Osteoarthritis: causes and symptoms to diagnosis and treatment

The disease has many names: arthritis, osteoarthritis is osteoarthritis (see definitions M15, M19, M47 and in ICD-10 "International statistical classification of diseases and related health problems", version who for 2016). Anyway, the essence of the disease remains the same: gradually breaks down the articular cartilage interferes with the normal operation of the joint, there are pathological bony growths — osteophytes. From this disease suffer an average of 10% of the population, but with age, its frequency increases: after 60 years, certain symptoms of osteoarthritis have 97% of patients.

what is arthrosis

Osteoarthritis can affect any joint, but mainly the hip and knee. In addition, men often suffer from ankle, wrist and temporomandibular joint, the lumbar spine. In women the cervical and thoracic spine, joints of the fingers and the joint at the base of the big toe.

Osteoarthritis can be primary or secondary. The primary appears at unmodified joints, second — on the background of existing pathology.

Risk factors for development of osteoarthritis:

  • gender: women suffer ten times more often;
  • age;
  • excess body weight;
  • inadequate stress on the joints — professional sports, the work requires being on my knees or squatting, frequent walking up the stairs;
  • surgery on the joints, such as removal of the meniscus;
  • the trauma of the joint;
  • acute or chronic inflammation of the joint;
  • heredity.

Combining these factors, we can say that the development of osteoarthrosis promotes the constant overuse or micro-traumas of the joints.

The mechanism of development of arthrosis and symptoms

The main cause of osteoarthritis is the imbalance between the destruction and restoration of the articular cartilage. The body always parallel to the processes of anabolism, that is, the creation of new complex structures, and catabolism — the destruction of obsolete or damaged tissues. In normal condition, these processes are roughly the same speed. In osteoarthritis cartilage damage increases, and its recovery, on the contrary, slows down. Roughly speaking, articular cartilage begins to rapidly and actively to grow old. Reduced the number of special cells that produce the material for cartilage — the chondrocyte. Change their properties: the cells begin to produce the "wrong" proteins. Articular cartilage gradually becomes thinner, it becomes fragile, divided into fibers, covered with cracks, over time, disappear completely.

These changes may not be reflected on the articular parts of bones, because the main function of articular cartilage to protect the bone from load. The affected cartilage to lose its cushioning properties, and the entire load is transferred to the head bone, and it is transferred unevenly, as well as uneven changes in the cartilage. In areas with an increased pressure, impaired blood flow, changing the density of the bone tissue, its structure, the marginal areas appear bony growths — osteophytes that limit the mobility of the joint. Because it is limited not only because of osteophytes, but simply because it actively hurts to move, over time, around the affected joint atrophy of muscle, which exacerbates the problem, because the normal active muscles maintain the stability of the joint, and atrophy when their load is increasing.

The main symptoms of osteoarthritis — joint pain that increases with movement and load and disappears at rest. Often attached to pain morning stiffness is the feeling of "gel" in the joint, reduced range of motion. This indicates insufficient blood circulation in the area of the joint. These symptoms may be added the crunching (crepitus) joint instability. Usually pain occurs in the affected area, but in case of arthrosis of the hip joint they can be felt in the groin, the buttocks and even the knee.

Stage of development of arthrosis

On the basis of radiological signs, there are four stages of osteoarthritis:

  • Rebuilding the bone structure, areas of osteosclerosis in subchondral region.
  • Added narrowing of the joint space, osteophytes appear.
  • Osteosclerosis in subchondral region of the bone (under the cartilage) becomes pronounced, the joint space is significantly reduced, large osteophytes;
  • The epiphyses (heads) of bones deformed, compacted, articular gap virtually disappears, rough prominent osteophytes.

It should be noted that radiological changes did not correlate with the severity of symptoms. Quite often severe pain and limited mobility are accompanied by slight changes in x-ray, and on the contrary, gross lesions of the joints may not manifest itself clinically.

osteoarthritis symptoms

Diagnosis and treatment

Treatment of osteoarthritis — a life, because of chronic nature of the disease. But the earlier the diagnosis and accordingly treatment is started, the slower will progress changes in cartilage. Therefore, for any pain in the joint as soon as possible to go to the doctor, who, on the basis of typical complaints, prescribe further examination and treatment.

Radiography of the affected joint will give a General idea of how far the process has gone. But accurate, reliable data can be obtained only with the help of modern methods of research: ultrasound, computed tomography, magnetic resonance imaging of the joint.

Treatments for osteoarthritis can be divided into non-pharmacological, pharmacological and surgical. Surgical treatment of osteoarthritis becomes necessary at the final stage of the disease when joint replacement is required — in other words, the replacement of the joint with synthetic. But before that process can be slowed down with medication and physical therapy.

Non-pharmacological methods of treatment:

  • Training of the patient. The majority of patients do not understand what is happening to them that they can, and what not. Therefore, training is necessary. It should be clearly understood that any affected joints is necessary to continue to perform the exercises and stretching, lessening the load and intensity. Can't walk — move around the apartment on all fours, but don't stop and lay in your bed. It is also worth learn special exercises that help reduce pain, maintain joint mobility and normal muscles.
  • The decrease in body mass. The decrease in body weight not only reduces pain, but improves biochemical indicators of changes in cartilage.
  • LFK. Physical exercise, especially to improve muscle strength, reduce joint pain and maintain their function.
  • Acupuncture helps to relieve pain and improve blood circulation in the area of the joint.
  • Knee braces, orthotics, knee braces and other devices, stabilizing the joint and reducing the load. They create an analgesic effect and improve joint function.
  • Physiotherapy. Include simple methods like hot-water bottles or bladder with ice and high-tech methods.
  • Shock-wave therapy. The joint area serves sound waves at a frequency of from 16 to 25 Hz (infrasound). This improves the blood circulation and metabolic processes in the affected joint. This therapy is effective in the early stages of the development of arthrosis and practically useless in severe cases.
  • Hivamat therapy. This is a vibrating massage that is created by the influence of an alternating electric field. Improves blood circulation and exchange in cartilage, relieves pain, reduces swelling and inflammation.
  • Cryotherapy, or exposure to very low temperatures. Reduces swelling and inflammation, reduces muscle spasm and pain, improves metabolism and regeneration.
  • Massage. With osteoarthritis massage is of secondary importance: reduces muscle spasm and slows the muscle atrophy, but does not affect the progress of degenerative processes in the joint.

Pharmacological therapies

Drugs in the treatment of osteoarthritis is most often used non-steroidal anti-inflammatory drugs (NSAIDs) that reduce inflammation and reduce pain, but cannot slow down the process of destruction of cartilage. To improve his nutrition and to stop the degeneration, it is recommended the so called joint Supplement— substances included in the composition of cartilage. About their effectiveness doctors vigorously debated the last ten years. At the moment, they are not recommended in many countries

Actively reduce inflammation synthetic hormones — glucocorticoids.

osteoarthritis treatment

Any medicinal drugs can be used in several ways. First of all, this is a traditional pills (oral). This method is simple and quite effective, but those drugs could affect the state of the body, primarily the gastrointestinal tract.

  • Ointment and creams. Despite the hype, this method of application is ineffective or inefficient: the active substance is simply "not get it" to the joint. Skin is the natural protective barrier of the body, through which penetrates not many substances, especially it is difficult to expect that drugs will be the subcutaneous tissue, penetrate inside the joint capsule and get into the cartilage.
  • Intra-articular administration. In this case, the active ingredient goes directly to the site of pathological changes. This is a complex manipulation that requires the participation of a qualified doctor, but at the same time — one of the most effective methods of delivery of therapeutic agents. To contemporary trends in the treatment of osteoarthritis refers to PRP therapy, or plasma therapy. In this case, the joint is injected own blood plasma of the patient, platelet-rich. This blood cells, which are responsible not only for timely stop the bleeding, but trigger active tissue repair. They stimulate the production of many biologically active substances, responsible for regeneration. Ionized plasma reduces inflammation, reduces pain and does not cause allergies, because it is a patient's own tissue.

Thus, the treatment of osteoarthritis — the process of life. But being chosen a competent physician, it helps to relieve pain, reduce inflammation, support the metabolic processes in the cartilage, and thus, long delay the need for hip replacement.