The lesion is dystrophic and degenerative, which leads to a change in the structure of the joint tissues, loss of their functionality. According to the same statistics, 12% of the total population of the planet is prone to arthritis. From 62% to 65% of all episodes of the disease occur in people over 60 years.
Another 30-35% of cases of joint damage with this pathology occur in patients aged 40-60 years. And about 3% are young people aged 20-40.What is this?
Simply put, arthropathy is a chronic disease in which progressive degenerative-dystrophic changes develop in the joint due to metabolic disorders. It is the most common pathology of the joints, diagnosed in 6-7% of the population. With age, the frequency increases dramatically. Most often, in arthropathy, the pathological process involves the small joints of the hand (10 times more common in women than in men), the big toe, the intervertebral joints of the thoracic and cervical spine, as well as theknee and hip joints. Arthropathy of the knee and hip joints takes first place in terms of the severity of clinical manifestations and the negative impact on quality of life. Arthropathy is characterized by a complex lesion of the joint and auxiliary device:- Chondritis - Inflammatory changes in the cartilage of the joint.
- osteitis - involvement of the underlying bone structures in the pathological process;
- arthritis - inflammation of the inner membrane of the joint capsule,
- bursitis - damage to the periarticular sacs;
- reactive inflammation of the soft tissues (muscles, subcutaneous tissue, ligaments) located in the projection of the involved joint (peripheral inflammation).
The disease is diagnosed in 2% of people under 45 years, in 30% - from 45 to 64 years and in 65-85% - in the age of 65 years and over. Arthropathy of the large and middle joints of the limbs is of the greatest clinical importance due to its negative impact on the standard of living and the ability of patients to work.
Types of joints
Depending on the cause of the pathological process in the joint, the primary arthropathy is distinguished, secondary and idiopathic.
Primary develops as an independent disease, secondary as a result of injury or infection and the cause of the idiopathic form is not known. In addition to the classification of the disease, depending on the cause of the pathological process, arthropathy is distinguished according to the location of the catastrophic changes:
- Gonorrhea is the most common type of pathology characterized by damage to the knee joints. Most often, knee arthritis is detected in people who are overweight, with chronic metabolic diseases in the body and weak immunity. Knee arthropathy develops over a long period of time and gradually leads to complete loss of motor function.
- Joint of the shoulder joint - the main cause of degenerative processes in this area are congenital anomalies in the development of the shoulder joint or excessive stress in this area, for example, when carrying heavy luggage on the shoulders. Ankle Joints - The main reasons for the development of degenerative processes in the ankle joint are trauma, sprain, sprain and fractures. In some cases, the development of a pathological process can cause an autoimmune disease - rheumatoid arthritis. Ankle arthritis affects dancers, women with high heels, athletes.
- Uncoarthrosis or arthropathy of the cervical spine - the causes are injuries to the neck, progressive osteochondrosis, obesity, sedentary lifestyle. At risk are people who work on a computer in offices. In addition to severe neck pain, patients have severe dizziness, depression of consciousness, reduced memory and fatigue. These symptoms are caused by compression of the vertebral artery, through which nutrients and oxygen enter the brain. Coxarthrosis or arthropathy of the hip joint - the main cause is age-related changes in the joint tissues. People over the age of 45 are at risk.
- Osteoarthritis of the fingers - develops for the same reason as vertebral arthritis. Polyarthritis is characterized by damage to multiple joints with progressive degenerative processes in them, while the pathological process involves ligaments, muscles and tissues that surround the joint.
- Spondyloarthrosis - the tissues of the spine, ie the lumbar region, are subject to catastrophic destruction. Women are at risk at the onset of menopause, as vertebral arthritis progresses to a deficiency of female sex hormones.
Causes of joints
Two reasons contribute to the formation of joints - stress and lack of adequate nutrition, which provides vitamins and minerals for tissue repair. Each person's joints carry a load. For athletes and dancers, during exercise, the load on the legs is greater, which means that the bone joints wear out faster and require a high quality diet. With a quiet lifestyle, the support device wears out more slowly, but also requires periodic tissue renewal.
Therefore, the main condition for the destruction and deformation of the joints is malnutrition, indigestion of useful components, which often occurs with metabolic disorders.
Let's list the factors that contribute to joint damage and metabolic disorders:
- Muscle weakness and abnormal loading of the joints. Weakening of one or more muscles increases the load on the joint and distributes it unevenly at the bone junction. Also, improper loading of the muscles with flat feet is formed, scoliosis, therefore, with these "harmless" diseases, the cartilage tissues wear out with age, joints appear.
The chance of a joint increases with strenuous physical exercise.
If the daily loads exceed the capacity of the bone tissues, a small injury is formed in them. In the areas of injury, thickeners appear, which grow over time and deform the joint;
- Metabolic disorders (gastrointestinal disorders - biliary stasis, discomfort, gastritis, cholecystitis, pancreatitis, metabolic disease - diabetes); Psychosomatic causes - The psychosomatic causes of arthropathy confirm that a negative emotional state also becomes the cause of the disease. Stress creates muscle spasm, constant stress disrupts the nutrition of all tissues (internal organs, bones, joints). Heredity (the type of metabolism and its possible disorders are inherited, a tendency for muscle weakness or improper formation of the bone apparatus, in poor digestion - which is the basis for the development of joints in old age).
Mechanism of disease progression
When one of the causes of joint disease occurs, pathological processes begin to develop in it. The mechanism of their progress is not fully understood, but the main stages of formal medicine are known.
In the early stages, there is depletion of cartilage tissue structure and abnormal changes in synovial fluid. All this happens due to metabolic disorders, in which the joint tissues do not receive the necessary components in sufficient quantities or lack some of them.
Furthermore, the elasticity of collagen fibers and the flexibility of cartilage are lost due to the fact that in the body with a lack of nutrients, hyaluronic acid has no production time, which provides softness and flexibility of the structural composition of collagen fibers. The cartilage dries gradually, becomes brittle and cracks. The fluid in the joint capsule gradually depletes and then disappears completely.
Roughness and growth of solid bones form in the cartilage tissue. At the same time, deformity of other joint tissues develops, their pathological degeneration, dystrophy and loss of normal activity. For the patient, these changes mean the appearance of pain, lameness, joint stiffness.
Joint symptoms
The acute clinical picture is not typical of arthropathy, the changes in the joints are progressive, they increase slowly, which is manifested by the gradual increase of the symptoms:
- pain,
- intermittent contraction of the affected joint,
- joint deformity that occurs and worsens as the disease progresses,
- stiffness,
- restriction of mobility (reduction of the volume of active and passive movements in the affected joint)
Arthropathy pain is dull, transient in nature, occurs when moving, with intense stress, until the end of the day (it can be so severe that it does not allow the patient to sleep). The persistent, non-mechanical nature of pain for arthropathy is not typical and indicates the presence of active inflammation (hypochondriac bone, synovial membrane, ligaments or periarticular muscles).
Most patients notice the presence of so-called initial pain that appears in the morning after waking up or after a long period of inactivity and passes during exercise. Many patients define this condition as the need for "joint development" or "disengagement. "
Arthropathy is characterized by morning stiffness, which is clearly localized and is short-lived (no more than 30 minutes), sometimes perceived by patients as a "jelly feeling" in the joints. The feeling of the wedge, the stiffness is possible.
With the development of reactive arthritis, the main symptoms of the joint are combined with:
- pain and local increase in temperature, determined by palpation of the affected joint,
- persistent pain
- joint enlargement, soft tissue swelling,
- progressive reduction in range of motion.
Stages and degrees of joints
During the course of the disease, the drug distinguishes between three stages, which differ in the location of the disease, the severity of the lesion and the location. At the same time, the differences in all three stages are related to the types of tissues that undergo pathological changes.- The first stage of joint development is the initial stage of the disease. It is characterized by mild damage to the cartilage tissue and loss of normal functions in the collagen fibers. At the same time, in the first stage, small morphological disorders of the bone tissue and structural changes in the synovial fluid are observed. The cartilage of the joint is covered with cracks, the patient has slight pain at the site of pathology.
- Second degree - the development of joints with increased dynamics. This stage is characterized by the appearance of constant pain, lameness. There are noticeable morphological and dystrophic changes in the cartilage; at diagnosis, the development of bone tissue is revealed. Osteophytes form - bone growth that is visible on visual examination of the lesion site. At the same time, the processes of degenerative changes in the joint capsule proceed, which leads to its structural exhaustion. The disease at this stage can often worsen and be regular. The pains gradually become constant.
- Third degree - active development. At this stage, synovial fluid is almost completely absent due to its degeneration and the bone tissue rubs against each other. The mobility of the joints is almost completely absent, the pain becomes more palpable. Cartilage is also absent due to degenerative and atrophic changes. Treatment of third-degree joint arthropathy is considered inappropriate.
In addition to these three stages of pathology development, there is a final stage - the irreversible destruction of all joint tissues. At this stage, not only effective treatment but also pain relief is impossible.
The inflammatory process usually begins in the second degree of damage, in rare cases, in the absence of medical intervention - in the first stage. It then becomes increasingly difficult to stop it, and this can lead to secondary pathologies, to the development of pathogenic microflora at the site of the disease.
In order to rule out serious consequences, treatment should start from the first degree and at the same time intensive treatment methods should be applied. In the last stage, which is related to the complete destruction of the cartilage tissue, only one technique is allowed for the patient to relieve the pain and immobility of the joint - arthroplasty with complete or partial replacement of the components of the joint.
Consequences
The consequences of early treatment and advanced joint disease are fraught with complications such as:
- disability,
- distortion beyond recovery,
- appearance of vertebral waxes,
- stiffness or stiffness in the joints,
- reduction in quality and standard of living
The chronic course, in addition to these complications, is accompanied by intense and frequent pain, complete destruction of the structural components of the joint, discomfort, inability to exercise and work out.
Diagnostics
The diagnosis of the joint is based on the evaluation of memory data, characteristic manifestations of the disease, the results of research methods. Indicative changes in general and biochemical blood tests are not typical of arthropathy, they occur only with the development of an active inflammatory process.
The main organic method for diagnosing arthropathy is x-ray. in diagnostically unclear cases, computed tomography or magnetic resonance imaging is recommended.
Knee and hip joint disease is a leader in the severity of clinical manifestations and the negative impact on quality of life.
Additional diagnostic methods:
- non-traumatic arthroscopy,
- ultrasound (estimation of articular cartilage thickness, articular, condition of joint capsules, presence of fluid);
- scintigraphy (assessment of the condition of the bone tissue of the bone heads forming the joint).
How to treat arthritis?
It is best to treat joint pain at an early stage, the treatment itself must be pathogenetic and complex. Its essence lies in eliminating the causes that contribute to the development of this disease, it is also necessary to eliminate inflammatory changes and restore previously lost functions.
Joint treatment is based on many basic principles:
- Oxygenation of the joint or so-called intra-articular oxygen therapy.
- Drug treatment.
- Intraosseous occlusions, as well as decompression of the postreservation.
- Sustainable nutrition.
- Damaged joints must be relieved of excessive stress. If possible, it should be kept to a minimum during treatment.
- Follow the standard orthopedic regimen.
- Physiotherapy exercises.
- Attend physiotherapy classes, which include magnet and electrotherapy, wave shock and laser therapy.
- Sanatorium treatment. To do this, it is necessary once a year, after a doctor's recommendation, to be treated in specialized resorts.
Preparations for the treatment of the joint
Medication is performed in the joint deterioration phase, selected by a specialist. Self-medication is unacceptable due to possible side effects (for example, the negative effect of non-steroidal anti-inflammatory drugs on the gastric mucosa).
Treatment includes the following drugs:
- Anti-inflammatory drugs. By starting treatment for arthritis in a comprehensive way, you can slow down the course of the disease and significantly improve your quality of life. Some treatment points are worth studying in more detail. In particular, drug treatment involves the initial stage - this is the removal of pain, as well as the elimination of inflammatory processes that occur in the joints. For this, all doctors use non-steroidal anti-inflammatory drugs. Experienced doctors do not recommend oral administration, as these drugs irritate the stomach to a great extent. Therefore, depending on the drug selected, either intravenous or intramuscular administration is used. NSAIDs are sometimes used as adjuvants in the form of ointments, but their absorption is extremely low, so no significant effect can be achieved.
- Hormonal corticosteroids. When arthropathy is in the aggravation stage, it is recommended to take hormonal corticosteroids. They are injected into the joint. Externally, you can use a special plaster, ointment or tincture, which are prepared on the basis of hot pepper.
- Chondroprotectors aimed at restoring cartilage and improving the quality composition of synovial fluid will not be superfluous. The course lasts quite a long time, until there is an improvement. However, if the expected effect does not occur within six months of administration, the medication should be canceled. Also, intra-articular, together with chondroprotective agents, the use of drugs prepared on the basis of hyaluronic acid is recommended. They contribute to the formation of the cell membrane that is responsible for the formation of cartilage in the joints.
Physiotherapy
To relieve pain, reduce inflammation, improve microcirculation and eliminate muscle spasms, a patient with arthritis is referred for physiotherapy:
- In deterioration phase. Introduce laser therapy, magnetotherapy and ultraviolet radiation,
- In recession. Electrophoresis and phonophoresis appear.
In addition, thermal processes, sulfides, radons and sea baths are used. To strengthen the muscles, electrical stimulation is performed. Gentle massage can also be used during depression.
Surgery
If the reported methods of exposure are ineffective, in the presence of complications, resort to surgical treatment of arthropathy:
- Post-resolution decompression and prolonged intraosseous occlusion (reduction of intraosseous pressure in the affected area),
- Corrective osteotomy,
- Joint endoprosthesis.
In the early stages of the disease, mechanical, laser or cold removal plasma is used (smoothing of the surface of the damaged cartilage, removal of unviable areas). This method effectively relieves pain, but has a temporary effect - 2-3 years.
Folk remedies
Most people these days do not want to take pills or injections. So they ask the question - how to treat arthritis with the help of folk remedies? For the most part, such funds are aimed at increasing body tone, improving blood circulation, relieving pain, and increasing immunity.
Traditional medicine recipes are used to treat this disease:
- Egg solution is prepared from fresh egg yolk, which is mixed with turpentine vinegar and apple cider in a ratio of 1: 1: 1. The liquid should be mixed well and rubbed over the affected joint all the waynight. Then you have to wrap everything with a woolen scarf. It is recommended to rub for 1 month 2-3 times a week.
- Buy elecampane root at the pharmacy. As a rule, it is packed in packages of 50 grams. To prepare the tincture, you will need half a pack of plant roots and 150 ml of high quality vodka. The ingredients are mixed, placed in a dark bottle and infused for 12 days. Rubbing is done before bed and, if possible, in the morning.
- Using boiled oats also gives good results. Take three to four tablespoons of oats, pour boiling water and cook on low heat for five to seven minutes. The amount of water used should provide a thick porridge, which should be cooled and used as a compress overnight. Use only fresh flakes. Yesterday porridge is not good for a squeeze.
- Birch leaves, nettle leaves and calendula inflorescences are taken in equal parts. As a result, you should take two tablespoons. Put the resulting crushed collection in a warm, fill with a liter of boiling water and leave overnight. Starting the next morning, you should take half a glass of broth four to five times a day. The course of taking this recipe is two to three months.
Tinctures of bay leaf, horseradish, garlic and rye are also considered effective. Treatment of arthritis with folk remedies will be more effective if combined with medication.
Nutrition for joints
The basic dietary principles for arthritis are reduced to the following points:
- Avoid heavy meals at night to avoid joint attack.
- Eat in fractions.
- Monitor weight constantly to avoid weight gain,
and therefore extra stress on joint wounds. - When there is no worsening of the disease, take a walk after eating.
- The menu must be balanced, drawn up with the treating physician.
There are absolutely no complaints about fish dishes - you can eat a lot of them, of course, in reasonable quantities.
- Do not forget to regularly take vitamins from food. For patients with arthritis, B vitamins are especially relevant
- Jelly meat plays an important role in the treatment of arthritis. These foods will be a real storehouse of trace elements for aching joints. The most important ingredient in aspic is natural collagen
- Vitamin B helps in the production of hemoglobin. It can be "taken" by eating bananas, nuts, cabbage and potatoes. It is worth getting carried away with herbs and legumes. It will be the source of folic acid. Liver, mushrooms, dairy products, and eggs will be helpful. It is rich in riboflavin.
Following the treatment regimen prescribed by the doctor, it is possible to achieve that the disease subsides and the damaged tissues begin to regenerate.
Prevention
Prevention of arthritis begins with proper nutrition. It is important to try to reduce your salt intake, as well as foods that can upset your metabolism. These include legumes, fatty meats and alcohol. The diet includes cabbage, greens and fish.
To prevent arthritis, it is necessary to attend physical education classes, to warm up. If possible, it is best to walk a few miles. It is also important to monitor your weight and prevent weight gain, as this will add extra stress to the joints. Taking pills for weight loss is not recommended, as they can disrupt the body's metabolism.
Prediction
Life prospects are favorable. The favorableness of the social and occupational prognosis depends on the timeliness of the diagnosis and the initiation of treatment. It is reduced when the decision on the surgical treatment of the disease is delayed if necessary.