Osteoarthritis: types and stages of the disease, its symptoms, diagnosis and treatment. What is osteoarthritis of the joints - causes, symptoms and treatment Symptoms of osteoarthritis of the joints

Various joint diseases are widespread among the population around the globe. There are a lot of varieties of such diseases. One of them is osteoarthritis. This is a degenerative-dystrophic disease of various origins. Its development is based on the destruction of all articular structures, proceeding quite progressively and leading to a violation of the functionality of the joints. Osteoarthritis of the joints is accompanied by severe pain syndrome. The disease often leads to partial or complete disability of patients. According to statistics, it is the second most common cause of disability in the population. Only various cardiovascular pathologies are ahead of osteoarthritis in this list.

Osteoarthritis: general information about the disease

According to statistics, osteoarthritis deformans is diagnosed in about every fifth person. In Russia, as a rule, this disease develops in people after 40 years. At the same time, osteoarthritis in its frequency is about 70% of all systemic articular lesions. By means of X-ray examination, the disease is determined in about 50% of people around the age of 55 years, and in 80% of patients after 75 years. In Russia, the number of cases is growing every year. At the same time, osteoarthritis of the knee joint ranks fourth among the main causes of disability in women, as well as eighth in terms of disability in men.

Most often, the degenerative-dystrophic process affects large, in particular the hip and knee. But in addition, the small joints of the foot and hands are also susceptible to osteoarthritis.

Women are more prone to developing osteoarthritis than men. According to statistics, approximately 30% of women aged 65-75 years have pronounced signs of osteoarthritis of the knee joints. In addition, the fairer sex is more susceptible to the development of degenerative-dystrophic changes in the joints of the base of the thumb and interphalangeal joints. Osteoarthritis of the hands occurs in approximately 50% of women with degenerative joint disease.

Women become more susceptible to the development of osteoarthritis due to the characteristics of their body. The so-called estrogen receptors, contained in cartilage cells, respond to a decrease in the level of female sex hormone and significantly increase the risk of developing the disease. It is estrogen that is responsible for the integrity of the cartilage tissue. If the level of the female sex hormone is insufficient, the cartilage tissue undergoes degenerative-dystrophic processes. Most often this occurs during menopause, then hormone replacement therapy can be prescribed to women at risk of developing osteoarthritis. Experts note that in women taking drugs with hormones during menopause, the risk of developing osteoarthritis of the hip and knee joints decreases significantly.

A study was also conducted in which 508 male and female respondents took part. According to its results, it was possible to find out that representatives of the weaker sex with osteoarthritis of the knee joint experience more pronounced pain when moving, while at rest the severity of pain in both sexes is the same. This is explained by the fact that the muscles in men, as a rule, are stronger than those of women.

Osteoarthritis in men

Cartilage thickness and volume are greater in men than in women. That is why the representatives of the stronger sex are less susceptible to the development of osteoarthritis. But there are a number of factors that increase the risk of joint damage in men. For example, men, unlike women, are more likely to be exposed to excessive physical exertion, they smoke and abuse alcohol more often, and are also more likely to be overweight. To a greater extent, men suffer from osteoarthritis, which affects the joints of the lower body (feet and toes, knees and thighs).

The main reasons for the development of the disease are excessive mechanical and functional overload of the cartilage, as well as a decrease in its resistance to normal physiological stress. In other words, osteoarthritis can develop against the background of loads that the joint simply cannot withstand, or against the background of deterioration of the articular cartilage, in which even ordinary loads can lead to the development of degenerative-dystrophic processes.

All factors that increase the risk of developing the disease can be divided into several categories:

1. Constant overload of joints and chronic microtraumatization of cartilage tissue. People are susceptible to the action of such factors:

• actively involved in sports;
• whose work is associated with constant overload of individual joints and muscle groups;
• suffering from neuropathies, observed, for example, in diabetes mellitus, and accompanied by a decrease in muscle tone, which in turn increases the load on the joints;
• obese, in which excess body weight also significantly increases the load on the joints and leads to their premature wear (the hip and knee joints suffer most from obesity).

2. Disorders of the musculoskeletal system, which are congenital or acquired. These include:

• dysplasia, which is an insufficient development of the surfaces of the joints, accompanied by impaired microcirculation, lack of proper support, subluxation and dystrophic processes that develop in the cartilage tissue;
• traumatic injuries and damage to joints due to surgical interventions;
• arthritis, which are inflammatory lesions of the joints;
• metabolic disorders, arising, for example, with gout, hemochromatosis, ochronosis, etc.

3. Genetic predisposition and natural aging processes. These include:

• age-related changes in cartilage tissue and an increased risk of osteoarthritis during menopause;
• hereditary predisposition and certain genetic factors, for example, ethnicity, hereditary pathologies of bone tissue and joints, etc.

As the body naturally ages, the joints lose moisture, which reduces the elasticity of the cartilage tissue. In addition, the work of cartilage cells called chondrocytes slows down. All this leads to a rapid loss of joint functionality.

With regard to heavy loads on the joints, it is worth noting that people of certain professions are more susceptible to the development of the disease. For example, osteoarthritis of the hands, or rather the hands, most often develops in women who work as seamstresses. Men who work with a jackhammer are more prone to osteoarthritis of the shoulder joint.

Another risk factor for the development of the disease is a sedentary lifestyle. Today this is the scourge of our society, because most people are subject to physical inactivity. With insufficient movement, the nutrition of the joints is disturbed, which leads to the development of degenerative processes in it.

Osteoarthritis: symptoms of the disease

As mentioned above, osteoarthritis most often affects the joints that are most exposed to excessive stress (hip and knee), the small joints of the hands and the spine. The defeat of the knee and osteoarthritis of the hip joint are the main reasons for a significant decrease in the quality of life of patients and their disability.

There are only three main symptoms of osteoarthritis. These include painful manifestations, an increase in joint volume, and crepitus. The latter is a characteristic crunch in the joints during their movement. Pain in deforming osteoarthritis of the joints is localized in the area of ​​the affected joint. But at the same time, its occurrence is not associated with damage to the cartilaginous tissue, since there are no nerve endings in it. Painful sensations arise from damage to bone tissue, damage to the joints themselves (stretching of the capsule and inflammation in the synovial membrane) and periarticular tissues (bursitis, damage to ligaments and muscle spasms). In addition, pain can occur against the background of psycho-emotional factors, etc.

Pain in osteoarthritis is most often of a mechanical nature, increasing with physical exertion and weakening at rest. If the pain intensifies or manifests itself at night, this may indicate the development of an inflammatory process in the joint. Swelling of the joint affected by osteoarthritis, and the stiffness of its movement in the morning may also indicate the presence of an inflammatory component. The intensity of pain can change under the influence of weather conditions and atmospheric pressure.

Depending on the clinical and morphological manifestations, specialists distinguish three degrees of development of osteoarthritis. Each of the three degrees is characterized by certain macro- and microscopic indicators. Otherwise, the degree of development of the disease is called their stages, which are determined taking into account the changes occurring in the affected joint.

Osteoarthritis 1 degree

The first stage of the disease is the initial one. With osteoarthritis of the 1st degree, there are slight restrictions on the mobility of the affected joint. Painful manifestations occur with stress on the joint. With the help of X-ray, in this case, it is possible to determine the narrowing of the joint space and the presence of osteophytes, which are the growth of bone tissue. In case of osteoarthritis of the 1st degree, it is possible to visually determine the roughness and dissociation of tissues along the edges of the cartilage. In this case, the structure of the tissues of the articular cartilage is preserved, but the content of glycosaminoglycans in its surface and intermediate zones is reduced.

Patients who develop grade 1 osteoarthritis experience pain with excessive exertion. The disease at this stage of development does not affect the quality of life.

At the second stage of development, the disease manifests itself as a significant limitation of the mobility of the affected joint and severe crepitus. Also, with osteoarthritis of the 2nd degree, there is a slight atrophy of the regional muscles. Painful manifestations at this stage of the development of the disease become permanent. By means of X-ray examination, it is possible to determine a more pronounced narrowing of the lumen of the joint space and the formation of osteophytes. With osteoarthritis of the 2nd degree, usurs and tubercles are formed on the surface of the articular cartilage. At the same time, the usurs are shallow, and chondrocytes accumulate along their edge. The level of glycosaminoglycans in cartilage tissue decreases. Osteoarthritis of the 2nd degree is accompanied by damage to the subchondral part of the bone.

Osteoarthritis grade 3

The third stage of the development of the disease is characterized by significant deformation of the affected joint and is accompanied by a sharp limitation of its mobility. With grade 3 osteoarthritis, the cartilage tissue almost completely disappears. In addition to constant pain, patients with grade 3 osteoarthritis experience functional insufficiency of the affected joints. This is due to subchondral sclerosis, which develops at this stage of the disease.

Due to the complete loss of cartilage tissue, dents are formed on the bones in contact with each other, which subsequently leads to deformation of the joints. The volume of synovial fluid in osteoarthritis grade 3 is rapidly decreasing. X-ray reveals a thickening of the folds, localized in the articular capsule, and lengthening of the papillae. With this diagnosis, the surface of the cartilage and partially its intermediate zone die off. Deep usurs are also formed, which can literally pierce the intermediate zone. In addition, the damage to the subchondral bone becomes more pronounced.

In addition to the classification according to the clinical and morphological signs of the disease, there is also a division of osteoarthritis according to which joints are subjected to degenerative-dystrophic processes. Since most often the disease affects joints that are exposed to excessive stress, the most common lesions are:

• The supporting joints, which bear the bulk of the load during movement. First of all, these are the knee and hip joints, as well as the joints of the hands.
• The big toe joint, the deformation of which leads to the formation of the so-called "bump".
• Spinal joints, often developing along with osteochondrosis. This type of osteoarthritis is called spondyloarthrosis.

But no less common are lesions of the joints of the hands, as well as the development of degenerative-dystrophic processes in the ankle and shoulder joints.

Osteoarthritis of the hands

Osteoarthritis of the hands is a disease that has practically no manifestations in the initial stages. The pain may be mild and usually ignored by patients at first. Over time, small nodular thickenings of bone tissue may form in the area of ​​the joints:

• Bouchard's nodules are formed on the proximal interphalangeal joints and are located on the palm of the hand, on the back of it. On palpation of such formations, painful sensations are most often not observed. But in some cases, patients may experience minor pain. If left untreated, bone formations called Bouchard's nodules can restrict joints in motion.
• Heberden's nodules usually occur at the interphalangeal distal joint. Such seals form most often on the middle and index fingers. However, they can sometimes occur on the ring finger or little finger. Heberden's nodules can be uncomfortable, but most often they are not the cause of joint pain.

Osteoarthritis of the hands most often develops against the background of natural age-related changes. Thinning of the cartilage tissue and the loss of its elasticity makes the joint unstable to stress. Also, the occurrence of disorders in the joints of the hands can be due to hormonal changes, features of professional activity and disorders of metabolic processes in the body.

As osteoarthritis of the hands develops, patients develop pain in the area of ​​the affected joints. The defeat of the fingers occurs symmetrically. Progressive disease deforms the joints and limits their movement.

Frequent excessive stress on the hands, injuries, metabolic disorders and many other factors can lead to the development of a disease such as osteoarthritis of the shoulder joint. People of certain professions are more susceptible to damage to the shoulder joint, for example, construction workers, workers at a factory, etc. Also, athletes who have the main load during classes on their hands are at risk of developing osteoarthritis of the shoulder joint.

Osteoarthritis of the shoulder joint, not diagnosed in time and left without treatment, can lead to a significant decrease in the quality of life of patients and partial disability.

The first sign of the development of this disease may be pain that manifests itself after prolonged exertion on the hands and recedes after rest. Over time, the disease manifests itself as a feeling of stiffness in the area of ​​the affected joint and a decrease in the amplitude of its movement. Crepitation also begins to appear.

Knee osteoarthritis

A disease such as osteoarthritis of the knee joint destroys not only the joint itself, but also the surrounding bone tissue. In the course of the development of the disease, hyaline cartilage loses its elasticity and strength, and its functionality is also limited. After the complete destruction of the cartilage tissue, the knee joint loses its mobility, and the knee begins to deform.

The first sign of developing osteoarthritis of the knee joint is knee pain. In the early stages of the disease, patients may experience mild discomfort when flexing and extending the knee. Stiffness of movement may also be present after a person has been in one position for a long time or after rest. This stiffness is most evident in the morning hours after sleep. In addition to stiffness of movements in such cases, crepitus may be observed, expressed by a characteristic crunch in the knee.

The progression of the disease turns into severe persistent pain for patients, which intensifies even with minor physical exertion. Among the factors that increase the risk of developing osteoarthritis of the knee joints, it is worth noting:

• excess weight;
• smoking and abuse of alcohol and other harmful substances;
• leg injuries leading to the development of post-traumatic arthrosis;
• congenital pathologies;
• disturbances in the work of the endocrine system;
• hormonal disruptions;
• vascular pathology.

The destruction of the cartilage tissue in the hip joint occurs for various reasons. Most often, the disease develops against the background of age-related changes, when the cartilage tissue in the joints actively loses moisture and is destroyed. Without cartilage, the bones connected by the joint begin to rub against each other as they move. Dents and osteophytes form on the bones, which cause severe pain during movement and ultimately lead to deformation of the joints and bones. Osteoarthritis of the hip joint is one of the most common causes of disability in patients with this diagnosis.

The main risk group for the development of this disease are people over the age of 45. Moreover, women suffer from osteoarthritis much more often than men. In addition to age, the risk of developing the disease in female representatives is increased by hormonal changes that occur during menopause. Excessive stress on the joint, provoked or by the peculiarities of professional activity, also increases the risk of developing the disease. Risk factors include congenital hip dislocation and hip dysplasia, Peters disease, and arthritis.

Ankle osteoarthritis

A disease such as osteoarthritis of the ankle joint is a degenerative-dystrophic process that affects all structures and tissues of a given joint. Risk factors for the development of the disease are:

• excessive physical exertion on the legs;
• excess weight;
• active sports;
• uneven distribution of loads on the legs when moving;
• getting injured;
• constant wearing of uncomfortable shoes;
• standing work;
• chronic and inflammatory diseases;
• genetic predisposition, etc.

The main symptoms of osteoarthritis are pain in the affected joint (in this case, the ankle), which increase with stress on the lower extremities, crepitus (characteristic crunch when the joints move), muscle atrophy, swelling in the ankle joints, stiffness of movements, especially manifested in the morning hours, when the legs are immobilized for a long time.

Joint pain that manifests itself during movement, at rest or during excessive physical exertion is a reason to immediately consult a doctor. After all, painful sensations in the joints, manifested constantly for a long time, may indicate various diseases, including deforming osteoarthritis. A rheumatologist or orthopedist can help in the initial diagnosis and prescribe subsequent treatment of osteoarthritis of the joints. To determine the disease, laboratory and instrumental studies are prescribed. The latter are more informative and make it possible to determine not only the presence of degenerative-dystrophic processes, but also to assess the degree of their development.

Initial examination of the patient allows to determine joint pain and crepitus, both with active and passive movements. Deformation of the affected joint and a reduction in the amplitude of its movements can also be visually observed. In the later stages of the development of deforming osteoarthritis, patients may have subluxation of the joints. With inflammation of the synovial membrane, the affected joint may visually increase in size. There may also be a local increase in temperature and pain on palpation.

When visiting a doctor with a complaint of joint pain, the specialist needs to tell in detail what kind of painful manifestations are observed, how long the pain lasts, how they manifest, etc. It is also important to tell whether any injuries preceded the onset of pain, whether there were any surgical interventions on the painful joint. After the initial examination, the doctor may prescribe a number of studies to the patient aimed at assessing the condition of the joint, examining its structures and tissues.

Laboratory research

Among the laboratory tests that can be prescribed to a patient when making a preliminary diagnosis of osteoarthritis deformans of the joints, it is worth noting a general analysis of blood and urine. However, such studies are not always informative. With the help of such analyzes, it is possible only to determine a slight increase in ESR and CRP, if an inflammatory process has developed in the synovial membrane of the joint.

Today, the main task of scientists is to find biological markers that would help determine the state of bone and articular tissue through laboratory tests. The discovery of such markers would make it possible to better study the mechanisms of development of osteoarthritis and would provide an opportunity to assess the effectiveness of certain drugs in the treatment of this disease. But until such markers are found, diagnostic tests are carried out on the basis of blood, urine and synovial fluid tests.

The synovial fluid in osteoarthritis differs from the biological fluid taken in the diagnosis of arthritis. It has good viscosity and a relatively small number of cells (up to 5 thousand per 1 mm3).

The most informative in the diagnosis of osteoarthritis are instrumental studies. So, after the initial examination, the collection of anamnesis and laboratory tests, the doctor may prescribe:

• X-ray

X-ray examination of the joint. This method of research in the diagnosis of deforming osteoarthritis of the joints is the most effective. X-ray images allow you to determine the narrowing of the lumen of the joint space, as well as the presence of osteophytes. By means of X-ray examination, it is possible not only to confirm or exclude the presence of the disease, but also to assess the stage of its development.

Ultrasound examination of the joints is another rather informative diagnostic method for determining such a disease as deforming osteoarthritis of the joints. It differs in mobility, accessibility and speed of execution. With the help of ultrasound, it is possible to determine the condition of the cartilage tissue, as well as to assess the volume of synovial fluid in the articular cavity. The most relevant ultrasound is to assess the condition of the shoulder and hip joints.

• Arthroscopy

Arthroscopy is a study that allows you to determine dystrophic changes in the menisci and ligamentous apparatus, to assess changes in cartilage tissue, to determine the state of the synovial membrane and, if necessary, to perform a tissue biopsy for subsequent histological studies. To perform arthroscopy in the affected joint, the doctor makes a small incision. Through it, a special instrument equipped with a mini-camera and a light bulb is introduced into the tissue. But when diagnosing osteoarthritis of the hip joint and joints of other localization, arthroscopy is prescribed only if absolutely necessary, since it is, at least a small, but still a surgical intervention.

Magnetic resonance imaging is an instrumental study, which is quite informative and allows you to determine even minor changes in the tissues and structures of the affected joint.

Also, a radioisotope study can be used to diagnose osteoarthritis. With its help, it is possible to determine the presence of an inflammatory process and the degree of its development. To carry out such a study, pyrophosphate labeled with the technetium isotope is used. This substance is absorbed by the inflamed and altered tissues, which are subsequently easily identified visually. By means of a radioisotope study, it is possible to determine the state of the synovial membrane of the joint.

Treatment of osteoarthritis of the joints

Having made a diagnosis, the doctor develops an individual treatment regimen for joint osteoarthritis for each patient. It should be noted that only complex treatment of the disease can be effective. Its main objectives are:

• bringing to the patient all the information about the disease, allowing him to understand the essence of the existing violations and ways to control them;
• teaching the patient the basic methods of protecting painful joints, which will prevent the rapid development of the disease;
• teaching the patient physical exercises that will help him maintain the functionality of the affected joints;
• prevention of subsequent destruction of the cartilage tissue of the joint.

Comprehensive treatment of osteoarthritis of the joints should include the use of non-drug methods and drug therapy. With a properly selected and effective treatment of osteoarthritis of the joints, it is possible to significantly slow down the process of destruction of cartilage tissue and eliminate the symptoms of the disease.

To understand how to treat osteoarthritis with non-drug methods, you first need to understand the main purposes of their application. Non-drug methods of treating osteoarthritis of the joints include special physiotherapy exercises, physiotherapy procedures and massage. Their appointment and implementation will help the patient to significantly reduce painful manifestations in the area of ​​the affected joint, strengthen the muscles surrounding it, and relieve muscle spasm. It should be noted that the listed methods are the most effective in the early stages of the development of the disease.

For obese patients, to effectively treat hip and knee lesions and ankle osteoarthritis, it is necessary to gradually reduce body weight. Since excessive physical activity in this disease is contraindicated, to combat excess weight, patients can be prescribed a special set of exercises that are safe for the joint and a diet. It is highly undesirable to struggle with excess weight on your own; it is best to consult your doctor about this issue.

Also, non-drug methods of treatment include the use of various devices, for example, special bandages and knee pads, which allow fixing the injured knee joint in the valgus position, etc.

Drug therapy for osteoarthritis

Medical treatment of ankle osteoarthritis and joint lesions of other localizations is primarily aimed at reducing painful manifestations and preventing further destruction of cartilage tissue. So, to eliminate pain in this disease, the following can be used:

• Rapid-acting drugs. For example, in the absence of synovitis and moderate pain in the area of ​​the affected joint, drugs with paracetamol as the active ingredient can be prescribed. If paracetamol is ineffective and the patient has signs of synovitis, the doctor may prescribe nonsteroidal anti-inflammatory drugs. If the listed drugs also do not give the desired result and the patient has severe pain, centrally acting opioid pain relievers can be used.
• Slow-acting medications such as chondroitin sulfate or glucosamine sulfate.

To replenish the volume of synovial fluid, drugs that are derivatives of hyaluronate can be prescribed. Such drugs are injected into the joint. To relieve the inflammatory process in osteoarthritis of the knee joint, the doctor may prescribe intra-articular administration of glucocorticosteroids. These injections have a number of side effects. negatively affecting the cardiovascular system, liver and stomach. In elderly patients, intra-articular administration of glucocorticosteroids can cause a sharp increase in glucose levels.

Surgical treatment of deforming osteoarthritis of the joints can be used in case of intense pain, with a real threat of the patient's disability and a significant decrease in his quality of life. If the joint is completely destroyed and it is impossible to restore its functionality, the only way out for the patient is endoprosthetics. Such an operation involves replacing the destroyed joint with an artificial one. Artificial joints are made from biocompatible metals and polymers. Such an operation is usually prescribed for grade 3 osteoarthritis, when the cartilage tissue is completely destroyed. After replacement, an artificial joint can last 5-25 years, depending on the quality of the material from which it is made and the characteristics of the patient's body.

Osteoarthritis is a group of non-inflammatory degenerative joint diseases due to degenerative changes in cartilage tissue. The danger of a violation is that it affects not only the cartilaginous tissue of the joint, but also the subchondral bone, the articular membrane, ligaments and muscles. That is, the entire joint is affected, which first leads to painful sensations, and later to its deformation and destruction, a decrease in mobility up to disability.

Today it is the most common joint disease, which affects about 7-10% of the total population. Moreover, with age, the risk of the onset and development of the disease increases significantly. So, according to statistics, only about 2-3% falls on the age category up to 45 years. While at the age of over 65, osteoarthritic disorders are manifested to one degree or another in half of the representatives of this age group.

The danger of osteoarthritis

The danger of osteoarthritis is that the disease progresses rather quickly without competent and comprehensive treatment. It results in deforming lesions of the joints, entailing a decrease in their mobility. As a result, the patient remains disabled, losing functional motor capabilities.

At the same time, changes in the cartilage tissue are still continuing, which leads to the spread of the disease to other joints. Gradually the disease spreads - usually along the limb. That is, osteoarthritis of the shoulder joint can be followed by damage to the elbow, wrist, and finger joints, which leads to complete atrophy of the limb. Disability sets in.

Osteoarthritis of the joints can also spread to the spine. Degenerative disorders of the tissue of the intervertebral discs lead to a general decrease in the mobility of the spinal column, the appearance of intervertebral hernias. In the absence of treatment aimed specifically at the root causes of the disease, and not at its manifestations, there is a high risk of complete or partial paralysis.

All this not only significantly complicates the life of the patient, who in many cases becomes unable to serve himself independently, but also negatively affects his psychological state. The patient may experience depression, develop an addiction to alcohol. If a person is still relatively young - not retired - then he will almost certainly lose his job.

Therefore, the earliest possible diagnosis of the disease and its correct treatment are so important, which will allow not only to stop the symptoms, but also to eliminate the root cause.

Causes of osteoarthritis

The causes of osteoarthritis can be various unfavorable factors affecting the joints in particular and the human body in general. Usually, a number of factors lead to the onset and development of the disease, which can be combined with each other.

Risk factors:

• Age. Irreversible age-related changes lead to disruption of the structure of cartilage tissue. It becomes less elastic, recovers more slowly, and its sensitivity to stress increases. Changes can manifest themselves to varying degrees - it depends on the individual characteristics of the organism. Therefore, the disease is not manifested in everyone, but in the presence of other factors, the risk of joint damage increases significantly with age;
• Congenital disorders. One of the most common is connective tissue dysplasia, which is expressed in the weakness of its structure, which causes hypermobility of the joints. In such patients, osteoarthritic diseases often manifest themselves at an early age and are accompanied by various postural disorders - scoliosis, stoop, flat feet, etc.;
• Birth trauma. The most common anomaly that occurs during the perinatal period or during childbirth is dislocation of the hip joint. If the violation is not corrected, or the intervention of a specialist is unqualified, then there is a high risk of developing a severe form of osteoarthritis of the joint with age;
• Genetic predisposition. In particular, this applies to the nodular form of osteoarthritis, which affects several joints at once and progresses and spreads rather quickly. The risk of the disease is especially high in girls whose mothers suffered from this disease;
• Endocrine Disorders. Any diseases associated with metabolic disorders in the body, sooner or later lead to the appearance of osteoarthritis. This happens due to a lack of vitamins and minerals necessary for the restoration and renewal of cartilage tissue. Therefore, when treating such diseases of the joints, the patient's nutrition must be corrected. Violations of the circulatory system are no less dangerous. In particular, varicose veins in the legs, which contribute to the onset and development of joint diseases;
• Injuries. Injuries that cause bruises, fractures, sprains and other serious joint disorders can cause (or one of the reasons) the development of the disease. Regular microtrauma can also lead to osteoarthritis, which cause scarring of the cartilaginous tissue and disruption of its structure. Similar microdamages are observed in many athletes, as well as representatives of professions whose activities are associated with regular heavy physical exertion - loaders, miners, typists, etc.;
• Diseases and Infections. Often, the initial cause of the development of the disease is the transferred infections. Because of them, the structure of the joints is disturbed, the surface of the cartilage becomes rough. Some diseases are no less dangerous, for example, Paget's disease;
• Increased body weight. Due to excess weight, an increased load affects the joints, which contributes to their accelerated wear and tear, abrasion of cartilage tissue. Often, overweight is accompanied by various metabolic disorders, which also leads to the development of osteoarthritis.

Regular exposure to even one of the above factors is a significant hazard. Therefore, if you are exposed to such influences, you need to regularly undergo examinations with a specialist and adjust your lifestyle in accordance with his advice and recommendations.

In a normal state, the joints are characterized by good mobility and friction inside them is minimal. Therefore, in the absence of changes in the structure of the cartilage tissue and ultra-high loads on the joints, they work in a "normal mode" for many years. At the same time, the cartilage tissue is regularly restored and renewed. The impact of at least one of the above factors upsets this balance, as a result of which the cartilage loses its elasticity. Friction increases between the moving elements of the joint, which leads to its premature wear.

The underlying causes of the onset of the disease are usually disorders that impede the normal blood supply to the joint area and metabolic disorders in the body. Since oxygen and most of the nutrients to the joint come precisely from the blood, spasmodic changes in muscle tissue and varicose-vascular diseases can lead to insufficient blood supply, and hence the lack of adequate nutrition in the articular region. Caused by this change in the structure of the articular tissue (both cartilaginous and bone), with a high degree of probability, lead to osteoarthritis.

Osteoarthritis symptoms

The main danger of diseases such as osteoarthritis is that in the early stages they are practically asymptomatic. A person does not experience pain and / or discomfort, the external state of the joint does not change, and its mobility remains at the same level for a long time. In this case, already on the roentgenogram, changes in the tissues of the joint will be clearly visible. Over time, the disease inevitably progresses and, if untreated, leads to impaired mobility of the joints and limbs.

The difficulty in diagnosing a disease is also in the fact that symptoms can manifest themselves in completely different ways, depending on the causes of its occurrence. In addition, pain sensations can be localized not in the area of ​​damaged joints, but in the area of ​​the cervical or lumbar spine, "given" to the limb, etc. Therefore, you should be as careful about your health as possible, especially if your age already indicates an increased risk of disease. After 45 years, visits to the doctor and examination (including X-ray) of the condition of the joints should be regular.

The main symptoms are:

• Pain. Painful sensations usually become the first sign of a violation of the state of the articular tissue. In the early stages of the development of the disease, they can be mild and usually occur after prolonged physical exertion. Over time, the pain intensifies, its attacks can occur even with minor loads on the joint, limb;
• Restricted mobility. Usually, as an early symptom of the disease, it manifests itself exclusively in the morning - within an hour after waking up. Physical warm-up, exercise helps to relieve the syndrome. But this only helps to alleviate the symptoms, does not affect the underlying causes of the disease. Over time - as the disorders develop - the mobility of the joint gradually decreases, which becomes noticeable not only in the morning hours. A decrease in the amplitude of flexion / extension of the joint leads to a gradual decrease in limb dysfunction, up to disability;
• Crunch. A dry crunch and crackle when flexing the joint is also one of the early symptoms of the disease. It occurs due to the coarsening of cartilage tissue, which produces a characteristic sound when rubbed and touched. Often, a dry crunch during movement does not cause pain and discomfort, which is why it remains unnoticed by the patient;
• Deformation. As the joint tissue degrades and there is no treatment, the joint begins to take on an unnatural shape. Deformations are becoming more and more noticeable due to bone growths caused by disturbances in tissue structure. In this case, the disease can be accompanied by inflammatory processes of both the joint itself and the periarticular region. There is swelling of the joints, possibly redness of the skin in the area;
• Numbness. The proliferation of bone tissue leads not only to deformation of the joint, but also to the compression of the nerve endings concentrated in it. The result is a violation of the sensitivity of the limb, its numbness. Since all nerve endings are connected to each other, pinching of the nerves in the area of ​​the joint can lead to the fact that numbness or pain will be observed in other parts of the body, in particular in the spine.

In addition to these classic symptoms, characteristic of almost any type of disease, other signs can be observed. In particular, if blood vessels are squeezed due to joint deformation, visual disturbances, dizziness and headaches, nausea and vomiting may occur.

It should be remembered that the symptoms of osteoarthritis manifest themselves in different ways, depending on which joint is affected by the disease. So, for example, in the case of a disease of the hip joint, there is a limitation of its mobility, impaired motility and functionality, while with a disease of the knee joint, osteoarthritis manifests itself in the loss of stability of the knee, stretching of the ligaments.

Thus, symptoms can manifest themselves in different ways, which is often misleading to the patient. In addition, signs of the disease may not always be observed, but periodically. Even the thrill of pain can recede. But this does not mean at all that the disease has really gone away - unfortunately, it is impossible to get rid of it without the correct (and most often complex) treatment.

Osteopathy in the treatment of the disease

The methods of osteopathy in combination with physiotherapy exercises and correction of the patient's nutrition make it possible to quite effectively treat osteoarthritis at almost any stage. Of course, the percentage of recovery largely depends on how early it was possible to detect the disease and begin to eliminate it. But even in the later stages, when articular deformities become apparent and the mobility of the limbs is significantly limited, the qualified help of an osteopath who knows how to properly treat disorders allows you to achieve good results, partially or completely eliminating pain, changes in the joint, restoring the amplitude of its movements.

In each case, the specialist makes a decision on how to treat osteoarthritis, based on the causes of its occurrence, the nature of the course of the disease and the presence of complications. Usually, in this case, both direct manual techniques of osteopathic influence are used, as well as other therapeutic and prophylactic procedures.

Nutrition correction is mandatory, which allows the body to provide all the necessary substances for the restoration of cartilage tissue. And although modern methods allow you to get most of the minerals and vitamins in the form of pharmacological preparations, osteopathy promotes a different approach. It is necessary to ensure that the patient's body receives the necessary substances and vitamins in a natural way - with normal and healthy food. At the same time, the use of harmful and "empty" food is minimized in order to reduce the possible influence of various harmful factors.

Temporary joint limitation is often used as temporary measures in the treatment of osteoarthritis. For this, various devices, corsets, bandages are used to fix the limb. Thus, painful manifestations that prevent the patient's body from becoming maximally susceptible to osteopathic effects are excluded.

At the first stage of treatment, the effect of an osteopath is aimed at relieving pain and symptoms of the disease. This is achieved by directed manual action on the affected area. At the same time, the specialist eliminates muscle spasms, which can cause infringement of nerve endings, impaired blood supply to the joint, and its deformation.

Having completely relieved the patient of pain and limiting the mobility of the joint, the specialist continues the treatment, acting on the root causes of the disease. Usually these are disturbances in the functioning of the blood supply and metabolic systems. The manual effects of an osteopath are aimed at eliminating disorders of the body caused by improper position of the bones of the skeleton, muscles, which can cause squeezing of various parts of the circulatory system, blood can stagnate in the muscles, not providing adequate oxygen supply to the joints and nutrients... Usually, after several sessions, during which the osteopath eliminates disturbances in the functioning of the blood supply system, a noticeable improvement is observed. Receiving a powerful impulse for recovery, the human body begins to adapt to new conditions. Since the treatment involves, among other things, correction of nutrition, the articular tissue begins to recover, receiving the substances necessary for this. Having normalized the blood supply system, the osteopath ensures their delivery to tissues that have already undergone changes and began to deteriorate. Cartilage, bones, ligaments, joint shells begin to recover. At the same time, the mobility of the joint also increases.

Exercise can help restore mobility and strengthen the joint in the later stages of treatment. Their complex is selected by a specialist, based on the complexity and nature of the disease, the area where the lesions are located, the general condition of the patient's body.

Depending on the degree of the disease, treatment can be quite long. Usually, sessions are alternated at intervals from several days to several weeks, which are necessary for the body to absorb the changes made by a specialist.

Prevention of osteoarthritis

Like the vast majority of other diseases, osteoarthritis is easier to prevent than cure. Practice shows that preventive measures aimed at strengthening the cartilage tissue and its restoration can significantly reduce the risk of the disease, and in case of its presence - to suspend or completely stop the course of the disease.

Preventive measures can be performed independently or under the supervision of a specialist - depending on his recommendations. They can be exclusively prophylactic in nature or be rehabilitative - after the treatment of the disease, and also be of an auxiliary nature - in the course of the treatment course. The osteopath will be able to monitor the condition of the joints and adjust both the preventive procedures themselves and the patient's lifestyle in general, preventing the onset of the disease and its relapse.

Osteopath Tips:

• Proper nutrition. This is one of the foundations of a healthy lifestyle that keeps joints healthy for as long as possible. Normalization of the diet allows not only to provide the body with all the substances and vitamins it needs, but also to control weight, avoiding obesity. Indeed, as a result of excess weight, the load on the patient's joints can increase by 4-5 times, leading to their premature wear. If the patient has weight problems, then they must be solved, preferably at the very beginning, when the treatment is just beginning or even before the onset of the disease as such;
• Physical exercise. Although in the initial period, when treatment is carried out, the mobility of the joints is usually limited, physical activity on them is still necessary, but already at later stages, when mobility is partially or completely restored. Also, moderate physical activity is recommended as an effective preventive procedure aimed at strengthening joints and, in particular, cartilage tissue. Exercises can be different - depending on which group of joints they are aimed at. In general, exercise should be given 40-50 minutes a day, practicing several times for 10-15 minutes. You can consistently do the entire cycle of exercises aimed at different muscle groups, or you can combine them in various combinations - all on the recommendation of a specialist;
• The rhythm of physical activity. Correct stress on the joints is one of the most important preventive procedures. In the process of physical work, try to adhere to the following rhythm - 15-20 minutes of load - 5 minutes of rest. During the moments of rest, take a comfortable position to minimize the load on the skeleton and give the joints "rest";
• Liquid balance. The peculiarity of cartilaginous tissue is that it absorbs and retains fluid, which, when the joint is loaded, is partially "squeezed" out of the cartilage, minimizing friction. In the process of physical exertion, the human body must receive in full the volume of fluid it needs, for constant rehydration of the cartilaginous tissue, which is subject to particular wear and tear;
• Orthopedic aids. To reduce the load on the knee and hip joints, properly selected shoes and instep supports for it will help. Also, during physical exertion, one should limit the "looseness" of the joints that are most loaded with the use of specialized tips and elbow pads;
• Chondroprotectors. This is the name of drugs and substances that help strengthen and restore cartilage tissue. These can be both medications and natural foods that contain a large number of fiber, cartilage. The latter, in particular, include all sorts of jellies, jellies, jellies. As for medications and food additives, their use should be as careful as possible and carried out only as directed by a doctor.

No matter how dangerous osteoarthritis is, its treatment with osteopathic methods is possible at almost any stage of the disease and demonstrates high efficiency, especially with an integrated approach. Therefore, it is so important at the first signs of the disease, as well as upon reaching the age of 45, to regularly consult an osteopathic doctor who knows exactly how to treat osteoarthritis and how to avoid its reappearance.

Osteoarthritis (OA) affects not only cartilage, like arthrosis, but also other tissues of the articulation. It can occur during pregnancy, children, and the elderly. The symptoms of osteoarthritis of the joints are manifested unequally, doctors prescribe a complex treatment, but the methods are selected taking into account the age of the patient, the causes of the onset and the clinical picture of the disease.

Diagnostics is the first step to getting rid of osteoarthritis

The disease is caused by degenerative-dystrophic changes in all tissues of large and / or small joints. This leads to a violation of the form of the joint and the gradual loss of its function.

Deforming osteoarthritis (DOA) is of the following types:

• generalized;
• localized (pathology affects one joint);
• primary (the reasons that caused the development of DOA were not found);
• secondary (occurs due to trauma [post-traumatic OA] or against the background of another disease).

Generalized osteoarthritis Is a DOA that has affected two or more joints in different anatomical regions.

TO localized the species includes OA, which affects the joints of the following localizations:

• sacroiliac joints;
• shoulder ();
• elbow;
• the clavicular-acromial joint;
• hip joint ();
• knee ();
• ankle;
• spine (osteochondrosis);
• peripheral joints (wrists, hands, feet, other areas).

There is also "patellofemoral pain syndrome". It occurs when OA destroys the joint that consists of the upper edge of the patella and the femur. Experts consider this syndrome a harbinger of gonarthrosis.

OA is a common disease that can occur at any age. Guys with third-fourth degree osteoarthritis are not recruited into the army. In the first or second stages of OA, the conscript is assigned a category B and is given a reprieve.

A delay for up to a year is given for osteoarthritis of 1 to 2 degrees

Which doctor treats osteoarthritis

If the patient decides to use folk remedies, then you need to contact a phytotherapist in order to choose the right medications that help with joint diseases.

It is necessary to get advice from the following specialists:

• orthopedist;
• rheumatologist;
• traumatologist;
• orthopedic surgeon.

It is advisable to consult a nutritionist and physiotherapist in order to choose the right diet, exercise, physiotherapy. Women with osteoarthritis, who have confirmed pregnancy, need to be observed not only by a gynecologist-obstetrician, but also by a rheumatologist.

Where do you get your disability?

It is necessary to contact the medical and social expert commission. Doctors of the MSEC will assess the patient's health status in order to assign him disability groups 1, 2 or 3, which depends on the presence of an endoprosthesis, rapid progression of OA or its frequent exacerbations. To obtain a disability, a patient must submit to experts radiographs, an outpatient card with specialist records, and hospital discharge.

Factors provoking the onset of osteoarthritis

The reasons for the development of DOA can be persistent microtrauma, dysplasia and inflammatory processes in the structures of the joint, which disrupt its biomechanics.

Often, the following pathological circumstances are capable of provoking the onset of DOA:

• obesity;
• endocrine diseases;
• diseases of the musculoskeletal and muscular system;
• estrogen deficiency and hormonal imbalance;
• genetic disorders.
• excessive stress on the joints.

Sometimes the impetus for the onset of the disease is given by non-compliance with the drinking regime. Due to a lack of fluid, the articular cartilage loses its elasticity and begins to crumble. Torn off fragments during movement cause intra-articular inflammation, which is the main cause of pain in DOA.

Additionally, the following risk factors are distinguished:

• over 60 years of age;
• hereditary predisposition;
• the presence of chronic joint diseases;
• previous operations on the joints;
• physical overload.

Osteoarthritis manifestations

Pathology has four degrees of severity, develops slowly. Often, in children and adults, the disease manifests itself in different ways.

Initial symptoms are often confused with fatigue, as aching pains disappear after rest.

General subjective signs of osteoarthritis:

• stiffness in the area of ​​the damaged joint after sleep;
• crepitus (crunching, crackling or creaking is heard during movement);
• increased muscle fatigue;
• over time, the pain becomes constant, and pain relievers do not help.

The progression of the disease is confirmed by symptoms such as periodic exacerbations of the disease and gradual deformation of the joint. In deforming OA, pain syndrome is associated with constant inflammation of the articular structures, damage to bone and cartilage tissue during movement. The range of motion in the joint decreases due to the proliferation of osteophytes and the gradual destruction of the osteochondral elements.

In osteoarthritis, joint deformity is eliminated by surgical methods

Objective signs

Each degree of DOA has a different radiological and arthroscopic picture. Using X-rays, specialists assess the extent of the damage to the joint.

X-ray signs of osteoarthritis:

1. In the first degree, there are minor nonspecific changes.
2. In the second degree, the picture shows some narrowing of the joint space, the formation of individual osteophytes. Joint deformation is negligible.
3. The third degree is manifested by multiple bone growths. The joint gap is moderately narrowed.
4. At the fourth stage of development of OA, a significant deformation of the bone, a sharply narrowed joint space, is determined in the image. Osteophytes reach large sizes.

Visual changes in the damaged joints are observed: the joint increases in size, tubercles are felt or protrude under the skin, curvature of the fingers and feet are visible.

Using an arthroscope camera, doctors assess the condition of the intra-articular tissues

Arthroscopic signs of OA (Outbridge classification):

1. First degree: no or minor visual changes.
2. In the second degree, the heterogeneity of the cartilage is visible. There are tears, cracks, patches or other defects on its surface.
3. Third degree: cartilage stratification appears, a "fringe" is formed along its edge. The severity of defects of the previous stage is aggravated.
4. At the fourth degree, the cartilage is destroyed so much that the bone is exposed, large erosions appear, congruence is disturbed (the correspondence of the elements of the articular surface to each other).

How to identify a disease

During the initial examination, the doctor listens to the patient's complaints and examines him carefully. Then, directions are written for general and biochemical blood tests, taking synovial fluid for laboratory research.

Hardware diagnostics of DOA includes the following methods:

• arthroscopy;
• x-ray;
• magnetic resonance imaging or computed tomography;
• thermography.

In the process of diagnosis, doctors exclude diseases that are similar in terms of symptoms.

Doctors rule out possible joint diseases that have similar clinical manifestations. Primarily carried out differential diagnosis of rheumatoid arthritis (RA) and osteoarthritis.

The difference between RA and DOA

1. In RA, at the very beginning of the disease, inflammation is manifested by reddening of the skin, swelling of the joints, and pain. With the development of DOA, these symptoms appear much later.
2. With RA, the work of internal organs is disrupted, rheumatic nodules appear on the fingers. Osteoarthritis does not cause such changes.
3. In rheumatoid arthritis, x-rays show osteoporosis, not osteosclerosis.

With RA in the blood, laboratory assistants detect an acceleration of ESR and the presence of rheumatoid factor. If an increased urea content is detected, then the person may have a psoriatic type of arthritis. The difference between osteoporosis and osteoarthritis is that OA destroys only the articular tissues, while osteoporosis is accompanied by a loss of bone tissue of various localization.

What can be the wording of the diagnosis:

1. Generalized form of arthrosis: bilateral coxarthrosis 3 degrees, gonarthrosis of the right knee 2 tbsp.
2. Local osteoarthritis: right-sided osteoarthritis complicated by synovitis.

Treatment methods

Therapeutic methods are selected individually. All methods should be aimed at stopping degenerative processes in the joints and maintaining their functionality.

Pharmacotherapy

Medical treatment is prescribed prior to arthroplasty. Medicines eliminate symptoms, slow down the progression of the disease.

Endoprosthetics completely restores the working capacity of the limb

For the treatment of osteoarthritis, the following drugs are used:

• analgesics (Baralgin, Analgin, Tramadol, Dexalgin);
• NSAIDs (Aceclofenac, Naproxen, Meloxicam, Nimesulide, Etoricoxib, other non-steroidal anti-inflammatory drugs);
• chondroprotectors (Elbona, Glucosamine sulfate, Structum).

In addition, agents are prescribed for the local treatment of stage 1–3 OA.

Medicines for osteoarthritis for external use - ointments, creams, gels. The most commonly used drugs are:

• Brufen;
• Veral;
• Dicloran;
• Ketonal;
• Enelbin Paste;
• Artrosenax;

Disease 2-3 degrees should be treated, also using intra-articular injections. Injections are done under ultrasound control to see the depth of penetration of the needle into the joint cavity.

In case of OA, the following medications are injected into the joint:

• hyaluronic acid preparations;
• long-acting glucocorticosteroid hormones;
• plasma platelet-rich injection fluids.

Intra-articular injections of Autoplasma ─ a new method of treating osteoarthritis

For pregnant women, an effective medicine is selected by the attending physician. Intra-articular injections, physiotherapy, mud therapy, folk external remedies (most!) Are considered safe for the fetus. It is dangerous to use non-steroidal anti-inflammatory drugs without consulting a doctor.

Operations are indicated for the second to fourth degree of the disease. The cheapest surgical intervention is arthroscopic debridement.

Arthroscopy is performed to remove cartilage fragments and excess synovial fluid

Debris, which consists of pathological synovial fluid, fragments of cartilage and fragments of osteophytes, is removed from the joint cavity with an arthroscope. Less commonly, periarticular osteotomy and endoprosthetics are performed. Each procedure has its own contraindications, which the attending physician warns about.

To eliminate joint deformity, bone correction is done

Drug-free treatment

These therapies include physiotherapy, massage, exercise therapy, and diet. With their help, they normalize metabolism, eliminate inflammation, relieve pain, develop a deformed joint.

Modern methods of physiotherapy:

• UFO-irradiation;
• infrared laser therapy;
• UBCH-therapy;
• CMB-therapy;
• magnetotherapy;
• ultrasound therapy;
• balneotherapy (hydrogen sulfide and radon baths).

The sanatoriums for the treatment of osteoarthritis combine the methods of balneotherapy and exercise therapy

Massage scheme:

1. First, the tissues of the joint are warmed up with stroking and rubbing movements.
2. During the massage, circular movements are performed more intensively, with pressure, stretching the periarticular muscles. It is necessary to avoid the appearance of pain during the procedure.
3. Finish the session with light stroking.

Physiotherapy

Daily gymnastics is a mandatory wellness procedure. Physiotherapy exercises can be combined with swimming, yoga, but you can not run, do aerobics. Patients begin to engage in exercise therapy under the supervision of a specialist, and later charging is done at home after sleep. The set of exercises recommended for joint diseases, see the video.

Diet

Meals must be selected individually, guided by the recommendations of a nutritionist. This is especially true for the treatment of children, pregnant women and the elderly.

The following general principles of therapeutic nutrition for osteoarthritis have been developed:

• the calorie content of food must correspond to the energy consumption of a person;
• lack of strict diets;
• fractional food intake;
• restriction of salt in the diet, simple carbohydrates, animal fats;
• eating fiber-fortified foods.

You can not eat refined fats, lard, fatty meat, canned food, fast food.
What vitamins are needed for DOA and what foods do they contain? You need to eat the following foods:

• C: citrus fruits, rose hips, melon, cabbage, tomatoes;
• D: seafood, eggs;
• β-carotene: pumpkin, asparagus, apricots.

It is also important to include in the diet foods containing the following beneficial substances:

• omega-3: flax seeds, nuts;
• bioflavonoids: green tea, apples, broccoli, lingonberries, blueberries;
• calcium: fermented milk drinks, cheese, cottage cheese.

There is a special calcium diet. Eating foods with a high Ca content will strengthen bones, improve cell metabolism, and accelerate the regeneration of joint tissues.

What foods are consumed with a calcium diet

How to treat at home

After consulting a doctor, you can purchase medical devices for the treatment of osteoarthritis at home. Experts often recommend Stiotron, Orion, Milta.

At home, you can carry out not only physiotherapy, but also apply the methods of alternative therapy. It is imperative to coordinate treatment with a doctor. Decoctions of medicinal herbs inside, medical compresses, rubbing and others help well. folk remedies for external use.

Conclusion

In all people, the pathogenesis of OA proceeds according to the same scheme, but the symptoms of osteoarthritis of the joints can manifest themselves in different ways depending on age, gender, health status. Treatment will be effective if patients strictly adhere to medical prescriptions. It is necessary to use joint fixators, engage in physiotherapy exercises, eat right, and receive spa treatment. It must be remembered that the best remedy for the progression of pathology is the prevention of exacerbations.

Surgical methods for eliminating osteoarthritis Diagnostic methods for ankle arthritis Osteoarthritis of the extremities - manifestations

There are many diseases of the musculoskeletal system. Slow tissue destruction leads to pain and discomfort, and interferes with an active lifestyle.

Osteoarthritis - what is it? This is a pathology of cartilage and adjacent bones, which is more common in adults 40-60 years old. The disease is chronic and leads to irreversible changes in the joints.

Causes of osteoarthritis

Osteoarthritis can affect people of any age, although until a few years ago, doctors believed that the disease was a sign of aging.

Today, there are a number of causes of osteoarthritis of the joints:

• Genetic predisposition to degenerative changes in the musculoskeletal system;
• Curvature of the spine and flat feet;
• Articular dysplasia;
• Injuries, bruises and bone fractures;
• Hormonal and endocrine changes;
• Overweight;
• Inflammatory processes;
• Autoimmune and allergic reactions.

High loads, systemic diseases, inflammation and damage to cartilage tissue are risk factors for the formation of osteoarthritis. The development of the disease takes a long time.

Interesting!

Most often, osteoarthritis affects the large joints of the lower extremities (hip and knee) or hands.

Signs of illness

The disease develops over a long time, so the initial symptoms of osteoarthritis often go unnoticed.

Pathological changes in tissues are noticeable on x-rays, but due to the blurring of symptoms, patients do not immediately consult a doctor.

With the development of the disease, the signs of osteoarthritis become more and more pronounced. The first symptoms include:

• Joint pain that gets worse during even minor physical activity;
• Decrease in the range of motion of the affected joint, which is most pronounced after awakening. After about half an hour, this symptom disappears;
• Cracking of joints when rolling or moving, an unpleasant sensation of rubbing bones with each other;
• Periodic joint jamming and the appearance of sharp pain;
• When touching the diseased cartilage, discomfort appears due to tissue swelling.

Classification

In osteoarthritis, the ICD 10 code has the value M15-M19. There are two main types of pathology, depending on the etiology of the origin of the disease:

• Primary osteoarthritis occurs in healthy cartilage due to congenital tissue features or due to age-related changes;
• Secondary osteoarthritis is formed due to various joint injuries () or some features and diseases: dysplasia, curvature of the spine, infections and viruses that have affected the connective tissues of the body.

By the location of the diseased joint, there are:

• ... The disease affects the hip joint, impairing the functionality of the pelvis. May lead to disability;
• ... It develops in the knee, usually caused by injury;
• most often appears due to dislocations or subluxations, deforms the shape of the legs;
• Osteoarthritis of the peripheral joints affects entire groups of joints, often including the tissues of the spine. A metabolic disorder usually leads to the occurrence of pathology;
• (at least 3 different joints are affected)

Doctors distinguish several degrees of development of osteoarthritis. Symptoms become more and more pronounced with the development of pathology. They are especially noticeable on x-rays.

1. At the first degree, the pain of the joint is insignificant, it appears locally, which is why it is often mistaken for fatigue and muscle strain. The secretion of synovial fluid changes, the nutrition of the joint worsens, but inflammation and swelling are not yet observed;
2. At the second stage, a characteristic crunch of the joint appears, the functionality of the muscles is disrupted, the mobility of the cartilage decreases due to its destruction and deformation, an inflammatory process develops, an increase in the general body temperature is possible, soreness manifests itself even without stress;
3. In the third stage, the patient can no longer move independently, he needs crutches or a cane. The joints lose their function due to severe deformation. A person complains of persistent pain, lameness, impaired blood circulation, inflammation, decreased muscle tone, limitation of cartilage mobility;
4. In some sources, grade 4 is called the last stage of osteoarthritis. At this stage, the cartilage tissue is completely destroyed, due to which all of its functionality is missing.

Interesting!

The rate of progression of the disease depends on the state of health of the patient, his age, concomitant diseases. It is possible to develop osteoarthritis in all symmetrical joints.

There are also radiological stages of osteoarthritis, they are characterized by external differences in the images, depending on the neglect of the pathology:

• The first stage of pathology is characterized by a slight, but already noticeable narrowing of the joint space. Symptoms of the disease are mild;
• Osteoarthritis of the 2nd degree looks like this in the photo: the gap becomes larger, small bone growths appear - osteophytes. The range of motion of the joint is reduced, the first signs of muscle atrophy appear;
• At the last stage, the articulation of the joints is severely deformed, due to which the mobility is minimal. Bone growths cover not only cartilage, but also other articular tissues.

Pathogenesis

The factor provoking the disease is a violation of the structure of the cartilage tissue. When metabolism is disturbed in its cells, the joint can no longer perform its functions.

At first, the cartilage thickens, but with the development of osteoarthritis, the tissues become softer and more fragile. Cysts, ischemic and sclerotic changes appear. Cartilage grows, forming bone growths - osteophytes, and surrounds the joints. The amount of synovial fluid produced decreases, and a deficiency of nutrients occurs.

Interesting!

The disease may be accompanied by synovitis (inflammation of the synovial fluid) or proceed without its manifestations.

How is the diagnosis

At the first suspicion of osteoarthritis, you should consult a doctor. In the initial stages of the disease, it is much easier to slow down its development than in the advanced stage.

The doctor conducts a visual examination and interviews the patient, examining his condition. After that, the specialist offers to undergo a series of laboratory examinations. Diagnosis of osteoarthritis includes:

• A general and biochemical blood test helps to find out the presence of inflammation in the body, to study the state of the internal systems of the body, to exclude other reasons for the appearance of signs of ailment;
• Ultrasound examination of the joints shows changes in soft tissues, the presence of edema and inflammation;
• Radiography indicates abnormal growth of bone tissue, cartilage dystrophy;
• Puncture of the synovial fluid will help to understand the causes of deformation and establish whether there is an inflammatory process;
• Magnetic resonance imaging is a modern method of research that shows a complete picture of changes in cartilage tissue.

After the diagnosis is confirmed, the doctor should think over a treatment plan depending on the location of the osteoarthritis focus and its stage of development.

The main methods of treatment

The orthopedic traumatologist deals with the treatment of osteoarthritis, and how quickly the results of therapy will appear depends on his qualifications. It is recommended to combine medication and various procedures at the early stages of the development of pathology, and in an advanced case, seek the help of surgeons.

Based on the following principles:

• Improving blood circulation in the affected area;
• Reducing swelling and inflammation, relieving pain;
• Reducing excessive stress on the joint;
• Suspension of the development of pathology.

Drug treatment

With the help of drugs, it is necessary to relieve pain and inflammation of the joints during the development of the disease. For this, non-steroidal anti-inflammatory drugs are used (Diclofenac, Paracetamol, Ibuprofen, Voltaren, Ketoprofen, etc.). They are used both for complex therapy and for local treatment in the form of ointments, creams and gels.

Self-treatment with such drugs can negatively affect the condition of the gastrointestinal tract. The doctor should monitor not only the dynamics of getting rid of signs of osteoarthritis, but also monitor the general health of the patient.

If treatment with non-steroidal drugs does not give any result, then corticosteroids (Diprospan, Prednisolone) may be prescribed. It is usually recommended to inject into the body of the joint to get rid of the signs of osteoarthritis. These are potent substances that are used every 2-4 months.

In order to restore functionality to the joint, it is recommended to take chondroprotectors. These drugs have a cumulative effect, so the results of therapy will be noticeable no earlier than 6-8 weeks. The most effective drugs are based on glucosamine and chondroitin sulfate (Artra, Dona, Stoparthrosis, Structum).

Physiotherapy and exercise therapy

With osteoarthritis of the 1st degree, when the cartilage still does not hurt much and there is no inflammation, it is possible to do only with physiotherapeutic procedures, without taking medications. Therapeutic exercises, massage, mud applications, mineral baths well eliminate the symptoms of the disease, stimulate blood flow in the affected areas, strengthen the ligamentous-muscular apparatus, and improve tissue nutrition.

At the subsequent stages of the progression of the pathology, it is advisable to supplement the drug treatment with various procedures. The most effective among them are:

• Therapeutic massage kneads the muscles, relieves tension from the joint;
• Laser and ultraviolet therapy stimulates blood circulation, warms up the joint, relaxes;
• Exposure to the electric current helps injecting medicines into the affected area and speeding up healing.

It is imperative to add physiotherapy exercises to the complex treatment. You can do it with a trainer or on your own at home. It is important that the training plan is drawn up by a specialized specialist and performed regularly.

Surgical intervention

If the joint is severely damaged, a surgical operation is necessary. Intervention can be of varying degrees, but the most effective are:

• Endoprosthetics is a complete replacement of a joint with an artificial analogue. Implants are made of lightweight, but durable materials, thanks to which the ability to walk and run is fully restored to a person. The disadvantage of this method of treatment is long-term rehabilitation - about 2-5 months;
• Osteotomy consists in dissecting the bone tissue and fixing it at a certain angle, due to which the load on the joint is reduced;
• Arthroscopic debridement involves cleansing the body of the joint. The affected area is punctured and the overgrown cartilage tissue is removed with an arthroscope. The operation is most effective at the initial stage of osteoarthritis development. The procedure will have to be repeated as the next contamination of the joint. This is a minimally invasive method that does not require a long recovery period.

If the doctor has confirmed the diagnosis of osteoarthritis, then treatment should be started immediately. It is necessary to reduce the load on the sore joint as much as possible: reduce activity, exclude exhausting training, get rid of excess weight, use special orthopedic devices (hand, cane).

It will help not only get rid of excess weight, but also improve overall health. Give preference to low-fat dairy products, eat vegetables, fruits and cereals more often, try to avoid fatty, flour, too spicy and salty foods.

Forecasts and prevention

Osteoarthritis is a chronic disease that cannot be completely eliminated, but it is possible to slow down the development and stop unpleasant symptoms. With early treatment, there is a chance to restore the function of the joints and restore their ability to recover, but in the later stages of the pathology, more and more tissues are affected, covering most of the large joints, which can cause disability.

For the prevention of osteoarthritis, it is important to follow the correct diet, exercise in a moderate mode, avoiding overstrain. Take care of yourself from injuries and get timely treatment for infectious and non-infectious diseases, choose comfortable and high-quality shoes.

To protect yourself from the disease, you need to know the symptoms and treatment of osteoarthritis. Patients often turn to doctors when it is too late and degenerative changes can only be corrected with surgery. Although earlier stages can be cured without even resorting to drug therapy.

Many people who have felt the first unpleasant symptoms are interested in: osteoarthritis - what is it? Osteoarthritis is a joint disease in which the cartilage tissue undergoes an inflammatory process and a person begins to experience pain. This problem is diagnosed mainly in older people, but in rare cases, young people also face it. Osteoarthritis is treated at an early stage in order to prevent the development of the disease, the consequence of which can be disability.

What is osteoarthritis

Osteoarthritis is a degenerative-dystrophic damage to the joints, in which the cartilage and subchondral bone become inflamed. If left untreated, the cartilage of the joint will begin to break down, exposing the surface of the bone tissue. This can lead to immobility and permanent pain. With osteoarthritis (arthrosis or deforming arthrosis), osteophytes are formed, which are growths on the bone.

Today, osteoarthritis is diagnosed in 70% of cases among rheumatological diseases, followed by arthritis. One in four 50-year-olds has this issue on their medical record. After 60 years, 97% of people are exposed to osteoarthritis. This is a disappointing statistics, every year the risk of getting a problem increases among young people.

Osteoarthritis is divided into clinical forms: polyosteoarthritis (presence of nodules and their absence), oligoosteoarthritis, monoarthrosis. It is also divided by the number of inflamed joints into primary generalized osteoarthritis and local osteoarthritis. Also, the disease has its own conditional stages of development and classification by reason of occurrence (primary and secondary).

Primary

Primary osteoarthritis is also called idiopathic. They are mostly affected by people after 40 years of age. Doctors cannot name the cause of the idiopathic type of disease, citing heredity or hormones. In primary osteoarthritis, several joints become inflamed at the same time (polyarthrosis), which must be urgently treated to prevent the development of the disease.

Secondary

Secondary osteoarthritis is diagnosed mainly in elderly people. It is the result of trauma, bruising, congenital (genetic) joint problems. The reason may be a previous inflammatory disease or infection, for example, syphilis, gonorrhea. Here the doctor, after a complete examination, can give an accurate conclusion and name the cause of secondary osteoarthritis.

Pathogenesis

The pathogenesis of osteoarthritis is as follows:

• With the disease, cartilage, synovial capsule, bone, tendons, blood vessels, nerve endings, etc. are affected.
• Due to lack of nutrition and poor metabolism, cartilage begins to lose chondrocytes and proteoglycans, it becomes thinner.
• Enzyme synthesis slows down, phagocytosis decreases, as a result, leukocytes cannot track microbes, and inflammation begins in the joint.

Symptoms

Symptoms of osteoarthritis both in the interphalangeal form and in the hip form are the same. It is possible to detect arthrosis of the joints of the first stage by chance when diagnosing other diseases or examining, but the other stages of development have quite tangible symptoms. If you feel that there are problems with your joints, you need to seek help from the clinic. Symptoms:

• pain with stress on the joint, which goes away at rest;
• crepitus or characteristic clicking when the joint rotates or twists;
• numbness of the joint with prolonged stay in one position;
• overgrowth of bone tissue of the arthritic joint;
• painful sensations do not go away even during a rest period and intensify when pressing on a sore spot;
• inflammation and hyperemia of the skin and muscles around the affected joint;
• joint paralysis.

Causes of arthrosis

The reasons for the development of osteoarthritis are extensive and not similar to each other. An important role here is played by heredity, trauma, lifestyle. Even malnutrition or hormonal imbalances can cause a problem. Experts do not name the exact cause of the development of osteoarthritis, highlighting the following possible factors:

• mechanical damage: injuries, bruises, fractures;
• inflammatory process;
• joint diseases such as rheumatoid arthritis;
• doing a certain kind of sport;
• great physical activity;
• transferred infections;
• sedentary lifestyle;
• hepatic or renal impairment;
• age;
• excess weight;
• endocrine and hormonal disorders;
• improper nutrition.

Diagnostics

Joint osteoarthritis can be diagnosed at the first stage of development with the help of a special examination. Therefore, if you suspect you have this disease, you need to go to the hospital, where an examination will be performed. Clinical analyzes of blood and urine do not reflect pathology in the early stages; the problem can be detected only with the help of special examination methods:

• X-ray of the joint;
• magnetic resonance imaging (MRI);
• ultrasound examination (ultrasound);
• arthroscopy;
• histological analysis of synovial fluid;
• blood test for leukocytes, antigen and antibodies.

Stages

Osteoarthritis has three degrees of development. You can independently determine the degree of osteoarthritis using the Leken algofunctional index:

1. First degree joint degeneration is characterized by changes in the synovium and fluid that affect the nutrition of the cartilage.
2. In the second stage the first "bells" appear: the patient feels pain and crunch in the joints when moving.
3. Next comes the third stage.... Changes are noticeable to the naked eye: thickening of bone tissue, swelling, persistent pain, possibly manifestation of Albeck's syndrome.

Osteoarthritis treatment

Osteoarthritis causes acute joint pain, restricts mobility and is accompanied by inflammatory processes. Pain in osteoarthritis can occur both in motion and at rest, so an effective way to quickly and permanently eliminate pain syndrome is needed. Drug therapy. Taking medications (pain relievers, anti-inflammatory drugs) should be agreed with your doctor. The innovative drug Dialrapid has proven itself well - a fast-acting analgesic that eliminates joint pain of any intensity, and also has a pronounced anti-inflammatory effect. Potassium bicarbonate acts as a pH buffer, providing the drug with complete dissolution in water, and subsequently creating a microenvironment around the active ingredient - diclofenac potassium. It is this microenvironment that promotes accelerated absorption and helps the drug to be fully absorbed by the body. Dialrapid begins to act within 5 minutes after administration and after 15-20 minutes its concentration in blood plasma reaches a peak. The drug is absorbed by the body as quickly as an injection, but it is much more convenient to use.

Chondroprotectors (Piaskledin, Rumalon) are also used in the treatment, which do not allow the cartilage to deteriorate further.

Treatment is complex and consists of the following methods:

• Physiotherapy... These are magnetic therapy, ultrasound, thermal procedures, baths.
• Massage... The patient needs to undergo a course of massage for osteoarthritis, which will help relieve swelling, establish blood microcirculation, and reduce pain.
• Acupuncture... This procedure relieves muscle tension, relaxes and relieves inflammation.
• Physiotherapy... Exercise is mandatory, the effectiveness of the treatment of osteoarthritis depends on them.
• Nutrition... The menu should include foods containing collagen. This is a red fish of the salmon family, seaweed, beef, turkey, jellied meat.

Prophylaxis

Any disease is better prevented than cured, and osteoarthritis is no exception. To prevent the disease from making itself felt, you need to follow preventive rules. A person must monitor his weight, eat right. In many ways, the prevention of osteoarthritis depends on physical activity: you cannot give up sports completely, physical education in the form of simple exercises should be present in the life of any person, regardless of age.