Today, osteoarthritis of the joints is the most common of all musculoskeletal pathologies. In addition, city dwellers, people who are accustomed to a sedentary lifestyle, and people who have recently suffered injuries of varying intensity, most commonly suffer from joint diseases.
The doctors' prognoses in this regard are disappointing. It is believed that in the near future, the number of people suffering from various forms of large joint osteoarthritis will only increase. According to the latest data, about 7 percent have experienced all of the symptoms and consequences of osteoarthritis.
This disease has become a leading cause of disability and poor performance. It is characteristic that the highest incidence occurs in the age groups from 40 to 60 years and not only in older retirees, as is wrongly assumed.
What is osteoarthritis?
Osteoarthritis (another name for osteoarthritis) should be understood as a complex degenerative pathology in which the cartilage plate of the bone that makes up the joint is destroyed. The reasons do not only lie in the processes in the hyaline cartilage.
There are many other conditions for the disease.
Osteoarthritis of the joints develops under the condition:
- excessive physical activity. Usually obese people get sick in such cases. Human joints are not designed for constant movement with heavy loads. For this reason, the increased compression of the knees during activity becomes a prerequisite for microtrauma of the cartilage tissue. There is a violation of the sliding properties of tissues and a decrease in joint mobility. Athletes often suffer from systematically damaged joints due to sharp and frequent changes in natural pressure between the joint surfaces or high stress with insufficiently heated joints.
- congenital or acquired malformations, injuries to the musculoskeletal system. In such conditions, the disease is provoked by insufficient contact between the articular surfaces of the bone. It is absolutely impossible to distribute all of the load on the joint, and injuries occur in areas of excessive compression. Notable examples of such an injury are rickets, scoliosis, and kyphosis. It should also include improper fusion of broken bones and various deformities of the limbs.
- Injury to cartilage regeneration. This mechanism of the development of osteoarthritis is observed in the presence of an inflammatory process in the body, impaired blood circulation and hormonal disorders. The problem is based on insufficient restoration of lost cartilage tissue, lack of natural remodeling and thinning.
- Problems with the formation and production of synovial fluid. With insufficient synovial fluid, the friction surfaces are constantly injured, their wear and tear and inflammation accelerate, the general condition of the body deteriorates.
Stages of osteoarthritis
Since the disease osteoarthritis provokes the destruction of the cartilage tissue of the joint, its symptoms vary significantly depending on the stage of the pathological process.
As a result of the active destruction of the joint surface, new symptoms appear in a person, and the prognosis for the restoration of motor activity does not change. Based on the clinical picture of the disease, the doctor will choose the optimal method of treatment and drugs.
1st degree osteoarthritis is characterized by the fact that discomfort and slight pain can only be felt after prolonged intense exertion. After a short break, the signs that have appeared during physical activity will go away.
In this case, the joint lesions will not be visible on the X-ray, but the joint space may narrow slightly.
Stage 2 of the pathology is characterized by an increase in symptoms. Now there is pain not only as a result of prolonged activity, but also with minor movements of the limbs.
Calm does not bring the desired relief. There is stiffness in movements, the mobility of the joint is limited. It is recommended at this time to reduce the load on the affected joints, but it should not be completely ruled out, otherwise muscle atrophy will occur. An x-ray shows clear signs of osteoarthritis:
- Bone growth;
- Deformation;
- Neoplasms (osteophytes) near the joint space, its narrowing.
When the disease reaches its terminal stages, the lesions in the joints cause excruciating pain. Therefore, at the reflex level, a person begins to severely restrict their movements in order to protect the affected joint from stress. Pain syndrome also occurs during sleep and rest when the joints are at rest.
The patient is forced to take the position in which he is the least painful. Movement is only possible with the help of a wheelchair or crutches.
It is characteristic that the 3rd and 4th degrees of osteoarthritis can completely deprive a person of the ability to walk due to the merging of the articular surfaces (ankylosis).
Which joint is most commonly affected?
According to medical statistics, the lower extremities are most susceptible to osteoarthritis. The joints suffer from inflammation and degeneration: hips, knees.
If there are problems in the hip joint, pain in the pelvis can be felt after a long walk or run. With the active progression of the pathology, the pain increases and mobility is reduced.
A person will notice an uncomfortable stiffness in the joint, and in certain positions the stiffness increases several times at the same time. In the last stages of osteoarthritis of the hip joint, the patient unconsciously protects the affected leg and tries not to step on it at all. He doesn't move his pelvis, which helps relieve pain.
Osteoarthritis of the knee joint manifests itself in discomfort and pain after walking. There are no external manifestations of the problem and inflammation. The most common prerequisite for osteoarthritis of the knee joint is the trauma in the past against the background of damage to the internal structures.
Such lesions usually cause abnormalities in the vicinity of the articular surfaces in contact. Also takes place:
- Congestion of certain areas of the cartilage;
- their rapid wear and tear.
Changes, as in the previous case, depend on the degree of osteoarthritis. You should also take into account the causes of the disease, the availability of adequate medical care, the general condition of the body and the dynamics of the pathological process. Some forms of the disease go unnoticed for a long time and do not progress.
Sometimes, even for decades, there is no obvious deterioration in the knee. In other cases, there is a rapid increase in symptoms and a high likelihood of loss of mobility.
Get rid of osteoarthritis
Today there are two main directions in the treatment of osteoarthritis of large joints: medical and surgical.
The treatment is initially aimed at quickly improving the blood flow to the diseased joint and accelerating the properties of the cartilage tissue with the help of drugs. Anesthesia and removal of inflammation are also required. For this purpose, doctors practice the use of the following drugs.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
These drugs disrupt the natural chemical chain in cartilage that causes inflammation. The tissue swells, pain occurs, and cartilage strength decreases during movement.
Thanks to the use of anti-inflammatory drugs, it is possible to reduce or completely stop the pain syndrome. The initiation of the so-called chain inflammatory process is also prevented, which helps to accelerate the regeneration of the affected areas.
Medicines are made in the form of tablets, powders and rectal suppositories. The tactics of treatment, the choice of a certain drug is determined by the doctor strictly individually, based on the clinical picture, its dynamics and associated pathologies.
Opioids and chondroprotectors
Strong centrally acting pain relievers are called opioids. Usually, such drugs have a narcotic effect on the body and raise thresholds for sensitivity to pain. Thanks to this treatment, pain in the affected joints can be reduced.
The use of drugs in this group should be strictly under the supervision of the attending physician, since such drugs cause mental and physical dependence.
To accelerate the restoration of cartilage tissue, special means are used - chondroprotectors. By and large, they are the structural elements of cartilage itself, which allows them to have an activating effect on your recovery.
These drugs include:
- Chondroitin sulfate;
- Glucosamine sulfate;
- Hyaluronic acid.
Chondroitin and glucosamine are organic substances that are abundant in the intercellular space of the cartilage. The mechanism of their effect on joints is not yet fully understood, but it has been repeatedly demonstrated that it has a beneficial effect on the regeneration of cartilage tissue during treatment.
Chondroitin-based drugs activate the production of special substances from the extracellular cartilage matrix (proteoglycans and hyaluronic acid). At the same time, the resorption process in tissues is significantly inhibited. In the same way, certain chemical processes are suppressed, there is a decrease in inflammation in the cartilage, damage and the severity of the pain syndrome.
Long-term drug use in this group is often required. Treatment is required for at least 6 months. Otherwise, the benefit of the therapy should not be expected. The organic combination of chondroitin and glucosamine is more commonly practiced. However, clinical studies have not confirmed any significant difference between such treatment and using just one of the chondroprotectors.
Despite the obvious benefits and safety, due to the relatively high cost, not everyone with such drugs can treat osteoarthritis of the joints.
Hyaluronic acid is no less common in modern medicine. It is a long chain of carbohydrates that gives the synovial fluid elasticity and viscosity. The unique properties of hyaluronic acid are largely responsible for the good sliding properties of the synovial fluid.
Intra-articular injections of the drug have a good effect on the condition of the body, as studies have shown that osteoarthritis is often caused by a decrease in the concentration of hyaluron in the joint and a shortening of the chain of its molecules.