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 joint mobility, alteration of its functions and severe deformations.Approximately between 10 and 25% of the population suffers from osteoarthritis.After 80 years, almost all people suffer from 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 joint.
Factors in the development of the disease.
Various reasons trigger destructive processes in the body.The most important are congenital anomalies of the connective tissue.Common joint microtrauma and acute joint diseases contribute to the development of osteoarthritis.Over time, the untreated disease enters a chronic phase with periodic exacerbations.
The provoking factors that lead to the development of osteoarthritis are:
- overweight;
- physical inactivity;
- hormonal disorders;
- atherosclerosis;
- venous insufficiency;
- endocrine disorders;
- genetic predisposition;
- regular, heavy loads on the joints (for example, in weightlifters or people whose profession involves lifting and moving heavy objects).
Under the influence of one provoking factor or several at once, the cells of the cartilage tissue begin to collapse.Gradually, the cartilage becomes thinner, less elastic, then becomes covered with cracks and falls off.The bones in the joint begin to rub against each other.The body launches a compensatory mechanism, as a result of which bone tissue grows on the damaged surface.As a result, the joint becomes inactive and deformed.
Species
Osteoarthritis can be primary, which appears independently, and secondary, which develops as a result of diseases, injuries and deformities of the joints.
Depending on the affected joint, the disease is named:
- 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 in the pathological process.
If 3 or more joints are involved in the degenerative process, we speak of a generalized form.If there are 1-2 joints, it is local osteoarthritis.
Symptoms
At first, the degenerative process goes unnoticed.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 start of dystrophic-degenerative processes, when the periosteum under the cartilage is injured or inflammation develops.
At first, there is pain in the extremities after intense exertion.In the morning or after a long stay at rest, a sensation of stiffness and dull pain of not too great intensity occurs.After a short warm-up or exercise, all painful symptoms disappear.Therefore, people do not go to the doctor because they consider this to be common.Meanwhile, it is at the initial stage that it is much easier to stop the progression of osteoarthritis.
Over time, all symptoms intensify.The pain becomes obsessive and constant, preventing sleep at night.The pain, the feeling of stiffness, the inability to work fully or carry out household tasks are increasingly disturbing.The aching and twisting pain in the joints and surrounding muscles intensifies in rainy weather.
Most often, osteoarthritis 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, since as a result of the destruction of cartilage tissue, stiffness of the joint is formed.An unsteady gait develops due to limb instability.When bending a joint, an unpleasant crunch is heard when the articular surfaces, devoid of cartilage, 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 develops in the joints of the upper extremities, this most often occurs after an injury 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.
At stage zero, a person is sometimes bothered by slight discomfort.X-ray examination does not reveal any degenerative changes. - Elementary.
When walking for a long time, a slight dull pain occurs.The x-ray shows the appearance of small areas of bone defects along the edges of the articular surfaces.When bending the joint, a crunch is heard. - Easy.
In the morning there is pain and stiffness.X-rays show osteophytes (single bone growths) along the edges of the joints, narrowing of the joint space. - Moderate.
The moderate stage is considered degenerative.Bones and muscles ache constantly, especially at night.The joint swells a little.X-ray examination shows even further narrowing of the joint space, proliferation of bone growths and increased bone density. - Heavy.
In the severe (deforming) stage, there is constant pain that intensifies with movement.When you try to bend the joint, a harsh crunch is heard.The x-ray shows a strong narrowing of the joint space;The osteophytes have already grown so much that they have caused deformation of the joint and a change 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 includes standard blood and urine tests.If necessary, an immunological analysis and examination of intra-articular fluid are performed to detect the presence of infection.Instrumental studies are performed (MRI, ultrasound to identify changes in periarticular and articular soft tissues, computed tomography, x-rays to determine changes in bone tissue).
Therapy
The disease cannot be stopped completely.Timely diagnosis and treatment allow you to maintain your mobility and prevent the progression of destruction.
Antispasmodics, NSAIDs, steroid blockers 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 medications in the treatment of osteoarthritis.
Patients with severe pain and an unstable joint are recommended to use 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 for support.
Physiotherapy procedures should be prescribed, including UHF, massage, ozone therapy, electrophoresis and phonophoresis with analgesic solution, magnetotherapy, acupuncture, electrical stimulation, darsonvalization, paraffin baths (in the absence of inflammation).
In the later stages of osteoarthritis, 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.It involves the replacement of a joint (totally or partially) 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 restore your 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 so if there is a family history of cases of this disease or if one reaches an age of over 40 years.
Prevention includes maintaining a normal body mass index and exercising regularly.Infectious pathologies and other joint diseases should be treated promptly, avoiding hypothermia and sudden prolonged physical exertion.People from risk groups (due to age, traumatic profession, bad heredity) need to periodically examine their joints using x-rays.
Only timely and adequate treatment helps keep the joint healthy.