Arthritis is an inflammatory disease of the joint. It can be either an independent disease (rheumatoid arthritis, infectious, traumatic) or associated with other diseases (metabolic disorders, diseases of internal organs, autoimmune or allergic processes, etc.).
The structural features of articular tissues - good vascularization of the synovial membrane and the presence of numerous nerve endings - determine the ability of joints to quickly respond with an inflammatory response to various direct and indirect influences.
In most cases, the disease begins with exudative synovitis; subsequently, all elements that form the joint (bones, cartilage, synovial membranes, ligaments, joint fluid) can be involved in the inflammatory process.
According to the nature of the course, acute, subacute and chronic forms of arthritis are distinguished.
In acute arthritis, pain in the joint is usually very severe and constant, indicating the presence of an acute inflammatory process.
Subacute arthritis is an intermediate degree of arthritis, accompanied by slightly less severe symptoms than the previous type.
Chronic arthritis develops gradually over a long period of time and may appear from time to time. In chronic arthritis, pain occurs mainly when moving the joint. Laboratory indicators indicate a lesser severity of the inflammatory process.
Based on the extent of damage, arthritis is divided into: monoarthritis (arthritis of one joint), oligo- and polyarthritis (with damage to several joints).
The basic principle of diagnosing arthritis is a comprehensive examination of the patient using various methods. The diagnosis is made based on:
For arthritis, complex therapy should be used aimed at:
Rheumatoid arthritis is an autoimmune disease that is characterized by inflammation of the inner (synovial) lining of the joints with the development of damage to the cartilage, bones, tendons and ligaments that form the joint. Damage to internal organs (kidneys, lungs, etc.) is also possible.
The course of rheumatoid arthritis is long, over many years, with gradual involvement of different groups of joints in the process. The cause of rheumatoid arthritis is still unknown. The disease can begin at any age, and both children and the elderly are at risk.
The progressive nature of the disease necessitates regular long-term use of medications, strict adherence to the rules for taking them and conducting control laboratory tests to monitor possible side effects of the drugs.
Goal of treatment:
Currently, it is impossible to completely cure rheumatoid arthritis, since the cause of the disease is unknown, but timely seeking help from a rheumatologist will stabilize your health, maintain your ability to work and improve your quality of life.
The manifestations of rheumatoid arthritis can be different. The disease most often manifests itself as inflammation of the joints of the hands and feet in the form of warming, swelling, and sometimes redness, pain in the joints and difficulty moving in them.
Rheumatoid arthritis, especially during periods of exacerbation, may be accompanied by:
A characteristic symptom of rheumatoid arthritis is stiffness in the joints, especially in the morning. About a fifth of people with rheumatoid arthritis develop rheumatoid nodules, which are firm growths under the skin, usually near joints or in an area that experiences pressure or friction (such as the elbow).
However, NSAIDs have side effects:
Therefore, in order to prevent complications when using NSAIDs, your doctor may prescribe medications to prevent the above-mentioned complications.
To reduce joint pain and morning stiffness, the doctor may prescribe non-steroidal anti-inflammatory drugs (NSAIDs) - diclofenac, etc., which have analgesic, anti-inflammatory and antipyretic effects.
Glucocorticoids (GC) are prescribed when the inflammatory process is highly active while waiting for the onset of basic therapy. The selection of the dose of the drug and the regimen of use is carried out only by a rheumatologist.
It is dangerous to suddenly stop or significantly reduce the dose of GC, as this can lead to a severe exacerbation of the disease.
In the presence of severe inflammation in a joint, which is accompanied by the accumulation of inflammatory fluid, GCs are administered into one or several joints as prescribed by a doctor (no more than once every three months per joint).
Basic antirheumatic drugs are drugs that directly affect the immunopathological process responsible for the development of arthritis (methotrexate, leflunomide, biological agents, etc.). Thanks to the use of this group of drugs, most patients can achieve a significant reduction in disease activity or a complete cessation of its progression and, in general, an improvement in the prognosis of the disease.
Almost all basic drugs begin to act gradually, after 2-3 months from the start of treatment, so for this period, NSAIDs or GCs are usually prescribed. In the future, depending on the effect of basic therapy, there may be a need for periodic or constant use of low doses of GCs or NSAIDs.
Taken once a week in tablets or given by injection. To more quickly obtain the effect and maximum concentration of the drug in the body, an injection form is used - methodject. During treatment with methotrexate, blood tests should be performed periodically in order to timely identify possible disorders of bone marrow and liver function.
Patients receiving methotrexate should not drink alcohol (especially on the days they are taking methotrexate). To reduce the likelihood of side effects, folic acid is prescribed on days when methotrexate is not taken, at a dose prescribed by the doctor.
Any adverse reactions during treatment with methotrexate should be reported to your doctor immediately!
The therapeutic effect begins to appear quite quickly - 4 weeks after the start of treatment and intensifies over the course of 4-6 months. When treated with leflunomide, side effects may occur in the form of intestinal dysfunction, nausea, vomiting, increased levels of liver transaminases, skin rashes, decreased levels of leukocytes and platelets in the blood. The drug is prescribed by a rheumatologist with mandatory monitoring of blood counts.
More often prescribed to treat milder forms of the disease. Side effects may include skin rashes, stomach upset, and a decrease in the number of white blood cells and platelets in the blood. The drug is prescribed by a rheumatologist with mandatory monitoring of blood tests.
In case of an aggressive course of the disease or if treatment with one of the basic drugs is ineffective, the doctor may prescribe a combination of 2-3 basic drugs.
Therapy with biological agents (adalimumab, etanercept, tocilizumab, etc.). Biological agents are a group of modern drugs obtained through genetic engineering. Prescription and treatment of biological agents is carried out strictly under the supervision of a physician. In most cases, biological agents are prescribed when traditional basic therapy is ineffective, in combination with methotrexate or other basic drugs.
Physical therapy prescribed by your doctor will help maintain or improve physical activity, joint flexibility, muscle strength, and improve heart and lung function. The ratio of the volume of physical therapy, duration of activity and rest is determined by the characteristics of the course of the disease.
With a high degree of activity of rheumatoid arthritis, physiotherapeutic treatment is contraindicated, with moderate activity it is limited. The most widespread use of physiotherapy occurs with a minimal degree of activity or clinical remission of the disease as prescribed by the attending physician.
Prevention of exacerbations of arthritis involves mandatory regular monitoring of the body's response to basic therapy. The patient should be observed by a rheumatologist at least once every three months, especially in the first years of diagnosis of the disease. The doctor prescribes and, if necessary, corrects treatment, determines indications for sanatorium-resort and inpatient treatment.
Sanatorium-resort treatment during the period of remission can be carried out annually. In case of a benign course of the disease without pronounced changes in the joints, the use of radon baths in Khmilnik and Mironovka is indicated. In case of a progressive course with extinction of the inflammatory process in the joints, treatment with hydrogen sulfide baths in Lubin the Great. With the development of severe joint deformities and contractures - treatment with mud applications in Odessa, Berdyansk. Sanatorium-resort treatment is contraindicated in the presence of an exacerbation and in the next 3-6 months after the exacerbation of rheumatoid arthritis subsides.
In case of severe pain caused by dysfunction of the joint, if it is seriously damaged, joint replacement or other corrective surgery is possible. To prevent the progression of deformities of the joints of the feet or hands, the attending physician may refer you for a consultation with an orthopedic traumatologist in order to select the necessary aids or devices.
Without adequate drug treatment, diet cannot significantly influence the course of the disease. However, during the treatment process, it is important to adhere to a diet that includes the consumption of the required amount of proteins, vitamins (preferably in vegetables and fruits), calcium salts, and sea fish. It is necessary to limit the consumption of spicy, fried, fatty, sour foods. Meals should be three or four times a day, in small portions.
Head of the Department of Rheumatology, Ichilov-Suraski Medical Center
Comprehensive treatment of rheumatoid arthritis in Israel is effective and in demand. Top Ichilov Clinic (Israel) has been successfully diagnosing and treating rheumatoid arthritis for many years. Timely diagnosis and treatment of this pathology leads to long-term stable remissions.
Rheumatoid arthritis (chronic polyarthritis) is a systemic chronic disease caused by autoimmune processes in the body. With this disease, a cascade of pathological reactions is launched in the immune system, as a result of which immunocytes begin to function against the own tissues that make up the joint.
Highly qualified specialists of the clinic will help not only carry out timely diagnostics in full and in the shortest possible time, determine the stage of the disease, clinical group, activity of the inflammatory process, but also prescribe comprehensive treatment with an individual approach to each patient. This allows you to quickly achieve stable, long-term remission, improving not only the patient’s quality of life, but also its duration.
Leading Israeli specialists in the field of rheumatology will diagnose rheumatoid arthritis and prescribe the necessary treatment at the Top Ichilov Clinic.
How is the examination carried out at the Top-Ichilov clinic for rheumatoid arthritis:
Day one – Initial examination:
The initial examination by a diagnostician includes:
1) conversation with the patient (what complaints are bothering you at the moment, how the disease began and progressed, whether you sought medical help, whether any treatment was carried out);
2) physical examination (visualization of the skin, mucous membranes is carried out, as well as examination of the patient’s organs and systems using methods of auscultation, percussion and palpation);
3) familiarization with the medical documentation available to the patient (particular attention is paid to the studies on the basis of which the diagnosis was made)
After the initial examination, the doctor writes out directions for the necessary diagnostic tests, which will be carried out the next day.
Day two – Diagnostic:
In the early morning hours, the patient undergoes a general blood test, a biochemical blood test, rheumatic tests of all types (to identify specific antibodies that confirm the autoimmune process), and a general urine test.
Then an X-ray examination of the affected joints is carried out in two projections, as well as, if indicated, an MRI - diagnostics of this area.
If necessary, they resort to a research method such as arthrocentesis (joint puncture) to collect synovial fluid for analysis.
Day three – Treatment planning:
With the results of the diagnostic studies, the patient is sent for consultation to a specialist , who makes an accurate clinical diagnosis and prescribes treatment.
As a rule, the patient is invited to Israel for 4-5 working days for examinations, consultations, tests and instrumental diagnostics.
Test results are available in approximately 14 days.
Arthrosis is a common joint disease, mainly developing in older people.
An asymptomatic course of the disease is also possible.
Surgical treatment of joint arthrosis
If there is significant pain, a sharp limitation in the range of motion in the joint and the ineffectiveness of conservative treatment, surgical treatment may be necessary. There are several surgical options:
Joint pain is one of the most common medical problems, which affects mainly the adult population and people who play sports professionally. However, in recent decades, joint diseases have become common among young people, since for most of us sedentary work and passive rest have become the norm; while active recreation, sports and simply mobility throughout the day have sunk into oblivion, and with them the health of our joints. Short-term joint pain often develops into permanent pain, which brings us to the doctor. In turn, the doctor, to obtain information about the causes of pain, refers us to an MRI of the joints.
Joint MRI is an advanced method for diagnosing and imaging problems of the knee, hip, shoulder and ankle joints.
Indications for this type of tomography may include:
The knee joint is one of the most structurally complex joints in the human body, and therefore violations of its function require careful examination. MRI of the joints, in this case the diagnosis of the knee joint, allows you to study in detail the structure of this area, visualize the development of tumors, examine the structure of bone tissue, assess the stage of development of arthritis, identify pathological changes in the structure and pathological changes of the knee joint.
It is known that MRI of the joint allows not only to make an accurate diagnosis, but also to see the problem at an early stage. And in case of acute injuries of the knee joint, this is still the only way to get correct data about what exactly happened. Such an MRI of joints in Kiev is very beneficial for the victim. Having in front of him the most accurate picture of the injury, the doctor may not prescribe surgery, but treat it in a different way.
The value of MRI of joints in Kiev is that the method perfectly diagnoses diseases of the hip joints . Their advanced stage often leads to disability. MRI also gives excellent results when examining the shoulder and ankle joints.
All that is needed for the procedure is a doctor’s referral, photographs (if any) of previous examinations, an extract from the outpatient card and all other documents relating to the department being examined. In our center you can be examined without a referral; this will not affect the cost of an MRI of the knee joint .
When there is a need to diagnose small bone tissues, MRI of the knee joint in Kyiv is performed with the introduction of contrast. It is administered intravenously. As the contrast passes through the vessels, it accumulates in the tissues, resulting in clearer visualization.
Metal elements present in the body (insulin pumps, pacemakers, vascular clips, etc.) are a contraindication due to the magnetic field created during operation of the tomograph, which distorts the processes of the artificial pacemaker.
No preliminary preparation for diagnosis is required. All that is needed is a doctor’s referral, pictures (if any) of previous examinations, an extract from the outpatient card and all other documents relating to the department being examined.
In cases where it is necessary to conduct a more precise study of the structures of the upper parts of the shoulder, tomography uses a contrast agent. When examining pathologies of the shoulder joints, MRI with contrast is performed much more often compared to examination of other joints. If you have had arm or leg fractures, tendon ruptures, a soft tissue tumor, chronic arthritis and other ailments, then you should see the specialists of our center as soon as possible. The consequences of not treating can be dire.
Magnetic resonance imaging has gained popularity due to the fact that the doctor can carefully examine the damaged area of the body, see in detail ruptures of tendons, muscles, nerve trunks, blood vessels and other things when the patient is being prepared for surgery, and prescribe effective treatment.
Arthritis is a clinical term for a group of joint diseases characterized by inflammation, pain and deformity. Based on statistical data, arthritis is one of the leading causes of human loss of ability to work and subsequent disability, more so in highly developed countries, such as the USA, Canada, etc.
Arthritis, as a term in modern medicine, is a general term used to define many types of inflammatory joint diseases. Arthritis of the joints comes in two varieties: primary or secondary (caused by an underlying disease, for example, rheumatism). When more than one joint is diseased at the same time, another term is used to define the disease - polyarthritis.
In its primary form, arthritis is represented by several types of joint diseases. The most common are osteoarthritis, rheumatoid and gouty types of disease, somewhat less often - septic, juvenile, Still's disease and spondylitis. In the secondary form, the most common forms of arthritis are purpura, systemic lupus erythematosus, hepatitis, hemochromatosis, psoriatic and reactive arthritis, as well as granulomatosis and borreliosis.
The main prerequisites for the secondary form of arthritis is the underlying disease. The reason contributing to the development of the primary form of the disease can be a variety of disorders in the body, for example, problems with metabolism, the nervous or immune systems, as well as infectious disorders and the consequences of injuries.
The cause of infectious arthritis is an autoimmune disease. Due to disruption of the immune system, excess immune complexes attack the joints. Traumatic and vibration arthritis (for example, knee arthritis), as a rule, are a consequence of mechanical damage to the joints that occurs during injuries or heavy loads.
If the joint is already affected by a mild form of inflammatory arthritis, then its injury can provoke a complication or exacerbation of the disease. Occupational arthritis usually develops due to regular microtrauma associated with the patient’s profession or activity. For example, arthritis of the joints of the hands and fingers is widespread among massage therapists, cosmetologists, seamstresses and hairdressers, and people whose work involves constant physical activity often develop arthritis of the spine.
High mechanical loads, injuries and genetic preconditions provoke not only such local forms as arthritis of the knee joint, but can also cause such a common form of the disease as osteoarthritis.
Among the causes contributing to the development of the disease are the presence of excess weight, congenital joint injuries, chronic inflammation and diseases of the nervous system. At a more detailed level of analysis, we can emphasize the presence in the majority of patients with arthritis of various disorders associated with bone nutrition and vascular tone. The symmetry with which damage to a diseased joint develops during arthritis indicates its neurotic nature.
Some types of arthritis of infectious origin are allergic in nature. Examples of this type of disease are tuberculosis, dysentery and gonorrhea, as well as nonspecific polyarthritis. Disruptions in the activity of the endocrine system during female menopause lead to the progression of rheumatoid arthritis.
Gout, as a rule, is formed on the basis of poor nutrition, genetic factors and excess weight. The rheumatoid form of the disease develops on the basis of an autoimmune disorder of the immune system, usually stimulated by infection, stress and fatigue.
With the development of most types of arthritis, inflammation and swelling of the joint occurs, which visually increases in size and changes the color of the skin to purple-bluish. Arthritis is often characterized by significant pain, unnatural crunching and deterioration of joint mobility, usually with its deformation. Sometimes other signs appear, for example, reduced joint mobility in the morning and with relatively prolonged immobility.
Arthritis, the symptoms of which are a “sausage-shaped” swelling of the finger over the entire area and redness of the skin, can be rheumatoid, gouty or psoriatic. Another common sign of the disease is “flying” inflammation of the joints, in which a suddenly swollen joint quickly takes on its previous shape, but after it, the symptom is alternately observed in other joints. Rheumatoid arthritis exhibits virtually no symptoms, such as redness of the skin in the area of swelling, which complicates its treatment. With gout, redness is observed, but is accompanied by severe pain.
One of the significant symptomatic definitions of arthritis from arthrosis can be considered a reduction (or disappearance) of pain after warming up a joint with arthritis, while with arthrosis the pain from movements will only intensify. The combination of a prolonged increase in temperature to 37 degrees or higher with joint swelling may indicate the development of rheumatoid or reactive arthritis, and possibly also ankylosing spondylitis. The same types of disease are very likely with obvious prolonged inflammation of the eyes, regular “chills” or profuse sweating - during inflammation of the joints.
Complicated arthritis is very dangerous, which makes timely identification of symptoms and competent therapy paramount tasks, despite the difficulty of determining the exact type of disease. There are early stages of complicated arthritis and late stages.
Among the early stages of complications, one can distinguish phlegmon, which is suppuration without a pronounced membrane, as well as panarthritis, an acute form of purulent arthritis, which is combined with inflammation of the ligamentous complex of the joint and suppuration of tissues close to the joint.
Complicated arthritis in the later stages is an extremely dangerous disease that can develop irreversible processes and is difficult to treat. Among the late complicated forms, the following are common: osteomyelitis, which affects areas of the bone close to the joint, and sepsis, which is blood poisoning. Contracture is also common, leading to a persistent limitation of joint mobility, up to the loss of its function, and pathological dislocation, in which the joint is separated (the head is displaced or falls out of the joint capsule).
Diagnosis of arthritis is carried out by determining the exact nature of the clinical picture, laboratory (tests) and instrumental examination (X-ray, ultrasound, MRI and CT). A relatively new but effective diagnostic method is arthroscopy, which provides the opportunity for a detailed examination of the joint cavity and analysis of synovial fluid. However, laboratory or instrumental analysis methods that make it possible to accurately determine the type of arthritis do not exist today.
To treat secondary forms of the disease, first of all, eliminate the root cause or, if possible, neutralize the provoking effect of the main disease. If extra-articular phenomena in arthritis are not observed, then drug therapy begins with the prescription of non-steroidal drugs. Such drugs include, for example, indomethacin, acetylsalicylic acid, diclofenac and brufen, and treatment is long-term and can last for years.
The most affected joints are treated by injecting them with corticosteroids, such as hydrocortisone or triamcinolone. Corticosteroid hormonal drugs are prescribed extremely carefully and only in cases where acute pain is observed that cannot be eliminated by other anti-inflammatory drugs. If febrile symptoms accompanying reactive arthritis are observed, treatment is carried out with the mandatory use of corticosteroid therapy, but they strive to replace it with non-steroidal medications at the first opportunity.
Arthritis, the treatment of which, using the above remedies, does not stop the progression of the disease, must be treated with basic drugs, for example, aurotioprole (a gold drug, now rarely used), D-penicillamine, chloroquine, levamisole. Basic drug therapy lasts from six months to several years.
For arthritis in general, patients are prescribed complex therapy aimed at overall strengthening the body and restoring the immune system (sanatorium-resort treatment). Treatment of arthritis is perfectly complemented by physiotherapeutic procedures (therapeutic exercises, massage), in particular, to restore the natural mobility of the joint complex.
Found 95 doctors treating the disease: Arthritis
Osteoarthritis (osteoarthritis) is a chronic degenerative joint disease that primarily affects the cartilage that covers the bones that make up the joint. The cartilage becomes less elastic and smooth, “cracks” and poorly protects the bones from stress. In addition, the production of synovial fluid decreases, the sliding of the articular surfaces of bones against each other is disrupted, pain occurs in the joints (especially when moving), the range of motion decreases over time, and joint deformity develops.
The disease usually develops after 35-40 years, is characterized by a slowly progressive course and leads to dysfunction:
To establish a diagnosis of osteoarthritis, it is necessary to consult a rheumatologist, since there are a number of other joint diseases with similar symptoms, but with fundamental differences.
Osteoarthritis is a chronic disease and requires constant monitoring. It is advisable to carry out ultrasound monitoring of problem joints at least twice a year, this will allow you to monitor the condition of the joints and, if necessary, promptly change treatment tactics. Consult your rheumatologist at least once every six months, regardless of how you feel.
If the joints of the hands are affected, any heavy load on the fingers should be limited. For arthrosis of the joints of the lower extremities, it is recommended to avoid running, jumping and squats. Fast and long walking also worsens the condition and increases joint pain. Avoid walking up stairs (especially downstairs), lifting and carrying heavy objects, and staying in a fixed position for long periods of time (for example, squatting or bending over when working in the garden).
It is important to develop a rhythm of motor activity in which periods of load (15-20 minutes) alternate with periods of rest (5-10 minutes), during which the joint should be unloaded. It is necessary to unload the joints of the legs in a lying or sitting position; you can perform several movements in the joints (flexion, extension, bicycle) to restore blood circulation.
To reduce pain in the knee joints, the doctor may recommend special knee pads (orthoses) or shoe insoles (instep supports), which must be selected individually. A properly selected orthosis significantly reduces the load on the affected joint and improves its function.
Particular attention should be paid to shoes. It is important that the shoes are wide enough and their tops are soft. Wearing shoes with low (no higher than 3-4 cm) wide heels with a soft elastic sole allows you to absorb the shock that spreads along the limb when the heel touches a hard surface, resulting in a load on the cartilage.
Using a cane when walking helps to reduce the load on the joints of the legs. If you have to stand for a long time, be sure to take a cane with you. If the left leg is more bothersome, then the cable must be held in the right hand and vice versa. If both, it is useful to walk with two canes at the same time.
At the same time, it is necessary to try to lead an active lifestyle by increasing physical activity, which does not have a negative effect on cartilage. It is imperative to do special exercises every day, during which the load on the articular cartilage is minimal and the muscles surrounding the joint work to a greater extent. You need to exercise for at least 30-40 minutes a day, several approaches of 10-15 minutes are recommended. This allows you to form a good muscle corset around the joint and maintain normal mobility. The effect occurs within 2-3 months.
Massage of the soft tissues surrounding the joints improves overall well-being, relieves painful muscle spasms, improves blood circulation and transmission of nerve impulses, providing improved nutrition to the articular cartilage. It is important to take a massage course from an experienced specialist 2 times a year in the absence of an inflammatory process.
Swimming is an optimal sport for diseases of the musculoskeletal system. If you don't know how to swim, you can practice in aquagymnastics groups. Pilates and yoga classes have a good effect. Cycling, in addition to having a beneficial effect on joints, brings a positive emotional charge, but you should avoid riding on uneven terrain and jumping. You can also use an exercise bike. Skiing is useful in winter.
The desired effect in the treatment of osteoarthritis can only be achieved through complex therapy. The goal of treatment is to alleviate the symptoms of the disease - reducing pain and improving joint mobility, slowing the progression of the disease.
To relieve pain, anti-inflammatory (meloxicam, etc.) and painkillers (paracetamol, etc.) drugs are used. They can also be used in the form of creams or gels to be applied to the painful joint at least 3 times a day. You should be aware of possible adverse reactions, mainly from the gastrointestinal tract, while taking this group of drugs. The question of their purpose and duration of use should be decided by a rheumatologist.
In cases of development of edema of a large joint, which is associated with the accumulation of inflammatory fluid in it, a puncture of the joint is performed with evacuation of the fluid and subsequent single administration of glucocorticoids. To achieve a positive result in the long term, it is necessary to use drugs that act directly on cartilage - chondroprotectors (glucosamine, chondroitin, diacerin, etc.). They prevent the progression of the disease and at the same time reduce inflammation and pain in the joints. Taking chondroprotectors should be long-term (at least 6 months a year).
A modern method in the complex treatment of osteoarthritis is the intra-articular administration of hyaluronic acid preparations (Fermatron, Viscoplus, etc.). Treatment with these drugs can improve the patient’s quality of life, reduce pain, and improve joint mobility. However, the effectiveness of these drugs directly depends on the correct choice of the drug itself, the accuracy and timeliness of administration. Injections must be carried out under visual ultrasound control - this ensures 100% accuracy of drug administration into the joint cavity. The frequency of administration depends on the stage of the disease and which drug is chosen.
Obesity is one of the most important risk factors for the development of osteoarthritis. Normalizing body weight reduces the risk of developing the disease and its progression, reduces pain in supporting joints and increases physical activity.
Changes in diet and diet should have the goal of gradually but constantly reducing body weight to an optimal value. Losing body weight by 5 kg improves your well-being by 2 times. Diet should always be combined with physical activity.
To lose weight, you should eat less fat and carbohydrates. There are simple rules for this:
An integral part of complex treatment and rehabilitation for osteoarthritis is sanatorium-resort treatment, which includes the positive effects of therapeutic mud (Saki, Evpatoria, Kuyalnik, Berdyansk, etc.), hydrogen sulfide or arsenic baths, thermal springs (Sinyak, Beregovo, etc.), saunas, physiotherapy, massage, exercise therapy. Sanatorium-resort treatment can only be carried out on the recommendation of a doctor.