Today, joint arthrosis disease has become the most common among all pathologies of the musculoskeletal system. In addition, urban dwellers, people who are accustomed to lead a sedentary lifestyle and those who have recently suffered injuries of varying degrees of intensity, most often suffer from joint disorders.
The doctors' predictions 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 increase. According to the most recent data, about 7% experienced all the symptoms and consequences of arthrosis.
This disease has become a major cause of disability and decreased performance. It is characteristic that the peak incidence occurs in the age groups of 40 to 60 years, and not only in retired elderly, as is mistakenly believed.
What is Arthrosis?
Arthrosis (another name for osteoarthritis) must be understood as a complex degenerative pathology in which the cartilaginous bone plate that forms the joint is destroyed. The reasons lie not only in the processes that take place in the hyaline cartilage.
There are many other prerequisites for the disease.
Joint arthrosis develops under the condition:
- excessive physical activity. Usually, overweight people fall ill in these 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 cartilaginous tissue. There is a violation of the sliding properties of the tissues and a decrease in joint mobility. Athletes often suffer from joints that are systematically damaged due to sudden and frequent changes in natural pressure between joint surfaces or high load with insufficiently heated joints;
- congenital or acquired deformities, injuries to the musculoskeletal system. Under these conditions, the disease is caused by inadequate contact of the articular surfaces of the bone. Absolutely the entire load cannot be distributed by the joint, and injuries are formed in places of excessive compression. A notable example of such a violation will be rickets, scoliosis and kyphosis. It must also include inadequate fusion of broken bones, various deformities of the limbs;
- violation of cartilage regeneration. This mechanism of development of osteoarthritis is observed in the presence of an inflammatory process in the body, impaired blood circulation and hormonal disorders. The problem is based on 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 friction surfaces are constantly injured, their wear and inflammation accelerates, the general condition of the body worsens.
Arthrosis stages
As the disease arthrosis causes the destruction of the cartilaginous 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, the person will experience new symptoms and the prognosis for restoring motor activity will not change. Based on the clinical picture of the disease, the doctor will choose the ideal method of treatment and medications.
1st degree arthrosis is characterized by the fact that only discomfort and mild pain are felt after intense and prolonged efforts. After a short rest, the signs that appeared during physical activity disappear.
In this case, joint injuries will not be visible on the radiographic photo, but a slight narrowing of the joint space is possible.
Stage 2 of the pathology is characterized by an increase in symptoms. Now there are pains not only as a result of prolonged activities, but also with small movements of the limbs.
Rest will not bring the desired relief. There is rigidity in the movements, the mobility of the joint is limited. It is recommended at this point 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;
- deformation;
- neoplasms (osteophytes) near the joint space, their narrowing.
When the disease reaches its final stage, joint damage causes constant and unbearable pain. Therefore, at the reflex level, the person begins to drastically limit his movements, to protect the affected joint from stress. The pain syndrome occurs even during sleep and rest, when the joints are at rest.
The patient is forced to take the position where it hurts the least. Movement is only possible with the help of a wheelchair or crutches.
It is characteristic that the 3rd and 4th degrees of arthrosis can completely deprive a person of the ability to walk due to the fusion of the joint surfaces (ankylosis).
Which joint is most affected?
According to medical statistics, the lower extremities are more susceptible to arthrosis. The joints suffer from inflammation and degeneration: hip, knee.
In the case of hip joint problems, pain in the pelvis is initially felt after a long walk or run. With the active progression of the pathology, the pain intensifies and mobility is limited.
A person will notice an unpleasant stiffness in the joint and, in certain positions, the stiffness increases several times at the same time. In the later stages of arthrosis of the hip joint, the patient subconsciously protects the affected leg and tries not to step on it. It does not move the pelvis, which helps to relieve pain.
Arthrosis of the knee joint is manifested by discomfort and pain after walking. There are no external manifestations of the problem and inflammation. The most common prerequisite for osteoarthritis of the knee joint is previous trauma due to damage to internal structures.
These injuries, as a rule, cause abnormalities in the adjacent articular contact surfaces. It also occurs:
- overloading certain areas of the cartilage;
- its quick wear.
The changes, as in the previous case, depend on the degree of arthrosis. You must 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 are not 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 osteoarthritis of the large joints: medical and surgical.
First, the treatment aims to quickly improve blood circulation in the diseased joint and to accelerate the properties of the cartilaginous tissue with the help of medications. Anesthesia and removal of inflammation are also necessary. For these purposes, doctors practice using the following medications.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
These drugs interfere with the cartilage's natural chemical chain that causes inflammation. There is swelling in the tissues, pain appears and the resistance of the cartilage decreases during movement.
Thanks to the use of anti-inflammatories, it is possible to reduce or completely stop the painful syndrome. It also prevents the onset of the so-called chain inflammatory process, which helps to accelerate the regeneration of the affected areas.
Medicines are produced in the form of tablets, powder and rectal suppositories. The treatment tactic, the choice of a particular medication, 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 central-acting painkillers are called opioids. Typically, these drugs have a narcotic effect on the body, raising pain sensitivity thresholds. Thanks to this treatment, the pain in the affected joints can be reduced.
Drug use in this group should be strictly supervised by the attending physician, as they cause physical and mental dependence.
To accelerate the restoration of cartilaginous tissue, special means are used - chondroprotectors. They, in general, are the structural elements of the cartilage itself, which allows them to have an activating effect on their recovery.
These medications include:
- chondroitin sulfate;
- glucosamine sulfate;
- hyaluronic acid.
Chondroitin and glucosamine are organic substances abundant in the intercellular space of cartilage. The mechanism of its action on the joints has not yet been fully understood, however, it has been repeatedly proven to have a positive effect on the regeneration of cartilaginous tissue during treatment.
Chondroitin-based drugs activate the production of special substances in the extracellular matrix of cartilage (proteoglycans and hyaluronic acid). At the same time, the process of resorption in the tissues is significantly inhibited. Likewise, certain chemical processes are suppressed, there is a reduction in cartilage inflammation, damage and the severity of the painful syndrome.
Long-term medication use in this group is often necessary. A course of treatment is required for at least 6 months. Otherwise, the benefits of therapy are not to be expected. The organic combination of chondroitin and glucosamine is most 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 joint arthrosis with these drugs due to the relatively high cost.
Hyaluronic acid is no less common in modern medicine. It is a long chain of carbohydrates that provides 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, as studies have shown that arthrosis is often triggered by a decrease in the concentration of hyaluronium within the joint and a shortening of the chain of its molecules.