Osteoarthritis is a chronic disease of the joints, accompanied by pathological changes in the hyaline cartilage, then in adjacent tissues, the joint capsule and the synovium.
The lesion is dystrophic and degenerative, which leads to a change in the structure of the joint tissues, a loss of their functionality. According to the same statistics, 12% of the total population of the planet is susceptible to osteoarthritis. Between 62% and 65% of all episodes of the disease occur in people over the age of 60.
Another 30-35% of cases of joint damage with this pathology occur in patients aged 40-60 years. And about 3% are young people between the ages of 20 and 40.
What is this?
Simply put, osteoarthritis is a chronic disease in which progressive degenerative-dystrophic changes develop in the joint due to metabolic disturbances. It is the most common joint pathology, diagnosed in 6 to 7% of the population. With age, the incidence increases dramatically.
Small joints of the hand (in women 10 times more often than in men), the big toe, the intervertebral joints of the thoracic and cervical spine, as well as the knee and hip joints are the mostoften involved in the pathological process of osteoarthritis. Osteoarthritis of the knee and hip joints ranks first in terms of severity of clinical manifestations and negative impact on quality of life.
Osteoarthritis is characterized by a complex lesion of the articular and auxiliary apparatus:
- chondritis - inflammatory changes in the cartilage of the joint;
- osteitis - involvement of the underlying bone structures in the pathological process;
- synovitis - inflammation of the inner membrane of the joint capsule;
- bursitis - damage to periarticular pockets;
- reactive inflammation of soft tissues (muscles, subcutaneous tissue, ligaments) located in the projection of the involved joint (periarticular inflammation).
The disease is diagnosed in 2% of people under 45 years old, in 30% - from 45 to 64 years old, and in 65-85% - by the age of 65 and over. Osteoarthritis of the large and medium joints of the extremities has the greatest clinical significance due to its negative impact on the standard of living and working capacity of patients.
Types of osteoarthritis
Depending on the cause of the pathological process inside the joint, primary, secondary and idiopathic osteoarthritis are distinguished.
Primary develops as an independent, secondary disease as a result of injury or infection, and the cause of the idiopathic form is not known. In addition to the classification of the disease, depending on the cause of the pathological process, osteoarthritis is distinguished depending on the location of destructive changes:
- Knee osteoarthritis is the most common type of disease characterized by damage to the knee joints. Most often, knee osteoarthritis is detected in people with overweight, with chronic metabolic diseases in the body and weak immunity. Osteoarthritis of the knee progresses for a long time and gradually leads to complete loss of motor function.
- Osteoarthritis of the shoulder joint - the main cause of degenerative processes in this area is congenital anomalies in the development of the shoulder joint or excessive stress on this area, for example during transportof heavy luggage on the shoulders.
- Osteoarthritis of the ankle - the main reasons for the development of degenerative processes in the ankle joint are trauma, sprains, sprains, fractures. In some cases, the development of a pathological process can provoke an autoimmune disease - rheumatoid arthritis. Osteoarthritis of the ankle affects dancers, women wearing high heels, athletes.
- Uncoarthrosis or osteoarthritis of the cervical spine - the causes are neck injury, progressive osteochondrosis, obesity, sedentary lifestyle. People working on computers in offices are at risk. In addition to severe neck pain, patients present with severe dizziness, depression of consciousness, impaired memory, and fatigue. These symptoms are caused by compression of the vertebral artery, through which nutrients and oxygen enter the brain.
- Coxarthrosis or osteoarthritis of the hip joint - the main cause of this is age-related changes in the tissues of the joint. People over 45 are at risk.
- Osteoarthritis of the fingers - develops for the same reason as spondylarthrosis.
- Polyarthrosis is characterized by lesions of multiple joints with progressive degenerative processes, while the pathological process involves ligaments, muscles and tissues surrounding the joint.
- Spondyloarthrosis - the tissue of the spine, namely its lumbar region, is subjected to destructive destruction. Women are at risk at the onset of menopause, as spondylarthrosis develops against the background of a deficiency of female sex hormones.
Causes of osteoarthritis
Two reasons contribute to the formation of osteoarthritis: stress and the lack of adequate nutrition, which provides vitamins and minerals for tissue repair. Each person's joints carry a load. For athletes and dancers, during physical work, the load on the legs is greater, which means that the bone joints wear out faster and require high-quality nutrition. With a calm lifestyle, the support device wears out more slowly, but also requires regular tissue renewal.
Therefore, the main condition of the destruction and deformation of the joints is malnutrition, indigestion of useful components, which often occurs with metabolic disorders.
Let's list the factors that contribute to joint wear and tear and metabolic disorders:
- Muscle weakness and abnormal load on the joints. The weakening of one or more muscles increases the load on the joint and distributes it unevenly within the bone junction. In addition, an incorrect load of muscles is formed with flat feet, scoliosis, therefore, with these "harmless" diseases, cartilage tissue wears out with age, arthrosis appears.
The likelihood of osteoarthritis increases with intense physical exertion.
If the daily loads exceed the capacity of bone tissue, microtrauma is formed in them. At the sites of injury, thickenings appear, which develop over time and deform the joint;
- Metabolic disorders (gastrointestinal diseases - stagnation of bile, dysbiosis, gastritis, cholecystitis, pancreatitis, metabolic disease - diabetes);
- Psychosomatic Causes - The psychosomatics of osteoarthritis confirms that a negative emotional state also becomes the cause of the disease. Stress forms muscle spasms, constant stress disrupts the nutrition of all tissues (internal organs, bones, joints);
- Heredity (the type of metabolism and its possible disorders are hereditary, a tendency to muscle weakness or poor bone formation, poor digestion - which is the basis for the development ofosteoarthritis in the elderly).
Osteoarthritis is a disease of worn joints that have lost a significant amount of minerals and the ability to resist stress and destruction. Therefore, with age, the predisposition to the disease increases. After 70 years, osteoarthritis is diagnosed in one in two retirees. Since the maximum load falls on the legs (a person moves - walks, stands, runs, jumps), this is where the first signs of osteoarthritis are formed.
Mechanism of disease progression
When one of the reasons provoking disease of the joint with osteoarthritis appears, pathological processes begin to develop. The mechanism of their progression is not fully understood, but the main stages of official medicine are known.
At the initial stage, there is a depletion of the structure of cartilage tissue and abnormal changes in synovial fluid. This is all due to metabolic disorders, in which the tissues of the joints do not receive the necessary components in sufficient quantities, or are deprived of some of them.
In addition, the elasticity of collagen fibers and the flexibility of cartilage are lost, due to the fact that in the body lacking in nutrients, hyaluronic acid does not have time to be produced, which bringssoftness and flexibility to the structural composition of collagen fiber. The cartilage gradually dries out, becomes brittle and cracks. The fluid in the synovial capsule gradually depletes and then disappears completely.
Roughness and solid bone growths form on cartilage tissue. At the same time, the deformation of other tissues of the joint develops, their pathological degeneration, dystrophy and loss of physiological activity. For the patient, these changes result in the appearance of pain, lameness, joint stiffness.
Symptoms of osteoarthritis
The acute clinical picture is not typical of osteoarthritis, joint changes are gradual, increasing slowly, manifested by a gradual increase in symptoms:
- pain;
- intermittent cracking of the affected joint;
- joint deformity that appears and gets worse as the disease progresses;
- stiffness;
- limitation of mobility (decrease in volume of active and passive movements in the affected joint)
Pain in osteoarthritis is dull, transient, appears moving, against a background of intense stress, towards the end of the day (it can be so intense that it does not allow the patient to fall asleep). The constant, non-mechanical nature of OA pain is uncharacteristic and indicates the presence of active inflammation (subchondral, synovial bone, ligamentous apparatus, or periarticular muscles).
Most patients note the presence of so-called onset pains which occur in the morning after waking up or after a long period of inactivity and disappear during physical activity. Many patients define this condition as the need to “develop a joint” or “disengage”.
Osteoarthritis is characterized by morning stiffness, which has a clear localization and is short-term in nature (no more than 30 minutes), sometimes it is perceived by patients as a "frozen sensation" in the joints. A feeling of wedging, stiffness is possible.
With the development of reactive synovitis, the main symptoms of osteoarthritis are joined by:
- pain and local increase in temperature, determined by palpation of the affected joint;
- persistent pain;
- joint enlargement, swelling of soft tissue;
- gradual decrease in range of motion.
Stages and degrees of osteoarthritis
In the course of the disease, medicine distinguishes three stages, which differ in the signs of the disease, the intensity of the lesion and the location. At the same time, the differences in the three stages relate to the types of tissues undergoing pathological changes.
- The first stage of development of osteoarthritis of the joints is the initial stage of the disease. It is characterized by slight damage to cartilage tissue and loss of physiological functions of collagen fibers. At the same time, at the first stage, minor morphological disorders of the bone tissue and structural changes in the synovial fluid are noted. The cartilage of the joint is covered with cracks, the patient has slight pain at the site of the pathology.
- Second degree - the development of osteoarthritis with increased dynamics. This stage is characterized by the appearance of stable pain, lameness. There are morphological and dystrophic changes visible in the cartilage; when diagnosed, the growth of bone tissue is revealed. Osteophytes form - bony growths visible on visual examination of the site of the injury. At the same time, the processes of degenerative changes in the synovial capsule continue, which leads to its structural exhaustion. The disease in this phase can often worsen and be regular. The pains gradually become constant.
- Third degree - active progression. At this point, the synovial fluid is almost completely absent due to its degeneration, and the bone tissue is rubbed against each other. Joint mobility is almost completely absent, the pain becomes more palpable. Cartilage is also absent due to degenerative and atrophic changes. Treatment of third degree osteoarthritis of the joints is considered inappropriate.
In addition to these three degrees of development of pathology, there is a final stage - the irreversible destruction of all tissues in the joint. In this phase, it is impossible not only to conduct effective therapy, but even to relieve pain.
The inflammatory process usually begins at the second degree of the lesion, in rare cases, in the absence of medical intervention - at the first stage. Subsequently, it becomes more and more difficult to stop it, which can lead to secondary pathologies, the development of pathogenic microflora in the place of the localization of the disease.
To exclude serious consequences, treatment should be started at the first degree, and at the same time intensive therapy methods should be applied. At the last stage, associated with the complete destruction of cartilage tissue, only one technique is allowed to relieve the patient from pain and immobility of the joint - arthroplasty with full or partial replacement of the components of the joint.
Consequences
The consequences of untimely treatment and advanced arthritis of the joints are fraught with complications such as:
- handicap;
- warping beyond recovery;
- occurrence of vertebral hernias;
- stiffness or joint stiffness;
- decline in the quality and standard of living.
The chronic course, in addition to these complications, is accompanied by severe and frequent pain, complete destruction of the structural components of the joint, discomfort, inability to perform physical work and to performsport.
Diagnostics
The diagnosis of osteoarthritis is based on the evaluation of anamnestic data, the characteristic manifestations of the disease, the results of instrumental research methods. Indicative changes in general and biochemical blood tests are not typical for osteoarthritis, they only appear with the development of an active inflammatory process.
The main instrumental method for diagnosing osteoarthritis is x-ray; in diagnostic unclear cases, magnetic or computed resonance imaging is recommended.
Osteoarthritis of the knee and hip joints ranks first in terms of severity of clinical manifestations and negative impact on quality of life.
Additional diagnostic methods:
- atraumatic arthroscopy;
- ultrasound (assessment of joint cartilage thickness, synovium, condition of joint capsules, presence of fluid);
- scintigraphy (assessment of the condition of the bone tissue of the heads of the bones that form the joint).
How to treat osteoarthritis?
Osteoarthritis of the joints is best treated at an early stage, the treatment itself should be pathogenetic and complex. Its essence lies in the elimination of the causes that contribute to the development of this disease, it is also necessary to eliminate inflammatory changes and restore previously lost functions.
The treatment of osteoarthritis is based on several basic principles:
- Oxygenation of the joint or so-called intra-articular oxygen therapy.
- Drug therapy.
- Intraosseous blockages, as well as decompression of the metaepiphysis.
- Sustainable food.
- Damaged gaskets must be relieved of excessive stress. If possible, it should be kept to a minimum during processing.
- Follow the established orthopedic pattern.
- Physiotherapy exercises.
- Take a physiotherapy course, which includes magneto and electrotherapy, shock waves, and laser therapy.
- Treatment at the sanatorium. To do this, it is necessary once a year, on the recommendation of a doctor, to undergo treatment in specialized stations.
Preparations for the treatment of osteoarthritis
Drug treatment is carried out in the phase of exacerbation of osteoarthritis, chosen by a specialist. Self-medication is unacceptable due to possible side effects (for example, the negative effect of nonsteroidal anti-inflammatory drugs on the gastric mucosa).
Therapy includes the following drugs:
- Anti-inflammatory drugs. By starting osteoarthritis treatment comprehensively, you can slow the progression of the disease and significantly improve the quality of life. It is worth dwelling on some points of treatment in more detail. In particular, drug treatment includes at the initial stage - this is the elimination of pain, as well as the elimination of inflammatory processes occurring in the joints. For this, all doctors use nonsteroidal anti-inflammatory drugs. Experienced doctors do not recommend their oral administration, because these drugs irritate the stomach lining to a large extent. Therefore, depending on the drug chosen, intravenous or intramuscular administration is used. Sometimes, as auxiliary agents, NSAIDs are used in the form of ointments, but their absorption is extremely low, so that a significant effect cannot be achieved.
- Hormonal corticosteroids. When osteoarthritis is in the exacerbation stage, it is advisable to take hormonal corticosteroids. They are injected into the joint. On the outside, you can use a bandage, ointment or special tincture, based on chilli.
- Chondroprotectors aimed at restoring cartilage and improving the qualitative composition of synovial fluid will not be superfluous. The course lasts for a rather long period, until the moment when there is an improvement. However, if the expected effect does not appear within six months of administration, the drugs should be canceled. Also intra-articular, with chondroprotectors it is advisable to use drugs based on hyaluronic acid. They contribute to the formation of the cell membrane responsible for the formation of articular cartilage.
Physiotherapy
To relieve pain, reduce inflammation, improve microcirculation and eliminate muscle spasms, a patient with osteoarthritis is referred for physiotherapy:
- In phase of aggravation. Prescribe laser therapy, magnetotherapy and ultraviolet radiation,
- In remission. Illustrated electrophoresis and phonophoresis.
In addition, thermal processes, sulphides, radon and sea baths are used. To strengthen the muscles, electrical stimulation is performed. Gentle massage can also be used during remission.
Surgery
If the exposure methods listed are ineffective, in the presence of complications, they resort to surgical treatment of osteoarthritis:
- Decompression of the metaepiphysis and prolonged intraosseous blockage (decrease in intraosseous pressure in the affected area);
- Corrective osteotomy;
- Joint endoprostheses.
In the early stages of the disease, mechanical, laser or cold plasma debridement is used (smoothing the surface of damaged cartilage, removing non-viable areas). This method effectively relieves pain, but has a temporary effect - 2-3 years.
Folk remedies
Most people these days don't want to take pills or injections. Therefore, they ask the question - how to cure osteoarthritis with the help of folk remedies? For the most part, these funds are aimed at increasing the tone of the body, improving blood circulation, relieving pain and increasing immunity.
Traditional medicine recipes are used to treat this disease:
- The egg solution is made from fresh egg yolk, which is mixed with turpentine and apple cider vinegar in a 1: 1: 1 ratio. The liquid should be thoroughly mixed andrubbed on the affected joint overnight. Then you need to wrap everything with a woolen scarf. It is recommended to rub for 1 month 2-3 times a week.
- Buy elecampan root at the drugstore. As a rule, it is packed in packages of 50 grams. To prepare the tincture you will need half a packet of plant roots and 150 ml of high-quality vodka. The ingredients are mixed, placed in a dark bottle and infused for 12 days. Rubbing is done before bedtime, and if possible in the morning.
- Using boiled oatmeal also works well. Take three to four tablespoons of oatmeal, pour boiling water over it and cook on low heat for five to seven minutes. The amount of water used should provide a thick porridge, which should be cooled and used as a compress overnight. Use only freshly boiled flakes. Yesterday's porridge is not good for a compress.
- Birch leaves, nettle leaves and calendula inflorescences are taken in equal parts. As a result, you need to get two tablespoons. We put the resulting crushed collection in a thermos, fill it with a liter of boiling water and leave it overnight. From the next morning you need to take half a glass of broth four to five times a day. The course of taking this prescription is two to three months.
Tinctures of bay leaves, horseradish, garlic and rye are also considered to be effective. Treatment of osteoarthritis with folk remedies will be more effective if combined with medication.
Nutrition for osteoarthritis
The basics of nutrition for osteoarthritis are reduced to the following:
- Avoid large meals at night to avoid an attack of osteoarthritis.
- Eat in portions.
- Constantly controlling weight, in order to avoid weight gain,
and, therefore, additional stress on painful joints. - When there is no worsening of the disease, take a walk after eating.
- The menu must be balanced, established with the attending physician.
There's absolutely nothing wrong with the fish dishes - you can eat a lot, of course, in reasonable amounts.
- Do not forget about the regular intake of vitamins from food. For patients with osteoarthritis, group B vitamins are particularly relevant
- Jellied meat plays an important role in the treatment of osteoarthritis. Such food will be a real reservoir of trace elements for painful joints. The most important component of aspic is natural collagen
- Vitamin B contributes to the production of hemoglobin. It can be "obtained" by eating bananas, nuts, cabbage, and potatoes. It is worth getting carried away by herbs and legumes. They will be the source of folic acid. Liver, mushrooms, dairy products, as well as eggs will help. They are rich in riboflavin.
Following the treatment regimen prescribed by the doctor, the disease may recede and the damaged tissue may begin to regenerate.
Prevention
Prevention of osteoarthritis begins with proper nutrition. It is necessary to try to reduce the intake of salt, as well as foods that can disrupt the metabolism. These include legumes, fatty meats, and alcohol. The diet includes cabbage, greens, and fish.
For the prevention of osteoarthritis, it is necessary to take physical education classes, do warm-ups. If possible, it is better to walk a few kilometers. It is also important to watch your weight and avoid weight gain, as this will put additional stress on sore joints. It is not recommended to take pills for the purpose of weight loss as they can disrupt the metabolism in the body.
Forecast
The outlook for life is favorable. The favorable character of the social and labor prognosis depends on the speed of diagnosis and the start of treatment; it decreases when the decision on the issue of surgical treatment of the disease is delayed, if necessary.