Deforming arthrosis - symptoms, degrees and treatment

Causes of deforming arthrosis Symptoms of deforming arthrosis Stages of deforming arthrosis Medicines for deforming arthrosis Nutrition for deforming arthrosis

Deforming arthrosis is a chronic disease of cartilage and bone tissue, which is associated with the gradual destruction of articular cartilage and loss of mobility in the joint. Due to friction and microtrauma, the heads of the involved bones begin to grow and flatten, leading to a change in the appearance of the joint. Left untreated, deforming osteoarthritis of the joints can lead to complete or partial disability of the patient with loss of the ability to care for himself.

People over 45 years of age are most susceptible to this disease. With age, the risk of the disease increases.

General information about deforming arthrosis

Deforming arthrosis (osteoarthrosis, osteoarthritis) is a metabolic-dystrophic disease accompanied by the destruction of cartilage with subsequent proliferation of bone tissue and joint deformation. Constant mechanical irritation of all articular tissues leads to periodic inflammation in the synovium (synovitis), which further aggravates the patient’s condition.

The combination of synovitis with dystrophy and deformation of the joint has led to the fact that the disease is often called osteoarthritis, as well as osteoarthritis and deforming arthrosis. In accordance with the 10th International Classification of Diseases, these names are identical. The disease code according to 10 ICD is M15-M19.

Previously, it was believed that this is an age-related disease that develops against the background of aging of the body. But it has now been established that osteoarthritis can develop at any age, including in children. Depending on a number of reasons, the disease can progress slowly or rapidly. Therefore, it is preferable to treat it in the initial stages, when the process is easier to stop or slow down. But you can help a patient even at an advanced stage.

Diagnosis of the disease

Any clinical recommendations for deforming osteoarthritis are prescribed after a thorough examination. Therefore, if you discover its signs, you should see a rheumatologist as soon as possible.

He will prescribe the following diagnostic procedures:

X-ray diagnostics, thanks to which the degree of narrowing of the joint gap, the size and localization of growths, and features of bone changes will be clearly visible;
for a more detailed examination - CT and ultrasound of the spine, as well as MRI of the damaged joint;
puncture of the diseased joint (if necessary);
endoscopy (arthroscopy) of the damaged knee joint (not mandatory, at the discretion of the specialist).

Causes and mechanism of development

Deforming arthrosis can be primary, when clear causes cannot be identified, and secondary, developing after illnesses and injuries.

Primary arthrosis deformans is mainly an age-related disease. It has a connection not only with age, but also with family history, excess body weight and a sedentary lifestyle. Progresses slowly but steadily. Pathological processes in the joints are mainly associated with a decrease in the volume of synovial fluid, impaired tissue nutrition, and atrophy (reduction in volume) of articular cartilage. It becomes thinner, cracks, the bones are injured and this stimulates their growth with the formation of marginal growths - osteophytes, which deform the joint. Constant irritation contributes to the periodic occurrence of inflammation, but degenerative-dystrophic processes still predominate.

Secondary osteoarthritis develops at any age after illnesses and injuries. Main reasons:

acute injuries - intra-articular fractures, dislocations and subluxations, severe bruises;
constant microtrauma associated with the professional activities of athletes is one of the common causes;
congenital dysplasia (developmental abnormalities);
osteochondropathy – destruction of joints due to malnutrition; for example, Perthes disease, which develops in adolescence;
metabolic disorders - obesity and sedentary lifestyle, disorder of purine metabolism with deposition of uric acid salts in the joint cavity (gout), etc.;
endocrine diseases - diabetes mellitus, hormonal disorders in men and women associated with an imbalance of sex hormones, etc.;
inflammatory processes - chronic arthritis - rheumatoid, psoriatic, etc.;
diseases that cause circulatory disorders in the lower extremities - varicose veins (more common in women), obliterating endarteritis, atherosclerosis of the arteries of the lower extremities (more often in men).

If the underlying cause continues to operate (for example, inflammation or endocrine disorders), this contributes to the rapid progression of deforming arthrosis.

Therefore, secondary pathological processes are more dangerous; they require timely consultation with a doctor to treat the underlying disease.

Prevalence of osteoarthritis

This is the most common joint disease in the world. According to statistics, every fifth inhabitant of the Earth suffers from osteoarthritis. Every year the number of cases increases by a quarter. At the age of 30-40 years, radiological signs of osteoarthritis are present in every tenth person, at 55-60 years – in half, at 75 years – in 80% of people. Sometimes osteoarthritis is found in young people.

Primary and secondary

Primary is a disease that develops on an undamaged joint.
Secondary osteoarthritis affects a joint after an injury or one that already has changes caused by a congenital or acquired disease, metabolic or endocrine characteristics.

Symptoms of deforming arthrosis

The main symptoms of deforming arthrosis are joint pain, deformation and impaired joint function. Primary age-related arthrosis occurs and progresses slowly. The course of secondary arthrosis depends on the cause of its development - injury or disease.

First signs

The first signs of deforming arthrosis usually disappear within 5-10 minutes

At the initial stage, there is no deformation of the joint or impairment of its function. The pain is mechanical in nature and appears after prolonged walking or standing. At rest they pass quickly enough. Slight starting pain and slight stiffness of movement are also characteristic - these symptoms appear after a night's sleep or a long stay in a forced position and disappear within a few minutes after the start of physical activity. But this is already the first bell - a signal that you need to see a doctor.

Obvious symptoms

The pain after exercise is more intense and does not go away immediately. Prolonged aching night pain appears, and sometimes painful convulsive muscle twitching. Muscle pain can be of a long-term reflex nature, associated with increased load on the limb.

When moving, a characteristic crunching sound appears - crepitus, which indicates unevenness of the articular surfaces. Periodically, the skin in the affected area swells and becomes slightly inflamed, the pain becomes constant, and the body temperature may rise, but after some time these symptoms go away without treatment. This indicates inflammatory processes in the synovium - synovitis. After each exacerbation of synovitis, the progression of degenerative-dystrophic processes is activated. Often at this stage the patient requires support when walking and uses a cane. Over time, the joint becomes deformed and gradually loses its function.

On the fingers you can sometimes see bone growths - Heberden's and Bouchard's nodes, changing the shape of the hand.

There is good news - all this can be treated. But you need to choose the right clinic, where doctors have experience in treating such diseases.

Dangerous symptoms

The following symptoms are a signal that you need to urgently consult a doctor:

joint pain has become constant, worsening at night;
periarticular tissues periodically swell and become inflamed, sometimes this is accompanied by a slight increase in body temperature;
the joint has increased in volume due to bone growths;
movements are accompanied by crepitation;
the limb is difficult to bend and straighten;
you have to walk with a stick.

If you experience such symptoms, do not delay, seek medical help immediately.

Why is deforming arthrosis dangerous?

Despite its slow progression, arthrosis deformans is a disease with serious consequences.

Degrees/stages of deforming arthrosis

There are different classifications of deforming arthrosis. In our country, most specialists adhere to the clinical and radiological classification developed in the early 60s of the last century by N. S. Kosinskaya. According to this classification, there are 3 degrees of deforming arthrosis:

Deforming arthrosis of the 1st degree (early stage). It may be asymptomatic or accompanied by slight pain during exercise. X-rays show no changes or some reduction in the joint space and slight thickening of the articular surfaces of the bone tissue (initial manifestations of osteosclerosis).
Deforming arthrosis of the 2nd degree (progressive stage). The pain is severe, aching, and often appears not only during the day, but also at night. Crepitation during active movements, the first symptoms of limitation of joint function and mobility. On the radiograph: the joint space is reduced by 2–3 times, initial signs of articular deformation (osteophytes), severe osteosclerosis.
Deforming arthrosis of the 3rd degree (advanced stage). The pain is constant, painful crepitus due to the appearance of articular mice - separated bone segments. On the radiograph: the joint space is practically absent, overgrown osteophytes significantly deform the joint. Severe osteosclerosis, areas of necrosis with the formation of cystic cavities and bone fragments (sequestra) are visible.

The stages of deforming arthrosis are usually

Don’t despair: an experienced doctor can help a patient at any stage of the disease!

Possible complications

If the disease is not treated or treated independently without seeking medical help, the following complications cannot be avoided:

constant severe pain not only during exercise, but also at rest;
persistent articular deformation;
loss of limb function - difficulties in flexion, extension, rotation and even complete immobility;
decreased performance and disability.

Exacerbations

Increased pain is usually associated with exacerbation of the inflammatory process - synovitis. The articular surface swells slightly, becomes painful, sometimes slight redness of the skin appears, and the temperature rises to 37. Sometimes increased pain is associated with changes in weather (changes in atmospheric pressure, etc.). In case of exacerbation you need:

take a pain reliever: Diclofenac, Ibuprofen, Nise, etc.;
apply a gel (ointment, cream) with the same anesthetic composition to the painful area;
lie down, give the affected area of the body an elevated position;
after the pain subsides, go to the clinic; If the pain is very severe, call a doctor at home.

Localizations

Any localization and form of arthrosis has serious complications, so you should not delay treatment.
See how easily the disease can be cured in 10-12 sessions.

Deforming arthrosis of the skeletal joints can have different localizations. And each localization has its own characteristics.

Deforming arthrosis of the leg joints

The most common localization. Different joints of the legs have their own characteristics of the structure, functioning and course of osteoarthritis.

Hip (Hip) deforming arthrosis

The hip joint must withstand the load of the entire body. Deforming arthrosis of the hip joint can be age-related, the outcome of bone tuberculosis, congenital articular anomalies or osteochondropathy (Perthes disease). The hip joint is located deep, so when osteophytes grow, nearby muscles and ligaments can become injured and inflamed. It is also possible to compress blood vessels and nerves with the appearance of neurological symptoms - pain along the pinched nerve and sensory disturbances.

Read more about the causes, symptoms and treatment of arthrosis of the hip joint here.

Deforming arthrosis of the knee joint

The most common causes of deforming arthrosis of the knee joints are age-related changes and injuries. Primary age-related deforming arthrosis is mainly a female disease. Injuries can occur in both women and men at any age. Frequent knee injuries are associated with the peculiarities of its structure and functioning - even a small but sharp deviation from normal movement parameters can lead to injury. I am concerned about severe pain and the inability to fully bend the knee. Deforming arthrosis of the knee joint is also characterized by the appearance of pathological changes in the hip and ankle joints.

Read more about arthrosis of the knee joint in this article.

Ankle

Osteoarthritis occurs slowly, unnoticed at first, but already in the second stage chronic pain syndrome develops. It is often complicated by flat feet, which further increases pain, especially when moving. Complete immobility is rare, but quite often the process is complicated by subluxations and dislocations of the ankle.

Deforming arthrosis of the knee joint

Deforming arthrosis of the hand joints

The upper extremities are less likely than the lower extremities to undergo acute trauma, so the cause of deforming arthrosis of the joints of the hands is most often inflammatory diseases and professional activity (systematic microtrauma).

Deforming arthrosis of the shoulder joint

The cause of deforming arthrosis of the shoulder is often macro- and microtrauma in athletes and people engaged in heavy physical labor. In this case, the periarticular tissues are also injured, which leads to the development of their inflammation - glenohumeral periarthritis, which increases pain and articular degenerative-dystrophic disorders. The cause of the disease can also be chronic arthritis, most often rheumatoid arthritis. The disease is long-lasting, painful and often causes disability. Read our article “arthrosis of the shoulder joint.”

Deforming arthrosis of the elbow joint

The elbow suffers from acute injuries (falling on the hand) and systematic exposure to vibration, which is typical for such professions as builders, miners, etc. Chronic arthritis is also a cause, but not often. The disease progresses unnoticed at first, but pain gradually develops when bending and straightening the arm at the elbow, and then dysfunction of the limb.

Deforming arthrosis of the hand

Deforming arthrosis of the hand develops after injuries and rheumatoid arthritis. The carpometacarpal joint of the thumb is mainly injured, as a result of which degenerative-dystrophic processes develop in it with pain and dysfunction. In rheumatoid arthritis, arthrosis deformans occurs against the background of constant exacerbations of the inflammatory process, and therefore often leads to disability.

Deforming arthrosis of the fingers

The deforming dystrophic process of this localization is a consequence of microtraumas during the systematic performance of minor work (sewing, knitting) or inflammatory processes. Psoriatic arthritis affects the end joints of the fingers. The growth of osteophytes in this area is called Heberden's nodes. In rheumatoid arthritis, the lower interphalangeal joints are affected and bony growths on them are called Bouchard's nodes.

Deforming arthrosis of the temporomandibular joint (TMJ)

It develops against the background of dental problems that cause inflammation or poor circulation in the TMJ area. Aching pain appears when chewing or opening the mouth, accompanied by a characteristic crunching sound. With exacerbation of synovitis, the pain intensifies. Advanced disease can lead to facial asymmetry and speech impairment.

Pathogenesis of arthrosis of the knee joints

Morphologically, arthrosis is wear and tear of the cartilage lining of the joint, leading to disruption of the normal anatomical structure of the articular surfaces. The joint is formed by the articular surfaces of the tibia and femur, covered with cartilage tissue. During movements, cartilage acts as a shock absorber. Cartilage consists of connective tissue fibers loosely located in a jelly-like substance (matrix). Due to the matrix, cartilage is nourished and regenerated.

Cartilage tissue is like a sponge: at rest it absorbs fluid, and when loaded, squeezes it into the joint cavity, allowing the bones to glide. Under load, some of the fibers are worn out and destroyed. Normally, they are replaced by newly synthesized ones. Osteoarthritis occurs when there is an imbalance between the synthesis of cartilage and its destruction.

Damaged, less complete cartilage structure absorbs less fluid, drier and more brittle cartilage easily splits under stress. The structure of the underlying bone changes - osteophytes grow along the edges of the joint, compensating for the loss of cartilage by the growth of articular surfaces.

Not only the cartilaginous covering of the joint suffers; meniscal tears, cruciate ligament injuries are periodically diagnosed with DOA, and sometimes loose intra-articular bodies are detected. Due to partial or complete destruction of the cartilage and subchondral plate, the contact surfaces are displaced, causing the joint to become deformed.

Deforming osteoarthritis of the knee joint is arthrosis of the last stage.

Primary arthrosis of the knee joint

Primary ACS is considered if the immediate causes of the disease have not been identified (there were no injuries, no concomitant diseases, no professional history).

Secondary arthrosis of the knee joint

Secondary AKS is degenerative-dystrophic changes in the knee joint due to metabolic diseases (diabetes mellitus, gout), rheumatoid diseases (rheumatoid arthritis), vascular pathology (vasculitis, atherosclerosis) or in the presence of a professional history (sports, heavy physical labor) .

Diagnostics

It is impossible to make a correct diagnosis at home without a doctor, so it is very important to choose a clinic where you can conduct a full examination:

Laboratory diagnostics – blood tests that detect inflammatory, metabolic, and autoimmune disorders.
Instrumental research methods:
magnetic resonance imaging (MRI) – if necessary to clarify the diagnosis in the initial stages of the disease;
Ultrasound – to identify disorders in the surrounding soft tissues;
arthroscopy with tissue biopsy – if necessary to clarify the nature of the pathological process.

Treatment of deforming arthrosis

Deforming arthrosis requires long-term complex treatment, including:

drug therapy;
non-drug treatment methods;
traditional methods;
surgery.

Drug therapy

The primary goal is to relieve sick people from pain. For this purpose, symptomatic treatment is carried out. Depending on the severity of the pain syndrome, drugs from the following drug groups are prescribed intramuscularly, rectally, orally or externally:

Nonsteroidal anti-inflammatory drugs (NSAIDs), which have an analgesic effect. All NSAIDs are divided into:
selective (selective) - drugs of the latest generation that suppress the action only of the COX-2 enzyme, which is responsible for the synthesis of pro-inflammatory PGs; they do not suppress the effect of COX-1 and do not have side effects on the gastrointestinal tract; these are Nimesulide (Nise), Meloxicam (Movalis), Celecoxib (Celebrex), Etoricoxib (Arcoxia); they can be used for gastrointestinal diseases.
Muscle relaxants that relieve painful muscle spasms - Mydocalm.
Local anesthetics (novocaine and lidocaine blockades) - injections into the most painful points.

Pathogenetic therapy (impact on the mechanisms of disease development) includes:

Preparations containing chondroitin and glucosamine (chondroprotectors) are biologically active substances that promote the restoration of cartilage tissue; they are prescribed in the form of tablets, injections, ointments (Teraflex, Artra, Dona, Structum, Chondroitin).
Preparations based on hyaluronic acid - intra-articular administration improves the shock-absorbing properties of the joint, prevents injury to cartilage and bone tissue.

Non-drug treatment

Taping for deforming arthrosis

This section of conservative treatment includes: proper balanced nutrition, means of fixing joints, physical therapy, massage, physiotherapeutic methods, etc.

Nutrition

There is no special diet for deforming osteoarthritis. You should adhere to the rules of a rational, nutritious diet, excluding high-calorie foods (fatty meat, canned meat, smoked sausages) and easily digestible carbohydrates (sweets, baked goods, sweet carbonated drinks) from the diet, since it is necessary to maintain normal body weight, preventing obesity.

Joint fixation

The need for fixation arises to give the limb the correct position. For this purpose, they are prescribed to wear orthoses, knee pads (if the patient has deforming arthrosis of the knee joint), fixation of joints using special adhesive tapes (taping), support when walking on canes and crutches.

Therapeutic exercise (physical therapy) and massage

Physical activity stimulates the restoration of joint function. Therefore, exercise therapy complexes are the main type of treatment for deforming arthrosis. Complexes are selected for each patient individually depending on his condition. The first classes must be supervised by a physical therapy instructor, and only after the patient learns to perform all the exercises correctly can they be performed at home. Basic rules for performing exercise therapy:

regularity of classes;
no sudden movements;
increasing loads under the control of pain - as soon as pain appears, the load is reduced.

Swimming and gentle physical exercises (Pilates, yoga) are very beneficial. It is not recommended to jump or play outdoor games that place stress on pathologically altered joints.

Massage activates blood circulation and metabolism in articular and periarticular tissues, promoting their regeneration.

Physiotherapy

Physiotherapy is necessarily part of complex therapy. Procedures are prescribed to eliminate pain, inflammation and swelling during synovitis (electrophoresis with novocaine, hydrocortisone), eliminate muscle spasms (paraffin, ozokerite), stimulate tissue regeneration (magnetic and laser therapy), and increase the body's overall resistance (UVR).

Chondroprotectors: what are they, how to choose, how effective are they?

Joint pain at rest

Folk remedies

These methods allow you to expand the range of complex treatment and reduce the drug load:

onion broth in vegetable broth; Chop a medium-sized onion, fry in butter, then boil in half a liter of water until the onion is completely boiled; add a glass of vegetable broth (cabbage + carrots + potatoes) to the broth and bring to a boil; divide the resulting broth into 2 servings and drink in two doses half an hour before meals; course from 4 to 6 weeks; perfectly stimulates metabolic processes;
honey massage before bed; Apply a tablespoon of warm liquid honey to the painful area above the joint and rub in with light circular movements for 3 to 5 minutes; cover with a cotton napkin, wrap and leave overnight.

Surgical treatment of deforming arthrosis

In cases where conservative treatment methods do not help, endoprosthetics is performed - replacing the destroyed joint with an artificial one.

Approach to treating the disease in our clinic

Specialists at the Paramita clinic in Moscow not only use all modern methods of diagnosing and treating osteoarthritis, but also actively use traditional oriental methods. Such as reflexology (acupuncture, moxibustion, acupressure), herbal medicine, etc.

Each patient is unique to us. This approach allows you to quickly eliminate pain and significantly speed up the process of treatment and rehabilitation of patients with deforming arthrosis. With regular maintenance treatment, our patients forget about their problems and lead a normal lifestyle.

We combine proven techniques of the East and innovative methods of Western medicine.
Read more about our unique method of treating arthrosis

At an appointment with a rheumatologist

The rheumatologist at our clinic determines the method and course of treatment taking into account the following indicators:

the degree of development of the disease and involvement of joints in the process;
how long the disease has been progressing;
is there any pain syndrome?

Basic treatment requires the following measures:

Decreased activity in the joint area.
Weight loss in the presence of obesity.
Administration of metabolites in courses intramuscularly.
Cartilage restoration therapy (intramuscular injections of stimulants in courses).
As an additional treatment, anti-inflammatory therapy is used and quinol drugs are prescribed.
If inflammation is present, a course of hormonal therapy is sometimes prescribed.
It is necessary to undergo a course of massages, a set of physiotherapeutic measures, and sanatorium-resort treatment.

Treatment of advanced cases is carried out through a surgical operation such as joint replacement.

For the treatment of polyarthritis of the joints, arthritis, arthrosis, you can contact our clinic.

General clinical recommendations

For osteoarthritis you can and should:

move more, alternating loads with rest;
regularly engage in exercise therapy; Swimming is a particular priority;
eat properly regularly;
avoid physical injury and prolonged stress - this reduces the risk of disease progression;
follow all doctor's orders.

It is forbidden:

lift weights, do hard physical work;
perform physical exercises when pain occurs;
be in a forced position for a long time, especially in a standing position;
allow excess weight to appear;
smoke a lot and drink alcohol too much.

Prevention

To prevent age-related degenerative-dystrophic disorders, you need to lead a healthy, active lifestyle. To prevent secondary osteoarthritis, all joint diseases and injuries must be carefully treated.

Forecast. Prevention

Osteoarthritis of the knee joint is difficult to treat and is one of the ten main causes of disability in the Russian Federation and Belarus. However, in the early stages, the progression of the disease can be significantly slowed down. If there are risk factors for the purpose of prevention, it is recommended to:

balanced loads on joints (optimal training and work regimen);
swimming;
massage of thigh and calf muscles;
maintain optimal weight;
rejection of bad habits;
regular physical therapy exercises;
wear comfortable shoes, do not get too cold, do not overwork;
diet therapy;
treatment of concomitant diseases.

Long-acting hyaluronic acid preparations GIAL-SIN, GIAL-SIN PROLONG, GIAL-SIN PROLONG PLUS will improve trophism and slow down the degeneration of the cartilage lining of the knee. Course treatment is the key to achieving a positive effect. The duration of therapeutic and preventive action is 12-24 months.

Frequently asked questions about the disease

Is it possible to stop deforming arthrosis?

Not only is it possible, but it is also necessary. Only a doctor can do this.

How quickly does arthrosis deformans progress?

It all depends on genetics, lifestyle and compliance with doctor’s orders.

Which doctor treats you?

Depending on the cause of development, this can be done by an orthopedic traumatologist or rheumatologist.

What prognosis do doctors usually give?

It is quite possible to stop the progression of the disease and improve the quality of life at any stage.

Can children develop the disease?

Yes, against the background of congenital malformations of the joints, as well as after illnesses and injuries.

Arthrosis deformans is a long-term, constantly progressive disease. If left untreated, excruciating pain and disability are guaranteed. Only a doctor can help, but it is very important to choose a clinic with experienced specialists. The doctors of the Moscow Medical Center have such experience, they will definitely help you!

Literature:

Alekseeva L.I. Modern approaches to the treatment of osteoarthritis // Breast cancer. 2003. T. 11. No. 4. pp. 201–205.
Reginster JY, Deroisy R, Rovati LC et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomized, placebo-controlled clinical trial// Lancet. 2001; V. 357: 251–256.
Hajjal HEL, Marcelis A., Devogelaer JP, Manicourt DH Celecoxib has a positive effect on the overall metabolism of hyaluronan and proteoglycans in human osteoarthritic cartilage // J. Rheum. 2003; 30:2444–2451.

Themes

Arthrosis, Joints, Pain, Treatment without surgery Date of publication: 10/29/2021 Date of update: 11/04/2021

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