Types of osteoarthritis: symptoms and treatment methods.

Osteoarthritis is a chronic disease of the joints, accompanied by pathological changes in the hyaline cartilage and, later, 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 the joint 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 60 years of age.

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

What's this?

In simple words, osteoarthritis is a chronic disease in which progressive degenerative-dystrophic changes develop in the joint due to metabolic alterations. It is the most common joint pathology, diagnosed in 6-7% of the population. With age, the incidence increases dramatically.

Most often, in osteoarthritis, the pathological process involves the small joints of the hand (in women 10 times more often than in men), the big toe, the intervertebral joints of the thoracic and cervical spine, as well as the knee and hip joints. Osteoarthritis of the knee and hip joints ranks highly in terms of severity of clinical manifestations and negative impact on quality of life.

Osteoarthritis is characterized by a complex lesion of the joint and auxiliary apparatus:

  • chondritis: inflammatory changes in the cartilage of the joint;
  • osteitis: involvement of the underlying bone structures in the pathological process;
  • synovitis: inflammation of the inner membrane of the joint capsule;
  • bursitis - damage to periarticular bursa;
  • Reactive inflammation of soft tissues (muscles, subcutaneous tissue, ligamentous apparatus) located in the projection of the affected joint (periarticular inflammation).

The disease is diagnosed in 2% of people under 45 years of age, in 30% - aged 45 to 64 years and in 65-85% - at the age of 65 or over. Osteoarthritis of the large and medium joints of the extremities is of the highest clinical importance due to its negative impact on the standard of living and the ability to work of patients.

Types of osteoarthritis

Depending on the cause of the pathological process within the joint, primary, secondary and idiopathic osteoarthritis are distinguished.

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

  1. Gonarthrosis is the most common type of pathology characterized by damage to the knee joints. Most often, gonarthrosis is detected in overweight people, with chronic metabolic diseases in the body and weak immunity. Knee osteoarthritis progresses for a long time and gradually leads to a complete loss of motor function.
  2. Osteoarthritis of the shoulder joint: the main cause of degenerative processes in this area are congenital anomalies in the development of the shoulder joint or excessive stress in this area, for example, when carrying heavy luggage on the shoulders.
  3. Ankle osteoarthritis: the main reasons for the development of degenerative processes in the ankle joint are trauma, sprains, sprains and fractures. In some cases, the development of a pathological process can provoke an autoimmune disease - rheumatoid arthritis. Osteoarthritis of the ankle affects dancers, women with high heels, athletes.
  4. Osteoarthritis
  5. Uncoarthrosis or osteoarthritis of the cervical spine: the causes are neck injuries, progressive osteochondrosis, obesity and a sedentary lifestyle. People who work with a computer in offices are at risk. In addition to severe neck pain, patients present with pronounced dizziness, depressed consciousness, memory impairment, and fatigue. These symptoms are caused by compression of the vertebral artery, through which nutrients and oxygen enter the brain.
  6. Coxarthrosis or osteoarthritis of the hip joint: the main cause of appearance is age-related changes in the tissues of the joint. People over 45 are at risk.
  7. Osteoarthritis of the fingers: develops for the same reason as spondyloarthrosis.
  8. Polyarthrosis is characterized by damage to multiple joints with progressive degenerative processes in them, while the pathological process involves ligaments, muscles and tissues that surround the joint.
  9. Spondyloarthrosis - The tissues of the spine, that is, its lumbar region, are subject to destructive destruction. Women are at risk during the onset of menopause, as spondyloarthrosis progresses against the background of a deficiency of female sex hormones.

Causes of osteoarthritis

Two reasons contribute to the formation of osteoarthritis: stress and lack of proper nutrition, which provides vitamins and minerals for tissue repair. Every person's joints carry a load. For athletes and dancers, during physical work, the load on the legs is greater, which means that the bone joints wear out faster and require high-quality nutrition. With a calm lifestyle, the supportive apparatus wears out 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 components, which often occurs with metabolic disorders.

Let's list the factors that contribute to joint wear and tear and metabolic disorders:

  • Muscle weakness and abnormal load on the joints. The weakening of one or more muscles increases the load on the joint and distributes it unevenly within the bony joint. In addition, the wrong load on the muscles is formed with flat feet, scoliosis, therefore, with these "harmless" diseases with age, cartilaginous tissues wear out and osteoarthritis appears.

    The probability of osteoarthritis increases with intense physical effort.

    If the daily loads exceed the capacity of the bone tissues, microtrauma forms in them. Thickening appears at the lesion sites that grow over time and deform the joint;

  • Metabolic disorders (gastrointestinal diseases - stagnation of bile, dysbiosis, gastritis, cholecystitis, pancreatitis, metabolic disease - diabetes);
  • Psychosomatic causes: the psychosomatic of osteoarthritis confirms 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);
  • Heredity (the type of metabolism and its possible disorders are hereditary, a tendency to muscle weakness or inadequate bone formation, poor digestion, which is the basis for the development of osteoarthritis in old age).

Osteoarthritis is a disease of worn 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 in every second pensioner. Since the maximum load falls on the legs (a person moves, walks, stands, runs, jumps), it is here that the first signs of osteoarthritis form.

Mechanism of disease progression

When any of the reasons that cause a disease of the joint with osteoarthritis appear, pathological processes begin to develop in it. The mechanism of its progression is not fully understood, but the main stages of official medicine are known.

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

In addition, the elasticity of the collagen fibers and the flexibility of the cartilage are lost, because in the body with a lack of nutrients, hyaluronic acid does not have time to be produced, which provides softness and flexibility to the structural compositionof collagen fiber. Cartilage gradually dries out, becomes brittle, and cracks. Synovial capsule fluid gradually depletes and then disappears completely.

Roughs and solid bony growths form in cartilage tissue. At the same time, deformation of other tissues of the joint, their pathological degeneration, dystrophy and loss of physiological activity develops. For the patient, these changes mean the appearance of pain, lameness, joint stiffness.

Osteoarthritis symptoms

The acute clinical picture is not typical of osteoarthritis; joint changes are progressive, slowly increasing, manifested by a gradual increase in symptoms:

  • pain;
  • intermittent crunching of the affected joint;
  • joint deformity that appears and worsens as the disease progresses;
  • stiffness;
  • limitation of mobility (decreased volume of active and passive movements in the affected joint)

Pain in osteoarthritis is dull and temporary, appears when moving, in a context of intense stress, at the end of the day (it can be so intense that it does not allow the patient to fall asleep). The constant, non-mechanical nature of pain for osteoarthritis is not characteristic and indicates the presence of active inflammation (subchondral bone, synovium, ligamentous apparatus, or periarticular muscles).

Most patients notice the presence of so-called initial pains that occur in the morning after waking up or after a long period of inactivity and disappear during physical activity. Many patients define this condition as the need to "develop a joint" or "disconnect".

Osteoarthritis is characterized by morning stiffness, which is clearly localized and of short duration (no more than 30 minutes), sometimes perceived by patients as a "gelatinous sensation" in the joints. A wedging feeling, stiffness is possible.

Joint pain with osteoarthritis

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

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

Stages and degrees of osteoarthritis

In the course of the disease, medicine distinguishes between three stages, which differ in the signs of the disease, the intensity of the injury and the location. At the same time, the differences in the three stages are related to the types of tissues that undergo pathological changes.

  1. The first stage of development of osteoarthritis of the joints is the initial phase 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, minor morphological disorders of bone tissue and structural changes in synovial fluid are observed. The cartilage of the joint is covered with cracks, the patient has slight pain at the site of the pathology.
  2. Second degree: the development of osteoarthritis with greater dynamics. This stage is characterized by the appearance of stable pain, lameness. There are notable morphological and dystrophic changes in the cartilage; During diagnosis, growth of bone tissue is revealed. Osteophytes form - bone growths that are visible during a visual examination of the injury site. At the same time, the processes of degenerative changes continue in the synovial capsule, which leads to its structural depletion. The disease in this phase can often worsen and be regular. The pains gradually become constant.
  3. Third grade: active progression. At this stage, the synovial fluid is almost completely absent due to its degeneration, and the bone tissue rubs together. Joint mobility is almost completely absent, pain becomes more palpable. Cartilage is also absent due to degenerative and atrophic changes. Treatment of third degree osteoarthritis of the joints is considered inadequate.

In addition to these three degrees of development of the pathology, there is a final stage: the irreversible destruction of all the tissues of the joint. In this phase, it is impossible not only to perform effective therapy, but even to relieve pain.

The inflammatory process usually begins in the second degree of the injury, 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 pathologies, the development of pathogenic microflora at the site of the disease.

To exclude serious consequences, treatment should be started from the first degree, and at the same time intensive therapy methods should be applied. In the last stage, associated with the complete destruction of cartilaginous tissue, only one technique is allowed to relieve the patient of pain and joint immobility: arthroplasty with total or partial replacement of joint components.

Consequences

The consequences of untimely treatment and advanced osteoarthritis of the joints are fraught with complications such as:

  • disability;
  • deformation beyond recovery;
  • appearance of vertebral hernias;
  • stiffness or stiffness of the joint;
  • decrease in quality and standard of living.

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

Diagnosis

The diagnosis of osteoarthritis is based on the evaluation of anamnestic data, characteristic manifestations of the disease, results of instrumental research methods. Indicative changes in general and biochemical blood 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 cases with unclear diagnosis, magnetic resonance imaging or computerized imaging is recommended.

Osteoarthritis of the knee and hip joints ranks high in terms of severity of clinical manifestations and negative impact on quality of life.

Additional diagnostic methods:

  • atraumatic arthroscopy;
  • ultrasound (evaluation of the thickness of the articular cartilage, synovial membrane, state of the joint capsules, presence of fluid);
  • scintigraphy (assessment of the state of the bone tissue of the heads of the bones that make up the joint).

How to treat osteoarthritis?

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

The treatment of osteoarthritis is based on several basic principles:

  1. Oxygenation of the joint, or the so-called intra-articular oxygen therapy.
  2. Drug therapy.
  3. Intraosseous blockages, as well as decompression of the metaepiphysis.
  4. Sustainable diet.
  5. Damaged gaskets must be relieved of excessive stress. If possible, it should be kept to a minimum during treatment.
  6. Follow established orthopedic regimen.
  7. Physiotherapy exercises.
  8. Taking a course in physical therapy, which includes magneto and electrotherapy, shock wave therapy, and laser.
  9. Sanatorium treatment. To do this, it is necessary once a year, on the recommendation of a doctor, to undergo a course of treatment in specialized centers.

Preparations for the treatment of osteoarthritis

Pharmacological treatment is carried out in the phase of exacerbation of osteoarthritis, selected by a specialist. Self-medication is unacceptable due to possible side effects (for example, the negative effect of non-steroidal anti-inflammatory drugs on gastric mucosa).

The therapy includes the following medications:

  1. Anti-inflammatory drugs. By starting therapy for arthrosis comprehensively, you can slow down the course of the disease and significantly improve the quality of life. It is worth dwelling in more detail on some treatment points. In particular, drug therapy includes at the initial stage - this is the elimination of pain, as well as the elimination of inflammatory processes that occur in the joints. For this, all doctors use non-steroidal anti-inflammatory drugs. Experienced doctors do not recommend their oral administration, since these drugs greatly irritate the stomach wall. Therefore, depending on the drug chosen, 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 no significant effect can be achieved.
  2. Hormonal corticosteroids. When osteoarthritis is in the exacerbation stage, it is advisable to take hormonal corticosteroids. They are injected into the joint. Externally, you can use a special plaster, ointment or tincture, which are made on the basis of hot pepper.
  3. Chondroprotectors intended to restore cartilage and improve the qualitative composition of the synovial fluid will not be superfluous. The course lasts quite long, until such time as an improvement occurs. However, if the expected effect does not appear within six months after administration, the drugs should be canceled. Also intra-articular, together with chondroprotectors, it is advisable to use drugs made from hyaluronic acid. They contribute to the formation of the cell membrane responsible for the formation of articular cartilage.

Physiotherapy

To relieve pain, reduce inflammation, improve microcirculation and eliminate muscle spasms, a patient with osteoarthritis is referred for physical therapy:

  • In a phase of aggravation. Prescribe laser therapy, magnetotherapy and ultraviolet radiation,
  • In remission. Electrophoresis and phonophoresis are shown.

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

Surgery

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

  1. Decompression of the metaepiphysis and prolonged intraosseous block (decrease in intraosseous pressure in the affected area);
  2. Corrective osteotomy;
  3. Joint endoprosthesis.

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

Folk remedies

Most people these days don't want to take pills or injections. Therefore, they ask the question: how to cure arthrosis with the help of folk remedies? For the most part, such funds are intended to increase the tone of the body, improve blood circulation, relieve pain and increase immunity.

Traditional medicine recipes are used to treat this disease:

  1. The egg solution is made from fresh egg yolk, which is mixed with turpentine and apple cider vinegar in a 1: 1: 1 ratio. The liquid should be mixed well and rubbed over the affected jointovernight. Then you need to wrap everything with a woolen scarf. It is recommended to rub for 1 month 2-3 times a week.
  2. Buy helenium root at the drugstore. As a general rule, it is presented in packages of 50 grams. To prepare the tincture, you will need half a packet of plant roots and 150 ml of high-quality vodka. The ingredients are mixed together, placed in a dark bottle and infused for 12 days. It is rubbed before going to bed and, if possible, in the morning.
  3. Knee osteoarthritis
  4. Using boiled oats also works well. Take three to four tablespoons of oatmeal, pour boiling water and simmer 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 freshly boiled flakes. Yesterday's porridge is not good for a compress.
  5. Birch leaves, nettle leaves and calendula inflorescences are taken in equal parts. As a result, you need to get two tablespoons. We put 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 drink half a glass of broth four to five times a day. The course of taking this recipe is two to three months.

Bay leaf, horseradish, garlic, and rye grain tinctures are also considered effective. Treating osteoarthritis with home remedies will be more effective if combined with medications.

Nutrition for osteoarthritis

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

  1. Avoid heavy meals at night to avoid an attack of osteoarthritis.
  2. Eat little.
  3. Constantly monitor the weight, to avoid weight gain,Vitamins for osteoarthritisand therefore additional stress on sore joints.
  4. When the illness is not severe, take a walk after eating.
  5. The menu must be balanced, prepared with the attending physician.

There are absolutely no complaints about the fish dishes; can eat many, naturally, in reasonable quantities.

  1. Don't forget about regular intake of vitamins from food. For patients with osteoarthritis, the B vitamins are especially relevant
  2. Meat in jelly plays an important role in the treatment of osteoarthritis. Such food will be a real storehouse of trace elements for sore joints. The most important component of aspic is natural collagen
  3. Vitamin B helps in the production of hemoglobin. It can be "obtained" by eating bananas, walnuts, cabbage, and potatoes. It is worth getting carried away with herbs and legumes. They will be the source of folic acid. Liver, mushrooms, dairy products, and eggs will come in handy. They are rich in riboflavin.

By following the treatment regimen prescribed by the doctor, it is possible to make the disease regress and the damaged tissues begin to regenerate.

Prevention

Prevention of osteoarthritis begins with proper nutrition. It is necessary to try to reduce the intake of salt, as well as foods that can alter the metabolism. These include legumes, fatty meats, and alcohol. The diet includes cabbage, vegetables and fish.

For the prevention of osteoarthritis, it is necessary to attend physical education classes, do warm-ups. If possible, it is better to walk a few kilometers. It is also important to control your weight and prevent weight gain, as this will put additional pressure on aching joints. Taking pills for the purpose of weight loss is not recommended as they can alter the metabolism in the body.

Forecast

Life prospects are favorable. The favorable socio-labor prognosis depends on the timing of the diagnosis and the initiation of treatment; decreases when the decision on the subject of surgical treatment of the disease is delayed, if necessary.