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.Pain and difficulty moving in them complicate a person's life physically and emotionally, and given the fact that arthrosis often appears 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 soon as possible and start comprehensive treatment of arthrosis.
Treatment of arthrosis
In the initial stage of arthrosis, conservative methods are used that do not involve surgical intervention.Meanwhile, the correction methods used 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 a person's life.
- Drug treatment:
- NSAIDs;
- GCS;
- chondroprotectors.
- PRP therapy.
- Therapeutic exercises.
- Massage and manual therapy.
- Withdrawal therapy.
- Physiotherapy.
Physiotherapy techniques widely used for arthrosis:
- magnetic therapy;
- UHF;
- inductothermy;
- ultrasound therapy;
- balneotherapy;
- surgical treatment.
Drug treatment
There is a widespread belief among patients that taking drugs with an analgesic effect (orally in the form of tablets or by injection - intramuscularly) is the most important method for relieving pain in arthrosis.In fact, the use of medications is a method of quick pain relief, which should be prescribed only in the acute period.The fact is that drugs widely prescribed for these purposes have serious side effects, which increase with long-term use and especially with uncontrolled use.We are talking about unwanted effects from the digestive, cardiovascular, nervous system, which with a high probability can lead the patient to the hospital bed (stomach bleeding, heart rhythm disorders, effects on the liver and kidneys, etc.).
Nonsteroidal anti-inflammatory drugs
NSAIDs- Non-steroidal anti-inflammatory drugs, many of which are available without a prescription and are widely taken by patients themselves.This group includes drugs of different chemical structures.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 for accompanying synovitis (accumulation of fluids in the joints).
GKS— Glucocorticosteroid drugs have a strong anti-inflammatory and analgesic effect.Their periarticular administration is advisable and effective.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 surface and cartilage degeneration.But with periarticular administration, 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 ingredients are usually used in combination and are included in various medications and ancillary products.Chondroprotectors do not have a rapid analgesic effect;improvement develops with long-term use of drugs based on them, which is accompanied by partial restoration of cartilage tissue.It is recommended in all stages of the disease.
PRP therapy
One of the most modern methods of restorative medicine, used for sports injuries and degenerative-dystrophic joint diseases, is PRP therapy (PRP - platelet-rich plasma) or plasma biorevitalization, autoplasma 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 administration is taken 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.) included 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, thus achieving partial tissue restoration, mainly cartilage.
The technique is most applicable in stages 1-2 of osteoarthritis.It shows good results and allows you to delay the rapid development of the disease due to the release of growth factors from platelets.The method is relatively new, but it has been proven to be very effective.PRP therapy was first used in surgery;today the technique is successfully used in many fields of medicine, including rheumatology and orthopedics, neurology and cosmetology.Performing autoplasma therapy allows you to increase 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 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 lubricating the articular surfaces).It is used in the later stages of arthrosis.
Medicines of this group are also called "prosthetics of synovial fluid", "biological substitutes of synovial fluid".The effect after drug administration 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 have only auxiliary value in the treatment of arthrosis.
Therapeutic exercises
Special therapeutic exercises can and should be used even during an exacerbation, in all stages of arthrosis.Such measures can reduce pain and prevent severe limitations in joint movement.However, the method is unpopular among patients with arthrosis, as most of them are mistaken in the belief that in case of pain it is necessary to limit any movement.The timely start of physical exercises, on the contrary, promotes faster recovery and reduction of symptoms, mainly pain.
Especially effective are physical therapy in water, joint movements in a unloading position (lying, sitting, hanging) and moderate walking on a flat surface.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 soon 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 the affected joints, relieve muscle spasms and normalize muscle function.
Withdrawal therapy
In a hospital setting or in a medical sanatorium, it is possible to perform traction therapy - this is pulling the joint (hip, knee) using a special technique using different loads.The standard withdrawal scheme is designed 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 the simulators are more comfortable for the patient.
Physiotherapy
The use of various physical therapy techniques in the initial stages of arthrosis can achieve significant pain relief and increased mobility in the affected joints.Physiotherapy courses help to slow down the pathological process and prolong the period without irritations.
Physiotherapy techniques widely used for arthrosis:
Magnetotherapy- local exposure to a constant or alternating low-frequency magnetic field.In the area of the affected joint, metabolic processes are accelerated, blood circulation and distribution of nutrients to the joint structures are increased, the processes of regeneration and synthesis of substances necessary for the functioning of the joint are activated.
Magnetic therapy has anti-edematous, analgesic, anti-inflammatory effects almost from the first session, which positively affects the general condition of the patient.Magnetic therapy is successfully used in hospitals and sanatoriums, where medical devices of various modifications are used.
A great advantage for patients with arthrosis is the ability to carry out independent courses of magnetic therapy at home, as prescribed and under the supervision of the attending physician.The timely use of portable magnetic therapy equipment allows you to stop the development of pain, the beginning of a deterioration or to carry out 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 state of the cardiovascular and nervous systems.Considering the fact that most patients with arthrosis are middle-aged and elderly people with an existing group of chronic diseases (arterial hypertension, coronary heart disease, atherosclerosis, etc.), the mild soothing and stabilizing effect of magnetic therapy will be very useful.
Ultrasound therapyit is most often used in combination with the effects of drugs with anti-inflammatory, analgesic, restorative effects - ultraphonophoresis or phonophoresis.Ultrasound increases tissue permeability to drugs, so their main effect increases.Even without a medicinal component, the method is very effective for arthrosis: ultrasound has a mechanical effect on tissues (micromassage), activates local immune and regenerative processes in the joint area and adjacent muscles, and has a pronounced analgesic and anti-inflammatory effect.
Laser therapy– one of the most common and most used procedures.The therapeutic effect is based on the reflex expansion of blood vessels on the site of the pathological process.This leads to an improvement of local blood circulation, activation of metabolism, removal of hypooxidized metabolic products and reduction of pain intensity.Laser therapy, due to its small penetration depth, has a minimally pronounced systemic effect, while increasing the therapeutic effect of other procedures.
Shock wave therapy– high energy impact method.It is based on the piezoelectric effect.By applying a piezoelectric discharge to a pathological focus, a number of effects are achieved.Non-viable cells are destroyed, which leads to the activation of local immunity.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 effects on the body with diadynamic pulse currents.The diadynamic currents used in this method rhythmically excite the skin receptors, which indirectly leads to the activation of the descending physiological mechanisms of pain suppression and leads to a decrease in the patient's pain, up to complete analgesia.Therefore, such procedures are effective for severe pain.
Electrostimulation– exposure to electric current in muscle tissue.With arthrosis of the large joints, the work of the surrounding muscles is disturbed, which leads to atrophy of some and overloading of others.A disturbance in walking develops.When exposed to alternating electric current according to a special program, the muscles contract rhythmically, producing 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, a reflex expansion of blood vessels occurs, local blood flow is accelerated and recovery processes are activated.This method is particularly effective in combination with shock wave therapy.
Balneotherapy.In the conditions of the sanatorium, hydrotherapy is carried out - medical baths, among which radon baths are especially effective for arthrosis.There is a general effect on the body of radioactive decay products of radon dissolved in water.The most important effect is the activation of metabolic processes.
A similar effect, although less pronounced, is characteristic of therapeutic baths of mud (peloids), hydrogen sulphide and carbon dioxide.
Surgical treatment
Surgical techniques are used in the late stages of arthrosis, when joint mobility is very limited or absent, which affects the patient's quality of life.Various methods of joint replacement are used all over the world, which make it possible to fully restore the range of motion and return the patient to an active life at any age.
The tactics and purpose of the 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, excess weight and others.The best results after endoprosthetics were obtained in young and middle-aged patients (almost complete restoration of the range of motion), but even in the elderly there is a significant improvement in their condition, since after a successful operation and recovery they can fully provide for themselves in everyday life and move not only inside the apartment, but also go outside, without being limited in communication.
Preventing
Arthrosis belongs to the group of walking diseases and develops mainly as a result of age-related changes in the joints, increased by the influence of negative external factors.Attention to the condition of the musculoskeletal system, prevention of joint diseases and treatment of arthrosis in the early stages allows you to maintain physical activity and avoid massive medical intervention in the future.