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 impaired movement in them physically and emotionally complicate a person's life, and considering the fact that arthrosis often occurs at a young age, it can hinder the achievement of professional and personal goals.That is why 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.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 life of a person.
- Drug treatment:
- NSAIDs;
- GCS;
- chondroprotectors.
- PRP therapy.
- Therapeutic exercise.
- Massage and manual therapy.
- Traction therapy.
- Physiotherapy.
Physiotherapy techniques that are 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 alleviating pain in arthrosis.In fact, the use of drugs is a method of quick relief from pain, which should be prescribed only in the acute period.The fact is that the drugs that are widely prescribed for these purposes have serious side effects, which increase with long-term and especially with uncontrolled use.We are talking about side effects from the digestive, cardiovascular, nervous system, which with a high probability can lead the patient to a hospital bed (stomach bleeding, heart rhythm disturbance, effects on the liver and kidneys, etc.).
Nonsteroidal anti-inflammatory drugs
NSAIDs- non-steroidal anti-inflammatory drugs, many of them 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 simultaneous synovitis (accumulation of fluid in the joint).
GCS— glucocorticosteroid drugs have a strong anti-inflammatory and analgesic effect.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 surface and cartilage degeneration.But with periarticular administration, the risk of these complications is minimal.
Chondroprotectors- the substances are natural components of cartilage tissue, which, when taken orally, contribute to the gradual restoration of cartilage, normalizing its density and elasticity.These active components are usually used in combination 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 is associated with 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, which is used for sports injuries and degenerative-dystrophic joint diseases, is PRP therapy (PRP - plasma rich in platelets) or plasma biorevitalization, autoplasma therapy.The technique is actively used abroad.
The essence of the procedureit consists of injecting platelet-rich plasma directly into the site of injury, 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 other biologically active substances (serotonin, bradykinin, prostaglandins, etc.) contained in plasma rich in platelets contribute to the activation of regeneration processes and synthesis of its own basic substances.
The resulting plasma rich in platelets is injected both periarticularly and directly into the affected joint, which achieves a partial restoration of the tissue, primarily the 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 proven to be very effective.PRP therapy was first used in surgery;today the technique is successfully used in many areas of medicine, including rheumatology and orthopedics, neurology and cosmetology.Carrying out autoplasma therapy allows you to increase the life of the joint without other aggressive interventions.
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 (that is, it provides the role of lubrication of the articular surfaces).It is used in the later stages of arthrosis.
Medicines from this group are also called "synovial fluid prostheses", "biological substitutes for synovial fluid".The effect after the administration of the drugs is long-lasting - from 6 to 13 months, depending on the drug used.
Some applyother groups of drugs- antispasmodics, muscle relaxants, group 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 even during 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, because most of them are mistaken in the belief that in case of pain it is necessary to limit any movements.The timely start of physical exercises, on the contrary, promotes faster recovery and reduction of symptoms, especially pain.
Especially effective are physical therapy in water, joint movements in 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 wrist, but physical education should be started as early as possible.
Massage and manual therapy
Methods of mechanical impact on the joint, 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.
Traction therapy
In hospital conditions or a medical sanatorium, it is possible to carry out traction therapy - this is pulling the joint (hip, knee) using a special technique using different loads.The standard traction scheme is designed for 28 days, with a gradual increase in the time of loading and exposure.Classical techniques and more modern ones 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 exacerbations.
Physiotherapy techniques that are 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 the delivery of nutrients to the joint structures are increased, the processes of regeneration and synthesis of the own substances necessary for the functioning of the joint are activated.
Magnetic therapy has an anti-edematous, analgesic, anti-inflammatory effect 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 equipment with 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.The timely use of portable magnetic therapy devices allows you to stop developing pain, start an exacerbation or 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.Taking into account the fact that most patients with arthrosis are middle-aged and elderly with an existing set of chronic diseases (arterial hypertension, coronary heart disease, atherosclerosis, etc.), the mild sedative and stabilizing effect of magnetic therapy will be very useful.
Ultrasound therapyit is used more often in combination with the effects of drugs with anti-inflammatory, analgesic, restorative effects - ultraphonophoresis or phonophoresis.Ultrasound increases the permeability of tissues to drugs, so their main effect is enhanced.Even without a medical component, the method is very effective for arthrosis: ultrasound has a mechanical effect on the tissue (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 commonly 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 insufficiently oxidized metabolic products and reduction of pain intensity.Laser therapy, due to the small depth of penetration, has a minimal systemic effect, while at the same time it enhances the therapeutic effect of other procedures.
Shock wave therapy– high-energy influence method.It is based on the piezoelectric effect.By applying 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– 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 reduction of the patient's pain, to complete analgesia.Therefore, such procedures are effective for severe pain.
Electromyostimulation– exposure to electric current of muscle tissue.With arthrosis of large joints, the work of the surrounding muscles is disturbed, which leads to atrophy of some and overloading of others.A gait disorder develops.When exposed to alternating electric current according to a special program, the muscles rhythmically contract, 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, 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, reflex expansion of blood vessels occurs, local blood flow accelerates and recovery processes are activated.This method is particularly effective in combination with shock wave therapy.
Balneotherapy.In the conditions of a sanatorium-resort, 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, although less pronounced effect is characteristic of therapeutic baths with mud (peloids), hydrogen sulfide and carbon dioxide.
Surgical treatment
Surgical techniques 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 methods of joint replacement are used, which allow full restoration of the range of motion and return of the patient to an active life at any age.
Tactics and extent 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, excess weight and others.The best results after endoprosthetics are achieved in young and middle-aged patients (almost complete restoration of the range of motion), but also in elderly people there is a significant improvement in their condition, because after a successful operation and recovery they can fully provide themselves in everyday life and move not only in the apartment, but also go outside, without limiting themselves in communication.
Prevention
Arthrosis belongs to the group of diseases of upright walking and develops mainly as a result of age-related 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 in the early stages allows you to maintain physical activity and avoid massive medical intervention in the future.