Today, the disease of arthrosis of the joints has become the most common among all pathologies of the musculoskeletal system. Moreover, urban dwellers, people who are accustomed to leading a sedentary way of life and those who have recently suffered injuries of varying degrees of intensity, most often suffer from joint disorders.
The forecasts of doctors in this regard are disappointing. It is assumed that in the near future the number of people suffering from various forms of arthrosis of large joints will only grow. According to the latest data, about 7 percent have experienced all the symptoms and consequences of arthrosis.
This disease has become one of the leading causes of disability and decreased performance. It is characteristic that the peak incidence occurs in the age groups from 40 to 60 years old, and not only elderly pensioners, as it is mistakenly believed.
What is arthrosis?
Arthrosis (another name for osteoarthritis) should be understood as a complex degenerative pathology in which the cartilaginous plate of the bone that forms the joint is destroyed. The reasons lie not only in the processes occurring in the hyaline cartilage.
There are many other prerequisites for the disease.
Arthrosis of the joints develops under the condition:
- excessive physical activity. Usually, overweight people get sick in such cases. Human joints are not designed for constant movement with a large load. For this reason, the increased compression experienced by the knees during activity becomes a prerequisite for microtrauma to the cartilage tissue. There is a violation of the sliding properties of tissues and a decrease in articular mobility. Athletes often suffer who have systematically damaged joints due to sharp and frequent changes in natural pressure between the surfaces of the joint or high load with insufficiently warmed joints;
- congenital or acquired deformities, injuries of the musculoskeletal system. In such conditions, the disease is provoked by inadequate contact of the articular surfaces of the bone. Absolutely the entire load is not able to be distributed over the joint, and injuries are formed in places of excessive compression. A striking example of such a violation will be rickets, scoliosis and kyphosis. It should also include improper fusion of broken bones, various deformities of the limbs;
- violation of cartilage regeneration. This mechanism of development of arthrosis is observed in the presence of an inflammatory process in the body, impaired blood circulation and hormonal disruptions. At the heart of the problem is inadequate restoration of lost cartilage tissue, lack of natural remodeling and thinning;
- problems of formation and production of synovial fluid. In case of insufficient joint fluid, the rubbing surfaces are constantly injured, their wear and inflammation accelerates, the general condition of the body worsens.
Stages of arthrosis
Since the disease arthrosis 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 active destruction of the joint surface, a person will experience new symptoms, and the prognosis for the restoration of motor activity will not change. Based on the clinical picture of the disease, the doctor will choose the optimal method of treatment and drugs.
Arthrosis of the 1st degree is characterized by the fact that discomfort and slight soreness are felt only after prolonged intense exertion. After a short rest, the signs that have arisen during physical activity fade away.
In this case, the joint lesions will not be visible on the X-ray photo, but a slight narrowing of the joint space is possible.
Stage 2 pathology is characterized by an increase in symptoms. Now there are pains not only as a result of prolonged activity, but also with minor movements of the limbs.
Rest will 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 excluded, otherwise muscle atrophy occurs. An X-ray will show clear signs of arthrosis:
- bone growth;
- neoplasms (osteophytes) near the joint space, its narrowing.
When the disease reaches its final stage, the lesions in the joints deliver excruciating constant pain. Therefore, at the reflex level, a person begins to sharply limit his movements, to protect the affected joint from the load. Pain syndrome occurs even during sleep and rest, when the joints are at rest.
The patient is forced to take the position in which it hurts the least. Movement becomes possible only with the help of a wheelchair or crutches.
It is characteristic that the 3rd and 4th degree of arthrosis can completely deprive a person of the ability to walk due to the fusion of the articular surfaces (ankylosis).
Which joint is most often affected?
According to medical statistics, the lower extremities are most susceptible to arthrosis. The joints suffer from inflammation and degeneration: hip, knee.
With problems in the hip joint, pain in the pelvis is initially felt after a long walk or run. With the active progression of the pathology, pain intensifies and mobility is limited.
A person will notice unpleasant stiffness in the joint, and in certain positions the stiffness increases several times at once. In the last stages of arthrosis of the hip joint, the patient subconsciously protects the affected leg and tries not to step on it at all. He does not move his pelvis, which helps to reduce pain.
Arthrosis of the knee joint is manifested by discomfort and aching pain after walking. There are no external manifestations of the problem and inflammation. The most common prerequisite for arthrosis of the knee joint is its past trauma against the background of damage to internal structures.
Such lesions, as a rule, cause abnormalities in the adjoining of the contacting articular surfaces. Also takes place:
- overloading certain areas of the cartilage;
- their rapid wear.
Changes, as in the previous case, depend on the degree of arthrosis. 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 do not make themselves felt 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 probability of loss of mobility.
Getting rid of arthrosis
Today, there are 2 main directions in the treatment of arthrosis of large joints: medical and surgical.
First of all, treatment is aimed at quickly improving blood circulation in the diseased joint and accelerating the properties of cartilage tissue with the help of medications. Anesthesia and removal of inflammation are also required. For these purposes, doctors practice the use of the following drugs.
Non-steroidal anti-inflammatory drugs (NSAIDs)
These drugs interfere with the natural chemical chain in cartilage that causes inflammation. There is swelling in the tissues, soreness appears, and the strength of the cartilage 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 produced in the form of tablets, powder and rectal suppositories. The tactics of treatment, the choice of a specific drug is determined by the doctor strictly on an individual basis, based on the clinical picture of the disease, its dynamics and concomitant pathologies.
Opioids and chondroprotectors
Strong centrally acting pain relievers are called opioids. Usually, such drugs have a narcotic effect on the body, increasing the thresholds of pain sensitivity. 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, because such drugs cause mental and physical dependence.
To accelerate the restoration of cartilage tissue, special means are used - chondroprotectors. They, by and large, are the structural elements of the cartilage itself, which allows them to have an activating effect on their recovery.
These medicines include:
- chondroitin sulfate;
- glucosamine sulfate;
- hyaluronic acid.
Chondroitin and glucosamine are organic substances that are abundant in the intercellular space of cartilage. The mechanism of their action on joints has not yet been fully understood, however, it has been repeatedly proven to have a positive effect on the regeneration of cartilage tissue during treatment.
Chondroitin-based drugs activate the production of special substances from the extracellular matrix of cartilage (proteoglycans and hyaluronic acid). At the same time, the process of resorption 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 use of drugs in this group is often required. A course of treatment is required for at least 6 months. Otherwise, the benefits of therapy should not be expected. The organic combination of chondroitin and glucosamine is more commonly practiced. However, clinical studies have not confirmed a significant difference between such treatment and the use of only one of the chondroprotectors.
Despite the obvious benefits and safety, not everyone can treat arthrosis of the joints with such drugs due to the relatively high cost.
Hyaluronic acid is no less common in modern medicine. It is a long chain of carbohydrates that provide elasticity and viscosity to the synovial fluid. The unique properties of hyaluron are largely responsible for the good sliding properties of the joint fluid.
Intra-articular injections of the drug have a good effect on the state of the body, because studies have shown that arthrosis is often triggered by a decrease in the concentration of hyaluron inside the joint and a shortening of the chain of its molecules.