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The osteoarthritis (deforming an osteoarthrosis) — is the most widespread type of arthritis, and represents a chronic disease, the striking joint, a joint cartilage, a joint bag, bones, muscles and sheaves. At the same time the cartilage hardens, loses the elasticity therefore it collapses, and sliding of joint surfaces worsens. Cartilages can become thinner that leads to disturbance of their depreciation functions during blows.
The disease most often develops on large joints of a human body — knee, coxofemoral, joints of a backbone and small joints of hands, especially on thumbs. During an illness the joint can be deformed.
Men and women are subject to an osteoarthritis, and hip joints are surprised at men more often, and hand and knee – at women. This disease progresses over the years and can lead to working capacity loss.
The illness is usually shown in two forms. Primary osteoarthritis which develops after 45 flyings is most widespread and steadily progresses over the years. Primary arthritis affects first of all hip and knee joints. Excessive loads of joints act as its reasons.
The secondary osteoarthritis most often strikes the young people having the repeating injuries or injuries of joints, and also infection of a joint, inborn defect of joints, disbolism, obesity.
The osteoarthritis develops as a result in cartilaginous tissue the metabolism is broken that leads to its gradual destruction. As a result of initial injury of a joint destruction of a cartilage begins. It loses elasticity, on it microcracks which lead to department of cartilaginous fragments, up to final fracture of a cartilage are formed. It can lead to the fact that bones can begin to adjoin with each other when walking.
Physicians also carry to the reasons of development of an osteoarthritis:
- age since with age the cartilage tends to elasticity loss;
- excess weight which promotes acceleration of process of destruction of a cartilage;
- injury of a cartilage by excessive loadings, namely – injuries, fractures, dislocations, stretching of the copular device of a joint, and also constant microtraumas of a joint – dislocations, incomplete dislocations, for example, at professional athletes and at representatives of certain professions;
- organism intoxication since alcohol, smoking, viral infections lead to the fact that toxins collect in cartilaginous tissue;
- vascular disorders – atherosclerosis. For example, if walls of the artery feeding a head and a joint of a coxofemoral bone are struck with atherosclerosis, then it leads to disturbance of food of a head and development of an osteoarthrosis;
- endocrine disturbances – a diabetes mellitus, a hypothyroidism, a climacteric;
- shin varicosity that results in venous stagnation and a hypoxia of fabrics that promotes disturbance of exchange processes in joints;
- hereditary weakness of a cartilage therefore some forms of an osteoarthritis are shown in families.
The main symptom of an osteoarthritis is the affected joint pain which amplifies when walking. At first pain develops periodically, after loadings, and disappears at rest, but if a disease not to treat, then pain becomes a constant, even at the minimum activity. Patients characterize it pain as "aching".
If the osteoarthritis struck knee joints, then pain arises when bending a knee, for example, during descent from a ladder. At an osteoarthritis of hip joints hip pain is most often observed, but also can disturb also painful feelings in a groin, buttocks.
Primary osteoarthritis of a backbone causes neck pain and in a waist. Intensity of pain can change depending on changes of weather and atmospheric pressure. Over time all this can lead to reduction of mobility of a joint, constraint of movements, there can be also "a blockade of a joint" when pieces of a cartilage get between joint surfaces that is followed by sharp pain and restriction of the movement. Also the krepition in joints is often observed – the crunch and a crash can disturb at the movement, the friction of joint surfaces of bones is the reason of what.
Such symptoms of an osteoarthritis as the constraint of joints and strengthening of pain at their bend lasting usually till 15 minutes, especially after the immovability period, for example, in the mornings after a dream, long sitting or after the superactivity period can be also observed. The simplification comes after physical warm-up.
Also the joint can change outward – to increase in volume, temperature increase of a joint, its reddening can be observed. In joints liquid because of constant irritation of a synovial membrane (an inside layer of a joint bag) can accumulate.
One and most difficult complications of an osteoarthritis the emergence of bone outgrowths in joints of brushes meeting at women aged after 40 flyings more often is. These outgrowths can be painful, and can not be followed by painful feelings, and then people continue to lead active lifestyle.
Often secondary osteoarthritis can proceed asymptomatically, even then, when the X-ray shows changes of a joint.
Diagnosis of an osteoarthritis
The diagnosis can be made on the basis of data of poll and survey of the patient, and also results of laboratory researches. Besides, to the patient usually appoint a X-ray analysis and ultrasonic research of a joint.
The doctor will be interested in damages which caused osteoarthritis symptoms in a joint, about way of life. Survey will be directed to attentive studying of outward of the disturbing joints.
Also X-ray inspection of joints since with its help it is possible to see the changes accompanying an osteoarthritis, for example, regional growths of a bone, narrowing of a joint crack is appointed. The X-ray shows, joints are how seriously injured. For an assessment of thickness of a joint cartilage, a condition of a joint bag and fabrics near a joint and identification in them of an inflammation, ultrasonic research of joints is conducted. As additional diagnosis of an osteoarthritis, for confirmation of the diagnosis, can be carried out artrotsentez – a joint puncture, or a magnetic and resonant tomography.
Special laboratory researches for identification of an osteoarthritis do not exist. Due to the lack of inflammatory changes, blood test is carried out usually for this purpose to exclude other forms of arthritis, for example, a pseudorheumatism, gout.
Treatment of an osteoarthritis
Treatments of an osteoarthritis are the cornerstone of action for protection of joints against influence of factors which promote progressing of a disease. Unfortunately, now there are yet no drugs which could recover a joint cartilage.
The purposes of treatment are:
- reduction of pain in a joint;
- improvement of functioning of a joint, increase in its mobility;
- reduction of risks of progressing of a disease;
- work with the patient for this purpose that he learned to cope with a disease, to avoid long standing standing, long walking, rise and transfer of weights, sports activities promoting the raised loads of joints.
The purpose of medicamentous therapy is elimination of symptoms of an illness, namely: reduction of painful feelings in joints and improvement of a condition of cartilaginous tissue. For decrease in pain doctors appoint the anesthetizing drugs and non-steroidal anti-inflammatory drugs.
At moderate pains use Ksefokam (lornoksika), the Ibuprofen, Ortophenum (Voltarenum), to meloksika (movalis), to surga, Nimesulide, paracetamol, taylenol. Also local drugs possessing anesthetic and antiinflammatory action are appointed. Similar creams, gels or sprays – Finalgon, to kapsika, fastum-gel, indovazin, feloran apply on a joint 2-3 times a day.
If severe pains that appoint diclofenac (diklonat). At their use it is necessary to be careful as these drugs possess side effects, for example, long reception of paracetamol can lead to increase of arterial pressure. Non-steroidal anti-inflammatory drugs negatively affect a digestive tract, and can lead to an inflammation of a mucous membrane of a stomach, to development of stomach ulcer, disturbance of functions of kidneys. For improvement of blood supply of elements of a joint vascular drugs, for example, agapurin, trental, Xantinoli nicotinas are also appointed.
At an initial stage of an osteoarthritis also the drugs promoting improvement of a condition of a cartilage – hondroprotektor, for example, of chondroitin sulfate and a glycosamine sulfate, diatserein, hyaluronic acid are used. At their continuous reception, at patients improvement of mobility of joints since material for recovery of a cartilage is entered into an organism can be observed. These drugs work slowly therefore it is necessary to accept them is long.
For improvement of sliding in a joint and for removal of an inflammation, the doctor can appoint and intra joint introduction of a glucocorticoid, Kenalogum, diprospan, sodium hyalrunate solution. The anesthetizing drugs – for example, lidocaine are at the same time entered. This method of treatment works very quickly that leads to the fact that patients begin to apply actively it, however this method does not treat a disease, and only cleans osteoarthritis symptoms. Also frequent use of this method can lead to injuries of a cartilage and bones. Therefore often it is impossible to use this method.
At high extent of damage of a joint which is followed by sharp restriction of mobility at the expressed pain syndrome which will not respond to drug treatment, appoint endoprosthesis replacement of joints – replacement of a joint with a mechanical prosthesis. Most often this operation is performed on hip and knee joints. After this operation of the patient can increase the physical activity. Also the arthroplasty – plastic surgery on a joint for recovery or correction of functions of a joint, by replacement of surfaces of a joint with artificial materials can be carried out.
At a secondary osteoarthritis also sanatorium-health-resort treatment of an osteoarthritis is appointed. It is possible to carry out complex rehabilitation which includes therapeutic muds, physiotherapeutic procedures, physiotherapy exercises, bathtubs, massage to sanatoria. Ultra-violet radiation, an electrophoresis, variation magnetic fields belong to physiotherapeutic procedures. Also various thermal procedures, applications of ozokerite, peat and silt dirt are useful. Favorable impact is made by medical bathtubs, namely sea, sulphidic and iodine-bromine.
Around joints apply electrostimulation to strengthening of muscles. Positively influence disease continuous stay in the fresh air and lack of stressful situations. However such treatment is shown out of the periods of an exacerbation of a disease.
It is very important to change at the same time the lifestyle, to regulate body weight and it is obligatory to give itself exercise stresses. Special physical exercises will help to create around a joint a strong muscular corset and sufficient blood circulation in all extremity. In house conditions before sports activities it is possible to put a hot-water bottle or the special warming lamp to a sore joint. It is very important not to overcool joints.
Prevention of an osteoarthritis
Prevention of a disease is directed to reduction of load of joints, i.e. by avoidance of the factors increasing probability of development of a disease.
It is important to watch the weight, it is correct to organize food and to have regular exercise stresses. In sports activities it is necessary to be careful and use possible ways of protection, for example, kneecaps. Exercise stresses promote decrease in pain, increase their mobility and strengthen muscles.
Three types of an exercise stress – exercise for increase in mobility of joints, exercise for increase in mobility of muscles and dynamic exercises are optimum for patients with an osteoarthritis.
Swimming at least 2 weekly is recommended. It is desirable not to choose sports which constitute danger to joints – for example, soccer, tennis, athletics, especially if in a family there were cases of an osteoarthritis. It is necessary to avoid long circulation, stay on a lap, circulations on ladders, run is undesirable.
Injury of joints to youth increases risk of emergence of an osteoarthritis at advanced age therefore prevention of an osteoarthritis consists in the prevention of various injuries capable to cause a disease. At injuries of joints their emergency treatment under supervision of the doctor is necessary, and the suffering osteoarthritis recommends to pass complex medical examination at least 2 times a year.
The osteoarthritis does not affect internals, however progresses also without the correct timely treatment, this illness is capable to worsen considerably quality of life, to bring to the person of suffering, and also to lead to loss of working capacity by it.