Types of arthrosis: symptoms and treatment methods

23 August 2020

Osteoarthritis is a chronic disease of the joints, accompanied by pathological changes in the hyaline cartilage and, subsequently, in the adjacent tissues, joint capsule and synovium.

The lesion is dystrophic and degenerative, which leads to a change in the structure of the joint tissues, with loss of its functionality. According to the same statistics, 12% of the total population of the planet is susceptible to arthrosis. 62% to 65% of all episodes of the disease occur in people over 60.

Another 30-35% of cases of joint damage with this pathology occur in patients aged 40-60 years. And about 3% are young people aged 20 to 40.

What's that?

In simple words, arthrosis is a chronic disease in which progressive degenerative-dystrophic changes develop in the joint due to metabolic disorders. It is the most common joint pathology, diagnosed in 6-7% of the population. With age, the incidence increases dramatically.

In most cases, in arthrosis, the pathological process involves the small joints of the hand (in women, 10 times more often than in men), the big toe, the intervertebral joints of the thoracic and cervical spine, as well asthe knee and hip joints. Arthrosis of the knee and hip joints ranks first in terms of the severity of clinical manifestations and the negative impact on quality of life.

Arthrosis is characterized by a complex lesion of the articular and auxiliary apparatus:

chondritis - inflammatory changes in the joint cartilage;
osteitis - involvement of underlying bone structures in the pathological process;
synovitis - inflammation of the inner membrane of the joint capsule;
bursitis - damage to periarticular bags;
reactive inflammation of the soft tissues (muscles, subcutaneous tissue, ligaments) located in the projection of the involved joint (periarticular inflammation).

The disease is diagnosed in 2% of people under 45 years old, in 30% - from 45 to 64 years old and in 65-85% - at the age of 65 years old or more. Arthrosis of the large and medium joints of the extremities has the greatest clinical significance due to its negative impact on the patients' standard of living and work capacity.

Types of arthrosis

Depending on the cause of the pathological process within the joint, primary arthrosis is distinct, secondary and idiopathic.

Primary develops as an independent, secondary disease as a result of an injury or infection, and the cause of the idiopathic form is not known. In addition to the classification of the disease, depending on the cause of the pathological process, arthrosis is distinguished according to the location of the destructive changes:

Gonarthrosis is the most common type of pathology characterized by damage to the knee joints. Most of the time, gonarthrosis is detected in overweight people, with chronic metabolic diseases in the body and weak immunity. Knee arthrosis progresses for a long time and gradually leads to a complete loss of motor function.
Arthrosis of the shoulder joint - the main cause of degenerative processes in this area are congenital anomalies in the development of the shoulder joint or excessive stress in this area, for example, when carrying heavy luggage on the shoulders.
Ankle arthrosis - the main reasons for the development of degenerative processes in the ankle joint are trauma, sprains, sprains and fractures. In some cases, the development of a pathological process can cause an autoimmune disease - rheumatoid arthritis. Ankle arthrosis affects dancers, women in high heels, athletes.

Uncoarthrosis or osteoarthritis of the cervical spine - the causes are neck injuries, progressive osteochondrosis, obesity, sedentary lifestyle. At risk are people working on a computer in the offices. In addition to severe neck pain, patients experience pronounced dizziness, depression of consciousness, impaired memory and fatigue. These symptoms are caused by compression of the vertebral artery, through which nutrients and oxygen enter the brain.
Coxarthrosis or arthrosis of the hip joint - the main cause of occurrence is age-related changes in the tissues of the joint. People over 45 are at risk.
Osteoarthritis of the fingers - develops for the same reason as spondyloarthrosis.
Polyarthrosis is characterized by injury to multiple joints with progressive degenerative processes in them, while the pathological process involves ligaments, muscles and tissues around the joint.
Spondyloarthrosis - the tissues of the spine, in particular the lumbar region, are subject to destructive destruction. Women are at risk during the onset of menopause, as spondyloarthrosis progresses in the context of a deficiency of female sex hormones.

Causes of arthrosis

Two reasons contribute to the formation of osteoarthritis - stress and lack of adequate nutrition, which provides vitamins and minerals for tissue repair. Each person's joints carry a load. For athletes and dancers, during physical work, the load on the legs is greater, which means that the bone joints wear out more quickly and require high quality food. With a peaceful lifestyle, the support device wears out more slowly, but it also requires periodic tissue renewal.

Therefore, the main condition for joint destruction and deformation is malnutrition, the indigestion of useful components, which often occurs with metabolic disorders.

Let's list the factors that contribute to joint wear and metabolic disorders:

Muscle weakness and abnormal joint load. The weakening of one or more muscles increases the load on the joint and distributes it unevenly at the bone junction. In addition, the inadequate load of the muscles is formed with flat feet, scoliosis, therefore, with these "harmless" diseases, the cartilage tissues wear out with age, arthrosis appears.
The probability of arthrosis increases with intense physical effort.

If the daily loads exceed the capacity of the bone tissues, microtrauma forms in them. At the lesion sites, thickening appears, which grow over time and deform the joint;
Metabolic disorders (gastrointestinal disorders - bile stagnation, dysbiosis, gastritis, cholecystitis, pancreatitis, metabolic disease - diabetes);
Psychosomatic causes - the psychosomatics of arthrosis confirm that a negative emotional state also becomes the cause of the disease. Stress forms muscle spasm, constant stress disrupts the nutrition of all tissues (internal organs, bones, joints);
Heredity (the type of metabolism and its possible disorders are inherited, a tendency to muscle weakness or inadequate formation of the bone system, to poor digestion - which is the basis for the development of osteoarthritis in old age).

Osteoarthritis is a disease of worn joints that have lost a significant supply of minerals and the ability to withstand stress and destruction. Therefore, with age, the predisposition to the disease increases. After 70 years, arthrosis is diagnosed every two retirees. As the maximum load falls on the legs (a person moves - walks, stands, runs, jumps), this is where the first signs of arthrosis form.

Mechanism of disease progression

When any of the reasons that cause a joint disease with arthrosis arise, pathological processes begin to develop in it. The mechanism of its progression is not fully understood, but the main stages of official medicine are known.

In the initial stage, there is depletion of the structure of the cartilage tissue and abnormal changes in the synovial fluid. All of this occurs due to metabolic disorders, in which the tissues of the joints do not receive the necessary components in sufficient quantities, or are deprived of some of them.

In addition, the elasticity of collagen fibers and the flexibility of cartilage are lost, due to the fact that in the body lacking nutrients, hyaluronic acid does not have time to be produced, which provides softness and flexibility to the structural composition. of collagen fiber. Cartilage gradually dries, becomes brittle and cracks. The fluid in the synovial capsule is gradually depleted and subsequently disappears completely.

Roughness and solid bone growth are formed in the cartilage tissue. At the same time, deformation of other joint tissues, their pathological degeneration, dystrophy and loss of physiological activity develops. For the patient, these changes mean the appearance of pain, lameness, joint stiffness.

Arthrosis symptoms

Acute clinical picture is not typical of osteoarthritis, joint changes are progressive, increasing slowly, which is manifested by a gradual increase in symptoms:

pain;
intermittent grinding of the affected joint;
joint deformity that appears and worsens as the disease progresses;
stiffness;
limitation of mobility (decreased volume of active and passive movements in the affected joint)

The pain in arthrosis is monotonous and transient, it appears when moving, in a context of intense stress, at the end of the day (it can be so intense that it does not allow the patient to fall asleep). The persistent, non-mechanical nature of arthrosis pain is not characteristic and indicates the presence of active inflammation (subchondral bone, synovial membrane, ligament apparatus or periarticular muscles).

Most patients notice the presence of so-called initial pains that occur in the morning upon waking up or after a long period of inactivity and pass during physical activity. Many patients define this condition as the need to "develop a joint" or "disengage".

Arthrosis is characterized by morning stiffness, clearly located and of short duration (not more than 30 minutes), it is sometimes perceived by patients as a "gelatinous sensation" in the joints. Wedge feeling, stiffness is possible.

With the development of reactive synovitis, the main symptoms of arthrosis are linked by:

pain and local temperature rise, determined by palpation of the affected joint;
persistent pain;
enlargement of joints, swelling of soft tissues;
progressive decrease in range of motion.

Stages and degrees of arthrosis

In the course of the disease, medicine distinguishes between three stages, which differ in the signs of the disease, the intensity of the lesion and the location. At the same time, the differences in all three stages are related to the types of tissues that undergo pathological changes.

The first stage of development of joint arthrosis is the initial stage of the disease. It is characterized by mild damage to cartilage tissue and loss of physiological functions in collagen fibers. At the same time, in the first stage, minor morphological disorders of bone tissue and structural changes in the synovial fluid are noted. The joint cartilage is covered with cracks, the patient has mild pain at the pathological site.
Second degree - the development of arthrosis with increased dynamics. This stage is characterized by the appearance of stable pain, lameness. Morphological and dystrophic changes are observed in the cartilage. During the diagnosis, bone tissue growth is revealed. Osteophytes are formed - bone growths that are visible during a visual examination of the injury site. At the same time, the processes of degenerative changes in the synovial capsule continue, which leads to its structural exhaustion. The disease at this stage can often get worse and be regular. The pains gradually become constant.
Third degree - active progression. At this stage, synovial fluid is almost completely absent due to its degeneration, and bone tissue is rubbed together. Joint mobility is almost completely absent, the pain becomes more palpable. Cartilage is also absent due to degenerative and atrophic changes. The treatment of the third degree of arthrosis of the joints is considered inadequate.

In addition to these three degrees of development of the pathology, there is a final stage - the irreversible destruction of all tissues of the joint. At this stage, it is impossible not only to conduct effective therapy, but even to relieve pain.

The inflammatory process usually begins in the second degree of the injury, in rare cases, in the absence of medical intervention - in the first stage. Subsequently, it becomes increasingly difficult to interrupt it, which can lead to secondary pathologies, the development of pathogenic microflora at the location of the disease.

To rule out serious consequences, treatment should be started in the first degree and, at the same time, intensive care methods should be applied. In the last stage, associated with the total destruction of the cartilaginous tissue, only one technique is allowed for the relief of pain and immobility of the joint in the patient - the arthroplasty with total or partial replacement of the components of the joint.

Consequences

The consequences of premature treatment and advanced joint arthrosis are fraught with complications such as:

deficiency;
deformation beyond recovery;
occurrence of vertebral hernias;
stiffness or stiffness of the joint;
decline in quality and standard of living.

The chronic course, in addition to these complications, is accompanied by intense and frequent pain, complete destruction of the structural components of the joint, discomfort, inability to perform physical work and play sports.

Diagnosis

The diagnosis of arthrosis is based on the evaluation of anamnesis data, characteristic manifestations of the disease, results of instrumental research methods. General indicative changes and biochemical blood tests are not typical of arthrosis, they appear only with the development of an active inflammatory process.

The main instrumental method for the diagnosis of arthrosis is radiography; in cases of unclear diagnosis, computerized or magnetic resonance imaging is recommended.

Arthrosis of the knee and hip joints ranks first in terms of the severity of clinical manifestations and the negative impact on quality of life.

Additional diagnostic methods:

atraumatic arthroscopy;
ultrasound (evaluation of the thickness of the joint cartilage, synovium, condition of the joint capsules, presence of liquid);
scintigraphy (evaluation of the state of bone tissue in the heads of the bones that form the joint).

How to treat arthrosis?

It is best to treat joint arthrosis at an early stage, the treatment itself must be pathogenic and complex. Its essence lies in eliminating the causes that contribute to the development of this disease, it is also necessary to eliminate inflammatory changes and restore previously lost functions.

Arthrosis treatment is based on several basic principles:

Oxygenation of the joint, or the so-called intra-articular oxygen therapy.
Medical therapy.
Intraosseous blocks, as well as decompression of the metaepiphysis.
Sustainable diet.
Damaged joints must be relieved from excessive stress. If possible, it should be kept to a minimum during treatment.
Follow the established orthopedic regime.
Physiotherapy exercises.
Take a physiotherapy course, which includes magnet and electrotherapy, shock waves and laser therapy.
Sanatorium treatment. For this, it is necessary once a year, at the doctor's recommendation, to take a course of treatment in specialized spas.

Preparations for the treatment of osteoarthritis

Drug treatment is carried out in the phase of exacerbation of arthrosis, selected by a specialist. Self-medication is unacceptable due to possible side effects (for example, the negative effect of non-steroidal anti-inflammatory drugs on the gastric mucosa).

Therapy includes the following medications:

Anti-inflammatories. By starting osteoarthritis therapy comprehensively, you can delay the course of the disease and significantly improve the quality of life. It is worthwhile to dwell in more detail on some points of treatment. In particular, drug therapy includes the initial phase - that is, the removal of pain, as well as the elimination of inflammatory processes that occur in the joints. For this, all doctors use non-steroidal anti-inflammatory drugs. Experienced doctors do not recommend oral administration, as these drugs irritate the stomach wall a lot. Therefore, depending on the drug chosen, intravenous or intramuscular administration can be used. Sometimes, as auxiliary agents, NSAIDs are used in the form of ointments, but their absorption is extremely low, so that a significant effect cannot be achieved.
Hormonal corticosteroids. When arthrosis is in the process of exacerbation, it is advisable to take hormonal corticosteroids. They are injected into the joint. Externally, you can use a plaster, ointment or special tincture, which are made based on pepper.
Chondroprotectors aimed at restoring cartilage and improving the qualitative composition of synovial fluid will not be superfluous. The course lasts a very long time, until the moment when there is an improvement. However, if the expected effect does not appear within six months of administration, the drugs must be canceled. Also intra-articular, together with chondroprotectors, it is advisable to use medicines based on hyaluronic acid. They contribute to the formation of the cell membrane responsible for the formation of articular cartilage.

Physiotherapy

To relieve pain, reduce inflammation, improve microcirculation and eliminate muscle spasms, a patient with osteoarthritis is referred to physiotherapy:

Worsening. Prescribe laser therapy, magnetotherapy and ultraviolet radiation,
In remission. Electrophoresis and phonophoresis shown.

In addition, thermal procedures, sulfide, radon and sea baths are used. To strengthen the muscles, electrical stimulation is performed. Gentle massage can also be used during remission.

Surgery

If the exposure methods listed are ineffective, in the presence of complications, resort to surgical treatment of arthrosis:

Decompression of the metaepiphysis and prolonged intraosseous block (decreased intraosseous pressure in the affected area);
Corrective osteotomy;
Joint endoprosthesis.

In the early stages of the disease, mechanical, laser or cold plasma debridement is used (smoothing the damaged cartilage surface, removing unviable areas). This method effectively relieves pain, but has a temporary effect - 2-3 years.

Folk remedies

Most people today don't want to take pills or injections. So, they ask - how to cure arthrosis with the help of folk remedies? For the most part, these resources aim to increase the body's tone, improve blood circulation, relieve pain and increase immunity.

Traditional medicine recipes are used to treat this disease:

The egg solution is made from fresh egg yolk, which is mixed with turpentine and apple cider vinegar in a 1: 1: 1 ratio. The liquid must be well mixed and rubbed over the affected joint duringnight. Then you need to wrap everything up with a woolen scarf. It is recommended to rub for 1 month 2-3 times a week.
Buy elecampane root at the pharmacy. As a rule, it is packaged in 50 gram packs. To prepare the tincture, you will need half a pack of plant roots and 150 ml of high quality vodka. The ingredients are mixed, placed in a dark bottle and infused for 12 days. Rubbing is done before bed and, if possible, in the morning.

The use of boiled oats also gives good results. Take three to four tablespoons of oatmeal, pour boiling water and cook over low heat for five to seven minutes. The amount of water used should provide a thick porridge, which must be cooled and used as a compress during the night. Use only freshly boiled flakes. Yesterday's porridge is not good for a compress.
Birch leaves, nettle leaves and marigold inflorescences are divided into equal parts. As a result, you need two tablespoons. We put the resulting crushed collection in a thermos, fill it with a liter of boiling water and leave it overnight. Starting the next morning, you need to drink half a glass of the broth four to five times a day. The course for taking this recipe is two to three months.

Dyes of bay leaves, horseradish, garlic and rye grains are also considered effective. Treatment of osteoarthritis with folk remedies will be more effective if combined with medications.

Nutrition for arthrosis

The basic principles of nutrition for osteoarthritis are reduced to the following points:

Avoid heavy meals at night to avoid an attack of arthrosis.
Eat fractionally.
Control your weight constantly, to avoid weight gain,and therefore additional stress on your joints.
When there is no worsening of the disease, take a walk after eating.
The menu needs to be balanced, prepared with the attending physician.

There is absolutely no complaint about fish dishes - you can eat a lot of them, of course, in reasonable quantities.

Don't forget your regular vitamin intake from food. For patients with arthrosis, group B vitamins are especially relevant
Gelled meat plays an important role in the treatment of osteoarthritis. This food will be a real deposit of trace elements for painful joints. The most important component in aspic is naturally occurring collagen
Vitamin B helps in the production of hemoglobin. It can be "obtained" by eating bananas, nuts, cabbage and potatoes. It is worth getting carried away by the herbs and vegetables. They will be the source of folic acid. Liver, mushrooms, dairy products and eggs are also useful. They are rich in riboflavin.

Following the treatment regime prescribed by the doctor, it is possible to make the disease regress and the damaged tissues to begin to regenerate.

Prevention

Prevention of osteoarthritis begins with proper nutrition. It is necessary to try to reduce the intake of salt, as well as of foods that can hinder the metabolism. This includes vegetables, fatty meats and alcohol. The diet includes cabbage, vegetables and fish.

For the prevention of arthrosis it is necessary to attend physical education classes, do warm-up. If possible, it is best to walk a few kilometers. It is also important to monitor your weight and prevent weight gain, as this will increase stress on your joints. It is not recommended to take pills to lose weight, as they can disturb the body's metabolism.

Forecast

Life prospects are favorable. The favorability of the social and labor prognosis depends on the opportunity for diagnosis and the beginning of treatment, decreases when the decision on the surgical treatment of the disease is delayed, if necessary.