Osteoarthritis is a chronic degenerative disease that affects all parts of the joint: cartilage, joint membrane, ligaments, capsule, periarticular bones and periarticular muscles and ligaments.
According to European doctors, osteoarthritis accounts for almost 70% of all rheumatological diseases. People aged 40 to 60 are most susceptible to joint osteoarthritis. This is facilitated by both lack of movement and prolonged overload, poor nutrition and, of course, injuries.
What is a joint?
Typically, a human joint is made up of 2 or more connected bones. All working surfaces of the joint have a protective coating and are constantly lubricated with synovial fluid for better gliding. The joint cavity itself is hermetically closed by the joint capsule.
In our body there are many joints that are "responsible" for certain types of movements, can experience various loads and have different safety margins.
The amount of movement in the joints depends on the structure of the joint, the ligamentous apparatus that limits and strengthens the joint, and the various muscles attached to the bones by the tendons.
Causes of joint osteoarthritis
Normal functioning of the joints is possible due to the constant self-renewal of cartilaginous tissue. At a young age, the death rate of obsolete joint cells is equal to the rate of birth of new cells. Over the years, the cell renewal process slows down and the cartilage tissue begins to thin. Synovial fluid production also decreases. As a result, joint cartilage begins to thin and break down, leading to osteoarthritis.
Furthermore, there are other causes of joint osteoarthritis:
- increased physical activity. Osteoarthritis of the joints frequently accompanies excess weight. As a result of overload, microtraumas form in the joints. Athletes develop joint damage due to increased loads on "unheated" joints;
- joint injuries;
- congenital or acquired malformations of the musculoskeletal system (rickets, kyphosis, scoliosis, poor fusion of bones after injuries with the appearance of deformities of the limbs: O-shaped and X-shaped deformities of the legs).
Osteoarthritis stages
Depending on the degree of destruction of the cartilage tissue, different stages or degrees of osteoarthritis can be distinguished.
Degrees and symptoms of osteoarthritis
- 1st degree osteoarthritis is characterized by periodic pain in the joints, especially with increased physical activity. After rest, the pain usually disappears. The range of motion of the joint is not limited and the muscle strength of the injured limb is not changed. X-rays may show minimal signs of joint damage.
- Osteoarthritis of the 2nd degree is manifested by painful sensations not only during severe physical stress, but also during minor loads. Even when resting, joint pain may not subside. This degree is characterized by stiffness of movements and limited mobility of the joints. This ultimately leads to muscle atrophy. An x-ray may show deformation of the joint, a reduction in the joint space and the appearance of bony growths near this space.
- Osteoarthritis of the 3rd degree - any movement causes great pain in a person. Joint pain is present even at rest. Therefore, a person tries to move as little as possible so that the pain is minimal. In some cases, moving requires the use of crutches or a stretcher. Sometimes fusion of bones occurs - ankylosis (as in ankylosing spondylitis).
With deforming osteoarthritis, irreversible changes occur in the cartilaginous tissue of the joint and its functions and structure are completely disrupted. Deforming osteoarthritis of the joints is based on the appearance of a dysfunction in the formation of hyaline cartilage and synovial fluid.
Diagnosis of joint osteoarthritis
Radiography is the main method of diagnosing joints. In cases of osteoarthritis, joint changes, uneven joint surfaces and narrowing of the joint space may be observed.
Which joints are most likely to suffer from osteoarthritis?
The extremity joints most susceptible to osteoarthritis are the hips, knees, shoulders, elbows and hands.
With osteoarthritis of the hip joint, a person may first feel mild discomfort in the legs after running or walking. Over time, the pain intensifies, limitation and stiffness of movements appear. At stage 3 of the disease, the patient protects his leg and tries, if possible, not to step on it.
Osteoarthritis of the knee joint is manifested by pain in the knee joint after bending and straightening the legs. Injuries suffered in the past are the most common cause of knee osteoarthritis. As a result of these injuries, the sliding of the joint surfaces is disrupted and their rapid wear occurs. In some cases, the joint may gradually lose mobility.
Osteoarthritis of the ankle joint manifests itself as swelling and pain in the ankle of the leg. The cause of osteoarthritis of the ankle joint can be: deformities, fractures of the ankles and talus, dislocations, flat feet, chronic injuries of the ankle joint in athletes and ballerinas. By the way, they often suffer from osteoarthritis of the foot.
Osteoarthritis of the shoulder, elbow and wrist joint most often appears as a result of injuries, bruises, dislocations and intra-articular fractures. Osteoarthritis of the shoulder joint is characterized by pressing, aching, dull pain that radiates to the forearm and hand. The pain appears most often at night. In cases of osteoarthritis of the hands, the pain is accompanied by hand dysfunction.
Treatment of osteoarthritis
The main ways to treat osteoarthritis are drug treatment, the use of physiotherapy and surgical treatment.
Medical treatment
The use of drugs helps to improve blood circulation in damaged joints, restore the properties of cartilage and has an analgesic and anti-inflammatory effect.
Non-steroidal anti-inflammatories
With osteoarthritis, swelling in the joint may appear, the joint begins to hurt, and the range of motion decreases. When taking anti-inflammatory drugs (NSAIDs), pain is reduced, the inflammatory chain reaction is stopped, and the process of cartilage restoration is accelerated.
Medicines can be used in the form of tablets, rectal suppositories and powder. But remember that self-medication is unacceptable: the choice and dosage of drugs for osteoarthritis is carried out by a rheumatologist.
Centrally acting analgesics
Opioid medications lower the patient's pain threshold. These medications can be taken strictly according to a prescription and only under the supervision of a doctor!
Chondoprotective drugs
Chondoprotective drugs are structural elements of the cartilage itself, therefore they actively restore this tissue and prevent its further destruction. Treatment is effective from the early stages of the disease. When the joint is already completely destroyed, it is not possible to restore the original shape of the deformed bones or to grow new cartilage.
However, in stages 1-2 of osteoarthritis, chondroprotectors can bring significant relief to the patient. Combined preparations, which contain both glucosamine and chondroitin sulfate, provide better results than a single-component preparation.
Chondroitin sulfate and glucosamine sulfate
These medications help slow the tissue's inflammatory response, reduce cartilage damage, and reduce pain. Most often, these 2 drugs are used together in treatment, since they have a cumulative effect, but they must be taken for 3-6 months.
Hyaluronic acid
Provides viscosity and elasticity of synovial fluid. Promotes good joint glide. Therefore, doctors often prescribe hyaluronic acid injections into the affected joint.
Physiotherapeutic treatments
Physiotherapeutic treatments may include:
- UHF therapy;
- magnetic therapy;
- low-level laser irradiation;
- electrophoresis with drugs;
- phonophoresis (use of ultrasound to introduce medication into the site of inflammation).
Surgery
Surgical treatment is used to restore and improve joint mobility, as well as to remove some of the damaged cartilage or menisci.
Surgical treatment of osteoarthritis is used in extreme cases, when drug treatment does not give results, in cases of severe pain, partial or complete immobility of the joints.
During arthroscopic surgery, it is possible to remove some of the cartilage affected by osteoarthritis, polish it to a smooth surface, remove fragments and growths of the cartilage, and cut some of the damaged ligaments.
Knee replacement
With this operation, the articular surfaces of the knee joint are replaced with metal or combined prostheses. The prepared plates reproduce the surface of the articular cartilage. Such prostheses are made from special alloys, they do not cause rejection reactions in patients, do not oxidize and do not injure surrounding tissues.
Hip surgery for osteoarthritis
During this operation, a partial removal of the cartilage and bone tissue of the pelvis and femur is carried out. Typically, the head of the femur and the articular surface of the pelvic bone are removed and replaced with a metal or metal-ceramic prosthesis.
Diet for osteoarthritis
Excess weight is a big enemy of your joints. Most patients with hip and knee osteoarthritis are overweight.
Therefore, for osteoarthritis, a correctly selected diet is recommended. Jellied meat cooked in cartilage broth is believed to be beneficial for osteoarthritis. It contains a lot of collagen and structural components of cartilage, which help restore cartilage tissue.
Dairy products, protein and calcium are beneficial. Animal proteins are found in lean meats and fish, while plant proteins are found in buckwheat porridge, beans and lentils. Boiled, stewed and steamed dishes are very healthy.
The best diet for joints is one with a slight predominance of carbohydrates (preferably complex), fruits and vegetables, and a sufficient amount of protein and calcium.
Osteoarthritis prevention
The prevention of osteoarthritis, as banal as it may be, lies in a healthy lifestyle. If possible, try to be in the fresh air, move around, walk barefoot on sand, green grass and just on the ground. This type of walking improves muscle function and increases blood circulation in the feet.
The use of physiotherapy with various arm and leg swings, turns and bends will provide feasible support to your joints.
Patients often ask if alternative treatment for osteoarthritis is possible? Yes, folk remedies can help in the early stages of the disease, reduce pain and improve the general condition of the patient. But this is no substitute for following your doctor's instructions.