OsteoarthritisIs a chronic non-inflammatory disease of the joints or articular cartilage, as well as the tissues around them. Osteoarthritis is one of the most common diseases affecting 10-14% of the world's population. The disease mainly affects women between the ages of 45 and 55. Osteoarthritis is the most common disease of the joints and accounts for almost 80% of all joint etiologies.
The etiology of this disease is currently unknown.. . . All the factors that cause tissue degeneration and aging of the body can lead to the emergence of this disease, therefore the appearance of osteoarthritis with age is almost inevitable.
There are external and internal factors in the detection 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 vibration. The main and quite common cause of osteoarthritis is the inability of the cartilage to resist the increased stress on the joints. Causes of this manifestation can be impaired posture, prolonged work, standing, and even some sports: lifting weights, jogging, or jumping.
Internal factors causing this disease include the following: hereditary predisposition to the emergence of cartilage tissue diseases, impaired blood supply to the joint, hormonal imbalance and metabolic disorders. Osteoarthritis in women can be caused by ovarian dysfunction during menopause. In addition, vascular processes with early development of atherosclerosis may 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 symptoms and clinical signs of this disease?
The manifestation of osteoarthritis is manifested by severe pain and deformation of the joints, which leads to disruption of their functions. This disease most often causes damage to the loaded joints (hip and knee joints) and small joints of the hand. The spine is also involved in the process. But most often the knee and thigh joints are injured.
The most basic symptomOsteoarthritis is characterized by severe pain in the area of the injured joints. These pains cause damage to bones, joints or periarticular tissues. Typically, such pain increases with effort and decreases with rest. Night pains, swelling of the joints, as well as the appearance of a "gel viscosity" in the damaged joint in the morning - all indicate the onset of osteoarthritis. The intensity of such pain depends on many factors (atmospheric pressure, humidity and temperature changes). These pains.
The next major symptom of osteoarthritis is the appearance of cramps or tingling in the joints not only during walking but also during any movement. The appearance of such a crack or pus is associated with a violation of the joint surfaces, which leads to a restriction of mobility of this joint.
In osteoarthritis there is an increase in the volume of the joints, which is the result of the appearance of swelling of the periarticular tissues. Swelling or fever in the injured joint is very 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.
- Deformation of spondylosis.
- Intervertebral osteochondrosis.
GonarthrosisIs an injury to the knee joint during osteoarthritis. In this case, the pain in the knee joints is pronounced while walking and is especially intensified when climbing stairs. The site of localization of this pain is in the inner and anterior parts of the affected knee joint. An increase in discomfort occurs when the knee is bent. In addition, gonarthrosis often causes deviation of the knee joint. The disease starts gradually and the pain increases. Convulsions are heard with active and passive movements. The pain begins to intensify and in many cases develops synovitis - inflammation of the capsule membrane of the joint or tendon.
Coxarthrosis- This is an injury to the femoral joint. The initial pain of a hip injury is not manifested in the thigh area, but in the knee, groin, or buttocks. They increase during walking and decrease during rest. These pains, which appear even with small changes in the X-ray, are associated with muscle spasm. With the defeat of the femoral joint, the restriction of mobility in the joint gradually increases. This disease is the result of trauma or arthritis. Coxarthrosis is characterized by "duck" gait, lameness, hypotrophy of the muscles of the buttocks and thighs, as well as pain on palpation of the thigh.
Osteoarthritis of the distal interphalangeal joints of the hand or Heberden nodes. . . The appearance of such nodules is most often observed in women during menopause. They first appear on the first and third fingers of the hand. Over time, particularly months or even years later, symmetrical damage is observed in other distal interphalangeal joints. Such nodes are located on the dorsal-lateral surface of the joints.
Osteoarthritis of the proximal interphalangeal joints of the hands or bushes. Unlike Heberden nodes, these nodes appear on the lateral surface of the joint, causing lateral expansion of the joint. As a result of this increase, the finger acquires a fusiform shape.
Deformation of spondylosis- As a result of this disease, marginal bone growths appear in the area of the spine. This disease is manifested from the age of 20 years. Osteophytes (bone growths) look like swelling - swelling occurs due to compression of blood vessels. The result is spinal stiffness, and in some cases neurological disorders.
Intervertebral osteochondrosisOccurs with spinal curvature or deformed spondylosis. In this disease the disc degenerates and the nucleus protrudes in different directions, causing spinal cord injury. Excessive growth of osteophytes and increase in the surface of the joint are also noted. In this case, the choroid of the joint suffers, resulting in vasculitis - inflammation of the walls of small blood vessels. The pain syndrome is very pronounced and increases during exercise or hypothermia.
There are two major forms of osteoarthritis- Primary or idiopathic (causes of the disease are not specified) and secondary (the disease occurs against the background of other diseases).
Primary osteoarthritisLocalized with less than 3 joint lesions. Localized osteoarthritis affects the spine, the joints of the hands and feet, the knee joints, the hip joints, and other joints.
There is also generalized osteoarthritis when 3 or more joints are damaged. In this case large joints and distal interphalangeal joints are damaged. In addition, in the generalized form, erosive osteoarthritis also occurs.
Secondary osteoarthritisMay be post-traumatic. Also, secondary osteoarthritis can be caused by metabolic diseases such as Gaucher disease, which is a genetic disease; Wilson 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 pigmented cirrhosis, is an inherited disease in which iron metabolism is disrupted and it accumulates in organs and tissues. Diseases such as diabetes mellitus, hypothyroidism - hypothyroidism, acromegaly - hyperfunction of growth hormone, can also be the cause of osteoarthritis. In addition to these diseases, osteoarthritis can also lead to calcium deposition disease, neuropathy and many other diseases.
What happens to osteoarthritis?
This disease causes intense aging of the articular cartilage. As a result, the elasticity of the articular cartilage is lost. In addition to roughening the joint surfaces, cracks still appear on them. In many cases, the cartilage is thin enough to expose the bone. All this leads to a decrease in the elasticity of the articular cartilage and leads to the collapse of the joints. In addition, inflammation can join all of the listed changes, causing bone tissue to grow, causing joint disease and deformity.
Diagnosis of osteoarthritis
Diagnosing osteoarthritis often does not cause much difficulty. But there are exceptions, for example, patients with shoulder joint injury and symptoms of joint inflammation. Complications can also arise in the diagnosis of primary and secondary osteoarthritis, the onset of which is associated with metabolic or other diseases. X-ray examination reveals signs of osteoarthritis quickly (especially in the elderly) if there are clinical signs of osteoarthritis. X-ray and laboratory data are not sufficient to make a final diagnosis. This requires a number of additional examinations to determine the exact cause of the joint pain.
Treatment of osteoarthritis
There are both medicated and non-narcotic methods that include physiotherapy and exercise therapy to reduce or completely relieve pain. Individual approach to each patient is required to prescribe the correct treatment. In this case, the individual characteristics of the patient and the peculiarities of the course of this disease must be taken into account.
In the treatment of osteoarthritis, first of all, it is necessary to follow the regime, since the mechanical unloading of the joint is not only a major factor in reducing pain, but also plays an important role in the treatment of this disease. In this case, it is necessary to exclude a fairly long stay in a certain fixed position, prolonged walking and long standing, as well as the exclusion of weight transfer, which can lead to mechanical overload of the joints. If the disease is neglected, the patient is advised to walk with crutches or crutches. Some patients with quite pronounced pain during exacerbation of the disease are prescribed a half-bed regimen.
In the treatment of osteoarthritis it is recommended to follow a diet to reduce excess weight. This is especially true for those who have knee joint damage.
Also, physiotherapeutic methods are used to treat this disease, which not only reduces pain and inflammation, but also has a positive effect on metabolic processes in joint tissues and improves microcirculation. Physiotherapy treatment involves the application of electrical currents, alternating magnetic currents, electrophoresis, as well as ultraviolet radiation and phonophoresis to the affected joints. In addition, thermal procedures, the use of peat mud and paraffin wax are prescribed.
Patients using therapeutic massage elements should try to avoid mechanical irritation of the joint capsule. Only in this case the painful muscle spasm is reduced and the weakened muscle tone is also increased, thus improving the patient's functional abilities.
Drug treatment is prescribed according to the form of the disease and the severity of the course. In more severe cases, patients are prescribed surgical treatment (arthroplasty).
Also, patients are advised to seek spa treatments on the beach.
Prevention of osteoarthritisConsists of performing daily special exercises that help strengthen the musculoskeletal system. Avoiding excess weight, restricting weight bearing, as well as including in the menu dishes such as jelly, jelly meat or aspic, all of these are prophylactic measures for osteoarthritis. And, of course, go in for a sport like swimming. We must remember that it is better to prevent any disease than to cure it. The same goes for diseases like osteoarthritis. In order not to think in the future about how to get rid of severe pain during osteoarthritis, as well as how to cure this disease, it is necessary to take preventive measures today, without delaying them later.
Treatment of deformed osteoarthritis by various methods
Highly qualified and accumulated experience in the use of shock wave therapy allows to achieve the maximum positive effect of the treatment even in the advanced stages of the disease, in many cases to avoid surgical treatment.
Shock wave therapy is performed on a modern device:
- The course of treatment of arthritis, arthrosis by the UHT method consists of 5-7 sessions;
- The session is held 1 time in 5-7 days.
Under the influence of the shock wave, microcrystals of calcium salts and areas of fibrosis that form in the tissues of the joints break down in the affected tissues. At the same time, blood circulation in the damaged tissue increases tenfold, which promotes the resorption of calcium salts and areas of fibrosis.
Advantages of SWT method:
- Efficiency;
- Good tolerance (does not require the use of anesthesia);
- Reduces the need for other methods, especially surgical treatment;
- Rapid pain relief without analgesics;
- Possibility of use in the chronic stage of the disease and its initial manifestations;
- It is performed on an outpatient basis, does not require hospitalization, does not disrupt the usual rhythm of the patient's life.
Photodynamic therapy in orthopedicsIs a non-invasive, problem-free, two-component treatment method. A photosensitizer and a medically approved laser radiation source with a wavelength of 660-670 nm are used to carry out the method.
Under the influence of the laser beam, the photosensitizer excites the release of single oxygen, which has a toxic effect on the energy complexes of the cell (mitochondria and Golgi complex), destroys the latter and thus causes an irreversible process of apoptosis. At the same time, healthy cells are not damaged. Damaged pathological tissue is aseptically absorbed.
The photosensitizer is injected into the patient's body transcutaneously (through applications).
PRP Plasma Lifting- This orthopedic procedure is based on a patented method of patient's blood treatment using special vacuum biotechnology tubes and a special centrifugation regime.
During the procedure, an injection form of platelet-containing autoplasm 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 reduces the amount of medication used or eliminates them altogether, thereby reducing the toxic effects of the medication on the patient's body. Also, autoplasm injections help to reduce the treatment time by 2-3 times.
Procedure indications (PRP plasmolifting):
- Osteoarthritis;
- Osteoarthritis;
- Periarthritis;
- Tendonopathies of tendons,
- Damage to ligaments and muscles.
Thus, shock wave therapy, photodynamic therapy, and plasma lifting (PRP) are the best choices in orthopedics for the treatment of joint diseases. Using modern equipment and technologies and the experience of doctors, they allow you to achieve positive results.