Arthrosis- a disease that develops over many years with a predominant damage to certain joints.The most painful changes affect the large joints - knee, hip, shoulder, etc.Pain and restricted movement in them make a person's life physically and emotionally difficult, and given that osteoarthritis often occurs at a young age, it can interfere with the achievement of professional and personal goals.Therefore, it is important to diagnose the disease as early as possible and start a comprehensive treatment of arthrosis.
Treatment of arthrosis
In the initial stage of arthrosis, conservative methods are used that do not involve surgical intervention.On the other hand, the used correction methods make it possible to stop the development of the disease, maintain motor activity, reduce the severity of the main symptoms of arthrosis and generally improve the quality of human life.
- Drug treatment:
- NSAIDs;
- GCS;
- chondroprotectors.
- PRP therapy.
- Therapeutic exercise.
- Massage and manual therapy.
- Traction therapy.
- Physiotherapy.
Physiotherapy methods widely used for the treatment of arthrosis:
- Magnetic therapy;
- UHF;
- inductothermy;
- ultrasound therapy;
- balneotherapy;
- surgical treatment.
Treatment with drugs
There is a common belief among patients that the most important method of pain relief in case of arthrosis is the use of painkillers (orally in the form of tablets or by injection - intramuscularly).In fact, the use of medication is a method of quick pain relief, which should be prescribed only in the acute period.The fact is that the drugs widely prescribed for these purposes have serious side effects that increase with long-term and especially uncontrolled use.We are talking about undesirable consequences from the digestive, cardiovascular, and nervous systems, which can lead the patient to a hospital bed with a high probability (abdominal bleeding, heart rhythm disorders, effects on the liver and kidneys, etc.).
Nonsteroidal anti-inflammatory drugs
NSAIDs- nonsteroidal anti-inflammatory drugs, many of which are available without a prescription and are widely used alone by patients.This group includes drugs of various chemical structures.The preparations have a pronounced anti-inflammatory and analgesic effect, they can reduce pain in the joint area and adjacent muscle tissue, but do not affect the development of the disease.They are used only to relieve symptoms at all stages of the disease.Effective in case of simultaneous synovitis (accumulation of fluid in the joint).
GKS— glucocorticosteroids have strong anti-inflammatory and analgesic effects.It is recommended and effective to administer them periarticularly.However, patients often have a negative attitude towards the use of these drugs in treatment, which is associated with possible side effects: infectious complications, deterioration of ligaments, joint surfaces, cartilage degeneration.But with periarticular administration, the risk of these complications is minimal.
Chondroprotectors— the substances are natural components of cartilage tissue, which, when used orally, contribute to the gradual regeneration of cartilage, normalize its density and elasticity.These active ingredients are usually used in combination and are included in various medications and ancillary products.Chondroprotectors do not have a quick analgesic effect;improvement develops with long-term use of drugs based on them, which is associated with partial regeneration of cartilage tissue.Recommended in all stages of the disease.
PRP therapy
One of the most modern regenerative medicine methods used in cases of sports injuries and degenerative-dystrophic joint diseases is PRP therapy (PRP – platelet-rich plasma) or plasma biorevitalization, autoplasm therapy.The technique is actively used abroad.
The nature of the procedureconsists of administering platelet-rich plasma directly to the site of injury, in this case the joint.Medicines for administration are obtained from the patient's own blood, so the method is considered not only very effective, but also safe for humans.Growth factors and other biologically active substances (serotonin, bradykinin, prostaglandins, etc.) present in platelet-rich plasma contribute to the activation of regeneration processes and the synthesis of their basic substances.
The resulting platelet-rich plasma is injected both periarticularly and directly into the affected joint, thereby achieving partial tissue regeneration, mainly cartilage.
The method is most suitable for osteoarthritis 1.-2.stage.Shows good results and allows delaying the rapid development of the disease due to the release of platelet growth factors.The method is relatively new, but has proven to be very effective.PRP therapy was first used in surgery;today this technique is successfully used in many fields of medicine, including rheumatology and orthopedics, neurology and cosmetology.Performing autoplasma therapy allows you to extend the life of the joint without any other aggressive intervention.
Synovial fluid protectors- a group of drugs based on hyaluronic acid, which are injected directly into the joint cavity (injection) and perform the role of a viscous lubricating fluid in the absence of natural synovial fluid almost completely (it provides the role of lubricating the joint surfaces).It is used in the later stages of arthrosis.
Medicines of this group are also called "synovial fluid prostheses", "biological substitutes for synovial fluid".The effect after taking the medicine is long-lasting - from 6 to 13 months, depending on the medicine used.
Some applyother groups of drugs- antispasmodics, muscle relaxants, B vitamins in therapeutic (large) doses, but all of them have only auxiliary value in the treatment of arthrosis.
Therapeutic exercise
Special medical exercises can and should be used during exacerbations, in all stages of arthrosis.Such measures can reduce pain and prevent serious restrictions on joint movement.However, the method is unpopular among arthrosis patients, as most mistakenly believe that any movement should be restricted in case of pain.Timely initiation of physical exercises, on the contrary, contributes to faster recovery and relief of symptoms, first of all, pain.
Physical therapy in water, joint movements in unloading position (lying, sitting, hanging), moderate walking on a flat surface is especially effective.If necessary, for example, in case of severe pain, a special bandage can be applied to the joint, but physical education should be started as early as possible.
Massage and manual therapy
Methods of mechanical action of joints, muscles and ligaments can reduce the severity of pain, increase mobility, improve blood circulation and metabolism in the area of the affected joints, reduce muscle spasms, normalize muscle function.
Traction therapy
In a hospital or medical sanatorium, it is possible to perform traction therapy - it is pulling a joint (hip, knee) using a special technique, using different loads.The standard traction scheme is designed for 28 days, gradually increasing the load and exposure time.Classical techniques are used and more modern using simulators.Their effectiveness is almost the same, but simulators are more comfortable for the patient.
Physiotherapy
Using various physical therapy methods in the early stages of arthrosis can achieve significant pain relief and increase the mobility of the affected joints.Physiotherapy courses help to slow down the pathological process and prolong the period without exacerbations.
Physiotherapy methods widely used for the treatment of arthrosis:
Magnetotherapy— local exposure to a permanent or alternating low-frequency magnetic field.In the area of the affected joint, metabolic processes are accelerated, blood circulation and nutrient supply to the joint structures are increased, and the processes of regeneration and synthesis of substances necessary for the functioning of the joints are activated.
Magnetic therapy has an anti-edematous, analgesic, anti-inflammatory effect almost from the first session, which positively affects the patient's general condition.Magnetic therapy is successfully used in hospitals and sanatoriums, where medical equipment of various modifications is used.
A huge advantage for patients with arthrosis is the possibility of conducting independent courses of magnetic therapy at home, as prescribed and under the supervision of the attending physician.Timely use of portable magnetic therapy devices allows you to stop the occurrence of pain, the beginning of an aggravation or to carry out a preventive course - that is, to maintain normal health.
The beneficial effect of the procedures on the condition of the cardiovascular and nervous systems can also be called a positive aspect of magnetic therapy.Considering the fact that the majority of arthrosis patients are middle-aged and elderly people with an already existing complex of chronic diseases (arterial hypertension, coronary heart disease, atherosclerosis, etc.), the mild calming and stabilizing effect of magnetic therapy will be useful.
Ultrasound therapyis used more often in combination with the effect of drugs with anti-inflammatory, analgesic, restorative effects - ultraphonophoresis or phonophoresis.Ultrasound increases tissue permeability to drugs, so their main effect is enhanced.Even without the medicinal component, the method is very effective in the case of arthrosis: ultrasound has a mechanical effect on tissues (micromassage), activates local immune and regenerative processes in the joint area and adjacent muscles, has a pronounced analgesic and anti-inflammatory effect.
Laser therapy– one of the most common and widely used procedures.The therapeutic effect is based on the expansion of vascular reflexes above the site of the pathological process.This leads to improvement of local blood circulation, activation of metabolism, removal of insufficiently oxidized metabolic products and reduction of pain intensity.Due to its shallow penetration depth, laser therapy has a minimal systemic effect, while enhancing the therapeutic effect of other procedures.
Shock wave therapy– high energy impact method.It is based on the piezoelectric effect.Applying a piezoelectric discharge to the pathological focus produces a number of effects.Non-viable cells are destroyed, which leads to the activation of local immunity.Hibernation (inactive) cells are stimulated, which promotes regeneration processes.At the same time, the intensity of the pain syndrome is significantly reduced (although the procedure itself is painful).The undoubted advantage of the method is its use once every 4-7 days.
Diadynamic therapy– method of therapeutic effects of the body with diadynamic impulse currents.The diadynamic currents used in this method rhythmically excite the skin receptors, which indirectly leads to the activation of descending physiological pain suppression mechanisms and leads to the reduction of the patient's pain until complete analgesia.Therefore, such procedures are effective for severe pain.
Electromyostimulation– the effect of electric current on muscle tissue.With arthrosis of the large joints, the work of the surrounding muscles is disturbed, which leads to atrophy for some and overloading for others.Developmental gait disorders.When exposed to alternating current according to a special program, the muscles contract rhythmically, creating a certain amount of work, which leads to the restoration of their volume and function.
Cryotherapy- a simple and effective method of treatment, unfortunately rarely used.Local exposure to low temperature reduces the sensitivity of pain receptors and the synthesis of biologically active substances that stimulate the development of inflammation.After cryotherapy, there is a reflex expansion of blood vessels, local blood circulation is accelerated, recovery processes are activated.This method is especially effective in combination with shock wave therapy.
Balneotherapy.In the conditions of the sanatorium-resort, hydrotherapy is carried out - medical baths, among which radon baths are especially effective in the case of arthrosis.The radioactive decay products of radon dissolved in water affect the body as a whole.The most important effect is the activation of metabolic processes.
A similar, albeit less pronounced, effect is characteristic of therapeutic mud (peloids), hydrogen sulfide and carbon dioxide baths.
Surgical treatment
Surgical methods are used in the late stages of arthrosis, when joint mobility is severely limited or absent at all, which affects the patient's quality of life.Various methods of joint endoprosthesis are used all over the world, which allow to completely restore the range of motion and return the patient to an active life at any age.
The tactics and extent of surgical intervention are determined by the attending physician;the choice is based on such parameters as the general condition of the patient, age and the presence of concomitant diseases, overweight and others.The best results after endoprosthesis were achieved in young and middle-aged patients (almost complete restoration of range of motion), but also in elderly people, a significant improvement in their condition can be observed, because after a successful operation and recovery, they can fully provide for themselves in everyday life and move not only in the apartment, but also go out without limiting themselves in communication.
Prevention
Arthrosis belongs to the group of walking diseases and develops mainly as a result of age-related changes in the joints, which are aggravated by the influence of external negative factors.Attention to the condition of the musculoskeletal system, prevention of joint diseases and treatment of arthrosis at an early stage allows maintaining physical activity and avoiding massive medical intervention in the future.