Types of osteoarthritis: symptoms and methods of treatment

Osteoarthritis is a chronic disease of the joints, accompanied by pathological changes in the hyaline cartilage, and subsequently 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 joint tissues, loss of their functionality. According to the same statistics, 12% of the total population of the planet is susceptible to osteoarthritis. Between 62% and 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?

In simple words, osteoarthritis is a chronic disease in which the joint develops progressive degenerative-dystrophic changes due to metabolic disorders. This is the most common pathology of the joints, diagnosed in 6-7% of the population. With age, the frequency increases dramatically.

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 are most often involved in the pathological process. in osteoarthritis. Osteoarthritis of the knee and hip joints occupies a leading position in terms of the severity of clinical manifestations and the 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 major 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 affected joint (periarticular inflammation).

The disease is diagnosed in 2% of people under 45 years, in 30% - from 45 to 64 years and in 65-85% - aged 65 years and older. Osteoarthritis of the large and medium joints of the limbs has the greatest clinical significance 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, a distinction is made between primary arthrosis, secondary and idiopathic.

The primary develops as a separate 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 according to the location of the destructive changes:

  1. Gonarthrosis is the most common type of pathology characterized by damage to the knee joints. Gonarthrosis is most often found in overweight people, with chronic metabolic diseases in the body and weak immunity. Osteoarthritis of the knee progresses over a long period of time and gradually leads to 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 on this area, for example when carrying heavy luggage on the shoulders.
  3. Osteoarthritis of the ankle - the main reasons for the development of degenerative processes in the ankle joint are injuries, 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 wearing high heels, athletes.
  4. Osteoarthritis
  5. Necoarthritis or arthrosis of the cervical spine - the causes are neck injuries, progressive osteochondrosis, obesity, sedentary lifestyle. At risk are people working on computers in offices. In addition to severe neck pain, patients experience severe dizziness, depression of consciousness, impaired memory and fatigue. These symptoms are caused by compression of the spinal artery, through which nutrients and oxygen enter the brain.
  6. Coxarthrosis or osteoarthritis of the hip joint - the main cause is age-related changes in the tissues of the joint. People over the age of 45 are at risk.
  7. Osteoarthritis of the fingers - develops for the same reason as spondyloarthritis.
  8. Polyarthrosis is characterized by damage to many joints with progressive degenerative processes in them, while the pathological process involves ligaments, muscles and tissues surrounding the joint.
  9. Spondyloarthritis - the tissues of the spine, namely the lumbar region, are subject to destructive destruction. Women are at risk during menopause as spondyloarthritis progresses against a background of female sex hormone deficiency.

Causes of osteoarthritis

Two causes contribute to the formation of osteoarthritis - stress and lack of adequate nutrition, which supplies vitamins and minerals to repair tissues. Everyone's joints carry a load. In athletes and dancers during physical activity, the load on the legs is greater, which means that the bone joints wear out faster and require high quality nutrition. In a quiet lifestyle, the support device wears out more slowly, but also requires periodic tissue renewal.

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

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

  • Muscle weakness and abnormal joint strain. Weakening of one or more muscles increases the load on the joint and distributes it unevenly in the bone node. Also, improper muscle load is formed with a flat foot, scoliosis, therefore, in these "harmless" diseases with age, cartilage tissue wears out, osteoarthritis appears.

    The likelihood of osteoarthritis increases with strenuous exercise.

    If the daily loads exceed the capacity of the bone tissues, microtrauma is formed in them. Thickenings appear at the site of injury, which over time increase and deform the joint;

  • Metabolic disorders (gastrointestinal diseases - bile stasis, dysbiosis, gastritis, cholecystitis, pancreatitis, metabolic disease - diabetes);
  • Psychosomatic causes - the psychosomatics of osteoarthritis confirm that a negative emotional state also causes the disease. Stress forms muscle spasm, constant stress disrupts the nutrition of all tissues (internal organs, bones, joints);
  • Heredity (the type of metabolism and its possible disorders are inherited, tendency to muscle weakness or improper formation of the skeletal system, to indigestion - 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 withstand stress and destruction. Therefore, with age, the predisposition to the disease increases. After 70 years, osteoarthritis is diagnosed in every second retiree. As the maximum load falls on the legs (a person moves - walks, stands, runs, jumps), this is where the first signs of osteoarthritis form.

Mechanism of disease progression

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

In the initial stage, depletion of the structure of cartilage tissue and abnormal changes in synovial fluid are observed. All this is 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 collagen fibers and the flexibility of cartilage are lost due to the fact that in the body with a lack of nutrients hyaluronic acid does not have time to produce, which provides softness and flexibility of the structural composition of collagen fibers. The cartilage gradually dries, becomes brittle and cracks. The fluid in the synovial capsule is gradually depleted and then disappears completely.

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

Symptoms of osteoarthritis

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

  • pain;
  • periodic crunching of the affected joint;
  • joint deformity that occurs and worsens as the disease progresses;
  • stiffness;
  • restriction of mobility (reduction of the volume of active and passive movements in the affected joint)

The pain of osteoarthritis is of a dull transient nature, appearing when moving, against a background of severe stress, until the end of the day (it can be so severe that it does not allow the patient to fall asleep). The persistent non-mechanical nature of the pain in osteoarthritis is uncharacteristic and indicates the presence of active inflammation (subchondral bone, synovial membrane, ligamentous apparatus or periarticular muscles).

Most patients report the presence of so-called initial pains, which appear in the morning after waking up or after a long period of inactivity and pass during physical activity. Many patients define this condition as the need to "develop a joint" or "dissociate. "

Osteoarthritis is characterized by morning stiffness that has a clear localization and is short-lived (no more than 30 minutes), sometimes perceived by patients as a "feeling of jelly" in the joints. Feeling of wedges, stiffness is possible.

Joint pain with osteoarthritis

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

  • soreness and local fever, determined by palpation of the affected joint;
  • constant pain;
  • joint enlargement, soft tissue swelling;
  • progressive reduction of range of motion.

Stages and degrees of arthrosis

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

  1. 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 the bone tissue and structural changes in the synovial fluid are noted. The cartilage of the joint is covered with cracks, the patient has a slight soreness at the site of pathology.
  2. Second degree - the development of osteoarthritis with increased dynamics. This stage is characterized by the appearance of stable, lame pain. There are noticeable morphological and dystrophic changes in the cartilage, during the diagnosis the growth of bone tissue is revealed. Osteophytes are formed - bone growths that are visible during visual examination of the lesion. At the same time, the processes of degenerative changes in the synovial capsule take place, which leads to its structural depletion. The disease in this phase can often worsen and be regular. The pain gradually becomes permanent.
  3. Third degree - active progression. At this stage, the synovial fluid is almost completely absent due to its degeneration, and the bone tissue rubs into each other. Joint mobility is almost completely absent, the pain becomes more noticeable. Cartilage is also missing 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, there is a final stage - the irreversible destruction of all joint tissues. In this phase, it is impossible not only to conduct effective therapy, but even to relieve pain.

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

To rule out severe consequences, treatment should be started at the first stage and intensive care methods should be used at the same time. At the last stage, associated with the complete destruction of cartilage tissue, only one technique is allowed to relieve the patient from pain and immobility of the joint - arthroplasty with complete or partial replacement of the components of the joint.

Consequences

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

  • disability;
  • deformation after recovery;
  • occurrence of spinal hernias;
  • stiffness or stiffness of the joints;
  • decline 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 physical work and sports.

Diagnostics

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

The main instrumental method for diagnosing osteoarthritis is radiography, in diagnostically unclear cases computer or magnetic resonance imaging is recommended.

Osteoarthritis of the knee and hip joints occupies a leading position in terms of the severity of clinical manifestations and the negative impact on quality of life.

Additional diagnostic methods:

  • atraumatic arthroscopy;
  • ultrasonography (assessment of articular cartilage thickness, synovium, condition of joint capsules, fluid presence);
  • scintigraphy (assessment of the condition 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 at an early stage, the treatment itself should be pathogenetic and complex. Its essence is to eliminate 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 so-called intra-articular oxygen therapy.
  2. Drug therapy.
  3. Intra-basal blockages as well as decompression of the metaepiphysis.
  4. Sustainable diet.
  5. Damaged joints should be relieved of excessive stress. If possible, it should be kept to a minimum during treatment.
  6. Follow the established orthopedic regimen.
  7. Physiotherapy exercises.
  8. Undertake a course of physiotherapy that includes magnet and electrotherapy, shock wave and laser therapy.
  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 resorts.

Preparations for the treatment of osteoarthritis

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

Therapy includes the following drugs:

  1. Anti-inflammatory drugs. By starting a complex therapy for osteoarthritis, you can slow down the course of the disease and significantly improve the quality of life. It is worthwhile to dwell in more detail on some points of treatment. In particular, drug therapy involves the initial stage - this is the elimination of pain, as well as the elimination of inflammatory processes occurring in the joints. For this, all doctors use nonsteroidal anti-inflammatory drugs. Experienced doctors do not recommend their oral administration, as these drugs irritate the stomach wall to a great extent. Therefore, depending on the drug selected, either intravenous or intramuscular administration is used. NSAIDs are sometimes used in the form of ointments, but their absorption is extremely low, so that no significant effect can be achieved.
  2. Hormonal corticosteroids. When osteoarthritis is in the acute stage, it is recommended to take hormonal corticosteroids. They are injected into the joint. Externally, you can use a special plaster, ointment or tincture, which is made on the basis of hot pepper.
  3. Chondroprotectors aimed at restoring cartilage and improving the quality of synovial fluid will not be superfluous. The course lasts quite a long time, until there is improvement. However, if the expected effect does not appear within six months after administration, the drugs should be discontinued. Also intra-articularly, together with chondroprotectors, it is recommended to use drugs made on the basis of 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 physiotherapy:

  • In the exacerbation phase. Prescribe laser therapy, magnetic therapy and ultraviolet radiation,
  • In remission. Electrophoresis and phonophoresis are shown.

In addition, thermal treatments, sulfide, radon and sea baths are used. Electrical stimulation is performed to strengthen the muscles. Gentle massage can also be used during remission.

Surgery

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

  1. Decompression of the metaepiphysis and prolonged intraosseous blockade (reduction of intra-base pressure in the affected area);
  2. Corrective osteotomy;
  3. Joint arthroplasty.

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

Folk remedies

Most people today 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 increasing immunity.

For the treatment of this disease are used recipes of traditional medicine:

  1. The egg solution is prepared from fresh egg yolk, which is mixed with turpentine and apple cider vinegar in a ratio of 1: 1: 1. The liquid should be mixed thoroughly and rubbed on the affected joint overnight. 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 elecampane root from the pharmacy. As a rule, it is packed 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, placed in a dark bottle and infused for 12 days. Rubbing is done before bed and if possible in the morning.
  3. Osteoarthritis of the knee
  4. The use of cooked oatmeal also gives good results. Take three to four tablespoons of oatmeal, pour boiling water and cook on low heat for five to seven minutes. The amount of water used should provide a thick slurry that should be cooled and used as a compress overnight. Use only freshly cooked flakes. Yesterday's porridge is not good for compresses.
  5. Birch leaves, nettle leaves and calendula inflorescences are taken in equal parts. As a result, you should get two tablespoons. 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 take half a cup of broth four to five times a day. The course of taking this recipe is from two to three months.

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

Nutrition for osteoarthritis

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

  1. Avoid heavy meals at night to avoid an attack of osteoarthritis.
  2. Eat partially.
  3. Constantly monitor your weight to avoid weight gain,Vitamins for osteoarthritisand therefore additional stress on inflamed joints.
  4. When there is no worsening of the disease, take a walk after a meal.
  5. The menu should be balanced, compiled with the attending physician.

There are absolutely no complaints about fish dishes - you can eat a lot of them, of course, in reasonable quantities.

  1. Don't forget about regular intake of vitamins from food. For patients with osteoarthritis, B vitamins are especially important
  2. Desired meat plays an important role in the treatment of osteoarthritis. Such food will be a real storehouse of trace elements for inflamed joints. The most important component in aspic is natural collagen
  3. Vitamin B helps in the production of hemoglobin. It can be "obtained" by eating bananas, nuts, cabbage and potatoes. It is worth getting carried away with herbs and legumes. They will be a 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 subsides and the damaged tissue begins to regenerate.

Prevention

Prevention of osteoarthritis begins 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, cabbage and fish.

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

Forecast

The prognosis for life is favorable. The favorable social and labor prognosis depends on the timeliness of diagnosis and initiation of treatment; it decreases when the decision on the surgical treatment of the disease is delayed, if necessary.