Mar 06, 2018
Deforming arthrosis is the most common joint disease caused by premature aging and degeneration of articular cartilage.
It is known as a degenerative joint disease, is the gradual age-related wear of the cartilage within the joints, which causes pain and sometimes deformation.(Inflammation of the joints is rare.) This is the most common form of arthrosis: almost all people have some degree of arthrosis in one or more joints at the age of 60 years. The disease can affect any joint, but most often arthrosis affects the joints of the fingers, neck, spine, hips, knees and legs.
Because the elastic cartilage, which serves as a lining between the bones, is damaged, the ends of the bones may begin to rub against each other, resulting in abnormal outgrowths called osteophytes or spurs;when the joint works they can rub against each other. Damage usually develops gradually over the years. In some people, the symptoms remain moderate or even disappear;in others, the symptoms gradually increase until they take the person out of action. Affected joints may begin to lose their shape. There may also be weakness and exhaustion of the muscles surrounding the joints, if pain and stiffness interfere with normal movement.
Osteoarthritis does not affect life expectancy, but it can worsen the quality of life. There is no way to treat the disease, but there are many medications that can ease the pain and minimize incapacity. About folk methods of treatment of this disease look here.
The basis of the disease is associated with a violation of metabolic processes in the cartilage. It is assumed that the metabolic disturbance arises because of prolonged traumatization of the joint, due to high physical exertion, circulatory disorders. An important role belongs to hereditary factors, the state of immunity and the endocrine system.
• Osteoarthritis is one of the effects of aging, developing as a result of gradual wear and friction of the joints.
• Obesity increases the risk of developing arthrosis in the joints, which account for the main load, for example, on the joints of the hips, knees and back.
• Injury or excessive strain on the joint can accelerate the development of arthrosis. This is usually observed in athletes, as well as in those whose occupations require a constant repetition of one movement, for example, pianists, typists, machinists and dancers.
• Joint pain, which increases with movement and decreases with rest.
• Stiffness, especially in the morning or after exercise;loss of flexibility in the affected joints.
• Knotty growths on the joints, in particular at the terminal phalanges of the fingers( Geberden's nodules) or on the middle joints of the fingers.
• Audible crackling when moving joints.
• Changes in the gait.
• Occasionally, redness, fever and swelling of the joint.
Deforming arthrosis leads to a decrease in the size of cartilage, causes compaction and deformation of articular surfaces with areas of abundant growth of bone protrusions. Sclerosis and wrinkling of the joint capsule are attached to all of the above phenomena. All this leads to a permanent deformation of the joint, however, as a rule, does not cause a significant disruption of its function.
Women who are aged 40-60 years are more likely to get sick. Damaged mainly hip and knee joints, as well as the joints of hands and fingers. In severe cases, arthrosis can be generalized, and virtually all the joints of the body are involved in the process. As the disease develops, small pains appear in the joints, mainly towards the evening, and the deformity of the joints slowly develops, their shape changes. Movement in the joints remain in full and only occasionally hampered due to soreness.
The clinical picture of the disease largely depends on which of the joints is most heavily involved in the process. With deforming arthrosis of the hip joint, patients complain of pain while resting on the aching leg. Lameness is an early symptom of the disease. In the future there is a significant limitation of all movements in the joint. In the late stage, the limb is shortened due to subluxation of the femoral head, atrophy and a decrease in the mass of the hip muscles. Osteoarthritis of the knee joint is manifested by dull pain, mainly when descending the stairs. Pain is localized from the inner surface of the joint;there may be a slight swelling, deformation due to the altered bone. The deforming arthrosis of the interphalangeal joints of the hands is observed mainly in women in the climacteric period.
Persistent, dense symmetrical thickening of the joints of the fingers is developed, sometimes painful on palpation and often leading to a curvature of phalanges. Pain occurs mainly in the evening, after physical exertion and hypothermia.
The course of the disease is chronic and prolonged, without marked exacerbations. During the period of involvement in the process of the joints, some pain may be somewhat increased.
The diagnosis of deforming arthrosis is established in the event that the patient has a persistent deformation of the joint, a change in its configuration. At the same time there is no significant restriction of the function, inflammatory phenomena( swelling, redness, severe pain syndrome, presence of inflammatory reactions in the blood) take place. On the radiographs, the articular fissure of the affected joint is narrowed, the configuration of articular surfaces is changed, and the marginal bony projections grow.
• A medical history and physical examination are needed.
• X-rays can be taken.
• In rare cases, when the diagnosis is inaccurate, a liquid for laboratory analysis can be taken from the affected joint with a needle.
Treatment of deforming arthrosis is a difficult and complex task. Only constant, long-term therapy can lead to improvement of the subjective state of the patient, to stop the development of the process. It is necessary to reduce the load on the affected joint( restrict walking, prolonged standing, categorically forbidden to carry weights).Reducing body weight is an indispensable cause of adequate treatment of the disease.
Obesity not only increases the load on the joints, but also contributes to the violation of blood circulation in the joints due to a disorder in the hemodynamics of the body as a whole. At far gone processes it is recommended to use crutches or sticks.
From drugs prescribe drugs that improve the metabolism of cartilage( annual courses of rumalone, 0.5-10 ml intramuscularly every other day, only 25 injections).Anti-inflammatory drugs( indomethacin, voltaren, brufen, acetylsalicylic acid, etc.), biostimulants( aloe, vitreous), vitamin therapy( vitamins B, nicotinic acid) are used.
Intraarticular administration of hydrocortisone is recommended when involving the articular membranes and strengthening the pain syndrome.
• Relief can bring packets of ice, warm compresses, heating with lamps and a warm bath or shower.
• Tires, corsets, cervical collars, supports or walking sticks can provide support and limit the strain on the affected joint.
• Regular exercise is recommended under the guidance of a physician or physiotherapist. A proper exercise program can help maintain flexibility, strengthen the muscles( and thus reduce the burden on the joints) and improve the overall condition. Doctors can also evaluate the performance of daily activities( eg dressing, brushing teeth, cooking) and recommend ways to improve their performance.
• The main goal of using drugs is to reduce pain. Acetaminophen and non-steroidal anti-inflammatory drugs( eg, ibuprofen, naproxen and salsalate) can be very useful. Now there are new drugs( called cyclooxygenase-2 inhibitors) that reduce pain and have an anti-inflammatory effect with a lower risk of bleeding or stomach ulcers( common side effects of non-steroidal anti-inflammatory drugs).
• Treatment of arthrosis of the knee is aimed at reducing joint pain and consists in the additional introduction or increase of natural lubrication and enhancing the protective properties of the synovial fluid. Two medicinal preparations are obtained from the substance contained in the synovial fluid. These drugs( hyalgene and synviscus) are recommended for the treatment of knee arthrosis after traditional therapies are unsuccessful.
• Various surgical procedures, including arthroplasty( complete replacement of joints), can be used for the expressed development of the disease. The joints of the hip or knee are most often replaced. The doctor should discuss with the patient what actions he would like to perform after the replacement of the joint;this helps the surgeon to choose the appropriate type of prosthesis and helps the patient understand the risks and limitations that await him after the operation.
• Scientists are studying new drugs that can stop the disease or repair damage as a result of arthrosis. Much attention is paid to glucodamine and chondroitin sulfate. These substances, occurring in nature, play an important role in the formation and maintenance of cartilage of the joint and can contribute to its recovery. Since these substances obviously cause some side effects, research is needed to determine their long-term benefit and safety.
• Injections of corticosteroids into the joint can be used to relieve severe pain, especially if only one or more joints are affected. One injection can provide long-term relief of pain( for several weeks or months).
The use of physiotherapeutic procedures is shown: general hydrogen sulphide and radon baths, ultrasound with hydrocortisone on the affected joints, UHF, paraffin or mud applications, massage, therapeutic exercises without stress on the joints( lying or sitting).Recommended spa treatment in Pyatigorsk, Evpatoria, Sakah, Odessa, Sochi, Kemerovo, Sernovodsk. At a far gone process resort to surgical treatment of the disease, even to a complete replacement of the joint with an artificial prosthesis.
The course of the disease is undulating.
Forecast is favorable. The ability to work is in most cases preserved, with hip injury reduced or lost.
• Maintain a healthy weight.
• If symptoms of arthrosis begin to interfere with normal actions, arrange a meeting with your doctor.