Osteoarthritisis a chronic non-inflammatory disease of the joints or articular cartilage as well as the tissues surrounding them. Osteoarthritis is one of the most common diseases affecting 10-14% of the world's population. Basically, this disease affects women between the ages of 45 and 55. Osteoarthritis is the most common joint disease and accounts for almost 80% of the overall joint etiology.
The etiology of this disease is currently unknown.. . . All the factors that cause tissue degeneration and aging of the body can lead to the appearance of this disease, so with age the occurrence of osteoarthritis is almost inevitable.
There are external and internal factors in the development of this disease.The main external factors of osteoarthritis are moisture, hypothermia, unfavorable working conditions, functional overload of the joints with frequent microtraumas, as well as exposure to radiation energy and vibration. The main and fairly common cause of osteoarthritis is the inability of cartilage to withstand increased stress on the joints. The reasons for this manifestation can be impaired posture, long-term work, standing, and even some sports: lifting weights, running or jumping.
Internal factors that cause this disease are: hereditary predisposition to cartilage disease, impaired blood flow to the joint, hormonal imbalance and metabolic disorders. Osteoarthritis in women can be caused by menopausal ovarian dysfunction. 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 in 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, which leads to a violation of their functions. This disease most often causes damage to the load joints (hip and knee joints) and small wrist joints. The spine is also involved in the process. But the knee and hip joints are most commonly affected.
The most basic symptomin osteoarthritis, severe pain occurs in the affected joints. These pains cause damage to bones, joints or periarticular tissue. Typically, such pain increases with exertion and decreases at rest. Night pains, 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 appearance of osteoarthritis. The intensity of such pain depends on many reasons (atmospheric pressure, humidity and temperature changes). All these factors begin to affect the pressure in the joint cavity, which causes these pains.
The next one of the main symptoms of osteoarthritis is the appearance of squeaking or squeaking in the joints, not only when walking, but also with any movement. The appearance of such a squeak or squeak is associated with a violation of the articular surfaces, which causes limited mobility in this joint.
In osteoarthritis, there is an increase in the volume of the joints, which is a consequence of the appearance of edema of the periarticular tissues. Swelling or fever in the affected joint is extremely rare.
Clinical forms of osteoarthritis:
- Gonarthrosis.
- Coxarthrosis.
- Osteoarthritis of the distal interphalangeal joints of the hand.
- Osteoarthritis of the proximal interphalangeal joints of the hands.
- Spondylosis deformans.
- Intervertebral osteochondrosis.
GonarthrosisIt is a lesion of the knee joint in osteoarthritis. In this case, the pain in the knee joints is pronounced when walking, and they are especially intense if you go down the stairs. The site of localization of these pains is in the inner and front part of the affected knee joint. Increased discomfort occurs when the knee is bent. In addition, in many cases of gonarthrosis, the knee joint deviates. The disease begins gradually, and the pain increases. Creaking can be heard during active and passive movements. The pain begins to intensify, and in many cases synovitis develops - inflammation of the capsule of the joint or tendon.
Coxarthrosis- This is a hip joint lesion. The initial pain in a hip injury does not occur in the thigh area, but in the knee, groin or buttocks. They increase during walking, and recede at rest. These pains, which occur even with minor changes on the X-ray, are associated with muscle spasm. With the defeat of the hip joint, there is a gradual increase in the limitation of mobility in the joint. This disease is the result of trauma or arthritis. In coxarthrosis, there is a "duck" gait, lameness develops, buttrophy of the muscles of the buttocks and thighs. Also, there is pain on palpation in the area of the femoral head.
Osteoarthritis of the distal interphalangeal joints of the hand or Heberden's nodules. . . The appearance of such nodules is most often observed in women during menopause. They initially appear on the 1st and 3rd fingers of the hand. Over time, namely after a few 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 nodes.Unlike Heberden's nodules, these nodules appear on the lateral surface of the joint, resulting in lateral enlargement of the joint. As a result of this increase, the finger takes on a spindle shape.
Spondylosis deformans- as a result of this disease, marginal bone growths appear in the area of the vertebrae. This disease occurs at the age of 20 years. Osteophytes (bone growths) look like swellings - edema occurs due to vascular compression. As a result, spinal stiffness and, in some cases, neurological disorders occur.
Intervertebral osteochondrosisoccurs in combination with curvature of the spine or deforming spondylosis. In this disease, the disc degenerates and the nucleus protrudes in different directions, leading to spinal trauma. There is also excessive growth of osteophytes and an increase in joint surface area. In this case, the vascular joint suffers, which causes vasculitis - inflammation of the walls of small blood vessels. The pain syndrome is very pronounced and intensifies with physical exertion or hypothermia.
There are two main forms of osteoarthritis- it is primary or idiopathic (the causes of the disease have not been clarified) and secondary (the disease occurs in the background of other diseases).
Primary osteoarthritislocalized when less than 3 joints are affected. In localized osteoarthritis, the spine, wrist and foot joints, knee joints, hip joints and other joints are affected.
There is also generalized osteoarthritis, when 3 or more joints are affected. In this case, the large joints and the distal interphalangeal joints are affected. In addition, erosive osteoarthritis occurs in a generalized form.
Secondary osteoarthritismay be posttraumatic. 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 disrupted; hemochromatosis or, as this disease is also called, bronze diabetes or pigmented cirrhosis is an inherited disease in which there is a disorder of iron metabolism and its accumulation in organs and tissues. Causes of osteoarthritis can be diseases such as diabetes mellitus, hypothyroidism - decreased thyroid function, acromegaly - hyperfunction of growth hormone. In addition to these diseases, osteoarthritis can also cause calcium deposition disease, neuropathy and many other diseases.
What happens to osteoarthritis?
In this disease, there is an intensive aging of the articular cartilage. As a result, there is a loss of elasticity of the articular cartilage. Apart from the fact that the joint surfaces become rough, cracks still appear on them. In many cases, the cartilage is worn out enough to reveal the bone. All this leads to a decrease in the elasticity of the articular cartilage and causes disorders in the joints. Furthermore, all these changes can be accompanied by inflammation, which leads to the growth of bone tissue, which leads to disease and deformity of the joints.
Diagnosis of osteoarthritis
The diagnosis of osteoarthritis in many cases does not cause great difficulties. But there are exceptions, for example, patients with a lesion of the shoulder joint and symptoms of arthritis. Difficulties can also arise in the diagnosis of primary and secondary osteoarthritis, the occurrence of which is associated with metabolic or other diseases. X-ray examination quickly reveals signs of osteoarthritis (especially in the elderly) if clinical signs of osteoarthritis are present. There is not enough X-ray and laboratory data to make a final diagnosis. To do this, it is necessary to conduct additional studies to determine the exact cause of joint pain.
Treatment of osteoarthritis
To reduce or completely eliminate pain, there are both medical and non-medical methods, which include physical therapy and exercise therapy. An individual approach to each patient is required to prescribe the correct treatment. In this case, the individual characteristics of the patient and the peculiarities of the course of this disease must be taken into account.
In the treatment of osteoarthritis, it is first necessary to adhere to the regime, because mechanical relief 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 rather long stay in a certain fixed position, long-term walking and long standing, as well as the exclusion of weight transfer, which can lead to mechanical overload of the joints. If the disease is neglected, the patient is advised to walk with crutches or a cane. With quite pronounced pain at the time of exacerbation of the disease, some patients are prescribed a semi-bed rest.
During the treatment of osteoarthritis, it is recommended to follow a diet to lose weight. This is especially true for those who have a knee joint lesion.
Also, in the treatment of this disease are used physiotherapeutic methods that not only reduce pain and inflammation, but have a positive effect on metabolic processes in joint tissues and improve microcirculation. Physiotherapy treatments include the use of electric currents, alternating magnetic currents, electrophoresis, as well as ultraviolet radiation and phonophoresis on the affected joints. In addition, thermal procedures, use of peat mud and paraffin wax are prescribed.
By using elements of therapeutic massage, patients should try to avoid mechanical irritation of the joint capsule. Only in that case, there is a reduction in painful muscle spasm, and the tone of weakened muscles increases, due to which the functional abilities of the patient improve.
Drug treatment is prescribed depending on the form of the disease and the severity of its course. In severe cases, patients are prescribed surgical treatment (arthroplasty).
Also, patients are advised to resort to spa treatment on the seashore.
Prevention of osteoarthritisconsists of daily performance of special exercises that help strengthen the musculoskeletal system. Eliminating excess weight, limiting weight bearing, as well as including in the menu foods such as jellies, jellies or aspic are all preventive measures for osteoarthritis. And, of course, playing such sports as swimming. It should be borne in mind that it is better to prevent any disease than to cure it. The same goes for diseases such as 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 for later.
Treatment of deforming osteoarthritis by various methods
High qualifications and accumulated experience in the application of shock wave therapy enable the achievement of the maximum positive effect of treatment even in advanced stages of the disease, avoiding surgical treatment in many cases.
Shock wave therapy is performed on modern devices:
- the course of treatment of arthritis, arthrosis UHT method consists of 5-7 sessions;
- session is performed 1 time in 5-7 days.
Under the influence of the shock wave, the microcrystals of calcium salts and areas of fibrosis that form in the tissues of the joints loosen in the affected tissues. At the same time, the blood flow in the damaged tissue increases tenfold, which contributes to the resorption of calcium salts and areas of 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 pain relief without analgesics;
- the possibility of use in the chronic stage of the disease and with its primary manifestations;
- it is performed on an outpatient basis, does not require hospitalization, does not disrupt the patient's normal rhythm of life.
Photodynamic therapy in orthopedicsIt is a non-invasive two-component method of treatment without complications. A photosensitizer and a laser radiation source approved for medical use with a wavelength of 660-670 nm are used to implement the method.
Under the influence of the laser beam, the photosensitizer is excited by releasing singlet oxygen, which is toxic to the energy complexes of the cell (mitochondria and Golgi complex), destroying the latter and thus initiating the irreversible process of apoptosis. At the same time, healthy cells are not damaged. Damaged pathological tissue is aseptically absorbed.
The photosensitizer is injected into the patient's body transcutaneously (applications).
PRP plasma lifting- This orthopedic procedure is based on the patented method of processing the patient's blood with the help of special vacuum biotechnological tubes and a special way of centrifugation.
During the procedure, an injectable form of platelet-containing autoplasma is isolated from the patient's blood, which is then injected into the soft tissues surrounding the joint and directly into the patient's joint cavity. Autoplasma injections can reduce inflammation, relieve pain and restore range of motion in the joint. The autoplasma treatment procedure minimizes the number of drugs used or completely eliminates them, thus reducing the toxic effect of drugs on the patient's body. Also, autoplasma injections help reduce treatment time by 2-3 times.
Indications for the procedure (PRP plasmalifting):
- osteoarthritis;
- osteoarthritis;
- periarthritis;
- tendon tendopathy,
- ligament and muscle damage.
Therefore, shock wave therapy, photodynamic therapy and plasma lifting (PRP) in orthopedics are the best choices for the treatment of joint disease. With the use of modern equipment and technologies and the experience of doctors, they enable the achievement of positive results.