What is osteoarthritis? Causes, symptoms and treatment of pathology

Osteoarthritis is a chronic pathology aimed at damage to the joint structures of the musculoskeletal system. The main reason for a chronic disease is a metabolic imbalance, which leads to a progressive process of a degenerative-dystrophic nature. The targets of the damaging reaction are articular cartilage, connective tissue, bursa, tendons, bones and muscle corsets. In the chronic form of pathology, periarticular muscles are involved in the inflammatory process and lose anatomical elasticity due to joint deformation and swelling. In order to avoid complications associated with blockage of skeletal biomotility and not become disabled, you need to arm yourself with information about arthrosis - what it is, what are the causes, symptoms and treatment.

Causes and risk factors for the development of pathology

The inflammatory-destructive process in the joints often begins for no reason. This onset occurs in idiopathic (primary) osteoarthritis. The mechanism of development of secondary arthrosis begins according to certain conditions and factors, namely:

• Joint injury (fracture, meniscus damage, ligament tear, dislocation, compression + bruise, bone fracture).
• Dysplasia (abnormal intrauterine development of joint components).
• Violation of material metabolism.
• Pathologies of the autoimmune type (rheumatoid arthritis, psoriasis, autoimmune toxic 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 pituitary gland).
• Hormonal dysfunction (decreased estrogen and androgen levels).
• Degenerative + dystrophic reactions (multiple sclerosis, Perthes disease).
• Oncological diseases.
• Blood diseases (hemophilia, anemia, leukemia).

Risk factors that provoke and lead to osteoarthritis:

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

The 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 tests of military equipment or interstate wars, the result of which are ozone holes + strong ultraviolet radiation). Radiation). Contaminated drinking water + foods rich in preservatives lead to the development of osteoarthritis.

The mechanism of arthrosis development

The basis for the triggering mechanism of osteoarthritis is a disruption in the chain of restoration processes of the cartilage cells and correction of the affected connective tissue areas by young cells. Cartilage plates tightly cover the end surfaces of the bones that are part of the movement joints. Normal cartilage has anatomically strong structure, is smooth, elastic, and lubricating thanks to synovial fluid, a biological material that lubricates intra-articular components. It is the synovial fluid that allows unhindered movement of the joint components relative to each other.

Cartilage tissue and synovial lubrication perform the main function of shock-absorbing effect and reduce abrasion of bones covered with cartilage. The bony ends are separated from each other by bags of fluid and stabilized by a corset of ligaments and muscles. A specific configuration and mesh of the muscular-ligamentous apparatus allows this structure to perform precise biomechanical movements such as flexion, extension, rotation + rotation. The design, thanks to the interweaving of the bands, allows you to hold a certain position as well as perform coordinated movements, thereby maintaining the balance of the body.

High stress or hormonal imbalance leads to the destruction of the collagen plates and exposes the bones. Sharp osteophytes appear in these areas, which cause pain with any movement of the joints of the musculoskeletal system. The bones thicken and false joints appear between the osteophytes, which completely change the functionality of the locomotor organ. Due to the trauma to the bursa (rupture), there is less synovial fluid and the entire joint structure as well as the corset of ligaments and muscles begin to suffer. Joint swelling occurs and a microbial infection may also occur. Ossification zones lead to restricted movement and ankylosis of the joint.

Stages of clinical manifestation of joint pathology: stages

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

• Stage 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 average physical activity. During forced labor, pain and swelling of the joint occur.
• Stage II:Depletion of the cartilage plate is observed, foci of osteophytic islands are formed, and ossifications appear at the edges of the joint. The pain syndrome intensifies, swelling increases and difficulty moving occurs. When the pathology passes into the chronic stage, pain is constant and is accompanied by inflammation with periods of exacerbation/remission. The biomechanics are partially impaired, the patient protects the joint.
• Stage III:the cartilage plate is completely worn out; instead of cartilage, a system of osteophytes + incorrectly fixed interosteophytic joints is formed at the ends of the bones. The anatomical shape is completely disturbed. Joint ligaments and muscles become shortened and thickened. The slightest injury can lead to dislocations, fractures and tears. The trophism of the locomotor organs is damaged, so they do not receive the required amount of blood and nutrients. Pinched nerves lead to a strong pain reaction that only subsides after the administration of strong painkillers or drugs from the COX1/COX2 group.

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

Osteoarthritis pain syndrome

Pain is characteristic of osteoarthritis. They increase with movement, physical activity, with changes in weather conditions, with changes in temperature, humidity and air pressure. Pain can be triggered by any posture or sudden movements. Walking, running, and prolonged vertical standing place some strain on the sore joints, resulting in acute or aching pain. In the first and second stages of 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 disappear. The affected shock-absorbing layer, pinched nerves and blood vessels lead to a stagnant process with impaired trophism and the accumulation of interstitial fluid. Swelling causes acute throbbing pain.

Pain after a long period of rest with strong motor impulses is specific to osteoarthritis; this condition is called starting pain. The mechanism of origin of this pain is osteophytic zones, which are covered with destructive remnants of cartilage tissue, fibrin and viscous fluid. As the joints move, a film of these components, or detritus, covers the exposed areas, lubricating them and thus absorbing pain. Blockage pain occurs when products of destruction from the intra-articular space, i. e. bone remnants or large connective tissue films, get into the muscles. There is another type of pain: constant, aching, bursting + independent of movements, they are characteristic of reactive synovitis.

Attention!The blockage type of pain is accessible only through surgical intervention with subsequent reconstruction of the affected joint. Treatment with folk remedies is not recommended, as this is fraught with the development of purulent arthrosis with the spread of infection throughout the body, and after sepsis, obvious morphological changes appear in all organs and systems.

Symptoms of joint inflammation

Symptoms are divided depending on the degree of development of the pathology. Osteoarthritis becomes noticeable after 38-40 years, when the joint wear system begins to wear out and renewed or young cartilage pads do not appear in its place. In the event of a hormonal imbalance, "chaos" occurs in all vital systems, this also applies to the musculoskeletal system, so that there is no regeneration of the tissue in the affected areas, but rather destruction + deformation.

Symptoms of osteoarthritis:

Degrees and periods of osteoarthritis	Description of symptoms
I'm getting a degree	Mild, short-term pain with precise localization. Rapid fatigue of the painful joint. The pain increases after long walks, running or lifting weights and disappears after rest. A slight clicking noise can be heard when bending over or making other movements. There are no visual + palpatory changes, the anatomical shape of the joint is preserved, no swelling is observed.
II degree	Discomfort in the affected joints, stiffness is noted after rest. Partial traffic restrictions. Nighttime pain and weather-related pain. A characteristic loud clicking noise occurs when bending and other movements. Visual and palpative changes occur: the joints become enlarged and shortened, and the patient also reacts sharply to acute pain when pressure is applied.
III. Degree	Complete discomfort in the affected joints, joint instability or ankylosis are noted. The movement is paralyzed. Stinging or aching pains occur constantly at night. The anatomical shape of the joints is lost: thickening/shortening and displacement of the axis of the joint structure. When pressed, swelling and pain occur. The gait changes and the shape of the bone skeleton changes as the movement organ is protected. Movement is done with the help of a stick or crutches. When there are morphological changes caused by an infectious factor or pinched nerves, a high temperature occurs (37-38 degrees).
Phases of exacerbation and remission	In osteoarthritis, exacerbations alternate with remissions. The pathology is aggravated by physical activity. Exacerbations are caused by synovitis. The pain syndrome covers all affected areas, including the muscle corset. It spasms reflexively and forms painful contractures. Osteoarthritis is characterized by muscle spasms. As the destruction increases, the pain syndrome becomes more pronounced. In reactive synovitis, the joint enlarges and takes on a spherical shape. Fluid appears in the joints, which creates a swaying effect when palpated. During a brief remission, pain subsides but movement is difficult.

Timely detection of pathology using diagnostic tests and consultation with the necessary specialists will help overcome the second and third stages and maintain the functionality and health of all joint groups of the musculoskeletal system into old age.

Diagnostic measures

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

The study list consists of:

• General and biochemical blood tests.
• Blood test for rheumatism drugs.
• Urine and feces analysis.
• X-ray examination: image in three positions.
• CT scan of the joint to clarify the bone structure.
• MRI of the joint: examination of ligaments and muscles.
• Computed Tomography.

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

Treatment regimen

Therapeutic tactics include a whole range of measures aimed at eliminating the root cause, correcting the diet, restoring lost functions + a gentle lifestyle, that is, without special physical activity (long walking, 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 osteoarthritis

Complex therapy consists of:

1. drugs of the NSAID group;
2. painkillers (tablets + injections);
3. medicines to relieve muscle spasms (muscle relaxants);
4. cartilage tissue restorers (chondroprotectors);
5. antibiotics;
6. antihistamines;
7. drugs 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 the following in the treatment regimen for rheumatoid arthritis:

• gold-based medicines;
• immunosuppressants;
• antimalarial medicines;
• Medicines that inhibit malignant cells.

Attention! During remission of pathology, nonsteroidal anti-inflammatory drugs are not recommended; they affect the gastrointestinal tract, cause numerous ulcers, and also inhibit the nutritional process of cartilage tissue.

Ointments for local use for osteoarthritis

Local treatment has a direct effect. Gels and ointments come into direct contact with the affected tissue, reaching the site quickly and eliminating pain and inflammation. To restore the cartilage layer, preparations in the form of gels are often used. For local use, warming + anti-inflammatory ointments are used.

physical therapy

Relieving spasmodic pain with reducing inflammation + improving trophism and innervation occurs with the help of physiotherapy. Phases of exacerbation are eliminated or shortened by laser therapy, magnetic fields and UV irradiation. In the remission phase of osteoarthritis, i. e. in the resting phase, electrophoresis procedures with dimethyl sulfoxide and anesthetics are useful. Destructive and inflammatory processes are influenced by phonophoresis with glucocorticosteroids, inductothermy, thermal applications of ozokerite or paraffin, as well as sulfide, radon and sea baths. The muscle corset is strengthened through electrical stimulation.

surgery

The problem of a deformed/ankylosed joint is ultimately solved by surgical interventions such as endoprosthetics, as well as a palliative method of unloading the articular frame (coxarthrosis is eliminated by transtrochanteric osteotomy + fenestration of the femoral fascia; gonarthrosis is corrected by arthrotomy with cleaning). the intra-articular space from destruction residues plus artificial cartilage reconstruction). If the bone is completely dysfunctional, it is replaced with an artificial graft and the axis of the tibia is corrected.

home remedies

Traditional medicine helps eliminate pain and inflammation, temporarily eliminate pain and restore lost functions. There are isolated cases of complete healing through traditional methods using the following tinctures, ointments and compresses:

1. Garlic tincture + onion and honey: 100 g garlic pulp + 100 g chopped onion + 2 large spoons of honey + 200 ml vodka. Absorbs for 3-5 days. Apply in the form of compresses and rubs.
2. Sabelnik in the form of a tincture: 200 g of dry powder or fresh gruel + 200 ml of diluted medical alcohol, leave for 24 hours. Drink a spoon three times a day before meals.
3. Ointment based on badger fat and propolis: rub into joints, apply twice a day.
4. Table horseradish + honey: 100 g horseradish + 100 g honey + 100 ml vodka. Let it steep for 24 hours, drink 20 drops. This tincture can be rubbed onto painful joints 3-5 times a day.
5. Hot pepper ointment + pork fat: 1 teaspoon powder + 200 g fat. Absorbs for 2-3 days. Used as a warming local medicine. Apply 1-2 per day.
6. Compress: oak bark + spruce needles: 200 g oak bark + 200 g crushed spruce needles + 100 ml alcohol.

It is recommended to use all listed recipes of traditional healers only after consulting a doctor. If the patient is allergic to certain medications, their use is strictly prohibited, as they can cause anaphylactic shock.

Features of prevention

Prevention is an effective means of preventing joint diseases, destruction and deformation. For prevention you need to do the following:

• Adjust the menu and exclude fried, fatty, peppery, salty, alcohol + nicotine.
• Add jellies and jellies to your daily menu.
• Avoid tiring stress.
• Increase safety precautions to prevent injuries.
• Regularly perform special exercises for the musculoskeletal system.
• Try taking vitamins B and C.
• For prevention, take chondroprotectors, calcium and potassium supplements and other minerals every six months.
• After a joint sprain or mechanical injury, be examined by a doctor.

Added to this are constant physical exercises to improve blood supply, innervation and restore the cartilage layer of the joints. These exercises are prescribed by a doctor.

Summary

Destruction with deformation of the joints begins after 38-40 years, so the fight against this pathology does not need to be delayed. A neglected disease can lead to a wheelchair, and a timely response to the disease with effective treatment is a clear success on the road to recovery. It is impossible to treat osteoarthritis alone; This type of pathology refers to metabolic disorders that are directly related to changes in hormonal levels or chronic pathologies of other systems. At the first symptoms, contact a traumatologist or surgeon, do not hesitate, otherwise you will only be treated in a surgical department with long rehabilitation.