Osteoarthritisis a chronic non -inflammatory disease of the joints or articular cartilage, as well as the tissues that surround it. Osteoarthritis is one of the most common diseases affecting 10-14% of the world’s population. Basically, the disease affects women aged 45 to 55 years. Osteoarthritis is the most common joint disease and accounts for nearly 80% of all articular etiologies.
The etiology of the disease is currently unknown.. . . All the factors that cause tissue degeneration and aging of the body can lead to the occurrence of this disease, therefore, with age, the appearance of osteoarthritis is almost inevitable.
There are external and internal factors in the onset of the disease.The main external factors of osteoarthritis include dampness, hypothermia, poor working conditions, overload of joint function with frequent microtraumas, as well as exposure to radiation and vibration energy. The main and relatively common cause of osteoarthritis is the inability of the cartilage to withstand the increased pressure on the joints. The causes of these manifestations can be postural disorders, long-term work, standing on their feet, as well as some sports: weight lifting, running or jumping.
Internal factors that cause this disease include the following: hereditary predisposition to the occurrence of cartilage tissue disease, impaired blood supply to the joints, hormonal imbalances and metabolic disorders. The cause of osteoarthritis in women may be ovarian dysfunction in 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 dislocations, rheumatoid arthritis, intra-articular fractures, and even with alcoholism.
What are the symptoms and clinical signs of this disease?
Manifestations of osteoarthritis are expressed by severe pain and deformation of the joints, which leads to a violation of their function. With this disease, the most frequent damage to the load joints (hip and knee joints) and small joints of the hands. The spine is also involved in the process. But often the knee and hip joints are affected.
The most basic symptomswith osteoarthritis, there is severe pain in the affected joint area. This pain causes damage to the bones, joints, or periarticular tissue. Typically, such pain increases with energy and decreases during rest. Night pain, swelling of the joints, as well as the appearance of a feeling of "gel viscosity" on the affected joints in the morning - all this indicates the occurrence of osteoarthritis. The intensity of such pain depends on many factors (atmospheric pressure, humidity and temperature changes). All these factors begin to affect the pressure in the joint cavity, which causes this pain.
One of the next main symptoms of osteoarthritis is the appearance of cracks or itching in the joints, not only during walking, but even during any movement. The appearance of such a crunch or squeak is associated with a violation of the articular surface, which causes restriction of mobility in this joint.
With osteoarthritis, an increase in joint volume occurs, which is a consequence of the appearance of periarticular tissue edema. Swelling or fever in the affected joint is very rare.
Clinical forms of osteoarthritis:
- Gonarthrosis.
- Coxarthrosis.
- Osteoarthritis of the distal interphalangeal joint of the hand.
- Osteoarthritis of the proximal interphalangeal joint of the hand.
- Spondylosis deformans.
- Intervertebral osteochondrosis.
GonarthrosisIs a lesion of the knee joint in osteoarthritis. In this case, the pain in the knee joint when walking is expressed, and it is very intense if you go down the stairs. The localization of this pain is on the inside and front of the affected knee joint. Increased discomfort occurs when the knee is bent. In addition, in many cases of gonarthrosis, there is a malformation of the knee joint. The disease begins gradually, and the pain increases. With active and passive movements, a buzzing sound can be heard. The pain begins to worsen, and in many cases synovitis develops - inflammation of the membranes of the joint capsules or tendons.
Coxarthrosis- This is a wound on the hip joint. The initial pain of a hip injury does not appear in the thigh area, but in the knee, groin, or buttocks. They increase with walking, and subside during rest. This pain, which occurs even with small changes on the x-ray, is associated with muscle spasms. With the defeat of the hip joint, there is a gradual increase in the limit of mobility in the joint. The disease is the result of trauma or arthritis. With coxarthrosis, there is a "duck" gait, developing lameness, hypotrophy of the muscles of the back and thighs. Also, there is pain on palpation in the femoral head area.
Osteoarthritis of the distal interphalangeal joint of the hand or Heberden nodules. . . The appearance of such nodules is most often observed in women during menopause. Initially, they appear on the first and 3rd fingers of the hand. Over time, i. e. after several months or even years, symmetrical lesions are observed in other distal interphalangeal joints. Such nodules are located on the dorsal-lateral surface of the joint.
Osteoarthritis of the proximal interphalangeal joint of the hand or Bouchard's nodule.Unlike Heberden nodules, these nodules appear on the lateral surface of the joint, resulting in lateral enlargement of the joint. As a result of this increase, the finger acquires a fusiform shape.
Spondylosis deformans- as a result of this disease in the vertebral area, marginal bone growth appears. The disease appears from the age of 20 years. Osteophytes (bone growths) look like swelling - edema appears as a result of vascular compression. As a result, stiffness of the spine appears, and in some cases neurological disorders appear.
Intervertebral osteochondrosisoccurs in combination with curvature of the spine or deformed spondylosis. With this disease, the disc degenerates and the nucleus protrudes in different directions, and this leads to trauma to the spine. There is also excessive growth of osteophytes and an increase in the joint surface. In this case, the choroid joints suffer, as a result of which vasculitis occurs - 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 cause of the disease has not been explained) 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, 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, the large joint and the distal interphalangeal joint are affected. In addition, in its general form, erosive osteoarthritis also occurs.
Secondary osteoarthritiscan be post -traumatic. Also, the cause of secondary osteoarthritis can be a metabolic disease such as Gaucher’s 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 the disease is also called, bronze diabetes, or pigment cirrhosis, is a hereditary disease in which there is a violation of iron metabolism and its accumulation in organs and tissues. Diseases such as diabetes mellitus, hypothyroidism - a decrease in the function of the thyroid gland, acromegaly - hyperfunction of growth hormone, can also be a cause of osteoarthritis. In addition to this disease, osteoarthritis can also cause calcium deposition disease, 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 of the articular cartilage. In addition to the fact that the articular surfaces become rough, cracks still appear on them. In many cases, the cartilage is worn enough to expose the bone. All this leads to a decrease in the elasticity of the articular cartilage and causes disorders in the joints. Further, inflammation can accompany all of the listed changes, as bone tissue growth occurs, and this leads to joint disease and deformation.
Diagnosis of osteoarthritis
The diagnosis of osteoarthritis in many cases does not cause great difficulty. But there are exceptions, for example, patients with lesions on the shoulder joint and symptoms of joint inflammation. Difficulties may also arise in the diagnosis of primary and secondary osteoarthritis, events 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, X-ray and laboratory data are insufficient. To do this, it is necessary to conduct some additional studies to identify the real cause of pain in the joints.
Osteoarthritis Treatment
To reduce or suppress pain completely, there are drug and non -drug methods, including physical therapy and exercise therapy. To prescribe the right treatment, an individual approach for each patient is needed. In this case, the individual characteristics of the patient and the peculiarities of the course of the disease must be taken into account.
In the treatment of osteoarthritis, first of all it is necessary to observe the regimen, because the mechanical unloading of the joints 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 relatively long stay in a certain fixed position, prolonged walking and long standing on the feet, as well as the exclusion of weight transfer that can cause mechanical strain on the joints. If the disease is ignored, the patient is advised to walk using a cane or crutches. With relatively significant pain at the time of disease exacerbation, some patients are prescribed a half -bed regime.
During the treatment of osteoarthritis, it is recommended to follow a diet to reduce excess weight. This is especially true for those who have lesions on the knee joint.
Also, 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 tissue and improve microcirculation. Physiotherapy treatment includes 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 were prescribed.
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 spasm, and weak muscle tone also increases, as a result of which the functional abilities of the patient are improved.
Drug treatment is prescribed depending on the form of the disease and the severity of its course. In more severe cases, patients are given surgical treatment (arthroplasty).
Also, patients are advised to use spa treatments on the sea beach.
Prevention of osteoarthritisconsists of daily performance of special exercises that help strengthen the musculoskeletal apparatus. Losing excess weight, limiting weight carriers, as well as including in the menu dishes such as jelly, jelly meat or aspic are all osteoarthritis prevention measures. And, of course, participate in sports like swimming. Keep in mind that preventing any disease is better than curing it. The same goes for diseases like 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 it until later.
Treatment of osteoarthritis deformities 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 performed on modern apparatus:
- course of treatment of arthritis, arthrosis with UHT method consists of 5-7 sessions;
- sessions are conducted 1 time in 5-7 days.
Under the influence of shock waves, microcrystals of calcium salts and areas of fibrosis formed in the joint tissue are loosened in the affected tissue. At the same time, blood flow in the damaged tissue increases tenfold, which contributes to the absorption of calcium salts and areas of fibrosis.
Advantages of SWT method:
- efficiency;
- good tolerance (does not require the use of anesthesia);
- reducing the need for other methods, especially surgical treatment;
- rapid pain relief without analgesics;
- the possibility of using at the chronic stage of the disease and with its main manifestations;
- performed on an outpatient basis, does not require hospitalization, does not interfere with the normal rhythm of life of the patient.
Photodynamic therapy in orthopedicsIt is a non -invasive and complication -free two -component treatment method. To implement the method, photosensitizers and laser radiation sources approved for medical use with wavelengths of 660–670 nm were used.
Under the influence of the laser beam, the photosensitizer is excited by the release of singlet oxygen, which toxically affects the cell energy complex (mitochondria and Golgi complex), destroying the latter and thus triggering an irreversible process of apoptosis. At the same time, healthy cells are not damaged. Damaged pathological tissue is absorbed aseptically.
Photosensitizers are injected into the patient's body transcutaneously (application).
Plasma uptake of PRP- This orthopedic procedure is based on a patented patient blood processing method using a special vacuum biotechnology tube and a special centrifugation mode.
During the procedure, an autoplasma injection form containing platelets is isolated from the patient’s blood, which is then injected into the soft tissue surrounding the joint and directly into the patient’s joint cavity. Autoplasma injections can reduce inflammation, relieve pain and restore range of motion in the joints. The autoplasma treatment procedure minimizes the number of drugs used or eliminates them altogether, thus reducing the toxic effects of the drug on the patient’s body. Also, autoplasma injections help reduce treatment time by 2-3 times.
Instructions for the procedure (PRP plasmolifting):
- osteoarthritis;
- osteoarthritis;
- periarthritis;
- tendonitis,
- damage to ligaments and muscles.
Therefore, shock wave therapy, photodynamic therapy and plasma ablation (PRP) in orthopedics are the best options for the treatment of joint disease. With the use of modern equipment and technology and the experience of doctors, they allow you to achieve positive results.