Osteoarthritis is a chronic degenerative disease that affects all parts of the joint: cartilage, articular membrane, ligaments, capsule, periarticular bones, and periarticular muscles and ligaments.
According to European doctors, osteoarthritis accounts for almost 70% of all rheumatological diseases. People aged 40 to 60 are most susceptible to joint osteoarthritis. This is promoted by a lack of exercise as well as by persistent overload, poor nutrition and of course injuries.
What is a joint?
Typically, a human joint consists of two or more connecting bones. All working surfaces of the joint are covered with a protective layer and are constantly lubricated with synovial fluid for optimal gliding. The joint cavity itself is hermetically sealed by the joint capsule.
There are many joints in our body that are "responsible" for certain types of movement, can experience different loads and have different safety margins.
The amount of movement in the joints depends on the structure of the joint, the ligaments that limit and strengthen the joint, and the various muscles that are connected to the bones via tendons.
Causes of joint osteoarthritis
The constant self-renewal of the cartilage tissue enables the joints to function normally. At a young age, the death rate of old joint cells is equal to the birth rate of new cells. Over the years, the process of cell renewal slows down and the cartilage tissue begins to become thinner. The production of synovial fluid also decreases. The result is that the joint cartilage becomes thinner and breaks down, leading to osteoarthritis.
There are also other causes of joint arthrosis:
- increased physical activity. Osteoarthritis of the joints is a common side effect of being overweight. Overloading causes microtrauma in the joints. In athletes, joint damage occurs due to increased stress on "unheated" joints;
- joint injuries;
- congenital or acquired deformities of the musculoskeletal system (rickets, kyphosis, scoliosis, defective bone fusion after injuries with the appearance of limb deformities: O-shaped and X-shaped deformities of the legs).
Stages of osteoarthritis
Depending on the degree of destruction of the cartilage tissue, different stages or degrees of osteoarthritis can be distinguished.
Extents and symptoms of osteoarthritis
- Grade 1 osteoarthritis is characterized by periodic joint pain, especially with increased physical activity. The pain usually disappears after rest. The range of motion in the joint is not restricted and the muscle strength in the injured limb is not changed. X-rays may show minimal signs of joint damage.
- Osteoarthritis of the 2nd degree is manifested by painful sensations not only during heavy physical exertion, but also during light exertion. Even with rest, joint pain may not go away. This degree is characterized by stiffness of movement and limited mobility of the joints. This ultimately leads to muscle loss. An x-ray may show deformation of the joint, a reduction in the joint space, and the appearance of bone growth near this gap.
- Osteoarthritis of the 3rd degree – every movement causes a person great pain. Pain in the joint also occurs when at rest. Therefore, a person tries to move as little as possible so that pain is minimal. In some cases, movement requires the use of crutches or a stretcher. Sometimes bone fusion occurs - ankylosis (as in ankylosing spondylitis).
In deforming osteoarthritis, irreversible changes occur in the cartilage tissue of the joint and its function and structure are completely disrupted. Deforming arthrosis of the joints is due to the occurrence of a dysfunction in the formation of hyaline cartilage and synovial fluid.
Diagnosis of joint osteoarthritis
The most important method for joint diagnosis is radiography. With osteoarthritis, joint changes, uneven joint surfaces and a narrowing of the joint space can be observed.
Which joints are more commonly affected by osteoarthritis?
The extremity joints most susceptible to osteoarthritis are the hips, knees, shoulders, elbows and hands.
If you have osteoarthritis of the hip joint, you may initially experience slight discomfort in your legs after running or walking. Over time, the pain increases, movement restrictions and stiffness occur. In stage 3 disease, the patient protects their leg and tries not to step on it if possible.
Osteoarthritis of the knee joint is manifested by pain in the knee joint after bending and straightening the legs. The most common cause of knee osteoarthritis is injuries sustained in the past. These injuries disrupt the sliding of the joint surfaces and cause them to wear out quickly. In some cases, the joint may gradually lose its mobility.
Osteoarthritis of the ankle manifests itself as swelling and pain in the ankle area of the leg. The cause of arthrosis of the ankle joint can be: deformations, fractures of the ankle joints and talus, dislocations, flat feet, chronic injuries to the ankle joint in athletes and ballerinas. By the way, they often have arthrosis of the foot.
Osteoarthritis of the shoulder, elbow and wrist joints most often occurs as a result of injuries, bruises, dislocations and intra-articular fractures. Osteoarthritis of the shoulder joint is characterized by pressing, aching, dull pain that radiates to the forearm and hand. The pain most often occurs at night. With osteoarthritis of the hands, the pain is accompanied by dysfunction of the hand.
Treatment of osteoarthritis
The main means of treating osteoarthritis are drug treatment, the use of physiotherapy and surgical treatment.
Medication
The use of medications helps to improve blood circulation in damaged joints, restores the properties of cartilage and has an analgesic and anti-inflammatory effect.
Non-steroidal anti-inflammatory drugs
With osteoarthritis, the joint can swell, the joint begins to hurt and mobility decreases. Taking anti-inflammatory drugs (NSAIDs) reduces pain, stops the inflammatory chain reaction, and accelerates the process of cartilage restoration.
The drugs can be used in the form of tablets, rectal suppositories and powder. However, remember that self-medication is not acceptable; The selection and dosage of medication for osteoarthritis is carried out by a rheumatologist.
Centrally acting painkillers
Opioid medications lower the patient's pain threshold. Such medications may be taken strictly according to a prescription and only under medical supervision!
Chondoprotective drugs
Chondoprotective drugs are structural elements of the cartilage itself, therefore they actively restore this tissue and prevent its further destruction. Treatment is effective in the initial stages of the disease. If the joint is already completely destroyed, it is not possible to restore the original shape of the deformed bones or to form new cartilage.
However, in stages 1-2 of osteoarthritis, chondroprotectors can bring significant relief to the patient. Combination preparations containing both glucosamine and chondroitin sulfate provide better results compared to a single-component preparation.
Chondroitin sulfate and glucosamine sulfate
These medications help slow the inflammatory response in tissues, reduce cartilage damage, and relieve pain. Most often, these two drugs are used together in treatment, as they have an accumulating effect, but they must be taken for 3-6 months.
Hyaluronic acid
Provides viscosity and elasticity of synovial fluid. Promotes good gliding of the joints. Therefore, doctors often prescribe injections of hyaluronic acid into the affected joint.
Physiotherapeutic treatments
Physiotherapy treatments may include:
- UHF therapy;
- magnetic field therapy;
- Low intensity laser irradiation;
- electrophoresis with medication;
- Phonophoresis (introducing a drug into the site of inflammation using ultrasound).
surgery
Surgical treatment is aimed at restoring and improving joint mobility and removing parts of the cartilage or damaged menisci.
In extreme cases, surgical treatment of arthrosis is resorted to when drug treatment does not bring results, when severe pain occurs and the joints are partially or completely immobile.
During arthroscopic surgery, it is possible to remove part of the cartilage affected by arthrosis, polish it to obtain a smooth surface, remove fragments and growths of cartilage, and cut off part of the damaged ligaments.
Knee replacement
During this operation, the articular surfaces of the knee joint are replaced with metal or combination prostheses. The prepared plates replicate the surface of the articular cartilage. Such prostheses are made from special alloys; They do not trigger a rejection reaction in the patient, do not oxidize and do not injure the surrounding tissue.
Hip surgery for osteoarthritis
This operation involves partial removal of the cartilage and bone tissue of the pelvis and femur. Typically, the femoral head and articular surface of the pelvic bone are removed and replaced with a metal or metal-ceramic prosthesis.
Diet for osteoarthritis
Excess weight is a big enemy of your joints. Most patients with osteoarthritis of the hip and knee joints are overweight.
Therefore, a properly selected diet is recommended for arthrosis. Jellied meat cooked in cartilage broth is believed to be helpful for osteoarthritis. It contains a lot of collagen and structural components of cartilage, which help restore cartilage tissue.
Dairy products, protein and calcium are beneficial. Animal protein is found in lean meat and fish, while plant protein is found in buckwheat porridge, beans and lentils. Boiled, stewed and stewed dishes are very healthy.
The best diet for joints is one that is light in carbohydrates (preferably complex carbohydrates), fruits and vegetables, and adequate amounts of protein and calcium.
Prevention of osteoarthritis
Prevention of osteoarthritis, no matter how trivial it may be, lies in a healthy lifestyle. If possible, try to be in the fresh air, exercise, walk barefoot on sand, green grass and just on the ground. This type of walking improves muscle function and increases blood flow to the feet.
The use of physiotherapy with various arm and leg swings, twists and bends provides useful support for your joints.
Patients often ask themselves whether an alternative treatment for osteoarthritis is possible? Yes, folk remedies can help in the initial stages of the disease, relieve pain and improve the general condition of the patient. However, it does not replace following your doctor's instructions.