Arthrosis: causes, symptoms and diagnosis

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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What is arthrosis

Arthrosis is a disease of the joints of a degenerative-dystrophic nature with the gradual destruction of cartilage and proliferation of bone tissue. The process is accompanied by deformation, impaired joint function and pain. Recently, the term osteoarthritis (OA osteoarthritis) is more often used - a group of diseases that are based not on purely dystrophic, but on dystrophic-inflammatory processes leading to gradual destruction of the joint. More and more experts believe that the causes of arthrosis and osteoarthrosis, the mechanisms of their development are the same, that is, in fact, they are the same disease.

According to statistics, from 10 to 20% of the population suffers from arthrosis in different countries. By the age of 80, almost everyone has age-related disorders in the musculoskeletal system. At the same time, patients do not always consult a doctor on time and take a long time to treat themselves, which leads to disability. Whereas the right treatment can relieve suffering and stop the progression of the disease. Arthrosis codes according to ICD 10: M15-M19.

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.

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.

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.

General symptoms of arthrosis

• freezing feet (a symptom of poor circulation in the lower extremities);
• “crunching” while driving;
• “ache” due to the weather;
• discomfort and limited joint mobility when walking;
• aching pain, which can be replaced by sharp pain;
• swelling and hyperemia around the inflamed joint;
• painful calluses in areas of primary stress;
• Heberden's nodes (tumors the size of a pea at the level of the interphalangeal joints of the foot; can periodically rupture);
• deformation and destruction of joints (especially the thumb).

This is a common set of symptoms. The full picture of arthrosis can only be described taking into account one or another stage of the disease.

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.

Symptoms of arthrosis of the metatarsophalangeal joints

The disease is characterized by smooth progression. Therefore, it can develop completely unnoticed over several years, and at this time a person does not even suspect the presence of deviations from the norm in the condition of these small joints of the foot. Only in isolated cases, usually after injuries, does the disease begin acutely.

But gradually the intensity of the symptoms of arthrosis of the metatarsophalangeal joints increases. The disease is characterized by:

• the occurrence of pain that increases over time in the area of ​​the bases of the phalanges of the fingers;
• the formation of subcutaneous dense protrusions that can be felt independently (this may be accompanied by painful sensations);
• swelling;
• gait disturbances in the form of instability, lameness, clubfoot;
• a sharp increase in pain in the foot when standing and walking;
• increased leg fatigue;
• limited mobility of affected joints;
• formation of calluses in the joint area.

Most often, arthrosis of the 1st metatarsophalangeal joint or big toe is observed. This is accompanied by the formation of a bone growth or exostosis in the projection of the affected joint (on the lateral surface of the foot). This kind of thing is usually called a bump or a bone.

In this case, the thumb gradually deviates towards the neighboring ones, and the callus increases in size. This is accompanied by severe pain, and swelling and redness of the soft tissues may also occur. The formation causes discomfort when wearing tight shoes, and over time, patients may notice that previously comfortable shoes or boots have become too tight. In the future, exostosis causes difficulties in choosing shoes, and a big toe that deviates from the normal axis provokes deformation of neighboring ones. Thus, arthrosis of the 1st metatarsophalangeal joint can lead to the development of hallux valgus.

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.

Diagnostics

An external examination and conversation with the patient is sufficient to make a primary diagnosis.

However, in order to exclude similar pathologies (grade II flat feet, gout, heel spur, rheumatoid arthritis, etc.), as well as to determine the level of damage, additional studies should be performed:

• radiography (records degenerative changes in cartilage tissue and the stage of their development);

• laboratory tests (check for the presence of rheumatoid changes);
• magnetic resonance or computed tomography (if necessary).

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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Diagnosis and treatment of deforming arthrosis

Due to the fact that most patients do not attach due importance to the first pain symptoms in the joints, therapeutic treatment of osteoarthritis begins late and may be ineffective. The goal of conservative treatment of osteoarthritis is to restore blood circulation and nutrition in the tissues of the affected joint. The administration of anti-inflammatory drugs such as naproxen, voltaren, indomethacin, ortafen, brufen, etc. helps relieve inflammation. A course of treatment with drugs that improve metabolic processes in the joints (rumalon, arteparon) is also indicated. Physiotherapeutic treatment with ultrasound and pulsed currents, electrophoresis, paraffin baths, and therapeutic massage gives good results. Patients are shown mud baths and spa therapy. Patients are not recommended to overload the sore joint with physical movements. In case of stage 3 disease, surgical intervention is recommended to eliminate pain and restore the ability to support the limbs.

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.

Arthrosis of the big toe diagnosis.

On x-rays it looks something like this. Note that the length of the first metatarsal in these images is equal to the length of the second. But in reality this is not so, it is longer, it’s just, firstly, raised up, secondly, the cartilage on the head is worn away, and thirdly, the base of the first finger is located under it, all together this masks the true length.

The process progresses very slowly, usually over 10-30 years. At first, the patient may only be bothered by the inability to stand on his toes, but over time, the limitation of dorsiflexion progresses, sports activities, and then normal walking, become impossible. The photograph below clearly shows that the thumb is fixed in a 10° plantar flexion position, and there is no range of motion in it.

There are two possible ways to solve this problem. The first way is conservative.

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).

Treatment of foot joints using MBST therapy

An effective innovative technique of MBST therapy will help you completely get rid of arthrosis of the foot. This type of treatment starts the metabolic process, the cells begin to recover quickly. The exact cause of the disease is eliminated, while the patient feels a significant improvement in well-being, and the unpleasant symptoms of pain and inflammation go away.

The affected area of ​​the foot is influenced by a special magnetic resonance field. It sends signals that trigger the regeneration process. In this case, the progression of the disease stops, and the active recovery process begins. At the moment, MBST therapy is the most effective and fastest treatment method. After 10 sessions the patient feels improvements. Treatment of arthrosis of the feet using the MBST method allows you to maintain the positive effect for more than 5 years after completing the course.

Moscow, metro station Dubrovka, st. Sharikopodshipnikovskaya, 6/14

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.

Prevention of foot arthrosis

There is probably no universal way to avoid this disease. However, a number of factors can reduce the risk of foot arthrosis:

• body weight control;
• balanced diet;
• giving up bad habits (alcohol, smoking);
• physical activity;
• wearing comfortable shoes - the heel should be no more than 4 cm. Flat soles and high heels can become an impetus for the onset of pathological processes;
• timely treatment of foot injuries and follow-up with a specialist.

If an unpleasant diagnosis could not be avoided, take action as quickly as possible. Modern treatment methods will help avoid many problems. Effective help can be obtained from medical institutions. Ultrasound therapy is carried out by highly professional specialists, and prices for services are lower than in other Moscow clinics without compromising the quality of treatment.

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.