osteoarthritisit is a chronic non-inflammatory disease of the joints or articular cartilage, as well as the tissues that surround them. Osteoarthritis is one of the most common diseases that affects 10 to 14% of the world's population. Basically, this disease affects women 45 to 55 years old. Osteoarthritis is the most common joint disease and accounts for almost 80% of all joint etiology.
The etiology of this disease is currently unknown.. . . All factors that cause tissue degeneration and the aging of the body can lead to the onset of this disease, therefore, with age, the onset of osteoarthritis is almost inevitable.
There are external and internal factors in the onset of this disease.The main external factors of osteoarthritis include dampness, hypothermia, unfavorable working conditions, functional overload of joints with frequent microtraumas, as well as exposure to radiation and vibration energy. The leading and quite common cause of osteoarthritis is the cartilage's inability to withstand the increased stress on the joints. The reasons for this manifestation can be compromised posture, prolonged work, standing and even some sports: weight lifting, running or jumping.
The internal factors that cause this disease include the following: hereditary predisposition to cartilage tissue diseases, poor blood supply to the joints, hormonal imbalance, and metabolic disturbances. The cause of osteoarthritis in women can be ovarian dysfunction at menopause. Furthermore, vascular processes with 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 alcoholism.
What are the clinical signs and symptoms of this disease?
The manifestation of osteoarthrosis is expressed by severe pain and deformation of the joints, which leads to a violation of their functions. With this disease, damage to the loading joints (hip and knee joints) and small hand joints most often occurs. The spine is also involved in the process. But most of the time, 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 cause damage to bones, joints or periarticular tissues. Typically, this pain increases with exertion and decreases with rest. Night pain, swelling in the joints, as well as the appearance of a "gel-sticky" feeling in the affected joint in the morning - all of these indicate that osteoarthritis has occurred. The intensity of this pain depends on several reasons (atmospheric pressure, humidity and temperature changes). All 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 clicking or creaking in the joints, not only when walking, but even during any movement. The appearance of such clicking or creaking is associated with a violation of the joint surfaces, which causes a restriction of mobility in this joint.
In osteoarthrosis, there is an increase in the volume of the joints, which is a consequence of the appearance of edema in 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.
gonarthrosisIt is an injury to the knee joint in osteoarthritis. In this case, pain in the knee joints is expressed when walking, and is especially severe if you walk down the stairs. The location of these pains is in the inner and front parts of the affected knee joint. Increased discomfort occurs when the knee is flexed. Also, in many cases of gonarthrosis, a deviation of the knee joint occurs. The illness starts gradually and the pain is increasing. With active and passive movements, you can hear a crackle. The pain begins to intensify and, in many cases, synovitis develops - an inflammation of the membrane of the joint capsule or tendon.
Coxarthrosis- This is a hip joint injury. The initial pain of a hip injury does not appear in the thigh region, but in the knee, groin or buttock. They increase with walking and decrease with rest. These pains, which occur even with small changes in the radiograph, 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 the result of trauma or arthritis. In coxarthrosis, a "duck" gait occurs, developing lameness, muscular atrophy of the buttocks and thighs. Additionally, 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 seen in women during menopause. Initially, they appear on the 1st and 3rd finger of the hand. Over time, namely after several months or even years, a symmetrical lesion is observed in other distal interphalangeal joints. These nodules are located on the dorsolateral 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, resulting in lateral enlargement of the joint. With this increase, the finger acquires a fusiform shape.
Spondylosis deforming- as a result of this disease in the region of the vertebrae, marginal bone growths appear. This disease appears after the age of 20 years. Osteophytes (bone growths) look like swelling - edema appears due to vascular compression. As a result, spinal stiffness arises and, in some cases, neurological disorders appear.
Intervertebral osteochondrosisoccurs in combination with spinal curvature or deforming spondylosis. With this disease, the disc degenerates and the nucleus projects in different directions, which leads to spinal trauma. There is also an overgrowth of osteophytes and an increase in the surface of the joint. In that case, the choroid in the joint suffers, resulting in 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 in the context of other diseases).
primary osteoarthritisit is located when less than 3 joints are affected. In localized osteoarthritis, the spine, hand 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, large joints and distal interphalangeal joints are affected. Furthermore, in the generalized form, erosive osteoarthritis also occurs.
secondary osteoarthritisit can be post-traumatic. Furthermore, 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 injury 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 thyroid gland function, acromegaly - growth hormone hyperfunction can also be the causes of osteoarthritis. In addition to these diseases, osteoarthritis can also cause calcium deposition diseases, neuropathy and many other diseases.
What happens to osteoarthritis?
With this disease, intensive aging of the articular cartilage occurs. As a result, there is a loss of elasticity in the articular cartilage. In addition to the articular surfaces becoming rough, cracks also appear. In many cases, the cartilage is worn out enough to expose the bone. All of this leads to a decrease in the elasticity of the articular cartilage and causes the joints to rupture. In addition, inflammation can join all of the listed changes, due to which bone tissue regrowth, and this leads to joint disease and deformation.
Osteoarthritis Diagnosis
The diagnosis of osteoarthritis in many cases does not cause great difficulties. But there are exceptions, for example, patients with shoulder joint damage and symptoms of joint inflammation. Difficulties can also arise in diagnosing primary and secondary osteoarthritis, the occurrence of which is associated with metabolic or other diseases. On X-ray examination, signs of osteoarthritis are detected quickly (especially in the elderly) if clinical signs of osteoarthritis are present. To make a final diagnosis, there are not enough X-rays and laboratory data. For this, it is necessary to carry out a series of additional studies in order to identify the exact cause of joint pain.
Osteoarthritis treatment
To reduce or completely suppress pain, there are drug and non-drug methods, which include physical therapy and exercise therapy. To prescribe the correct treatment, an individual approach is needed for each patient. In this case, the individual characteristics of the patient and the peculiarities of the course of the disease are necessarily taken into account.
In the treatment of osteoarthritis, adherence to the regimen is necessary first of all, since mechanical joint release is not only the main factor in pain reduction, but also plays an important role in the treatment of this disease. In this case, it is necessary to exclude a very long stay in a certain fixed position, prolonged walking and long stay on the legs, as well as the exclusion of weight transfer that can lead to mechanical overload on the joints. If the disease is neglected, the patient is instructed to walk with crutches or a cane. With very pronounced pain at the time of disease exacerbation, some patients are given a half-bed regimen.
During the treatment of osteoarthritis, it is recommended to follow a diet to reduce excess weight. This is especially true for anyone who has an injury to their knee joints.
Furthermore, 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 joint tissues and improve microcirculation. Physical therapy treatments include the use of electrical currents, alternating magnetic currents, electrophoresis, as well as ultraviolet radiation and phonophoresis in the affected joints. In addition, thermal procedures, use of peat slurry and paraffin wax are prescribed.
Using elements of therapeutic massage, patients should try to avoid mechanical irritation of the joint capsule. Only in this case does a decrease in painful muscle spasm occur, and the tone of the weakened muscles also increases, with which the patient's functional abilities improve.
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 seek spa treatments on the sea coast.
osteoarthritis preventionit consists of the daily performance of special exercises that help to strengthen the muscle-ligament system. Getting rid of excess weight, limiting the transport of weight, as well as including dishes such as jellies, frozen meats or pastries on the menu are preventive measures against osteoarthritis. And, of course, playing a sport like swimming. It must be remembered that it is better to prevent any disease than to cure it. The same applies to diseases like osteoarthritis. In order not to think in the future how to get rid of the severe pain of osteoarthritis, as well as cure this disease, it is necessary to take preventive measures today, without postponing them for later.
Treatment of Osteoarthritis Deformans by Various Methods
The high qualification and accumulated experience in the use of shockwave therapy allow reaching the maximum positive effect of the treatment even in advanced stages of the disease, avoiding surgical treatment in many cases.
Shockwave therapy is performed in a modern device:
- the course of treatment of arthritis, arthrosis 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, the calcium salt microcrystals and areas of fibrosis that form in the joint tissue are loosened in the affected tissue. At the same time, blood flow to the damaged tissue increases tenfold, which contributes to the reabsorption 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;
- quick pain relief without analgesics;
- the possibility of use in the chronic phase of the disease and with its primary manifestations;
- performed on an outpatient basis, does not require hospitalization, does not interfere with the patient's usual pace of life.
Photodynamic therapy in orthopedicsIt is a non-invasive and complication-free two-component treatment method. To implement the method, a photosensitizer and a medical-approved laser radiation source 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 toxically affects the cell's energy complexes (mitochondria and Golgi complex), destroying the latter and thus triggering the irreversible process of apoptosis. At the same time, healthy cells are not harmed. Damaged pathological tissue is aseptically absorbed.
The photosensitizer is injected into the patient's body transcutaneously (applications).
PRP plasma survey- This orthopedic procedure is based on a patented method of processing the patient's blood using special biotech vacuum tubes and a special centrifuge mode.
During the procedure, an injection form of autoplasma containing platelets is isolated from the patient's blood, which is then injected into the soft tissue around 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 eliminates them completely, thus reducing the toxic effect of the drugs on the patient's body. In addition, autoplasma injections help to reduce treatment time by 2 to 3 times.
Indications for the procedure (PRP plasmalifting):
- osteoarthritis;
- osteoarthritis;
- periarthritis;
- tendon tendon disorders,
- damage to ligaments and muscles.
Thus, shockwave therapy, photodynamic therapy and plasma lifting (PRP) in orthopedics are the best options for the treatment of joint diseases. With the use of modern equipment and technologies and the experience of doctors, they allow us to obtain positive results.