Osteoarthritis refers to diseases that affect the joints.As a result of dystrophic-degenerative processes, cartilage is gradually destroyed and replaced by growing bone tissue.The pathological process is accompanied by pain, limited joint movement, disruption of its functions and severe deformation.Approximately 10-25% of the population suffers from arthrosis.After 80 years, almost every person has degenerative disorders in the musculoskeletal system.Most often, the disease affects the most mobile joints (fingers, hips, knees, neck).But sometimes degenerative processes develop in the ankle and shoulder.
Factors in the development of the disease
Various reasons cause destructive processes in the body.The most important are congenital anomalies of the connective tissue.Regular joint microtraumas and acute joint diseases contribute to the occurrence of arthrosis.Over time, the untreated disease passes into a chronic phase with regular exacerbations.
Provocative factors that lead to the development of arthrosis are:
- excess weight;
- physical inactivity;
- hormonal disorders;
- atherosclerosis;
- venous insufficiency;
- endocrine disorders;
- genetic predisposition;
- regular and heavy loads on the joints (for example, in weightlifters or people whose profession involves lifting and moving heavy objects).
Under the influence of a provocative factor or several at once, cartilage tissue cells begin to collapse.Gradually, the cartilage becomes thinner, becomes less elastic, then becomes covered with cracks and falls off.The bones in the joint begin to rub against each other.The body releases a compensatory mechanism, as a result of which bone tissue grows on the damaged surface.As a result, the joint becomes inactive and deforms.
The types
Arthrosis can be primary, which appears independently, and secondary, which develops as a result of diseases, injuries and deformations of the joints.
Depending on the affected joint, the disease has its name:
- Gonarthrosis affects the knee joint.
- Coxarthrosis is a disease of the hip joint.
- Spondyloarthrosis affects the intervertebral discs of the lumbar, cervical and thoracic regions.
- Crusarthrosis involves the ankle in the pathological process.
If 3 or more nodes are involved in the degenerative process, we speak of a generalized form.If there are 1-2 joints, this is local arthrosis.
Symptoms
At first, the degenerative process occurs unnoticed.There are no nerve fibers in the cartilage, so in the initial stages of development the patient does not even know what destructive processes are taking place in his body.The first signs appear only a few years after the onset of dystrophic-degenerative processes, when the periosteum under the cartilage is damaged or inflammation develops.
At first, there is pain in the limb after heavy exercise.In the morning or after a long stay at rest, there is a feeling of stiffness and a dull ache of not too great intensity.After a short warm-up or exercise, all painful symptoms disappear.Therefore, people do not go to the doctor, considering this as a common occurrence.While in the initial stage it is much easier to stop the progression of arthrosis.
Over time, all signs intensify.The pain becomes obsessive and constant, preventing you from sleeping at night.The pains, the feeling of stiffness, the inability to work or do household chores are becoming more and more disturbing.The aching, twisting pain in the joints and surrounding muscles intensifies in rainy weather.
Most often, arthrosis affects the joints of the lower extremities, so a person quickly gets tired of walking, it is difficult for him to climb the stairs or any height, since as a result of the destruction of the cartilage tissue, stiffness of the joint is formed.An unsteady gait develops due to limb instability.When you bend a joint, an unpleasant clicking sound is heard as the articular surfaces, without cartilage, rub against each other.Patients try to limit the mobility of the diseased joint, so muscle atrophy develops over time.They decrease in volume and the gait becomes even more unstable.
If arthrosis develops in the joints of the upper extremities, it happens more often after injuries or as a result of chronic arthritis.In this case, bony growths appear on the fingers, and the hands become square.
Clinical symptoms depend on the stage of development of arthrosis:
- Zero.
In the zero phase, a person is sometimes disturbed by mild discomfort.X-ray examination does not reveal any degenerative changes. - Elementary.
When you walk for a long time, a dull ache appears.X-ray shows the appearance of small areas of bone defects along the edges of the articular surfaces.When you bend the joint, a clicking sound is heard. - Easy.
In the morning there is pain and stiffness.X-rays show osteophytes (single bony growths) along the edges of the joints, narrowing of the joint space. - Moderate.
The moderate stage is considered degenerative.Bones and muscles ache constantly, especially at night.This joint swells slightly.X-ray examination shows an even greater narrowing of the joint space, increased bone growth and increased bone density. - Heavy.
In the severe (deforming) stage, constant aching pains appear, intensifying with movement.When you try to bend the joint, a harsh crack is heard.X-ray shows a sharp narrowing of the joint space;osteophytes have already grown so much that it has led to deformation of the joint and a change in its structure.
Diagnosis and treatment
An orthopedist, rheumatologist and surgeon are involved in determining the type and stage of degenerative-dystrophic processes in the joints.Diagnosis involves standard blood and urine tests.If necessary, an immunological analysis and examination of the intra-articular fluid for the presence of infection is performed.Instrumental studies were performed (MRI, ultrasound to identify changes in periarticular and articular soft tissues, CT, x-ray to determine changes in bone tissue).
therapy
The disease cannot be completely stopped.Timely diagnosis and treatment allows you to maintain its mobility and prevent the progression of destruction.
As drugs in the treatment of arthrosis, antispasmodics, NSAIDs, steroid blockades injected into the joints, chondroprotectors, muscle relaxants, vitamin and mineral complexes, drugs to improve trophism in the affected tissues, proteolysis inhibitors to slow down the destruction of cartilage and bone tissue are used.
Patients with severe pain and unstable joints are recommended to wear braces that fix the joint in a normal position using adhesive tapes, orthoses, elastic knee pads or elbow pads.Crutches or canes should be used as support.
Physiotherapy procedures should be prescribed, which include UHF, massage, ozone therapy, electrophoresis and phonophoresis with a solution of sedatives, magnetic therapy, acupuncture, electrical stimulation, darsonvalization, paraffin baths (in the absence of inflammation)
In the later stages of arthrosis, when the tissues are already destroyed and the joints are severely deformed, the only way is surgical intervention:
- Arthroscopy with the removal of bone growths, spines and partial replacement of damaged cartilage.
- Endoscopy.This is the replacement of a joint (completely or only a part) with an artificial joint.
- Artodez.The connection is closed and fixed in a comfortable position.Over time, the articular surfaces grow together.
Preventing
Since it is impossible to restore your joint to a normal physiological state, it is necessary to take measures in advance to prevent this disease.It is especially important to do this if there is a family history of cases of this disease or if you reach the age of 40.
Prevention includes maintaining a normal body mass index and regular exercise.Infectious pathologies and other joint diseases should be treated immediately, hypothermia and prolonged and sudden physical exertion should be avoided.People from risk groups (by age, having a traumatic occupation, poor heredity) should regularly examine their joints using x-rays.
Only timely and adequate treatment helps to keep joints healthy.