Osteoarthritisis a chronic non-inflammatory disease of the joints or articular cartilage as well as the tissues that surround them. Osteoarthritis is one of the most common diseases affecting 10-14% of the world's population. Basically, this disease affects women aged 45 to 55 years. Osteoarthritis is the most common joint disease and accounts for almost 80% of the joint etiology.
The etiology of this disease is currently unknown.. . . All the factors that cause tissue degeneration and aging of the body can lead to the appearance of this disease, therefore, with age, the appearance of osteoarthritis is almost inevitable.
There are external and internal factors in the occurrence of this disease.The main external factors of osteoarthritis include humidity, hypothermia, adverse working conditions, functional overload of the joints with frequent minor injuries, as well as exposure to radiation energy and vibrations. The main and quite common cause of osteoarthritis is the inability of cartilage to resist the increased pressure on the joints. The reasons for this event can be a disorder of posture, long-term work, standing, and even some sports: weightlifting, running or jumping.
Internal factors that cause this disease include the following: hereditary predisposition to cartilage tissue disease, impaired blood supply to the joint, hormonal imbalance and metabolic disorders. The cause of osteoarthritis in women can be ovarian dysfunction in menopause. In addition, vascular processes with early development of atherosclerosis can also be the cause of this disease.
Osteoarthritis also has a secondary development in diseases such as congenital dislocation, rheumatoid arthritis, intra-articular fractures, and even with alcoholism.
What are the symptoms and clinical signs of this disease?
The manifestation of osteoarthritis is expressed with severe pain and deformity of the joints, which leads to a violation of their functions. With this disease, damage most often occurs to the load joints (hip and knee joints) and the small joints of the hand. The spine is also involved in the process. But more often the knee and hip joints are affected.
The most basic symptomwith osteoarthritis, there is severe pain in the area of the affected joints. These pains cause damage to bones, joints or periarticular tissues. Typically, this pain increases with effort and decreases with rest. Nocturnal pains, swelling of the joints, and the appearance of a "viscous gel" sensation in the affected joint in the morning - all of these indicate the onset of osteoarthritis. The intensity of such pain depends on many factors (atmospheric pressure, humidity and temperature changes). All of these factors begin to affect the pressure in the joint cavity, which causes these pains.
The next of the main symptoms of osteoarthritis is the appearance of creasing or creaking in the joints, not only while walking, but even during any movement. The appearance of such a crease or creak is associated with a violation of the articular surfaces, which causes limited mobility in this joint.
With osteoarthritis, there is an increase in the volume of the joints, which is a consequence of the appearance of swelling of the periarticular tissues. Swelling or fever in the affected joint is extremely rare.
Clinical forms of osteoarthritis:
- Knee joint.
- Coxarthrosis.
- Osteoarthritis of the peripheral interphalangeal joints of the hand.
- Osteoarthritis of the proximal interphalangeal joints of the hands.
- Deformative spondylosis.
- Intervertebral osteochondrosis.
Knee jointIt is a lesion of the knee joint in osteoarthritis. In this case, the pain in the knee joints when walking is expressed and is especially intense if you go down the stairs. The location of these pains is in the inside and front of the affected knee joint. An increase in discomfort occurs when the knee is bent. In addition, in many cases of knee joints, there is a deviation of the knee joint. The disease starts gradually and the pain increases. With active and passive movements, a trauma is heard. The pain begins to intensify and in many cases arthritis develops - an inflammation of the membrane of the joint capsule or tendon.
Coxarthrosis- This is a damage to the hip joint. The initial pain of a hip injury does not appear in the thigh area, but in the knee, groin or buttocks. They increase with walking and subside in calm. These pains, which appear even with small changes on the x-ray, are associated with muscle spasm. With the defeat of the hip joint, there is a gradual increase in the restriction of mobility in the joint. This disease is a consequence of trauma or arthritis. With coxarthrosis, "duck" gait, developing lameness, muscular scholarship of the buttocks and thighs are observed. There is also pain on palpation of the femoral head.
Osteoarthritis of the peripheral interphalangeal joints of the hand or Heberden nodules. . . The appearance of such nodules is more common in menopausal women. Initially they appear on the 1st and 3rd finger of the hand. Over time, ie after several months or even years, symmetrical damage is observed in other distal interphalangeal joints. Such nodules are located on the dorsal-lateral surface of the joints.
Osteoarthritis of the proximal interphalangeal joints of the hands or Bouchard's nodules. Unlike Heberden nodules, these nodules appear on the lateral surface of the joint, resulting in lateral enlargement of the joint. As a result of this increase, the finger acquires a spindle shape.
Deformative spondylosisAs a result of this disease in the area of the vertebrae, marginal bone growths occur. This disease appears from the age of 20 years. Osteophytes (bone growths) look like edema - edema occurs due to vascular compression. As a result, stiffness of the spine occurs, and in some cases neurological disorders occur.
Intervertebral osteochondrosisoccurs in combination with curvature of the spine or deforming vertebrae. With this disease, the disc degenerates and the nucleus protrudes in different directions, and this leads to trauma to the spine. Osteophyte overgrowth and increase in joint surface area are also observed. In this case, the choroid of the joint suffers, resulting in vasculitis - an inflammation of the walls of small blood vessels. The pain syndrome is very intense and increases with physical exertion or hypothermia.
There are two main types of osteoarthritis- is primary or idiopathic (the causes of the disease have not been clarified) and secondary (the disease occurs in the context of other diseases).
Primary osteoarthritisis detected when less than 3 joints are affected. Localized osteoarthritis affects the spine, the joints of the hands and feet, the joints of the knees, the joints of the hip and other joints.
There is also generalized osteoarthritis when 3 or more joints are affected. In this case, large joints and distal interphalangeal joints are affected. In addition, corrosive osteoarthritis occurs in the generalized form.
Secondary osteoarthritiscan be post-traumatic. Also, the causes of secondary osteoarthritis can be metabolic diseases such as Gaucher disease, which is a genetic disease. Wilson's disease is a rare form of liver damage in which copper metabolism is reduced. Hemochromatosis, or as it is also called, bronchitis or pigment cirrhosis, is an inherited disease in which there is a violation of iron metabolism and its accumulation in organs and tissues. Diseases such as diabetes, hypothyroidism - decreased thyroid function, acromegaly - overgrowth of growth hormone, can also be the causes of osteoarthritis. In addition to these diseases, osteoarthritis can also cause calcium deficiency disease, neuropathy and many other diseases.
What About Osteoarthritis?
With this disease, intensive aging of the articular cartilage occurs. As a result, there is a loss of elasticity of the articular cartilage. Apart from the fact that the articular surfaces become rough, cracks still appear in them. In many cases, the cartilage is worn enough to expose the bone. All this leads to a decrease in the elasticity of the articular cartilage and causes a disorder of the joints. Furthermore, inflammation can unite all the reported changes, due to which the development of bone tissue occurs and this leads to disease and deformity of the joints.
Diagnosis of osteoarthritis
The diagnosis of osteoarthritis in many cases does not cause much difficulty. But there are exceptions, for example, patients with shoulder joint damage and symptoms of joint inflammation. Difficulties may also arise in diagnosing primary and secondary osteoarthritis, the onset of which is associated with metabolic or other diseases. On radiography, signs of osteoarthritis are quickly detected (especially in the elderly) if there are clinical signs of osteoarthritis. There is not enough radiographic and laboratory data to make a final diagnosis. To do this, it is necessary to conduct some additional studies in order to identify the exact cause of joint pain.
Treatment of osteoarthritis
There are both pharmacological and non-pharmacological methods for reducing or completely suppressing pain, which include physical therapy and exercise therapy. Individual approach to each patient is required to prescribe the correct treatment. In this case, the individual characteristics of the patient and the peculiarities of the course of this disease are necessarily taken into account.
In the treatment of osteoarthritis, it is first of all necessary to adhere to the shape, as the mechanical unloading of the joint is not only the main factor for the reduction of pain, but also plays an important role in the treatment of this disease. In this case, it is necessary to exclude a rather long stay in a certain stable position, prolonged walking and prolonged standing, as well as the exclusion of weight transfer that can lead to mechanical overload of the joints. If the disease is neglected, the patient is advised to walk on crutches or a cane. With rather severe pain at the time of the onset of the disease, some patients are prescribed a semi-bed rest.
During the treatment of osteoarthritis, it is recommended to follow a diet to reduce unnecessary weight. This is especially true for those who have damage to the knee joints.
Also, in the treatment of this disease, physiotherapy methods are used that not only reduce pain and inflammation, but also have a positive effect on metabolic processes in the tissues of the joints and improve microcirculation. Physiotherapy includes the use of electric currents, alternating magnetic currents, electrophoresis, as well as ultraviolet radiation and phonophoresis on the affected joints. In addition, thermal procedures, the use of peat mud and paraffin wax are prescribed.
Using therapeutic massage elements, patients should try to avoid mechanical irritation of the joint capsule. Only in this case there is a reduction of the painful muscle spasm and also the tone of the weakened muscles is increased, as a result of which the functional abilities of the patient are improved.
Medication is prescribed depending on the form of the disease and the severity of its course. In more severe cases, patients are prescribed surgery (arthroplasty).
Patients are also advised to resort to spa treatments on the sea shore.
Prevention of osteoarthritisconsists in the daily execution of special exercises that help strengthen the musculoskeletal mechanism. Getting rid of excess weight, limiting weight transfer, and including it in the menu of foods such as jelly, jelly or aspic are all preventative measures for osteoarthritis. And, of course, to engage in such a sport as swimming. We must remember that it is better to prevent any disease than to cure it. The same goes for diseases such as osteoarthritis. In order not to think in the future how to get rid of the severe pain in osteoarthritis, as well as how to treat this disease, it is necessary to take preventive measures today, without postponing them for later.
Treatment of deforming osteoarthritis with various methods
The high qualifications and the accumulated experience in the use of shock wave therapy allow to achieve the maximum positive result of the treatment even in advanced stages of the disease, avoiding the surgical treatment in many cases.
Shock wave treatment is performed in a modern device:
- The course of treatment of arthritis, arthritis with the UHT method consists of 5-7 sessions.
- the session takes place once in 5-7 days.
Under the influence of a shock wave, microcrystals of calcium salts and fibrous regions formed in the tissues of the joints relax in the affected tissues. At the same time, blood flow to the damaged tissue increases tenfold, which contributes to the absorption of calcium salts in areas with fibrosis.
Advantages of the SWT method:
- efficiency;
- good tolerance (does not require the use of anesthesia).
- reduces the need for other methods, especially surgical treatment.
- rapid pain relief without analgesics.
- the possibility of use in the chronic stage of the disease and with its main manifestations.
- is done in outpatient clinics, does not require hospitalization, does not disrupt the patient's normal rhythm of life.
Photodynamic therapy in orthopedicsIt is a non-invasive, uncomplicated two-component treatment. To apply the method, a photosensitizer and a laser radiation source approved for medical use with a wavelength of 660-670 nm are used.
Under the influence of a laser beam, a photosensitizer is stimulated by the release of solitary oxygen, which toxicly affects the energy complexes of the cell (mitochondria and Golgi complex), destroying the latter and thus triggering the irreversible process. At the same time, healthy cells are not destroyed. The damaged pathological tissue is aseptically absorbed.
The photosensitizer is injected into the patient's body transdermally (applications).
PRP plasma elevation- This orthopedic procedure is based on a patented method of treating the patient's blood using special biotechnological vacuum tubes and a special centrifugation function.
During the procedure, a platelet-containing autoplasm injection form is isolated from the patient's blood, which is then injected into the soft tissues surrounding the joint and directly into the patient's joint cavity. Autoplasmic injections can reduce inflammation, relieve pain, and restore range of motion in the joint. The autoplasm treatment process minimizes the number of drugs used or eliminates them completely, thus reducing the toxic effect of the drugs on the patient's body. Also, autoplasm injections help to reduce the treatment time by 2-3 times.
Indications for the process (PRP plasmolifting):
- osteoarthritis;
- osteoarthritis;
- periarthritis;
- tendon diseases,
- damage to ligaments and muscles.
Thus, shock wave therapy, photodynamic therapy and plasma lifting (PRP) in orthopedics are the best options for the treatment of joint diseases. With the use of modern equipment and technologies and the experience of doctors, they allow you to achieve positive results.