What is arthrosis? Pathology causes, symptoms and treatment

Arthrosis is a chronic pathology aimed at damaging the articular structures of the locomotor system. The main cause of chronic disease is a metabolic imbalance that leads to a progressive process of a degenerative-dystrophic nature. The targets of the damaging reaction are articular cartilage, connective tissue, bursa, tendons, bones and muscle corset. In the chronic form of the pathology, the periarticular muscles are involved in the inflammatory process, lose their anatomical flexibility due to joint deformation and swelling. In order to eliminate the complications associated with inhibiting the biomotility of the skeleton and not become disabled, you need to arm yourself with information about arthrosis - what it is, what are its causes, symptoms and treatment.

Causes and risk factors for the development of pathology

The inflammatory-destructive process in the joints often begins without any reason. Idiopathic (primary) arthrosis has this beginning. The mechanism of development of secondary arthrosis begins after certain conditions and factors, namely:

• Joint injury (fracture, meniscus damage, ligament tear, dislocation, compression + bruise, bone fracture).
• Dysplasia (abnormal intrauterine development of articular components).
• Disturbance of material metabolism.
• Autoimmune-type pathologies (rheumatoid arthritis, psoriasis, autoimmune toxic goiter, systemic lupus erythematosus).
• Non-specific destructive arthritis (with purulent component).
• Infections of various etiologies (tuberculosis, meningitis, encephalitis, gonorrhea, syphilis, hepatitis).
• Pathologies of endocrine glands (diabetes mellitus, toxic goiter, pathology of adrenal glands and pituitary gland).
• Hormonal dysfunction (decrease in the level of estrogens, androgens).
• Degenerative + dystrophic reactions (multiple sclerosis, Perthes disease).
• Oncological diseases.
• Blood diseases (hemophilia, anemia, leukemia).

Risk factors that provoke and lead to arthrosis:

1. Age-related changes.
2. Obesity (excessive body weight causes constant vertical loads, which causes the joints to be overloaded, wear out quickly, and lose cartilage plates).
3. Professional costs, that is, the load on a certain group of joints, which leads to their inflammation or premature destruction before other groups.
4. Postoperative results: highly traumatic surgery with extirpation of affected tissues (soft, cartilage, bone). After restorative manipulations, the joint structure does not have the same consolidation, so any load leads to arthrosis.
5. Hereditary factor, that is, arthrosis can affect one or more family members.
6. Hormonal imbalance during menopause or after removal of ovaries in women and prostate gland in men.
7. Violation of water-salt balance.
8. Neurodystrophic damage of the spine is the trigger of glenohumeral, lumbosacral and femoral arthritis-arthrosis.
9. Intoxication with pesticides, heavy metals.
10. Sudden changes and temperature changes with hypothermia.
11. Permanent trauma of a certain group of joints.

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

Mechanism of development of arthrosis

The basis of the triggering mechanism of arthrosis is the disruption of the chain of regeneration processes of cartilage cells and the correction of affected connective tissue areas by young cells. Cartilaginous plates tightly cover the terminal surfaces of the bones that are part of the musculoskeletal joints. Normal cartilage is anatomically strong, smooth, flexible, and glides thanks to synovial fluid, a biological material that lubricates the components inside the joint. It is the synovial fluid that ensures the unhindered movement of the articular components relative to each other.

Cartilage tissue and synovial lubrication perform the main function of shock absorption by reducing the wear of cartilage-covered bones. The ends of the bones are separated by sacs of fluid, and ligaments and a corset of muscles firmly stabilize them. The specific configuration and plexus of the musculo-ligamentous apparatus allows this structure to perform precise biomechanical movements such as flexion, extension, rotation + rotation. The design allows you to hold firmly in a certain position thanks to the intertwining of the ligaments, as well as make coordinated movements while maintaining the balance of the body.

High stress or hormonal imbalance leads to the destruction of the collagen plates that expose the bones. Sharp osteophytes appear in these areas, which cause pain with any movement of the musculoskeletal joints. Bones thicken, false joints develop between osteophytes, which completely change the functionality of the motor organ. Due to the trauma of the bursa (its rupture), there is less synovial fluid, and the entire joint structure, including the corset + muscles of the ligaments, begins to suffer. Joint swelling appears and microbial infection may also occur. Ossification zones cause limited movement and ankylosis of the joint.

Stages of clinical manifestation of joint pathology: stages

Arthrosis is characterized by three stages of development, which include:

• Phase I:there are no specific morphological changes, trophism is not disturbed, synovial fluid is produced in sufficient quantity. The stability of the joint structure corresponds to moderate physical activity. Joint pain and swelling appear with forced work.
• Phase II:depletion of the cartilage plate is observed, foci of osteophytic islands develop, ossification appears along the edges of the joint. The pain syndrome intensifies, the swelling increases, there is discomfort in movement. As the pathology progresses to the chronic stage, the pain is stable, accompanied by inflammation with periods of exacerbation/remission. Biomechanics is partially disturbed, the patient spares the joint.
• III stage:the cartilaginous plate wears out completely, instead of cartilage, osteophytes + a system of pseudo-stable interosteophytic connections develop at the ends of the bones. The anatomical shape is completely broken. Articular ligaments and muscles shorten and thicken. The slightest injury can cause dislocations, fractures and cracks. The trophism of the motor organs is damaged, so they do not receive the necessary amount of blood and nutrients. Compressed nerves lead to a severe pain response, which disappears only after taking strong painkillers or drugs from the COX1/COX2 group.

Conditionally, one more stage can be added: the fourth - the final stage with a bright clinical picture of inflammation, infection, unbearable pain, immobilization of diseased joints, high fever and a critical condition. This stage is the most severe and can lead to sepsis and death.

Arthritis pain syndrome

Pain is characteristic of arthrosis. They intensify with movement, physical activity, changes in weather conditions, changes in temperature, humidity level and atmospheric pressure. Pain can occur as a result of any body position or sudden movements. Walking, running and standing vertically for a long time puts a certain load on painful joints, after which sharp or painful pain begins. In the first and second stages of the 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 go away. The affected shock-absorbing layer, compressed nerves and blood vessels cause a stagnant process with disruption of trophism and accumulation of interstitial fluid. The swelling causes a sharp, throbbing pain.

Characteristic of arthrosis is pain after a long rest with a sharp motor impulse, this condition is called onset pain. The mechanism of development of these pains is osteophytic zones covered with destructive remnants of cartilage tissue, fibrin and viscous fluid. When the joints move, a film of these components or detritus covers the exposed areas, lubricating them and thus absorbing the pain. Blockage pain occurs after the destruction of products from the intra-articular space, that is, bone remnants or a large connective tissue film enters the muscles. There is another type of pain: constant, aching, exploding + regardless of movements, they are characteristic of reactive synovitis.

Attention!Blockade type of pain is suitable only for surgical intervention and then restoration of the affected joint. Treatment with folk remedies is not recommended, it is fraught with the development of purulent arthrosis with the spread of infection throughout the body, and obvious morphological changes occur in all organs and systems after sepsis.

Symptoms of joint inflammation

Symptoms are divided depending on the degree of development of the pathology. Arthrosis makes itself felt after 38-40 years, the joint cushioning system begins to wear out, and new or young cartilage pads do not appear in its place. With hormonal imbalance, "chaos" occurs in all vital systems, this also applies to the musculoskeletal system, so the tissues in the affected areas are not regenerated, but destruction + deformation occurs.

Symptoms of arthrosis:

Degrees and cycles of arthrosis	Description of symptoms
I degree	Weak, short-term pain with precise localization. Rapid fatigue of the painful joint. The pain worsens after long walks, jogging or lifting weights and disappears after rest. A faint clicking sound is heard during bending or other movements. There are no visual+palpation changes, the anatomical shape of the joint is preserved, swelling is not observed.
II degree	Discomfort in the affected joints, stiffness after rest is noted. Partial restriction of traffic. Pain at night, as well as pain depending on the weather. A characteristic loud click appears during bending and other movements. There are visual and palpation changes: the joints expand and shorten, moreover, when pressure is applied, the patient reacts sharply to acute pain.
III degree	Complete discomfort, joint instability or ankylosis is noted in the affected joints. Movement is paralyzed. There are constant sharp or aching pains at night. The anatomical shape of the joints is lost: thickening/shortening and displacement of the axis of the articular structure. There is swelling + pain when pressing. Due to the preservation of the motor organ, the gait changes, the shape of the bone skeleton changes. Movement is carried out with the help of a stick or crutches. A high temperature (37-38 degrees) appears with morphological changes due to an infectious factor or pinched nerves.
Periods of exacerbation and remission	Exacerbations in arthrosis are replaced by remissions. The pathology is aggravated by physical activity. Aggravation is caused by synovitis. The pain syndrome covers all affected areas, including the muscle corset. It reflexively spasms and produces painful contractures. Arthritis is characterized by muscle cramps. As the destruction increases, the pain syndrome becomes more pronounced. With reactive synovitis, the joint increases in size and takes on a spherical shape. During palpation, fluid appears in the joints, which creates a ripple effect. During a short remission, the pain decreases, but movement becomes difficult.

Timely detection of pathology using diagnostic tests and consultation with the necessary specialists will help to pass the second and third stages, maintaining the functionality and health of all joint groups of the locomotor 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 individual approach to each patient.

The list of studies includes:

• General and biochemical blood tests.
• Blood test for rheumatoid agent.
• Analysis of urine and feces.
• X-ray examination: description in three positions.
• CT scan of the joint to clarify the bone structure.
• Joint MRI: study of ligaments and muscles.
• Computed tomography.

It is important!Patients with arthrosis are recommended to consult an orthopedist, rheumatologist, endocrinologist, hematologist, oncologist, and female patients are recommended to consult a gynecologist.

Treatment regimen

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

Drug treatment for arthrosis

Complex therapy consists of:

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

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

• Gold-based drugs;
• Immunosuppressants;
• antimalarial drugs;
• Drugs that inhibit malignant cells.

Attention!Nonsteroidal anti-inflammatory drugs are not recommended during remission of the pathology, they affect the gastrointestinal tract, cause multiple ulcers, and also inhibit the nutrition process of cartilage tissue.

Ointments for local use for arthrosis

Local treatment has a direct effect. Gels and ointments come into direct contact with the affected tissues, quickly reach the site, relieve pain and inflammation. Preparations in gel form are widely used to restore the cartilage layer. Warming + anti-inflammatory ointments are used for local application.

Physiotherapy

Eliminating spasmodic pain by reducing inflammation + improving trophism and innervation is carried out with the help of physiotherapy. Exacerbation stages are eliminated or shortened by laser therapy, magnetic fields and ultraviolet radiation. Electrophoresis procedures using dimethyl sulfoxide and anesthetics are useful in the remission phase of arthrosis, i. e. the quiet phase. Phonophoresis with glucocorticosteroids, inductothermy, thermal applications of ozokerite or paraffin, as well as sulphide, radon and sea baths are affected by destructive and inflammatory processes. The muscle corset is strengthened by electrical stimulation.

Surgery

The problem of a deformed/ankylosed joint is finally solved by surgical operations such as endoprosthetics, as well as by a palliative method of loosening the joint frame (coxarthrosis is eliminated by transtrochanteric osteotomy + femoral fascia fenestration; gonarthrosis is cleared by arthrotomy. articular space from destruction remnants and artificial cartilage augmentation). If the bone is completely immobile, it is replaced with an artificial graft and the axis of the tibia is corrected.

Folk treatment

Traditional medicine helps relieve pain and inflammation, temporarily relieves pain and restores lost function. There are isolated cases of complete recovery by traditional methods using the following tinctures, ointments and compresses:

1. Garlic tincture + onion and honey: 100 g of garlic pulp + 100 g of chopped onion + 2 large spoons of honey + 200 ml of vodka. It is brewed for 3-5 days. Apply in the form of compresses and rubbing.
2. Sabelnik in the form of tincture: 200 g of dry powder or fresh gruel + 200 ml of diluted medical alcohol, leave for 24 hours. Drink one spoon before meals 3 times a day.
3. Ointment based on badger oil and propolis: rub on the joints, apply twice a day.
4. Table horseradish + honey: 100 g horseradish + 100 g honey + 100 ml vodka. Brew for 24 hours, drink 20 drops. This tincture can be applied to painful joints 3-5 times a day.
5. Hot pepper ointment + pork fat: 1 teaspoon of powder + 200 g of fat. It is brewed for 2-3 days. It is used as a warming local medicine. 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.

It is recommended to use all the listed prescriptions of traditional healers only after consulting a doctor. If the patient is allergic to certain drugs, their use is strictly prohibited, as they can cause anaphylactic shock.

Features of prevention

Prevention is an effective means of preventing joint diseases, destruction and deformation. For preventive purposes, you should:

• Adjust the menu that excludes fried, fatty, peppery, salty, alcohol + nicotine.
• Add jellies and jellies to your daily menu.
• Avoid tiring loads.
• Increase safety precautions to prevent injuries.
• Regularly perform a set of special exercises for the musculoskeletal system.
• Try taking B and C vitamins.
• For preventive purposes, take chondroprotectors, calcium, potassium supplements and other minerals once every six months.
• After a joint sprain or mechanical injury, undergo a medical examination.

The list is joined by doing regular physical exercises to improve blood supply, innervation and regeneration of the cartilage layer of the joints. These exercises are prescribed by a doctor.

Summary

Destruction by deformation of the joints begins after 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 on the road to recovery. It is impossible to treat arthrosis independently, 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 only receive treatment in the surgical department with long rehabilitation.