Osteoarthritisis a chronic, non-inflammatory disease of the joints or joint cartilage, as well as the tissues around 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 all joint etiologies.
The etiology of this disease is currently unknown.. . . All the factors that cause the degeneration of the tissues and the aging of the organism can lead to the occurrence of this disease, therefore, with age, the onset of osteoarthritis is almost inevitable.
There are external and internal factors in the appearance of this disease.The main external factors of osteoarthritis are humidity, hypothermia, unfavorable working conditions, functional overload of the joints with frequent microtraumas, as well as exposure to radiation energy and vibrations. The main and quite common cause of osteoarthritis is the inability of the cartilage to withstand the increased stress on the joints. The reasons for this manifestation can be impaired posture, long work, standing on the feet, and even some sports: lifting weights, running or jumping.
The internal factors causing this disease are: hereditary predisposition to the occurrence of diseases of the cartilage tissue, impaired blood supply to the joint, hormonal imbalance and metabolic disturbances. The cause of osteoarthritis in women can be ovarian dysfunction during menopause. In addition, vascular processes with the early development of atherosclerosis can 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, which leads to a violation of their functions. With this disease, most often damage to the load joints (hip and knee joints) and small joints of the hand occurs. The spine is also involved in the process. But most often the knee and hip joints are affected.
The most basic symptomwith osteoarthritis, there is severe pain in the area of the affected joints. These pains damage bones, joints or periarticular tissues. Typically, this pain increases with exertion and decreases at rest. Night pain, swelling of the joints, as well as the appearance of a feeling of "gel stickiness" in the affected joint in the morning - all this indicates the onset of osteoarthritis. The intensity of such pain depends on many reasons (atmospheric pressure, humidity and temperature changes). All of these factors start to influence the pressure in the joint cavity, which causes these pains.
The next of the main symptoms of osteoarthritis is the appearance of a cracking or grinding in the joints, not only when walking, but even during any movement. The appearance of such a cracking or squeaking is associated with a violation of the articular surfaces, which causes restriction of mobility in this joint.
With 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.
- Deforming spondylosis.
- Intervertebral osteochondrosis.
GonarthrosisIs an injury to the knee joint in osteoarthritis. In this case, pain in the knee joints when walking is expressed, and it is especially intense if you go down the stairs. The place 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 knee osteoarthritis there is a deviation of the knee joint. The disease begins gradually and the pain increases. With 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 an injury to the hip joint. The initial pain from a hip injury does not appear in the thigh area, but in the knee, groin, or buttock. They increase with walking 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 limitation of mobility in the joint. This disease is a consequence of trauma or arthritis. With coxarthrosis, there is a "duck" gait, developing lameness, muscular hypotrophy of the buttocks and thighs. In addition, 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. Initially, they appear on the 1st and 3rd fingers of the hand. Over time, that is, after several months or even years, a symmetrical lesion is observed in the other distal interphalangeal joints. These 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, causing the joint to widen laterally. As a result of this increase, the finger acquires a spindle shape.
Deforming spondylosis- as a result of this disease in the region of the vertebrae, marginal bony growths appear. This disease appears from the age of 20. Osteophytes (bone growths) look like swelling - edema appears due to vascular compression. As a result, spinal stiffness appears, and in some cases, neurological disorders appear.
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, resulting in trauma to the spine. There is also an overgrowth of osteophytes and an increase in the area of the joint. In this case, the choroid of the joint suffers, which leads to vasculitis - 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 forms of osteoarthritis- it is primary or idiopathic (the causes of the disease have not been clarified) and secondary (the disease occurs against the background of other diseases).
Primary osteoarthritisit is localized when less than 3 joints are affected. With localized osteoarthritis, the spine, joints of the hands and feet, 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, in the generalized form, erosive osteoarthritis also occurs.
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, bronze 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 - decreased function of the thyroid gland, acromegaly - hyperfunction of growth hormone, can also be the cause of osteoarthritis. In addition to these diseases, osteoarthritis can also cause calcium deposit disease, neuropathy, and many other diseases.
What happens with osteoarthritis?
With this disease, there is intensive aging of the articular cartilage. This results in a loss of elasticity of the articular cartilage. Besides the fact that the joint surfaces become rough, cracks still appear on them. In many cases, the cartilage is worn down enough to expose the bone. All this leads to a decrease in the elasticity of the articular cartilage and causes disruption of the joints. In addition, inflammation can join all the listed changes, due to which the growth of bone tissue occurs, which leads to disease and deformation of the joints.
Diagnosis of osteoarthritis
The diagnosis of osteoarthritis in many cases is not very difficult. But there are exceptions, for example, patients with injury to the shoulder joint and symptoms of joint inflammation. Difficulties may also arise in the diagnosis of primary and secondary osteoarthritis, the occurrence of which is associated with metabolic or other diseases. On radiographic examination, signs of osteoarthritis are detected quickly (especially in the elderly) if clinical signs of osteoarthritis are present. In order to make a final diagnosis, there is not enough x-ray and laboratory data. To do this, it is necessary to conduct a number of additional studies in order to identify the exact cause of pain in the joints.
Osteoarthritis Treatment
In order to reduce or completely remove pain, there are both drug and non-drug methods, which include physical therapy and exercise therapy. To prescribe the right treatment, an individual approach to each patient is necessary. 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 diet, since the mechanical discharge from the joint is not only the main factor in reducing pain, but also plays an important role in the treatmentof this disease. In this case, it is necessary to exclude a rather long stay in a certain fixed position, prolonged walking and long standing on the legs, as well as the exclusion of weight transfer that can lead to mechanical overload of the joints. If the disease is overlooked, the patient is advised to walk with crutches or a cane. With quite severe pain at the time of exacerbation of the disease, some patients are prescribed a half-bed diet.
When treating osteoarthritis, it is recommended to follow a diet to reduce excess weight. This is especially true for those who have an injury to the knee joints.
In addition, in the treatment of this disease, physiotherapeutic methods are used 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, alternating magnetic 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.
When 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 spasms, and the tone of weakened muscles also increases, which improves the patient's functional abilities.
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).
In addition, patients are advised to resort to spa treatment on the sea coast.
Prevention of osteoarthritisconsists of the daily performance of special exercises that help strengthen the musculo-ligamentous system. Getting rid of excess weight, limiting weight bearing, as well as including in the menu such dishes as jelly, jelly meat or aspic are all preventive measures for osteoarthritis. And, of course, playing a sport like swimming. It must be remembered that it is better to prevent a 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 tolater.
Treatment of deforming osteoarthritis by various methods
High qualifications and accumulated experience in the use of shock wave therapy allow to achieve the maximum positive effect of treatment even in advanced stages of the disease, avoiding surgical treatment in many cases.
Shock wave therapy is carried out on a modern device:
- the course of treatment of arthritis, osteoarthritis by the UHT method consists of 5-7 sessions;
- the session is performed 1 time in 5-7 days.
Under the influence of a shock wave, microcrystals of calcium salts and areas of fibrosis that form in the tissues of the joints relax in the affected tissues. At the same time, blood flow to damaged tissues is increased 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;
- fast pain relief without pain reliever;
- the possibility of using at the chronic stage of the disease and with its primary manifestations;
- performed on an outpatient basis, does not require hospitalization, does not disturb the patient's usual rhythm of life.
Photodynamic therapy in orthopedicsIs a non-invasive and uncomplicated two-component treatment method. To carry out the method, a photosensitizer and a laser radiation 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 energy complexes of the cell (mitochondria and Golgi complex), destroying them and thus triggering the irreversible process ofapoptosis. 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 via the skin (applications).
PRP plasma lifting- This orthopedic procedure is based on a patented method of processing the patient's blood using special biotechnology vacuum tubes and a special centrifugation mode.
During the procedure, a form of autoplasm injection containing platelets 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. Autoplasm injections can reduce inflammation, relieve pain, and restore range of motion in the joint. The autoplasm treatment procedure minimizes the number of drugs used or completely eliminates them, thereby reducing the toxic effect of drugs on the patient's body. In addition, autoplasm injections help reduce treatment time by 2-3 times.
Indications for the procedure (plasmolifting PRP):
- osteoarthritis;
- osteoarthritis;
- periarthritis;
- tendon tendopathies,
- damage to ligaments and muscles.
Thus, 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 allow you to achieve positive results.