Osteoarthritis is a chronic-degenerative disease that affects all parts of the joint: cartilage, articular membrane, ligaments, capsule, periarticular bones, and periarticular muscles and ligaments.
According to European doctors, osteoarthritis accounts for almost 70% of all rheumatological diseases. People between 40 and 60 years old are the 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?
Normally, a human joint consists of 2 or more connected bones. All working surfaces of the joint have a protective layer and are constantly lubricated with synovial fluid for better gliding. The joint cavity itself is hermetically sealed by the joint capsule.
In our body there are many joints that are "responsible" for certain types of movements, they 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 tendons.
Causes of joint osteoarthritis.
Normal joint function is possible with constant self-renewal of cartilage tissue. At a young age, the rate of death of obsolete joint cells is equal to the rate of birth of new cells. As we age, the cell renewal process slows down and cartilage tissue begins to thin. It also decreases the production of synovial fluid. As a result, the articular cartilage begins to thin and break down, leading to osteoarthritis.
In addition, there are other causes of joint osteoarthritis:
- Increased physical activity. Osteoarthritis of the joints is a frequent accompaniment to excess weight. As a result of overload, microtraumas form in the joints. Athletes develop joint damage due to increased loads on "unwarmed" joints;
- joint injuries;
- congenital or acquired deformities of the musculoskeletal system (rickets, kyphosis, scoliosis, inadequate fusion of bones after injuries with the appearance of deformities of the extremities: O-shaped and X-shaped deformity of the legs).
Stages of osteoarthritis
Depending on the degree of destruction of the cartilage tissue, different stages or degrees of osteoarthritis can be distinguished.
Degrees and symptoms of osteoarthritis.
- First 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 does not change. X-rays may show minimal signs of joint damage.
- Arthritis of the second degree is manifested by painful sensations not only with intense physical stress, but also with minor loads. Even during rest, joint pain may not go away. This degree is characterized by rigidity in movements and limited mobility in the joints. Ultimately, this leads to muscle atrophy. An x-ray may show deformation of the joint, a decrease in joint space, and the appearance of bone growths near this gap.
- Third degree osteoarthritis - any movement causes great pain to a person. Pain in the joint is present even at rest. Therefore, a person tries to move as little as possible so that the pain is minimal. In some cases, movement 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 altered. 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.
The main method for diagnosing joints is x-ray. Changes in the joints, uneven joint surfaces and narrowing of the joint space can be observed in osteoarthritis.
Which joints are most likely to suffer from osteoarthritis?
The joints of the extremities most susceptible to osteoarthritis are the hips, knees, shoulders, elbows and hands.
With osteoarthritis of the hip joint, a person may first feel slight discomfort in the legs after running or walking. Over time, the pain intensifies, limitation and stiffness in movement appear. In stage 3 of the disease, the patient protects his leg and tries, if possible, not to step on it.
Osteoarthritis of the knee joint manifests itself as pain in the knee joint after bending and straightening the legs. The most common cause of knee osteoarthritis is injuries suffered in the past. As a result of these injuries, the sliding of the articular surfaces is altered and their rapid wear occurs. In some cases, the joint may gradually lose its 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 ankle and talus, dislocations, flat feet, chronic injuries of the ankle joint in athletes and dancers. By the way, they often have osteoarthritis of the foot.
Osteoarthritis of the shoulder, elbow and wrist joints most often appears as a result of injuries, bruises, dislocations and intra-articular fractures. Osteoarthritis of the shoulder joint is characterized by a dull, aching, squeezing pain that radiates to the forearm and hand. The pain appears most often at night. With arthrosis of the hands, pain is accompanied by hand dysfunction.
Osteoarthritis treatment
The main means of treating osteoarthritis are drug treatment, the use of physiotherapy and surgical treatment.
Pharmacotherapy
The use of medications helps to improve blood circulation in damaged joints, restores the properties of cartilage, and has an analgesic and anti-inflammatory effect.
Non-steroidal anti-inflammatory drugs
With osteoarthritis, swelling of the joint may appear, the joint begins to hurt, and the range of motion decreases. By taking anti-inflammatory drugs (NSAIDs), pain is reduced, the inflammatory chain reaction is stopped, and the cartilage restoration process is accelerated.
Medications can be used in the form of tablets, rectal suppositories and powder. But remember that self-medication is unacceptable, the selection and dosage of the drug for osteoarthritis is carried out by a rheumatologist.
Central acting analgesics
Opioid drugs lower the patient's pain threshold. These medications can be taken strictly with a doctor's 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 in the initial stages of the disease. When the joint is completely destroyed, it is not possible to return the original shape of the deformed bones or develop new cartilage.
However, in stages 1-2 of osteoarthritis, chondroprotectors can bring significant relief to the patient. Combined preparations, which include glucosamine and chondroitin sulfate, give better results compared to a single-component preparation.
Chondroitin sulfate and glucosamine sulfate
These medications help slow down the inflammatory response in the tissues, help reduce cartilage damage, and reduce pain. Most often, these 2 drugs are used together in treatment, as they have a cumulative effect, but they must be taken for 3 to 6 months.
Hyaluronic acid
It provides viscosity and elasticity to the synovial fluid. Helps the joints slide properly. Therefore, doctors often prescribe hyaluronic acid injections into the affected joint.
Physiotherapeutic treatments
Physiotherapeutic treatments may include:
- UHF therapy;
- magnetic therapy;
- low intensity laser irradiation;
- drug electrophoresis;
- Phonophoresis (use of ultrasound to introduce medication to 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 meniscus.
Surgical treatment of osteoarthritis is resorted to in extreme cases, when drug treatment does not give results, when intense pain, partial or total immobility occurs in the joints.
During arthroscopic surgery, it is possible to remove part of the cartilage affected by osteoarthritis, polish it to give it a smooth surface, remove cartilage fragments and growths, and cut part 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 replicate the surface of articular cartilage. These prostheses are made of special alloys, they do not cause a rejection reaction in patients, they do not rust and they do not damage the surrounding tissues.
Hip surgery for osteoarthritis
During this operation, partial removal of cartilage and bone tissue from the pelvis and femur is performed. 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 body weight is a great enemy of your joints. Most patients suffering from osteoarthritis of the hip and knee joints are overweight.
Therefore, in case of osteoarthritis, a properly selected diet is recommended. Jellied meat cooked in cartilage broth is believed to be beneficial for osteoarthritis. It contains a large amount of collagen and cartilage structural components, which help restore cartilage tissue.
Dairy products, protein and calcium are beneficial. Animal protein is found in lean meats and fish, while plant protein is found in buckwheat porridge, beans and lentils. Boiled, stewed and steamed dishes are very healthy.
The best diet for joints is a diet 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, no matter how trivial, lies in a healthy lifestyle. If possible, try to be outdoors, move around, walk barefoot on sand, green grass and just the ground. This type of walking improves muscle function and increases blood circulation in the feet.
Using physical therapy with various arm and leg movements, twists and bends will provide feasible support for your joints.
Patients often ask if an alternative treatment for osteoarthritis is possible. Yes, home remedies can help in the initial stages of the disease, reduce pain and improve the general condition of the patient. But it is no substitute for following your doctor's instructions.