Osteoarthritis and a degenerative joint disease characterized by the progressive slow destruction of articular cartilage. Arthritis includes the un group of diseases of the joints, destructive and inflammatory nature, which have different causes and similar development of working mechanisms.
Osteoarthritis, one of the most common diseases in the world, occupying the leading position of the women and the homes of over 30 years and with age the risk of developing the disease only increases.
The causes of the pathology
Osteoarthritis develops as a result of a violation of metabolic processes in the joints, against which intra-articulate cartilage begins to lose water and becomes elastic. Factors of these changes in the cartilage can be internal and external reasons:
- the hormonal changes;
- age features;
- the genetic predisposition;
- rheumatoid arthritis;
- excessive load on the joints;
- the trauma and sprains injuries, fractures, wounds, torn ligaments;
- changes in the metabolism within the joint, associated with obesity, diabetes;
- hypothermia;
- I imbalance improper nutrition, causing you to lose the body calcium, fatty acids omega-3 and 6, proteins and fats;
- the inflammatory process in the set;
- violation of blood supply of the femoral head – Perthes disease;
- problems with blood coagulation, hereditary disease;
- autoimmune diseases – systemic lupus erythematosus, rheumatoid arthritis.
To activate the development of osteoarthritis can also specific diseases, that have nothing to do with the joints, and said:
- gonorrhea;
- syphilis;
- hyperthyroidism;
- thyroiditis.
At risk are people who engage in heavy physical work, forced hypothermia, and the experience of the object the extension of the stress on the musculoskeletal system – miners, Smiths, athletes, motors and pregnant women.
The symptoms of osteoarthritis
The first symptom of osteoarthritis and the pain to the minimum tension on the joints, which happens quickly, as soon as they left the set alone. L is for osteoarthritis characterized 4 major clinical signs:
- Pain – pain when osteoarthritis has some characteristics of a difference of pain accidental injury of the joint or inflammation in it. First of all, you should pay attention to the appearance of pain, physical discomfort, and to any movement and the load affected joint. There is one person to stop the movement and remove the tension, like the pain it goes as well as as well, which is not possible in trauma or inflammation of the joint. On the night of the collapse of the joint in virtually cause the patient discomfort, and the pain of a possible only when you change the position of the body, but that quickly pass. Ca serious of processes progression-destructive testing on the joints at the night of the pot experience sharp shooting pains, which will eventually become stronger and make adjustments to their style of life. Acute pain occurs with any change in the weather, the different phases of the moon, the lesser effort.
- Crisis – and thus the result of a decrease in the smoothness of the rotation of the bones around the joint, which leads to a rubbing of the bones against each accompanied by another and the characteristics of the crisis. The progression of degenerative processes in the joint, the crisis s sharpens, and it's accompanied by pain.
- Limitation of joint mobility – in the initial phase of development of the pathological process to express the restriction of the mobility that there is in the how, but the progression of the destruction of the articulation of the interior of the patient more difficult to do simple actions. Finally, the affected joint completely immobilized.
- Deformation of the joint – on the bone surfaces are beginning to grow osteophytes and synovial fluid s accumulates. Deformation of the joint s, which was observed in the operation extent of the pathological process.
Degenerative processes in the joint do not develop quickly the disease is characterized by phases of exacerbation and remission, what are patients reluctant to seek medical assistance, thereby contributing to the progression of destructive processes within the joint.
Stage
The stage of progression of the process in the pathological joint is determined by the use of raigs-x. Assign only 4 stages of the disease:
- It is The first characterized by a slight narrowing of the joint space, sense pathological growths in the bone that is there;
- Second – there are un small narrowing of the space of articulation on the surface of the bone osteophytes are formed;
- Third – the articulation of the reduced space and, on the surface of the bone multiple osteophytes, have a deformation of the joint;
- Fourth – joint cracks are almost not there, there are multiple osteophytes, severe deformation of the joint.
Degree
Osteoarthritis and expressed in the form of degenerative diseases destructive processes in the joint which affects the cartilage, develop changes in the and the capsule synovial membrane " of the joints and the ligaments around and bone structures. Depending on the severity and the intensity that these destructions accepted to allocate 3 degrees of osteoarthritis.
First grade
Expresses the deformation or the change of the joint but not disturbed synovial fluid – this leads to the insufficiency of the provision of the set of tissues with nutrients, water and mineral salts, causing the cartilage becomes no ca quickly more flexible and not adapted to the loads. Over time, this causes inflammation and is accompanied by pain with movement and l l en stress joint.
In the first grade of osteoarthritis one of their patients do not seek medical attention, the writing off of the discomfort and pain in an awkward position during sleep, fatigue, unhealthy lifestyle. Sometimes, the patient may notice a characteristic of the crisis in the affected joint, but this does not and accompanied by pain of serious, but only physical discomfort, again, do not pay a lot of attention.
If the osteoarthritis, and for accident diagnosed in the first stage, the disease is easily treatable.
Second degree
In this stage, the disease is accompanied by destructive processes in cartilage tissue in the joints. On the surface of the bone osteophytes grew, and the more intense the load on the affected area, the more pronounced progress of the destruction.
This patient is complaining of pain and pain characteristics, constant of character that are held regularly by themselves and can be a lot of time to be heard. Original work of art that the disease progresses again. In the context of the process of the pathological muscles that surround the inflamed joint, gradually lose their functions, causing the patient with facilitat tires and can't resist the physical stress that before easily suffered. In the second grade of osteoarthritis, the patient gradually deformity of the cartilage and joint.
Third grade
And the most serious. Intra-articulate cartilage affected of the joint thins s hard and it breaks, that leads to a clearly visible place, and the of the deformation, dysfunction of the limb is affected. Located next to the set of bindings and missty experiencing a shortage of nutrients and oxygen, and gradually atrophy, and that, accompanied by severe loss of mobility. In this case, the patient all the time who are suffering from acute pain, which increases with any intention to change the position of the body when the weather changes and the phases of the moon and gradually leads to the total loss of the function.
Types of arthritis
Depending on what and the cause caused by a pathological process within the set there are osteoarthritis, primary, secondary, and idiopathic.
Primary develops as an independent disease, the secondary, as a result of trauma or infection, and the cause of the form idiopathic and not known. In addition to the classification of the disease depending on the causes of the pathological process distinguish osteoarthritis in the place of location of changes earthquakes:
- Gonarthrosis and the type most Marta of pathology characterized by a knee injury. Osteoarthritis detected more often in people with obesity, chronic diseases of metabolism in the body, the immune system is weak. Osteoarthritis of the knee progresses for a long time and a little, a little leads to the total loss of the motor.
- Osteoarthritis of the ankle the main reasons of development of degenerative processes in the ankle are injury, sprains, strains, fractures. In some cases, the pathological process may trigger autoimmune disease – rheumatoid arthritis. Osteoarthritis of the ankle is exposed to a dancers, the women with the clutches, high, athletes.
- Shoulder osteoarthritis joint the main cause of degenerative processes in this phase are congenital abnormalities of the joint or shoulder of the excessive load in the area, for example, at the time of carry on Luggage heavy shoulders.
- Coxarthrosis, or arthrosis of the hip joint – the main cause of appearance are the age-related changes in the tissues of the joint. At risk are people over 45 years.
- Encountres or arthrosis of the cervical – causes of injuries are to the neck, progressive, low back pain, obesity, sedentary lifestyle. A risk of the people who work in the computer of the office. In addition to expressing the pain in the neck in patients with marked dizziness, depression of consciousness, impaired memory and fatigue. These are symptoms caused by the compression of the artery spinal, through which the brain receives nutrients and oxygen.
- Spondiloarthrosis – destructive destruction of the tissue affected of the spine, and, in other words, the lumbar region of his Department. In a situation of risk for women in the period of the menopause, such as the spondylosis progresses in the background of the deficiency of sex hormones.
- Osteoarthritis of the fingers – is developed by the same that the reason for spondylosis.
- The polyarthrosis – is characterised by the involvement of multiple joints progressive with degenerative processes in them, while in the pathological process involved ligaments, muscles, and tissues around the joint.
Possible complications
A lack of timeliness in the diagnosis and treatment of the progress to osteoarthritis involve other joints, promote the development of gruzevich emergencies and development total polyarthrosis.
Complications of osteoarthritis the following are the States:
- the destruction of the integrity of the union;
- the form of deformation;
- the limitation;
- disability of the patient.
All these complications lead to a significant decrease in the quality of life of the patient, attach related diseases and disorders, fully immobilize the patient.
Methods of diagnosis
For the diagnosis of the disease, the patient should seek the help of the traumatologist-orthopedist. In order to differentiate osteoarthritis from other diseases of the joints and diseases locomotor system of the is prescribed x-ray 2 projections. This study helps to identify the modified portions of the tissues adjacent to the affected joint, the presence of damage in the bones and ligaments, osteopenia expansion.
And necessary If the doctor may, in addition, prescribe the magnetic RESONANCE imaging, computed tomography and arthroscopy. In some cases, produce a puncture of the joint for specimen collection synovial fluid.
Treatment of osteoarthritis
The arthritis treatment is a better to do it in the early stages, then the disease better responds to conservative therapies. And important to establish the cause of progressive destructive changes in the joint and in the time of the arrest of these factors.
Treatment of osteoarthritis and complex and involves the removal of the inflammatory process, relieve pain, slow the progression of the pathological process and the restoration of the loss of the functions of the joint. Conservative therapy includes the selection of methods of physiotherapeutic drugs and treatment.
The medication
Treatment of osteoarthritis varies in different sites of localization of the pathological process:
- Osteoarthritis of the fingers and of the hands the patient to reduce pain prescribe non-steroidal anti-inflammatory drugs in the form of ointments, cream, gel. To avoid examining the progression of the pathological process, is shown receiving chondroprotectors. Original work of art of the relief of the acute inflammatory prescribed process for treatments, massages and physiotherapy.
- In the case of osteoarthritis of the joint shoulder of it into the joint injection, the patient analgesics and non-steroidal anti-inflammatory drugs. Oral can schedule a cita that are antispasmodic drugs that relax the muscles and something to reduce the intensity of the pain. Work of art the Original release of the of the acute inflammation and the pain shows therapeutic physical formacio and massage.
- Osteoarthritis of the knee managed with non-steroidal anti-inflammatory drugs topically in the form of compresses, ointments, gels. To the affected joint show physiotherapeutic therapies.
- L of the joint to arthrosis of the hip on the affected area pads soaked in apply the ointment or gel of the NSAID group, and within the union and injected with painkillers injection.
- Osteoarthritis of knee in the affected area, s tips gels, creams and l with analgesic effect, and original works of art for the relief of acute pain and inflammation in a sample of physical methods of treatment.
- Osteoarthritis of the ankle – the patient is recommended higher than strict rest with the maximum rest the affected by the joint. With the subsiding process of the acute inflammatory s assigned physiotherapy, baths and massages.
Physiotherapy
You physiotherapeutic used in different methods and degrees of severity of osteoarthritis are:
- Wave shock treatment-you get the patient the growth of osteophytes, and thus eliminate the pain and mobility limitation joint;
- Stimulation of the muscles around the affected joint electrical currents, this procedure and very sure for patients with severe difficulties of mobility and helps to improve the blood circulation in the joint, accelerate regenerative processes, improves the muscle tone;
- Ozone therapy, in the cavity affected the joint of the gas mixture enter, thereby decreasing the patient pain, normal joint flexibility, fade the signs of inflammation. For a un maximum effect, ozone therapy courses are conducted;
- Phonophoresis – the impact on the area affected by the waves of the ultrasound with the use of drugs. This method of drugs, a much more effective, since the ultrasounds of those deliver the drug directly to the lesion.
In addition to the physiotherapy treatment includes physical therapy, massage, manual therapy, mechanotherapy.
The diet
Diet for arthritis in the should be balanced, rich in I polyunsaturated fatty acids, proteins, trace elements. Recommended to include in the diet of fresh fish, vegetable oils, cheese, dairy products, meat, fresh fruits and vegetables.
From the diet should exclude flour products and "fast" carbohydrates, chocolate, coffee, alcohol, meat, pork, fat and spicy dishes.
Surgical treatment
If the conservative treatment has not brought a l o expected outcome osteoarthritis diagnosed at a very advanced stage, when there are changes pronounced degenerative the with the joint in severe limitation of mobility, then the patient is prescribed surgery.
Surgical treatment of osteoarthritis and taken out of destinations ways:
- Puncture affected the joint – both this method and diagnostic and therapeutic. Specimen collection synovial fluid allows to define precisely the nature of the origin of the disease and to select effective drugs. During the operation of the puncture in the joint cavity administered corticosteroids and anti-inflammatory drugs several, that relieves alleviates the pain and the burden of the joint.
- Arthroscopy in the joint cavity, the arthroscope to the un study of the comprehensive articulation of the interior. During the operation, the doctor can remove the growths in bones and various neoplasms.
- Osteotomy – the operation of the joints, the bones adjust a little special tools and fixed in the correct position, which not only allow to restore the motor function, but relieve also to the patient of discomfort and severe pain.
- Joint replacement and destroyed by the joint un and eliminated and in its place install a prosthesis of high quality materials, fully assumed that the functions of the loss is joint, full mobility of the limb is and save the pain of the patient.
Prevention
Prevention of osteoarthritis is part of the campaign:
- maintain a healthy lifestyle, active and lifestyle;
- I proper rational nutrition,
- elimination of bad habits;
- the prevention of injuries and harm to the joints;
- the treatment processes appropriate to the inflammatory.
The people of risk groups should be especially attentive to the slightest changes in the joints and the appearance of pain, crack and crack find immediately the advice of traumatologist-orthopedist.