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 mobility of the joint, disruption of its functions and severe deformation.Approximately 10-25% of the population suffers from arthrosis.After 80 years, almost every person has degenerative disorders in the musculoskeletal system.Most often, the disease affects the most mobile joints (fingers, hip, knee, neck).But sometimes degenerative processes develop in the ankle and shoulder joints.
Factors of disease development
Various reasons trigger destructive processes in the body.The most important are congenital abnormalities of the connective tissue.Regular joint microtraumas and acute joint diseases contribute to the development of arthrosis.Over time, an untreated disease turns into a chronic phase with regular exacerbations.
The provoking factors that lead to the development of arthrosis 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 a provoking factor or several at once, cartilage tissue cells begin to deteriorate.Gradually, the cartilage becomes thinner, becomes less elastic, then becomes covered with cracks and falls off.The bones in the joint begin to rub against each other.The body initiates a compensatory mechanism, which causes bone tissue to grow on the worn-out surface.As a result, the joint becomes inactive and deforms.
Species
Arthrosis can be primary, which occurs independently, and secondary, which develops as a result of diseases, injuries and joint deformities.
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 joint 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, it is local arthrosis.
Symptoms
At first, the degenerative process takes place imperceptibly.There are no nerve fibers in the 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 a few years after the beginning of dystrophic-degenerative processes, when the bone tissue 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 period of rest, there is a feeling of stiffness and dull pain of not too much intensity.After a short warm-up or exercise, all painful symptoms disappear.That's why people don't go to the doctor, thinking it's a common occurrence.Meanwhile, it is much easier to stop the progression of arthrosis in the initial stage.
Over time, all signs intensify.The pain becomes obsessive and constant, preventing you from sleeping at night.The pains, the feeling of stiffness, the inability to work full time or do household chores become more and more disturbing.Aching, twisting pain in the joints and surrounding muscles intensifies in rainy weather.
Most 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 as a result of the destruction of cartilage tissue, stiffness of the joint is formed.Unsteady gait develops due to limb instability.When bending the joint, an unpleasant creaking sound is heard as the joint surfaces, without cartilage, rub against each other.Patients try to limit the mobility of the affected 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 occurs after injuries or as a result of chronic arthritis.In this case, bony growths appear on the fingers, and the hands become square-shaped.
Clinical symptoms depend on the stage of development of arthrosis:
- Zero.
In the zero stage, a person sometimes suffers from slight discomfort.X-ray examination does not reveal any degenerative changes. - Elementary.
A slight dull pain occurs when walking for a long time.The X-ray shows the appearance of small areas of bone defects along the edges of the joint surfaces.A creaking sound is heard when bending the joint. - Easy.
Pain and stiffness appear in the morning.X-rays show osteophytes (outgrowths of individual bone) along the edges of the joints, narrowing of the joint space. - Moderately.
The moderate stage is considered degenerative.Bones and muscles ache all the time, especially at night.The joint swells a little.X-ray examination shows even greater narrowing of the joint space, proliferation of bone growths and increased bone density. - Heavy.
In the severe stage (deforming), there is constant pain that is intensified by movement.When you try to bend the wrist, there is a harsh crunch.The X-ray shows a sharp narrowing of the joint space;osteophytes have already grown so much that it has led to joint deformation and changes in its structure.
Diagnosis and treatment
An orthopedist, a rheumatologist and a surgeon are involved in determining the type and stage of degenerative-dystrophic processes in the joints.Diagnosis involves standard blood and urine tests.If necessary, an immunological analysis and an examination of the intra-articular fluid for the presence of infection are performed.Instrumental studies are performed (MRI, ultrasound to determine changes in soft periarticular and joint tissues, CT, X-rays to determine changes in bone tissue).
Therapy
The disease cannot be completely stopped.Timely diagnosis and treatment allow you to maintain his 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 the affected tissues, proteolysis inhibitors to slow down the destruction of cartilage and bone tissue are used as drugs in the treatment of arthrosis.
Patients with severe pain and an unstable joint are recommended to wear tapes that fix the joint in a normal position using adhesive tapes, orthoses, elastic knee or elbow protectors.Crutches or sticks should be used as support.
Physiotherapy procedures must be prescribed, including UHF, massage, ozone therapy, electrophoresis and phonophoresis with a solution of painkillers, magnetic therapy, acupuncture, electrostimulation, 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, spines and partial replacement of damaged cartilage.
- Endoscopy.This is the replacement of a joint (in whole or only part) with an artificial joint.
- Artodez.The joint is closed and fixed in a comfortable position.Over time, the articular surfaces grow together.
Prevention
Since it is impossible to return one's 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 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 immediately, hypothermia and prolonged and sudden physical efforts should be avoided.People from risk groups (by age, traumatic profession, weak heredity) must regularly examine their joints with an X-ray.
Only timely and adequate treatment helps to maintain joint health.