We are not afraid of arthrosis of the hands: simple prevention

Traumatologist-orthopedist (adults and children)

Bogatov

Victor Borisovich

21 years of experience

Highest qualification category. Doctor of Medical Sciences, Professor of the Department of Traumatology and Orthopedics, First Moscow Medical University. I.M. Sechenov.

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Arthrosis is a disease that affects human joints. First, the disease affects the articular cartilage, and then becomes chronic and spreads to nerves, ligaments, muscles and bone.

general information

Arthrosis is a chronic, long-term process that affects not only the joints. As it progresses, dystrophic and degenerative changes and auxiliary apparatus occur. In the process, the patient faces inflammation of the cartilage and bone tissue, joint capsule and periarticular bursa, as well as the muscles, ligaments and subcutaneous tissue in contact with them.

Regardless of the location, the pathological process follows a single pattern. First, in the thickness of the tissue, the balance between the processes of growth and destruction of cartilage is disturbed, and the balance shifts in favor of dystrophy and reverse development (degeneration). At this time, invisible changes occur in the microstructure of the cartilage, which leads to its thinning and cracking.

As the disease progresses, the joint loses its elasticity and becomes more dense. This reduces its ability to absorb shock; the rate of tissue damage is constantly increasing due to vibration and microtrauma during movements. The thinning of the cartilage layer provokes the active growth of bone structures, as a result of which spines and protrusions appear on the smooth surface of the joint - osteoarthritis develops. Movement becomes increasingly limited and painful. Spasms of the muscles surrounding the affected area develop, which aggravates the pain and deforms the limb.

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Joints love warmth

The main axiom for preventing arthrosis is that joint tissues and cartilage do not like cold. Also, keeping joints warm should be done both for preventive purposes and for patients with arthrosis of the knee joint and those who have been diagnosed with osteoarthritis. Knee pads, which you can buy or sew yourself, can provide tangible benefits for maintaining heat. Knee pads are able to firmly support the joint, fix and warm the knee.

The basic rule for people who have joint diseases or are simply concerned about their health is not to get colds in their knees, elbows and hip joints.

Stages of the disease

Arthrosis of the joints develops gradually and in the process goes through three successive stages that determine the severity of the disease:

• Stage 1: the pathology is not detected on X-ray or ultrasound, but the destruction processes have already started; the composition of the joint fluid changes, as a result of which the tissues receive fewer nutrients and become more sensitive; increased stress on the affected area causes inflammation (arthritis) and pain;
• Stage 2 is characterized by active destruction of cartilage tissue, and bone spines and growths appear along the edges of the articular platform (the area of ​​contact of surfaces); at this time, the pain becomes habitual, and the inflammatory processes become stronger and weaker; spasms of the muscles associated with the joint are periodically observed;
• Stage 3: areas of destruction affect almost the entire surface of the cartilage, the articular area is deformed, the affected limb deviates from its axis; range of motion decreases and ligaments weaken and become short.

Some experts also distinguish stage IV of the development of arthrosis. It is characterized by almost complete immobility of the joint.

Walking with a cane with arthrosis

Using a cane will free the joints from unnecessary stress, so this preventive measure is also considered as an additional way to treat arthrosis of the legs. By leaning on a stick, patients with arthrosis of the hip or knee joints reduce the load by 40%.

To choose the right cane that will suit a person's height, stand up straight, lower your arms down and measure the distance from the floor to your wrist. The result is the recommended stick length. When buying a cane, you should pay attention to the tip. It should have a rubber pad that will prevent slipping and absorb movement.

It must be taken into account that if the left knee is sick, the stick must be held in the right hand, and vice versa. When taking a step, you need to transfer part of your body weight to the cane. As a result, walking will become less painful.

To make the disease cause less pain, you can purchase special chairs with armrests that protrude forward. When standing up, you need to lean on them, focusing on the wrist area. This will redistribute your body weight so that your joints won't hurt when you stand up.

Kinds

Depending on the cause of the disease, primary and secondary arthrosis are distinguished. In the first case, the pathology occurs independently against the background of the complex influence of predisposing factors. The secondary form is a consequence of other diseases and is divided into the following groups:

• joint damage resulting from metabolic disorders or endocrine diseases (gout, diabetes mellitus, acromegaly, hyperparathyroidism);
• destruction associated with congenital pathologies (Paget's disease, congenital hip dislocation, scoliosis, hemophilia, etc.);
• post-traumatic arthrosis, which arose against the background of fractures, cracks, necrotic processes or surgical operations, as well as due to the characteristics of the profession.

The most popular classification of osteoarthritis is depending on the location of the pathological process:

• gonarthrosis: damage to the knee, one of the varieties of which is palletofemoral arthrosis - destruction of the joint between the femur and the patella);
• arthrosis of the ankle joint: occurs against the background of heavy load and frequent injuries;
• arthrosis of the foot joints: the big toe most often suffers at the junction with the foot; the lesion develops against the background of gout or hallux valgus;
• shoulder arthrosis is characterized by damage to the shoulder and often occurs at a young age against the background of increased physical activity (loaders, athletes, construction workers);
• coxarthrosis: damage to the hip joint; can be both unilateral and bilateral and is one of the common causes of disability in people over 50 years of age;
• vertebral arthrosis: destruction of the cartilage discs between the vertebrae, most often affecting the cervical and lumbar spine;
• arthrosis of the joints of the hand: the joints of the fingers are most often affected; women in menopause are especially susceptible to pathology;
• arthrosis of the temporomandibular joint: it is quite rare, most often against the background of chronic inflammation due to malocclusion or improper prosthetics;
• Arthrosis of the elbow joint: a rare form of the disease, most often associated with injuries to this area.

Categories of people most susceptible to disease

Despite the fact that absolutely anyone can get arthrosis, there are a number of categories of people who are especially susceptible to this disease. These include:

• elderly people suffering from disorders of the endocrine system;
• obese persons;
• athletes and people whose work involves excessive physical activity, often abnormal;
• patients who have undergone joint surgery in the past;
• people with a genetic predisposition: if parents or grandparents suffered from arthrosis, then there is a high probability that it can also be passed on to their children (grandchildren);
• patients with dystrophic disorders in the lumbar and cervical spine.

Reasons for development

The main factor in the development of arthrosis is the discrepancy between the load experienced and the ability of the joint to withstand this load. Acute or chronic, this process inevitably leads to tissue destruction.

The list of reasons that increase the risk of developing arthrosis of any localization includes:

• heredity;
• endocrine pathology (diabetes mellitus);
• injuries of the articular apparatus: bruises, dislocations, fractures or cracks of bones inside the joint capsule, complete or partial ruptures of ligaments, penetrating wounds;
• regular increased load on the joints associated with the profession);
• obesity;
• hypothermia;
• previous inflammatory diseases of the joints: acute arthritis, tuberculosis, etc.;
• blood diseases in which bleeding into the joint often occurs (hemophilia);
• sudden changes in hormonal levels (pregnancy, menopause);
• local circulatory disorders due to atherosclerosis, varicose veins, thrombophlebitis, etc.;
• autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, etc.);
• connective tissue dysplasia (congenital pathology, accompanied, among other things, by excessive joint mobility);
• congenital pathologies of the musculoskeletal system (flat feet, dysplasia or congenital dislocation of the hip joint, etc.);
• age over 45-50 years (increased risks are associated with a decrease in collagen synthesis);
• osteoporosis (bone loss);
• chronic intoxication of the body (including salts of heavy metals, drugs, alcohol);
• surgical interventions on joints.

Preventive measures

The basis for preventing arthrosis is reducing the risk of injury. The main measures include:

• a competent training regimen (if the sick person plays sports);
• getting rid of excess weight;
• timely diagnosis and treatment of rheumatic and endocrine diseases;
• in the case of a genetic predisposition, be attentive to your health and not overexert yourself physically, and ensure moderate physical activity.

Symptoms

Symptoms of arthrosis practically do not depend on its cause and location, since changes in the joints follow the same scenario. The disease develops gradually and begins to manifest itself when the cartilage is quite seriously damaged.

One of the first signs of trouble is a crunching sound in the problem area when moving. It most often occurs when the knee or shoulder is affected. At the same time, a person may feel a slight decrease in mobility after prolonged inactivity, for example, in the morning.

When asked what symptoms appear with arthrosis, most patients name pain first. At first insignificant and weak, it gradually gains strength, preventing normal movement. Depending on the stage and location of the pathology, a person may feel:

• starting pain: occurs during the first movements after prolonged inactivity of the joint and is associated with the formation of a thin film of destroyed tissue on the surface of the cartilage; after starting work, the film moves and the discomfort disappears;
• pain during prolonged physical activity (standing, walking, running, etc.): appears due to a decrease in the shock-absorbing properties of the joint;
• weather pain: provoked by low temperature, humidity, changes in atmospheric pressure;
• night pain: associated with venous stagnation and increased blood pressure inside the bones;
• joint blockade: sharp, severe pain associated with pinching of a piece of cartilage or bone located in the joint cavity.

As arthrosis develops, the symptoms become more noticeable, the patient notes the following signs:

• increase in morning stiffness;
• intensification and increase in duration of pain;
• decreased mobility;
• joint deformation due to bone growths;
• deformation of bones and surrounding tissues: the process is clearly visible on the limbs and fingers, which become noticeably curved.

When inflammation occurs, the affected area swells, turns red and becomes hot to the touch. Pressing on it causes a sharp increase in pain.

What is this?

Arthrosis is a chronic degenerative disease of the joints, which is expressed in their destruction (Fig. 1). In this case, all structures of the joint articulation are damaged - cartilaginous, bone, connective tissue (ligaments and joint capsule). The disease is common: it affects from 6–7 to 10–15% of the population of different countries. Thus, in the territory of the former USSR, 6-7% of the population suffers from arthrosis, and in the United States, 32.5 million adults suffer from arthrosis. Most often, this percentage includes people over 45 years of age, but there are also patients younger.

Figure 1. Development of arthrosis of the right hip joint (front view, diagram). During arthrosis, cartilage is destroyed, which over time leads to bone deformation. The damaged joint swells and hurts. Source: CC0 Public Domain

Tests and diagnostics

An orthopedic surgeon diagnoses arthrosis. He conducts a detailed interview with the patient to identify complaints and medical history. The doctor asks in detail about the time of the first signs and the speed of their development, previous injuries and illnesses, and the presence of similar problems in relatives.

A general blood test can reveal the inflammatory process that often accompanies arthrosis.

The main diagnostic method is radiography. The following signs are clearly visualized in the image:

• narrowing of the joint space;
• change in the contours of contacting bones;
• impaired bone structure in the affected area;
• bone growths (osteophytes);
• curvature of the axis of a limb or finger;
• subluxation of the joint.

For a more detailed diagnosis, the following may be prescribed:

• computed tomography (CT);
• magnetic resonance imaging (MRI);
• Ultrasound of the joint;
• arthroscopy (internal examination of the joint cavity using a camera inserted through a small puncture);
• scintigraphy (assessment of the condition of bones and metabolism in them using the introduction of radiopharmaceuticals).

If a secondary nature of the disease is suspected, appropriate tests and consultations with specialists are prescribed.

Treatment of joint arthrosis

The choice of treatment for joint arthrosis depends on the cause of the disease, its stage and symptoms. In the arsenal of doctors there are:

• medications;
• non-drug treatment;
• surgical techniques.

In addition, the patient is required to strictly follow a diet and adjust their lifestyle to minimize further damage to the joints.

Drug treatment

Prescribing medications for arthrosis has two main goals:

• relieving pain and inflammation;
• restoration of cartilage tissue or, at least, stopping further degeneration.

To alleviate the patient's condition, various types of drugs are used:

• non-steroidal anti-inflammatory drugs: ibuprofen, ketorolac, diclofenac and their analogues in the form of tablets, injections, ointments or suppositories; they relieve pain and inflammation well;
• hormones (corticosteroids): indicated for severe pain and, most often, injected directly into the joint cavity;
• other analgesics, for example, antispasmodic (mydocalm): help reduce pain by relaxing muscles;

It is important to remember: all types of painkillers are used only to alleviate the patient’s condition. They do not affect the condition of cartilage, but when taken for a long time, they accelerate its destruction and cause serious side effects.

The main drugs for joint restoration today are chondroprotectors. They help saturate the cartilage with nutrients, stop degeneration and initiate cell growth processes. The most common remedy in this group is glucosamine and its analogues. They have an effect only at the early and middle stages of the disease and with regular long-term use.

Drugs that improve microcirculation in tissues and antienzyme agents help enhance the effect of chondroprotectors. The former provide a good supply of oxygen and nutrients to the affected area, while the latter slow down the processes of tissue destruction.

The doctor selects specific medications, their dosage and regimen.

Non-drug treatment

Non-drug treatment includes the following methods:

• physiotherapy: shock wave therapy: destroys bone growths and stimulates blood circulation due to ultrasound;
• automated electromyostimulation: exposure to electrical impulses to stimulate muscle contraction;
• ultraphonophoresis: exposure to ultrasound combined with the use of medications;
• ozone therapy: introduction of a special gas mixture into the joint capsule;

Surgery

Most often, the help of a surgeon is required in severe stages of the disease. Depending on the localization of the pathological process and the degree of damage, the following may be prescribed:

• puncture: puncture of the joint with removal of part of the fluid and, according to indications, administration of drugs;
• corrective osteotomy: removal of part of the bone followed by fixation at a different angle to relieve the load on the joint;
• endoprosthetics: replacement of a damaged joint with a prosthesis; used in extremely advanced cases.

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Types of disease

In modern orthopedics, the diagnosis of arthrosis begins with determining its type. Thus, according to localization, diseases of the ankle, elbow, shoulder and other joints are distinguished.

At the appointment, the stage of spread of the disease is determined:

• the first implies the absence of pronounced changes. The cartilage tissue lacks nutrients, and the cartilage itself becomes less resilient. Primary inflammation leads to unpleasant pain;
• the second stage of arthrosis involves the destruction of the cartilage structure and the spread of bone growths. The patient suffers from regular pain, which either subsides or reappears;
• in the third degree of arthrosis, the cartilage becomes especially thin and deformed, and joint mobility is sharply limited due to shortening of the ligaments.

Are you experiencing symptoms of arthrosis?

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Arthrosis in children

Arthrosis is considered a disease of older people, but it can also occur in children. The most common causes of pathology are:

• congenital pathology of connective tissue;
• severe injuries;
• heredity;
• metabolic disorders and functioning of the endocrine glands;
• orthopedic disorders (flat feet, scoliosis, etc.);
• overweight.

Children's arthrosis is rarely accompanied by severe symptoms: the pain is aching, and there is virtually no stiffness or limitation of function. Degenerative changes are detected on x-rays, MRI and ultrasound. The treatment process uses the same means as for adults. Maximum attention is paid to exercise therapy and physiotherapy, since they are especially effective at a young age. Without treatment, the disease sooner or later goes into an advanced stage with complete loss of mobility.

Diet

Diet is one of the most important factors in the treatment of arthrosis. If you are overweight, you need to reduce it to reduce the stress on your joints. In this case, a balanced diet with a calorie deficit is prescribed. Regardless of body mass index, doctors recommend completely avoiding:

• fast carbohydrates (sugar, desserts, flour);
• alcoholic drinks;
• spices;
• legumes;
• strong tea and coffee;
• excessively fatty and spicy foods.

Canned food and offal are not excluded, but are significantly limited, as is salt. An ideal diet for osteoarthritis includes:

• lean meats;
• fish and seafood;
• eggs;
• dairy products;
• flaxseed and olive vegetable oils;
• vegetables and fruits, a large amount of greens;
• cereals in moderation, durum wheat pasta;
• products with a high content of collagen (jellied meat, jellied meat, jelly).

How to avoid “dacha disease”

Avid summer residents often complain about exacerbation of gonarthrosis during the season, which is understandable. In an effort to redo all the garden work, a person completely forgets about pain in the joints, often squats, and spends a lot of time immobile. If you are not ready to give up dacha worries completely, follow these tips:

• use a chair with high and durable armrests at the dacha that will help you get up from it;
• When working in the garden, a small, light stool will come in handy.

If you plan to spend the whole summer or so in a country house, make sure that it is comfortable and safe. Get rid of worn-out carpets and rugs with curled edges. Screw in light bulbs everywhere, and make sure there are no tripping hazards in hallways or garden paths.

At dachas, the likelihood of injuring joints increases: take care of safety in advance

Prevention

Arthrosis is easier to prevent than to treat. To maintain healthy joints for many years, it is recommended:

• to live an active lifestyle;
• do exercises regularly and visit the pool;
• eat right, consume enough omega-3 and collagen;
• do not exceed the BMI norm;
• wear comfortable shoes.

If the disease is diagnosed at an early stage, it is recommended to undergo regular spa treatment, as well as to exclude occupational risk factors: prolonged standing, heavy lifting, vibration.

How is rheumatoid arthritis treated?

At the initial consultation, the rheumatologist will prescribe additional examinations - a blood test, x-ray of the joint, ultrasound or MRI. It is impossible to completely cure the disease, so therapy is aimed at relieving unpleasant symptoms and preventing complications.

• Anti-inflammatory drugs relieve inflammation and pain.
• Immunomodulatory - inhibit immune reactions.

With proper treatment, remission lasts a very long time, and sometimes the disease disappears completely, but treatment will take many years. But it is strictly forbidden to massage or warm up joints affected by rheumatoid arthritis. Such manipulations lead to exacerbations.

For rheumatoid arthritis, massage and warming are contraindicated

Treatment at the Energy of Health clinic

Medical orthopedists invite everyone to check the condition of the joints and, if necessary, begin treatment. We use modern effective techniques:

• full-fledged drug therapy in accordance with indications;
• physiotherapy, exercise therapy and massage;
• diagnostic and therapeutic punctures of the joint with the introduction of a synovial fluid substitute or medications;
• drug blockades for complete pain relief and other techniques.

You can view the full list of services on the website or by phone.

Advantages of the clinic

“Health Energy” is a multidisciplinary medical center equipped in accordance with modern standards. We offer patients:

• consultations with experienced doctors;
• examination using high-quality diagnostic equipment;
• individual approach to treatment selection;
• regular monitoring and performance monitoring.

The joints of our body can withstand enormous loads, but there are situations when they need help. Don’t let arthrosis change your life, sign up for a consultation at Health Energy.