Chondroitin is formed by a cartilaginous tissue and is present in the synovial fluid. It is she who lubricates the joint and accelerates its regeneration. Preparations of chondroprotectors significantly slow down progress in osteoarthritis. They are a good defense and assistant. Proteoglycans in the cartilage increase, the fluid begins to linger better, and the cartilage again becomes more elastic and springy. The effectiveness of these drugs has been proven by various studies.
This category of drugs includes a variety of gels, liniments, triturates that have anti-inflammatory and analgesic effects. Their positive work is difficult to underestimate. With their help, you can achieve the removal of pain and be more active. Now there is a huge amount of drugs that are produced by different companies. Their action is reduced to increased blood supply and removal of muscle fatigue, increased motor activity, improvement of local lymph circulation, activation of metabolic processes. Such a drug has anti-inflammatory and analgesic effect, stimulates oxygenation and can even be antimicrobial and moisturizing.
These ointments and gels can contain different components that are selected according to their effects and create a complete composition. If you carefully read the composition of several of them, you can see camphor, menthol, rosemary or lavender oils, menthol racemate, arnica infusion, sage oil, chamomile extract or calendula, zinc oxide, salicylic acid, aluminum silicate, sodium salt of polysaccharide and many other ingredients. Each gel or cream contains several of these components, and each manufacturer develops its formula.
But you need to remember that these drugs will not treat osteoarthritis. They will only relieve the pain. Often they are used in the early stages, rubbing into a sore spot. After that, almost immediately there comes a feeling of relief and pain relief. Apply these drugs several times a day.
In the treatment of deforming osteoarthritis, hyaluronic acid is used. It is one of the important components of the synovial fluid. It provides cushioning and toughness, which reduces friction and rapid wear of fabrics. Now the treatment with this acid, which is administered intra-articularly, gives very good results. After hyaluronic acid enters the joint, it replenishes the synovial fluid. And further, gradually penetrating into its cells, it attracts water, which makes the cartilage more elastic and with good cushioning.
But before carrying out such treatment, you need to start an anti-inflammatory therapy. You can use glucocorticoids for this. This is done because the inflamed joint will be difficult to regenerate. And with the introduction of acid, the effect of it will be very small, it may even not be.
It is possible to prescribe treatment with such a drug only after examination of several doctors - a rheumatologist, orthopedist and traumatologist. This procedure is performed by a qualified technician. The dose of the drug will match the size of the joint. After the procedure of the limb, you need to ensure a long rest, so as not to disturb the absorption of acid by the patient with cartilage. Therefore, it is advisable not to move around and lie for a long time. Usually about 5 injections are applied per year, and this allows you to slow down the disease by almost 16 months. But every patient has everything individually. Therefore, one course can help one, and others need to be repeated.
The correct mode of life for osteoarthritis
It is not necessary to think that if after all the medications there was a huge relief, then you can again live as before. You need to be more attentive to your health and, in addition to medical treatment, use supportive and health-preserving actions. To begin with, you need to exclude an increased strain on the joints. Therefore, running, squats, jumps, long walking, climbing stairs, carrying heavy weights are not recommended. It is necessary to monitor the position of the legs. They can not be completely inactive for a very long time. This leads to poor blood circulation and poor cartilage nutrition.
You need to move, so there are special exercises that will not burden the affected joints, but retain their normal functionality. Very helps to reduce the load when walking cane. Sometimes doctors can prescribe the use of special knee pads or insteps that will keep the joints in the correct position.
When osteoarthritis is affected, it is important to eat properly. After all, excessive consumption of food leads to the accumulation of weight, which is bad for the joints. Therefore, it is better to gradually part with the extra pounds. It's enough just to change your food style. You can go swimming for weight loss. This is a very good kind of exercise for osteoarthritis.
In some cases, cold or heat can reduce pain in the joint. Therefore, hot water bottles or frozen peas can reduce pain. But overdo it with cold. To monitor your health you need always, then osteoarthritis will not interfere with the normal course of life, only you do not need to start the disease and engage in self-medication.
Anti-inflammatory tablets for jointsThere are many anti-inflammatory drugs for the treatment of joints. Consider what tablets are for the joints, how they affect the body and whether they relieve unpleasant sensations. If there are pains in the joints or ligaments, we must immediately begin treatment.
Joint pain in young people appears from the overload of the musculoskeletal system, with a deficiency of full nutrition. For this reason, the interarticular cartilage deforms. In the joints there is a crunch, creak, pain.
You can not tolerate these pains, because the restoration of the destroyed surfaces of bones and joints is a very difficult and time-consuming process. Self-medication can not be done, because the drugs recommended for pain in the joints, and have side effects. Therefore, before using them, a specialist consultation is necessary.
Rules for treatment with nonsteroidal agents for joint diseases
Nonsteroid drugs for the management of inflammation in the joints are the main drugs in the treatment of arthritis and osteoarthritis. They relieve the inflammatory process and reduce pain in problem joints. Their feature in comparison with corticosteroids is the absence of hormones and fewer side effects.
When using non-steroidal joints, certain rules must be followed.
- NSAIDs are contraindicated in diseases of the digestive tract, as they negatively affect the mucosa of the intestine and stomach.
- Prolonged courses of NSAIDs adversely affect the liver, kidneys and heart, can disrupt their work and lead to blood pressure jumps.
- Allergic reactions of the body to the intake of NSAIDs are possible, so it is necessary to start treatment with minimal dosages.
- When taking anti-inflammatory drugs, it is necessary to drink plenty of water to reduce the effect on the digestive tract.
- Do not take 2 or 3 non-steroid drugs at once, this will increase the number of adverse reactions of the body.
- NSAIDs can not be used to treat pregnant women and nursing mothers.
- During the course of treatment of NSAIDs it is necessary to refrain from alcoholic beverages, they will strengthen the effect on the digestive tract.
It is inappropriate to use non-steroidal drugs only urgently, to relieve pain. For effective therapy, they should be uniformly applied throughout the day. This will ensure a constant concentration of the drug in the blood and reduce the total daily dose of the drug.
List of non-steroidal anti-inflammatory drugs
Consider the most commonly used NSAIDs. A group of salicylates. Acetylsalicylic acid - the ancestor of all non-steroid drugs. Its discovery allowed many suffering diseases of the osseous system to return to normal life and not suffer from chronic painful joint pains. A small dose of aspirin reduces the temperature and pains the affected joint, to stop the inflammatory process, the dose increases.
There are also preparations similar to celecoxib, from the coxib group. They equally well relieve pain and affect the inflammatory process. They are used in the form of capsules only for the treatment of adult patients, because the infant formula has not yet been calculated.
Artra tablets and their use
Preparations from the Artra line are chondroprotectors. The composition of the preparation includes two components: chondroitin sulfate and glucosamine hydrochloride. The function of chondroitin is to stimulate the regeneration of interarticulate cartilage and to activate the production of hyaluron and collagen. These substances give elasticity to the connective tissues of the joint. A glucosamine not only affects the regeneration of interarticulate cartilage, but also provides reliable protection against the adverse effects of non-steroidal drugs and corticosteroids. Therefore, the preparation of Arthra is prescribed for the complex treatment of diseases of the bone system.
The most effective use of Arthra tablets at the initial stage of the disease. With progressive diseases of the musculoskeletal system, endoprosthetics of the affected joint are prescribed. Contraindications for the treatment of Arthra tablets are kidney diseases, bronchial asthma, diabetes mellitus, poor blood coagulability, pregnancy and lactation. Taking Arthra is relatively well tolerated by the body, but there are also weak side effects: diarrhea, flatulence, constipation, pain in the abdomen, dizziness, allergies. At such symptoms it is necessary to consult to the doctor about the further reception of Artra-tablets.
The course of treatment with these drugs is long, about 6 months. Take the medicine in the form of tablets or capsules. And at the initial stage, the drug is prescribed twice a day, and after a 3-week course, the pill is taken once a day. In addition to tablets, Artra products are also available in the form of a cream-balm. This kind of curative care for joints is effective in degenerative processes in the knees, feet, shoulders, elbows and hands.
Complex treatment with tablets and Arthra cream provides external and internal nutrition of articular tissues with all necessary substances for reconstitution.
Better disease is prevented than cured. To do this, it is necessary to establish a full-fledged supply of nutrients to their joints. The product Forever Freedom deserves attention. The ideal tool for joints contains shark cartilage, crustacean shell, active sulfur, vitamin C in the composition of the joints. All these active substances in combination with the aloe vera juice are perfectly absorbed by the body, which increases the healing effectiveness of this dietary supplement many times.
What are the injections and why are they made in the joints of
Today joint diseases have become a sign of our century. Elderly people and young people are increasingly complaining of unbearable pain in the joints of the legs, hands or in the spine.
The best time for an active lifestyle is the age of 30 to 40 years, with the achievement of this bar, a person suddenly loses the ability to move normally and turns into a lump of pain.
What's going on?
treatment with injections has its advantages
Our joints wear out, the cause is age, weight, active sports, the habit of women for long periods of walking on their heels.
Wearing joints over time leads to friction of the bones, destruction of the cushioning cartilage, distortion or imbalance of ligaments of the joint, the appearance of bone spines. In the end - constant and painful pain.
Regular pains provoke sleep disturbances, loosen the nervous system, lead to blood pressure jumps. Insidious diseases most often affect joints-workers:
- lumbar and cervical spine;
- knee and hip joints;
- interphalangeal joints.
Fortunately, modern medicine has provided an opportunity for a non-operative way of treating osteoarthritis, arthrosis and arthritis. Today, an effective method is recognized throughout the world, the essence of which is the introduction of drug solutions into the joint. These drugs can be prepared on the basis of corticosteroid hormones, hyaluronic acid and other components.
In healthy joints, there is a sufficient amount of synovial fluid. Over the years and under the influence of unfavorable factors, it runs low and performs its defensive function worse. Today, medicine has found ways to interfere in the development of pathological processes, now you can slow down or stop the process of joint destruction altogether.
Intra-articular injections are prescribed in cases where conventional analgesics and NSAIDs are no longer necessary.
The most common drugs for injection are:
hormonal injections help to remove inflammation
Most often intraarticularly injected such drugs containing corticosteroid hormones: Kenalog, celeston, diprospan, flosterone, hydrocortisone.
Corticosteroids have gained popularity thanks to the rapid and effective suppression of pain, the removal of inflammation with synovitis( swelling and swelling of the joint) . There is one problem here - corticosteroids can not prevent and cure arthrosis. Hormones do not strengthen the bone tissue, do not improve the state of cartilage, do not restore normal blood circulation. They can only reduce the inflammatory response to damage in the joint. Therefore, intra-articular injections containing hormonal drugs should be used in complex therapy.
The patient was diagnosed with stage II gonarthrosis with fluid congestion and edema. This situation makes it difficult to conduct the necessary treatment procedures. In order to eliminate synovitis, the doctor introduces a hormonal drug into the joint. Only after withdrawal of the edema he starts active therapeutic measures.
If intraarticular hormone administration is really necessary, some rules should be followed:
1. It is not advisable to inject into one joint more than once every 2 weeks.
2. The first injection brings relief more. If the first administration of the drug is ineffective, it is necessary to change the drug, or to specify the place for the injection more accurately.
3. If, after these recommendations, the introduction of corticosteroids did not work, then it is better to abandon the idea of treating joints with hormonal drugs.
Hyaluronic acid is a lubricant that compensates for the sliding of the destroyed cartilage. In other words, it is analogue with lubricating fluid, which helps to prolong the functioning of the joint, as well as adjacent tissues in the most natural way( without hormones and without surgical intervention).
Treatment with these drugs is expensive, but effective. The product has no harmful effect on the cartilage. For treatment, it is sufficient to conduct 3-5 injections of hyaluronic acid into the affected joint. The interval between the procedures should be 7-15 days. The course is carried out once a year:
- for stage II arthrosis, treatment is carried out for 2-3 years;
- with gonarthrosis of the 1st stage - for 2 years;
- for stage III arthrosis - for 3-4 years.
Chondroprotectors can also be injected with
. These are joint healing medications. They are used in cases of malnutrition of the joint( osteochondrosis, arthrosis, metabolic disturbances) or in case of trauma. A full-fledged treatment with chondroprotectors can be started only after relief of inflammation.
With the introduction of chondroprotectors in the joint, they have a faster effect than ingestion of drugs. The result can be noticeable after the first injection. The course of treatment includes 1 to 5 intra-articular injections, with the subsequent transition to taking drugs inside.
All of these drugs are not the cheapest, but their use helps put the patient on their feet without surgery. For the sake of fairness it is worth mentioning that lifelong injections in the joints involve a constant risk of infection. Intra-articular injections are seen as an emergency, after which complex treatment should be initiated.
Arthrosis medicine: what drugs help stop the disease
- Anti-inflammatory therapy( it is also anesthetic).These are not just drugs that relieve pain, as many people think. These are drugs that are designed to stop the process described above, when enzymes actively destroy the joint. The earlier you apply this therapy, the more chances your cartilage has to "stay alive".
With anti-inflammatory and analgesic, tablets and ointments are used with preparations similar to analgin: they block the main enzyme responsible for the development of inflammation and pain. AD) Ointments( gels).This Diklak-gel, Voltaren-Emulgel, Ibuprofen-gel. They can be used in the initial stages of arthrosis, when they effectively relieve pain, while not giving those side effects that are characteristic for systemic( in tablets and injections) anti-inflammatory drugs. Such effects include damage to the walls of the stomach and intestines with the development of ulcers. B) Paracetamol. It has fewer side effects than other drugs of similar action, in addition, it well helps to relieve pain. You can not only exceed its maximum dosage, it is also necessary to take into account its contraindications.
c) Non-steroidal anti-inflammatory non-selective agents. These are Ibuprofen, Diclofenac, Indomethacin and others. Good relief of pain and inflammation, but they have quite a few side effects.
d) A subgroup of anti-inflammatory non-steroidal agents - coxibs, which are designed specifically to relieve pain and inflammation in arthrosis( Celecoxib, Lumiracoxib, Rofica).But they have other side effects: they can not be used for severe heart, liver, kidney problems, you must carefully consider the compatibility with those drugs that a person usually takes.
e) Medicines for arthrosis, which relieve inflammation when other drugs are ineffective. These hormones are glucocorticoids, which are injected into the joint( Kenalog, Diprospan, Hydrocortisone).They are used only with inflammation, effectively relieve pain. But often( more often than once a week) they can not be used, as they contribute to the destruction of cartilage. If one drug for three injections did not show its effectiveness, you need to change it to another, rather than continue to methodically destroy the cartilage.
- Tablets, whose action is aimed at restoring the cartilage of the joint. These are those that contain glucosamine and chondroitin. They are produced quite a lot both by the domestic and foreign pharmaceutical industry. These drugs require a long reception( at least three months).Apply them ineffectively when there is no cartilage left.
For the present effect, it is necessary to take chondroitin at least 1000 mg per day, and glucosamine - at least 1200 mg. It is possible to take both combined preparations( in which there are both components, for example, Artra), and monopreparations( for example, Don, which contains only glucosamine and is very effective, especially in injections).
Also there are bioadditives( Susanorm, Stoartite, Chondro) containing these two components. They are not a remedy, since their clinical effectiveness has not been proven. Preparations containing chondroitin and glucosamine, positioned as an ointment from arthrosis( Teraflex-ointment), have rather low efficiency.
- A preparation based on soy and avocado - Piascladin. It effectively slows down the process of cartilage destruction by blocking the production of an enzyme that breaks down collagen. These pills for arthrosis are quite expensive, they should be taken 1 capsule per day for 6 months.
- Hyaluronic acid, which is called "liquid lubrication" of the hip joint, and other joints is also very effective. The only nuance: sodium hyaluronate( Synvisc, Fermatron, Ostenil) must be administered after the inflammation in the joint has subsided, otherwise the drug will not act.
- In the treatment also used drugs, which are called proteolysis inhibitors( Counter, Gordoks): they are used for inflammation. Their action is aimed at suppressing the production of enzymes that provoke the "dissolution" of the articular cartilage.
- Heating compresses and ointments can also be used as a cure for arthrosis of joints: their action is aimed at increasing blood flow to the joint, alleviating pain and increasing filtration of intraarticular fluid. These are such drugs as Bischofite, bile medical, Dimexid( it needs to be diluted 1: 3 or 1: 4 with water, otherwise you can get a burn).
- Also improve microcirculation in the joints such drugs as Actovegin, nicotinic acid, Troxevasin, vitamins of group B.
Osteoarthritis is the destruction of articular cartilage - a special "interlayer" tissue that covers each of the rubbing surfaces of bones in the joint. This disease can occur due to frequent inflammatory phenomena in the joint( arthritis), after injuries, hormonal changes and as a result of a constant load of excess weight of a person. Osteoarthritis can be complicated by arthritis, that is inflammation, but these two diseases - arthrosis and arthritis - are completely different in essence and approaches to treatment for them should not be the same.
How is the process started with arthrosis?
cartilage destruction structure
Articular cartilage itself does not have blood vessels in it, it gets the substances necessary for itself from the fluid produced by the capsule of the joint. Arthrosis occurs when a process disrupts the production of this fluid. As a result, the usual load on the joint becomes stress for the articular cartilage. From its cells, enzymes are released that begin to destructively act first on their surface layers, then on deeper. Such destruction changes the intra-articular pH, and a vicious circle turns on: a violation of the acid-base balance prevents the cartilage from recovering, the normal relationship between its two main components, chondroitin and glucosamine, changes. And this same pH shift to the acid side further activates the destructive enzymes.
arthrosis affects the hands
The joint tries to restore itself in ways that are accessible to it: osteophytes arise( bone growths, replacing areas with "spoiled" cartilage ").What does it need to know? To understand what is the correct approach in the treatment, in what sequence of medication for arthrosis you need to take in order to achieve a good effect.
What you need to know for effective treatment of
pathology As already mentioned, the usual load on the joints affected by osteoarthritis becomes stress for the cartilage. Therefore, before you start treatment, be concerned about reducing this burden. For example, if you have osteoarthritis of the knee, you can use a walking stick when walking, and also wear special fixing devices on the foot - calipers, which will minimize this load.
Completely remove the load, too, can not. For example, fix it with a bandage and do not move your fingers at all, if the destruction of cartilage occurs in these joints. Why? Articular cartilage can only be fed while moving in this articulation of bones: it works like a sponge, sucking in nutrients from the joint fluid, when the bones converge, and then diverge. Therefore, avoiding movements is wrong, they just need to be dosed, with the support of various devices.
support for the knee
Also reduce the load on the joint, especially when it comes to the ankle joint disease( it has one of the biggest loads in ordinary walking), it is necessary by eliminating excess weight and further observing proper nutrition.
Also a great help in the treatment are joint massage and manual therapy: since more blood flows into the "sick" capsule, it starts to update itself more quickly and to update the liquid produced by it. As a result, the cartilage gets better nutrition. One "but": these types of manual exposure( like other thermal procedures) are not applicable in the presence of an acute inflammatory process. Therefore, first those drugs are used for arthrosis, which will reduce inflammation, and then massage is applied.
Medical treatment of arthrosis
All medicines used for the treatment of arthrosis are divided into several groups depending on the purpose of the exposure:
is one of the effective means of
introduction of the drug into the joint
The use of the drugs in the complex has a positive effect and makes it possible to forget about arthrosis for a long time.