Osteoarthritis is a degenerative-dystrophic diseases of the joints, by a slow and progressive destruction of the intra-articular of the cartilage. The arthritis includes a group of destructive joint diseases of inflammatory nature, which have different causes and similar mechanisms of development.
Osteoarthritis - one of the most common diseases in the world, occupying the leading Position in women and men older than 30 years, and with age increases the risk of diseases.
The causes of the pathology
Osteoarthritis develops as a result of infringement of metabolism in the joints, the background of the intra-articular cartilage loses water and is not elastic. Predisposing factors of such changes in the cartilage can causes internal and external:
- hormonal changes;
- age features;
- genetic predisposition;
- rheumatoid Arthritis;
- excessive load on the joints;
- the laid-wounds and injuries – sprains, bone fractures, heavy bruising, torn ligaments;
- Change of metabolism in the interior of the joint is associated with obesity, Diabetes mellitus;
- Under cooling;
- Inadequate and unbalanced nutrition, causing the body to lose Calcium, Omega-3 and 6, fats, and proteins;
- Inflammatory process in the joint;
- Circulatory disorders of the femoral head – Perthes disease;
- Problems with the coagulation of the blood, genetic disorders;
- Autoimmune disease – Lupus erythematosus, rheumatoid Arthritis.
The development of osteoarthritis also provoke specific diseases of the joints, namely:can
- Gonorrhea;
- Syphilis;
- Hyperthyroidism;
- Thyroiditis.
In the group of risk people, the forced with heavy physical work, constantly supercool and experience increased load on the musculoskeletal system – the miners, Smiths, athletes, movers, and pregnant women.are
Symptoms of osteoarthritis
The first Symptom of osteoarthritis is pain at the slightest load on the joint, it's fast, as soon as the joint is at rest. Osteoarthritis is characterized by the 4 main clinical features are:
- Pain – pain associated with osteoarthritis, some of the special features in contrast to pain in the event of accidental injury to the joint or inflammatory process in it. Especially the attention should be paid to the emergence of discomfort and pain with every movement and strain on the affected joint. Should be a Person of the movement to stop and remove the load, as the pain is gone immediately, which is not the case in the case of injury or inflammation of the joint. In the night, collapsing joint is causing the patient discomfort, pain in the change of the Position of the body, but they pass quickly. In marked progression of the destructive processes within the joint, progressing at night, sharp pain, shoot, the way with the time stronger and stronger, and bring changes in the life. Acute pain occurs with changes in the weather, the changing phases of the moon, the least amount of stress.
- Crunch – the sound occurs as a result of the decline in the softness of the Rotation of the bone, the use of the joint, to take advantage of what the friction of the bone against each other, and a crunch accompanied by a characteristic. As the progression of the degenerative processes in the joint grinding is becoming stronger and pain.
- Restricted mobility of the joint in the initial stage of development of the pathological process marked limitations of mobility, but with progression of joint destruction of the patient's progress to commit more and more difficult simple steps. Finally, the affected joint is completely immobilized.
- Deformity of the joint – on the bone surface and begin to grow actively osteophytes and collects the synovial fluid. Deformity of the joint occurs in an advanced degree of the pathological process.
Degenerative processes in the joint do not develop quickly, characteristic of the disease, Phase of exacerbation and Remission, the patients go in a hurry, a doctor, a contribution to the further development of destructive processes within the joint.
Stage
The stage of Progression of the pathological process in the joint is determined with the help of the x-ray examination. You only mark the 4 stages of the disease:
- The first is with the insignificant narrowing of the columns are not sustawnoj, however, no pathological growths on the bone use;
- The second – there is slight joint space narrowing, on the surface of the bone osteophytes are formed;
- The third joint surface gap is narrowed, on the surface of the bone, multiple osteophytes, observed deformation of the joint;
- The fourth joint gap does not almost exist multiple osteophytes, severe deformation of the joint.
Degree
Osteoarthritis is affected, as degenerative-destructive processes in the joint, in consequence of the cartilage, around develop changes in the capsule and synovium of the joint, as well as in the bale to him, and bony structures. Depending on the severity and the expression of the above-mentioned destruction 3 degree of osteoarthritis, it is accepted.
The first degree
Pronounced Deformation or changes in the joint, but the synovial fluid is disturbed, this leads to insufficient supply of the joint tissue with nutrients, water and trace elements, causing the cartilage to quickly suitable to a non-elastic, and not at the expense. With time, it causes inflammation and is accompanied by pain with movement and stress on the joint.
In the first stage of osteoarthritis, none of their patients do not seek medical help, depreciation discomfort and pain in an uncomfortable posture during sleep, fatigue, unhealthy way of life. Sometimes the Patient can notice the characteristic crunch in the area of the affected joint, but it is not accompanied by strong pain, but just discomfort, that no one attracts considerable attention.
If the osteoarthritis is diagnosed by chance in the first stage, then the disease is easily treatable.
The second stage
In this stage of the disease of cartilage tissue is accompanied by destructive processes within the joint. On the surface of the bone reinforces osteophytes grow, and the more intense the load on the range, the more pronounced the progress of the destruction.
The Patient complains of constant pain and shoot type, not felt regularly by itself and can take a long time. Then the disease progresses again. Against the background of this disease process of the muscles that surround the inflamed joint, gradually lose their function, what is the Patient tired quickly and can't withstand physical activity, the bear slightly earlier. The second degree of osteoarthritis, the Patient has gradually the Deformation of the cartilage and the joint progresses.
The Third Stage
The hardest part is. Intra-articular of the cartilage of the affected joint becomes thinner and exhausting destroyed, which leads to a clearly visible deformation and dysfunction of the affected limb. Located in the vicinity of the ligaments and joint missty a noticeable lack of nutrients and oxygen, and gradually atrophy, accompanied by a severe loss of mobility. The Patient is all the time tormented by acute pain, which increases with every attempt to change the Position of the body, changes in the weather and the phases of the moon and gradually leads to a complete loss of legal capacity.
Types of osteoarthritis
Depending on the cause distinguish triggered by a pathological process inside the joint primary osteoarthritis, secondary, idiopathic.
Primarily developed as a distinct disease, which is secondary as a result of a previous injury or infection, and the cause of the idiopathic Form. In addition to the classification of the disease depending on the cause of the pathological process, destructive changes differ according to the place of the localization of osteoarthritis:
- Osteoarthritis is the most common type of pathology, characterized by the defeat of the knee joints. Most often osteoarthritis of the knee show for people with obesity, chronic diseases of metabolism in the body, weak immunity. King meadow-osteoarthritis progresses, a long time, and gradually leads to a complete loss of motor functions.
- Osteoarthritis of the ankle – the main reasons for the development of degenerative processes in the area of the ankle are the laid-injuries, dislocations, sprains, bone fractures. In some cases, can trigger the development of the pathological process of autoimmune-disease – rheumatoid Arthritis. The ankle is susceptible to osteoarthritis, dancers, women wearing High Heels, athletes.
- Osteoarthritis of the shoulder joint – the main cause of degenerative processes in this area are congenital malformations of the shoulder joint or excessive strain on this area, for example, when carrying heavy Luggage on the shoulders.
- Coxarthrosis, or arthrosis of the hip joint are the main cause of age-related changes in the tissues of the joint. In the group of risk people older than 45 years.
- Encountres or osteoarthritis of the cervical spine – causes are injury to the neck, progressive osteochondrosis, obesity, lack of exercise. In the group of the risk, the people working at the Computer in the office. Apart from the pronounced pain in the neck in patients with significant dizziness, Depression of consciousness, memory disturbances and fatigue. These symptoms are feeling of pressure vertebral artery, in the brain nutrients and oxygen.
- Spondylarthrosis – destructive destruction prone to the tissues of the spine, namely the lumbar spine in his Department. In the group of risk of women in the time of the Menopause, since the spondylarthritis progress against the noticeable lack of female sex hormones.
- Osteoarthritis of the Finger develops from the same reason that spondylarthrosis.
- The polyarth roses – lesions of multiple joints with Progressive degenerative processes in them, in the pathological process involved ligaments, muscles and joint surrounding tissue.
Possible Complications
If not timely diagnosis and treatment of osteoarthritis progression, spread to the other joints, and promote the development of the gruzevich of projections and development of the total of the polyarth roses.
Complications of osteoarthritis are those States:
- the destruction of the integrity of the joint;
- shape deformation;
- Restriction of mobility;
- Disability of the patient.
All of these complications lead to a significant reduction in the quality of life of the patient, the accession of opportunistic diseases and injuries, the full immobilization of the patient.
Methods of diagnosis
For the diagnosis of the disease, the Patient should stomatologist the help of the trauma-orthopedists. In order to differentiate osteoarthritis from other pathologies of the joints and of the musculoskeletal system x-ray prescribed in 2 projections. This study allows to accurately determine the modified areas of the tissue adjacent to the affected joint, the use of the presence of destruction in the bone and ligaments, osteopenia growths.
If necessary the doctor will appoint patients MRI, CT scan can extend to the arthroscopy. In some cases, the puncture of the joint to produce for the extraction of synovial fluid sample.
The treatment of osteoarthritis
The treatment of osteoarthritis of the best, in the early stages, then the disease will be better suited for conservative therapies. It is important to the cause of progressive destructive changes in the joint and to stop in time, these factors.
The treatment of osteoarthritis in a complex and consists in the elimination of the inflammatory process, pain relief, stop the progression of the pathological process and the possibility of recovering the lost functions of the joint. The conservative therapy includes the selection of drugs and physiotherapy treatments.
Drug Treatment
The treatment of osteoarthritis is different at different points in the localization of the pathological process:
- Osteoarthritis of the fingers and hands of patients to reduce pain prescribe non-steroidal anti-inflammatory drugs in the Form of ointments, cream, Gel,. For the prevention of the progression of the pathological process, the recording of chondroprotectors shows. After the relief of acute inflammation, massage and physio to prescribe therapeutic therapies.
- In the case of osteoarthritis of the shoulder joint to the inner joint of the patient to be introduced, by injection of painkillers and non-steroidal anti-inflammatory drugs. Oral can prescribe antispasmodic medications that relax the muscles and some of the reduction in the intensity of the pain. After the relief of acute inflammation and the pain gymnastics, and Massage shown sick.
- The osteoarthritis of the knee – prescribe non-steroidal anti-inflammatory drugs topically in the Form of compresses, ointments, gels. On the area of the affected joint physio shown therapeutic methods of treatment.
- Osteoarthritis of the hip joint – to the affected area with a compress applied, impregnated with an ointment or Gel from the group of NSAIDs and inside the joint, painkillers injected by injection.
- Osteoarthritis of the knee joint – the Zone of destruction are ointments and gels has an analgesic effect, and after the relief of acute pain and inflammation physio shows therapeutic treatments.
- Ankle arthritis – Patient strict bed rest is recommended, with maximum relaxation of the affected joint. As the acute inflammatory process physiotherapy, baths, massages assigned.
Physiotherapy Treatment
To the effective physio therapeutic methods, often used in different degrees of severity of osteoarthritis include:
- Shock-Wave-treatment – effective osteophytes relieves the patients of growths, resulting in pain and limitations of mobility of the joint;
- The Stimulation of the muscles increase the affected joint to the current, this method is very effective for patients with severe reduced mobility and improves the blood circulation in the joint to accelerate regenerative processes, muscle tone;
- Ozone therapy – in the cavity of the affected joint is injected with the gas mixture to be normalized, making the patient less pain, mobility of the joint again, disappearance of the signs of inflammation. For maximum effect, ozone therapy courses;
- Phonophoresis – the impact on the affected area ultrasound waves with the drugs. This method of application of the drugs very much better, since the ultrasonic waves to deliver the drug directly into a hotbed of defeat.
In addition to physiotherapy treatment, physiotherapy, massage, manual therapy, mechano-therapy.
Diet meals
Diet for osteoarthritis should be balanced and rich in polyunsaturated fatty acids, proteins, trace elements. It is recommended in the diet of fresh fish, vegetable oils, cheese, dairy products, meat, fresh Can and fruit.
From the diet exclude floury products and "fast" carbohydrates, chocolate, coffee, alcohol, pig meat, fat and spicy food should be.
Surgical Treatment
To diagnosed when conservative therapies have led to the desired result or osteoarthritis is the most advanced stage, where there is severe degenerative changes in the joint with marked restriction of mobility, then the Patient will prescribe surgery.
Surgical treatment of osteoarthritis in several ways:
- Puncture of the affected joint – this method is both diagnostic and therapeutic. Fence sample of the joint fluid, you can determine exactly the type of emergence of the disease to pick up and effective medicines. During the Operation, during the puncture of the joint cavity glucocorticosteroids and various inflammation injected-inflammatory drugs, which relieves the pain immediately and relieve the stress on the joints.
- Arthroscopy – in the joint cavity arthroscope is introduced for a thorough examination of the joint from the inside. During the Operation, the doctor can immediately use to remove growths on the bone, and various neoplasms.
- Osteotomy – bone use during the Operation of the joint a little correct of special tools and in the right Position, so that not only the motor function to restore, but to rid the patient of the discomfort and severe pain.
- Prosthetic joint replacement – the damaged joint is removed and in its place a tooth replacement made of high quality Material, which completely takes over the lost functions of the joint, a full mobility of the limbs, and relieve the patient of pain.
Prevention
Prevention of osteoarthritis consists of a in a single campaign:
- the management of a healthy and active lifestyle;
- rational and well-balanced diet;
- Exclusion of bad habits;
- The prevention of injury and damage to the joints;
- timely treatment of inflammatory processes.
People from risk groups should be especially orthopedists attentive to the smallest changes in the working of the joints and the occurrence of pain, crackling and creaking to the stomatologist of the immediately the Council of experts of the trauma.