arthrosis- a disease that develops over many years with predominant damage to certain joints.Most often, painful changes affect large joints - knee, hip, shoulder, etc.The pain and difficulty in movement in them complicates a person's life physically and emotionally, and given that arthrosis often occurs at a young age, it can interfere with the achievement of professional and personal goals.That is why it is important to diagnose the disease as early as possible and start comprehensive treatment of arthrosis.
Treatment of arthrosis
At the initial stage of arthrosis, conservative methods are used that do not involve surgical intervention.At the same time, 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:
- non-steroidal anti-inflammatory drugs;
- GCS;
- Chondroprotectors.
- PRP therapy.
- therapeutic exercise.
- Massage and manual therapy.
- Traction therapy.
- Physiotherapy.
Physiotherapy techniques widely used in arthrosis:
- magnetic therapy;
- UHF;
- inductothermy;
- ultrasound therapy;
- balneotherapy;
- surgical treatment.
Treatment with drugs
There is a widespread opinion among patients that taking drugs with an analgesic effect (orally in the form of tablets or by injection - intramuscularly) is the most important method of pain relief in arthrosis.In fact, the use of drugs is a quick method of pain relief, which should be prescribed only in an acute period.The fact is that drugs widely prescribed for these purposes have serious side effects that increase with long-term and especially uncontrolled use.We are talking about the undesirable effects of the digestive, cardiovascular, and nervous systems, which can most likely bring the patient to the hospital (stomach bleeding, heart rhythm disturbances, effects on the liver and kidneys, etc.).
Nonsteroidal anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs- Nonsteroidal anti-inflammatory drugs, many of which are available without a prescription and are widely taken by patients on their own.This group includes preparations of different chemical structure.Medicines have a pronounced anti-inflammatory and analgesic effect, can reduce pain in the joint area and surrounding muscle tissue, but do not affect the development of the disease.They are used only to reduce symptoms at all stages of the disease.It is effective in accompanying synovitis (accumulation of fluid in the joint).
GKS- Glucocorticosteroid drugs have a strong anti-inflammatory and analgesic effect.It is advisable and effective to introduce 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, articular surfaces, and cartilage degeneration.But with periarticular administration, the risk of these complications is minimal.
Chondroprotectors- The substances are natural components of the cartilage tissue, which when taken orally contribute to the gradual restoration of the cartilage, normalizing its density and elasticity.These active ingredients are usually used in combination and are included in various medicines and auxiliary products.Chondroprotectors do not have a quick analgesic effect;Improvement develops during long-term use of drugs based on them, which is associated with partial restoration of cartilage tissue.It is recommended for all stages of the disease.
PRP therapy
One of the most modern methods of restorative medicine used in sports injuries and degenerative-dystrophic joint diseases is PRP therapy (PRP - platelet-rich plasma) or plasma biorevitalization, autoplasmotherapy.The technique is actively used abroad.
The essence of the procedureIt consists of injecting platelet-rich plasma directly into the injury site, in this case the joint.The drug for administration is obtained from the patient's own blood, so the method is considered not only highly effective, but also safe for humans.Growth factors and biologically active substances (serotonin, bradykinin, prostaglandins, etc.) contained in plasma rich in platelets contribute to the activation of regeneration processes and the synthesis of its own basic substances.
The resulting platelet-rich plasma is injected both periarticularly and directly into the damaged joint, thus achieving partial tissue recovery, mainly cartilage.
The technique is most commonly used in stages 1-2 of osteoarthritis.It shows good results and allows you to postpone the rapid development of the disease due to the release of growth factors by platelets.The method is relatively new, but it has been 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.Carrying out autoplasmic therapy allows you to increase the life of the joint without other aggressive interventions.
Synovial fluid protectants- a group of drugs based on hyaluronic acid, which are injected directly into the joint cavity (injection) and play the role of a viscous lubricating fluid in the case when the natural synovial fluid is almost completely absent (this is what provides the role of lubrication of the joint surfaces).It is used in the later stages of arthrosis.
Medicines of this group are also called "synovial fluid prostheses", "biological replacements of synovial fluid".After taking the drug, the effect is long-lasting - from 6 to 13 months, depending on the medication used.
Some applyOther groups of drugs- Antispasmodics, muscle relaxants, B vitamins in therapeutic (high) doses, but all of them have only auxiliary value in the treatment of arthrosis.
therapeutic exercise
Special therapeutic exercises can and should be used during exacerbations, at all stages of arthrosis.Such measures can reduce pain and prevent severe limitations of joint movement.However, the method is unpopular among patients with arthrosis, because most of them are mistaken in the belief that in case of pain it is necessary to limit any movement.On the contrary, the timely start of physical training contributes to quick recovery and reduction of symptoms, primarily pain.
Physiotherapy in water, joint movements in a relaxed state (lying, sitting, hanging) and moderate walking on a flat surface are 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 impact on joints, muscles and ligaments can reduce the severity of pain, increase mobility, improve blood circulation and metabolism in the area of affected joints, relieve muscle spasms and normalize muscle function.
Traction therapy
In a hospital environment or a medical sanatorium, it is possible to perform traction therapy - this is joint traction (hip, knee) using special techniques using different loads.The standard traction scheme is intended for 28 days, with a gradual increase in load and exposure time.Classical and more modern techniques using simulators are used.Their effectiveness is almost the same, but simulators are more comfortable for the patient.
Physiotherapy
At the initial stage of arthrosis, the use of various physical therapy techniques can achieve significant pain relief and increase mobility in the affected joints.Physiotherapy courses help to slow down the pathological process and prolong the period without exacerbation.
Physiotherapy techniques widely used in arthrosis:
magnetotherapy- local exposure to a constant or alternating low-frequency magnetic field.In the area of the damaged joint, metabolic processes are accelerated, blood circulation and supply of nutrients to the joint structures are increased, the processes of regeneration and synthesis of own substances necessary for the functioning of the joint are activated.
Magnetic therapy has an anti-swelling, pain-relieving, anti-inflammatory effect almost from the first session, which has a positive effect on the general condition of the patient.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 ability to conduct 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 development of pain, the beginning of an exacerbation or to conduct a preventive course - that is, to maintain normal health.
A positive aspect of magnetic therapy can also be called the beneficial effect of the procedures on the condition of the cardiovascular and nervous systems.Given that most patients with arthrosis are middle-aged and elderly people with an existing set of chronic diseases (arterial hypertension, coronary heart disease, atherosclerosis, etc.)
Ultrasound therapyIt is used more often together with the effects of drugs with anti-inflammatory, pain-relieving, restorative effects - ultraphonophoresis or phonophoresis.Ultrasound increases tissue permeability to drugs, so their main effect is enhanced.Even without a healing component, the method is very effective in arthrosis: ultrasound has a mechanical effect on tissue (micromassage), activates local immune and regenerative processes in the joint area and surrounding muscles, and 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 reflex expansion of blood vessels above the site of the pathological process.This leads to improvement of local blood flow, activation of metabolism, removal of insufficient oxidation of metabolic products and reduction of pain intensity.Laser therapy, due to the shallow depth of penetration, has a minimal systemic effect, while enhancing the therapeutic effect of other procedures.
Shock wave therapy- Method of high energy impact.It is based on the piezoelectric effect.Using piezoelectric discharge on the pathological focus, many effects are achieved.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 impact on the body with diadynamic pulse currents.The diadynamic currents used in this method rhythmically excite skin receptors, which indirectly leads to the activation of descending physiological mechanisms of pain suppression and leads to a reduction of the patient's pain, up to complete analgesia.Therefore, such procedures are effective for severe pain.
Electromyostimulation- Effects of electric current on muscle tissue.During arthrosis of large joints, the work of surrounding muscles is disturbed, which causes atrophy of some and overloading of others.A gait disorder develops.According to a special program, under the influence of alternating electric current, the muscles contract rhythmically, generating a certain amount of work, which leads to the restoration of their volume and function.
Cryotherapy- A simple and effective method of treatment, unfortunately, is 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, acceleration of local blood flow and activation of recovery processes.This method is especially effective in combination with shock wave therapy.
Balneotherapy.In the conditions of the sanatorium-resort, hydrotherapy is carried out - healing baths, among which radon baths are especially effective in arthrosis.The radioactive decay products of radon dissolved in water have a general effect on the body.The most important effect is the activation of metabolic processes.
A similar, though less pronounced effect is characteristic of medicinal mud (peloids), hydrogen sulfide and carbon dioxide baths.
surgical treatment
Surgical techniques are used in the late stage of arthrosis, when joint movement is severely limited or absent, which affects the patient's quality of life.Different methods of joint replacement are used all over the world, which makes it possible to fully restore the range of motion and return the patient to an active life at any age.
The attending physician determines the tactics and scope of surgical intervention;The choice is based on such parameters as the general condition of the patient, age and presence of concomitant diseases, overweight and others.After endoprosthesis, the best results were obtained in young and middle-aged patients (almost complete recovery of the range of motion), but even in elderly people, a significant improvement in their condition is observed, because after a successful operation and recovery, they can fully support themselves in everyday life and move not only in the apartment, but also outside, without limiting communication.
Prevention
Arthrosis belongs to the group of diseases of vertical walking and develops mainly as a result of age changes in the joints, enhanced 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 you to maintain physical activity and avoid massive medical intervention in the future.