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 and severe deformation.Approximately 10-25% of the population suffers from osteoarthritis.After the age of 80, almost all people have degenerative disorders of the musculoskeletal system.Most often, the disease affects the most mobile joints (fingers, hips, knees, neck).But sometimes degenerative processes develop in the ankle and shoulder joints.
Factors in the development of the disease
Various causes trigger destructive processes in the body.The most important are congenital abnormalities of connective tissue.Regular microtrauma in the joints and acute joint diseases contribute to the appearance of osteoarthritis.Over time, the untreated disease enters a chronic stage with regular exacerbations.
Provocative factors that lead to the development of osteoarthritis are:
- excess weight;
- 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 provocative factors at once, the cells in the cartilage tissue begin to collapse.Gradually, the cartilage becomes thinner, becomes less elastic, then becomes covered with cracks and falls off.The bones at the joint begin to rub against each other.The body launches a compensatory mechanism, as a result of which bone tissue grows on the decayed surface.As a result, the joint becomes inactive and becomes deformed.
Species
Osteoarthritis can be primary, which occurs independently, and secondary, which develops as a result of diseases, injuries and deformities in the joints.
Depending on the affected joint, the disease has its name:
- Gonarthrosis affects the knee joint.
- Coxarthrosis is a disease of the hip joint.
- Spondyloarthrosis affects the intervertebral discs in 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 speak of a generalized form.If there are 1-2 joints, it is local osteoarthritis.
Symptoms
At first, the degenerative process happens unnoticed.There are no nerve fibers in cartilage, so in the initial stages of development, the patient does not even know what destructive processes are taking place in his body.The first signs appear only several years after the onset of dystrophic-degenerative processes, when the periosteum under the cartilage is injured or inflammation develops.
At first there is pain in the limbs after heavy exertion.In the morning or after a long stay at rest, a feeling of stiffness and dull aching pain of not too great intensity occurs.After a short warm-up or exercise, all painful symptoms disappear.Therefore, people do not go to the doctor as this is considered a common occurrence.Meanwhile, it is in the initial phase that it is much easier to stop the progression of osteoarthritis.
Over time, all signs intensify.The pain becomes obsessive and constant, it prevents you from sleeping at night.Pain, a feeling of stiffness, the inability to fully work or perform household chores become more and more disturbing.Pain, twisting pain in the joints and surrounding muscles are intensified in rainy weather.
Most often, arthrosis affects the joints of the lower limbs, so a person quickly gets tired of walking, it is difficult for him to climb stairs or any height, since as a result of the destruction of cartilage tissue, stiffness is formed in the joint.An unsteady gait develops due to limb instability.When you bend a joint, an unpleasant crunching sound is heard as the joint surfaces, devoid of cartilage, rub against each other.Patients try to limit the mobility of the diseased joint, so muscle atrophy develops over time.They decrease in volume and the gait becomes even more unstable.
If arthrosis develops in the joints of the upper extremities, it most often happens after injuries or as a result of chronic arthritis.In this case, bone growth appears on the fingers and the hands become square in shape.
Clinical symptoms depend on the stage of development of arthrosis:
- Zero.
At stage zero, a person is sometimes bothered by slight discomfort.X-ray examination reveals no degenerative changes. - Elementary.
When walking for a long time, dull pain easily occurs.The radiograph shows the appearance of small areas of bone defects along the edges of the articular surfaces.When bending the joint, a crunching sound is heard. - Easy.
In the morning there is pain and stiffness.X-rays show osteophytes (single bone growth) along the edge of the joints, narrowing of the joint space. - Moderate.
The moderate stage is considered degenerative.Bones and muscles hurt constantly, especially at night.The joint swells slightly.X-ray examination shows an even greater narrowing of the joint space, proliferation of bone growth and increased bone density. - Heavy.
In the severe phase (deformation), there is constant aching pain that intensifies with movement.When you try to bend the joint, a coarse crunch is heard.The X-ray shows a sharp narrowing of the joint space;the osteophytes have already grown so much that it has led to deformation of the joint and a change in its structure.
Diagnosis and treatment
An orthopedist, rheumatologist and surgeon are involved in determining the type and stage of degenerative-dystrophic processes in the joints.The diagnosis includes standard blood and urine tests.If necessary, an immunological analysis and examination of intra-articular fluid for the presence of infection is performed.Instrumental examinations are performed (MRI, ultrasound to identify changes in soft periarticular and articular tissue, CT, X-rays to determine changes in bone tissue).
Therapy
The disease cannot be stopped completely.Timely diagnosis and treatment allow you to preserve its mobility and prevent the progression of destruction.
Antispasmodics, NSAIDs, steroid blockades injected into the joint, chondroprotectors, muscle relaxants, vitamin and mineral complexes, drugs to improve trophism in affected tissues, proteolysis inhibitors to slow down the destruction of cartilage and bone tissue are used as medicines in the treatment of arthrosis.
Patients with severe pain and an unstable joint are advised to wear tape that fixes the joint in a normal position using adhesive tape, orthoses, elastic knee pads or elbow pads.Crutches or canes must be used as support.
Physiotherapy procedures should be prescribed, which include UHF, massage, ozone therapy, electrophoresis and phonophoresis with a solution of analgesics, 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 growth, spine and partial replacement of damaged cartilage.
- Endoscopy.This is the replacement of a joint (completely or only partially) with an artificial joint.
- Artodez.The joint is closed and fixed in a comfortable position.Over time, the joint 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.It is especially important to do this if there is a family history of cases of this disease or if you reach the age of over 40 years.
Prevention includes maintaining a normal body mass index and regular exercise.Infectious pathologies and other joint diseases should be treated immediately, hypothermia and prolonged and sudden physical exertion should be avoided.People from risk groups (by age, with a traumatic occupation, poor heredity) should regularly examine their joints using X-rays.
Only timely and appropriate treatment helps to keep the joint healthy.