Osteoarthritis refers to diseases that affect the joints.As a result of dystrophic-degenerative processes, cartilage is gradually destroyed and replaced by growing bone tissue.The pathological process is accompanied by pain, limited joint mobility, disruption of its functions, severe deformation.About 10-25% of the population suffers from arthrosis.After 80 years, almost every person has degenerative disorders in the musculoskeletal system.Often, the disease affects the most mobile joints (fingers, hips, knees, neck).However, sometimes degenerative processes develop in the joint of the ankle and shoulder.
Factors that lead to the development of the disease
Various reasons trigger destructive processes in the body.The most important are congenital anomalies of the connective tissue.Regular microtrauma of the joints and acute joint diseases contribute to the appearance of arthrosis.Over time, the untreated disease passes into a chronic stage with regular exacerbations.
Provocative factors that lead to the development of arthrosis:
- overweight;
- physical inactivity;
- hormonal disorders;
- atherosclerosis;
- venous insufficiency;
- endocrine disorders;
- genetic predisposition;
- regular and heavy loads on the joints (for example, in weightlifters or people whose profession involves lifting and moving heavy objects).
Under the influence of one or more inciting factors, cartilage tissue cells begin to collapse.Gradually, the cartilage becomes thinner, less elastic, then covered with cracks and falls off.The bones in the joint begin to rub against each other.The body activates a compensatory mechanism, as a result of which bone tissue grows on the damaged surface.As a result, the joint becomes immobile and deforms.
Species
Arthrosis can be primary, which appears independently, and secondary, which develops as a result of diseases, injuries and deformations of the joints.
Depending on the affected joint, the disease has its own name:
- Gonarthrosis affects the knee joint.
- Coxarthrosis is a disease of the hip joint.
- Spondyloarthrosis affects the intervertebral discs of the lumbar, cervical and thoracic regions.
- Crusarthrosis involves the ankle in the pathological process.
If 3 or more joints are involved in the degenerative process, we are talking about a generalized form.If there are 1-2 joints, this is local arthrosis.
Symptoms
At first, the degenerative process occurs imperceptibly.Cartilage does not have nerve fibers, so in the early stages of development, the patient does not even know what destructive processes are taking place in his body.The first signs appear only a few years after the onset of dystrophic-degenerative processes, when the periosteum under the cartilage is damaged or inflammation develops.
At first, there is pain in the limbs after a heavy load.In the morning or after a long stay at rest, there is a feeling of stiffness and dull aching pain of not too great intensity.After a short warm-up or exercise, all painful symptoms disappear.That's why people don't go to the doctor, considering it to be a common occurrence.Meanwhile, it is easier to stop the development of arthrosis at the initial stage.
Over time, all signs become stronger.The pain becomes obsessive and constant, preventing you from sleeping at night.Pains, stiffness, inability to work fully or do housework become increasingly troublesome.Aching, writhing pains in the joints and surrounding muscles intensify in rainy weather.
Often, arthrosis affects the joints of the lower extremities, so a person quickly gets tired of walking, it is difficult for him to climb stairs or any height, because the destruction of cartilage tissue causes stiffness of the joint.Unsteady gait develops due to limb instability.When bending a joint, an unpleasant crunching sound is heard as the articular surfaces, devoid of cartilage, rub against each other.Patients try to limit the mobility of the affected joint, so muscle atrophy develops over time.Their volume decreases and the gait becomes more unstable.
If arthrosis develops in the joints of the upper limbs, it most often occurs after injuries or as a result of chronic arthritis.At this time, bony growths appear on the fingers, and the hands take on a square shape.
Clinical symptoms depend on the stage of development of arthrosis:
- Zero.
At the zero stage, a person is sometimes disturbed by mild anxiety.X-ray examination does not reveal degenerative changes. - Primitive.
Slight dull pain occurs during a long walk.X-ray shows the appearance of small areas of bone defects along the edges of the articular surfaces.A creaking sound is heard when the joint is bent. - Easy.
There is pain and stiffness in the morning.X-rays show osteophytes (single bone growths) along the edges of the joints, narrowing of the joint space. - Medium.
The middle stage is considered degenerative.Bones and muscles ache constantly, especially at night.The joint is slightly swollen.X-ray examination shows further narrowing of the joint space, spread of bone growths and increased bone density. - Heavy.
In the severe stage (deformation), there is a constant aching pain that is aggravated by movement.When you try to bend the joint, a rough creaking sound is heard.X-ray shows a sharp narrowing of the joint space;the osteophytes have already grown to such an extent that it has caused the joint to deform and change its structure.
Diagnosis and treatment
To determine the type and stage of degenerative-dystrophic processes in the joints, an orthopedist, a rheumatologist and a surgeon participate.Diagnosis involves standard blood and urine tests.If necessary, an immunological analysis and an examination of the intra-articular fluid are performed for the presence of infection.Instrumental studies are carried out (MRI, ultrasound to determine changes in soft periarticular and joint tissues, CT, X-ray to determine changes in bone tissue).
Therapy
It is impossible to completely stop the disease.Timely diagnosis and treatment allow to maintain its mobility and prevent the development of destruction.
In the treatment of arthrosis, antispasmodics, NSAIDs, steroid blockades injected into the joint, chondroprotectors, muscle relaxants, vitamin and mineral complexes, drugs that improve trophism in affected tissues, and proteolysis inhibitors are used to slow down the destruction of cartilage and bone tissue.
Patients with severe pain and an unstable joint are advised to wear tapes that stabilize the joint in its normal position using adhesive tapes, orthoses, elastic knee pads, or elbow pads.A crutch or cane should be used as support.
Physiotherapy procedures should be prescribed, including UHF, massage, ozone therapy, electrophoresis and phonophoresis with a solution of painkillers, magnetic therapy, acupuncture, electrical stimulation, darsonvalization, paraffin baths (in the absence of inflammation).
In the later stages of arthrosis, when the tissues are already destroyed and the joints are severely deformed, the only way is surgical intervention:
- Arthroscopy with removal of bone growths, vertebrae and partial replacement of damaged cartilage.
- Endoscopy.It is the replacement of a joint (completely or only a part) with an artificial joint.
- Artodesis.The joint is closed and fixed in a comfortable position.Over time, the articular surfaces grow together.
Prevention
Since it is impossible to restore your own joint to a normal physiological state, it is necessary to take measures in advance to prevent this disease.This is especially important if you have a family history of the disease or if you are over 40 years old.
Prevention includes maintaining a normal body mass index and regular exercise.Infectious pathologies and other joint diseases should be treated in time, hypothermia, long and sudden physical exertion should be avoided.People from risk groups (due to age, those with traumatic occupations, weak heredity) should regularly examine their joints using X-rays.
Only timely and adequate treatment helps to keep the joint healthy.