Osteoarthritis is a disease that affects 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, dysfunction and severe deformities.Around 10-25% of the population suffers from osteoarthritis.After 80 years, almost everyone suffers from degenerative diseases of the musculoskeletal system.Most often, the disease affects the most mobile joints (fingers, hips, knees, neck).But sometimes degenerative processes occur 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 malformations of the connective tissue.Regular microtrauma to the joints and acute joint diseases contribute to the occurrence of osteoarthritis.Over time, if left untreated, the disease progresses to a chronic stage with regular exacerbations.
Triggering factors that lead to the development of osteoarthritis are:
- obesity;
- physical inactivity;
- hormonal disorders;
- Arteriosclerosis;
- venous insufficiency;
- endocrine disorders;
- genetic predisposition;
- regular and heavy strain on the joints (e.g. in weightlifters or people whose job involves lifting and moving heavy objects).
Under the influence of one or more provoking factors at the same time, the cells of cartilage tissue begin to collapse.Gradually the cartilage becomes thinner, less elastic, then becomes cracked and falls off.The bones at the joint begin to rub against each other.The body triggers a compensatory mechanism, causing bone tissue to grow on the ailing surface.This causes the joint to become inactive and deformed.
species
Osteoarthritis can be primary, which occurs independently, and secondary, which develops as a result of diseases, injuries and deformities of 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, neck and thoracic regions.
- In cruciate arthrosis, the ankle joint is involved in the pathological process.
If 3 or more joints are involved in the degenerative process, it is called a generalized form.1-2 joints are local arthrosis.
Symptoms
The degenerative process initially goes unnoticed.There are no nerve fibers in the cartilage, so at the initial stage 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 injured or inflammation develops.
Initially, pain occurs in the limbs after heavy exertion.In the morning or after a long period of rest there is a feeling of stiffness and a dull, aching pain of not too great intensity.After a short warm-up or workout, all painful symptoms disappear.Therefore, people do not go to the doctor as this is a common occurrence.It is now much easier to stop the progression of osteoarthritis in the early stages.
Over time, all signs become more pronounced.The pain becomes obsessive and constant, preventing you from sleeping at night.Pain, a feeling of stiffness, the inability to work fully or do household chores become more and more bothersome.In rainy weather, aching, twisting pains in the joints and surrounding muscles intensify.
Most often, arthrosis affects the joints of the lower extremities, so a person quickly gets tired when walking and it becomes difficult for him to climb stairs or heights, as stiffness of the joint occurs due to the destruction of cartilage tissue.Due to the instability of the limbs, an unsteady gait occurs.When bending a joint, an unpleasant crunching sound can be heard as the cartilage-free joint surfaces 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 osteoarthritis occurs in the joints of the upper extremities, it most often occurs after injuries or as a result of chronic arthritis.In this case, bone growths appear on the fingers and the hands acquire a square shape.
Clinical symptoms depend on the stage of development of osteoarthritis:
- Zero.
In stage zero, a person sometimes experiences mild discomfort.X-ray examination shows no degenerative changes. - Elementary school.
Mild dull pain occurs when walking for long periods of time.The X-ray shows the appearance of small areas of bone defects along the edges of the articular surfaces.A crunching sound can be heard when the joint is flexed. - Simply.
Pain and stiffness occur in the morning.X-rays show osteophytes (individual bone growths) along the edges of the joint, which lead to a 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 even greater narrowing of the joint space, increased bone growth and increased bone density. - Difficult.
In the severe stage (deformation), persistent, aching pain occurs that increases with movement.When attempting to flex the joint, a harsh crunching sound is heard.The x-ray shows severe narrowing of the joint space;The osteophytes have already grown so much that the joint has deformed and its structure has changed.
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 includes standard blood and urine tests.If necessary, an immunological analysis and an examination of intra-articular fluid are carried out for the presence of infection.Instrumental examinations are carried out (MRI, ultrasound to detect changes in soft periarticular and articular tissues, CT, X-ray to detect changes in bone tissue).
therapy
The disease cannot be stopped completely.Timely diagnosis and treatment allows you to maintain mobility and prevent the progression of destruction.
As drugs in the treatment of arthrosis, antispasmodics, NSAIDs, steroid blockades injected into the joint, chondroprotectors, muscle relaxants, vitamin and mineral complexes, drugs to improve trophism in affected tissues and proteolysis inhibitors to slow down the destruction of cartilage and bone tissue are used.
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 pads or elbow pads.Crutches or canes should be used as support.
Physiotherapeutic procedures must be prescribed, including UHF, massage, ozone therapy, electrophoresis and phonophoresis with an analgesic solution, magnetic therapy, acupuncture, electrical stimulation, darsonvalization, paraffin baths (if there is no inflammation).
In the later stages of osteoarthritis, when the tissue has already been destroyed and the joints are severely deformed, the only option left 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 in part) 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 return one's own joint to a normal physiological state, measures must be taken in advance to prevent this disease.This is especially important if there is a family history of this condition or if you are over 40 years old.
Prevention includes maintaining a normal body mass index and regular exercise.Infectious diseases and other joint diseases should be treated promptly, hypothermia and prolonged and sudden physical exertion should be avoided.People from risk groups (by age, traumatic occupation, poor heredity) need to regularly examine their joints with X-rays.
Only timely and adequate treatment can help maintain the health of the joint.