What is osteoarthritis? Causes, symptoms and treatment of the pathology.

Osteoarthritis is a chronic pathology whose objective is to damage the joint structures of the musculoskeletal system. The main reason leading to chronic disease is metabolic imbalance, which leads to a progressive process of a degenerative-dystrophic nature. The targets of the damaging reaction are the articular cartilage, connective tissue, bursae, tendons, bones and muscle corset. In the chronic form of the pathology, the periarticular muscles are involved in the inflammatory process, losing anatomical elasticity due to deformation and swelling of the joints. To eliminate complications associated with the blockage of skeletal biomotility and not become disabled, you need to arm yourself with information about osteoarthritis: 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. Idiopathic (primary) osteoarthritis has this onset. The mechanism of development of secondary osteoarthritis begins after certain conditions and factors, namely:

• Joint injury (fracture, meniscus damage, ligament rupture, dislocation, compression + hematoma, bone fracture).
• Dysplasia (abnormal intrauterine development of joint components).
• Violation of material metabolism.
• Autoimmune type pathologies (rheumatoid arthritis, psoriasis, autoimmune toxic goiter, systemic lupus erythematosus).
• Nonspecific destructive arthritis (with 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 and pituitary glands).
• Hormonal dysfunction (decreased levels of estrogens, androgens).
• Degenerative + dystrophic reactions (multiple sclerosis, Perthes disease).
• Oncological diseases.
• Blood diseases (hemophilia, anemia, leukemia).

Risk factors that cause and lead to osteoarthritis:

1. Age-related changes.
2. Obesity (excess body weight causes constant vertical loads, which overload the joints, which wear out quickly and lose 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 surgery with removal of affected tissues (soft, cartilaginous, bone). After restorative manipulations, the joint structure does not have the same consolidation, so any load leads to osteoarthritis.
5. A hereditary factor, that is, osteoarthritis can affect one or more members of the family.
6. Hormonal imbalance during menopause or after removal of the ovaries in women, 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-osteoarthritis.
9. Intoxication with pesticides, heavy metals.
10. Temperature variations with sudden changes plus hypothermia.
11. Permanent trauma to a certain group of joints.

Risk factors include the environment, which has recently been saturated with high background radiation, toxic substances (smog over industrial cities and industrial zones, as well as frequent testing of military equipment or interstate wars, the result of which is ozone holes + strong ultraviolet). radiation). Dirty drinking water + foods rich in preservatives cause the development of osteoarthritis.

The mechanism of development of osteoarthritis.

The basis of the triggering mechanism of osteoarthritis is the interruption of the chain of restoration processes of cartilage cells and the correction of the affected areas of connective tissue by young cells. Cartilage plates firmly cover the terminal surfaces of the bones that are part of the locomotor joints. Anatomically normal cartilages have a strong structure, they are smooth, elastic and thanks to the synovial fluid, which is a biological material to lubricate the intra-articular components, they slide. It is the synovial fluid that provides unhindered movement of the joint components relative to each other.

Cartilage tissue and synovial lubrication perform the main function of the cushioning effect, reducing the abrasion of cartilage-covered bones. The bone ends are separated by pockets of fluid and are firmly stabilized by a corset of ligaments and muscles. A certain configuration and plexus of the musculoligamentous apparatus allows this structure to perform precise biomechanical movements such as flexion, extension, rotation + rotation. The design, thanks to the interweaving of ligaments, allows you to stay firmly in a certain position, as well as perform coordinated movements, maintaining the balance of the body.

High stress or hormonal imbalance causes the destruction of collagen plates, exposing bones. In these areas, pointed osteophytes appear and create pain with any movement of the musculoskeletal joints. The bones thicken and false joints develop between the osteophytes, which completely change the functionality of the organ of movement. There is less synovial fluid due to trauma to the bursa (its rupture), and the entire joint structure begins to suffer, along with the corset of ligaments + muscles. Swelling of the joints appears and a microbial infection may also occur. Ossification areas cause limitation of 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. With forced labor, pain and swelling of the joint appear.
• Stage II:Depletion of the cartilaginous plate is observed, foci of osteophytic islands develop, and ossification appears along the edges of the joint. The pain syndrome intensifies, swelling increases, and discomfort appears when moving. As the pathology progresses towards the chronic stage, the pain is constant, accompanied by inflammation with periods of exacerbation/remission. The biomechanics are partially altered, the patient respects the joint.
• Stage III:the cartilaginous plate is completely worn away, instead of cartilage, a system of osteophytes + fixed false interosteophytic joints develops at the ends of the bone. The anatomical shape is completely altered. Joint ligaments and muscles shorten and thicken. The slightest injury can cause dislocations, fractures and cracks. The trophism of the locomotor organs is damaged, which is why they do not receive the necessary amount of blood and nutrients. Pinched nerves cause an intense painful reaction that only disappears after the administration of strong analgesics or drugs from the COX1/COX2 group.

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

Osteoarthritis pain syndrome

Pain is characteristic of osteoarthritis. They intensify with movement, physical activity, with changes in weather conditions, with changes in temperature, humidity levels and atmospheric pressure. Pain can be caused by any position of the body or sudden movements. Walking, running and long standing in an upright position put a certain load on sore joints, after which sharp or aching pain begins. 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 buffer layer, pinched nerves and blood vessels lead to a stagnant process with impaired trophism and accumulation of interstitial fluid. The swelling causes a sharp stabbing pain.

Specific to osteoarthritis is pain after prolonged rest with a sharp motor impulse; This condition is called initial pain. The mechanism of development of these pains is osteophytic areas covered with destructive remains of cartilaginous tissue, fibrin and viscous fluid. When joints move, a film of these components or debris covers the exposed areas, lubricating them and thus absorbing pain. Blocking pain occurs after the products of destruction of the intra-articular space, that is, bone debris or a large film of connective tissue, enter the muscles. There is another type of pain: constant, painful, bursting + independent of movements, they are characteristic of reactive synovitis.

Attention!The locking type of pain is only amenable to surgical intervention followed by restoration of the affected joint. Treatment with folk remedies is not recommended, this is fraught with the development of purulent arthrosis with the spread of infection throughout the body, and after sepsis, obvious morphological changes occur in all organs and systems.

Symptoms of joint inflammation.

The symptoms are divided according to the degree of development of the pathology. Osteoarthritis makes itself felt after 38-40 years, when the depreciation system of the joint begins to wear out and new or young cartilage pads do not appear in its place. With a hormonal imbalance, "chaos" sets in in all vital systems, this also applies to the locomotor system, so in the affected areas the tissues do not regenerate, but destruction + deformation occurs.

Osteoarthritis symptoms:

Degrees and periods of osteoarthritis.	Description of symptoms.
I degree	Weak and short-lasting pain with precise location. Rapid fatigue of the sore joint. The pain intensifies after long walks, running, or lifting weights and disappears after rest. A slight clicking sound is heard when bending or performing other movements. There are no visual changes + palpation, the anatomical shape of the joint is preserved, no swelling is observed.
second grade	Discomfort in the affected joints, stiffness is noted after rest. Partial traffic restrictions. Night pains, as well as pains depending on weather conditions. When bending and performing other movements, a characteristic loud click appears. There are visual and palpation changes: the joints increase and shorten, in addition, when pressure is applied, the patient responds sharply to acute pain.
III degree	Complete discomfort is noted in the affected joints, joint instability or ankylosis. The movement is paralyzed. There are constant, sharp or painful pains at night. The anatomical shape of the joints is lost: thickening/shortening and displacement of the axis of the joint structure. There is swelling + pain when pressing. The gait changes, due to the preservation of the organ of movement, the shape of the bone skeleton changes. The movement is carried out with the help of a cane or crutches. With morphological changes with an infectious factor or pinched nerves, a high temperature (37-38 degrees) appears.
Periods 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 has reflex spasms, forming painful contractures. Osteoarthritis is characterized by muscle cramps. As the destruction increases, the pain syndrome becomes more pronounced. With reactive synovitis, the joint increases in size and acquires a spherical shape. Fluid appears in the joints, which on palpation creates a fluctuation effect. During a brief remission, the pain subsides, but movement is difficult.

Timely detection of pathology through diagnostic tests and consultation with the necessary specialists will help to overcome the second and third stages, maintaining the functionality and health of all joint groups of the musculoskeletal system until old age.

Diagnostic measures

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

The list of studies consists of:

• General and biochemical blood tests.
• Blood test for rheumatoid agent.
• Analysis of urine and feces.
• Radiological examination: image in three positions.
• CT scan of the joint to clarify the bone structure.
• Magnetic resonance imaging of the joint: study of ligaments and muscles.
• Computed tomography.

Important!Patients with osteoarthritis should consult an orthopedist, rheumatologist, endocrinologist, hematologist, oncologist, and it is recommended that patients consult a gynecologist.

Treatment regimen

Therapeutic tactics include a wide range of measures aimed at eliminating the root cause, correcting the nutritional diet, restoring the lost function + a gentle lifestyle, that is, without special physical activity (long walks, running, carrying heavy objects). The therapeutic treatment regimen consists of pharmacotherapy, local treatment, physiotherapeutic procedures and exercise therapy. In parallel with these methods, home remedies are used.

Drug therapy for osteoarthritis.

Complex therapy consists of:

1. Medicines from the NSAID group;
2. Pain relievers (tablets + injections);
3. Medicines that relieve muscle spasms (muscle relaxants);
4. Restorers of cartilage tissue (chondroprotectors);
5. Antibiotics;
6. Antihistamines;
7. Medicines that improve blood circulation;
8. Vitamins: B2, B12, PP and A;
9. Antioxidants: vitamin C;
10. Medications based on hormonal substances.

It is recommended to include in the rheumatoid arthritis treatment regimen:

• Gold-based medicines;
• Immunosuppressants;
• Antimalarial drugs;
• Medications that inhibit malignant cells.

Attention!During the remission of the pathology, non-steroidal anti-inflammatory drugs are not recommended, which affect the gastrointestinal tract, cause numerous ulcers, and also inhibit the process of nutrition of cartilage tissue.

Ointments for local use for osteoarthritis.

Local treatment has a direct effect. The gels and ointments contact directly the affected tissues, quickly reaching the site, eliminating pain and inflammation. Preparations in the form of gels are widely used to restore the cartilage layer. For local application, warming + anti-inflammatory ointments are used.

Physiotherapy

Relief of spasmodic pain with reduction of inflammation + improvement of trophism and innervation is carried out with the help of physiotherapy. Exacerbation phases are eliminated or shortened by laser therapy, magnetic fields and ultraviolet irradiation. In the remission phase of osteoarthritis, that is, during the calm phase, electrophoresis procedures using dimethyl sulfoxide and anesthetics are useful. Destructive and inflammatory processes are affected by phonophoresis with glucocorticosteroids, inductothermy, thermal application of ozokerite or paraffin, as well as sulfur, radon and sea baths. The muscle corset is strengthened by electrical stimulation.

Surgery

The problem of a deformed/ankylosed joint is finally solved by surgical operations such as endoprostheses, as well as a palliative method of unloading the joint framework (coxarthrosis is eliminated by transtrochanteric osteotomy + fenestration of the femoral fascia; gonarthrosis is corrected by arthrotomy with cleanliness). of the intra-articular space from remains of destruction plus artificial augmentation of cartilage). If the bone is completely disabled, 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 eliminates pain and restores lost function. There are isolated cases of complete healing by traditional methods using the following tinctures, ointments and compresses:

1. Garlic + onion and honey tincture: 100 g of garlic pulp + 100 g of chopped onion + 2 large spoons of honey + 200 ml of vodka. Infuse 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 medicinal alcohol, leave for 24 hours. Drink one tablespoon before meals 3 times a day.
3. Ointment based on badger fat and propolis: rub for joints, apply twice a day.
4. Table horseradish + honey: 100 g horseradish + 100 g honey + 100 ml vodka. Infuse for 24 hours, drink 20 drops. This tincture can be rubbed on sore joints 3 to 5 times a day.
5. Hot pepper ointment + pork fat: 1 teaspoon of powder + 200 g of fat. Infuse for 2-3 days. It is used as a local medicine for warmth. Apply 1-2 per day.
6. Compress: oak bark + spruce needles: 200 g of oak bark + 200 g of crushed spruce needles + 100 ml of alcohol.

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

Prevention features.

Prevention is an effective tool to prevent diseases, destruction and deformation of the joints. For preventive purposes, you should do the following:

• Adjust the menu, from which fried, fatty, spicy, salty, alcohol + nicotine are excluded.
• Add gelatins and jellies to your daily menu.
• Avoid strenuous loads.
• Increase safety precautions to avoid injuries.
• Constantly perform a special series of exercises for the musculoskeletal system.
• Try taking vitamins B and C.
• For preventive purposes, take chondroprotectors, calcium, potassium and other mineral supplements once every six months.
• After a joint sprain or mechanical injury, you should be examined by a doctor.

Added to the list is the performance of constant physical exercises to improve blood flow, innervation and the restoration of the cartilage layer of the joints. These exercises are prescribed by a doctor.

Summary

Destruction with deformation of the joints begins at 38-40 years, so there is no need to delay the fight against this pathology. A neglected condition can lead to a wheelchair, and a timely response to the disease with effective treatment is a clear success towards recovery. It is impossible to treat osteoarthritis on your own; this type of pathology refers to metabolic disorders directly related to changes in hormonal levels or chronic pathologies of other systems. At the first symptoms, contact a traumatologist or surgeon, do not delay, otherwise you will be treated only in a surgical department with long rehabilitation.