What is osteoarthritis? Causes, symptoms and treatment of pathology

Arthrosis is a chronic pathology aimed at damaging the articular structures of the locomotor system. The main reason that leads to chronic diseases is the metabolic imbalance, which leads to a progressive process of a degenerative-dystrophic nature. The targets of the harmful reaction are articular cartilage, connective tissue, bursae, tendons, bones, and muscle fibers. In the chronic form of the pathology, the periarticular muscles are involved in the inflammatory process, losing anatomical elasticity due to joint deformation and swelling. In order to eliminate the complications associated with blocking the biomobility of the skeleton and not to become disabled, you should arm yourself with information about arthrosis - what it is, what are its causes, symptoms and treatment.

Causes and risk factors for the development of pathology

The inflammatory-destructive process in the joint often begins for no reason. Idiopathic (primary) arthrosis has this beginning. The mechanism of development of secondary arthrosis begins after certain conditions and factors, namely:

• Joint injury (fracture, meniscus damage, ligament tear, dislocation, compression + contusion, bone fracture).
• Dysplasia (abnormal intrauterine development of articular components).
• Violation of material metabolism.
• Autoimmune type pathologies (rheumatoid arthritis, psoriasis, toxic autoimmune goiter, systemic lupus erythematosus).
• Nonspecific destructive arthritis (with a purulent component).
• Infections of various etiologies (tuberculosis, meningitis, encephalitis, gonorrhea, syphilis, hepatitis).
• Pathologies of the endocrine glands (diabetes mellitus, toxic goiter, pathology of the adrenal glands and the pituitary gland).
• Hormonal dysfunction (decreased levels of estrogens, androgens).
• Degenerative + dystrophic reactions (multiple sclerosis, Perthes disease).
• Oncological diseases.
• Blood diseases (hemophilia, anemia, leukemia).

Risk factors that provoke and lead to arthrosis:

1. Age-related changes.
2. Obesity (excess body weight leads to constant vertical loads, which overload the joints, which wear out quickly, losing cartilage plates).
3. Professional costs, that is, the load on a certain group of joints, which leads to their inflammation or premature destruction before other groups.
4. Postoperative consequences: very traumatic surgery with extirpation of affected tissues (soft, cartilaginous, bony). After restorative manipulations, the joint structure does not have the same consolidation, so any load leads to arthrosis.
5. A hereditary factor, that is, arthrosis can affect one or more family members.
6. Hormonal imbalance during menopause or after removal of ovaries in women, prostate gland in men.
7. Violation of water-salt balance.
8. Neurodystrophic damage to the spine is a trigger for glenohumeral, lumbosacral, and hip arthritis.
9. Intoxication with pesticides, heavy metals.
10. Temperature changes with sudden changes plus hypothermia.
11. Permanent trauma to a particular set of joints.

Risk factors include the environment, which has recently been saturated with high background radiation, toxic substances (smog over industrial cities and in industrial areas, as well as frequent testing of military equipment or interstate wars, the result of which are holesof ozone + strong ultraviolet radiation). Dirty drinking water + foods rich in preservatives lead to the development of arthrosis.

Mechanism of arthrosis development

The basis of the triggering mechanism of arthrosis is a disruption of the chain of cartilage cell restoration processes and the correction of affected areas of connective tissue by new cells. Cartilage plates tightly cover the end surfaces of the bones that are part of the locomotor joints. Anatomically normal cartilage has a strong structure, they are smooth, elastic and thanks to the synovial fluid, which is a biological material for the lubrication of intra-articular components, they slide. It is the synovial fluid that provides the unhindered movement of the articular components in relation to each other.

Cartilage tissue and synovial lubrication perform the main function of shock-absorbing effect, reducing the wear and tear of cartilage-covered bones. The bony ends are separated by sacs of fluid, and a corset of ligaments and muscles firmly stabilizes them. A certain configuration and plexus of the musculo-ligamentous apparatus allows this structure to perform precise biomechanical movements such as flexion, extension, rotation + rotation. The design, thanks to the braiding of ligaments, allows you to hold firmly in a certain position, as well as perform coordinated movements, while maintaining the balance of the body.

High stress or hormonal imbalance leads to the destruction of the collagen plates, exposing the bones. Pointed osteophytes appear in these areas, they create pain with every movement of the musculoskeletal joints. Bones thicken and false joints develop between osteophytes, which completely change the functionality of the organ of movement. There is less synovial fluid due to the trauma of the bursa (its rupture), and the entire structure of the joint begins to suffer, along with the corset of ligaments + muscles. Joint swelling occurs and a microbial infection may also occur. Areas of ossification lead to limited movement and ankylosis of the joint.

Stages of clinical manifestation of joint pathology: stages

Arthrosis is characterized by three stages of development, consisting of:

• Phase I:there are no special morphological changes, trophism is not disturbed, synovial fluid is produced in sufficient quantities. The stability of the joint structure corresponds to the average physical activity. With forced work, joint pain and swelling appear.
• Phase II:depletion of the cartilage plate is observed, foci of osteophytic islands develop and ossification appears along the edges of the joint. The pain syndrome intensifies, swelling increases and discomfort in movement appears. As the pathology progresses to the chronic stage, the pain is constant, accompanied by inflammation with periods of exacerbation/remission. Biomechanics is partially damaged, the patient spares the joint.
• Phase III:the cartilaginous plate is completely consumed; instead of cartilage, a system of osteophytes + fixed false interosteophytic nodes develops at the ends of the bones. The anatomical form is completely broken. Articular ligaments and muscles are shortened and thickened. The slightest injury can cause dislocations, fractures and tears. The trophism of the locomotor organs is damaged, so they do not receive the necessary amount of blood and nutrients. Pressed nerves lead to a strong pain reaction, which goes away only after the administration of strong pain relievers or drugs from the COX1/COX2 group.

Conventionally, one more stage can be added: the fourth stage - the last one with a vivid clinical picture of inflammation, infection, unbearable pain, immobilization of diseased joints, high temperature and serious condition. This stage is the most severe, which can lead to sepsis and death.

Arthritis pain syndrome

Pain is characteristic of arthrosis. They intensify with movement, physical activity, with changes in weather conditions, with changes in temperature, humidity levels and atmospheric pressure. Pain can be caused by any body position or sudden movement. Walking, running and standing for a long time put a certain load on the injured joints, after which acute or painful pain begins. In the first and second stages of the pathology, the pain syndrome disappears without a trace after a night's rest, but in the advanced stage the pain is constant and does not go away. The affected shock-absorbing layer, compressed nerves and blood vessels lead to a stagnant process with impaired trophism and accumulation of interstitial fluid. The swelling provokes acute throbbing pain.

Specific for arthrosis is pain after a long rest with a sharp motor impulse; this condition is called incipient pain. The mechanism of development of these pains is the osteophyte area covered with destructive remnants of cartilage tissue, fibrin and viscous fluid. When the joints move, a film of these compounds or detritus covers the exposed areas, lubricating them and thus absorbing the pain. Blockade pain occurs when the destruction products from the intra-articular space, that is, bone debris or a large film of connective tissue, enter the muscles. There is another type of pain: constant, aching, bursting + independent of movements, they are characteristic of reactive synovitis.

Careful!Blockade type of pain can only be treated with surgical intervention followed by restoration of the affected joint. Treatment with folk remedies is not recommended, this is fraught with the development of purulent arthrosis with the spread of infection throughout the body, and after sepsis there are obvious morphological changes in all organs and systems.

Symptoms of joint inflammation

Symptoms are divided depending on the degree of development of the pathology. Arthrosis is felt after 38-40 years, when the cushioning system of the joints begins to wear out and renewed or new cartilage does not appear in its place. With a hormonal imbalance, "chaos" is established in all vital systems, this also applies to the locomotor system, so in the affected areas tissues do not regenerate, but instead destruction + deformation occurs.

Symptoms of arthrosis:

Degrees and periods of arthrosis	Description of symptoms
Graduate	Weak, short-term pain with precise localization. Rapid fatigue of the injured joint. The pain intensifies after long walks, running or lifting weights and goes away after rest. A faint clicking sound is heard during bending or other movements. There are no visual changes + palpation, the anatomical shape of the joint is preserved, no swelling is observed.
degree II	Discomfort in the affected joints, stiffness is noted after rest. Partial traffic restrictions. Pain at night, as well as pain depending on weather conditions. When bending and other movements, a characteristic loud click appears. There are visual and palpative changes: the joints enlarge and shorten, plus when pressure is applied, the patient responds sharply to acute pain.
degree III	Complete discomfort in the affected joints, joint instability or ankylosis is noted. Movement is paralyzed. There are constant sharp or aching pains at night. The anatomical shape of the joints is lost: thickening/shortening and displacement of the axis of the articular structure. There is swelling + pain when pressing. The gait is changed, due to the saving of the movement organ, the shape of the bone skeleton changes. Movement is carried out with the help of a stick or crutches. With morphological changes with an infectious factor or compressed nerves, a high temperature (37-38 degrees) appears.
Periods of irritation and remission	In arthrosis, exacerbations alternate with remissions. The pathology is aggravated by physical activity. Aggravations are caused by synovitis. The pain syndrome covers all affected areas, including the muscle corset. It reflexively spasms, forming painful contractures. Arthrosis is characterized by muscle spasms. As the destruction increases, the pain syndrome becomes more pronounced. With reactive synovitis, the joint increases in size and takes on a spherical shape. Fluid appears in the joint, which creates a ripple effect when palpated. During a brief remission, the pain subsides, but movement is difficult.

Timely detection of pathology using diagnostic tests and consultation with the necessary specialists will help pass the second and third stages, maintaining the functionality and health of all joint groups of the locomotor system until old age.

Diagnostic measures

Clarification of the diagnosis is based on laboratory/instrumental studies. Each case is studied differently, that is, with an individual approach to each patient.

The list of studies consists of:

• General and biochemical blood tests.
• Blood test for rheumatoid agent.
• Analysis of urine and feces.
• X-ray examination: imaging in three positions.
• CT scan of the joint to clarify the bone structure.
• MRI of joints: study of ligaments and muscles.
• Computed tomography.

Important!Patients with arthrosis should consult an orthopedist, rheumatologist, endocrinologist, hematologist, oncologist, and female patients are recommended to consult a gynecologist.

Treatment regimen

Therapeutic tactics include a whole range of measures aimed at eliminating the main cause, correcting the nutritional diet, restoring the lost function + a gentle lifestyle, that is, without special physical activity (long walks, running, carrying heavy objects). The therapeutic treatment regimen consists of drug therapy, local treatment, physiotherapeutic procedures and exercise therapy. In parallel with these methods, folk remedies are used.

Drug therapy for arthrosis

Complex therapy consists of:

1. Drugs of the NSAID group;
2. Painkillers (tablets + injections);
3. Medicines that relieve muscle spasms (muscle relaxants);
4. Cartilage tissue restorers (chondroprotectors);
5. Antibiotics;
6. Antihistamines;
7. Medicines that improve blood circulation;
8. Vitamins: B2, B12, PP and A;
9. Antioxidants: vitamin C;
10. Medicines based on hormonal substances.

It is recommended to include in the treatment regimen for rheumatoid arthritis:

• Gold-based medicines;
• Immunosuppressants;
• Antimalarial drugs;
• Medicines that inhibit malignant cells.

Careful!During the remission of the pathology, non-steroidal anti-inflammatory drugs are not recommended, they affect the gastrointestinal tract, causing multiple ulcers and also inhibit the process of cartilage tissue nutrition.

Ointment for local use for arthrosis

Local treatment has a direct effect. Gels and ointments directly contact the affected tissues, quickly reaching the site, eliminating pain and inflammation. Preparations in the form of gel are widely used to restore the cartilage layer. For local application, warming + anti-inflammatory ointments are used.

Physiotherapy

Alleviation of spasmodic pain with reduction of inflammation + improvement of trophism and innervation is carried out with the help of physiotherapy. Phases of deterioration are eliminated or shortened by laser therapy, magnetic fields and ultraviolet radiation. In the remission phase of arthrosis, that is, during the quiet phase, electrophoresis procedures using dimethyl sulfoxide and anesthetics are useful. Destructive and inflammatory processes are affected by phonophoresis with glucocorticosteroids, inductothermy, thermal applications of ozokerite or paraffin, as well as sulphide, radon and sea baths. Corset muscle is strengthened using electrical stimulation.

Surgery

The problem of the deformed/ankylosed joint is finally solved with surgical operations such as endoprosthetics, as well as with a palliative method of unloading the articular framework (coxarthrosis is eliminated with transtrochanteric osteotomy + femoral fascia fenestration; gonarthrosis is corrected with arthrotomy with cleaning of the intra-articular spacefrom destruction debris plus artificial cartilage augmentation). If the bone is completely disabled, it is replaced with an artificial graft and the shaft of the tibia is corrected.

Folk remedies

Traditional medicine helps to get rid of pain and inflammation, temporarily eliminates pain and restores lost function. There are isolated cases of complete healing through traditional methods using the following tinctures, ointments and compresses:

1. Tincture of garlic + onion and honey: 100 g of garlic pulp + 100 g of chopped onion + 2 large spoons of honey + 200 ml of vodka. Infusion for 3-5 days. Apply in the form of compresses and rubbing.
2. Sabelnik in the form of a solution: 200 g of dry powder or fresh grains + 200 ml of diluted medical alcohol, leave for 24 hours. Drink a spoonful before meals 3 times a day.
3. Ointment based on badger fat and propolis: rub on the joints, apply twice a day.
4. Table horseradish + honey: 100 g horseradish + 100 g honey + 100 ml vodka. Inject for 24 hours, drink 20 drops. This solution can be rubbed on the injured joints 3-5 times a day.
5. Chili + pork fat ointment: 1 teaspoon powder + 200 g fat. Infusion for 2-3 days. It is used as a local remedy for heat. Apply 1-2 per day.
6. Compress: oak bark + fir needles: 200 g oak bark + 200 g crushed fir needles + 100 ml alcohol.

All recipes listed by traditional healers are recommended to be used only after consulting a doctor. If the patient is allergic to certain medications, their use is strictly prohibited, as they can lead to anaphylactic shock.

Features of prevention

Prevention is an effective means of preventing diseases, destruction and deformation of joints. For preventive purposes, you should do the following:

• Adjust the menu, from which exclude fried, fatty, peppery, salty, alcohol + nicotine.
• Add jelly and jelly to your daily menu.
• Avoid tiring loads.
• Take safety precautions to avoid injury.
• Continuously perform a special set of exercises for the locomotor system.
• Try to take vitamins B and C.
• For preventive purposes, take chondroprotectors, calcium, potassium supplements, plus other minerals once every six months.
• After a joint sprain or mechanical injury, it should be examined by a doctor.

The list is also joined by performing continuous physical exercises to improve blood supply, innervation and restoration of the cartilage layer of the joints. These exercises are prescribed by a doctor.

Briefing

Deformation of the joints begins after 38-40 years, so there is no need to delay the fight against this pathology. A neglected condition can lead to a wheelchair, and a timely response to the disease with effective treatment is a clear success towards recovery. It is impossible to treat arthrosis on your own; this type of pathology refers to metabolic disorders directly related to changes in hormonal levels or chronic pathologies of other systems. At the first symptoms, contact a traumatologist or surgeon, do not delay, otherwise you will be treated only in a surgical department with long rehabilitation.