Osteoarthritis refers to diseases that affect the joints.As a result of dystrophic-degenerative processes, cartilage is gradually destroyed and replaced by growing bone tissue.The pathological process is accompanied by pain, limited joint mobility, disruption of its functions and severe deformation.Approximately 10 to 25% of the population suffers from osteoarthritis.After age 80, almost everyone suffers from degenerative disorders of the musculoskeletal system.Most often, the disease affects the most mobile joints (fingers, hip, knee, neck).But sometimes degenerative processes develop in the ankle and shoulder joint.
Disease development factors
Various reasons trigger destructive processes in the body.The most important are congenital connective tissue abnormalities.Regular microtrauma of the joints and acute joint diseases contribute to the development of osteoarthritis.Over time, the untreated disease enters a chronic phase with regular exacerbations.
The factors provoking the development of osteoarthritis are:
- excess weight;
- physical inactivity;
- hormonal disorders;
- atherosclerosis;
- venous insufficiency;
- endocrine disorders;
- genetic predisposition;
- regular, heavy loads on the joints (for example, in weightlifters or people whose job involves lifting and moving heavy objects).
Under the influence of one or more provoking factors at once, the cells of the cartilage tissue begin to collapse.Little by little, the cartilage thins, becomes less elastic, then becomes covered with cracks and falls off.The bones in the joint begin to rub against each other.The body launches a compensatory mechanism, as a result of which bone tissue grows on the decayed surface.As a result, the joint becomes inactive and becomes deformed.
Species
Osteoarthritis can be primary, appearing independently, and secondary, developing as a result of diseases, injuries and deformities of the joints.
Depending on the affected joint, the disease has its name:
- Gonarthrosis affects the knee joint.
- Coxarthrosis is a disease of the hip joint.
- Spondyloarthrosis affects the intervertebral discs of the lumbar, cervical and thoracic regions.
- Crusarthrosis involves the ankle in the pathological process.
If 3 or more joints are involved in the degenerative process, we are talking about a generalized form.If there are 1 to 2 joints, it is local osteoarthritis.
Symptoms
At first, the degenerative process goes unnoticed.There are no nerve fibers in the cartilage, so at the early stages of development the patient does not even know what destructive processes are taking place in his body.The first signs appear only a few years after the onset of dystrophic-degenerative processes, when the periosteum under the cartilage is injured or inflammation develops.
At first there is pain in the limbs after intense exertion.In the morning or after a long stay at rest, a feeling of stiffness and a dull, aching pain of not too great intensity appear.After a short warm-up or exercise, all painful symptoms disappear.Therefore, people do not go to the doctor, considering it a common phenomenon.Meanwhile, it is at the initial stage that it is much easier to stop the progression of osteoarthritis.
Over time, all the signs intensify.The pain becomes obsessive and constant, it prevents you from sleeping at night.Aches, a feeling of stiffness, the inability to work fully or carry out household chores become more and more worrying.Aching and twisting pains in surrounding joints and muscles intensify in rainy weather.
Most often, osteoarthritis affects the joints of the lower extremities, so a person quickly gets tired of walking, it is difficult for him to climb the stairs or any height, because as a result of the destruction of the cartilaginous tissue, stiffness of the joint is formed.An unsteady gait develops due to limb instability.When bending a joint, an unpleasant cracking sound is heard when the joint surfaces, devoid of cartilage, rub against each other.Patients try to limit the mobility of the diseased joint, so muscle atrophy develops over time.They decrease in volume and the gait becomes even more unstable.
If osteoarthritis develops in the joints of the upper extremities, it most often occurs as a result of injuries or chronic arthritis.In this case, bony growths appear on the fingers, and the hands take on a square shape.
Clinical symptoms depend on the stage of development of osteoarthritis:
- Zero.
At stage zero, a person is sometimes bothered by slight discomfort.X-ray examination reveals no degenerative changes. - Elementary.
During prolonged walking, a slight dull pain appears.The x-ray shows the appearance of small areas of bone defects along the edges of the joint surfaces.When folding the joint, a cracking noise is heard. - Easy.
In the morning there is pain and stiffness.X-rays show osteophytes (single bony growths) along the edges of the joints, narrowing the joint space. - Moderate.
The moderate stage is considered degenerative.Bones and muscles hurt constantly, especially at night.The joint swells a little.X-ray examination shows further narrowing of the joint space, proliferation of bone growths and increased bone density. - Heavy.
In the severe stage (deformity), constant aching pain appears, intensifying with movement.When you try to bend the joint, a sharp crack is heard.The x-ray shows a strong narrowing of the joint space;the osteophytes have already grown so much that this has led to deformation of the joint and a change in its structure.
Diagnosis and treatment
An orthopedist, a rheumatologist and a surgeon take part in determining the type and stage of degenerative-dystrophic processes in the joints.Diagnosis includes standard blood and urine tests.If necessary, immunological analysis and examination of intra-articular fluid for the presence of infection are carried out.Instrumental studies are carried out (MRI, ultrasound to identify changes in periarticular and articular soft tissues, CT scan, x-rays to determine changes in bone tissue).
Therapy
The disease cannot be completely stopped.Prompt diagnosis and treatment allows you to maintain its mobility and prevent the progression of destruction.
Antispasmodics, NSAIDs, steroid blockages injected into the joint, chondroprotectors, muscle relaxants, vitamin and mineral complexes, drugs to improve the trophism of affected tissues, proteolysis inhibitors to slow down the destruction of cartilage and bone tissue are used as drugs in the treatment of osteoarthritis.
Patients with severe pain and unstable joints are recommended to wear bands that fix the joint in a normal position using adhesive tapes, orthotics, elastic knee pads or elbow pads.Crutches or canes should be used for support.
Physiotherapy procedures should be prescribed, which include UHF, massage, ozone therapy, electrophoresis and phonophoresis with a solution of analgesics, magnetotherapy, acupuncture, electrical stimulation, darsonvalization, paraffin baths (in the absence of inflammation)
In the later stages of osteoarthritis, when the tissues are already destroyed and the joints are severely deformed, the only solution is surgical intervention:
- Arthroscopy with removal of bone growths, thorns and partial replacement of damaged cartilage.
- Endoscopy.This involves the replacement of a joint (in whole or in part only) with an artificial joint.
- Artodez.The joint is closed and fixed in a comfortable position.Over time, the joint surfaces become closer together.
Prevention
Since it is impossible to restore your own joint to a normal physiological state, it is necessary to take measures in advance to prevent this disease.It is especially important to do this if there is a family history of cases of this disease or if you reach the age of over 40.
Prevention includes maintaining a normal body mass index and exercising regularly.Infectious pathologies and other joint diseases must be treated promptly, hypothermia and prolonged and sudden physical exertion must be avoided.People belonging to risk groups (by age, having a traumatic profession, poor heredity) should regularly examine their joints using x-rays.
Only timely and adequate treatment can maintain a healthy joint.