Osteoarthritis - a group of diseases of different origin, which are based on the defeat of joint components, especially the cartilage and bone okolohryaschevogo portion, ligaments, capsules, periarticular muscles.
The predominant age - 40-60 years.
Causes
- The mismatch between the mechanical load on the joint and its capacity to resist this load. Biological properties of the cartilage may be due to genetic or acquired change under the influence factors.
- Genetic factors: discuss the role of defects in collagen type II gene.
- Overweight.
- Deficiency of female sex hormones - estrogen in postmenopausal women.
- Acquired diseases of bones and joints.
- Joint injuries.
- Operations in the joints.
symptoms of osteoarthritis
In general, osteoarthritis is characterized by mechanical rhythm of pain - the emergence of pain under the influence of daily physical activity and subsidence in the period of night rest, which is associated with a reduction in amortization abilities of a cartilage and subchondral bone structures to loads.
Osteoarthritis possible symptoms such as nightly continuous dull pain associated with venous stasis and increased intraosseous pressure. Short-term "starting" pain occurs after the rest and soon against the backdrop of motor activity. Initial articular pains caused by friction surfaces on which settles detritus - fragments of cartilage and bone destruction. At the first movement in the joint detritus pushed inversions in the joint capsule, and pain significantly reduced or stopped completely.
It is also a symptom of osteoarthritis is the so-called "joint blockade" or "frozen joint" - pronounced fast-paced pain due to the appearance of "articular mouse" - a bone or cartilage fragment with its infringement between the joint surfaces or the introduction of a soft periarticular tissues. The intensity of pain at the same time deprives the patient the opportunity to make the slightest movement in the joint.
In the presence of inflammation, in addition to joint pain - both in movement and at rest is the characteristic morning stiffness, joint swelling, local increase in skin temperature.
When osteoarthritis gradually develop deformity and joint stiffness.
Osteoarthritis usually develops slowly, and begins as a disease of a joint, but after some time involved in the process and other joints, usually those compensatory assumed the increased mechanical load to unload originally diseased joint.
Osteoarthritis is often associated with venous disease (varicose veins the lower extremities, thrombophlebitis). The most commonly affected joints are the knee, wrist joints, lumbar and cervical spine, hip joints, ankle, shoulder joint.
Diagnostics
If you suspect that osteoarthritis is necessary to pass the following tests and studies:
- General and biochemical analysis of blood
- The study of synovial fluid
- X-ray study
- Ultrasound of the joints
- arthroscope.
treatment of osteoarthritis
- Regime and diet. It is important to weight loss in order to reduce mechanical stress on the joint. Avoid physical overload and traumatic joints, soft chairs and putting pads for the joints; recommend the use of straight-backed chair and a bed with a hard wooden base, fixtures, facilitate mechanical stress on the affected joints - corset, cane, knee pads, the implementation of special LFK complexes.
- In the treatment of osteoarthritis of the most optimal are considered "short-lived" drugs: ibuprofen, diclofenac, ketoprofen. For the rapid elimination of pain prescribers with high analgesic activity: diclofenac (Rapten Rapid). Rapten Rapid may also be recommended for induction therapy for the purpose of pain relief with a subsequent transition to another analgesic. Significantly better results were obtained using meloxicam and nimesulide. In isolated articular lesions for the treatment of osteoarthritis using local funds in the form of ointments, creams, that avoids systemic side reactions, particularly in the elderly, and chondroitin sulfate, in combination with dimethylsulfoxide (Hondroksid).
- In the presence of intra-articular effusion used corticosteroids. Unfortunately, certain aspects of this therapy remains controversial (its relative efficiency, potentially damaging action and potentially structure-modifying effect), so place the prolonged use of intra-articular corticosteroid therapy for the treatment of osteoarthritis is not yet clear - needed long-term studies. It is now believed that the number of intra-articular injections in one joint should not exceed 3-4 during one year.
- Chondroitin sulphate 500 mg 2-3 p. / Day., A course of 3-6 months.
- Glucosamine 1500 mg 1 time a day, the course of 6 weeks, the breaks between courses of 2 months.
- Alflutop 1 ml / m daily, a course of 20 injections. Perhaps intraarticular injection of 1-2 ml in large joints, a course of 5-6 injections, then continued / m to 1 ml. Repetition rate at 6 months.
- Physiotherapy osteoarthritis: electric, electrophoresis 5% novocaine solution for Vermelen procedure acupuncture, microwave resonance therapy, hyperbaric oxygen therapy, diadynamic, amplipulse therapy, magnetic therapy, phonophoresis, laser therapy, gravity energy. Physical factors - ultraviolet irradiation, ultrasonic irradiation, laser therapy, diadynamic currents - at synovitis; paraffinic and mud applications - in the absence of synovitis. Resorts with sulfur, hydrogen sulfide, radon springs, therapeutic mud and brine.
prevention
One of the very effective prevention of osteoarthritis is to reduce body weight by adhering to diet, physical activity, rational. For osteoarthritis is particularly important combination of exercise, which would include a combination of gradually increasing the distance and time to strengthen muscles of the lower extremities. In order to strengthen the musculature shows isometric contraction of the quadriceps muscle, which can be achieved knee-joint stress, bending with the stress of the ankle joint, as well as transcutaneous electrical stimulation nerves. Strengthening the quadriceps femoris for 6 months reduced pain and improved function of the knee.
Equally important is wearing comfortable shoes with arch support with individualized flatfoot.
It is also useful when wearing knee pads joint instability or uncertainty of the patient in his reference. This knee should also be individually selected, it should not disturb the blood circulation in the vessels of the lower extremities, especially in conjunction with the violation in the venous system.
Recently, much attention is given to the use of podpyatochnyh wedges in lesions of the knee joint.
And we must remember that patients with osteoarthritis should avoid overloading the knee, so any physical activity should alternate with rest.
