Osteoarthritis refers to diseases that affect the joints.As a result of dystrophic-degenerative processes, cartilage is gradually destroyed and replaced by growing bone tissue.The pathological process is accompanied by pain, limited mobility of the joint, disruption of its functions and severe deformation.About 10-25% of the population suffers from arthropathy.After 80 years, almost every person has degenerative disorders in the musculoskeletal system.Most often, the disease affects the most mobile joints (fingers, hip, knee, neck).But sometimes degenerative processes develop in the ankle and shoulder joint.
Factors in the development of the disease
Various reasons trigger destructive processes in the body.The most important are congenital anomalies of the connective tissue.Regular microtraumas of the joints and acute joint diseases contribute to the appearance of joints.Over time, the disease that is not treated enters a chronic stage with regular exacerbations.
Provocative factors that lead to the development of arthropathy are:
- overweight;
- physical inactivity;
- hormonal disorders;
- atherosclerosis;
- venous insufficiency;
- endocrine disorders;
- genetic predisposition;
- regular and heavy loads on the joints (for example, in weightlifters or people whose profession involves lifting and moving heavy objects);
Under the influence of a causative factor or several at the same time, cartilage tissue cells begin to break down.Gradually, the cartilage becomes thinner, becomes less elastic, then becomes covered with cracks and falls off.The bones in the joint begin to rub against each other.The body launches a compensatory mechanism, causing bone tissue to grow over the damaged surface.As a result, the joint becomes inactive and deforms.
Kind
Arthropathy can be primary, which occurs independently, and secondary, which develops as a result of diseases, injuries and deformations of the joints.
Depending on the affected joint, the disease has its name:
- Gonarthrosis affects the knee joint.
- Coxarthrosis is a disease of the hip joint.
- Spondyloarthritis affects the intervertebral discs of the lumbar, cervical and thoracic regions.
- The cruciate joint involves the ankle in the pathological process.
If 3 or more joints are involved in the degenerative process, we are talking about a generalized form.If there are 1-2 joints, this is local arthropathy.
Symptoms
At first, the degenerative process occurs unnoticed.There are no nerve fibers in the cartilage, so in the early stages of development the patient does not even know what destructive processes are happening in his body.The first signs appear only several years after the onset of dystrophic-degenerative processes, when the periosteum under the cartilage is injured or inflammation develops.
At first, there is pain in the extremities after vigorous exertion.In the morning or after a long stay at rest, there is a feeling of stiffness and dull pain of not too much intensity.After a short warm-up or exercise, all painful symptoms disappear.Therefore, people do not go to the doctor, thinking that this is a common occurrence.Meanwhile, at the initial stage it is much easier to stop the progression of arthropathy.
Over time, all signs intensify.The pain becomes obsessive and constant, preventing you from sleeping at night.The pains, the feeling of stiffness, the inability to fully work or perform household chores are becoming more and more worrying.Pain, pain in joints and surrounding muscles intensifies in rainy weather.
Most often, arthropathy affects the joints of the lower limbs, so a person quickly gets tired of walking, it is difficult for him to climb stairs or any height, as as a result of the destruction of cartilage tissue, stiffness of the joint is formed.An unsteady gait develops due to limb instability.When bending a joint, an unpleasant crunching sound is heard as the articular surfaces, devoid of cartilage, rub against each other.Patients try to limit the mobility of the affected joint, so over time muscle atrophy develops.They decrease in volume and the gait becomes even more unstable.
If arthropathy develops in the joints of the upper limbs, it is more often after injuries or as a result of chronic arthritis.In this case, bone growths appear on the fingers and the hands acquire a square shape.
Clinical symptoms depend on the stage of development of arthropathy:
- Zero.
In stage zero, a person is sometimes bothered by slight discomfort.X-ray does not reveal degenerative changes. - Elementary.
When walking for a long time, a slight dull pain occurs.X-ray shows the appearance of small areas of bone defects along the edges of the articular surfaces.When bending the joint, a cracking sound is heard. - Easy.
In the morning there is pain and stiffness.X-rays show osteophytes (individual bony growths) along the edges of the joints, narrowing of the joint space. - Moderate.
The moderate stage is considered degenerative.Bones and muscles ache all the time, especially at night.The joint swells a little.X-ray shows even more narrowing of the joint space, proliferation of bony growths and increased bone density. - Heavy.
In the severe stage (deformation), there is constant pain that intensifies with movement.When you try to bend the joint, a harsh creaking sound is heard.X-ray shows a sharp narrowing of the joint space.the osteophytes have already grown so much that it has led to deformation of the joint and a change in its structure.
Diagnosis and treatment
Orthopedist, rheumatologist and surgeon are involved in determining the type and stage of degenerative-dystrophic processes in the joints.Diagnosis involves standard blood and urine tests.If necessary, immunological analysis and examination of intra-articular fluid for the presence of infection is done.Instrumental studies are carried out (MRI, ultrasound to identify changes in soft peri-articular and articular tissues, computed tomography, x-rays to determine changes in bone tissue).
Treatment
The disease cannot be completely stopped.Early diagnosis and treatment allows you to maintain its mobility and prevent the progression of the disaster.
Antispasmodics, NSAIDs, steroid blocks injected into the joint, chondroprotectors, muscle relaxants, vitamin and mineral complexes, drugs to improve trophism in the affected tissues, proteolysis inhibitors to slow down the destruction of cartilage and bone tissue are used as drugs in the treatment of arthropathy.
Patients with severe pain and an unstable joint are advised to wear bands that fix the joint in a normal position using adhesive tapes, orthoses, elastic knee pads or knee pads.Crutches or canes should be used as support.
Physiotherapy procedures should be prescribed, which include UHF, massage, ozone therapy, electrophoresis and phonophoresis with a painkiller solution, magnetic therapy, acupuncture, electrical stimulation, darsonvalization, paraffin baths (in the absence of inflammation)
In the last stages of arthropathy, when the tissues are already damaged and the joints are severely deformed, the only way is surgery:
- Arthroscopy with removal of bony growths, spine and partial replacement of damaged cartilage.
- Introspection.It is the replacement of a joint (in whole or only part) with an artificial joint.
- Artodez.The joint is closed and fixed in a comfortable position.Over time, the articular surfaces grow together.
Prevention
Since it is impossible to restore your own joint to a normal physiological state, it is necessary to take measures in advance to prevent this disease.It is especially important to do this if there is a family history of cases of this disease or if you reach the age of over 40.
Prevention includes maintaining a normal body mass index and regular exercise.Infectious pathologies and other joint diseases must be treated promptly, hypothermia and prolonged and sudden physical exertion must be avoided.People from risk groups (by age, traumatic occupation, poor heredity) should regularly examine their joints using X-rays.
Only timely and adequate treatment helps to maintain the health of the joint.