Arthrosis- a disease that develops over many years, when damage to certain joints prevails.Most often, painful changes affect large joints - knees, hips, shoulders, etc.Pain and movement difficulties in them complicate a person's life physically and emotionally, and given that osteoarthritis often develops 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 complex treatment of arthrosis.
Treatment of arthrosis
In the initial stage of arthrosis, conservative methods are used that do not require surgical intervention.Meanwhile, the applied 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 in the treatment of arthrosis:
- magnetic therapy;
- UHF;
- induction temperature;
- ultrasound therapy;
- balneotherapy;
- surgical treatment.
Drug treatment
There is a common belief among patients that the use of analgesic drugs (oral tablets or intramuscular injections) is the most important way to relieve pain in arthrosis.In fact, the use of drugs is a method of quick pain relief, which should only be given in the 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 adverse effects of the digestive, cardiovascular, and nervous systems, which are very likely to cause the patient to be hospitalized (bleeding from the stomach, heart rhythm disorders, effects on the liver and kidneys, etc.).
Nonsteroidal anti-inflammatory drugs
NSAIDs- non-steroidal anti-inflammatory drugs, many of which are sold without a prescription and are widely used by patients themselves.Medicines of various chemical structures belong to this group.Medicines have a pronounced anti-inflammatory and analgesic effect, 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 reduce symptoms in all stages of the disease.Effective at the same time as synovitis (accumulation of fluid in the joint).
GKS- glucocorticosteroid drugs have a strong anti-inflammatory and analgesic effect.It is advisable and effective to administer them periarticularly.However, patients often negatively evaluate the use of these drugs during treatment, which is related to possible side effects: infectious complications, deterioration of ligaments, articular surface, cartilage degeneration.However, with periarticular use, the risk of these complications is minimal.
Chondroprotectors— substances are natural components of cartilage tissue, which, when taken orally, contribute to the gradual restoration of cartilage, normalize its density and elasticity.These active components are usually used together and are included in various drugs and auxiliary products.Chondroprotectors do not have a quick analgesic effect;improvement develops with long-term use of drugs based on them, which are associated with partial restoration of cartilage tissue.Recommended in all stages of the disease.
PRP therapy
One of the most modern methods of restorative medicine applied to the treatment of sports injuries and degenerative-dystrophic joint diseases is PRP therapy (PRP - platelet-enriched plasma) or plasma biorevitalization, autoplasmic therapy.The technique is actively used abroad.
The essence of the procedureconsists of injecting platelet-rich plasma directly into the site of injury, in this case the joint.The drug for use is 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 main substances.
The resulting platelet-enriched plasma is injected both periarticularly and directly into the damaged joint, thereby partially restoring the tissue, primarily the cartilage.
The method is most commonly used in stages 1-2 of osteoarthritis.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 areas 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 interventions.
Synovial fluid protection measures- 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 (namely, it plays 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 medication is long-lasting - from 6 to 13 months, depending on the medication used.
Some applyother groups of drugs- antispasmodics, muscle relaxants, vitamins of group B in therapeutic (large) doses, but all of them have only an auxiliary value in the treatment of arthrosis.
Therapeutic exercise
Special therapeutic exercise can and should be used even during an exacerbation, in all stages of arthrosis.Such measures can reduce pain and prevent serious restrictions on joint movement.However, the method is unpopular among patients with arthrosis, because most of them are mistaken in thinking that it is necessary to limit any movements in case of pain.On the contrary, physical activity started on time promotes faster recovery and reduction of symptoms, primarily pain.
Physiotherapy in water, joint movements in the unloading position (lying, sitting, hanging), 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 training should be started as early as possible.
Massage and manual therapy
Methods of mechanical impact on joints, muscles and ligaments can reduce the intensity of pain, increase mobility, improve blood circulation and metabolism in the area of damaged joints, relieve muscle spasms, and normalize muscle activity.
Traction therapy
Traction therapy can be performed in a hospital or medical sanatorium - this is pulling a joint (hip, knee) using a special technique, using various loads.The standard traction scheme is for 28 days, gradually increasing the load and exposure time.Classical and more modern techniques are used using simulators.Their efficiency is almost the same, but the simulators are more comfortable for the patient.
Physiotherapy
The application of various physical therapy methods in the initial stages of arthrosis can significantly reduce pain 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 in the treatment of 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 the supply of nutrients to the joint structures are increased, and the processes of regeneration and synthesis of own substances necessary for the functioning of the joint are activated.
Magnetotherapy has an anti-edematous, pain-relieving, anti-inflammatory effect almost from the first session, which positively affects the general condition of the patient.Magnetotherapy is successfully applied in hospitals and sanatoriums, where medical equipment of various modifications is used.
A huge advantage for patients with arthrosis is the ability to independently carry out magnetic therapy courses at home, as prescribed and under the supervision of the attending physician.Timely use of portable magnetic therapy devices allows you to stop the onset of pain, the beginning of an exacerbation or to carry out a preventive course - that is, to maintain normal health.
The positive aspect of magnetic therapy can also be called the positive effect of the procedures on the condition of the cardiovascular and nervous systems.Given that the majority of arthrosis patients are middle-aged and elderly people with chronic diseases (arterial hypertension, coronary heart disease, atherosclerosis, etc.), the mild sedative and stabilizing effect of magnetic therapy will be very useful.
Ultrasound therapymore often used together with drugs with anti-inflammatory, analgesic, restorative effects - ultraphonophoresis or phonophoresis.Ultrasound increases the permeability of tissues to drugs, thus enhancing their main effect.Even without a medicinal component, the method is very effective in arthrosis: ultrasound affects tissues mechanically (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 reflex expansion of blood vessels above the site of the pathological process.As a result, local blood circulation improves, metabolism is activated, insufficiently oxidized metabolic products are removed, and pain intensity decreases.Due to the low penetration depth, laser therapy has a minimally pronounced systemic effect, while enhancing the therapeutic effect of other procedures.
Shock wave therapy- high energy exposure method.It is based on the piezoelectric effect.The application of piezoelectric discharge in the pathological focus achieves a number of effects.Dead cells are destroyed, so local immunity is activated.Hibernating (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- a method of therapeutic effect on the body with diadynamic pulse currents.The diadynamic currents used in this method rhythmically excite skin receptors, which indirectly activates descending physiological mechanisms of pain inhibition and reduces the patient's pain to complete analgesia.Therefore, such procedures are effective in severe pain.
Electromyostimulation- the effect of electric current on muscle tissue.In the case of arthrosis of the large joints, the work of the surrounding muscles is impaired, as a result of which some atrophy, while others are overloaded.A gait disorder develops.Under the action of alternating electric current according to a special program, the muscles contract rhythmically, produce a certain amount of work, which restores their volume and function.
Cryotherapy- a simple and effective method of treatment, unfortunately, rarely used.The local effect of low temperature reduces the sensitivity of pain receptors and the synthesis of biologically active substances that promote the development of inflammation.After cryotherapy, reflex expansion of blood vessels occurs, local blood flow accelerates, and 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 - therapeutic baths, among which radon baths are especially effective for 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 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, which affects the patient's quality of life.All over the world, various joint replacement techniques are used, which allow to completely restore the range of motion and return the patient to an active life at any age.
The tactics and scope of surgical intervention are determined by the attending physician;The choice is based on parameters such as the general condition of the patient, age and the presence of concomitant diseases, overweight, etc.The best results after endoprosthesis were obtained in young and middle-aged patients (almost complete restoration of the range of motion), but the condition of older people has also improved significantly, because after a successful operation and recovery, they can fully settle in everyday life and move not only in the apartment, but also go outside, not limited to communication.
Prevention
Arthrosis belongs to the group of diseases of upright walking and develops mainly due to age-related changes in the joints, which are enhanced by the influence of external negative factors.Attention to the condition of the musculoskeletal system, prevention of joint diseases and treatment of arthrosis in the early stages allows maintaining physical activity and avoiding mass medical intervention in the future.