Osteoarthritis is degenerative-degenerative disease of the joints, characterized by a slow and progressive destruction of intra-articular injection of cartilage. Arthritis includes a group of joint diseases destructive-inflammatory in nature, which have different causes and similar mechanisms of development.
Osteoarthritis is one of the most widespread diseases in the world, occupies a position of leadership among women and men over the age of 30 years, and with age, the risk of the development of the disease is on the rise.
Causes of malocclusion
Osteoarthritis develops as a result of violations of metabolic processes in the joints, on the background of which the intra-articular cartilage begins to lose water and becomes elastic. Predisposing factors similar changes in the cartilage can be internal and external causes:
- the hormonal changes;
- characteristics of age;
- genetic predisposition;
- rheumatoid arthritis;
- excessive load on the joints;
- previous injury and property damage – dislocations, fractures, severe contusions, rupture of the ligaments;
- metabolic changes within the joint, associated with obesity, diabetes;
- hypothermia;
- defective and unbalanced diet, in which the body loses calcium, omega 3 and 6, fats and proteins;
- the inflammatory process in the joint;
- the violation of the vascularity of the femoral head – the perthes disease:;
- problems with the clotting of the blood, hereditary diseases;
- autoimmune diseases – systemic lupus erythematosus, rheumatoid arthritis.
Trigger the development of osteoarthritis can also specific diseases, that have nothing to do with the joints, and in particular:
- gonorrhea;
- syphilis;
- hyperthyroidism;
- thyroiditis.
At risk are people who do a heavy physical work, are constantly forced to supercool and to experience an increased load on the musculoskeletal system – miners, blacksmiths, of athletes, porters, and even pregnant women.
The symptoms of osteoarthritis
The first symptom of osteoarthritis is pain to a minimum effort in common, that passes quickly, once they leave in peace. Osteoarthritis is characterized by 4 major clinical signs:
- The sensation of pain – the pain from osteoarthritis has certain characteristics, unlike the pain in case of injury of the joint or an inflammatory process in it. First of all, you should pay attention to the occurrence of pain and discomfort in every movement and loading of the affected joint. Is a person to stop the movement and remove the load, as the pain once it passes, which is not the case when a trauma or inflammation of the joint. In the night destroy the joint virtually does not cause the patient discomfort, the painful sensations are possible only when you change the position of the body, but pass quickly. When expressed, the progression of destructive processes within the joint of the night may occur strong rastrellatura pain, which with time become more and more strong, and make lifestyle changes. Acute pain occur as a result of changes of the time, the change of phase of the moon, the minimum load.
- Crunch – this sound appears as a result of a reduction of softness of the rotation of the bones around the joint, which leads to friction of the bones between them and accompanied by a distinctive crunch. As the progression of degenerative processes in the joints crunch becomes more pronounced and accompanied by pain.
- Limitation of joint mobility – in the initial phase of development of a pathological process expressed limitation of mobility no, but with the progress of the destruction of the joint within the patient always more difficult to do simple operations. At the end of the affected joint becomes completely immobilized.
- Deformation of the articulation – on the surface of the bone are beginning to grow osteophytes and accumulates in the synovial fluid. Deformation of the joint is observed in the execution of the measure of a pathological process.
The degenerative processes in the joints do not develop rapidly, the disease is characterized by the phase of exacerbation and remission, in which patients are in no hurry to go to a doctor, contributing to the progression of the destructive processes within the joint.
Phase
The stage of progression of the pathological process in the joint is defined by means of an x-ray examination. Distinguish 4 stages of disease:
- The first one is characterized by slight narrowing of the joint space, without pathological excrescences to the bone no;
- The second – a slight reduction of the joint space, on the surface of the bone to form osteophytes;
- The third – articular slit reduced, on the surface of the bone multiple osteophytes, it is observed the deformation of the joint;
- The fourth of the joint space there is virtually no, there are multiple osteophytes, severe deformation of the joint.
Measure
Osteoarthritis is expressed in the form of degenerative-destructive processes within the joint, which affects the cartilage, develop changes in the capsule and the sheath, the synovial fluid of the joint, and also in bales around him and bony structures. Depending on the severity and the manifestation of one of the destruction has decided to assign to the 3 degrees of osteoarthritis.
The first degree of
Expressed deformation or changes in the joint no, but it is broken the composition of the synovial fluid – this results in the absence of guarantee joint tissues of nutrients, water and trace elements, causing the cartilage becomes quickly is not elastic and is not adapted to the loads. With the passage of time is the cause of inflammatory processes and accompanied by pain during movement, and the load in common.
In the first instance osteoarthritis none of their patients do not go to a doctor, the reset of the discomfort and pain in an uncomfortable position during sleep, fatigue, improper lifestyle. Sometimes the patient may notice a crunch in the area of the affected joint, however, is not accompanied by a sharp pain, but only discomfort, which nobody pays much attention.
If the osteoarthritis is diagnosed case in the first phase, the disease is easily treatable.
The second degree
In this stage the disease is accompanied by devastating processes of cartilage within the joint. On the surface of the bone strenuously grow osteophytes, and the more intense the load on the affected area, the more strong will be the progress of destruction.
When the patient complains of persistent pain aching and shooting nature, taking place periodically in themselves and can for a long time not to be known. Then the disease progresses. On the background of the pathological process in the muscles that surround the inflamed joint, gradually lose their function, which the patient gets tired quickly and can not endure the physical stress, that, without difficulty, has moved before. During the second part of the osteoarthritis, the patient gradually progresses, the deformation of the cartilage and joints.
The third degree
Is the most severe. Intra-articular cartilage of the affected joint thins and highly degraded, which results clearly evident that the deformation and the breakage of functionality of the affected limb. Located close to the joint ligaments and missty registers a lack of nutrients and oxygen, and gradually atrophy, which is accompanied by a significant loss of mobility. With this sick all the time, plagued by an acute pain, which is enriched every attempt of change of position of the body, in the case of changes of the meteorological conditions and the phases of the moon and gradually leads to the total loss of the ability to act.
The types of arthritis
Depending on which of the triggered a pathological process within the joint to distinguish primary osteoarthritis, secondary and idiopathic.
The primary develops as a disease, independent secondary, as a result of trauma or infection, and the reason for the idiopathic form is not known. Also the classification of the disease depending on the cause of the pathological process distinguish osteoarthritis of the place of localization of destructive changes:
- Knee osteoarthritis – the most common type of malocclusion, is characterized defeat of the knee. Often knee osteoarthritis to identify the people who are overweight, with chronic diseases of the metabolism in the body, weak immunity. Knee osteoarthritis progresses a lot of time, and gradually leads to the complete loss of motor function.
- The arthrosis of the ankle – the main causes of the development of degenerative processes in the area of the ankle are transferred to trauma, dislocations, sprains, fractures. In some cases, the development of a pathological process can cause an autoimmune disease – rheumatoid arthritis. Ankle osteoarthritis are the dancers, with the women wearing high heels, athletes.
- Osteoarthritis of the shoulder joint – the main cause of degenerative processes in this phase are congenital anomalies of the development of the articulation of the shoulder, or excessive loads in this area, for example, when you wear heavy fax machine on your shoulders.
- Were or hip osteoarthritis – the main cause are the age-related changes in the tissues of the joint. At-risk people over the age of 45 years.
- Encountres or cervical osteoarthritis – the causes are injuries to the neck, progressive low back pain, obesity, sedentary lifestyle. At risk people who work at a computer, in the office. Over expressed pain in the neck in the observed patients expressed dizziness, depression of consciousness, memory disorders, and fatigue. These symptoms are due to compression, vertebral artery, through which the brain receives nutrients and oxygen.
- Spondiloartrosi – destructive destruction of the subjects of the fabric of the spine, namely the lumbar department. At-risk women in the period of menopause, as well as spondiloartrosi progresses in a context of deficiency of female sex hormones.
- Osteoarthritis of the fingers – spread for the same reason, that spondiloartrosi.
- The polyarthrosis – is characterized by multiple lesions joints with progressive degenerative processes in them, when the pathological process involved the ligaments, muscles and joints tissue.
Possible complications
In the absence of a timely diagnosis and treatment of osteoarthritis will progress, distributed about other joints, promote the development gruzevich projections and the total development of the polyarthrosis.
Complications of osteoarthritis are:
- the destruction of the integrity of the joint;
- deformation of shape;
- limitation of mobility;
- the disability of the patient.
All of these complications lead to a significant reduction in the quality of life of the patient, the adhesion of comorbidities and violations, complete immobilization of the patient.
Methods of diagnosis
For the diagnosis of the disease, the patient should contact the orthopedic trauma. In order to differentiate osteoarthritis from other joint diseases and muscle-skeletal prescribed an x-ray in 2 projections. This research enables us to determine with precision the changing textures of the tissues adjacent to the physical coupling, the presence of destruction of bones and joints, osteopenia growth.
If necessary, the doctor can also give the patient an mri, ct scan, at the arthroscopy. In some cases, produce the puncture of a joint to withdraw a sample of synovial fluid.
The treatment of osteoarthritis
The treatment of osteoarthritis of the best produce in the early stages, then the disease is more suitable conservative therapy methods. It is very important to set correctly the cause of the progress of destructive changes to the joint and the time to stop these factors.
The treatment of the arthrosis develops in a comprehensive way and consists in the resolution of the inflammatory process, relieve pain, halt the progression of the pathological process and the possibility of recovery of the lost functions of the joint. Conservative therapy includes a selection of medication medication and physiotherapy treatment techniques.
Pharmacological treatment
The treatment of osteoarthritis is different in the different areas of localization of the pathological process:
- Osteoarthritis of the fingers and hands – the patient to reduce the pain prescribe non steroidal anti inflammatory drugs in the form of ointments, cream, gel. For the prevention of the progression of the pathological process shown hospitality chondroprotectors. After the relief of acute inflammation, prescribed massage and physical therapy techniques therapy.
- With osteoarthritis of the shoulder – joint the patient are to be introduced to injection of painkillers and anti-inflammatory drugs. Oral can prescribe medications anti-spasmodic, which will relax the muscles and a couple of decrease the intensity of the pain. After the relief of acute inflammation and pain shown to physiotherapy and massage.
- Osteoarthritis of the knee – prescribe nonsteroidal anti-inflammatory drug locally in the form of compresses, ointments, gels. On the area of the affected joint this physiotherapy therapy techniques.
- Osteoarthritis of the hip – the area concerned impose compresses soaked in ointment or gel from a group of FANS, and within the municipality is administered pain-relieving injection.
- Osteoarthritis of the knee – the area concerned is applied creams and gel with analgesic effect, and after the relief of acute pain and inflammation by showing therapies physiotherapy.
- The arthrosis of the ankle – patient recommended strict bed rest with complete peace of mind of the affected joint. How to fix acute inflammatory process are assigned physiotherapy, baths, massages.
Physiotherapy treatment
To effective physical therapy techniques, often used in various degrees of severity of osteoarthritis are:
- Shock-wave – treatment effectively eliminates the patient from growths osteophytes, eliminating the pain and limitation of joint mobility;
- The stimulation of the muscles around the affected joint of the current – this procedure is very effective for patients with marked reduced mobility and also helps to improve blood circulation in the municipality, accelerate the regenerative processes, improve muscle tone;
- Ozone therapy – in the cavity of the affected joint introduced mixture of gas, thanks to which the patient reduces the pain, normal joint mobility, disappear the signs of inflammation. To get the maximum effect of ozone therapy is carried out courses;
- Fonoforesi – the impact on the affected area, the ultrasonic waves with the use of drugs. This method of using drugs much more efficient, as well as the ultrasonic sound waves expresses the medication directly intralesional.
In addition to physiotherapy treatment include physical THERAPY, massage, chiropractic, physiotherapy.
Diet
Diet with arthritis should be the most balanced and rich in polyunsaturated fatty acids, proteins, trace elements. We recommend that you include in the diet fresh fish, vegetable oil, fresh cheese, dairy products, meat, fresh fruit and vegetables.
From the diet should exclude flour products, and "details" carbohydrates, chocolate, coffee, alcohol, pig meat, fat and spicy.
The surgical treatment
If treatment methods of the conservatives have not led to the expected result or osteoarthritis were diagnosed in advanced stage, when they are expressed degenerative changes of the joint with severe restriction of mobility, the patient is prescribed the surgery.
The surgical treatment of osteoarthritis take place in several ways:
- Needling the affected joint – this method is also diagnostic and therapeutic. Taking a sample of synovial fluid allows to determine with precision the nature of the origin of the disease and to collect effective drug. In the course of an operation, during the injection in the joint cavity is introduced by glucocorticoids and various anti-inflammatory medications, which in an instant relieves the pain and reduces the load on the joints.
- Arthroscopy – in the joint cavity introduced the arthroscope to a careful examination of the internal structure. In the course of a surgery, the doctor may immediately remove growths on the bones, and a variety of neoplasms.
- Osteotomy – in the course of an operation the bones of the joint a little bit correct special tools and fixed in the correct position, which allows not only to recover the motor function, but also relieve the patient of discomfort and severe pain.
- Knee – ruin the joint is removed and in its place establish a prosthesis of high quality material, which is completely take upon himself the functions of the lost joint, will provide full mobility of the limb, and to free the patient from pain.
Prevention
Prevention of osteoarthritis is a beautiful campsite:
- lead a healthy, active life;
- rational nutrition;
- the elimination of bad habits;
- the prevention of accidents and damage to the joints;
- timely treatment of inflammatory processes.
The people of the risk groups must be especially attentive to the slightest change in the functioning of the joints and the appearance of pain, the crunch and the crunch immediately contact the advice of an orthopedic trauma.