All you need to know about arthrosis – its causes, symptoms, varieties and diagnostic methods – will help to detect the ailment in the early stages. And effective treatment methods will help get rid of this disease. Arthrosis is characteristic of people over 40 years old. However, unbiased statistics in recent decades have shown a tendency for rejuvenation – it began to suffer men and women aged 30-35 years.
What is arthrosis?
Arthrosis is a chronic joint disease accompanied by pathological changes in the hyaline cartilage, and subsequently in adjacent tissues, the joint capsule and synovial membrane. The defeat is dystrophic and degenerative in nature, which leads to a change in the structure of articular tissues, the loss of their functionality.
According to the same statistics, 12% of the world’s population is affected by arthrosis. From 62% to 65% of all episodes of the disease occur in people over the age of 60 years. Another 30-35% of cases of joint damage by this pathology occur in patients aged 40-60 years. And about 3% are young people aged 20-40 years.
The danger of joint disease manifests itself in the fact that it is practically not completely cured. Although, in diagnosing pathology in the early phase of progression, it helps to maintain joint functionality.
Most often, cases of arthrosis in the joints are diagnosed:
- wrist joints;
- cervical and lumbar spine;
- the knee joint ;
- the hip joint ;
- shoulder joint;
- ankle joint;
- metatarsophalangeal joint.
The disease is more characteristic of the female population – representatives of the female half of the population suffer from this pathology more often at an older age. Arthrosis of the interphalangeal joint occurs in women 10 times more often than in the male population.
The likely consequences of arthrosis
With timely treatment, the disease is manifested by a lower intensity of development and, as a consequence, by a stop of degenerative and dystrophic changes. This means that timely surgical or therapeutic intervention allows you to maintain the functionality of the joint, normal gait and eliminates soreness.
At the same time, delaying treatment leads to frequent and stable pain, lameness, swelling of the joint. Progressive pathological changes in the tissues deprive the joint of its usual functionality. In the short term, in the absence of a competent treatment, arthrosis quickly flows into a chronic form. Such consequences give rise to the need for constant medical supervision and regular treatment of the disease during periods of exacerbation.
In order to avoid consequences and complications, at the first suspicion of its development, you should contact medical specialists. In the early stages of progression, a rheumatologist is involved in the treatment of joint arthrosis. In a chronic form, the treatment of this pathology is performed by an orthopedic traumatologist.
Types of Arthrosis
This joint pathology has several forms and varieties that differ by such criteria:
- causes of occurrence (primary and secondary form);
- stages of arthrosis (three stages of progression are classified);
- localization of pathology (the place of manifestation of the disease and the type of articulation);
- localization form (generalized and local form);
- the course of the disease (acute or chronic).
Hip, knee, carpal, ulnar, brachial, ankle, and cervical arthrosis are distinguished at the place of symptoms.
According to etiological signs, pathologies of a primary nature are classified, developing on their own without any prerequisites, and a disease of a secondary nature. In the latter case, joint damage occurs due to the development of infectious diseases in adjacent tissues, mechanical disorders, loss of physiological functionality of the joint, as well as a consequence of a progressive inflammatory process, hypothermia, trauma or other factors.
Classification according to the form of localization involves local and generalized damage to the joints. In the first case, the disease and its symptoms cover a small area of the joint or its individual tissues and components. With a generalized form, several joints are affected, or one of them with full coverage of all articulation tissues.
At different stages of the progression of the disease manifests itself in varying degrees of intensity. In this case, symptoms and complications can be more clearly expressed, the process of tissue destruction and impaired joint function more or less dynamically proceed.
Depending on the course of arthrosis, there are:
- acute form;
- chronic form.
The acute form is usually manifested by an increased intensity of the development of symptoms and their severity. Painful sensations manifest themselves more strongly, and morphological changes in the tissues proceed more dynamically.
In the chronic form, the course of the disease is slow, it manifests itself as individual signs during periods of exacerbation and is practically untreatable
Degrees of disease
During the course of the disease, medicine distinguishes between three stages that differ in the signs of the disease, the intensity of the lesion, and localization. At the same time, distinguishing in all three stages concern the types of tissues undergoing pathological changes.
- The first degree of development of arthrosis of the joints is the initial phase of the disease. It is characterized by mild cartilage damage and loss of physiological functions in collagen fibers. However, at the first stage, minor morphological disorders of bone tissue and structural changes in synovial fluid are noted. The cartilage of the joint is covered with cracks, the patient has a slight soreness at the location of the pathology.
- The second degree is the development of arthrosis with increased dynamics. This stage is characterized by the appearance of stable pain, lameness. Marked morphological and dystrophic changes in the cartilage are noted, in the diagnosis, bone tissue overgrowths are detected. Osteophytes are formed – bone growths that are visible during a visual examination of the lesion site. At the same time, processes of degenerative changes in the synovial capsule occur, which leads to its structural depletion. The disease in this phase can often worsen and be regular. The pains gradually become permanent.
- The third degree is active progression. At this stage, synovial fluid is almost completely absent due to its degeneration, and bone tissue is abraded against each other. The mobility of the joint is almost completely absent, the pain becomes more noticeable. Cartilage is also absent due to degenerative and atrophic changes. Treatment of the third degree of arthrosis of the joints is considered inappropriate.
In addition to these three degrees of development of pathology, there is a final stage – the irrevocable destruction of all articulation issues. In this phase, it is impossible not only to carry out effective therapy but even to remove the pain syndrome.
The inflammatory process usually begins with the second degree of damage, in rare cases, in the absence of medical intervention – in the first stage. Subsequently, it becomes increasingly difficult to stop it, and this can lead to secondary pathologies, the development of pathogenic microflora in the localization of the disease.
To avoid serious consequences, treatment should be started from the first degree, and intensive care methods should be used. At the last stage, associated with the complete destruction of the cartilage tissue, only one technique is allowed to rid the patient of pain and immobility of the joint – endoprosthetics with full or partial replacement of the components of the joint.
Causes of the disease
The reasons may be primary and secondary factors. In older people, the disease can occur with a mixed etiology, that is, in the presence of primary and secondary causes. Their complex manifestation exacerbates the course of arthrosis and reduces the dynamics of recovery.
The main cause of most types of this pathology is metabolic disorders. Altered metabolic processes lead to morphological abnormalities in the cartilage and synovial fluid. As a consequence of this, the changes relate to the entire joint and are often accompanied by the emergence of inflammatory local foci.
In addition to metabolic pathologies, the causes of arthrosis of the joints are:
- traumatic damage to individual tissues or the entire joint. This includes dislocations, fractures, sprains, torn meniscus, penetrating wounds. This reason is more common in people involved in sports, or whose activity is associated with dangerous working conditions and physical activity;
- inflammatory process – this factor often acts as a secondary cause. Inflammation usually develops in patients suffering from gout, psoriasis, rheumatic anomalies, autoimmune pathologies. Inflammation of the joint affects patients who are at the stage of exacerbation of infectious diseases, including tuberculosis, chlamydia, staphylococcus and other infectious diseases;
- consequences of an exacerbated form of respiratory disease – influenza, acute respiratory viral infections, acute respiratory infections;
- increased bodyweight of the patient – with a disproportionate load on the joints of their tissues, they undergo a constant mechanical effect, which leads to morphological abnormalities and destruction of the structure of the cartilage;
- excessive hypothermia, leading to the destruction of the integrity of the cartilage tissue and the loss of the structure of the synovial fluid;
- thyroid disease.
A separate place in the etiology of arthrosis is the genetic factor. It is a genetic abnormality that is able to provoke dysplasia of articular tissues and a disorder in the physiological functions of collagen fibers, which are responsible for the flexibility and mobility of the joint.
At the same time, the reasons for the development of this pathology are other related factors: vitamin deficiency, intoxication due to poor-quality products or excessive drug overdose, the patient’s old age, pathological processes of the blood formation and blood flow system, hormonal abnormalities, diseases of the reproductive system of infectious origin.
The mechanism of disease progression
When any of the causes of joint disease with arthrosis appears, pathological processes begin to develop in it. The mechanism of their progression is not fully understood, but the main stages of official medicine are known.
At the initial stage, there is a depletion of the structure of the cartilage tissue and abnormal changes in the synovial fluid. All this proceeds as a result of metabolic disturbances, in which the tissues of the joints do not receive the necessary components in sufficient quantities, or are deprived of some of them.
Further, 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 does not have time to be produced, which provides softness and flexibility of the structural composition of collagen fiber. The cartilage dries out gradually, becomes brittle and crack. The fluid in the synovial capsule is gradually depleted and subsequently completely disappears.
Roughnesses, hard bone tumors are formed on the cartilaginous tissue. At the same time, deformation of other tissues of the joint, their pathological degeneration, degeneration, and loss of physiological activity develop.
For the patient, these changes mean the appearance of pain, lameness, joint immobility.
Symptoms of arthrosis
Signs of arthrosis of the joints are manifested from its first degree, although sometimes they are not so pronounced. The characteristic phenomena for all stages of arthrosis are:
- pain syndrome;
- crispy sounds when moving;
- inactivity or a complete decrease in joint mobility;
- articulation deformation.
Pain usually occurs while moving. With intense physical exertion, pain sensations intensify and acquire a persistent tendency. With all types of arthrosis in any place of their localization, soreness is sharp.
In the initial phase, pain is weak, they often appear in the daytime. Usually, the pain is short-lived and subsides at rest. In the chronic form and with the intensive progression of the acute form, the pain syndrome manifests itself more often, has an increased period of manifestation, and often worries even at rest at night.
By the nature of the crunch, experienced orthopedists or rheumatologists establish a differential diagnosis, since this symptom is characteristic of a number of diseases. With arthrosis of the joints, a crunch is usually accompanied by painful sensations or discomfort. It occurs due to the lack of synovial lubrication and the drying of the cartilage tissue. As the pathology progresses, the sound of the crunch intensifies, it is dry and occurs more often.
A decrease in articulation mobility develops against the background of the appearance of bone neoplasms that impede the movement of cartilaginous tissue and block the elasticity properties of collagen fibers.
This phenomenon is accompanied by severe painful sensations – any attempt to increase the intensity of movement and create a load on the joint will inevitably provoke severe pain.
Swelling and deformation
Swelling in the area of arthrosis localization, growths of bone tissue that are released under the skin are visually observed. Swelling increases with the development of the disease. Similarly, the deformation of cartilage and bone tissue progresses.
The consequences of untimely treatment and advanced joint arthrosis are fraught with complications such as:
- deformation without the possibility of recovery;
- the appearance of vertebral hernias;
- stiffness or immobility of the joint;
- decline 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 perform physical work and play sports.
For the correct appointment of medical procedures, it is necessary to eliminate the cause of arthrosis. For its detection and accurate diagnosis, the following diagnostic methods are used:
- puncture with a fence of synovial fluid;
- cartilage biopsy to check its structure;
- radionuclide examination method;
Together with a rheumatologist or orthopedist, additional laboratory tests are prescribed – a general blood test, a study on the content of electrolytes, rheumatic tests, the detection of sugar levels in blood samples, the examination of protein fractions.
In medical practice at the initial stages for the treatment of arthrosis, conservative methods of therapy are used, including the use of such drugs and preparations:
- anti-inflammatory medicines – indomethacin, dexalgin, ketans, movilis, rheumatic drugs, diclofenac;
- chondroprotectors – struktum, chondroitin, arthron, movex, teraflex;
- intraosseous preparations for blocking painful sensations and relieving inflammation – glucocorticoids (diprospan, Kenalog, hydrocortisone, and others), as well as synthetic analogs of synovial fluid with chondroprotective components (noltrex, hyalual, singial, fermatron).
The use of all drugs demonstrates more significant results with complex administration.
In the chronic form of the disease, medications are ineffective. An insignificant result is achieved by physiotherapeutic procedures. They suggest carrying out thermal and water procedures, magnetotherapy, electrophoresis, shock wave therapy, UHF, and mud therapy. But with increased dynamics of the development of arthrosis, surgical treatment is usually prescribed.
Methods of surgical treatment for arthrosis includes three methods:
- Endoprosthetics with the replacement of all components of the joint with a metal prosthesis.
- Arthroscopy, involving the removal of bone tumors and plastic surgery of the cartilage using a video camera and micromanipulators inserted into the joint cavity.
- Arthrodesis – removal of damaged tissue with the simultaneous installation of a fixing articular plate.
How to forget about pain in arthrosis of joints
To get rid of the pathology itself is a rarely attained goal. And to solve this problem is possible only at the initial stage. In other circumstances, the patient has to deal with pain. Some methods of conservative therapy will help to forget about joint pain. And with them it is worth applying the advice of your doctor and observes the following conditions:
- conducting periodic physiotherapy sessions;
- the formation of a balanced diet;
- therapeutic exercise;
- periodic intraosseous blockade;
- maintaining an orthopedic regimen;
- decrease in physical activity;
- fighting overweight.