Osteoarthritis is degenerated degenerative disease of the joints characterized by a slow and progressive destruction of intra-articular administration to the cartilage. Osteoarthritis is comprised of a group of joint diseases destructively-inflammatory nature, which have different causes and mechanisms of development.
Osteoarthritis is one of the most widespread diseases in the world, occupying a leading position among women and men over 30 years old, and with age, the risk of developing the disease increases.
The causes of the pathology
Osteoarthritis develops as a result of violations of metabolic processes in the joints, on the bottom of which intra-articular cartilage begins to lose water and is not elastic. The factors contributing to these changes in the cartilage can be the internal and external causes:
- the hormonal changes;
- characteristics of age;
- a genetic predisposition;
- rheumatoid arthritis;
- excessive load on the joints;
- transferred injuries and damages, sprains, diseases, bruises serious, the rupture of the ligaments;
- changes in metabolism of the inside of the joint linked to obesity, diabetes;
- hypothermia;
- defective and unbalanced diet, a result of which the body under-paid calcium, omega-3 and 6, fats and proteins;
- the inflammatory process of the joint;
- the violation of the vascularity of the femoral head – mr. Perthes;
- the problem with the clotting of the blood, an inherited disease;
- autoimmune diseases – systemic lupus erythematosus, rheumatoid arthritis.
Cause the development of osteoarthritis may also be specific to the disease, that have nothing to do with the joints, namely:
- gonorrhea;
- syphilis;
- hyperthyroidism.
- the thyroiditis.
In the risk group are the people who are engaged in the physical work heavy, must constantly supercooled, and experience an increased load on the musculoskeletal system – the miners, the blacksmiths, the athletes, dockworkers, and pregnant women.
The symptoms of osteoarthritis
The first symptom of osteoarthritis is pain at the slightest load on the joint, which passes quickly, as soon as the joint leave it alone. Osteoarthritis is characterized by 4 major clinical signs:
- The sensation of the pain – the pain in the arthritis has certain characteristics, unlike the pain in case of ingestion, injury to the joint or of the inflammatory process in it. First of all, you should pay attention to the appearance of the discomfort and pain of movement and the load on the affected joint. If a person to stop movement and to remove the load, as the pain immediately goes, which is not an injury or an inflammation of the joint. During the night, collapsing the joint virtually does not cause the patient discomfort, pain are possible during a change of the position of the body, but they pass quickly. During the progression of the destructive processes within the joint and night can produce sharp shooting pain, which, with time, economic stronger and bring about change in the lifestyle. Acute pain arise when there is a change of the weather, the change of phase of the moon, the lesser charge.
- The crunch is that the noise appears as a result of the reduction of the smoothness of the rotation of the bone around the joint, which leads to rubbing of bones with each other and accompanied by the characteristic crunch. With the progression of the degenerative process in the cracking of the joint is more pronounced and is accompanied by pain.
- The limitation of the mobility of the joint, a stage of development of a disease process expressed by mobility restrictions no, but with the progression of the destruction of the joint within the patient more difficult to commit simple actions. Eventually the affected joint is completely immobilized.
- The deformation of the joint, on the surface of the bone begin to grow osteophytes and accumulates in the synovial fluid. The deformation of the joint may occur in the course of the degree of a pathological process.
The degenerative processes in the joint will not develop rapidly, the disease is characterized by the phase of exacerbation and remission, that the sick are not in a hurry to seek treatment, thus contributing to the progression of the destructive processes within the joint.
Stage
The stage of progression of the disease in the joint is defined by an x-ray examination. Emit only 4 stages of disease:
- The first is characterized by a minor to a narrowing of the joint space, and in no case pathological growths on the bones not;
- The second – a bit of a narrowing of the joint space, on the surface of the bone to form osteophytes;
- The third joint of the slit is reduced, on the surface of the bone multiple osteophytes, we observe the deformation of the joint;
- The fourth is of the joint space, virtually no present multiple osteophytes, expressed deformation of the joint.
The degree of
Osteoarthritis is expressed in the form of a degenerate-destructive processes in the joint, the result of which is system the cartilage is develop changes in the capsule and synovium of the joint, as well as in the ligaments around it, and the bony structures. Depending on the severity and the expressiveness of this destruction has decided to award 3 degree of osteoarthritis.
The first degree
Denominated a deformation or a change in the articulation is not, but is broken the composition of the synovial fluid, which leads to a failure to provide the joint tissues of nutrients, water and trace elements, as a result, the cartilage becomes faster is not elastic and is not suitable for loads. With time, this leads to inflammatory processes and is accompanied by pain when driving and the load on the joint.
During the first step of oa ill person does not seek medical help, this inserts the discomfort and pain uncomfortable posture during sleep, the fatigue, the bad way of life. Sometimes, a patient may notice a characteristic of the crisis in the area of the affected joint, but it is not accompanied by severe pain, but only discomfort, again, that no significant attention.
If the osteoarthritis is diagnosed by chance on the first stage, the disease is easily treatable.
The second degree of the
At this stage, the disease is accompanied by damaging process of the cartilage inside the joint. On the surface of the bone complmentaires multiply osteophytes, and the more intense the load on the affected area, even more clearly progresses to destruction.
By doing this, the patient complained of persistent pain in whining and taking a view of nature, which are periodically by themselves, and can be a long time not to be felt. Then with the disease progresses. In a context of a disease process the muscles surrounding the joint inflamed, gradually lose their functions, what the patient gets tired quickly and can't handle the physical load, which, without the work has focused earlier. When the second measure of osteoarthritis in the patient progressively the deformation of the cartilage and the joint.
The third degree
Is the most severe. Intra-articular cartilage of the affected joint is thin and has greatly destroyed, which leads to is clearly visible in the deformation and rupture of the functions of the member system. Located to the side of the joint, ligament and missty are suffering a shortage of nutrients and oxygen, and gradually begin to atrophy, which is accompanied by the loss of mobility. At this all the time patient suffers acute pain, which is further enhanced when attempting to change the position of the body, during a change in weather conditions and phases of the moon and, gradually, resulting in a loss of capacity.
Types of osteoarthritis
Depending on the cause for the disease process to the inside of the joint to distinguish osteoarthritis primary, secondary, and idiopathic.
Primary develops as a secondary disease, as a consequence of trauma or infection, and the reason for the idiopathic form is not known. With the exception of the classification of the disease according to the cause of the disease distinguish between osteoarthritis on the place of location of changes in destructors:
- The knee is the most common variant of the pathology characterized by the defeat of the knee. The more often the knee reveal in people who are overweight suffering from chronic diseases such as metabolism, weak immunity. The knee osteoarthritis progresses for a long time and has progressively led to the complete loss of motor function.
- Osteoarthritis of the ankle one of the main causes of the development of degenerative processes in the area of the ankle is transferred to the injury, sprains, strains, diseases of the ... In some cases, the development of a pathological process can cause an auto-immune disease – rheumatoid arthritis. Ankle osteoarthritis exposed to dancers, women wearing high heels, athletes.
- Osteoarthritis of the shoulder joint – the main reason of degenerative processes in this site are the congenital abnormalities of the development of the shoulder joint or of excessive loads on this area, for example, when wearing a heavy baggage on shoulders.
- Coxarthrosis or hip osteoarthritis – the main cause is the age-related changes in the tissues of the joint. In the at-risk group of people aged over 45 years.
- Encountres or cervical osteoarthritis – the causes are an injury to the neck, progressing osteochondrosis, obesity, sedentary lifestyle. In the risk group people who work on the computer in the office. In addition to explicit pain in the region of the neck in patients with marked vertigo, oppression of consciousness, memory impairment, and fatigue. These symptoms are caused by compression of the vertebral artery, by which the brain receives nutrients and oxygen.
- Spondiloarthrosis – destructively exposed to the destruction of tissues of the spine and it is lumbar of his department. In the group of risk for women during menopause, because spondiloarthrosis is progressing on the background of deficiency of female hormones.
- Osteoarthritis of the fingers of the hands – grows for the same reason that spondiloarthrosis.
- The polyarthrosis – is characterized by lesions of multiple joints with the evolution of degenerative processes in them, in the process of the disease are involved ligaments, muscles, and people around the joint of the fabric.
The possible complications
In the absence of an early diagnosis and treatment of osteoarthritis will progress, to expand on other joints, promote the development of gruzevich projections and development total the polyarthrosis.
Complications of osteoarthritis are those of the state:
- the destruction of the integrity of the joint;
- the deformation of the form;
- the limitations of the mobility;
- disability of the patient.
All of these complications result in a significant reduction of the quality of life of the patient, the accession of the accompanying diseases and disorders of the full stop of the patient.
The methods of diagnosis
For the diagnosis of the disease, the patient should seek help at the trauma orthopedic. In order to differentiate osteoarthritis from other joint diseases and musculoskeletal prescribed an x-ray in 2 projections. This study allows to define precisely the areas of the adjacent tissues affected in the joint, destruction of the bones and ligaments, osteopenia expansion.
If necessary, the doctor may possibly prescribe an MRI, ct scan, arthroscopy. In some cases, produce a puncture of joint to remove a sample of synovial fluid.
The treatment of osteoarthritis
The treatment of oa is best done in the early stages, then the disease better lends itself to methods of conservative treatment. It is very important to correctly define the cause progressive changes destructive to the joint and the time to cut off these factors.
The treatment of osteoarthritis is carried out in a comprehensive manner and is to eliminate the inflammatory process to relieve the pain, stop the progression of the disease and on the possibilities of restoration of the lost functions of the joint. Conservative treatment includes the selection of medicines and physiotherapy treatments.
The drug treatment
The treatment of osteoarthritis is different, in different places of localization of the pathological process:
- Osteoarthritis of the hands and fingers – up with the patient to reduce the pain prescribed nonsteroidal anti-inflammatory drugs in the form of ointments, cream, gel. For the prevention of the progression of the disease illustrates the technique chondroprotectors. After a oedema acute inflammatory process prescribed massage and physiotherapy treatments.
- With osteoarthritis of the shoulder joint towards the interior of the diseased joint are introduced injection of analgesics and nonsteroidal anti-inflammatory drugs. By oral route may affect the reception of spasmolytic drugs that will relax the muscles and a number of decrease the intensity of the pain. After the relief of inflammation and pain shows physiotherapy and massage.
- Osteoarthritis of the knee joint – prescribing of nonsteroidal anti-inflammatory drugs by topical route in the form of compresses, ointments, gels. On the area of the affected joint view of the physiotherapy the therapy.
- Osteoarthritis of the hip on the reach deal compresses impregnated with an ointment or a gel to the group of NSAIDS, and the inside of the joint will introduce analgesic injection.
- Osteoarthritis of the knee joint – on the affected area is a bad sign, ointments and gels with analgesic effect, after the relief of acute pain and inflammation post physiotherapy treatment.
- Ankle osteoarthritis, the patient is recommended bed rest with a maximum of rest to the affected joint. By able to deliver to an inflammatory process acute are assigned to physiotherapy treatments, baths, massage.
Physiotherapy
Effective physiotherapy methods used in different degrees of severity of osteoarthritis, including:
- The basis of shock wave treatment relieves the patient of the growth of osteophytes, which eliminates the pain and limitation of mobility of the joint;
- The stimulation of the muscles around the affected joint of the current – this procedure is very effective for patients with reduced mobility, and can improve circulation in the joint, to speed up the process of regeneration, improve muscle tone;
- Therapy ozone in the cavity of the affected joint is introduced in the gas mixture, due to which the patient has pain, and the normalization of the mobility of the joint, to disappear the signs of inflammation. For maximum effect of the ozonothérapie is made exchange;
- Phonophorèse – the impact on the region of the defeat of ultrasound waves with the help of medication. Such way of the use of drugs much more effective than ultrasound to deliver the drug directly into the lesion.
The physiotherapy treatment PHYSIOTHERAPY, massage, manual therapy, mechanotherapy.
Dietary food
The diet with oa should be the most balanced and rich in polyunsaturated fatty acids, proteins, trace elements. It is recommended to include in the diet of fresh fish, vegetable oils, cheese, dairy products, meat, fruits and vegetables.
From a plan to exclude products made from flour and "fast" carbohydrates, chocolate, coffee, alcohol, meat of pork, fatty and salty.
The surgical treatment
If conservative treatments do not produce the expected result or osteoarthritis were diagnosed in the terminal phase, which are expressed degenerative changes of the joint, with a lack of mobility, then the patient is prescribed a rapid response.
The surgical treatment of osteoarthritis is done in several ways:
- The puncture of the affected joint – this method is both diagnostic and therapeutic. The collection of a sample of synovial liquid allows you to precisely define the nature of the origin of the disease and to pick up effective of the drug. In the course of the operation during the puncture articular injected corticosteroids, and a variety of anti-inflammatory drugs, which relieves pain instantly and relieves the pressure on the joint.
- Arthroscopy in the cavity of the joint is introduced arthroscope to a thorough investigation of the articulation of the interior. During the operation, the doctor can immediately remove growths on the bones and the different institute.
- Osteotomy – in the framework of an operation of the bone of the joint of the little adjustment special tools and fixed in the correct position, which allows not only for restoration of the motor function, but also to rid the patient of the discomfort and pain.
- The prosthesis of a joint is destroyed, the joint is removed and on its place establish a denture from high quality material that is fully assume the functions lost from the joint, will provide full mobility of the members and to rid the patient of pain.
Prevention
The prevention of osteoarthritis is integrated in the campaign:
- maintaining health and an active life;
- rational and nutrition;
- an exception of bad habits;
- the prevention of injuries and lesions of the joints;
- the timely treatment of inflammatory processes.
The people in the risk group should be particularly attentive to the slightest change in the functioning of the joints and pain, creaking and squeaking immediately consult the trauma-orthopedic.