Today, the disease of arthrosis of the joints is the most common among all pathologies of the musculoskeletal system. Moreover, city dwellers, people accustomed to leading an inactive lifestyle, and those who have recently suffered injuries of varying degrees of intensity, most often suffer from joint disorders.
The doctors' forecasts in this regard are disappointing. It is assumed that in the near future, the number of people suffering from various forms of arthrosis of large joints will only increase. According to the latest data, about 7 percent have experienced all the symptoms and consequences of osteoarthritis.
This disease has become one of the leading causes of disability and reduced performance. Characteristically, the peak incidence occurs in the age groups of 40 to 60 years, and not only older retirees, as is mistakenly believed.
What is osteoarthritis?
Osteoarthritis (another name for osteoarthritis) should be understood as a complex degenerative pathology in which the cartilaginous plate of the bone that makes up the joint is destroyed. The reasons do not lie only in the processes that occur in hyaline cartilage.
There are many other prerequisites for the disease.
Osteoarthritis of the joints develops under the condition:
- excessive physical activity. Usually overweight people get sick in such cases. Human joints are not designed for constant movement with a large load. For this reason, the increased compression experienced by the knees during activity becomes a prerequisite for cartilage tissue microtrauma. There is a violation of the sliding properties of tissues and reduced mobility of the joints. Athletes often suffer from systematically damaged joints due to sharp and frequent changes in natural pressure between the joint surfaces or a large load with insufficiently heated joints;
- congenital or acquired deformities, injuries of the musculoskeletal system. In such conditions, the disease is caused by inadequate contact of the articular surfaces of the bones. Absolutely the entire load cannot be distributed around the joint, and injuries occur in places of excessive compression. A striking example of such a violation will be rickets, scoliosis and kyphosis. It should also include irregular fusion of broken bones, various limb deformities;
- violation of cartilage regeneration. This mechanism of arthrosis development is observed in the presence of an inflammatory process in the body, impaired blood circulation and hormonal disorders. The problem is based on inadequate regeneration of lost cartilage tissue, lack of natural reshaping and thinning;
- problems of synovial fluid formation and production. In the case of insufficient joint fluid, the rubbing surfaces are constantly injured, their wear and inflammation is accelerated, the general condition of the body deteriorates.
Stages of arthrosis
Because osteoarthritis causes destruction of the cartilaginous tissue of the joint, the symptoms vary significantly depending on the stage of the pathological process.
As a result of active destruction of the joint surface, the person will experience new symptoms, and the prognosis for the resumption of motor activity will not change. Based on the clinical picture of the disease, the doctor will select the optimal method of treatment and medication.
Grade 1 osteoarthritis is characterized by the fact that discomfort and mild pain are felt only after prolonged intense exertion. After a short rest, the signs that appeared during physical activity disappear.
In that case, the lesions of the joints will not be visible on the X-ray photograph, but a slight narrowing of the joint space is possible.
Phase 2 pathology is characterized by an increase in symptoms. Now there are pains not only as a result of long-term activity, but also with less limb movements.
Rest will not bring the desired relief. There is stiffness in the movements, the mobility of the joint is limited. At this time, it is recommended to reduce the load on the affected joints, but this should not be completely ruled out, otherwise muscle atrophy occurs. X-rays will show clear signs of osteoarthritis:
- bone growth;
- deformation;
- neoplasms (osteophytes) near the joint space, its narrowing.
When the disease reaches its final stage, the lesions in the joints bring unbearable constant pain. Therefore, at the level of reflexes, the person begins to abruptly limit his movements, in order to protect the affected joint from stress. Pain syndrome occurs even during sleep and rest, when the joints are at rest.
The patient is forced to take the position in which he hurts the least. Movement becomes possible only with the help of a wheelchair or crutches.
It is characteristic that the 3rd and 4th degree of arthrosis can completely deprive a person of the ability to walk due to the fusion of joint surfaces (ankylosis).
Which joint is most commonly affected?
According to medical statistics, the lower limbs are most susceptible to osteoarthritis. Joints suffer from inflammation and degeneration: hip, knee.
In the case of hip joint problems, pelvic pain is initially felt after a long walk or run. With the active progression of the pathology, the pain intensifies, and mobility is limited.
The person will notice an uncomfortable stiffness in the joint, and in certain positions the stiffness increases several times at once. In the last stages of osteoarthritis of the hip joint, the patient subconsciously protects the affected leg and tries not to step on it at all. It does not move the pelvis, which helps relieve pain.
Osteoarthritis of the knee joint is manifested by discomfort and excruciating pain after walking. There are no external manifestations of the problem and inflammation. The most common precondition for osteoarthritis of the knee joint is its past trauma in the background of damage to internal structures.
Such lesions typically cause abnormalities in the vicinity of the contact joint surfaces. It also takes place:
- overload of certain areas of cartilage;
- their rapid wear.
The changes, as in the previous case, depend on the degree of arthrosis. You should also take into account the causes of the disease, the availability of appropriate medical care, the general condition of the body and the dynamics of the pathological process. Some forms of the disease are not felt for a long time and do not progress.
Sometimes, even for decades, there is no obvious worsening of the knee. In other cases, there is a rapid increase in symptoms and a high probability of loss of mobility.
Relief from osteoarthritis
Today, there are 2 main directions in the treatment of osteoarthritis of the large joints: medical and surgical.
First of all, treatment is aimed at rapidly improving blood circulation in the diseased joint and accelerating the properties of cartilage tissue with the help of drugs. Anesthesia and removal of inflammation are also required. For this purpose, doctors practice the use of the following drugs.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
These drugs interfere with the natural chemical chain of cartilage that causes inflammation. Swelling occurs in the tissues, pain occurs, and cartilage strength decreases during movement.
Thanks to the use of anti-inflammatory drugs, it is possible to reduce or completely stop the pain syndrome. It also prevents the initiation of the so-called chain inflammatory process, which helps accelerate the regeneration of the affected areas.
The drugs are produced in the form of tablets, powders and rectal suppositories. The tactics of treatment, the choice of a particular drug is determined by the doctor strictly on an individual basis, based on the clinical picture of the disease, its dynamics and accompanying pathologies.
Opioids and chondroprotectors
Strong central pain relievers are called opioids. Usually such drugs have a narcotic effect on the body, increasing the thresholds of sensitivity to pain. Thanks to this treatment, the pain in the affected joints can be reduced.
The use of drugs in this group should be strictly under the supervision of a physician, as such drugs cause mental and physical dependence.
In order to accelerate the renewal of cartilage tissue, special means are used - chondroprotectors. They are, to a large extent, structural elements of the cartilage itself, which allows them an activating effect on their recovery.
These medications include:
- chondroitin sulfate;
- glucosamine sulfate;
- hyaluronic acid.
Chondroitin and glucosamine are organic substances that abound in the intercellular space of cartilage. The mechanism of their action on the joints is not yet fully understood, however, it has been repeatedly proven to have a positive effect on the regeneration of cartilage tissue during treatment.
Chondroitin-based drugs activate the production of special substances from the extracellular matrix of cartilage (proteoglycans and hyaluronic acid). At the same time, the process of resorption in tissues is significantly inhibited. In the same way, certain chemical processes are suppressed, there is a reduction in inflammation in the cartilage, damage and the severity of the pain syndrome.
Long-term use of drugs in this group is often required. A course of at least 6 months is required. Otherwise, the benefits of therapy should not be expected. The organic combination of chondroitin and glucosamine is more commonly used. However, clinical studies have not confirmed a significant difference between such treatment and the use of only one of the chondroprotectors.
Despite the obvious advantages and safety, not everyone can treat arthrosis with such drugs due to the relatively high cost.
Hyaluronic acid is no less common in modern medicine. It is a long chain of carbohydrates that gives the synovial fluid elasticity and viscosity. The unique properties of hyaluronic acid are largely responsible for the good sliding properties of the joint fluid.
Intra-articular injections of the drug have a good effect on the condition of the body, because studies have shown that osteoarthritis is often triggered by a decrease in the concentration of hyaluronic acid inside the joint and a shortening of the chain of its molecules.