Osteoarthritis refers to diseases that affect the joints.As a result of dystrophic-degenerative processes, cartilage is gradually destroyed and replaced by growing bone tissue.The pathological process is accompanied by pain, limited mobility of the joint, disruption of its functions and severe deformation.Approximately 10-25% of the population suffers from osteoarthritis.After 80 years, almost every person has degenerative diseases of the musculoskeletal system.Most often, the disease affects the most mobile joints (fingers, hip joint, knee, neck).But sometimes degenerative processes develop in the ankle and shoulder joint.
Factors for the development of the disease
Various causes cause destructive processes in the body.The most important are congenital anomalies of the connective tissue.Regular microtraumas of the joints and acute joint diseases contribute to the appearance of arthrosis.Over time, the untreated disease passes into a chronic stage with regular exacerbations.
The provoking factors leading to the development of arthrosis are:
- overweight;
- lack of physical activity;
- hormonal disorders;
- atherosclerosis;
- venous insufficiency;
- endocrine disorders;
- genetic predisposition;
- regular and heavy loads on the joints (for example, in weightlifters or people whose profession is related to lifting and moving heavy objects).
Under the influence of a provoking factor or several at once, cartilage tissue cells begin to collapse.Gradually, the cartilage thins, becomes less elastic, then becomes covered with cracks and falls.The bones of the joint begin to rub against each other.The body starts a compensatory mechanism, as a result of which bone tissue grows on the destroyed surface.As a result, the joint becomes inactive and deforms.
species
Arthrosis can be primary, which occurs independently, and secondary, which develops as a result of diseases, injuries and deformations of the joints.
Depending on the affected joint, the disease has its name:
- Gonarthrosis affects the knee joint.
- Coxarthrosis is a disease of the hip joint.
- Spondyloarthrosis affects the intervertebral discs of the lumbar, cervical and thoracic regions.
- Crusarthrosis involves the ankle in the pathological process.
If 3 or more joints are involved in the degenerative process, we are talking about a generalized form.If there are 1-2 joints, this is local arthrosis.
Symptoms
Initially, the degenerative process goes unnoticed.There are no nerve fibers in the cartilage, so in the initial stages of development, the patient does not even know what destructive processes are taking place in his body.The first signs appear only a few years after the beginning of the dystrophic-degenerative processes, when the periosteum under the cartilage is injured or inflammation develops.
At first there is pain in the limbs after heavy exertion.In the morning or after a long stay at rest, a feeling of stiffness and dull pain with not very high intensity appears.After a short warm-up or exercise, all painful symptoms disappear.Therefore, people do not go to the doctor, considering this to be a common phenomenon.Meanwhile, in the initial stage, it is much easier to stop the progression of arthrosis.
Over time, all signs intensify.The pain becomes intrusive and constant, does not allow you to sleep at night.The pains, the feeling of stiffness, the inability to fully work or do housework become more and more worrying.The pain, twisting pain in the joints and surrounding muscles increases in rainy weather.
Most often, arthrosis affects the joints of the lower limbs, so a person quickly gets tired of walking, it is difficult for him to climb stairs or any height, because as a result of the destruction of cartilage tissue, stiffness of the joint is formed.An unsteady gait develops due to limb instability.An unpleasant crunch is heard when the joint is bent, as the articular surfaces, devoid of cartilage, rub against each other.Patients try to limit the mobility of the diseased joint, so muscle atrophy develops over time.They decrease in volume, and the gait becomes even more unstable.
If arthrosis develops in the joints of the upper limbs, this happens most often after injuries or as a result of chronic arthritis.In this case, bony outgrowths appear on the fingers, and the hands acquire a square shape.
Clinical symptoms depend on the stage of development of arthrosis:
- Zero.
At the zero stage, a person is sometimes worried about slight discomfort.X-ray examination does not reveal degenerative changes. - Elementary.
A slight dull pain occurs with prolonged walking.X-rays show the appearance of small areas of bone defects along the edges of the articular surfaces.A crunch is heard when the joint is bent. - easy.
In the morning there is pain and stiffness.X-rays show osteophytes (single bony growths) along the edges of the joints, narrowing of the joint space. - Moderate.
The moderate stage is considered degenerative.Bones and muscles ache constantly, especially at night.The joint swells a little.X-rays show further narrowing of the joint space, proliferation of bone growths and increased bone density. - heavy.
In the severe stage (deforming), constant pain appears, which increases with movement.When you try to bend the joint, a harsh crunch is heard.X-ray shows a sharp narrowing of the joint space;osteophytes have already grown so much that it has led to deformation of the joint and a change in its structure.
Diagnosis and treatment
Orthopedist, rheumatologist and surgeon are involved in determining the type and stage of degenerative-dystrophic processes in the joints.Diagnosis involves standard blood and urine tests.If necessary, an immunological analysis and examination of intra-articular fluid for the presence of infection is performed.Instrumental studies are performed (MRI, ultrasound to identify changes in soft periarticular and joint tissues, CT, X-rays to determine changes in bone tissue).
Therapy
The disease cannot be completely stopped.Timely diagnosis and treatment allow you to maintain its mobility and prevent the progression of destruction.
As drugs for the treatment of arthrosis, antispasmodics, NSAIDs, steroid blockades injected into the joint, chondroprotectors, muscle relaxants, vitamin and mineral complexes, drugs to improve trophism in the affected tissues, proteolysis inhibitors to slow down the destruction of cartilage and bone tissue are used.
Patients with severe pain and an unstable joint are advised to wear tapes that fix the joint in a normal position with the help of tapes, orthoses, elastic knee pads or elbow pads.Crutches or canes should be used for support.
Mandatory physiotherapy procedures are prescribed, which include UHF, massage, ozone therapy, electrophoresis and phonophoresis with a solution of painkillers, magnetotherapy, acupuncture, electrostimulation, darsonvalization, paraffin baths (in the absence of inflammation)
In the later stages of arthrosis, when the tissues are already destroyed and the joints are severely deformed, the only way is surgical intervention:
- Arthroscopy with removal of bone growths, spikes and partial replacement of damaged cartilage.
- Endoscopy.This is the replacement of a joint (in whole or only in part) with an artificial joint.
- Artodesis.The joint is closed and fixed in a comfortable position.Over time, the joint surfaces fuse together.
Prevention
Since it is impossible to restore your own joint to a normal physiological state, it is necessary to take measures to prevent this disease in advance.It is especially important to do this if there is a family history of cases of this disease or if you reach the age of 40.
Prevention includes maintaining a normal body mass index and regular exercise.Infectious pathologies and other joint diseases should be treated promptly, hypothermia and prolonged and sudden physical exertion should be avoided.People from risk groups (by age, with a traumatic profession, bad heredity) should regularly examine their joints with X-rays.
Only timely and adequate treatment helps to preserve the health of the joint.