According to WHO (World Health Organization) statistics, joint diseases occupy one of the main places in terms of prevalence among the population. Currently, there is a rapid increase in such diseases, primarily associated with lifestyle changes. Low level of physical activity, stress, excess body weight, sedentary work, incorrectly selected shoes, injuries have led to the fact that diseases of the musculoskeletal system have become “younger” and are increasingly found not only in older people, but also in young people. One of the common symptoms when visiting a doctor is pain, decreased range of motion, redness, joint deformity, swelling, and dysfunction. Medical specialists will be able to diagnose the cause of the disease and prescribe the necessary treatment.
Causes of joint disease
The musculoskeletal system of each person consists of bones, ligaments, muscles and joints. Changes in the functioning of the joint link affect the functioning of the joint as a whole, leading to dystrophic changes and characteristic symptoms. For example, osteoporosis is a disease of the bones and joints, in which the density of bone tissue decreases, it becomes more fragile, and the risk of fractures increases. This disease can be asymptomatic for a long time, but most often the vertebral bodies are affected and become displaced, thereby causing pain and forcing you to go to the doctor. Constant monotonous physical work associated with lifting weights, a static, “sedentary” lifestyle, irrational, sudden load in the gym - all this leads to excessive impact on the joint, leading to its wear and deformation. Injuries, fractures, and bruises received at home can lead to muscle rupture, ligaments, bone fractures and dysfunction of the joint as a whole. Poor nutrition and a high body mass index lead to poor circulation in the tissues, heavy load on the joints and rapid wear.
Inflammatory causes of joint disease
One of the causes of joint diseases is inflammatory processes caused by autoimmune, allergic reactions in the body or infectious agents. Arthritis is a collective term for joint diseases of inflammatory etiology. These include:
- Rheumatoid arthritis is an autoimmune disease, the characteristic feature of which is inflammation in the joints. The causes of rheumatoid arthritis are the following factors: genetic, infectious and trigger. Their complex effect triggers the autoimmune mechanism of disease development.
- Septic (infectious) arthritis is a disease in which inflammation of the joints occurs due to the entry of an infectious agent hematogenously (through the blood), lymphogenous (through the lymph and lymphatic system) or directly (due to injury and damage). Thus, the source of infection can be located not only in the joint cavity, but also remotely. Most often, this disease affects large joints (monoarthritis), but as it progresses, the process can spread throughout the body.
- Polyarthritis is an inflammatory process that affects several joints simultaneously or sequentially. It can occur as an independent pathological process, or be a consequence of infectious and non-infectious diseases: sepsis, gout, severe stressful situations and others.
- Spondylitis is an inflammatory disease affecting the vertebral bodies, which subsequently leads to their deformation and destruction and severe pain. The most severe form of spondylitis is spondyloarthritis - ankylosing spondylitis - in which there is a sharp limitation of joint mobility due to the replacement of the elastic connective tissue structure with bone tissue. The presumable cause of this disease is autoimmune processes, heredity and the trigger for the development of the disease in the form of infection, hypothermia and injury.
Metabolic causes of joint disease
Nutrition and metabolic disorders play an important role in the development of joint disease. Gout is a metabolic disease characterized by the deposition of urate crystals and the accumulation of uric acid. The cause of this disease is a combination of factors, such as: excessive consumption of red meat, coffee, tea, alcohol; concomitant pathology in the form of arterial hypertension, renal failure, autoimmune diseases. A characteristic symptom of gout is tophi - gouty nodules that lead to deformation and destruction of the joint. The disease subsequently spreads to the kidneys and other organs, leading to multiple organ failure.
Degenerative-dystrophic causes of joint disease
The pathogenesis of dystrophic diseases consists of progressive metabolic (metabolic) disorders of cartilage and bone tissue and the gradual involvement of other articular structures in the pathological process, the development of deformity, a decrease in active movements, loss of function, constant pain and a deterioration in the quality of life.
Osteochondrosis is a complex degenerative change in articular cartilage. There are three forms of spinal osteochondrosis: cervical, thoracic and lumbar. According to clinical recommendations, one of the reasons for the development and progression of this disease is genetic predisposition. This is due to the individual characteristics of the spinal-root-spinal relationship: variability in the number of lumbar and sacral vertebrae and the level of exit of the roots from the spinal cord. In addition, there are immune, hormonal, vascular, metabolic and infectious causes. Excess weight, injuries, bruises, sedentary, sedentary lifestyle, irrational physical activity, spinal overload, smoking, stressful situations also play an important role in the development and steady progression of the disease.
Osteoarthritis is a degenerative disease caused by damage to cartilage. The etiology of osteoarthritis is based on trauma, dysplasia (congenital inferiority of the joint) and inflammation. In addition, there are risk factors that affect the development of this disease: heredity, obesity, metabolic and endocrine disorders, inflammatory processes in the joint and in the body, trauma, surgery, hypothermia. A feature of osteoarthritis is the formation of osteophytes. Osteophyte is a pathological growth on the surface of bone tissue that causes deformation of the joint - deforming osteoarthritis.
Symptoms of pathology
The initial stages of degenerative-dystrophic pathologies are almost asymptomatic. Changes may occur in the knee, hip, ankle, shoulder, wrist, spinal joints and movable joints of the hand and foot. Depending on the type of pathology, the following may be observed:
- stiffness in movements;
- painful sensations;
- crunching in joints;
- appearance of lameness;
- creaking or clicking in the joint;
- muscle atrophy.
Diagnosis of joint and bone diseases
The basis for diagnosing any disease is a thorough history taking. It is important to objectively assess the patient’s complaints and differentiate them from other diseases. For example, pain in the lumbar region can occur not only with lumbar osteochondrosis, but also with diseases of the pelvic organs, and the clinical picture of osteochondrosis of the thoracic spine is similar to the symptoms of pain in the heart and even heart attacks.
It is important to establish how long ago the complaints began, whether there are congenital anomalies, previous injuries, surgeries, infectious, inflammatory and chronic diseases. It is necessary to note when and how often exacerbations occur, how quickly these symptoms stop, whether they are associated with physical activity or occur at rest. Next, a visual inspection and palpation of the joints is necessary. The integrity, shape, size of the joint, color and temperature of the skin are assessed. You can palpate rheumatoid nodules, establish pain during passive movements, crunching, degree of loss of function, range of mobility.
Laboratory diagnostics is of great importance. A biochemical, general blood and urine test will allow you to assess the presence of an inflammatory process in the body. Synovial fluid can be used for research, which reflects the presence or absence of infectious agents in the joint cavity. To confirm the inflammatory process, its color, transparency, consistency, and viscosity are assessed.
Instrumental diagnostic methods are often the gold standard for diagnosing joint disease. X-ray examination is most informative for injuries of bones and joints, fractures, dislocations, and sprains. Ultrasound diagnostics (ultrasound) is used to assess the condition of soft tissues, muscles, ligaments, cartilage, and the level of synovial fluid. Magnetic resonance and computed tomography (MRI and CT) are reliable, non-invasive and safe research methods. It is possible to assess the degree of joint destruction, the spread of the pathological process, and evaluate the labor and clinical prognosis.
Treatment
Pre-hospital assistance
In case of injury, the arm or leg is fixed using a splint or improvised devices (for example, planks), and the limbs are ensured in an elevated position. Cold is applied to the injured area, and an analgesic is given for severe pain. For pain, swelling, and redness of non-traumatic origin, rest is recommended; short-term use of painkillers and anti-inflammatory drugs is acceptable. An increase in symptoms, an increase in general temperature, and a deterioration in general condition are reasons for urgent consultation with a specialist.
Conservative therapy
For patients with traumatic injuries, a blockade of a fracture or dislocation is performed, reduction is performed, and immobilization is performed with a plaster cast. Sometimes skeletal traction is indicated. Conservative therapy for joint deformities may include the following measures:
- Protective mode
. Includes load limitation, sometimes the use of orthopedic devices, canes, crutches, walkers. - NSAIDs
. They are an essential part of the treatment of many diseases and injuries. Reduce pain, reduce the severity of the inflammatory process. Can be used in the form of tablets, injections, creams, ointments, gels. - Antibiotics
. Necessary for infectious pathology. For nonspecific infections, they are prescribed in short courses (from one to several weeks). For STIs, they are administered according to special regimens. For tuberculosis, long-term treatment lasting several months is indicated. - Hormonal drugs
. In the form of blockades, they are used when pain and anti-inflammatory treatment is ineffective during exacerbations. Some autoimmune pathologies require the use of general medications. - Chondroprotectors
. Improves the condition of cartilage tissue. Intra-articular administration, tablets or injections are possible. - Physiotherapeutic procedures
. Taking into account the characteristics of the pathology, drug therapy is supplemented with medicinal electrophoresis, UHF, ozokerite and paraffin applications, magnetotherapy, laser therapy, shock wave therapy, massage, manual therapy, acupuncture. - Physiotherapy
. During the treatment period, exercise therapy ensures the preservation of limb function and reduces the risk of complications. At the rehabilitation stage, it allows you to improve the functions of the affected segment and restore your ability to work.
Anatomy
Facet joints connect adjacent vertebrae to each other, eliminating bone friction due to the cartilage layer and the production of synovial fluid, thereby ensuring the mobility of the spine. In addition, these joints limit some trunk movements in order to reduce stretching of the intervertebral discs. For example, when twisting and turning the body, the articular surfaces diverge, forming uniform pressure on the core of the intervertebral disc. If the pressure is too strong, there is a risk of disc protrusion - a hernia. This makes it clear why some combinations of movements may be unsafe for the spine. For example, a sharp transition from leaning forward to the side.
Arthrosis of the knee joint 1st degree
At the initial 1st stage, patients feel satisfactory; they experience pain or discomfort in the affected knee only after a long walk or intense physical activity. Remember, a healthy joint should not hurt; if there is such a problem, you need to consult a doctor. As a rule, in patients with initial symptoms, the narrowing of the joint space is already clearly visible on the X-ray. There is no deformation of the articular surfaces yet, but the amount of articular fluid decreases, friction increases, and the trophism of the cartilage tissue worsens.
Arthrosis of the knee joint 3rd degree
Grade 3 gonarthrosis is characterized by a deformation of the knee that is noticeable to the naked eye. The patient is practically unable to move independently, the range of motion in the joint is limited, accompanied by a crunching sound. The X-ray shows signs of total destruction of cartilage and deformation of the articular surfaces. At this stage of the disease, only the installation of a knee joint endoprosthesis will help restore the ability to move.
Summarize. Symptoms that require immediate medical attention:
- pain when starting to move, which then goes away;
- discomfort in the knee when the weather changes;
- discomfort after physical activity;
- night pain;
- crunching in the knees;
- decreased range of motion in the joint;
- deformation, swelling of the knee.
Diagnosis of gonarthrosis
Diagnosis begins with a conversation with the patient and examination. Typically, complaints and the appearance of the knee allow a preliminary diagnosis to be made. To clarify the diagnosis, methods such as radiography, CT, MRI, and arthroscopy using an endoscope are used.
Additional studies are also prescribed to rule out rheumatic diseases and determine the condition that provoked the degeneration of articular cartilage.
Treatment methods for arthrosis of the knee joint
The main methods of treatment are drug therapy, physiotherapy, surgery and endoprosthetics of the affected joint. Also, a significant role belongs to the normalization of physical activity, nutrition, and the fight against diseases that cause changes in the joint. All patients are advised to control their body weight; prolonged standing on their feet and intense physical activity (sports training, weight lifting, etc.) are not recommended.
Many people prefer to treat arthrosis of the knee joint with folk remedies. For this purpose, mummy, compresses from burdock, horseradish, and turpentine are used. Unfortunately, these drugs cannot stop the process of joint degeneration; therefore, using them at an early stage, the patient loses valuable time. Many argue that traditional methods reduce pain, but this is not a reason to refuse drug therapy, which can actually stop the destruction of the joint.