A huge number of systemic pathologies can lead to a significant decrease in the quality of life, complete loss of working capacity and even severe disability. Diseases associated with the musculoskeletal system occur not only in old age. Every 2-3 cases are observed in patients of working age. The most dangerous and difficult to correct condition is arthrosis.
This degenerative disease is accompanied by thinning of the cartilage tissue in the large and small joints, which leads to a decrease in the range of motion and severe pain when trying to perform them. Serious consequences can be prevented only as a result of the appointment of adequate treatment at the earliest stages of the development of the disease. In this article, we will find out the causes of development, pathogenesis, clinical manifestations, modern methods of diagnosis and treatment of arthrosis.
Prevalence of arthrosis
Having paid attention to the statistical indicators, one can find that arthrosis is a very urgent disease, and every year the frequency of its occurrence only grows. According to the World Health Organization, pathology is observed in seven percent of the world's population. This puts it in first place in terms of detection frequency in comparison with other disorders of the musculoskeletal system.
Arthrosis is a chronic joint disease of non-inflammatory etiology that leads to deformities in the affected areas of the osteoarticular apparatus
Cartilage degeneration is often observed in young people, more often it can be found in men. Interphalangeal arthrosis is often detected in young girls. After reaching the age of fifty, the frequency of the lesion and the localization of the lesion becomes approximately the same in both sexes and is approximately 60%.
From the data presented, it can be understood that it is extremely important to identify pathology at an early stage in order to carry out the most effective drug therapy. Otherwise, the treatment of advanced arthrosis will be inaccessible for most elderly patients due to the financial component.
Causes and risk factors for the development of arthrosis
The frequency of occurrence of the presented joint disease has led to the fact that the problem is acute in the medical community of highly developed countries. Leading clinics spend hundreds of millions of dollars annually on research on arthrosis. The gradual study of the problem made it possible to find out the pathogenesis of the process and the factors that can increase the likelihood of an illness.
A modern and more complete classification of joint degeneration will be presented below, at this stage it is enough to understand that there are primary and secondary forms.
The reasons that can lead to the development of secondary joint disease include the following:
- congenital changes associated with the blood supply to the articular joints;
- trauma to the cartilaginous lip, ligamentous apparatus or bone growth zones;
- metabolic disorders, especially with the mineral link;
- autoimmune pathologies;
- infections affecting bone tissue;
Primary arthrosis is an independent disease, it can develop as a result of the influence of such provoking factors:
- old age;
- being overweight;
- excessive physical activity;
- joint surgery;
- genetic predisposition;
- insufficient nutritional intake of calcium and other minerals;
- chronic intoxication;
- long and frequent stay at low temperatures;
- frequent trauma to the bone articulation.
Arthrosis development mechanism
Normal bony articulation consists of two or more joint heads, ligamentous apparatus, cartilaginous lip, and synovial fluid. All these structures provide mobility in a certain area of the musculoskeletal system without painful sensations, they also allow to absorb the load received during walking and jumping, dissipating it without causing damage to the body.
Arthrosis of the joints belongs to a group of diseases of polyetiological origin. This means that most often the cause of development is the influence of a whole complex of triggers, including occupational hazards, overweight, old age and unhealthy diet. The pathogenesis lies in the fact that certain influences lead to a significant deterioration in blood supply and lymph outflow from the specified area.
Further, chondrocytes lose the ability to quickly regenerate and produce a normal amount of intra-articular fluid, which reduces the friction of surfaces during movement. Gradually, the cartilage becomes rough and begins to wear off under the influence of pressure during active body movements.
Gradually, the compensatory capabilities of the tissues are depleted and the layer of chondrocytes is gradually erased. When the degeneration reaches the bone, severe pain develops and mobility is greatly reduced. Without proper treatment, the patient can completely lose the ability to active movements and even to independently service his needs.
A person does not immediately know what arthrosis is, the disease begins gradually and does not manifest itself in the initial stages. Over time, the patient notes the appearance of minor pain without a specific localization, which intensifies against the background of significant physical exertion. Increasing degeneration leads to the fact that pains appear with minor movements and acquire a clear location.
Less noticeable symptoms of developing arthrosis include:
- "aching" pains when the weather changes;
- crunch when moving;
- morning stiffness;
- muscle cramps.
When the cartilage is deeply affected, signs of local inflammation appear, such as swelling, redness of the skin and localized fever. If a person does not seek help from a doctor, the symptoms progress and begin to manifest themselves not only against the background of physical exercise, but also at rest.
Thinning of the chondrocyte layer leads to deformation of the joints and disruption of the normal functioning of the limb. When feeling the pathological focus, the patient will mark the points of greatest pain. In addition, the cartilaginous lip will be significantly thickened along its edge, which will indicate compensatory hypertrophy.
A large number of disorders in the area of bone joints leads to certain difficulties in the process of differential diagnosis. However, by assessing the nature of the pain, arthrosis can be distinguished from arthritis of a different etiology. In the described condition, painful sensations arise, as a rule, when trying to perform active movements. Its intensity will gradually increase when trying to increase the load on the damaged joint.
The described clinical picture corresponds to the first stage of the process. At the second and third stages of progression, pain appears even in a state of complete rest, they can be stopped only by giving a position comfortable for the limb. The difference between arthritis is the constant presence of soreness, which does not disappear when changing position, and also intensifies at night.
The destruction of the natural structure of the cartilage causes the active proliferation of chondroblasts, but each pluripotent cell in our body has a certain division limit. This phenomenon is called a compensatory buffer. This means that after a certain number of mitotic divisions, the cell dies and can no longer reproduce its own kind.
After a while, this causes a change in the normal shape of the joint space, the appearance of so-called "cristae" or outgrowths in its lumen and depressions. This phenomenon only aggravates the process, since the spines formed in the process of destruction cause additional harm when moving.
Due to changes in the smoothness of the articular surface, the appearance of tuberosities and irregularities, the amplitude of active and passive movements is significantly reduced. It is this symptom that most often causes the patient to seek medical help. Unfortunately, at this stage, the effectiveness of drug treatment becomes too low, the situation can only be corrected by surgical correction of the joint.
- there is a high probability of developing "contracture" or complete disappearance of active and passive movements in the limb;
- Stiffness is observed throughout the day, not just in the morning, as in arthritis;
- In some cases, the limb has to be extended manually to give it a more comfortable position.
Many have heard the characteristic "crunchy" sound when kneading joints. There is a theory according to which, in a healthy person, this phenomenon is observed when the pressure in the capsule of the bone articulation changes, as a result, the density of the synovial fluid changes dramatically and the gas bubbles in it rapidly expand and burst, creating a kind of crunch. This phenomenon is not dangerous, but with arthrosis, a similar sound appears as a result of other processes.
The cristae formed in the course of cartilaginous destruction injure the joint and articular lip, leading to the formation of cracks and dissociation of the ligamentous apparatus. Even an inexperienced person will be able to distinguish the sound in a joint with arthrosis - it is coarser and "dry". The severity and loudness of the described symptom is directly proportional to the stage of the disease.
The specificity of sounds in the joint with arthrosis are:
- their presence only in the painful joint;
- is always accompanied by a deterioration in mobility;
- severity progresses in the later stages of the disease.
Change the appearance of the joint
At the initial stages of arthrosis development, the process does not lead to a change in the shape of the bony articulation. A noticeable change can be observed only with advanced disease, when one part of the joint is completely worn out, while the other is still producing cartilage cells. As a result, the pathological area increases significantly and loses its natural appearance. This symptom is extremely unfavorable, since the presence of deformation in the area, for example, of the knee or hip joint, will invariably lead to changes in the area of the underlying structures due to the displacement of the axis of the applied load.
Types and stages of arthrosis
The modern classification of arthrosis is quite ramified, which is due to the extensive list of possible localization of the pathological focus.
For the convenience of communication between specialists of different medical centers and even countries in the issue of diagnosis and treatment of this disease, the main ones are highlighted:
- hand arthrosis;
When establishing a diagnosis, a very important stage is precisely the precise definition of the stage of the destructive process. There are such stages in the development of arthrosis:
Stage 1 - there are no visible changes in the shape of the joint, there are violations in the biochemical composition of the intra-articular fluid, there is a slight pain syndrome, supplemented by inflammatory manifestations in the articulation area.
Stage 2 - a degenerative process is observed in the cartilaginous tissue, "cristae" are formed, stiffness and significant pain syndrome during movements are added. Dystrophy of the muscles surrounding the joint develops.
Stage 3 - the presence of extensive foci of cartilage destruction is determined, the shape of the joint is changed, the amplitude of active and passive movements in the limb is significantly reduced, or completely absent. Often, patients at this stage develop contractures that completely stop movement in the affected area.
An uncontrolled process of destruction can lead to serious complications that, in addition to a decrease in the quality of life, can lead to a complete inability to take care of oneself.
The most severe are:
- complete destruction of the cartilage tissue of the joint;
- the appearance of hernial protrusions in the area of intervertebral discs;
- severe disability of the patient;
- significant limb deformity.
Many patients, unfortunately, learn about what arthrosis is and how to treat it at the stages when it is no longer possible to achieve a significant effect with tablets. It is necessary to deal with the correction of the state of the musculoskeletal system after the onset of the first symptoms and for life. This is due to the fact that the impact of factors contributing to the development of the disease can rarely be prevented. For example, age-related changes in blood supply and lymph drainage from the joint require constant use of vascular drugs. Given the pathogenesis, therapy should be comprehensive and comprehensive. To begin with, after the appearance of unpleasant sensations when moving, contact a rheumatological specialist or a traumatologist. The doctor, based on the data of laboratory and instrumental diagnostics, will establish an accurate diagnosis and decide on the appointment of adequate treatment.
In the early stages of arthrosis, the situation can be corrected with the help of medication. For this purpose, the following groups of medicines are used:
- adrenal cortex hormones;
- non-steroidal anti-inflammatory drugs;
- drugs with chondroprotective effect.
The complex effect makes it possible to relieve the patient of pain, level the inflammatory process, and restore normal blood supply in the shortest possible time.
Advanced developments in the field of drug treatment have led to the creation of new drugs that are, in fact, substitutes for natural synovial fluid. The developed molecules are able to significantly reduce the process of cartilage degeneration, reduce pain and relieve the patient of inflammation. Artificial synovial fluid is injected directly into the joint capsule every week. The duration of one course of treatment is 3-5 weeks. Usually, the achieved result is sufficient for normal human activity for 6-12 months. Patients claim that comfort and quality of life are significantly improved. Unfortunately, this tactic is applicable only to people with stage 1-2 arthrosis.
In case of severe damage to large joints, such as the hip or knee, at a relatively young age of up to 60 years, patients are offered surgery for a complete joint replacement. Today, ceramic and titanium grafts are used that can completely restore the lost functions. These devices are strong enough to provide a patient with up to 20 years of life without any problems with mobility in the replaced joint.
Alternative medicine is widely used in the treatment of arthrosis. This is due to the fact that after stopping the acute process, lifelong therapy is required, aimed at restoring and maintaining the natural structure of the cartilage. To achieve the set goals, the means used must be safe and as natural as possible.
Compresses and lotions with decoction from the following plants are very popular:
- ginger root;
Diet for arthrosis
When treating the presented pathology, it is extremely important to provide the body with a constant supply of nutrients. This can be achieved only if the diet is complete in terms of the content of proteins, fats, carbohydrates, vitamins and microelements. To draw up the most adequate nutritional regimen, you should seek the help of a nutritionist. Fast carbohydrates and alcohol should be removed from the diet. The basis of the table should be dishes from fish, red meat and fresh fruit.
It is very important to observe the following nutritional rules for arthrosis:
- food intake 5-6 times a day in small portions;
- do not eat after 19: 00;
- getting rid of excess body weight.
Specific prophylaxis of arthrosis does not exist today, which is due to the polyetiological nature of the condition.
The disease can be prevented by following the general recommendations:
- proper nutrition;
- moderate physical activity 2-3 times a week;
- normalization of body weight;
- frequent split meals;
- observance of the rules of personal hygiene;
- quitting bad habits.
The presented pathological condition of the musculoskeletal system is often observed in older patients. It is necessary to increase the frequency of early diagnosis of the disease, since only in this case can one expect a successful outcome from conservative treatment. The prognosis for working capacity, subject to early detection and compliance with all doctor's prescriptions, is favorable. The presence of arthrosis of the third stage is accompanied by an unfavorable prognosis and can lead to a complete inability of the patient to care for himself.
Nevertheless, even the most severe form of the disease is corrected with the help of surgical treatment, the disadvantages of which are:
- invasiveness of the operation;
- high cost;
- long period of rehabilitation;
- cannot be used on patients over 60 years of age.