Laser therapy for osteochondrosis: treatment of joints and spine, laser therapy of the spine

This material takes into account the results of clinical trials on the treatment of joints and spine, conducted in a number of large scientific and clinical centers of the Russian Federation and CIS countries: Research Institute of Neurology, Neurosurgery and Physiotherapy of the Ministry of Health of the Republic of Belarus, RRC of Rehabilitation and Physiotherapy of the Ministry of Health of the Russian Federation, Belarusian Medical Academy of Postgraduate Education, Chief Clinical military hospital of the Federal Border Service of the Russian Federation, Research Institute of Laser Medicine (Moscow), Main Clinical Hospital of the Ministry of Internal Affairs of the Russian Federation, Tver State Medical Academy, Department of Traumatology and Orthopedics, Republican Medical Center “Armenia” (Yerevan), etc.

OSTEOCHONDROSIS

Osteochondrosis is a degenerative-dystrophic process that develops in the cartilage and bone tissue of the spine. This is the most common spinal disease, affecting more than 70% of the population. The resulting pain syndrome is explained by the fact that the intervertebral disc cannot withstand the load and its protrusion forms.

Nerve processes, blood vessels and the spinal cord are located around the intervertebral disc. A disc herniation, affecting any of the nerve processes, causes its inflammation, which leads to pain. The second cause of the pain symptom may be pinching of the spinal nerve at the site where its root exits the lumbar spine, and compression of the root can be caused by bone growths (reactive growth of marginal osteophytes).

Osteochondrosis most often affects older people, as well as overweight people. The disease is a serious medical and social problem, because has a chronic course and often leads to temporary or permanent disability.

Clinical trials conducted in a number of clinics in Russia and the CIS countries have proven the high effectiveness of laser therapy for osteochondrosis.

Considering the fact that with this therapy, the paravertebral vessels running along the sides of the spine enter the treatment zone, i.e. Simultaneously with the local effect, the effect on the blood is also carried out; laser hemotherapy (LHT) is not carried out separately.

Types and reasons for its development

Costovertebral arthrosis can be primary or secondary. Classification by form depends on the causes of pathological disorders. Primary arthrosis is characterized by subtle forms of its course, in which it is impossible to determine the cause of the appearance of dystrophic changes. This diagnosis is usually made to older people, in whom the development of disorders is associated with the natural processes of aging.

The nature of the occurrence of secondary type pathology is more or less clear. Causes of the disease:

inflammatory diseases;
back injuries and vertebral compression;
endocrine diseases;
infections, including tuberculosis;
genetic factors;
congenital disorders in the formation of the spine;
flat feet, as a result of impaired shock absorption of the foot;
excessive physical activity not related to work;
poor posture due to a sedentary lifestyle;
problems with metabolism.

Arthrosis of the costotransverse joints can also develop depending on the condition of the spine itself. It can be provoked by spondylolisthesis, intervertebral hernia, osteochondrosis, spondyloarthrosis and other diseases of the thoracic back.

OSTEOCHONDROSIS OF THE CERVICAL SPINE

Cervical osteochondrosis, or osteochondrosis of the cervical spine, due to morphological and functional characteristics, is characterized by various clinical manifestations and, often, the diagnosis is difficult due to the many “masks”. Clinical manifestations are directly dependent on the location of the lesion. Radicular (radicular) syndromes in cervical osteochondrosis are a manifestation of combined damage to often several roots.

Damage to the nerve root can be of the type of irritation, compression or conduction disturbance. With irritation and compression, the main clinical sign is pain, and with a conduction interruption - radicular paralysis. The pain is accompanied by widespread irritation, which leads to poor circulation, swelling and fibrosis of the tissue around the root.

The figure below (Fig. 2) shows the zones of innervation by nerves emanating from the cervical spine. Knowing these zones, it is easy to imagine the clinical picture of damage to one or another nerve root of the cervical spine.

Fig.2

If the C3 root (3rd cervical vertebra) is affected, pain occurs in the left or right half of the neck, a change in taste in the mouth, a feeling of swelling of the tongue, and difficulty moving food with it.

Irritation of the C4 root causes pain in the clavicle, shoulder girdle, atrophy and decreased tone of the posterior neck muscles, leading to an increase in the supraclavicular air cushion, which is a characteristic symptom of irritation of the above root.

When the C5 root is compressed or irritated, pain appears in the shoulder girdle and along the outer surface of the shoulder, and hypotrophy of the deltoid muscle.

When the C6 root is irritated, pain occurs in the neck and scapula, radiating along the outer surface of the shoulder, forearm and thumb, and hypotrophy of the biceps muscle appears.

Traumatization of the C7 root leads to pain in the neck, scapula with irradiation along the outer surface of the shoulder, into the dorsum of the forearm and to the 2nd and 3rd fingers of the hand.

Symptoms of uncovertebral arthrosis

Pain with uncovertebral arthrosis of the cervical spine occurs after physical exertion, active turning of the head, sleeping in an uncomfortable position, or lifting heavy objects. The first stages are characterized by shooting pain with sudden movements of the head, which may be accompanied by a crunching sound. Over time, aching periodic pain appears with a tendency to become constant, which can radiate to the chest. In addition to pain and spasms, which can signal other diseases or injuries, deforming arthrosis of the cervical spine has a number of nonspecific symptoms that appear regularly and can subside and reappear. Initial manifestations of uncovertebral arthrosis include:

severe headaches, mainly concentrated on one side and worsening when turning the head;
feeling of numbness in the neck, back of the head, hands;
stiffness and even stiffness of the neck (difficulty turning your head, especially in the morning);
burning, tingling and other unnatural sensations in the neck muscles;
nausea, dizziness, deterioration of coordination and balance (as people say - “skids”);
ringing in the ears, “floaters” and colored spots before the eyes associated with deterioration of blood supply to the brain;
increased fatigue;
deterioration of sleep and memory, frequent awakenings due to discomfort in the neck;
frequent and sudden changes in blood pressure;
in later stages - thinning of the neck due to muscle loss.

Less commonly observed is deterioration in vision, speech function, and finger motor skills.

The joint most susceptible to damage is between the 1st and 2nd cervical vertebrae.

As uncovertebral arthrosis progresses (already at the 2nd stage), so-called accessory intervertebral joints. They are bone growths (osteophytes) that arise to compensate for the load on the joint. At the same time, they limit his mobility, cause numbness, headaches and, growing, block the nerve roots.

SYNDROMES CHARACTERISTIC FOR CERVICAL OSTEOCHONDROSIS

Vertebrobasilar syndrome is mainly a functional neurovascular disorder of the vertebral arteries in osteochondrosis of the cervical spine. Clinical signs of vertebrobasilar syndrome are expressed by headache in the occipital region or forehead, dizziness during a sharp turn of the head.

There are persistent blanching and sensory disturbances on the face that do not coincide with the zones of innervation of the branches of the trigeminal nerve. Pain or noise in the ears, vestibular disorders, decreased vision, changes in voice and taste sensations periodically occur. Often these signs are combined with pain in the arm or heart area.

Sympathalgic syndrome - characterized by neck-shoulder pain of a burning, squeezing nature, mainly at night. After leaving the arm at rest for a long time, various types of pain arise in it, which forces patients not only to wake up and change the position of the arm, but also to stand up in order to make swinging movements with the arm. Often the pain spreads to the back of the head and the glenohumeral-thoracic region.

The syndrome of glenohumeral periarthritis, which occurs with cervical osteochondrosis due to dystrophic and inflammatory changes in the joint capsule, is accompanied by intense pain in the shoulder joint. Abduction and rotation of the arm are sharply painful, which forces patients to spare the arm and keep it in a state of immobilization, which can lead to the formation of persistent adduction contracture or ankylosis of the shoulder joint, accompanied by atrophy of the muscles adjacent to the joint.

Shoulder-hand syndrome (Steinbrocker syndrome) is a symptom complex of reflex neurovascular autonomic dystrophy of the limb with cervical osteochondrosis and is manifested by pain in the joints and muscles of the affected arm, swelling, cyanosis of the hand, increased sensitivity and increased temperature of the skin of the hand. Limitation of hand function leads to flexion contractures and atrophy of muscles and skin. Later, diffuse osteoporosis of the arm bones may occur.

Anterior scalene syndrome is a reflex muscle contracture associated with cervical osteochondrosis. Spasm of the anterior scalene muscle leads to compression of the brachial plexus and subclavian artery. Clinic: pain in the neck with irradiation along the ulnar surface of the forearm and hand, pallor, coldness, paresthesia and sometimes swelling of the hand. The pain intensifies during a deep breath, when the shoulder is abducted and when the head is tilted to the healthy side. Sometimes there is swelling of the supraclavicular fossa. Later, hypotrophy and weakness of the hand muscles appear.

Cardiovascular syndrome occurs due to irritation of sympathetic formations in the pathology of the cervical discs of the fifth - seventh cervical vertebrae. Clinically, this is manifested by pain in the heart, chest, behind the sternum, and in the shoulder girdle of the left arm.

Pulmonary syndrome in osteochondrosis of the cervical and upper thoracic spine is characterized by congestive and inflammatory manifestations of the lungs, leading to oxygen starvation, which significantly worsens the general condition of the patient and aggravates the course of the underlying disease.

Vegetative-irritative syndrome. Pain syndrome that occurs with a combination of lesions of the gallbladder and the cervicothoracic spine, with cholecystitis and cervicothoracic osteochondrosis. This syndrome is manifested by a reflected impulse from the affected organ.

The pathological impulse arising from these two foci is directed along the phrenic nerve and sympathetic fibers to the cervical spinal cord and is summarized there according to the dominant type. Cholecystitis and osteochondrosis are in close pathological connection.

Treatment. The main directions of therapy for osteochondrosis are: impact on the affected spinal motion segments and extravertebral neurodystrophic foci; correction of psycho-emotional and autonomic dysfunction; relief of pain. For this, a wide range of therapeutic effects are used: medications, physiotherapeutic, manual and reflex.

OSTEOCHONDROSIS OF THE THORACIC SPINE

It is characterized by a varied clinical picture, which is associated with the anatomical and physiological characteristics of this part of the spine. Despite the fact that the number of discs in the thoracic region is twice as large as in the cervical or lumbar region, clinical manifestations of osteochondrosis are observed much less frequently.

This phenomenon can be explained by the lower mobility of the thoracic spine, the small size of the nucleus pulposus and the small thickness of the intervertebral disc, which less often leads to the formation of hernias, however, thoracic physiological kyphosis (bend) contributes to the formation of anterior and lateral osteophytes.

Osteophytes in the area of the spinal-costal and transverse-costal joints come into contact with the spinal nerves, causing intercostal neuralgia or leading to irritation of the sympathetic trunk and the occurrence of autonomic syndromes. The lower cervical and upper thoracic sympathetic nodes connect at the level of C7 - Th1 (Th1 - 1st thoracic vertebra), then the sympathetic branches extend to the heart, esophagus, bronchi, spine, carotid arteries and recurrent nerve.

From the sympathetic nodes Th5 - Th10, the abdominal nerve is formed, passing through the diaphragm and woven into the solar plexus. Clinical symptoms depend on the compression lesion of a particular nerve trunk.

Before using laser therapy for osteochondrosis, consult our specialists. They will tell you the most appropriate treatment option, the type of device and tell you about its use.

What is arthrosis of the costovertebral joints?

The thoracic region includes 12 vertebrae. In their structure, they differ from the lumbar or cervical ones in that they have a smaller diameter and length. But their spinous processes are somewhat longer. In order for the vertebrae to connect to each other, they need pairs of symmetrical articulations located between these processes. They are called intervertebral, facet or arcuate. Such bone joints are present in all parts of the ridge, except the sacrum and coccyx. In this area the vertebrae are fused together. In the thoracic region they are flat and inactive.

Anatomy of the thoracic spine.

Osteoarthritis of the costovertebral joints is the destruction of cartilage and tendons between the edges of the vertebral articulations, a rare form of osteoarthrosis or spondyloarthrosis. Degenerative changes progress, cartilage and tendons become inflamed, and any friction in the area of inflammation causes pain and stiffness. The most common localization of dystrophic disorders in costovertebral pathology is the 9th and 10th ribs.

Changes in the joints of the spine often lead to disruption of the functionality of the entire musculoskeletal system. And if until recently it was believed that the disease was characteristic of older people, in whom the natural aging processes affect the rate of metabolic reactions, now it also occurs among young people over 30-40 years of age. In men, the risk of developing costovertebral pathologies is 3-5 times higher than in women . Most cases occur between 20 and 35 years of age.

Diagram of blood vessels.

Costovertebral arthrosis develops gradually and goes through several stages. Under the influence of provoking negative factors, the thoracic region of the back is exposed to external influences. In response to the irritant, inflammation occurs in the area of cartilage and tendons. If it repeats, the pathology becomes chronic. A compensatory reaction occurs - the proliferation of connective tissue in the area of dystrophy and the formation of osteophytes. This leads to deterioration in joint mobility and deformation. The process is closed: inflammation provokes deformation, and deformation generates inflammation. The more changes in the joint, the more pronounced the symptoms of the disease become: pain of varying degrees of intensity, limitation of body mobility, the amplitude of which gradually tends to zero.

Arthrosis of the costovertebral joints often manifests itself in the form of synovitis - a recurrent inflammatory process in cartilage and tendons. During an exacerbation, a person experiences pain that prevents movement. During the chronic course, no signs of malaise are noted.

DYSTROPHIC CHANGES IN THE THORACIC SPINE

Apart from osteochondrosis, these are the most common lesions of the spine.

Clinic. Manifestations of the disease in the form of thoracalgia (chest pain) are associated with reflex syndromes and are often accompanied by cardiovisceral, hyperventilation and other syndromes. Clinically, this usually manifests itself as long-term non-healing gastric ulcers, erosive gastritis, cardialgia of unknown origin with ECG changes in the form of ischemia of various parts of the left ventricle, prolonged bronchitis, and disturbances in emotional stability.

Causes

Osteoarthritis of the chest can occur due to:

falls from height;
maintaining a sedentary lifestyle;
sedentary work;
incorrect body position while sitting and sleeping;
playing sports that require excessive stress (in particular, weightlifting);
endocrine diseases;
scoliosis;
spinal deformities with displacement of intervertebral discs;
obesity;
severe prolonged hormonal imbalance;
unfavorable heredity;
living in poor environmental conditions, etc.

If treatment is not started in a timely manner, destruction of the vertebral cartilage may occur. This will lead to their mobility being significantly reduced, and the person himself will feel pain even with a slight bend.

OSTEOCHONDROSIS OF THE LUMBAR-SACRAL SPINE

Damage to this part of the spine (Fig. 1) occurs most often, which is due to both the anatomical features of the structure of the spine and the characteristics of human life, because The lumbar region bears the greatest load. The most common pathologies found in this part of the spine are osteochondrosis and complicated forms of osteochondrosis, compression-radicular syndromes, and dysfunction of the nerve root in the form of neuropathies.

The most common syndromes of the lumbar spine are sciatica, lumbago, lumbar radiculitis (lumbar osteochondrosis) and intercostal neuralgia. Each of these syndromes consists not only of pain in the spine, but also secondary inflammatory changes in the muscles near the affected part of the spinal column, as well as symptoms of poor circulation and swelling of internal organs.

Clinic. Manifestations of the disease can be very diverse, depending on the stage of the process. Long-term pain syndrome, foot paresis (“slap foot”), compensatory scoliosis in the lumbar region, tension of the rectus muscles of the back, pain on superficial palpation, hyporeflexia of tendon reflexes, hypotonia of the lower leg muscles with impaired walking function, etc.

The results of clinical observations indicate a pronounced therapeutic effect of laser therapy in patients with osteochondrosis. After the first RT session, the absence of pain was observed in 60-65% of patients, improvement in motor activity was noted in 20-25%, and normalization of sleep in 50% of patients. After the first course of treatment, a positive effect was observed in almost 100% of patients with an early stage of the disease. When the process is started, it is achieved after 2-3 courses of treatment.

Symptoms of the disease

The signs of costovertebral pathologies are identical and have common features. A person feels back pain of varying intensity depending on the stage of the disease, which can intensify with external stress. At rest, the patient does not experience discomfort. There is no morning stiffness associated with the disease, except for the starting pain at the beginning of movement. Other signs are slight swelling of the soft tissues and redness of the skin. But more often these symptoms are absent.

As the patient's condition worsens, the symptoms become more pronounced. The pain becomes intense, the limitation of mobility in the joints becomes more severe. Depending on which joints of the sternum are damaged, costal arthrosis differs.

When the bone and cartilage structures between the ribs and vertebrae are destroyed, the following symptoms are characteristic:

the appearance of pain in the back in the chest area;
discomfort increases with deep breaths and during movement;
tissue swelling and pain may be observed in the area of localization of inflammation;
reflex spasms appear in the spine;
mobility in the joints gradually deteriorates, which leads to severe pain even when breathing;
stiffness when moving goes away in a short time;
During movement, crunching and clicking may occur in the back.

Sometimes costovertebral arthrosis is asymptomatic for some time. It is often possible to find out about the disease by chance, during routine radiography. At first, the signs are mild. However, the clinical picture changes with the progression of the pathology. Symptoms worsen towards the end of the day after prolonged strain on the back, causing fatigue. The inflammation spreads mainly to the joints of the lower chest. Most often this type of pathology is diagnosed in women over 40 years of age.

Inflammation of the connection between the ribs and the sternum is much less common. It mainly develops due to systemic diseases, injuries and infections. Clinical signs of costotransverse arthrosis:

the appearance of unpleasant sensations along the edge of the sternum;
severe pain occurs with maximum inspiration;
inflammation of the costotransverse joints is insignificant;
upon palpation, slight swelling of soft tissues is noted;
there are no reflex spasms in the spine;
stiffness of joint mobility continues for quite a long time.

This type of disease rarely leads to serious deformation of the chest and does not cause severe pain when breathing. The course of the pathology is more favorable than with costovertebral.

Any type of arthrosis negatively affects posture. At rest and during movement, the patient develops a permanently slouched posture, when the shoulders drop and turn forward. In the absence of treatment, dystrophic processes continue to form in the structure of the vertebrae and tendons, destroying the integrity of the osteochondral apparatus. If the disease takes a severe course, the issue of the patient’s ability to work and his further disability is decided.

SPINAL HERNIA

Intervertebral hernia is one of the most complex diseases of the musculoskeletal system. The cause of the disease can be excessive stress on the spinal column, injuries, incorrect posture, and age-related changes. Under the influence of these factors, the membrane of the spinal disc is destroyed and its contents enter the spinal canal, compressing the spinal roots or the spinal cord itself. At an early stage of changes in the lumbosacral spine, they make themselves felt by aching pain in the lower back. If the disease is advanced, then the pain caused by the hernia depends on which roots it compresses, and clinically it can manifest itself as impaired movement in the legs, impaired urination and potency.

Treatment. Surgical intervention for this pathology gives quick results, but is fraught with postoperative complications and the development of diseases in other parts of the spine. It is indicated for only 10-12% of patients. The most effective method is a combination of laser and manual therapy. Laser therapy allows you to relieve swelling and inflammation in the hernia area, and manual therapy, which is carried out after a course of laser therapy, allows you to achieve stable and long-term remission, and live your life without surgery at all.

The disc is a completely avascular region, however, in its immediate vicinity the vascular network is quite wide. For example, many vessels are located in the vertebral body itself and along the periphery of the fibrous ring, which carry out exchange and nutrition of the disc. Actually, by improving this metabolism and tissue nutrition, the declared effectiveness of laser therapy is achieved. Blood circulation in the problem area improves, pain goes away, swelling and inflammation are relieved.

Before using laser therapy to treat joints and spine, consult our specialists.

How to prevent the development of pathology?

How to prevent the development of arthrosis of the costovertebral joints? Knowing the causes, the development of degenerative disorders can be avoided if you engage in their prevention. The exception is back injuries, which cannot be prevented. To prevent costovertebral arthrosis, doctors recommend physical activity: walking more, cycling, swimming, and including different types of physical activity.

Hula hoop has a good preventative effect. Contrary to all the myths that this device for rotating the body negatively affects the condition of the internal organs, all vertebral cartilage and tendons are perfectly worked out. Blood circulation along the back improves, tissues receive more oxygen and nutrients.

Body weight control also prevents the development of pathological disorders in the joints. It is important to adhere to a special diet so as not to gain weight, but to eat well and in a balanced manner. In case of excessive loads on bone joints in athletes and people whose work involves heavy physical labor, in order to prevent arthrosis, it is necessary to take a reasonable approach to training or loads.

If the first signs appear that are similar in their symptoms to diseases of the bone joints, you should consult a doctor and undergo a full examination. If the diagnosis is confirmed, remember: costotransverse arthrosis is not a death sentence, but a call to action. A set of methods of conservative therapy and physical treatment will help cope with the disease.

ARTHRITES AND ARTHROSIS

Arthritis is an inflammatory disease of the joint. Arthritis can be either an independent disease or a manifestation of some other disease. One of the first clinical manifestations of arthritis is joint pain. It is most intense in the second half of the night and in the morning. Pain relief usually occurs after movement. With the development of the pathological process, changes occur in the soft tissues and capsular-articular apparatus, leading to deformation of the joints, disruption of their function, changes in temperature and color of the skin.

The disease can occur with damage to one joint (monoarthritis) or several (polyarthritis). The onset of the disease can be acute and accompanied by severe pain in the joint (acute arthritis) or develop gradually (chronic arthritis). The causes of arthritis are varied: infection, trauma, allergies, metabolic disorders, diseases of the nervous system, lack of vitamins.

Arthrosis is a group of diseases of a metabolic-dystrophic nature, which typically involve damage to all components of the joint. First of all, cartilage, as well as adjacent to the cartilage, bone, synovial membrane, ligaments, capsule, periarticular muscles. Characterized by pain felt deep in the joints, aggravated by physical activity and relieved by rest, morning stiffness, crunching in the joints, and limited movement in the joints.

The cause of arthrosis is a change in the biological properties of cartilage. These properties can change both under the influence of external and internal environmental factors (gene defects, excess body weight, estrogen deficiency in women, joint injuries, joint surgeries, etc.).

Treatment. Most often, arthritis and arthrosis occur as a result of diseases such as rheumatism, psoriasis, gout, as well as a number of other, most often autoimmune diseases. Laser therapy of joints, in this case, is carried out against the background of drug treatment of the underlying disease, which allows reducing the amount of medications consumed. Treatment involves eliminating the underlying cause of arthritis (arthrosis) and local changes.

If you have the listed diseases, you should not forget that laser treatment of joints should be combined with laser hemotherapy. It is indicated as a desensitizing, analgesic, immunostimulating and decongestant therapy. Treatment regimens for affected joints are given in specific techniques.

Diagnostic measures

The first thing the doctor does is clarify the patient’s complaints and collect anamnesis (presence of injuries, back injuries, infectious diseases, heredity, difficult working conditions, etc.). Next, an external examination is carried out, during which moderate swelling of the tissues and redness of the skin in the area of the affected joints can be detected. Instrumental research methods allow you to make an accurate diagnosis, with the help of which you can determine the localization and severity of the pathological process.

X-rays show bone growth

For this purpose the following is carried out:

radiography in several projections - allows you to identify bone growths, destructive processes and some signs of inflammation;
Ultrasound – it can be used to detect inflammation of the inner joint membrane (synovitis);
CT – the method is informative in the early stages;
MRI is the best diagnostic method at the onset of the disease.

Most often, doctors limit themselves to X-rays, since the last two studies are more difficult to conduct and cost more.

Laboratory tests have no diagnostic value, so they are not usually performed. In the blood test, changes inherent in the course of any disease may be observed, against the background of which secondary arthrosis has developed. Thus, laboratory manifestations of inflammation are an increase in leukocytes and an acceleration of ESR. These signs are not specific.

RHEUMATOID ARTHRITIS

Rheumatoid arthritis.
Belongs to the group of systemic autoimmune diseases. Its characteristic feature is the formation of autoantibodies to various types of collagen. One of the components in the mechanism of development of autoimmune diseases is inflammation. With the development of inflammation under the influence of infectious factors (streptococcus-A - in rheumatism, intestinal microbes - in reactive arthritis), its main signs are revealed in tissues and organs - pain, swelling, dysfunction. Impaired microcirculation is one of the early mechanisms of rheumatic inflammation. It is caused by an increase in the permeability of the capillary wall due to cross-hemocirculatory disorders, leading to the development of edema and hyperemia. The role of hypercoagulation factors especially increases (chronic DIC syndrome in chronic rheumatoid inflammation).

It is necessary to note the systemic, progressive, self-sustaining nature of chronic inflammation in autoimmune diseases. Pathological metabolic disorders are diverse. Often, a complex metabolic disorder leads to inhibition of osteogenesis processes. Disruption of metabolic processes in articular cartilage leads to depletion of its main substance in proteoglycans, which causes the destruction of cartilage and the development of deforming osteoarthritis.

Arthrosis and metabolic arthropathy, as a rule, are generalized in relation to damage not only to many joints, but sometimes to internal organs. The central and peripheral nervous systems, especially the autonomic part, are involved in the pathogenesis of functional changes. Patients with rheumatoid arthritis experience symmetrical joint damage, muscle atrophy, osteoporosis, and various trophic disorders.

Treatment. It should be carried out taking into account all links of its pathogenesis. For this purpose, anti-inflammatory, immunomodulating, and painkillers are used. Modern complex therapy also includes physical factors. The use of physical factors has the following goal: to reduce or eliminate pain, reduce signs of general and local inflammatory activity. Due to the effect on the neuroendocrine and vascular components of trophism, it normalizes metabolism in the affected tissues. Influence the violation of immunoregulatory processes. Considering the fact that laser therapy has all of the above properties, it must certainly be part of the complex treatment being carried out. RT is prescribed both as a local effect on the joints and as laser hemotherapy.

Frequently asked questions

Does arthrosis occur in children and adolescents?

Contrary to popular belief, children are also diagnosed with this disease. Its occurrence at an early age is caused by infectious damage to the joints, as well as injury.

Which doctor should I contact for arthrosis?

If you have symptoms characteristic of arthrosis, make an appointment with your local physician. A preliminary examination and diagnosis can be carried out by a general practitioner, and based on the diagnostic results, he will refer you to a specialized specialist: a rheumatologist, traumatologist or orthopedist.

Does arthrosis exempt you from military service?

An illness without impairment of the functionality of one or more joints is not grounds for obtaining a deferment or complete exemption from military service. When passing the draft medical commission, the conscript will be examined in depth and the degree of pathology will be determined, on the basis of which a lawful decision will be made.

Is it possible to visit a sauna, steam room or steam room if you have arthrosis?

Warming joints with arthrosis is beneficial and relieves pain. But with concomitant inflammation and arthritis, taking water procedures is contraindicated. Before visiting the sauna, consult your doctor.

ARTHROPATHIC PSORIASIS

Arthropathic psoriasis. The most severe form and less manageable in terms of treatment in patients with psoriasis is arthropathic. According to established tradition, psoriasis still refers to skin diseases, although the systemic nature of this process and the ability of psoriasis to affect not only the skin, but also internal organs, the nervous system and joints have been established.

Psoriatic arthritis is characterized as a systemic process in which the most pronounced changes appear in the structure of connective tissue. Psoriatic arthropathy can occur benignly as monoarthritis or in the form of polyarthritis, and in some patients it takes on the character of severe destructive polyarthritis. Psoriatic arthritis often occurs in parallel with skin lesions or slightly later, and in some cases, articular syndrome may precede skin manifestations.

Joint involvement usually begins in the distal interphalangeal joints of the hands and feet. Gradually, medium and large joints are involved in the process, including the spine, with the development of ankylosing spondylitis (ankylosing spondylitis). Swelling, pain, and limited joint mobility are noted as a result of infiltration and compaction of the periarticular tissues. In the further course of the process, dislocations, subluxations, and ankylosis can form, leading to joint deformities, and the patient becomes completely disabled.

In addition, a progressive asthenic state sets in, up to cachexia, myalgia, atrophy of the muscles of the hands, forearms, and legs (12-15%). As with ordinary psoriasis, in patients with psoriatic arthropathy, insufficiency of liver and kidney function, immunodeficiency states, and cardiovascular pathology are determined.

Treatment. As with rheumatoid arthritis, treatment is comprehensive and is aimed at eliminating the manifestations of the disease, restoring metabolism in the articular cartilage and preserving the function of the affected joints. Drug therapy is aimed at achieving a desensitizing, detoxifying and anti-inflammatory effect.

We have already mentioned earlier that laser therapy has all these properties, and, in addition, it also has an immunocorrective effect - it must be included in the treatment process. Laser therapy is carried out both by affecting the blood (LHT) and locally on the area of the affected joints.

Treatment of uncovertebral arthrosis

In parallel with symptomatic treatment aimed at eliminating pain and improving the conduction of nerve impulses, supportive treatment is carried out, which is aimed at preserving the structure of the vertebrae and intervertebral discs. Its goal is to normalize metabolism in the involved tissues, as well as increase the elasticity and rate of regeneration of intervertebral cartilage. For this, rehydration drugs and chondroprotectors, vitamins, special exercises and active physiotherapy are used.

Arthrosis of the uncovertebral joints is treated by orthopedic doctors, neurologists, physiotherapists and rehabilitation specialists. In severe cases, neurosurgeons are involved to eliminate complications, as well as to remove osteophytes.

Pharmacotherapy

For the drug treatment of uncovertebral arthrosis, non-steroidal anti-inflammatory drugs (NSAIDs) are widely used, which in severe cases can be combined with steroid drugs (corticosteroids) to reduce pain and inflammation. Various dosage forms are used: tablets, ointments, gels, creams, capsules. Also effective are muscle relaxants and antispasmodics (in the presence of spasms), which must certainly be combined with drugs that stimulate blood microcirculation. This improves vegetative-trophic processes in tissues and protects the brain from damage due to hypoxia. To relieve pain in uncovertebral arthrosis of the cervical spine, analgesics (mostly prescription ones) can be prescribed.

To maintain intervertebral discs and curb their destruction, chondroprotectors are used in the form of tablets.

Drug therapy is allowed only with the recommendations of a doctor, since most NSAIDs have an irritating effect on the gastrointestinal tract and are also contraindicated in patients with ulcers and a number of other diseases. Without hardware diagnostics (radiography, MRI), it is not possible to determine the stage of the disease and the degree of compression of blood vessels and nerves. And therefore, prescribe a regimen appropriate to the severity of the disease.

Physiotherapy and other techniques

Physiotherapy in the treatment of uncovertebral arthrosis helps relieve the discomfort that occurs during the patient's daily activities. On the one hand, the gentle regime partially relieves spastic tension in the neck, on the other hand, the tissue blood supply deteriorates. To get out of this vicious circle and relieve the symptoms of uncovertebral arthrosis, the patient is shown moderate physical activity in compliance with the correct orthopedic regimen (therapeutic exercises), as well as physiotherapeutic and manual interventions aimed at improving blood circulation, increasing vascular permeability and relieving muscle tension while maintaining their masses.

Physiotherapy for deforming arthrosis of the neck involves the following treatment methods:

ultrasound therapy;
magnetic therapy;
medicinal electrophoresis;
mud therapy;
amplipulse
balneotherapy;
paraffin wraps;
salt compresses;
massage and manual therapy of the cervical-collar area.

Physiotherapy for uncovertebral arthrosis of the cervical spine helps to consolidate the effect of medications. It is carried out only during remission - pain and inflammation are direct contraindications. During the acute period, patients are shown a Shants collar, an orthosis aimed at limiting neck mobility. Its use is especially important in the presence of excessive mobility of the vertebrae - for example, when they are displaced.

Nutrition

Diet therapy for uncovertebral arthrosis involves a non-strict diet with limited consumption of table salt. The menu should be as varied as possible, rich in vitamins and minerals.

It is extremely important to give up bad habits, as they remove minerals from the body, and normalize water consumption. To effectively rehydrate cartilage, you need to drink at least 2.5 liters of clean water per day.

It is highly undesirable to consume mayonnaise and overcooked vegetable oils. It is also necessary to exclude foods high in sugar, nightshade vegetables (tomatoes, eggplants, bell and capsicum peppers, potatoes). Please note: the disease does not allow you to maintain a vegetarian diet.

If a patient is diagnosed with problems with collagen synthesis, he is indicated:

- menu with a large share of animal protein;

- consumption of fruits and vegetables rich in vitamins A, C, E, as well as potassium, magnesium, selenium;

- additional intake of omega acids.

GOUT

Gout. It is considered as a metabolic disease and is characterized by paroxysmal joint pain. Along with acute attacks of pain, gout is characterized by the deposition of salts (sodium urate) in the tissues, resulting in the formation of gouty nodules. In addition to uric acid, they contain a small amount of lime.

Favorite places for salt deposition are the auricles, cartilaginous covers of articular surfaces, especially the metatarsophalangeal joint of the big toe, wrist, and knee joints. This does not exclude the possibility of salt deposits in other joints. In addition to cartilage, the process affects the synovial membrane, periosteum, and tendons.

The joints thus change noticeably. They become swollen, red and painful to the touch. With a long course of the disease, persistent changes in the joints may occur: the ligaments thicken, effusion appears in the joint, and it becomes painful. When moving, a slight crunching sound is heard. Gouty nodes can enlarge over time and change the shape of the joint. In addition to the joints, gout affects blood vessels, usually the vessels of the kidneys and heart; Sclerotic changes occur in the vessels.

Treatment. Patients with gout need dietary, medication and physiotherapeutic treatment. Laser therapy is performed both on the blood (in the absence of contraindications) and locally on the area of the affected joints.

SCHLATTER'S DISEASE

This disease refers to necrosis of the epiphysis of the head of the tibia in combination with destruction of the bone core, which is caused by local overloads, chronic injuries and local circulation disorders. Boys aged 10 to 15-18 years are most often affected. Schlatter's disease develops for no apparent reason, more often on one side, less often on both.

Sometimes a link can be made to re-injury or increased quadriceps function (eg, sports). Clinic. There is swelling and local pain in the lower part of the knee, which increases with pressure. Movements in the knee joint are painful, especially after physical activity. An extreme degree of flexion of the limb at the knee joint is possible, but sharply painful. The pain does not go away even at rest. The course of Schlatter's disease is long. The chances of recovery are quite high, since this disease is cured after the period of growth of the body is completed. But until complete recovery, it is necessary to avoid overloading the limbs.

Laser therapy. The impact of laser radiation on the pathological focus is carried out in the same way as with other pathologies of the knee joint.

Recommendations, prevention and prognosis for arthrosis

In order to get rid of joint pain, prevent the development of arthrosis or relapses of the disease, experienced doctors recommend:

exclude heavy physical or prolonged static loads, do not lift heavy loads;
normalize body weight;
adhere to a low-calorie diet, eliminate alcohol and smoking;
do special gymnastics for joints, as well as creating a muscle corset;
minimize the risk of dangerous injury during sports or physical therapy;
use special devices to protect the impaired biomechanics of the musculoskeletal system;
take preventive courses of dietary supplements, chondroprotectors, vitamin-mineral complexes of drugs;
regularly attend scheduled medical examinations, clinical examinations, and if you experience any ailments or joint pain, immediately visit a specialized specialist.

By taking good care of your own body and following the rules of life prescribed by doctors, you can significantly slow down the progression of the pathology, as well as completely get rid of debilitating joint pain. Unfortunately, it is impossible to restore organs to their pre-arthritic state. But you have the power to achieve long-term, stable remission and restore the lost quality of life.

HEEL SPUR"

It is a bone outgrowth at the site of tendon attachment, which is characterized by painful sensations in the area of the sole.

Clinic. At the beginning of the disease, pain occurs when walking. It is especially difficult to start walking when acute pain occurs during exercise. Then, during the day, the pain when walking subsides somewhat, and by the end of the day it intensifies again. Over time, the pain becomes persistent.

People with excess weight, diseases of the spine and large joints of the lower extremities, flat feet, as well as athletes with prolonged local overload in this area are predisposed to the development of heel spurs. Currently, the treatment of heel “spurs” consists of providing relief with the use of various types of insoles and heels, complex physiotherapeutic treatment, and if there is no effect, surgical treatment - surgical removal of the bone outgrowth and excision of the altered tissue.

Laser therapy. Highly effective for this pathology. As a rule, the full effect is achieved after 2-3 courses.

The high efficiency and safety of modern laser therapy allows the population to use it as a home doctor. The manual included with the device allows you to correctly carry out the appropriate treatment of various diseases of the joints and spine. A prerequisite for purchasing a device for treatment at home is to carefully study the attached manual.

SPINAL HERNIA

At an early stage of changes in the lumbosacral spine, they make themselves felt by aching pain in the lower back. If the disease is advanced, then the pain caused by the hernia depends on which roots it compresses, and clinically it can manifest itself as impaired movement in the legs, impaired urination and potency.

Treatment. Surgical intervention for this pathology gives quick results, but is fraught with postoperative complications and the development of diseases in other parts of the spine. It is indicated in only 10-12% of patients. The most effective method is a combination of laser and manual therapy. Laser therapy allows you to relieve swelling and inflammation in the hernia area, and manual therapy, which is carried out after a course of laser therapy, allows you to painlessly correct the hernia. There have been cases where hernias disappeared only after several courses of laser therapy.

Diagnostic methods

To identify arthrosis of the costovertebral joints, various diagnostic methods will be required. This is necessary to identify damage to these joints, which can masquerade as a whole bunch of back diseases. For this purpose, the patient is prescribed the following types of instrumental methods:

X-ray of the chest in several projections. Makes it possible to detect osteophytes, minor deformations, and indirect signs of inflammation. A specialist can determine pronounced dystrophic disorders without the help of radiography;
computed tomography is more informative in the initial stages of the disease than radiography;
Magnetic resonance imaging is the most effective way to detect the disease in the early stages;

The last two methods are not always carried out. This is due to expensive equipment. Not all clinics have sophisticated equipment and the cost of diagnostics is not affordable for all patients.

Ultrasound examination can detect the phenomenon of synovitis.

Laboratory and clinical tests for costovertebral arthrosis are ineffective and have little impact on them. They are not used for diagnostic purposes.