Osteoarthritis is a degenerative joint pathology, accompanied by processes of dystrophy of cartilage tissue. As the disease progresses, the joint sac, ligamentous apparatus, synovial membrane and the nearest bone structures are also involved in the destructive process.
Prevalence of osteoarthritis
The majority of people with osteoarthritis are elderly. Illness after the age of 65 is not only the most frequently diagnosed joint pathology, but also the leading cause of disability with subsequent disability. Moreover, in old age most women are sick, but among young people most sick are men.
In different countries the incidence of osteoarthritis varies considerably. It has not yet been possible to establish the reasons for the wide dissemination of statistical data.
Causes and risk factors
Osteoarthritis is a disease that can be primary or secondary. If there are no objective reasons for the development of pathology, they speak of the primary type. If it was possible to identify the causes of osteoarthritis, they speak of a secondary type.
Secondary osteoarthritis can be triggered by the following negative factors:
- trauma to articular joints of various kinds (frequent falls, sprains, bruises);
- chronic congenital tissue dysplasia;
- pathological changes in metabolic processes;
- various autoimmune pathologies;
- non-specific inflammatory processes in the joint area;
- certain pathologies of the organs of the endocrine system;
- degenerative-dystrophic type process, occurring chronically;
- various diseases, accompanied by excessive joint mobility, coupled with a weak ligament apparatus;
- presence of hemophilia;
- specific type of inflammatory process.
In addition to the immediate causes, the action of which leads to the development of osteoarthritis, there are also predisposing factors that do not provoke the disease in themselves, but can increase the risk of its development.
These include:
- is over 55 years old;
- excess weight, due to which the load on the joint joints increases;
- excessive load on a joint or a group in case of inappropriate sports training, specific work which requires a long stay in one position;
- history of joint surgery; heredity
- ;
- hormonal changes in the body of postmenopausal women;
- constant hypothermia;
- pathologies of the untreated spine;
- Insufficient intake of useful micro and macroelements with food.
Mechanism of development
The mechanism of development of osteoarthritis is well known. Cartilage, which provides normal contact between two bones, is naturally smooth, without irregularities or roughness, which helps maintain normal joint movement. With a disease, the structure of cartilage changes, it becomes rough, defects appear on it, which reduces the effectiveness of natural sliding.
Due to the acquired inequality, the cartilage is gradually damaged, in places it begins to calcify and in places it ossifies. In this case, it is possible to separate the small particles that are found in the joint fluid and can injure the surrounding tissue.
As the pathology worsens, the joint may enter a state of chronic subluxation, which will significantly impair its motor function.
Degrees
Doctors divide osteoarthritis into three main degrees:
- I degree.It is characterized by the absence of a clear clinical picture. The patient may have rare complaints of pain in the affected joint, but usually does not see a doctor. At the same time, changes are observed in the ligament-muscular apparatus and joint fluid, but there are no visible deformities yet.
- II degree.The symptoms of osteoarthritis become more pronounced. The pain is characterized as bearable, but occurs regularly. The patient goes to the doctor, as he notices a decrease in the quality of life. A characteristic crunch can be heard in the affected joint. Changes are observed in nearby muscle structures, as nerve conduction is disturbed.
- III degree.Characterized by pronounced signs. The articular cartilage is very thinned, there are cysts, foci of calcification or ossification. The ligamentous apparatus becomes shorter, which leads to increased mobility in the affected area, which is accompanied by restriction due to a pronounced inflammatory process. The metabolism of the surrounding tissue suffers, which can lead to muscular dystrophy.
In all cases, the patient should clarify the diagnosis with the attending physician. This is due to the specificity of the course of the disease, which is characterized by stages of remission and exacerbation, alternately replacing each other.
Pain associated with the disease
Pain in osteoarthritis is the most common complaint with which patients go to the doctor. Their characteristic is their link with the time of day, the weather, and physical activity.
In most patients, the pain is exacerbated by walking, running or any other type of physical activity directed at the affected joint. As soon as the load stops, the pain gradually subsides. Their development is explained by the fact that the cartilage is no longer able to fulfill its functions of shock absorption.
At night, discomfort most often occurs as a result of stagnant blood in the veins. Another reason is the increased intraosseous pressure during this period.
One of the main diagnostic criteria is the presence of so-called onset pain that disturbs the patient when he has just started active movement. The onset pains usually go away if physical activity continues. Their appearance is explained by the presence of joint deposits (detritus) which irritate the nerve endings. As soon as these deposits move away from the nerves, the pain subsides.
Symptoms
In addition to pain, doctors identify other signs of osteoarthritis with which pathology may be suspected.
These include:
- Pain and crunchiness.Lomota appears mainly in the event that a person has received hypothermia. The crunch will initially be barely audible, but as the disease progresses without treatment it will become audible to people around.
- Decreased ability to move. At an early stage in the development of pathology, there is no decrease in mobility. However, the longer the disease is left untreated, the greater the limitation of movement in the joint becomes. This is due to the narrowing of the joint space and the spasm of the nearest muscle structures.
- Joint deformity.It is characteristic of the advanced stage of osteoarthritis, but is also an important indicator of the course of the disease. During this period, it is already very difficult to treat the disease.
Which doctor treats osteoarthritis?
Who treats osteoarthritis? In most cases, several specialists are involved in the therapy. First of all, an arthrologist, a joint specialist, is involved. In addition, the patient will also need to consult an orthopedist. If the disease is the consequence of an inflammatory process, it is also recommended to consult a rheumatologist.
If necessary, other specialists can be involved during the treatment period. Most often you need to resort to the services of traumatologists, physiotherapists, masseurs, surgeons.
Diagnostics
Treatment of osteoarthritis of the joints begins only after confirmation of the diagnosis and determination of the degree of pathology. First of all, the doctor questions the patient in detail and conducts an examination. The presence of characteristic complaints and deformities suggests that there is a disease.
An x-ray of the affected joint is a mandatory way to confirm the diagnosis. If the disease affects the knee, a photo of the knee is taken, if the pathology is in the hand, radiological signs of the disease are specifically looked for.
X-ray diagnosis does not always give sufficient results to diagnose the patient. In this case, it can be sent for MRI (this will make it possible to assess the state of the soft tissues and their involvement in the pathological process) or for CT (this will allow conclusions to be drawn about the state of the bone and cartilage structures, the involvement of the closest anatomical structures in the pathological process).
Processing
How to treat osteoarthritis of the joints? The choice of the appropriate treatment technique depends on the severity of the symptoms and the stage of the disease.
The doctor chooses the treatment regimen after assessing the general condition of the patient and the course of the disease. Conservative and surgical methods of treatment can be used.
Drugs
How to treat a disease if it is better not to operate, but to use drugs?
Conservative treatment is suitable only for patients at an early stage of the formation of the pathology and will include the use of three main groups of drugs:
- glucocorticosteroids- hormonal drugs that effectively relieve the inflammatory process during an exacerbation, are injected into the joint cavity;
- nonsteroidal anti-inflammatory drugs,which are mainly injected and injected into muscles near the joint or directly into a vein. But doctors can also recommend pills, although this option for taking NSAIDs is undesirable due to the negative effect on the gastrointestinal tract;
- chondroprotectors- drugs of this group can reduce the destruction of cartilage tissue and improve regeneration, are especially effective in the early stages of the formation of the disease.
Surgical
How to cure osteoarthritis, if the disease has gone far enough? In this case, conservative treatment will be ineffective, and doctors can only recommend surgery to the patient.
Today, joint replacement is done in most cases. During the operation, the actual joint is replaced with a prosthesis, which has all the functions of a healthy joint.
In some cases, options for palliative therapy are offered, the main task of which is to reduce the load on the joint surfaces.
Exercise
In the early stages of the disease, it is treated not only with drugs, but also with physiotherapy exercises. Exercise is an important step in therapy that helps maintain joint functionality and reduces the likelihood of further disease progression.
Depending on the severity of the pathology and the individual characteristics of the patient, the set of exercises is selected individually. The doctor must take into account the location of osteoarthritis, which allows the most effective effect on the affected tissues.
Self-study without medical supervision is not recommended, especially at the initial stage. Exercises should be chosen so that they are as fluid as possible, without sudden movements.
Exercise therapy courses are effective only if the patient devotes a little time each day to the recommended complex.
Traditional methods
Many people with osteoarthritis refuse to use medication or surgery until the last moment. In this case, alternative medicines are used as substitutes for drugs.
The most commonly used plants in therapy are:
- Kalanchoe;
- ginger;
- hell;
- bay leaf;
- garlic;
- cinnamon;
- horsetail and others.
They are used in the form of tinctures, decoctions, poultices in the affected area. It is important to keep in mind that a comprehensive treatment of the disease using only homemade recipes is impossible. It is preferable that traditional therapies are combined with traditional medicine.
Prevention
What can be done to reduce the risk of developing osteoarthritis in old age? Simple preventive measures are available to everyone.
Recommended:
- Moderate daily physical activity: walking, cycling, simple exercises as a load, etc.
- respect for the basic principles of a healthy diet: eat often, but little by little, avoid fast food, overeating, heavy and fatty foods, eat a lot of spices;
- weight control: weight gain increases stress on the joints, which can lead to osteoarthritis;
- prompt treatment of chronic diseases leading to metabolic disorders;
- the use of vitamin and mineral complexes in the event that the amount of nutrients supplied with the food is considered insufficient.
Difference between arthritis and osteoarthritis
Many people confuse arthritis with osteoarthritis because of the similarity of sounds. However, these are completely different diseases.
Arthritis is not dystrophy and degeneration of joint tissue, but any inflammatory reaction that can develop in the joint cavity, regardless of the cause. Inflammation most often affects not only the joint, but also the nearest muscles, bones and ligament structures. Pain in arthritis is not associated with physical activity, it can disturb the patient even at rest, and there is no cracking in the joints at all.
In most cases, it is impossible to independently distinguish arthritis from osteoarthritis, since the main symptom is pain, and patients rarely have an idea of its characteristics for each of the pathologies.
It is better to entrust the establishment of an accurate diagnosis to the attending physician, so as not to make a mistake in the further treatment and prevention of the disease.
Osteoarthritis is a serious condition that can lead to disability if the patient does not see a doctor in time. At the first signs of the disease, it is recommended to contact a specialist to confirm the diagnosis and select the most optimal treatment.
If it is possible to catch the disease at an early stage of development, it will certainly be possible to do without even surgery, limiting itself only to conservative treatment.