Arthrosis- a disease that develops over many years with predominant damage to certain joints.Often, painful changes occur in large joints - knees, hips, shoulders, etc.Therefore, it is important to diagnose the disease as early as possible and start comprehensive treatment of arthrosis.
Treatment of arthrosis
In the initial stage of arthrosis, conservative methods that do not involve surgical intervention are used.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 a person's quality of life.
- Drug treatment:
- NSAIDs;
- GCS;
- chondroprotectors.
- PRP therapy.
- Therapeutic exercise.
- Massage and manual therapy.
- Traction therapy.
- Physiotherapy.
Physiotherapy methods widely used for 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 way to relieve pain during arthrosis.In fact, the use of drugs is a quick pain relief method that should be prescribed only 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 undesirable effects from the digestive, cardiovascular, and nervous systems that can lead the patient to a hospital bed with a high probability (gastric bleeding, heart rhythm disturbances, 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 self-administered by patients.This group includes drugs of various 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 at all stages of the disease.It is effective for simultaneous synovitis (fluid accumulation in the joint).
GKS— glucocorticosteroid preparations have a strong anti-inflammatory and pain-relieving effect.Administering them periarticularly is appropriate and effective.However, patients often have a negative attitude to the use of these drugs in treatment, which is associated with possible side effects: infectious complications, degeneration of ligaments, joint surfaces and cartilage.However, with periarticular administration, the risk of these complications is minimal.
Chondroprotectors— the substances are natural components of cartilage tissue, when taken orally, they contribute to the gradual restoration of cartilage, normalize its density and elasticity.These active ingredients are usually used in combination and included in various pharmaceuticals and auxiliary products.Chondroprotectors do not have a quick analgesic effect;improvement develops with long-term use of drugs based on them, which is due to the partial restoration of cartilage tissue.It is recommended in all stages of the disease.
PRP therapy
One of the most modern methods of regenerative medicine used in sports injuries and degenerative-dystrophic diseases of the joints 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 in the injection of platelet-rich plasma directly into the injured area, in this case joint injection.For administration, the drug is taken 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 platelet-rich plasma contribute to the activation of regeneration processes and the synthesis of their main substances.
The resulting platelet-rich plasma is injected both periarticularly and directly into the affected joint, thereby achieving partial tissue regeneration, primarily cartilage.
The technique is most often used in stages 1-2 of osteoarthritis.It shows good results and allows delaying the rapid development of the disease due to the release of growth factors by platelets.The method is relatively new, but its high efficiency has been proven.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 to increase the life of the joint without any other aggressive interventions.
Synovial fluid protectors- a group of drugs based on hyaluronic acid, which are injected directly into the joint cavity (injection) and act as a viscous lubricant in the almost complete absence of natural synovial fluid (it provides the role of lubrication of articular surfaces).It is used in the later stages of arthrosis.
Medicines in this group are also called "synovial fluid prostheses", "biological replacements of synovial fluid".After the administration of drugs, the effect is long-lasting - from 6 to 13 months, depending on the drug used.
Some applyother drug groups- 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 at all stages of arthrosis, even during exacerbations.Such measures can reduce pain and prevent severe limitations in joint movement.However, the method is not popular among patients with arthrosis, because most of them believe that it is necessary to limit any movement in case of pain.The timely start of physical exercises, on the contrary, helps to recover faster and reduce symptoms, primarily pain.
Especially effective are physical therapy in water, joint movements in a relaxed state (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 begin as early as possible.
Massage and manual therapy
Methods of mechanical action on joint, muscles and ligaments can reduce the severity of pain, increase mobility, improve blood circulation and metabolism in the area of the affected joints, eliminate muscle spasms and normalize muscle function.
Traction therapy
It is possible to carry out stretching therapy in a hospital setting or in a medical sanatorium - this is stretching of the joint (hip, knee) using special techniques using different loads.The standard traction scheme is designed for 28 days with a gradual increase in the load and duration of exposure.Classical methods and more modern ones are used using simulators.Their effectiveness is almost the same, but simulators are more comfortable for the patient.
Physiotherapy
In the initial stages of arthrosis, the use of various physical therapy methods 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 methods widely used for arthrosis:
Magnetotherapy— local effect on constant or changing low-frequency magnetic field.Metabolic processes in the affected joint area are accelerated, blood circulation and the delivery of nutrients to the joint structures are increased, and the processes of regeneration and synthesis of its own substances necessary for the functioning of the joint are activated.
Magnetic therapy has an anti-edema, 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 applied in hospitals and sanatoriums where various modified medical equipment is used.
A great advantage for patients with arthrosis is the ability to conduct independent magnetic therapy courses at home, as prescribed and under the supervision of the attending physician.Timely use of portable magnetic therapy devices allows to stop the development of pain, the beginning of exacerbation or to carry out a preventive course, that is, to maintain normal health.
The positive side of magnetic therapy can also be called the beneficial effect of the procedures on the condition of the cardiovascular and nervous systems.Considering that the majority of patients with arthrosis are middle-aged and elderly people with an existing set of chronic diseases (arterial hypertension, ischemic heart disease, atherosclerosis, etc.), the mild soothing and stabilizing effect of magnetic therapy will be very useful.
Ultrasound therapymore often it is used in combination with the effect of drugs with anti-inflammatory, analgesic, restorative effect - ultraphonophoresis or phonophoresis.Ultrasound increases tissue permeability for drugs, so their main effect is enhanced.Even without a drug component, the method is highly 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 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 less oxidized metabolic products and reduction of pain intensity.Due to the depth of penetration, laser therapy enhances the therapeutic effect of other procedures and has a minimal systemic effect.
Shock wave therapy– high energy impact method.It is based on the piezoelectric effect.By applying a piezoelectric discharge in the pathological focus, a number of effects are achieved.Non-viable cells are destroyed, which leads to the activation of local immunity.Hibernating (dormant) 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 the skin receptors, which indirectly leads to the activation of the descending physiological mechanisms of pain suppression and leads to the reduction of the patient's pain to complete analgesia.Therefore, such procedures are effective for severe pain.
Electromyostimulation- electric current exposure to 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.Gait disorder develops.When exposed to an alternating electric current according to a special program, the muscles contract rhythmically, 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, it is rarely used.The local effect of 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 especially effective in combination with shock wave therapy.
Balneotherapy.Hydrotherapy is carried out in sanatorium-resort conditions - medical baths, among which radon baths are especially effective for arthrosis.Radioactive decay products of water-soluble radon have a general effect on the body.The most important effect is the activation of metabolic processes.
A similar, less noticeable 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.Different methods of joint replacement are used all over the world, which allows to completely restore the range of motion and return the patient to an active life at any age.
The 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 were 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 support themselves in everyday life and go out not only inside the apartment, but also without restrictions in communication.
Prevention
Arthrosis belongs to the group of upright walking diseases and develops mainly as a result of age-related changes in the joints, which are strengthened by the influence of external negative factors.Paying attention to the condition of the musculoskeletal system, prevention of joint diseases and treatment of arthrosis in the early stages makes it possible to maintain physical activity and avoid massive medical intervention in the future.