Arthrosis is a chronic degenerative disease that affects all parts of the joint: cartilage, articular membrane, ligaments, capsule, periarticular bones and periarticular muscles and ligaments.
According to European doctors, arthrosis accounts for almost 70% of all rheumatological diseases. People aged 40-60 years are most susceptible to joint arthrosis. This is facilitated by both lack of movement and prolonged overload, poor nutrition and, of course, injuries.
What is a joint?
Typically, a human joint consists of 2 or more connecting bones. All working surfaces of the joint have a protective coating and are constantly lubricated with synovial fluid for the best gliding. The joint cavity itself is hermetically sealed by the articular capsule.
In our body, there are many joints that are "responsible" for certain types of movements, can experience various loads and have different margins of safety.
The amount of movement in the joints depends on the structure of the joint, the ligamentous apparatus that limits and strengthens the joint, and the various muscles attached to the bones by tendons.
Causes of joint arthrosis
Normal functioning of joints is possible with constant self-renewal of cartilage tissue. At a young age, the rate of death of outdated joint cells is equal to the rate of birth of new cells. Over the years, the process of cell renewal slows down, and the cartilage tissue begins to thin out. The production of synovial fluid also decreases. As a result, the articular cartilage begins to thin and break down, leading to arthrosis.
In addition, there are other causes of joint arthrosis:
- increased physical activity. Arthrosis of the joints is a frequent accompaniment of excess weight. As a result of overload, microtraumas form in the joints. Athletes develop joint damage due to increased loads on "unheated" joints;
- joint injuries;
- congenital or acquired deformities of the musculoskeletal system (rickets, kyphosis, scoliosis, improper fusion of bones after injuries with the appearance of deformities of the limbs: O-shaped and X-shaped deformity of the legs).
Stages of arthrosis
Depending on the degree of destruction of cartilage tissue, different stages or degrees of arthrosis can be distinguished.
Degrees and symptoms of arthrosis
- Arthrosis of the 1st degree is characterized by periodic pain in the joints, especially with increased physical activity. After rest, the pain usually disappears. The range of motion in the joint is not limited, muscle strength in the injured limb is not changed. X-rays can show minimal signs of joint damage.
- Arthrosis of the 2nd degree is manifested by painful sensations not only with intense physical stress, but also with minor loads. Even during rest, joint pain may not subside. This degree is characterized by stiffness in movements and limited mobility in the joints. This ultimately leads to muscle atrophy. An x-ray may show deformation of the joint, a decrease in the joint space, and the appearance of bone growths near this gap.
- Arthrosis of the 3rd degree - any movement causes a person great pain. Pain in the joint is present even at rest. Therefore, a person tries to move as little as possible so that the pain is minimal. In some cases, movement requires the use of crutches or a gurney. Sometimes fusion of bones occurs - ankylosis (as in ankylosing spondylitis).
With deforming arthrosis, irreversible changes occur in the cartilage tissue of the joint and its functions and structure are completely disrupted. Deforming arthrosis of the joints is based on the appearance of dysfunction in the formation of hyaline cartilage and synovial fluid.
Diagnosis of joint arthrosis
The main method for diagnosing joints is radiography. With arthrosis, changes in the joints, uneven joint surfaces and narrowing of the joint space can be observed.
Which joints are more likely to suffer from arthrosis?
The joints of the extremities most susceptible to arthrosis are the hips, knees, shoulders, elbows and hands.
With arthrosis of the hip joint, a person may first feel slight discomfort in the legs after running or walking. Over time, the pain intensifies, limitation and stiffness in movement appears. With stage 3 disease, the patient protects his leg and tries, if possible, not to step on it.
Osteoarthritis of the knee joint manifests itself as pain in the knee joint after bending and straightening the legs. The most common cause of knee arthrosis is injuries sustained in the past. As a result of these injuries, the sliding of the articular surfaces is disrupted and their rapid wear occurs. In some cases, the joint may gradually lose its mobility.
Arthrosis of the ankle joint manifests itself in the form of swelling and pain in the ankle of the leg. The cause of arthrosis of the ankle joint can be: deformations, fractures of the ankles and talus, dislocations, flat feet, chronic injuries of the ankle joint in athletes and ballerinas. By the way, they often have arthrosis of the foot.
Arthrosis of the shoulder joint, elbow, and wrist joints most often appears as a result of injuries, bruises, dislocations, and intra-articular fractures. Arthrosis of the shoulder joint is characterized by pressing, aching, dull pain that radiates to the forearm and hand. The pain most often appears at night. With arthrosis of the hands, pain is accompanied by dysfunction of the hand.
Treatment of arthrosis
The main means of treating arthrosis are drug treatment, the use of physiotherapy and surgical treatment.
Drug treatment
The use of medications helps improve blood circulation in damaged joints, restore the properties of cartilage, and has an analgesic and anti-inflammatory effect.
Nonsteroidal anti-inflammatory drugs
With arthrosis, swelling of the joint may appear, the joint begins to hurt and the range of motion decreases. When taking anti-inflammatory drugs (NSAIDs), pain is reduced, the inflammatory chain reaction is stopped and the process of cartilage restoration is accelerated.
The drugs can be used in the form of tablets, rectal suppositories and powder. But remember that self-medication is unacceptable; the selection and dose of medication for arthrosis is carried out by a rheumatologist.
Centrally acting painkillers
Opioid drugs reduce the patient's pain threshold. Such medications can be taken strictly according to a prescription and only under the supervision of a doctor!
Chondoprotective drugs
Chondoprotective drugs are structural elements of the cartilage itself, therefore they actively restore this tissue and prevent its further destruction. Treatment is effective in the initial stages of the disease. When the joint is already completely destroyed, it is not possible to return the original shape of the deformed bones or grow new cartilage.
However, at stages 1-2 of arthrosis, chondroprotectors can bring significant relief to the patient. Combination preparations, which include both glucosamine and chondroitin sulfate, give better results compared to a single-component preparation.
Chondroitin sulfate and glucosamine sulfate
These medications help slow down the inflammatory response in tissues, help reduce cartilage damage and reduce pain. Most often, these 2 drugs are used together in treatment, since they have an accumulating effect, but they must be taken for 3-6 months.
Hyaluronic acid
Provides viscosity and elasticity of synovial fluid. Helps good gliding of joints. Therefore, doctors often prescribe injections of hyaluronic acid into the affected joint.
Physiotherapeutic treatments
Physiotherapeutic treatments may include:
- UHF therapy;
- magnetic therapy;
- low intensity laser irradiation;
- electrophoresis with drugs;
- phonophoresis (using ultrasound to introduce a drug into the site of inflammation).
Surgery
Surgical treatment is used to restore and improve joint mobility, as well as to remove part of the cartilage or damaged menisci.
Surgical treatment of arthrosis is resorted to in extreme cases, when medication treatment does not produce results, when severe pain occurs, partial or complete immobility in the joints.
During arthroscopic surgery, it is possible to remove part of the cartilage affected by arthrosis, polish it to give a smooth surface, remove fragments and growths of cartilage, and cut off part of the damaged ligaments.
Knee replacement
With this operation, the articular surfaces of the knee joint are replaced with metal or combined prostheses. The prepared plates replicate the surface of the articular cartilage. Such prostheses are made from special alloys; they do not cause a rejection reaction in patients, do not oxidize, and do not injure surrounding tissues.
Hip surgery for arthrosis
During this operation, partial removal of the cartilage and bone tissue of the pelvic and femur is performed. Typically, the head of the femur and the articular surface of the pelvic bone are removed and replaced with a metal or metal-ceramic prosthesis.
Diet for arthrosis
Excess body weight is a big enemy of your joints. Most patients suffering from arthrosis of the hip and knee joints are overweight.
Therefore, for arthrosis, a properly selected diet is recommended. It is believed that jellied meat cooked in cartilage broth is beneficial for arthrosis. It contains a lot of collagen and structural components of cartilage, which help restore cartilage tissue.
Dairy products, protein and calcium are beneficial. Animal protein is found in lean meats and fish, while vegetable protein is found in buckwheat porridge, beans and lentils. Boiled, stewed and steamed dishes are very healthy.
The best diet for joints is a diet with a slight predominance of carbohydrates (preferably complex carbohydrates), fruits and vegetables, and a sufficient amount of protein and calcium.
Prevention of arthrosis
Prevention of arthrosis, no matter how trivial it may be, lies in a healthy lifestyle. If possible, try to be in the fresh air, move, walk barefoot on sand, green grass, and just the ground. This type of walking improves muscle function and increases blood circulation in the feet.
The use of physical therapy with various swings of the arms and legs, turns, and bends will provide feasible support for your joints.
Patients often ask whether alternative treatment for arthrosis is possible? Yes, folk remedies can help in the initial stages of the disease, reduce pain and improve the general condition of the patient. But it does not replace following your doctor's instructions.