Osteoarthritis is a degenerative joint disease characterized by slow and progressive destruction of articular cartilage. Arthritis includes a group of joint diseases destructive and inflammatory nature, which have different causes and similar development mechanisms.
Osteoarthritis is one of the most common diseases in the world, occupying the leading position in women and men over the age of 30, and with age the risk of developing the disease only increases.
The causes of pathology
Osteoarthritis develops as a result of a violation of metabolic processes in the joints, against which intra-articular cartilage begins to lose water and becomes elastic. Contributing factors of such changes in cartilage can be internal and external reasons:
- hormonal changes;
- age features;
- genetic predisposition;
- rheumatoid arthritis;
- excessive load on the joints;
- the trauma and injuries – sprains, fractures, bruises, torn ligaments;
- changes in metabolism within the joint, associated with obesity, diabetes;
- hypothermia;
- inadequate and unbalanced nutrition, causing the body loses calcium, omega-3 and 6 fats and proteins;
- the inflammatory process in the joint;
- violation of blood supply of the femoral head – Perthes disease;
- problems with blood clotting, inherited disease;
- autoimmune diseases – lupus erythematosus, rheumatoid arthritis.
To trigger the development of osteoarthritis can also specific diseases, which have nothing to do with joints, namely:
- gonorrhea;
- syphilis;
- hyperthyroidism;
- thyroiditis.
At risk are people engaged in heavy physical labor, constantly forced to SuperCool and to feel an increased load on the musculoskeletal system – miners, Smiths, athletes, movers and pregnant women.
The symptoms of osteoarthritis
The first symptom of osteoarthritis is pain at the slightest stress on the joint, which quickly pass as soon as the joint is left alone. Osteoarthritis is characterized by 4 major clinical signs:
- Pain – pain when osteoarthritis has some features in contrast to pain in case of an accidental blow to the joint or inflammation in it. First of all, you should pay attention to the discomfort and pain at any movement and load on the affected joint. There is a person to stop the movement and remove the strain, as the pain immediately passed, which is not the case in trauma or inflammation of the joint. In the night time destroyed the joint is practically not harmful Khvorov discomfort, painful sensations are possible only by changing the position of the body, but they quickly pass. In marked progression of the destructive processes within the joint night may experience sharp shooting pains, which will eventually become stronger and make adjustments to lifestyle. Acute pain occurs with any change in weather, the changing phases of the moon, the slightest exertion.
- Crunch is the sound connection is the result of a decline in the quality of mild rotation of the bones around the joint, which leads to rubbing of bones against each other is accompanied by the characteristic crunch. Progression of degenerative processes in the joint, the crunch becomes more pronounced and is accompanied by pain.
- Limitation of joint mobility in the early stage of development of the pathological process the expressed restriction of mobility there, but as the progression of the destruction of the joint inside Khvorov harder to carry out simple actions. Eventually the affected joint is completely immobilized.
- Deformation of the joint surface of the bone beginning to grow osteophytes and synovial fluid accumulates. Deformation of the joint is observed in the running extent of the pathological process.
Degenerative processes in the joint develop rapidly, the disease is characterized by stages of exacerbation and remission, from what patients are reluctant to seek medical help, thereby contributing to the progression of destructive processes within the joint.
Stage
The stage of progression of the pathological process in the joint is determined by using x-rays. There are 4 stages of the disease:
- The first is characterized by a slight narrowing of the joint space, with no pathological growths on the bone there;
- Second – there is a slight narrowing of the joint space on the surface of the bone osteophytes are formed;
- Third – the joint space is narrowed, on the surface of the bone multiple osteophytes, there is a deformity of the joint;
- Fourth – articular slits are almost there, there are multiple osteophytes, severe deformation of the joint.
Degree
Osteoarthritis is expressed in the form of degenerative and destructive processes in the joint which affects the cartilage, develop changes in the capsule and synovial membrane of the joint, and the relations around it and bone structures. Depending on the severity and intensity of these destructions it is accepted to allocate 3 degrees of osteoarthritis.
First degree
Expressed deformation or change in the joint no, but disturbed synovial fluid – this leads to the insufficient provision of joint tissues with nutrients, water and minerals, causing the cartilage is quickly becoming flexible and adapted to the loads. Over time, this causes inflammation and is accompanied by pain with movement and stress on the joint.
At the first degree of osteoarthritis no of patients do not seek medical care, writing off the discomfort and pain in an uncomfortable position during sleep, fatigue, unhealthy lifestyle. Sometimes the patient may notice a characteristic crunch in the affected joint, but this is not accompanied by severe pain, but only discomfort, which again, no one pays enough attention.
If the osteoarthritis is diagnosed by accident in the first stage, disease is easily treatable.
Second degree
At this stage, the disease is accompanied by destructive processes in cartilage tissue in joints. On the surface of the bone strenuously grow osteophytes, and the more intense the load on the affected area, Tim more pronounced will progress destruction.
This patient skarzhitisya in constant pain aching and shooting character, which are held periodically by themselves and can a long time to make itself felt. Then the disease progresses again. Against the background of pathological process in the muscles that surround the inflamed joint, gradually lose their functions, causing the patient tires easily and cannot withstand the physical stress that easily endured before. While some degree of osteoarthritis, the patient gradually progressing deformity of the cartilage and joint.
Third degree
Is the most severe. Intra-articular cartilage of the affected joint thins and hard breaks, which leads to a clearly visible deformation and dysfunction of the affected limb. Located next to the joint communications and missty experiencing a shortage of nutrients and oxygen and gradually atrophy that is accompanied by severe loss of mobility. In this case, patient suffer from acute pain, which increases with any attempt to change the position of the body when the weather changes and moon phases and gradually leads to complete loss of effectiveness.
ViDi osteoarthritis
Depending on what the cause triggered by a pathological process inside the joint there are primary osteoarthritis, secondary and idiopathic.
Primary develops as an independent disease, secondary as a consequence of trauma or infection, and the cause of the idiopathic form is not known. In addition to classification of the disease depending on the causes of the pathological process distinguish osteoarthritis at the site of localization of destructive changes:
- Gonarthrosis is the most common type of pathology that is characterized by damage to the knee joints. Osteoarthritis most often detected in people with obesity, chronic diseases of metabolism in the body, weak immune system. Knee osteoarthritis progresses for a long period of time and gradually leads to complete loss of motor function.
- Arthrosis of the foot is the main causes of development of degenerative processes in the ankle injuries, sprains, strains, fractures. In some cases the pathological process may trigger autoimmune disease – rheumatoid arthritis. Ankle osteoarthritis-prone dancers, women who wear high heels, athletes.
- Arthrosis of the shoulder joint – the main cause of degenerative processes in this region are congenital malformations of the shoulder joint or excessive load on the zone, for example, when carrying heavy Luggage on shoulders.
- Coxarthrosis, or arthrosis of the hip joint – the main cause of appearance are the age-related changes in the tissues of the joint. At risk are people over 45 years old.
- Encountres or arthrosis of the cervical – causes are injuries to the neck, progressive low back pain, obesity, sedentary lifestyle. At risk people working at the computer in the office. In addition to expressed pain in the neck in patients with marked dizziness, depression of consciousness, impaired memory and fatigue. These symptoms are caused by compression of the vertebral artery, through which the brain receives nutrients and oxygen.
- Spondiloarthrosis – destructive destruction of the affected tissue of the spine, namely his lumbar. At-risk women in the period of menopause, as the spondylosis progresses on the background of deficiency of female sex hormones.
- Osteoarthritis of the fingers – develops for the same reason that the spondylosis.
- The polyarthrosis – is characterized by involvement of large joints with progressive degenerative processes in them, while in the pathological process involved ligaments, soft muscles and the tissues around the joint.
Possible complications
In the absence of timely diagnosis and treatment osteoarthritis will progress to involve other joints, promote the development of gruzevich of protrusions and development total polyarthrosis.
Complications of osteoarthritis are as follows:
- the destruction of the integrity of the joint;
- shape deformation;
- mobility limitation;
- disability of the patient.
All of these complications lead to a significant decline in the quality of life of the patient, accession related diseases and disorders, fully immobilize the patient.
Diagnostic methods
For the diagnosis of the disease the patient must turn for help to the traumatologist-the orthopedist. In order to differentiate osteoarthritis from other pathologies of the joints and musculoskeletal system is prescribed x-ray in 2 projections. This study allows to accurately determine changed areas of tissue adjacent to the affected joint, the presence of damage in the bones and connection relations, osteopenia sprawl.
If necessary, the doctor may additionally prescribe MRI, computer tomography, arthroscopy. In some cases, make arthrocentesis for a sample of synovial fluid.
Treatment of osteoarthritis
The treatment of arthritis is best done in the early stages, then the disease better responds to conservative therapies. It is important to establish the cause of progressive destructive changes in the joint and in time to eliminate these factors.
Treatment of osteoarthritis to be comprehensive and is to eliminate inflammatory process, relief of pain, stop the progression of the pathological process and restore lost functions of the joint. Conservative therapy includes the selection of drugs and physiotherapeutic methods of treatment.
Medication
Treatment of osteoarthritis in different ways in different places of localization of the pathological process:
- Osteoarthritis of the fingers and hands – Khvorov to reduce pain prescribe non-steroidal anti-inflammatory drugs in the form of ointments, cream, gel. To prevent the progression of the pathological process of receiving indications of chondroprotectors. After relief of the acute inflammatory process prescribed massage and physiotherapy treatments.
- In case of arthrosis of the shoulder joint, inside the joint Khvorov injection painkillers and non-steroidal anti-inflammatory drugs. Orally may prescribe taking antispasmodic medication that will relax the g muscle and lowering the intensity of the pain. After the relief of acute inflammation and pain shown therapeutic physical training and massage.
- Knee osteoarthritis are prescribed nonsteroidal anti-inflammatory drugs topically in the form of compresses, ointments, gels. On the affected joint shown physiotherapeutic therapies.
- Osteoarthritis of the hip joint – to the affected area apply compresses soaked in the ointment or gel from the NSAID group, and inside of the joint is injected with painkillers injection.
- Osteoarthritis of the knee on the affected area is applied creams and gels with the analgesic effect, and after the relief of acute pain and inflammation shown physical treatment methods.
- Ankle osteoarthritis – Khvorov recommended strict bed rest with confidence of the affected joint. With the subsiding of acute inflammatory process are assigned physiotherapy, baths, massages.
Physiotherapy treatment
To effective physiotherapeutic methods frequently used in different degrees of severity of osteoarthritis include:
- Shock wave treatment effectively relieves the patient from the growths osteophytes, thereby eliminating pain and limitation of joint mobility;
- Stimulation of the muscles around the affected joint by electric currents, this treatment is very effective for patients with severe reduced mobility and helps to improve blood circulation in the joint, accelerate regenerative processes, increase m atovi tone;
- Ozone therapy, in the cavity of the affected joint gas mixture is introduced, allowing the patient decreases pain and normalizes motility of the joint, signs of inflammation disappear. For maximum effect, ozone therapy courses to be conducted;
- Phonophoresis – the impact on the affected area by ultrasonic waves with the use of drugs. This method of medication is much more effective, since ultrasonic waves deliver the drug directly to the lesion.
In addition to physiotherapy treatment includes physical therapy, massage, manual therapy, mechanotherapy.
Diet
Diet for osteoarthritis should be as balanced and rich in polyunsaturated fatty acids, proteins, trace elements. It is recommended to include in the diet fresh fish, vegetable oils, cheese, dairy products, meat, fresh vegetables and fruits.
From the diet should exclude flour products and "fast" carbohydrates, chocolate, coffee, alcohol, pork, fatty and spicy dishes.
Surgical treatment
If conservative treatment has not led to expected result or osteoarthritis diagnosed at an advanced stage, when there are pronounced degenerative changes of the joint with severe mobility limitation that Khvorov appointed surgery.
Surgical treatment of osteoarthritis carried out in several ways:
- Puncture of the affected joint – this method is both diagnostic and therapeutic. Specimen collection synovial fluid allows to define precisely the nature of the origin of the disease and to select effective drug. During the operation of the puncture into the joint cavity administered corticosteroids and various anti-inflammatory drugs that eases pain and relieves strain on the joint.
- Arthroscopy in joint cavity to be introduced the arthroscope to a thorough examination of the joint from the inside. During the operation, the doctor can remove growths on the bones and various neoplasms.
- Osteotomy – the operation of the joint bones a little adjusting special tools and fixed in the correct position, which allows not only to restore motor function, but also to relieve the patient from discomfort and severe pain.
- Joint replacement is a destroyed joint is removed and in its place install a prosthesis of high quality material which will completely take over the functions of the lost joint, provide full mobility of the limb and save the patient from pain.
Prevention
Prevention of osteoarthritis is the integrated campaign:
- maintaining a healthy and active lifestyle;
- rational and adequate nutrition;
- elimination of bad habits;
- prevention of injuries and damage to the joints;
- timely treatment of inflammatory processes.
People from risk groups should be especially attentive to the slightest changes in the joints and the appearance of pain, crunching and creaking immediately seek the advice of traumatologist-orthopedist.