Types of osteoarthritis: symptoms and methods of treatment

23 August 2020

Arthrosis is a chronic disease of the joints, accompanied by pathological changes in the cartilage of the hyaline, and then in the adjacent tissues, the joint capsule and the synovium.

The lesion is dystrophic and degenerative, which leads to a change in the structure of articular tissues, loss of their functionality. According to the same statistics, 12% of the total population of the planet is susceptible to osteoarthritis. From 62% to 65% of all episodes of the disease occur in people over the age of 60.

Another 30-35% of cases of joint damage with this pathology occur in patients aged 40-60 years. And about 3% are young people aged 20-40.

what is this?

Simply put, osteoarthritis is a chronic disease in which progressive degenerative-dystrophic changes develop in the joints due to metabolic disorders. It is the most common joint pathology, diagnosed in 6-7% of the population. With age, the incidence increases significantly.

Small hand ligaments (10 times more common in women than in men), thumb, intervertebral joints of the thoracic and cervical spine, and knee and hip joints are more often involved in the process. pathological in osteoarthritis. Knee and hip arthrosis takes the lead in terms of the severity of clinical manifestations and the negative impact on quality of life.

Arthrosis is characterized by a complex lesion of the articular and auxiliary apparatus:

chondritis - inflammatory changes in the cartilage of the joint;
osteitis - the involvement of basic bone structures in the pathological process;
synovitis - inflammation of the inner membrane of the joint capsule;
bursitis - damage to the periarticular sacs;
reactive inflammation of the soft tissues (muscles, subcutaneous tissue, ligaments) located in the projection of the involved joint (periarticular inflammation).

The disease is diagnosed in 2% of persons under 45 years of age, in 30% - from 45 to 64 years of age and in 65-85% - at the age of 65 years and older. Arthrosis of the large and medium-sized joints of the extremities has the greatest clinical importance due to its negative impact on the standard of living and working capacity of patients.

Types of osteoarthritis

Depending on the cause of the pathological process inside the joint, primary arthritis is distinguished, secondary and idiopathic.

Primary develops as an independent, secondary disease, as a result of an injury or infection, and the cause of the idiopathic form is unknown. In addition to classifying the disease, depending on the cause of the pathological process, arthritis is distinguished by the location of destructive changes:

Gonarthrosis is the most common type of pathology characterized by damage to the knee joints. Most often, gonarthrosis is detected in people who are overweight, with chronic metabolic diseases in the body and weak immunity. Knee arthrosis progresses for a long time and gradually leads to a complete loss of motor function.
Osteoarthritis of the shoulder joint - the main cause of degenerative processes in this area is congenital anomalies in the development of the shoulder joint or excessive stress in this area, for example, when carrying heavy luggage on the shoulder.
Ankle osteoarthritis - the main reasons for the development of degenerative processes in the ankle joint are trauma, sprains, sprains, fractures. In some cases, the development of a pathological process can provoke an autoimmune disease - rheumatoid arthritis. Arthritis of the foot affects dancers, women wearing high heels, athletes.

Uncoarthrosis or osteoarthritis of the cervical spine - causes are neck injuries, progressive osteochondrosis, overweight, a sedentary lifestyle. At risk are people working on a computer in the office. In addition to severe neck pain, patients have pronounced dizziness, depression of consciousness, impaired memory, and fatigue. These symptoms are caused by compression of the vertebral artery, through which nutrients and oxygen enter the brain.

Causes of osteoarthritis

Two reasons contribute to the formation of osteoarthritis - stress and lack of adequate nutrition, which supplies vitamins and minerals for tissue repair. Each person’s connections carry a load. For athletes and dancers, during physical work, the load on the legs is greater, which means that the bone joints get tired faster and require high quality food. With a sedentary lifestyle, the support apparatus gets tired more slowly, but also requires periodic tissue renewal.

Therefore, the main condition for the destruction and deformation of the joints is malnutrition, indigestion of useful ingredients, which often occurs with metabolic disorders.

Let us list the factors that contribute to joint wear and metabolic disorders:

Muscle weakness and abnormal joint load. Weakening of one or more muscles increases the load on the joint and distributes it unevenly within the bony junction. Also, improper muscle loading is formed with flat feet, scoliosis, therefore, with these "harmless" diseases, cartilage tissues get tired with age, osteoarthritis appears.
The possibility of osteoarthritis increases with strenuous physical exercise.

If daily loads exceed the capacity of bone tissue, microtrauma forms in them. At the sites of injury, thickening occurs, which increases over time and deforms the joint;
metabolic disorders (gastrointestinal diseases - biliary obstruction, dysbiosis, gastritis, cholecystitis, pancreatitis, metabolic diseases - diabetes);
Psychosomatic causes - the psychosomatics of arthrosis confirm that a negative emotional state also becomes the cause of the disease. Stress forms muscle spasms, constant stress disrupts the nutrition of all tissues (internal organs, bones, joints);

Osteoarthritis is a disease of tired joints that have lost a significant supply of minerals and the ability to resist stress and destruction. Therefore, with age, the predisposition to the disease increases. After 70 years, osteoarthritis is diagnosed at every second retirement. Since the maximum load falls on the foot (a person moves - walks, stands, runs, jumps), here are the first signs of osteoarthritis.

Mechanism of disease progression

When any of the causes that provoke an arthritic joint disease appear, pathological processes begin to develop in it. The mechanism of their progress is not fully understood, but the main stages of formal medicine are known.

In the initial stage, there is a depletion of cartilage tissue structure and abnormal changes in synovial fluid. All this happens due to metabolic disorders, in which the tissues of the joints do not get the necessary ingredients in sufficient quantities, or are deprived of some of them.

Further, the elasticity of collagen fibers and the flexibility of cartilage are lost, due to the fact that in the nutrient-deficient body, hyaluronic acid does not have time to be produced, which ensures the softness and flexibility of the structural composition of the cartilage. collagen fiber. The crackle gradually dries, becomes brittle and cracks. The fluid in the synovial capsule gradually decreases and then disappears completely.

Proximity and strong bone growths form in cartilage tissue. At the same time, deformation of other connective tissues, their pathological degeneration, dystrophy and loss of physiological activity develop. For the patient, these changes mean the onset of pain, dementia, joint stiffness.

Symptoms of osteoarthritis

Acute clinical picture is not typical for osteoarthritis, joint changes are progressive, slowly increasing, which is manifested by a gradual increase in symptoms:

permanent pressure on the affected joint;

joint deformity that appears and worsens as the disease progresses;

stiffness,

restriction of mobility (reduction of the volume of active and passive movements in the affected node)

Pain in osteoarthritis is dull, transient, appearing when moving, against a background of intense stress, towards the end of the day (it can be so intense that it does not allow the patient to fall asleep). The persistent, non-mechanical nature of pain for osteoarthritis is uncharacteristic and indicates the presence of active inflammation (subchondral bone, synovium, ligament apparatus, or periarticular muscle).

Most patients notice the presence of so-called initial pain that occurs in the morning after waking up or after a long period of inactivity and disappears during the course of physical activity. Many patients define this condition as the need to "develop a node" or "detach".

Arthrosis is characterized by morning stiffness, which has a clear localization and is of a short-term nature (not more than 30 minutes), sometimes it is perceived by patients as a "jelly feeling" in the joints. The feeling of wedge, rigidity is possible.

With the development of reactive synovitis, the main symptoms of osteoarthritis are joined by:

local pain and fever, determined by palpation of the affected node;
persistent pain;
joint enlargement, soft tissue swelling;
progressive decrease in range of motion.

Stages and degrees of osteoarthritis

In the course of the disease, the drug distinguishes between three stages, which differ in the signs of the disease, the intensity of the lesion and the localization. At the same time, the changes in all three stages are related to the types of tissues that undergo pathological changes.

The first stage in the development of osteoarthritis of the joints is the initial stage of the disease. It is characterized by mild damage to cartilage tissue and loss of physiological functions in collagen fibers. At the same time, in the first stage, small morphological disorders of bone tissue and structural changes in the synovial fluid are observed. The cartilage of the joint is covered with cracks, the patient has a slight pain at the site of pathology.
Second stage - development of osteoarthritis with increased dynamics. This stage is characterized by the appearance of persistent pain, dementia. There are marked morphological and dystrophic changes in cartilage; during diagnosis, bone tissue growth is detected. Osteophytes form - bone growths that are visible during a visual examination of the lesion site. At the same time, the processes of degenerative changes in the synovial capsule continue, which leads to its structural impoverishment. The disease at this stage can often worsen and be regular. The pain gradually becomes constant.
Third degree - active progress. At this stage, the synovial fluid is almost completely absent due to its degeneration, and the bone tissue rubs against each other. Joint mobility is almost completely absent, the pain becomes more noticeable. Cartilage is also deficient due to degenerative and atrophic changes. Treatment of third degree arthrosis of the joints is considered inappropriate.

In addition to these three stages of pathology development, there is a final stage - the irreversible destruction of all joint tissue. At this stage, it is impossible not only to perform effective therapy, but also to relieve the pain.

The inflammatory process usually begins in the second degree of the lesion, in rare cases, in the absence of medical intervention - in the first stage. Subsequently, it becomes increasingly difficult to stop it, and this can lead to secondary pathology, the development of pathogenic microflora at the site of the disease.

To rule out severe consequences, treatment should be started from the first degree, and at the same time, intensive therapy methods should be applied. In the final stage, accompanied by complete destruction of cartilage tissue, only one technique is allowed to relieve the patient from joint pain and immobility - arthroplasty with complete or partial replacement of joint components.

consequences

The consequences of premature treatment and advanced arthrosis of the joints are fraught with complications such as:

, deformation beyond recovery;

appearance of vertebral hernia;

stiffness or joint stiffness;

decline in quality and standard of living.

Chronic course, in addition to these complications, is accompanied by severe and frequent pain, complete destruction of the structural components of the joint, discomfort, inability to perform physical work and play sports.

Diagnostics

The diagnosis of osteoarthritis is based on the evaluation of anamnestic data, characteristic manifestations of the disease, the results of instrumental research methods. Indicative changes in blood and general and biochemical tests are not typical for osteoarthritis, they appear only with the development of an active inflammatory process.

The main instrumental method for diagnosing osteoarthritis is radiography; in unclear diagnostic cases, computed tomography or magnetic resonance imaging is recommended.

Knee and hip arthrosis takes the lead in terms of severity of clinical manifestations and negative impact on quality of life.

Additional diagnostic methods:

atraumatic arthroscopy;
ultrasonography (assessment of articular cartilage thickness, synovium, condition of joint capsules, presence of fluid);
scintigraphy (assessment of the condition of the bone tissue of the bone heads that form the joint).

How to treat osteoarthritis?

It is better to treat osteoarthritis of the joints at an early stage, the treatment itself must be pathogenetic and complex. Its essence lies in removing the causes that contribute to the development of this disease, it is also necessary to eliminate inflammatory changes and restore the functions that were previously lost.

Treatment of osteoarthritis is based on several basic principles:

Oxygenation of the joint, or so-called intra-articular oxygen therapy.
Drug therapy.
Intraosseous blockage as well as metaepiphyseal decompression.
Sustainable Diet.
Damaged connections need to be relieved of excessive stress. If possible, it should be kept to a minimum during treatment.
Follow the orthopedic regimen.
Physiotherapy exercises.
Taking a physiotherapy course, which includes magneto and electrotherapy, shock waves and laser therapy.
Sanatorium treatment. To do this, it is necessary once a year, on the recommendation of a doctor, to pass a course of treatment in specialized resorts.

Preparations for the treatment of osteoarthritis

Drug treatment is performed in the stage of osteoarthritis exacerbation, chosen by a specialist. Self-medication is unacceptable due to possible side effects (for example, the negative effect of non-steroidal anti-inflammatory drugs on the gastric mucosa).

Therapy includes the following medications:

Anti-inflammatory drugs. By starting therapy for osteoarthritis in a comprehensive way, you can slow down the course of the disease and significantly improve your quality of life. It is worth dwelling in more detail on a few points of treatment. In particular, drug therapy involves in the initial stage - this is the removal of pain, as well as the elimination of inflammatory processes occurring in the joints. For this, all doctors use non-steroidal anti-inflammatory drugs. Experienced doctors do not recommend their oral administration, as these medications irritate the stomach wall to a great extent. Therefore, depending on the drug chosen, either intravenous or intramuscular administration is used. Sometimes, as auxiliary agents, NSAIDs are used in the form of ointments, but their absorption is extremely low, so a significant effect can not be achieved.
Hormonal corticosteroids. When osteoarthritis is in the exacerbation phase, it is advisable to take hormonal corticosteroids. They are injected into the joints. On the outside, you can use a special plaster, oil or solution, which are made on the basis of hot pepper.
Chondroprotectors aimed at restoring cartilage and improving the quality composition of synovial fluid will not be superfluous. The course lasts a fairly long period of time, until the moment when there will be an improvement. However, if the expected effect does not appear within six months of administration, the medication should be discontinued. Also intra-articular, along with chondroprotectors, the use of drugs made on the basis of hyaluronic acid is advised. They contribute to the formation of the cell membrane responsible for the formation of the common cartilage.

Physiotherapy

To soothe pain, reduce inflammation, improve microcirculation, and eliminate muscle spasms, a patient with osteoarthritis has been referred for physiotherapy:

In an aggravation phase. Recommend laser therapy, magnetotherapy and ultraviolet radiation,
Sorry. Electrophoresis and phonophoresis are shown.

In addition, thermal procedures, sulfides, radon and sea baths are used. To strengthen the muscles, electrical stimulation is performed. Gentle massage can also be used during remission.

Surgery

If the listed exposure methods are ineffective, in the presence of complications, they are directed to the surgical treatment of osteoarthritis:

Decompression of the metaepiphysis and prolonged intraosseous blockade (reduction of intraosseous pressure in the affected area);
Corrective ostotomy;
Endoprosthetics of the joints.

In the early stages of the disease, mechanical, laser or cold plasma debridement is used (softening of the damaged cartilage surface, removal of non-light areas). This method effectively removes the pain, but has a temporary effect - 2-3 years.

Folk remedies

Most people these days do not want to take pills or injections. Therefore, they ask the question - how to cure osteoarthritis with the help of folk remedies? For the most part, such funds are aimed at increasing body tone, improving blood circulation, relieving pain, and boosting immunity.

Prescriptions of traditional medicine are used to treat this disease:

Egg solution is made from fresh egg yolk, which is mixed with terpene vinegar and apple cider vinegar in a 1: 1: 1 ratio. The juice should be thoroughly mixed and rubbed on the affected joint overnight. . Then you have to finish everything with a wool scarf. It is recommended to rub for 1 month 2-3 times a week.
Buy elecampane root from pharmacy. As a rule, it is packaged in packages of 50 grams. To prepare the solution, you will need half a packet of plant roots and 150 ml of high quality vodka. The ingredients are mixed, placed in a dark bottle and infused for 12 days. Rubbing is done before bed, and if possible in the morning.

Using boiled flour also gives good results. Take three to four tablespoons of oats, pour boiling water over and cook on low heat for five to seven minutes. The amount of water used should provide a thick porridge, which should be cooled and used as a compress overnight. Use only fresh boiled flakes. Yesterday's pus is not good for a compress.
Birch leaves, nettle leaves and calendula flowers are taken in equal parts. As a result, you should take two tablespoons. We place the resulting crushed collection in a thermos, fill it with a liter of boiling water and leave it overnight. Starting the next morning, you should take half a glass of soup four to five times a day. The course of taking this recipe is two to three months.

Tinctures of bay leaves, horseradish, garlic and rye grains are also considered effective. Treatment of osteoarthritis with folk remedies will be more effective if combined with medication.

Nutrition for osteoarthritis

The basic nutrition principles for osteoarthritis are reduced to the following points:

Avoid heavy foods at night to avoid an attack of osteoarthritis.
Eat partially.
Constantly control your weight to avoid weight gain,and therefore extra stress on injured joints.
When there is no worsening of the disease, take a walk after eating.
The menu should be balanced, designed with the attending physician.

There is absolutely no complaint about fish dishes - you can eat many of them, of course, in reasonable quantities.

Do not forget about regular intake of vitamins from food. For patients with osteoarthritis, B vitamins are especially important
Jelly meat plays an important role in the treatment of osteoarthritis. Such food will be a real repository of trace elements for injured joints. The most important component in aspic is naturally occurring collagen
Vitamin B helps in the production of hemoglobin. It can be "gained" by eating bananas, nuts, cabbage and potatoes. It is worth dealing with herbs and legumes. They will be the source of folic acid. Liver, mushrooms, dairy products, and eggs will be helpful. They are rich in riboflavin.

After the treatment regimen prescribed by the doctor, it is possible to achieve that the disease recedes, and the damaged tissue begins to regenerate.

Prevention

Osteoarthritis prevention starts with proper nutrition. It is necessary to try to reduce salt intake as well as food that can disrupt metabolism. These include legumes, fatty meats and alcohol. The diet includes cabbage, vegetables and fish.

To prevent osteoarthritis, it is necessary to attend physical education classes, do warm-ups. If possible, it is best to walk a few miles. It is also important to monitor your weight and prevent weight gain, as this will put extra stress on the injured joints. It is not recommended to take pills for the purpose of weight loss, as they can disrupt the metabolism in the body.

Forecast

The outlook on life is favorable. The popularity of social and occupational prognosis depends on the timing of diagnosis and the start of treatment; is reduced when the decision on the issue of surgical treatment of the disease is delayed, if necessary.