Causes of arthrosis
The causes of arthrosis are varied - joint overload, trauma, hereditary predisposition, excess weight, flat feet, etc. Under the influence of these factors, thinning and deformation of the articular cartilage occurs. The cartilage becomes uneven, the congruence of the articular surfaces is disrupted, friction appears during movements, which causes pain and inflammation. At later stages, the articular surfaces of the bones begin to change - osteophytes (bone protrusions) appear, the articular surfaces become denser, the joint space narrows, until it completely disappears.
Before the age of 50, men get sick more often than women; after 50 years, women get sick 2 times more often than men.
Causes of polyarthrosis of the joints
Arthrosis is associated with the destruction of the cartilage plate, in place of which osteophytes grow as a compensatory mechanism. Cartilage performs shock-absorbing functions in the body, but when a disease occurs, it wears out, so a feeling of stiffness and pain occurs in the joints. Also, the occurrence of arthrosis is associated with poor circulation.
What can provoke the appearance of the disease:
- The presence of congenital malformations (the appearance of subluxations, congenital absence of certain articular structures).
- Previous injuries (fractures, tears, bruises).
- Joint hypermobility, which is also a congenital human characteristic.
- Autoimmune disorders causing arthritis. Against the background of long-term inflammation, arthrosis occurs in the joint.
- Previously suffered infectious diseases that caused complications in the joints - syphilis, tuberculosis, encephalitis.
- The presence of hormonal disorders, metabolic disorders - gout, diabetes.
- The presence of a hereditary bleeding disorder - hemophilia.
- The presence of rare pathologies associated with necrosis of joint structures.
- Excess weight, which creates excess pressure on the joints.
- Middle aged men. Typically, polyarthrosis is diagnosed more often in males aged 40-60 years than in women.
Living conditions are important as a prognosis factor for polyarthrosis. If a patient engages in heavy physical labor in cold conditions, eats poorly and has bad habits, the chance of getting the disease in the future will increase significantly.
Diagnosis of arthrosis
Most often, arthrosis affects the joints that are most exposed to stress - the joints of the lower extremities (knees, hips), but in principle, arthrosis can occur in any joint.
The disease develops gradually and usually progresses slowly. Patients complain of pain, mainly during movements and loads - a mechanical type of pain. The pain occurs with daytime exertion and decreases with rest. “Starting” pain is also characteristic - after prolonged immobility (for example, after sleep), the first steps are accompanied by severe pain, as the patient “paces” the pain goes away. Initial pain is caused by the accumulation of cartilage destruction products on its surface, which makes it uneven and causes pain. During the first movements in the joint, these products are “pushed out” into the joint cavity and the pain decreases or goes away. Later, deformation of the joint occurs; pain can be bothersome even at rest, at night. Stiffness occurs in the joint, and fluid may accumulate in it (synovitis).
Stages of arthrosis
Based on a combination of clinical and radiological data, three stages of arthrosis are distinguished -
Stage I arthrosis - minor pain and limited joint mobility. X-ray reveals a slight narrowing of the joint space, sharpening of the edges of the articular surfaces.
Stage II arthrosis - moderate pain and limited mobility in the joint. X-ray shows a pronounced narrowing of the joint space, marginal bone growths (osteophytes), compaction of the bone under the cartilage (subchondral osteosclerosis), cyst-like clearing in the bones.
III-IV stage of arthrosis - severe pain, significant limitation of mobility in the joint. X-rays show an almost complete absence of joint space, significant bone growths and deformities.
The diagnosis of arthrosis is made on the basis of complaints and clinical picture. Of the additional methods, X-ray examination is the most informative. In some cases, MRI (magnetic resonance imaging) is indicated.
The photo shows an x-ray for arthrosis of the small joints of the foot. Deformations of the joints and bone growths around them are visible—stage II-III of arthrosis.
A characteristic picture is observed with arthrosis of the distal interphalangeal joints (Heberden’s nodes) - photo below
Depending on the stage of the disease, we choose one or more treatment methods:
Therapeutic massage, osteopathy, manual therapy
Helps bones and joints take the correct physiological position, relieves pain and spasms, relaxes muscles.
Acupuncture
Work on biologically active points. It affects the affected area and the body as a whole. Eliminates the cause of the disease and removes the symptoms.
In addition, according to indications, the following are used: taping, pharmacopuncture, FormTotix insoles, exercise therapy with an instructor and other methods. The choice of procedures depends on the current condition; taken together, they act faster and give a more lasting result.
chiropractor, osteopathic massage therapist, osteopathic doctor
Polyarthrosis. Is it possible to cure polyarthrosis?
Characteristic
Polyarthrosis is a pathology of the joints. The disease is accompanied by increasing structural dysfunction of the interarticular cartilage. Along with this, the process affects adjacent tissues.
Over 10% of the population suffers from joint pain. Most of them are people with polyarthrosis.
This disease mainly affects middle-aged men and elderly women. As a rule, patients are bothered by pain in the knee and shoulder joints with polyarthrosis of 1.2 degrees, as well as in the feet. In some cases, arthrosis of the spine is noted, which is called osteoarthritis.
Causes
The prerequisites for the occurrence of the disease are the processes of destruction of cartilage, which performs the function of supporting motor activity. Under the influence of a number of negative reasons, cartilage loses its properties, due to which movements become difficult and the structure of the joint changes.
Acceleration of the development of the disease is facilitated by:
Birth defects. Injuries suffered. Excessive joint mobility. Reduced level of immunity. Infections. Hereditary and hormonal disorders.
Older people who are overweight or who have undergone surgery are most at risk. The presence of arthrosis in relatives, poor diet and regular hypothermia increases the likelihood of the disease.
Symptoms and treatment of grade 1, 2, 3 polyarthrosis of the hands, knee, and shoulder joints. How to treat polyarthrosis.
Polyarthrosis refers to long-term progressive pathologies, since the increase in characteristic symptoms occurs over a long period of time. Initially, patients report pain in the joints, especially when climate conditions change.
Then pain appears during physical activity, and then at rest. The pain appears in the morning and subsides over time. Then the symptoms progress steadily.
Regular relapses lead to inflammation of the joint lining. It swells and the skin turns red. The pain becomes more pronounced, and the surrounding muscles experience tension. During movement, a characteristic “crunch” appears.
The lack of timely treatment is indicated by a visual change in the joint, difficulty in movements or their impossibility. Curvatures of the spine often appear.
In some cases, a fragment of cartilage breaks off and a “joint mouse” effect occurs, in which this fragment can become pinched in the joint. As a result, severe pain occurs and the joint is completely blocked.
It should be noted that with this disease, each of the joints shows its own clinical situation, which at different stages of the disease has its own characteristic specificity.
Diagnostics
To correctly assess the condition, a complete and thorough examination, as well as a photograph, is necessary. X-ray allows you to visually determine the general picture of joint damage. An MRI is often prescribed.
In the most difficult cases, a special procedure called arthroscopy is prescribed. Its essence is to examine the joint using a special optical camera for maximum visualization of the internal structure.
If there is a preliminary diagnosis, it becomes necessary to conduct an examination by an endocrinologist, rheumatologist or other medical specialists.
How to treat polyarthrosis?
The goal of treatment is to minimize the likelihood of destruction of cartilage tissue or slow down this process, as well as restore the patient’s motor activity. Patients should avoid excessive physical activity and regularly wear special fixing bandages to correct the position of the joints.
Medicines
Treatment of polyarthrosis of the hands and joints consists of relieving the patient of pain and stopping inflammatory processes. For pain relief, non-steroidal medications are used - Paracetamol, Ketorolac. If the desired effect is not achieved, Tramadol or injections with an anesthetic are used.
To eliminate inflammatory processes, drugs are prescribed - Diclofenac or Nimesulide. To reduce spasms, Sirdalud and Mydocalm are used.
In order to stop the disruption of the functional state of cartilage tissue, medications based on glucosamine (Teraflex, Rumalon) are prescribed. Experts often recommend injections of hyaluronic acid, a synthetic analogue of synovial fluid, into the affected joint.
Physiotherapy
Physiotherapeutic procedures include laser and ultraviolet irradiation. Electrophoresis is often used. During the period of remission, massage procedures are recommended.
Surgery
Carrying out surgical operations is important for patients with an advanced stage of polyarthrosis with severe pain syndrome, when the use of medications does not give the necessary effect. In such cases, complete or partial replacement of the joint with a special implant is recommended.
When performing these operations, it should be taken into account that they are contraindicated if you have had a heart attack or stroke, if less than 3 months have passed since the attack. Increased precautions should be taken in patients with renal impairment.
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Treatment of arthrosis
Treatment of arthrosis is complex. Chondroprotectors are prescribed as basic drugs - substances that are structural components of cartilage and improve the properties of joint fluid. They are used long-term in tablets (structum, arthra, teraflex, etc.) or in courses of intramuscular or intra-articular injections (alflutop, etc.)
For exacerbations, anti-inflammatory drugs (NSAIDs) are prescribed orally and locally. In some cases, intra-articular injections are given (diprospan, kenalog) - see the video below.
One of the new methods of treating arthrosis is the intra-articular injection of fermatron (synovial fluid prosthesis).
More information about medications for the treatment of arthrosis can be found here.
Physical therapy and lifestyle play an important role in the treatment of arthrosis.
Diagnosis of coxarthrosis
The diagnosis of coxarthrosis is made based on a number of criteria developed by the American College of Rheumatology (ACR) in 1990. To make a diagnosis, the presence of pain in the hip joint and two clinical and radiological signs out of the following three are necessary: ESR <20 mm/h; osteophytes of the femoral head or acetabulum; narrowing of the joint space.
The photo below shows an x-ray with severe arthrosis of the hip joint.
Treatment of arthrosis of the hip joints (coxarthrosis)
Treatment of arthrosis of the hip joints (coxarthrosis) is aimed at slowing down further progression of the disease, reducing pain and inflammation during exacerbations, and improving joint function.
During exacerbations, non-steroidal anti-inflammatory drugs (Voltaren, Movalis, etc.) are prescribed in short courses. Physiotherapy may be used.
During the period of remission, the basic therapy consists of chondroprotectors - drugs that prevent further destruction of articular cartilage (structum, dona, arthra, alflutop, teraflex).
Physical therapy plays an important role, as well as measures aimed at reducing the mechanical load on the joint - weight loss, orthopedic correction, orthopedic regimen.
In case of severe coxarthrosis of stages 3-4, joint replacement is indicated (photo* below).
Prevention
To avoid the development of polyarthrosis, it is necessary to control physical activity, maintain the correct weight, avoid joint injuries, and if they occur, treat them in time, monitor your posture, stop sitting with your leg crossed over your knee (this posture interferes with proper blood circulation, and this in turn negatively affects condition of intra-articular cartilage), timely treatment of infectious and inflammatory diseases. It is recommended to include in your diet more amino acids that build protein structures in the body (lean meat, poultry, white fish, dairy products, eggs, cereals, legumes, soy, nuts, fruits and vegetables). Gymnastics and walks in the fresh air are encouraged.
Symptoms, diagnosis of arthrosis of the knee joints
The main manifestation of arthrosis is pain of a mechanical nature - i.e. more pronounced when moving, walking up stairs. Sometimes the pain bothers you at rest, at night, when standing for a long time (a feeling of “weaving” in your legs). Characteristic are “starting” pains that occur during the first steps after prolonged immobility; after several steps such pains disappear. Later, joint deformation and limited mobility develop. The pain is more disturbing, often at rest, at night, which indicates a violation of intraosseous circulation.
In the photo* - severe arthrosis of the knee joints with an X-shaped deformity of the limbs.
The course of arthrosis is characterized by alternating exacerbations and remissions. An exacerbation can be triggered by physical activity, prolonged walking, or hypothermia. With exacerbation of gonarthrosis, the pain intensifies, fluid may accumulate in the knee joint as a reaction to inflammation, the joint may become swollen, and palpation is painful. As the inflammation subsides, the symptoms regress and the disease goes into remission. Arthrosis is not characterized by an increase in body temperature. Blood tests may show a moderate increase in ESR during exacerbations.
Symptoms of polyosteoarthrosis
Symptoms of polyosteoarthrosis have certain specifics. According to existing information, treatment of arthrosis is not always a suitable solution, because the pathology has very unusual manifestations.
Symptoms of polyosteoarthrosis include:
- nodularity of several predominantly symmetrical joints at once (with a generalized type of arthrosis);
- quite severe pain, causing dizziness, ophthalmological disorders, migraine and other signs of compression of large vertebral vessels (if intervertebral tissue is damaged);
- proliferation of bone tissue and harmful, pathologically dangerous changes in connective tissue, accompanied by numbness of the limbs and other signs (with spondylosis of the lumbar and cervical region);
- inflammatory process, local swelling (with periarthritis or tendovaginitis).
The expanded range of symptoms of polyosteoarthrosis somewhat complicates the diagnostic process, which certainly affects the treatment process.
Main diagnostic method
The main diagnostic method is x-ray examination, which shows a narrowing of the joint space, thickening of the articular surfaces, sharpening of the intercondylar tubercles, and marginal bone growths (osteophytes). At stages 3-4 of arthrosis, the joint space is practically absent (photo* below).
To clarify the diagnosis, ultrasound and MRI (magnetic resonance imaging) of the knee joints are performed according to indications.
Treatment of arthrosis of the knee joints (gonarthrosis)
The basic principles of treatment are the same as for arthrosis of any joints. Features - intra-articular injections of hyaluronic acid derivatives (Ostenil, Fermatron) bring good results. During exacerbations, especially those accompanied by a strong inflammatory reaction, blockades with diprospan or Kenalog help (see video above). In later stages, knee joint replacement is successfully used (photo* below).
Read more about gonarthrosis.
* - photos courtesy of Dr. Kuzmin F.A.
Forecasts
Seeking qualified medical help at an early stage is the key to success and the most favorable scenario for the complete elimination of the symptoms of polyosteoarthrosis, and, sometimes, the complete recovery of the patient. If the intended treatment plan is followed, most diagnosed cases can be successfully treated.
Conservative therapy gives positive results within the first week of treatment, depending on the individual characteristics of the patient. After just 1-1.5 months, the mobility of the affected joints improves significantly.
Polyosteoarthrosis is one of the incurable diseases, which means that it is necessary to follow medical recommendations for life.