Types of osteoarthritis: symptoms and treatment methods

23 August 2020

Osteoarthritis is a chronic disease of the joints in the adjacent tissues, joint capsule and synovium, accompanied by pathological changes in the hyaline cartilage.

The lesion is dystrophic and degenerative, which leads to changes in the structure and loss of functionality of articular tissues. According to the same statistics, 12% of the total population of the planet is susceptible to osteoarthritis. 62% to 65% of all episodes of the disease occur in people over 60 years of age.

Another 30-35% of cases of co-injury with this pathology occur in patients aged 40-60 years. And about 3% are young people between the ages of 20 and 40.

What is this?

Simply put, osteoarthritis is a chronic disease that develops progressive degenerative-dystrophic changes in the joints due to metabolic disorders. It is the most common common pathology, diagnosed in 6-7% of the population. With age, the incidence increases sharply.

Often, the pathological process in osteoarthritis involves the small joints of the hand (10 times more common in women than in men), the big toes, the intervertebral joints of the thoracic and cervical spine, as well as the knee and hip joints. Osteoarthritis of the knee and hip joints is leading in terms of the severity of clinical manifestations and adverse effects on quality of life.

Osteoarthritis is characterized by a complex damage to the articular and accessory apparatus:

chondritis - inflammatory changes in the cartilage of the joint;
osteitis - involvement of lower bone structures in the pathological process;
synovitis - inflammation of the inner membrane of the joint capsule;
bursitis - damage to the periarticular sacs;
Reactive inflammation of soft tissues (muscles, subcutaneous tissue, ligaments) located in the projection of the involved joint (periarticular inflammation).

The disease is diagnosed in 2% of people under the age of 45, 30% between the ages of 45 and 64, and 65-85% over the age of 65. Osteoarthritis of the wide and middle joints of the extremities is of the greatest clinical importance as it adversely affects the living standards and ability to work of patients.

Types of osteoarthritis

Depending on the cause of the pathological process inside the joint, primary osteoarthritis is divided into secondary and idiopathic.

A primary independent disease develops as a result of an injury or infection, and the cause of the idiopathic form is unknown. In addition to the classification of the disease, depending on the cause of the pathological process, osteoarthritis is divided according to the location of destructive changes:

Gonarthrosis is the most common type of pathology characterized by damage to the knee joints. Gonarthrosis is most often found in people who are overweight, have chronic metabolic diseases and have weakened immunity. Osteoarthritis of the knee progresses over a long period of time and gradually leads to complete loss of motor activity.
Osteoarthritis of the shoulder joint - the main cause of degenerative processes in this area are congenital anomalies in the development of the shoulder joint or excessive stress in this area, for example, when carrying a heavy load on the shoulders.
Ankle arthrosis - the main causes of degenerative processes in the ankle joint are trauma, spikes, rashes and fractures. In some cases, the development of a pathological process can lead to an autoimmune disease - rheumatoid arthritis. Ankle arthrosis affects dancers, women with high heels, and athletes.

Uncoarthrosis or osteoarthritis of the cervical spine - causes neck injuries, progressive osteochondrosis, obesity, sedentary lifestyle. People who work on a computer in offices are at risk. In addition to severe neck pain, patients experience dizziness, depression, memory loss, and fatigue. These symptoms are caused by constriction of the vertebral artery, which carries nutrients and oxygen to the brain.
Coxarthrosis or arthrosis of the hip joint - the main cause is age-related changes in the tissues of the joint. People over the age of 45 are at risk.
Osteoarthritis of the fingers - develops for the same reason as spondyloarthritis.
Polyarthritis is characterized by damage to many joints, which have progressive degenerative processes, the pathological process involves the ligaments, muscles and tissues around the joint.
Spondyloarthritis - the destructive destruction of the tissues of the spine, ie the lumbar region. Because spondyloarthritis progresses against a background of female sex hormone deficiency, women are at risk at the onset of menopause.

Causes of osteoarthritis

Two causes of osteoarthritis are stress and lack of nutrition, which is rich in vitamins and minerals for tissue repair. Everyone's joints carry a load. For athletes and dancers, the load on the legs is greater during physical activity, which means that the bone joints are overcome more quickly and quality nutrition is required. With a quiet lifestyle, the support apparatus wears out more slowly, but also requires periodic tissue renewal.

Therefore, the main condition for the collapse and deformation of the joints is the feeding of beneficial components, which often occurs with metabolic disorders.

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

Muscle weakness and abnormal joint loading. Weakening of one or more muscles increases the extra load and distributes it unevenly at the bone junction. In addition, improper muscle loading occurs with flat feet, scoliosis, so with these "harmless" diseases, the cartilage tissue wears out with age, and osteoarthritis appears.
Strong physical exertion increases the likelihood of osteoarthritis.

When daily loads exceed the capacity of bone tissue, they cause microtrauma. Thickening occurs at the site of injury, which grows over time and deforms the joint;
Metabolic disorders (gastrointestinal diseases - bile, dysbiosis, gastritis, cholecystitis, pancreatitis, metabolic disease - diabetes);
Psychosomatic causes - The psychosomatics of osteoarthritis confirms that a negative emotional state is also the cause of the disease. Stress causes muscle spasms, constant stress disrupts the nutrition of all tissues (internal organs, bones, joints);
Heredity (type of metabolism and its possible disorders are hereditary, prone to muscle weakness or malformation of the bone apparatus, poor digestion - this is the basis for the development of osteoarthritis in old age).

Osteoarthritis is an obsolete joint disease that has lost a significant amount of mineral supply and the ability to resist stress and destruction. Therefore, with age, the tendency to disease increases. After 70 years, every second retiree is diagnosed with osteoarthritis. As the maximum load falls on the legs (a person moves - walks, stops, runs, jumps), the first signs of osteoarthritis appear here.

Mechanism of disease development

When osteoarthritis causes any of the causes of joint disease, then pathological processes begin to develop. The mechanism of their progression is not fully understood, but the main stages of formal medicine are known.

In the initial stage, there is depletion of cartilage structure and abnormal changes in synovial fluid. All this is due to metabolic disorders, in which the tissues of the joints do not receive the required amount of components or lose some of them.

In addition, collagen fibers lose their elasticity and cartilage elasticity because the malnourished body does not have time to produce hyaluronic acid, which ensures the softness and elasticity of the collagen fiber's structural composition. Cartilage gradually dries, becomes brittle and cracks. The fluid in the synovial capsule is gradually depleted and then completely disappears.

Hardness and solid bone growths occur in cartilage tissue. At the same time, there is deformation of other tissues of the joint, their pathological degeneration, dystrophy and loss of physiological function. For the patient, these changes mean the appearance of pain, aging, joint stiffness.

Symptoms of osteoarthritis

The acute clinical picture is not typical for osteoarthritis, joint changes are progressive, slowly increasing, manifested by a gradual increase in these symptoms:

pain;
intermittent bending of the affected joint;
joint deformity that occurs and worsens as the disease progresses;
hardness;
mobility restriction (reduction of active and passive movements in the affected joint)

Pain in osteoarthritis becomes dull, transient, and moves towards the end of the day against the background of intense stress (it can be so strong that it does not allow the patient to fall asleep). Osteoarthritis is not characterized by persistent, non-mechanical pain and indicates the presence of active inflammation (subchondral bone, synovium, ligamentous apparatus or periarticular muscles).

Most patients report so-called initial pain that occurs after waking up in the morning or being inactive for a long time and disappears during physical activity. Many patients define this condition as the need to "develop joints" or "remove. "

Osteoarthritis is characterized by a short-term (no more than 30 minutes) morning stiffness with a clear localization, and sometimes patients perceive it as a "jelly feeling" in the joints. Bleeding sensations, stiffness are possible.

The main symptoms of osteoarthritis are associated with the development of reactive synovitis:

pain and local increase in temperature determined by palpation of the affected joint;
persistent pain;
joint enlargement, soft tissue swelling;
progressive decrease in range of motion.

Stages and degrees of osteoarthritis

In the course of the disease, medicine distinguishes three stages, which differ in the symptoms of the disease, the intensity and localization of the lesion. At the same time, the differences in all three stages relate to the types of tissues that are subject to pathological changes.

The first stage in the development of osteoarthritis of the joints is the initial stage of the disease. It is characterized by mild damage to cartilage tissue and loss of physiological functions in collagen fibers. At the same time, in the first stage, small morphological disorders of bone tissue and structural changes in the synovial fluid are noted. The cartilage of the intestine is covered with cracks, the patient feels a slight pain in the pathological area.
Second degree - the development of osteoarthritis with the dynamics of osteoarthritis. This stage is characterized by constant pain, the appearance of lamellae. Significant morphological and dystrophic changes occur in the cartilage, bone growth is detected at the time of diagnosis. Osteophytes occur - bone growths that are visible on visual inspection of the lesion area. At the same time, the process of degenerative changes in the synovial capsule continues, which leads to its structural depletion. The disease at this stage can often worsen and become regular. The pain is becoming more and more constant.
Third degree - active development. At this stage, the synovial fluid is almost completely absent due to degeneration, and the bone tissue is rubbed against each other. Joint mobility is almost non-existent, pain is easier. Cartilage is not due to degenerative and atrophic changes. Treatment of third-degree osteoarthritis of the joints is not appropriate.

In addition to these three stages of pathological development, there is a final stage - the irreversible destruction of all tissues of the joint. At this stage, it is impossible not only to carry out effective therapy, but also to relieve pain.

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

In order to prevent serious consequences, treatment should be started in the first place, and at the same time intensive therapy methods should be applied. In order to relieve the patient of joint pain and immobility in the final stage of complete destruction of cartilage tissue - arthroplasty provides complete or partial replacement of the components of the joint.

Results

Improper treatment of joints and the consequences of osteoarthritis lead to the following complications:

disability;
non-recoverable deformation;
formation of vertebral hernias;
joint stiffness or stiffness;
Decrease in quality of life and standard.

In addition to these complications, the chronic course is accompanied by intense and frequent pain, complete destruction of the structural components of the joint, anxiety, inability to play physical work and sports.

Diagnostics

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

The main instrumental method of diagnosing osteoarthritis is radiography; Calculated or magnetic resonance imaging is recommended in cases where the diagnosis is unclear.

Osteoarthritis of the knee and hip joints is a leader in terms of the severity of clinical manifestations and adverse effects on quality of life.

Additional diagnostic methods:

atraumatic arthroscopy;
ultrasound (assessment of articular cartilage thickness, synovium, condition of joint capsules, presence of fluid);
scintigraphy (assessment of the condition of the bone tissue of the heads of the bones that make up the joint).

How to treat osteoarthritis?

It is better to treat osteoarthritis of the joints at an early stage, the treatment itself should be pathogenetic and complex. Its essence is to eliminate the causes that contribute to the development of this disease, as well as to eliminate inflammatory changes and restore previously lost functions.

Treatment of osteoarthritis is based on several basic principles:

Joint oxygenation or so-called intramuscular oxygen therapy.
Drug treatment.
Intraosseous obstruction, as well as decompression of the meteepiphysis.
Sustained diet.
Damaged joints need to be relieved of excessive stress. If possible, it should be kept to a minimum during treatment.
Follow the established orthopedic mode.
Physiotherapy exercises.
Physiotherapy course consisting of magneto and electrotherapy, shock wave and laser therapy.
Sanatorium treatment. To do this, once a year on the advice of a doctor should undergo a course of treatment in specialized resorts.

Preparation for the treatment of osteoarthritis

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

Therapy includes the following medications:

Anti-inflammatory drugs. By starting a comprehensive treatment for osteoarthritis, it is possible to slow the progression of the disease and significantly improve the quality of life. It is worth giving more information about some treatment points. In particular, drug treatment includes the initial stage - the elimination of the pain syndrome, as well as the elimination of inflammatory processes occurring in the joints. To do this, all doctors use non-steroidal anti-inflammatory drugs. Experienced doctors do not recommend oral administration, as these drugs are highly irritating to the stomach wall. Therefore, depending on the drug chosen, either intravenous or intramuscular administration is used. Sometimes NSAIDs are used as adjuvants in the form of ointments, but their absorption is extremely low, so a significant result can not be obtained.
Hormonal corticosteroids. When osteoarthritis is in the inflammatory phase of the disease, it is recommended to take hormonal corticosteroids. They are injected together. Externally, you can use a special plaster, ointment or tincture made on the basis of hot pepper.
Chondroprotectors aimed at restoring cartilage and improving the quality of synovial fluid are no longer available. The course lasts long enough, until there is a development. However, if the expected effect does not appear within six months of application, the drug should be discontinued. In addition to intramuscular chondroprotectors, it is recommended to use drugs based on hyaluronic acid. They help to form the cell membrane that is responsible for the formation of joint cartilage.

Physiotherapy

Physiotherapy is sent to a patient with osteoarthritis to reduce pain, reduce inflammation, improve microcirculation and relieve muscle spasms:

In the acute stage. Assign laser therapy, magnetotherapy and ultraviolet radiation,
In remission. Shown electrophoresis and phonophoresis.

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

Surgery

If the methods of exposure listed are ineffective, surgical treatment of osteoarthritis is recommended in case of complications:

Decompression of the metaepiphysis and prolonged intraosseous block (decrease in intraosseous pressure in the affected area);
Corrective osteotomy;
Endoprosthetics of joints.

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

Folk remedies

Most people today do not want to take pills and injections. Therefore, the question arises - how to treat osteoarthritis with folk remedies? Most of these funds are aimed at increasing body tone, improving blood circulation, reducing pain and increasing immunity.

Traditional medicine is used to treat this disease:

Egg solution is made from fresh egg yolk mixed with turpentine and apple cider vinegar in a ratio of 1: 1: 1. The liquid should be thoroughly mixed and rubbed on the affected joint overnight. Then you need to wrap everything in a woolen scarf. It is recommended to rub 2-3 times a week for 1 month.
Get elecampane root from a pharmacy. As a rule, it is collected in packages of 50 grams. To prepare the tincture you need half a packet of vegetable root and 150 ml of high quality vodka. The composition is mixed, placed in a dark bottle and infused for 12 days. Rolling is done before bedtime and in the morning if possible.

The use of boiled oatmeal also gives good results. Take three to four tablespoons of oatmeal, pour boiling water over it and cook on low heat for five to seven minutes. The amount of water used should be cooled and given a thick porridge used as a compress overnight. Use only freshly boiled flakes. Yesterday's porridge is not good for a compress.
maple leaves, nettle leaves and calendula inflorescences are taken in equal parts. As a result, you need to take two tablespoons. We put the resulting crushed collection in a thermos, fill it with a liter of boiling water and leave overnight. Starting the next day, you should take half a glass of broth four or five times a day. The period of purchase of this recipe is two to three months.

Tinctures of bay leaves, horseradish, garlic and rye grains are also considered effective. Folk remedies for osteoarthritis are most effective when combined with medication.

Nutrition for osteoarthritis

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

Avoid heavy meals at night to prevent osteoarthritis.
Eat in pieces.
Always manage your weight to lose weight,and therefore extra stress on the wound joints.
If there is no aggravation of the disease, walk after eating.
The menu should be designed and balanced by the attending physician.

There are no complaints about fish dishes - most of them you can eat naturally in reasonable quantities.

Don't forget to take vitamins regularly. B vitamins are especially important for patients with osteoarthritis
Jelly meat plays an important role in the treatment of osteoarthritis. This type of food will be a real storehouse of trace elements for wound joints. The most important component in aspic is naturally occurring collagen
Vitamin B helps produce hemoglobin. It can be "obtained" by eating bananas, nuts, cabbage and potatoes. It is worth dealing with grasses and legumes. These will be a source of folic acid. Liver, mushrooms, dairy products, as well as eggs will be useful. Rich in riboflavin

After a treatment regimen prescribed by a doctor, it is possible to reduce the disease and begin to regenerate the damaged tissue.

Prevention

Prevention of osteoarthritis begins with proper nutrition. In addition to foods that can disrupt metabolism, you should try to reduce salt intake. These include legumes, fatty meats and alcohol. The diet includes cabbage, greens and fish.

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

Forecast

Life is convenient. The availability of a social and labor prognosis depends on the timing of the diagnosis and the start of treatment, which is reduced when the decision on surgical treatment of the disease is postponed, if necessary.