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 all articular etiology.
The etiology of this disease is currently unknown.. . . All factors that cause tissue degeneration and aging of the body can lead to the occurrence of this disease, therefore, the appearance of osteoarthritis is almost inevitable with age.
There are external and internal factors at the onset of this disease.The most important external factors in osteoarthritis include moisture, hypothermia, adverse working conditions, functional overload of joints with frequent microtraumas, and exposure to radiant energy and vibration. The main and fairly common cause of osteoarthritis is the inability of the cartilage to withstand the increased load on the joints. The causes of this manifestation can be reduced posture, prolonged work, standing on one’s feet and even some sports: lifting weights, running or jumping.
The internal factors that cause this disease include the following: hereditary predisposition to the occurrence of diseases of the cartilage tissue, decreased blood supply to the joint, hormonal imbalance and metabolic disorders. The cause of osteoarthritis in women can be ovarian dysfunction during menopause. In addition, vascular processes with early development of atherosclerosis may 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 by severe pain and deformation of the joints, leading to a violation of their functions. With this disease, injuries most often occur to the load joints (hip and knee joints) and small joints in the hand. The spine is also involved in the process. But most often the knee and hip joint is 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 tissue. Typically, such pain increases with exertion and decreases at rest. Night pain, swelling of the joints, as well as the appearance of a feeling of "gel viscosity" in the affected joint in the morning - all this indicates the occurrence of osteoarthritis. The intensity of such pain depends on many causes (atmospheric pressure, humidity and temperature changes). All of these factors begin to affect the pressure in the joint cavity that causes these pains.
The next of the main symptoms of osteoarthritis is the appearance of a crunch or squeak in the joints, not only when walking, but even during any movement. The appearance of such a crunch or squeak is associated with a violation of the articular surfaces, which causes a limitation of mobility in this joint.
With osteoarthritis, an increase in the volume of the joints occurs, which is a consequence of the appearance of edema in the periarticular tissues. Swelling or fever in the affected joint is extremely rare.
Clinical forms of osteoarthritis:
- Gonarthrosis.
- Coxarthrosis.
- Osteoarthritis of the distal interphalangeal joint of the hand.
- Osteoarthritis of the proximal interphalangeal joints of the hands.
- Spondylosis deformans.
- Intervertebral osteochondrosis.
GonarthrosisIs a lesion in the knee joint in osteoarthritis. In this case, pain in the knee joints is expressed when walking, and they are especially intense if you walk down the stairs. The site of localization of these pains is in the inner and anterior parts of the affected knee joint. An increase in discomfort occurs when the knee is bent. In addition, in many cases of gonarthrosis there is a deviation of the knee joint. The disease begins gradually and the pain grows. During active and passive movements, a crunch can be heard. The pain begins to intensify, and in many cases synovitis develops - an inflammation of the capsular membrane of the joint or tendon.
Coxarthrosis- This is a lesion of the hip joint. The first pain of a hip injury does not occur in the thigh area, but in the knee, groin or buttocks. They increase with time, and decrease at rest. These pains, which occur even with minor changes on the x-ray, are associated with muscle spasms. With the defeat of the hip joint, there is a gradual increase in the restriction of movement in the joint. This disease is a consequence of trauma or arthritis. With coxarthrosis, there is a "duck" gait that develops lameness, muscle hypotrophy in the buttocks and thighs. There is also pain on palpation in the area of the femoral head.
Osteoarthritis of the distal interphalangeal joints of the hand or the nodules of the Heberden. . . The appearance of such nodules is most often observed in menopausal women. To begin with, they appear on the 1st and 3rd fingers of the hand. Over time, namely after several months or even years, a symmetrical lesion 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's nodules, these nodules appear on the lateral surface of the joint, resulting in lateral expansion of the joint. As a result of this increase, the finger acquires a fusiform form.
Spondylosis deformans- as a result of this disease in the area of the vertebrae, marginal bone growth occurs. This disease occurs from the age of 20 years. Osteophytes (bone growth) resemble swelling - edema occurs due to vascular compression. As a result, spinal stiffness occurs, and in some cases, neurological disorders occur.
Intervertebral osteochondrosisoccurs in combination with curvature of the spine or deforming spondylosis. With this disease, the disc degenerates and the nucleus protrudes in different directions, leading to trauma to the spine. There is also an overgrowth of osteophytes and an increase in the surface of the joint. In this case, the joint choroid suffers, as a result of which vasculitis occurs - an inflammation of the walls of small blood vessels. The pain syndrome is very pronounced and increases with physical exertion or hypothermia.
There are two main types of osteoarthritisit is primary or idiopathic (the causes of the disease are not clear) and secondary (the disease occurs on the background of other diseases).
Primary osteoarthritisit is localized when fewer than 3 joints are affected. In localized osteoarthritis, the spine, joints in the hands and feet, knee joints, hip joints and other joints are affected.
Osteoarthritis is also generalized when 3 or more joints are affected. In this case, large joints and distal interphalangeal joints are affected. In addition, erosive osteoarthritis also 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 impaired; Hemochromatosis or, as this disease is also called, bronchial diabetes or pigmentary 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 mellitus, hypothyroidism - a decrease in thyroid function, acromegaly - hyperfunction of growth hormone, can also be the causes of osteoarthritis. In addition to these diseases, osteoarthritis can also cause calcium deposition disease, neuropathy and many other diseases.
What happens to osteoarthritis?
With this disease, intensive aging of the articular cartilage occurs. As a result, there is a loss of elasticity of the articular cartilage. In addition to the fact that the articular surfaces become rough, cracks still occur on 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 disturbance of the joints. In addition, inflammation can join all the listed changes, due to which the growth of bone tissue occurs and this leads to disease and deformation of the joints.
Diagnosis of osteoarthritis
Diagnosis of osteoarthritis in many cases does not present great difficulties. However, there are exceptions, such as patients with a lesion in the shoulder joint and symptoms of arthritis. Difficulties can also arise in diagnosing primary and secondary osteoarthritis, the occurrence of which is associated with metabolic or other diseases. On X-ray examination, signs of osteoarthritis are detected quickly (especially in the elderly) if there are clinical signs of osteoarthritis. In order to make a definitive diagnosis, there is not enough X-ray and laboratory data. To do this, it is necessary to perform a series of additional examinations to identify the exact cause of the pain in the joints.
Osteoarthritis treatment
To reduce or completely suppress pain, there are both drug and non-medical methods, which include physiotherapy and exercise therapy. To prescribe the correct treatment, an individual approach is required for each patient. 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 observe the regimen, as mechanical reading of the joint is not only the main factor in reducing pain, but also plays an important role in the treatment of this disease. In this case, it is necessary to exclude a fairly long stay in a certain fixed position, prolonged gait and long standing on the legs, as well as the exclusion of the transfer of weights that can lead to mechanical overload of the joints. If the disease is neglected, the patient is advised to walk with crutches or cane. With fairly pronounced pain at the time of exacerbation of the disease, some patients are prescribed a half-bed regimen.
During the treatment of osteoarthritis, it is recommended to follow a diet to reduce obesity. This is especially true for those who have a lesion of the knee joints.
Also in the treatment of this disease are used physiotherapeutic methods 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 treatments include the use of electric currents, magnetic alternating 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 elements of therapeutic massage, patients should try to avoid mechanical irritation of the joint capsule. Only in this case, there is a decrease in painful muscle spasm, and the tone of the weakened muscles also increases, as a result of which the patient's functional abilities improve.
Drug treatment is prescribed depending on the form of the disease and the severity of its course. In more severe cases, patients are prescribed surgical treatment (arthroplasty).
Patients are also advised to resort to spa treatment on the sea coast.
Prevention of osteoarthritisconsists in the daily performance of special exercises that help to strengthen the musculo-ligamentous apparatus. Getting rid of excess weight, limiting carrying weights, as well as adding to the menu of such dishes as jelly, jelly meat or aspic are all preventative measures for osteoarthritis. And of course go in for such a sport as swimming. It must be remembered that it is better to prevent any disease than to cure it. The same goes for diseases like osteoarthritis. In order not to think in the future about how to get rid of severe pain in osteoarthritis, as well as how to cure this disease, it is necessary to take preventive measures today without postponing them until later.
Treatment of deforming osteoarthritis by various methods
High qualifications and accumulated experience in the use of shock wave therapy make it possible to achieve the maximum positive effect of the treatment even in advanced stages of the disease, and to avoid surgical treatment in many cases.
Shock wave therapy is performed on a modern device:
- the course of treatment of arthritis, osteoarthritis by the UHT method consists of 5-7 sessions;
- the session is conducted once in 5-7 days.
Under the influence of a shock wave, microcrystals of calcium salts and areas of fibrosis formed in the tissues of the joints are loosened in the affected tissue. At the same time, the blood flow in the damaged tissue is increased tenfold, which contributes to the resorption of calcium salts and 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 relief of pain without analgesics;
- the possibility of using in the chronic stage of the disease and with its primary manifestations;
- performed outpatient, does not require hospitalization, does not interfere with the patient's usual life rhythm.
Photodynamic therapy in orthopedicsIs a non-invasive, complication-free two-component treatment method. To implement the method, a photosensitizer and a laser beam source approved for medical use with a wavelength of 660-670 nm are used.
Under the influence of a laser beam, a photosensitizer is excited with the release of singlet oxygen, which toxicly affects the cell's energy complexes (mitochondria and the Golgi complex), destroying the latter and thereby triggering the irreversible apoptosis process. At the same time, healthy cells are not damaged. The damaged pathological tissue is absorbed aseptically.
The photosensitizer is injected into the patient's body by transcutaneous (applications).
PRP plasma lift- This orthopedic procedure is based on a patented method of treating the patient's blood using special vacuum biotechnology tubes and a special spin mode.
During the procedure, an injection form of autoplasm containing platelets is isolated from the patient's blood, which is then injected into the soft tissue surrounding the joint and directly into the patient's joint cavity. Autoplasm injections can reduce inflammation, relieve pain, and restore joint mobility. The autoplasm treatment procedure minimizes the number of drugs used or eliminates them completely, thereby reducing the toxic effect of drugs on the patient's body. Autoplasm injections also help reduce treatment time by 2-3 times.
Indications for the procedure (PRP plasma lifting):
- osteoarthritis;
- osteoarthritis;
- periarthritis;
- late tendons,
- injuries to ligaments and muscles.
Shock wave therapy, photodynamic therapy and plasma lift (PRP) in orthopedics are thus the best choices for the treatment of joint diseases. With the use of modern equipment and technologies and the experience of doctors, they enable you to achieve positive results.