The knee joint is formed by a movable “tandem” of the tibia and femur. Their lateral displacement is prevented by the patella, and easy, sliding movement is ensured by an elastic layer of durable cartilage tissue.
The thickness of “healthy” cartilage lining the articular surfaces of the bones of the knee joint is 5-6 mm.
Healthy cartilage softens mechanical friction of bones
This is enough to soften the mechanical friction of the bones and absorb the “shock” load. A disease leading to the destruction of natural shock absorber tissue and deformation of the joint - gonarthrosis, or arthrosis of the knee joint, has unpleasant symptoms, and its treatment is often difficult by launching a compensatory mechanism from the bone structures.
There is an opinion that gonarthrosis of the knee is a consequence of “salt deposition”. However, calcification, or deposition of calcium salts in the ligamentous apparatus of the knee, has no independent significance and is more a consequence than a cause.
What is gonarthrosis and how to treat it?
In reality, the “starting point” should be considered a violation of the blood supply to small bone vessels and its consequence – difficulty in the trophism of cartilage tissue and its depletion. This is followed by deformation of the hyaline cartilage. The latter exfoliates, becoming covered with multidirectional cracks. Synovial fluid becomes more viscous and loses its properties as a natural “moisturizer” of cartilage tissue.
The complete disappearance of the drying “shock absorber” could be called the end of the pathological process.
However, the underlying bones that have lost their cartilaginous “cover” compensate for the loss by growing along the periphery and becoming covered with “spikes” - bone growths. In this case, the knee joint becomes deformed, and the legs take on an X- or O-shape, which is why this pathology is also called deforming osteoarthritis of the knee joint (hereinafter referred to as DOA).
Learn more about what gonarthrosis is and how it develops.
Arthrosis is often confused with various arthritis.
The difference between arthrosis and arthritis of the knee joint
However, the difference between arthritis and arthrosis of the knee joint is that the former is often the result of the invasion of the body by various pathogenic agents, which “results” in inflammatory diseases of the entire body.
Sometimes signs of arthritis - inflammation and swelling of the joint, swelling, pain that gets worse at night - are the result of the immune system “deploying” an active defense against the body’s own cells.
Arthrosis, being an exclusively local disease, often becomes a logical continuation of arthritis or a consequence of the gradual “wear and tear” of the joint.
In orthopedics and traumatology, the types of arthrosis of the knee joint are usually distinguished depending on the reasons that gave rise to degenerative changes in the articular cartilage.
After an injury, secondary gonarthrosis may develop
Gradually developing, gonarthrosis is localized in the inner part of the knee joint. However, the disease can “lurk” between the patella and the surface of the femur.
The signs of gonarthrosis of the knee joint are quite vague at the beginning of the disease, and not many people will rush to visit a rheumatologist or arthrologist if they feel pain in the knee after a long hike.
After all, a short rest and relaxation relieves unpleasant symptoms in a slightly “crunchy” knee, giving a dubious feeling of physical well-being.
Condition of cartilage at various stages of gonarthrosis
In fact, the “vague” symptoms of the first stages of degenerative diseases of the musculoskeletal system extremely complicate their timely detection and treatment. Deforming gonarthrosis is no exception.
The movement of the joint is blocked by acute pain caused by “joint mouse” - fragments of broken bone growths.
A deformed joint loses stability and is difficult to move. An advanced disease at this stage requires prosthetics.
The well-known statement “Rest is not an end in itself, but a means to an end” is directly related to those who are faced with the initial manifestations of the disease. Rest ensures maximum unloading of the knee joint during an exacerbation. For the same purpose, the use of individual orthopedic insoles is recommended.
The use of individual orthopedic insoles will ensure maximum relief of the knee joint
A kind of insurance against the disease, or rather against its exacerbation, will be special orthoses that support the stability of the “loose” knee joint in athletes.
A cane will help older people “unload” their joints while walking. But the measures listed are more likely to prevent arthrosis of the knee joints. If such a “vaccination” did not help, and aggravated gonarthrosis manifests itself with inflammation and pain, you should hurry to see an orthopedist or arthrologist.
Non-steroidal anti-inflammatory drugs used orally, intramuscularly or intravenously will best cope with the “acute” problem. NSAIDs “sealed” in rectal suppositories will have a prolonged effect.
The use of corticosteroids is also justified - they are “delivered” directly to the diseased joint.
The local use of ointments or gels with an active anti-inflammatory component will help to enhance the anti-inflammatory effect of NSAIDs used internally. The latter help to quickly relieve swelling.
Topical application of ointments will help relieve swelling
Drugs that reduce vascular muscle tone are often prescribed together with NSAIDs. This improves periarticular blood flow.
What to do with arthrosis of the knee joint, for example, for patients suffering from gastrointestinal diseases for whom taking NSAIDs and painkillers is dangerous?
Oxygen therapy would be a good alternative.
Chondroprotectors intended for this purpose act slowly, but their long-term use promotes the synthesis of natural components of the cartilage matrix. The greatest effect is achieved by intra-articular administration of drugs.
Intra-articular administration of drugs gives the greatest effect
Read more about drugs for injections into the knee joint here...
Hirudotherapy will help in the fight against gonarthrosis
Physical therapy will help slow down the progressive destruction of articular elements. Its primary goals:
Physical therapy sessions, at least at first, are recommended to be carried out under the supervision of a physical therapy instructor. An experienced trainer will select exercises that correspond to the level of joint mobility, excluding high-amplitude exercises and exercises with excessive axial load - all that can damage the soft tissues of the joint and worsen the patient’s condition.
An effective set of exercises for gonarthrosis.
Provides gonarthrosis and treatment with traditional methods:
When treating gonarthrosis, one should not forget about folk recipes
You can read more about traditional medicine recipes for the treatment of gonarthrosis here...
Often severe pain and joint dysfunction threatens disability.
Then middle-aged patients, as well as young people diagnosed with arthrosis of the knee joint, require surgery.
The most common procedure is endoprosthetics. The duration of such an operation is no more than an hour, and its effect is painless functioning of the “restored” limb for at least 20 years. After time, the “loose” prosthesis will have to be replaced.
Read an article about the rehabilitation period after knee replacement surgery here...
To understand how and how to treat gonarthrosis, you need to remember a little about the main features of the functioning of the knee. This joint is formed by the articular surfaces of the femur and tibia, which are covered with hyaline cartilage. To ensure congruency of the surfaces in the joint, medial and lateral menisci are provided. In addition, the knee is strengthened by ligaments (some of them run in the joint cavity) and a periarticular bursa.
Inside the knee is synovial fluid that lubricates the joint, nourishes the surface of the cartilage, and prevents the articular surfaces from rubbing against each other. The structural features of the joint are such that only 2 types of movements are performed in it: extension and flexion of the knee, and also, if the leg is bent at the knee, rotation around an axis. The knee joint is one of the largest joints in the body, and it bears the brunt of the load when a person stands. It increases significantly with heavy lifting, excess body weight, jumping and running.
There are primary and secondary gonarthrosis. The primary form of this disease develops due to abnormalities of the femur or tibia, ligaments or joint surfaces. In this case, the knee experiences severe overloads, which provoke the destruction of cartilage.
The secondary form is caused by injuries and diseases of the knee. Its main reasons:
Depending on the cause, arthrosis can develop in one or both knees. A unilateral process most often occurs as a result of injuries, operations, and a bilateral process occurs with excess body weight.
Impaired blood circulation in the joint due to vascular spasm or other reasons leads to impaired microcirculation and hypoxia of cartilage tissue, which is accompanied by the gradual death of cartilage elements and its destruction. If the degenerative process affects the synovial membrane, then it begins to produce only a small amount of intra-articular fluid, and “dry knee” occurs. Particles of destroyed cartilage located in the joint cause reactive inflammation of other elements of the cartilage and promote the release of liposomal enzymes, which further dissolve and destroy the intra-articular surfaces.
This depends on the stage of the disease and the intensity of the pain syndrome. For example, the patient can be referred to an orthopedic traumatologist, rheumatologist, and in milder cases of arthrosis - even to a general practitioner or family doctor. In any situation, treatment of arthrosis of the knee joint at all stages of the disease should be comprehensive and selected individually.
The specific amount of treatment depends on the stage and severity of gonarthrosis. In any case, its goal is to achieve stable and long-term remission, and in the early stages, to completely cure it, eliminating the impact of the causes that caused it (for example, normalizing body weight).
The main goals of treatment for knee arthrosis:
To reduce a painful attack, eliminate reactive inflammation and relieve exacerbation, hormonal and non-steroidal anti-inflammatory drugs (injections, tablets, ointments) are used - diclofenac, indomethacin, ibuprofen or new generation NSAIDs (movalis, xefocam).
Chondroprotectors (chondrotin, dona, mucosat) help normalize the nutrition of cartilage and prevent its further destruction. However, they do not relieve pain, so patients are not always sure that they help. In fact, these drugs are included in the basic therapy of joint diseases because they create favorable conditions for the restoration of cartilage and its protection from new damage. In addition, intra-articular fluid substitutes and lysosomal membrane stabilizers are used. If necessary, a joint block can be performed. To improve blood circulation in arthrosis, tablet forms or injections of no-shpa and other antispasmodics are prescribed.
In terms of effectiveness, physiotherapeutic agents and exercise therapy outside of exacerbation are the best medicine for arthrosis. Physiotherapeutic procedures commonly used are:
At home, these can be warm compresses, self-massage of the knee or contrast baths, which also improve blood circulation. Exercise therapy involves performing exercises that are performed with minimal load on the joint. For example, swimming, water aerobics, exercise bike, as well as isometric exercises performed mainly in a lying or sitting position.
X-ray therapy is prescribed for advanced cases of gonarthrosis, severe pain and ineffectiveness of other treatment methods. If the joint is completely destroyed and cannot perform its functions, it is replaced with an endoprosthesis.
In order to prevent exacerbation and further destruction of cartilage, it is necessary:
ARTHROSIS is a non-inflammatory disease of the joint itself, associated with metabolic disorders, which causes degeneration of cartilage tissue in some joints. Instead of cartilage tissue, to compensate for its functions, bone formations, the so-called “spikes” or “salt deposits,” grow in the joints.
all indicators are normal. X-rays reveal changes in the shape of the knee joint; by the nature of the changes, you can understand what kind of disease you have.
The cause of arthrosis is a metabolic disorder. The main task in treatment is to restore metabolism in the joint (through exercise), restore cartilage tissue, dissolve thorns - remove salt deposits.
We advise you to read the article “WHAT IS THE DIFFERENCE BETWEEN ARTHRITIS AND ARTHROSIS?”
Medicines should only be used under the supervision of a doctor! We provide an overview of them for general information only.
Medicines for arthrosis are divided into the following types:
Magnet treatment is a proven folk remedy.
The man had arthrosis of the knee joint and was tormented by salt deposits for many years. Treatment with tablets, burdock leaves and many other remedies did not help. A doctor he knew advised him to use a ferrite magnet (diameter up to 5 cm). Such a magnet can be removed from the speaker of a radio or TV. Use this magnetic ring to massage the skin in a circular motion over the sore spot 2 times a day for 15-20 minutes. The course of treatment is 1.5-3 months. After this treatment, the pain in the man’s knee joints stopped. (source: ZOZH 2001 No. 4, p. 3)
How to relieve knee pain with burdock?
Wash 6-8 burdock leaves, wipe them, stack them with the fluffy side down. Place a pan of hot water on the stack. Lubricate the sore spot with vegetable oil, or even better, oil infused with cinquefoil, and apply this stack of burdock leaves with the fluffy side to the joint. On top there is cellophane and a woolen scarf. You can also use dry leaves in this recipe by soaking them in hot water. (source: Healthy Lifestyle 2000 No. 21, p. 17)
Another folk recipe for treating knee arthrosis with burdock : crush a burdock leaf so that the juice comes out, sprinkle with triple cologne, wrap the burdock around the knee, with polyethylene and a scarf on top. Keep the compress all night. The next evening, make the same compress, but smear the burdock leaf with honey, and then sprinkle with cologne. On the third evening, lubricate the leaf with garlic gruel, and then with cologne, on the fourth - with Vishnevsky ointment. Alternate compresses every evening. The course of treatment is 1-2 months. (recipe from Healthy Lifestyle 2004 No. 18, p. 17)
How to treat knees with burdock.
After an injury (bruise), the woman developed arthrosis of the knee joint. A tumor the size of a fist formed. For 4 months she was treated with pills, ointments, physical procedures, and injections. But the condition did not improve. Then she read an article about burdock and decided to try folk remedies. I picked 10 leaves, wrapped both knees, bandaged them with an elastic bandage and insulated them with a scarf. In the morning the leaves on the healthy knee were the same green as in the evening, but on the sick knee they became black and thin. The tumor was half asleep, and on the second night it disappeared completely. (source: ZOZH 2003 No. 5, p. 27)
Applications with celandine.
This folk remedy is recommended for use if the pain is caused by arthrosis. Soak a linen cloth in celandine juice, wrap the knee and hold for 40-50 minutes, then lubricate the knee with vegetable oil. The course of treatment is 7 days, then a break of 10 days and a new course. Three courses of treatment are required. If you also have varicose veins, then apply the application to the diseased veins - the condition of the veins will return to normal. (recipe from Healthy Lifestyle 2000 No. 23, p. 10 from a conversation with Dr. Lyubimova)
Traditional method of treatment with earthworms.
The woman had severe pain in her knee joints and could hardly walk. A neighbor advised her to treat her knees with earthworm ointment: dig up earthworms, rinse them, and put them in a warm place. Soon the worms will turn into a liquid paste, mix with alcohol 1:1 and rub into the sore spot. The woman found four worms and made herself an ointment. After the first rub, the pain stopped. Now she does rubs for prevention every spring. (source: Healthy Lifestyle 2000 No. 23, p. 20)
Honey massage if your knee joint hurts.
The woman's knees did not bend. Treatment in the hospital did not help, she decided to resort to folk remedies. First, I warmed my knees with a heating pad for 10 minutes, then spread honey on them and massaged them for 15 minutes. Then she placed burdock leaves with the bottom side to the skin, tied a warm cloth on top and went to bed. After 10 procedures, the stiffness and pain disappeared. (source: ZOZH 2001 No. 16, p. 17)
Traditional treatment with snowdrops.
The woman had severe pain in her knees and could not sleep properly. She found a folk recipe for treating joints using snowdrops. To treat, you need to pass the flowers through a meat grinder and apply a compress with this paste for 15 minutes. The woman applied such a compress before going to bed and accidentally fell asleep. I woke up from a burning sensation on my skin, took off the compress and continued to sleep. As a result, a severe burn, sick leave for 2 weeks. But since then my knees have never hurt again. (source: ZOZH 2001 No. 14, p. 4)
How to treat knees with birch leaves.
Within a week, the woman managed to recover with compresses made from birch leaves. She spread out a towel, sprinkled birch leaves on it and wrapped it around her knees before going to bed. In the morning I took off the bandage. After a week, the joint pain was completely gone. (source: ZOZH 2001 No. 19, p. 18)
How to treat arthrosis of the knee joint with fat at home.
After an unsuccessful fall, the man injured his knee; it hurt for a whole year. After 18 years, this injury recalled itself - pain in the knee joint arose. The doctor advised rubbing it with fat. The man did this at home for several months. 15 years passed and the pain no longer appeared. (source: ZOZH 2003 No. 8, p. 18)
Treatment with juices is an effective folk remedy.
A simple and delicious recipe. Take 0.5 kg of cranberries, beets, black radish. Pass through a meat grinder, add 0.5 l. cognac, leave in a tightly closed jar for 10 days, strain. Take 1 tbsp in the morning on an empty stomach. l. Course - until the composition runs out. The woman completed two such courses - in the fall and in the winter, and her joints stopped hurting. I gave the recipe to a neighbor who treated her joints every spring by immersing them in manure. It also helped her after two courses of treatment. (HLS 2004 No. 2, p. 27, two more issues confirm the effectiveness of this method)
Traditional treatment with celery.
The woman was found to have a thorn in her knee joint and had severe pain when walking. The rheumatologist offered her a traditional treatment recipe, which helped her in 4 procedures. Wash the celery root along with the leaves and squeeze the juice out of it. Take 2 tbsp juice. l. 3 times a day 40 minutes before meals. Make compresses from the cake on the joint, after lubricating the skin with vegetable oil. Keep the compress for 2 hours, or better all night. (source: ZOZH 2007 No. 9, p. 33)
Here is another recipe with celery: wash 1 kg of celery tubers, grate them on a coarse grater and pour in 1 liter of vodka. Leave for 10 days, strain. Pour the cake with 1 liter of clean water and leave for 24 hours, strain. Mix alcohol tincture and aqueous solution. Keep refrigerated. Apply 2 tbsp. l. three times a day 30 minutes before meals. The pain goes away after 3-4 weeks. The course of treatment is long, but true. It is better to use this remedy for 5-6 months.
A very simple and effective way. When you break and use an egg, the white remains on the walls. You need to scrape it out with your finger and rub it into the joint. The result is instant. Before using this recipe, the woman had difficulty walking, but now she is 87 years old and walks without a cane. (HLS 2008 No. 4, p. 30)
Treatment of joint arthrosis with horse gel is a folk method.
The man had severe pain in his knee joints. One day he met an acquaintance on the street who had not left his house for two years. This time the acquaintance walked cheerfully and quickly, as in his youth. The man was very surprised by such a transformation and found out that he was cured with the help of horse gel, which the doctor advised him to do. Before this, no “human” ointments helped him. The full name of the gel is: “Double-action cooling-warming gel with camphor and menthol”; the composition also includes extracts of capsicum, propolis, essential oils of clove and eucalyptus. The gel is packaged in 500 g plastic bottles with a silver horse on the label. After applying this gel to his knee joints twice a day for three months, his pain disappeared and his knees are now as good as new. The man who learned this recipe and wrote this story was helped by horse gel within a month. But for prevention, he uses this gel once a day (HLS 2008 No. 21, p. 10)
The woman developed pain in her knees. She was diagnosed with “arthrosis in the early stages” and was prescribed ointment. While I was applying this ointment, my knee did not hurt, but after the course of treatment the pain returned. Then she decided to be treated with clay - she applied compresses with clay diluted with evaporated urine for 2 hours. She only had five treatments and the pain never returned, even though 10 years had passed. (HLS 2008 No. 17, p. 9)
Traditional treatment with nettles
The man had a pain in his knee joint, first a point pain, then it spread to the entire knee. I made the rubbing on the advice of friends: 2 tbsp. l. dry mustard, 2 tbsp. l.salt, 2 pods of hot pepper, steep in 200 g of vodka for a week, shaking frequently, the pain became less, but did not go away. Then he began treatment with nettles: he came home from work in the evening, put two layers of gauze on his knee, put a layer of nettle leaves on top and secured it with a wide bandage. I worked with the bandage all evening in the garden, taking it off only in the morning. By morning the nettle was all dry. I did the compress every day for two weeks. The pain has gone completely (HLS 2009, No. 4, pp. 8-9)
How to relieve knee pain.
The woman developed arthrosis, the blood flow in her leg was slowed down, she could only walk very slowly with frequent stops, because her leg quickly got tired and hurt, medications and injections did not help. Then the woman made a tincture of potato sprouts - she filled the jar to the top with sprouts and filled it with vodka, let it sit for 3 weeks, the tincture turned brown. I rubbed this tincture on my knee and made 10 more compresses with clay, which I kept for 2 hours. The pain in her leg went away, and she began to overtake many passers-by. (HLS 2009 No. 21, p. 8, )
The woman had pain in her joints. Folk recipes, such as lilac, golden mustache, and chestnut tincture did not help her, but dandelion tincture did - pour 100 dandelion flowers along with stems into 500 g of vodka. Infuse for 21 days, rub the knee joints with the stems, and then apply a cloth soaked in tincture to the knees, on top of polyethylene and a scarf - make compresses at night. After a month, the pain went away, but the stiffness remained. Then she began to “spin the bike,” do “scissors,” and squat. The gait has become easy, nothing hurts anywhere, despite being 72 years old. (HLS 2010 No. 5, pp. 9-10)
The woman could not heal her knees. I tried various folk recipes, but it only helped for a short time. Then she came up with the idea of lining her leg with beet slices. On top there is polyethylene, an elastic bandage and a knee pad. After that, she went to bed, and in the morning she felt almost no pain. After 12 beetroot treatments, the pain in the knee was completely gone. For prevention, she made compresses for another month, twice a week. This remedy will be much more effective if you grate the beets, put them in a gauze bag, and drink beet juice, beet kvass. Beets relieve inflammation that causes joint pain, nourish the joint with essential microelements (Healthy Lifestyle 2010, No. 20, p. 8 ,)
The main thing in gymnastics for arthrosis is the restoration of metabolism in the diseased organ. Physical activity builds the muscles around the joint, blood flow increases in these muscles, nourishing the ligaments, cartilage and bones, restoring them.
How many times should I repeat? The more often you do these exercises, and the more repetitions you do, the faster the pain will go away.
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IT IS IMPORTANT TO KNOW! The only remedy for JOINT PAIN, arthritis, arthrosis, osteochondrosis and other diseases of the musculoskeletal system, recommended by doctors! Read more.
Нестероидные противовоспалительные РїСЂРµРїР°СЂР°С‚С ‹ — NSAIDs: diclofenac, piroxicam, ketoprofen, indomethacin, butadione, meloxicam, Celebrex, nimulide and their derivatives.
For arthrosis, non-steroidal, that is, non-hormonal, anti-inflammatory drugs are traditionally used to eliminate pain and inflammation of the joint, since against the background of severe pain it is impossible to begin normal treatment. Only by eliminating acute pain with anti-inflammatory drugs can you subsequently move on, for example, to massage, gymnastics and those physiotherapeutic procedures that would be intolerable due to pain.
However, it is undesirable to use drugs from this group for a long time, as they can “mask” the manifestations of the disease. After all, when the pain decreases, a deceptive impression is created that healing has begun. Arthrosis, meanwhile, continues to progress: NSAIDs only eliminate individual symptoms of the disease, but do not cure it.
Moreover, in recent years, data have been obtained indicating the harmful effects of long-term use of non-steroidal anti-inflammatory drugs on the synthesis of proteoglycans. Proteoglycan molecules are responsible for the entry of water into cartilage, and disruption of their function leads to dehydration of cartilage tissue. As a result, cartilage already affected by arthrosis begins to deteriorate even faster. Thus, pills that a patient takes to relieve joint pain may accelerate the destruction of that joint.
In addition, when using non-steroidal anti-inflammatory drugs, it is necessary to remember that they all have serious contraindications and, with long-term use, can give significant side effects (which are described in detail in Dr. Evdokimenko’s book “Pain in the Legs”).
Хондропротекторы — глюкозамин ондроитинсульфР°C‚.
Glucosamine and chondroitin sulfate belong to the group of chondroprotectors - substances that nourish cartilage tissue and restore the structure of damaged joint cartilage.
Chondroprotectors (glucosamine and chondroitin sulfate) are the most useful group of drugs for the treatment of arthrosis.
Unlike non-steroidal anti-inflammatory drugs (NSAIDs), chondroprotectors do not so much eliminate the symptoms of arthrosis as act on the “base” of the disease: the use of glucosamine and chondroitin sulfate helps restore the cartilaginous surfaces of the hip joint, improve the production of joint fluid and normalize its “lubricating” properties.
Such a complex effect of chondroprotectors on the joint makes them indispensable in the treatment of the initial stage of arthrosis. However, there is no need to exaggerate the capabilities of these drugs.
Chondroprotectors are not very effective in the third stage of arthrosis, when the cartilage is almost completely destroyed. After all, it is impossible to grow new cartilage tissue or return the deformed bones of the knee to their previous shape with the help of glucosamine and chondroitin sulfate. And even in the first and second stages of gonarthrosis, chondroprotectors act very slowly and do not immediately improve the patient’s condition. To get a real result, you need to undergo at least 2-3 courses of treatment with these drugs, which usually takes from six months to a year and a half, although advertising for glucosamine and chondroitin sulfate usually promises recovery in a shorter time.
I would like to note with regret that there is some deceit in these promises. Despite all the usefulness of chondroprotectors, one cannot expect miraculous medicinal cure for arthrosis. Recovery usually requires much more effort than taking two or three dozen pills.
It is probably the fact that the capabilities of chondroprotectors are often overestimated in advertising that was the reason for attacks on these drugs in one of the “popular” television shows. The TV presenter of the “Health” program, at someone’s suggestion, said that chondroprotectors are useless for the treatment of arthrosis.
Thus, she cast a huge shadow on these very useful drugs, calling into question the work of a number of serious medical institutes and clinics that tested these drugs and proved that chondroprotectors definitely contribute to the restoration of articular cartilage and inhibit the development of arthrosis.
After all, only after the clinical testing of chondroprotectors, the Russian Ministry of Health allowed their sale in pharmacies as medicines (we are, of course, not talking about those medicines that have not been registered as medicines and are sold as dietary supplements). Another thing is that, as I already said, chondroprotectors are not “omnipotent”. Treatment with these medications requires proper and long-term use in combination with other treatment methods.
However, of all the drugs used in the treatment of arthrosis, it is chondroprotectors that bring the greatest benefit. In addition, they have virtually no contraindications and extremely rarely give unpleasant side effects.
In addition, in order to get the maximum effect from the use of chondroprotectors, it is necessary to ensure that the body receives adequate, that is, sufficient doses of drugs daily throughout the course of treatment. A sufficient dose of glucosamine is 1000-1500 mg (milligrams), and chondroitin sulfate is 1000 mg per day.
Currently (in 2016) on our pharmacological market, chondroprotectors are most widely represented by the following proven drugs:
Arthra , made in the USA. Good drug. Available in tablets containing 500 mg of chondroitin sulfate and 500 mg of glucosamine. To achieve the full therapeutic effect, you need to take 2 tablets per day.
Dona, made in Italy. A monotherapy containing only glucosamine. Release form: solution for intramuscular injection; 1 ampoule of solution contains 400 mg of glucosamine sulfate. The solution is mixed with an ampoule of a special solvent and injected into the buttock 3 times a week. The course of treatment is 12 injections 2-3 times a year. In addition, there are DONA preparations for oral administration: powder, packaged with 1500 mg of glucosamine in 1 sachet; You need to take 1 sachet of the drug per day; or capsules containing 250 mg glucosamine; You need to take 4-6 capsules of the drug per day.
Structum, made in France. A monopreparation containing only chondroitin sulfate. Release form: capsules containing 250 or 500 mg of chondroitin sulfate. Per day you need to take 4 tablets containing 250 mg of chondroitin sulfate, or 2 tablets containing 500 mg of chondroitin sulfate.
Teraflex , made in Great Britain. Release form: capsules containing 400 mg of chondroitin sulfate and 500 mg of glucosamine. To achieve a full therapeutic effect, you must take at least 2 tablets per day.
Chondroitin AKOS, made in Russia. A monopreparation containing only chondroitin sulfate. Release form: capsules containing 250 mg of chondroitin sulfate. To achieve a full therapeutic effect, you must take at least 4 capsules per day.
Chondrolone, made in Russia. A monopreparation containing only chondroitin sulfate. Release form: ampoules containing 100 mg of chondroitin sulfate. To achieve a full therapeutic effect, it is necessary to carry out a course of 20-25 intramuscular injections.
Elbona , made in Russia. A monotherapy containing only glucosamine. Release form: solution for intramuscular injection; 1 ampoule of solution contains 400 mg of glucosamine sulfate. The solution is mixed with an ampoule of a special solvent and injected into the buttock 3 times a week. The course of treatment is 12 injections 2-3 times a year.
As you can see from the above list, the choice of chondroprotectors for the treatment of arthrosis is quite large. What exactly to choose from all this variety? Consult your healthcare provider. Personally, I really like Arthra - it is a good, proven and balanced drug.
Of the injectable drugs (that is, for injections), I most often use Dona. But in powder or capsules, according to my observations, Dona is less effective.
In any case, if used correctly, any proven chondroprotectors will bring clear benefits for the treatment of arthrosis, especially stage 1-2 arthrosis. And what’s important is that drugs containing glucosamine and chondroitin sulfate have almost no contraindications. They should not be used only by those who suffer from phenylketonuria or have hypersensitivity to one of these two components.
They also have very few side effects. Chondroitin sulfate sometimes causes allergies. Glucosamine may occasionally cause abdominal pain, bloating, diarrhea or constipation, and very rarely - dizziness, headache, leg pain or swelling of the legs, tachycardia, drowsiness or insomnia. But in general, I repeat, these drugs very rarely cause any discomfort.
The duration of treatment with glucosamine and chondroitin sulfate may vary, but most often I suggest my patients take chondroprotectors daily for 3-5 months. After at least six months, the course of treatment must be repeated, i.e. one way or another, glucosamine and chondroitin sulfate are recommended to be taken for arthrosis (depending on the stage of the disease) approximately 90 - 150 days a year for 2-3 years.
It is not difficult to completely restore JOINTS! The most important thing is to rub this into the sore spot 2-3 times a day.
Medicinal ointments and creams cannot in any way heal arthrosis of the knee joints (even if their advertising claims otherwise). But nevertheless, they can alleviate the patient’s condition and reduce pain in the sore knee. And in this sense, ointments are sometimes very useful.
Thus, for arthrosis of the knee joint that occurs without symptoms of synovitis, I recommend warming ointments to my patients in order to improve blood circulation in the joint.
For this purpose, Menovazin, Gevkamen, Espol, Nicoflex-cream, etc. are used. The listed ointments usually cause the patient a feeling of pleasant warmth and comfort. They rarely give any side effects.
Ointments based on non-steroidal anti-inflammatory substances (Indomethacin, Butadionic, Dolgit, Voltaren-gel, Fastum) are used in cases where the course of gonarthrosis is aggravated by symptoms of synovitis. Unfortunately, they do not act as effectively as we would like - after all, the skin allows no more than 5-7% of the active substance to pass through, and this is clearly not enough to develop a full anti-inflammatory effect.
Compress products have a slightly greater therapeutic effect compared to ointments.
Of the topical agents used in our time, in my opinion, three drugs deserve the greatest attention: dimexide, bischofite and medical bile .
Dimexide is a chemical substance, a liquid with colorless crystals, which has a good anti-inflammatory and analgesic effect. Moreover, unlike many other substances for external use, dimexide is actually able to penetrate skin barriers. That is, dimexide applied to the skin is actually absorbed by the body and works within it, reducing inflammation at the site of the disease. In addition, dimexide has a resolving property and improves metabolism in the area of application, which makes it most useful in the treatment of arthrosis that occurs with the presence of synovitis.
Bishofite is an oil derivative, a brine obtained during oil drilling. It gained its fame thanks to drillers who were the first to pay attention to its therapeutic effect on arthrosis. While working in oil wells, drillers experienced resorption of arthrosis nodules on their hands due to constant contact with oil brine. Later it turned out that Bishofite has a moderate anti-inflammatory and analgesic effect, and also has a warming effect, causing a feeling of pleasant warmth.
Medical bile is natural bile extracted from the gall bladders of cows or pigs. Bile has a resolving and warming effect and is used in the same cases as bischofite, but has some contraindications: it cannot be used for pustular skin diseases, inflammatory diseases of the lymph nodes and ducts, febrile conditions with increased body temperature.
Intra-articular injections are often used to provide emergency treatment for arthrosis of the knee joint. In many cases, intra-articular injection can actually alleviate the patient's condition. But at the same time, injections into the joint for arthrosis are done much more often than is actually necessary. It is about this incorrect, in my opinion, trend that I would like to talk in more detail.
Most often, corticosteroid hormone preparations are injected into the joint: Kenalog, Diprospan, hydrocortisone, flosterone, celeston.
Corticosteroids are good because they quickly and effectively suppress pain and inflammation due to synovitis (edema and swelling of the joint). It is the speed with which the therapeutic effect is achieved that is the reason why corticosteroid injections have gained particular popularity among doctors. But this led to the fact that intra-articular injections of hormones began to be carried out even without a real need. For example, I have more than once encountered the fact that hormones were injected into a patient’s joint for prophylactic purposes in order to prevent the further development of arthrosis.
However, the problem is that it is arthrosis itself that corticosteroids do not and cannot treat. This means they cannot prevent the development of arthrosis! Corticosteroids do not improve the condition of articular cartilage, strengthen bone tissue, or restore normal blood circulation. All they can do is reduce the body’s inflammatory response to this or that damage in the joint cavity. Therefore, it is pointless to use intra-articular injections of hormonal drugs as an independent method of treatment: they should be used only in the complex therapy of arthrosis.
For example, a patient has stage II gonarthrosis with swelling of the joint due to the accumulation of fluid in it. The accumulation of fluid (synovitis) makes it difficult to carry out medical procedures: manual therapy, gymnastics, physiotherapy. In such a situation, the doctor performs an intra-articular injection of a hormonal drug to eliminate synovitis, and a week later begins other active treatment measures - this is the right approach.
Now let's imagine a different situation. The patient also has stage II gonarthrosis, but without fluid accumulation and joint swelling. Is it necessary to inject corticosteroids into the joint in this case? Certainly not. No inflammation - no “point of impact” for corticosteroid hormones.
But even if intra-articular injection of corticosteroids is really necessary, a number of rules must be followed. Firstly, it is undesirable to do such injections into the same joint more often than once every 2 weeks. The fact is that the administered medicine will not “work” in full force immediately and the doctor will be able to finally assess the effect of the procedure just after 10 - 14 days.
You should also know that usually the first injection of corticosteroids brings more relief than subsequent ones. And if the first intra-articular injection of a drug does not produce results, it is unlikely that the second or third injection of the same drug in the same place will. If the first intra-articular injection is ineffective, you need to either change the drug, or, if changing the drug does not help, choose the injection site more accurately.
If after this the injection of a corticosteroid into the joint does not give the desired result, it is better to abandon the very idea of treating this joint with hormonal drugs. Moreover, it is generally extremely undesirable to inject hormones into the same joint more than four or five times, otherwise the likelihood of side effects increases significantly.
Unfortunately, in practice we have to deal with excessive “singleness” of doctors who inject corticosteroids into the same joint over and over again, without achieving at least a minimal effect with the first three injections. Two similar cases struck me more than others.
One of the patients received “only” ten injections of Kenalog, and the procedure was carried out daily, even without the required ten-day break necessary to evaluate the results of the injection. And the second patient was injected with hormones inside the knee joints, observing an interval (though only 3 to 5 days), but during the course of treatment the poor fellow received twenty to twenty-five injections of corticosteroids into one joint!
It would seem that the doctor “went too far” a little - no big deal. Could there be any harm from such treatment? It turns out it can! Firstly, with each injection, the joint, albeit slightly, is injured by the needle. Secondly, with intra-articular injection there is always some risk of infection in the joint. Thirdly, frequent injections of hormones provoke disruption of the structure of the joint ligaments and surrounding muscles, causing relative “looseness” of the joint.
And most importantly, frequent injections of corticosteroids worsen the condition of those patients whose joint damage is combined with diabetes mellitus, high blood pressure, obesity, renal failure, gastric or intestinal ulcers, tuberculosis, purulent infections and mental illness. Even when administered exclusively into the joint cavity, corticosteroids have an effect on the entire body and can aggravate the course of these diseases.
hyaluronic acid preparations into the knee joint affected by arthrosis (another name for hyaluronic acid is sodium hyaluronate). They went on sale about 15 years ago.
Hyaluronic acid (sodium hyaluronate) preparations are also called “liquid prostheses” or “liquid implants” because they act on the joint like healthy synovial fluid - that is, as a natural “joint lubricant”.
Hyaluronic acid preparations are very useful and effective medicines: sodium hyaluronate forms a protective film on damaged cartilage, protecting cartilage tissue from further destruction and improving the sliding of contacting cartilage surfaces.
In addition, hyaluronic acid preparations penetrate deep into the cartilage, improving its firmness and elasticity. Thanks to hyaluronidase, cartilage that has dried out and become thinner due to arthrosis restores its shock-absorbing properties. As a result of weakening the mechanical overload, pain in the sore knee joint decreases and its mobility increases.
At the same time, when administered correctly into the joint cavity, hyaluronic acid preparations have virtually no side effects.
Treatment with hyaluronic acid preparations is carried out in courses: in total, a course of treatment requires 3-4 injections into each sore knee, the interval between injections is usually from 7 to 14 days. If necessary, the course is repeated after six months or a year.
From my point of view, the main and only serious drawback of hyaluronic acid preparations is their high price. Thus, in 2015, hyaluronic acid was represented on our market mainly by imported drugs Synvisk, Fermatron, Ostenil, Duralan and the domestic drug Giastat.
On average, each injection with these drugs costs the patient no less than 3,000 - 5,000 rubles.
But returning to the issue of savings, I would like to note that despite the relatively high cost of hyaluronic acid preparations, their use made it possible to literally “put back on their feet” many patients who previously, before the advent of these drugs, would have definitely had to undergo surgery.
And taking into account the cost of joint surgery, it turns out that timely use of hyaluronic acid (even over several years) in any case and in every sense costs the patient much less than knee replacement surgery. Of course, provided that the doctor performing such injections knows the injection technique.
In addition to corticosteroid hormones and hyaluronic acid preparations, attempts are being made to introduce various chondroprotectors , such as alflutop, chondrolone or the homeopathic drug Cel T.
But these drugs are several times less effective than hyaluronic acid drugs. They help at most 50% of patients, and it is impossible to predict in advance whether their use will have an effect or not. In addition, a course of treatment requires 5 to 20 injections into the joint, which, as we said, is fraught with possible injury to the joint and various complications.
Manual therapy for gonarthrosis of stages I and II often gives excellent results. Sometimes several procedures are enough for the patient to feel significant relief. Manual therapy of the knee joints helps especially well if it is combined with joint traction, taking chondroprotectors and intra-articular injections of Ostenil.
This combination of treatment procedures, from my point of view, is much more effective than the numerous physiotherapeutic measures offered in any clinic. Let me give you one example from practice.
From this story (and by no means the only one of its kind) it becomes clear why I consider physiotherapy important, but only an additional part of the treatment program for gonarthrosis. In this sense, more than other procedures, I like laser therapy, thermal treatment (ozokerite, paraffin therapy, therapeutic mud) and especially cryotherapy (treatment with local cooling).
More details about each individual method of physiotherapy are described in the book “Pain in the Legs”.
Diet for arthrosis is also very important. You can read more about the anti-arthrosis diet here
Leaning on a stick when walking, patients with arthrosis of the knee joints seriously help their treatment, since the stick takes on 30 - 40% of the load intended for the joint.
It is important to choose a stick according to your height. To do this, stand up straight, lower your arms and measure the distance from your wrist (not your fingertips!) to the floor. This is exactly the length the cane should be. When buying a stick, pay attention to its end - it should be equipped with a rubber nozzle. Such a stick cushions and does not slip when people lean on it.
Remember that if your left leg hurts, then you should hold the stick in your right hand, and vice versa. When taking a step with your affected leg, transfer part of your body weight to the stick.
The most important method of treating arthrosis of the knee joints is special therapeutic exercises. Almost no person suffering from gonarthrosis will be able to achieve real improvement in their condition without therapeutic exercises.
After all, in no other way is it possible to strengthen muscles, “pump” blood vessels and activate blood flow as much as this can be achieved with the help of special exercises.
At the same time, Dr. Evdokimenko’s gymnastics is almost the only treatment method that does not require financial costs for the purchase of equipment or medications. All the patient needs is two square meters of free space in the room and a rug or blanket thrown on the floor.
Nothing more is needed except consultation with a gymnastics specialist and the desire of the patient himself to do this gymnastics. True, most sufferers do not have this desire. Almost every patient in whom I detect arthrosis during examination has to be literally persuaded to engage in physical therapy. And it is most often possible to convince a person only when it comes to the inevitability of surgical intervention.
The second “gymnastic” problem is that even those patients who are committed to physical therapy often cannot find the necessary sets of exercises. Of course, there are brochures for sale for patients with arthrosis, but the competence of a number of authors is questionable - after all, some of them do not have a medical education.
This means that such “teachers” themselves do not always understand the meaning of individual exercises and the mechanism of their action on sore joints. Often, gymnastic complexes are simply thoughtlessly copied from one brochure to another. At the same time, they contain such recommendations that you can just grab your head!
For example, many brochures instruct a patient with knee arthrosis to “do at least 100 squats a day and walk as much as possible.”
Often patients follow such advice without first consulting a doctor, and then sincerely wonder why they feel worse. Well, I’ll try to explain why the condition of sore joints from such exercises, as a rule, only worsens.
Let's think of a joint as a bearing. Damaged by arthrosis, the diseased joint has already lost its ideal shape. The surface of the “bearing” (or cartilage) is no longer smooth. Moreover, cracks, potholes and “burrs” appeared on it. Plus, the lubricant inside the sphere had thickened and dried out, and it was clearly not enough.
Try to put such a structure into operation and, in addition, give it a load beyond the norm. Do you think that due to excessive rotation, such a deformed “bearing” can become smoother and more even, and the lubricant more liquid and “sliding”? Or, on the contrary, will the entire structure quickly wear out, become loose and collapse? In my opinion, the answer is obvious: such a “bearing” will collapse prematurely due to excessive load. In the same way, any bearings are destroyed and worn out during movement if, for example, sand gets into the lubricant and excessive friction occurs.
It is not difficult to understand that already damaged, cracked and “dried out” joints are destroyed by stress in the same way. This means that from exercises that create excessive stress on sore joints, these same joints will only get worse.
So maybe if you have arthrosis you can’t do gymnastics at all? Nothing like that is possible and even necessary. As already mentioned, gymnastics is an important method of treating arthrosis. However, of all the exercises, it is necessary to choose only those that strengthen the muscles of the affected limb and the ligaments of the diseased joint, but do not force it to bend and unbend excessively.
Probably, after such a recommendation, many of the readers will be surprised: how can you load the muscles and ligaments of a limb without forcing its joints to bend and straighten?
In fact, everything is very simple. Instead of the fast dynamic exercises we are accustomed to, that is, active flexion and extension of the legs, we need to do static exercises. For example, if, while lying on your back, you slightly lift your straightened leg up and keep it suspended, then after a minute or two you will feel fatigue in the muscles of your leg and abdomen, although the joints in this case did not work (did not move). This is an example of a static exercise.
Another variant. You can very slowly raise your straightened leg to a height of 15 - from the floor and slowly lower it. After 8 to 10 such slow exercises, you will also feel tired. This is an example of a gentle dynamic exercise.
It’s a completely different matter if the exercise is performed quickly and energetically, with maximum amplitude. By swinging your legs or actively squatting, you put increased stress on your joints, and their destruction accelerates. But the muscles, oddly enough, are strengthened much worse with such movements. We conclude: to strengthen muscles and ligaments with arthrosis, exercises should be done either statically, fixing the position for a certain time, or slowly dynamically.
By the way, it is slow dynamic and static exercises that most of my patients do not like to do, since they are especially difficult to perform. But this is how it should be: correctly selected, these exercises strengthen those muscles and ligaments that have atrophied in a person due to illness. Therefore, at first, be patient.
When doing gymnastics, do not rush. If you want to recover, you will somehow have to train yourself to do the exercises slowly and smoothly, without jerking. A jerking effort can only “tear” the muscles and will bring absolutely no benefit. And remember: if some exercise causes sharp pain, it means that it is contraindicated for you or you are doing it incorrectly. In this case, be sure to consult with your doctor about the correct execution of this exercise.
At the end of the section on the treatment of arthrosis of the knee joint, I would like to address one question that patients often ask me: is it necessary to exercise the leg by walking for a long time and is walking useful for gonarthrosis?
I answer: of course, for a healthy person, long walking is useful in every sense - for the heart, for the respiratory system, for blood vessels, for the legs, etc. But with arthrosis, especially advanced, the knee joints cannot cope with even the minimum daily load, and here We invite you to download even more of them! Such actions will most likely only lead to aggravation and further destruction of the joints.
Before loading, or rather overloading, your knees, you must first relieve the aggravation, strengthen the leg muscles and properly treat the sore joints. Only then can you move on to active everyday activities, gradually increasing the load and in no case allowing pain.
Arthrosis of the knee joint is considered a polyetiological disease. Often the pathology is provoked by a combination of several factors that do not always have a clear etiology.
There are two types of gonarthrosis:
The classification is carried out according to the causal principle. In some patients, the articular cartilage is affected by several negative factors; it is not always possible to determine what was the impetus for the development of pathology.
Therapy for gonarthrosis of unknown etiology is more complex and lengthy; the problem with the knee joint causes a lot of trouble and worsens the quality of life. For this reason, doctors recommend that patients prevent the disease and follow preventive measures.
Main causes of the disease:
Main signs of the disease:
The danger of pathology is the incompletely studied mechanism of the development of gonarthrosis. The final link affects the initial factors, degenerative changes are launched with renewed vigor. With each turn, the condition of the cartilage worsens, the elasticity of the tissue decreases, and the disease progresses again. In the primary form of pathology, it is difficult for a doctor to determine the moment that gives impetus to the activation of negative changes.
Joint deformity is a pathology that requires an integrated approach to treatment. Not all patients know which doctor treats arthrosis.
If signs of illness appear, visit:
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Methods for treating gout during exacerbation with folk remedies at home are described on this page.
How to treat arthrosis of the knee joint at home? It is difficult to combat deformities of the articular cartilage in the knee area; the polyetiology of the pathology constantly leads to a new round of the disease. Treatment with regular use of medications, massage, exercise therapy, and folk remedies is required. The patient must follow a diet and be disciplined when prescribing procedures and special exercises.
Many patients ask: “Why is treatment so expensive?” The reason is the use of non-steroidal anti-inflammatory compounds, chondroprotectors, gels, ointments for inflammation in monthly (or more) courses. Only with regular use of effective drugs are good results noticeable. The later the patient seeks help, the longer and more expensive the therapy, especially if a complex operation is necessary.
The main methods of treating arthrosis of the knee joint:
The doctor always encourages patients to be disciplined and carry out some therapeutic activities at home. Many methods require virtually no material costs: all that is important is the desire to defeat arthrosis and the regularity of procedures.
Take medications prescribed by your rheumatologist:
The doctor will conduct several sessions in the office and show basic techniques so that the patient can massage the problematic knee on his own. Competent actions improve the condition of the damaged area.
Perform self-massage with your palm, the edge of your palm, your fingertips, or your fist. Gently act on the sore knee, maintain forceful pressure on the affected area: strong patting, blows, active kneading of tissues often worsen the condition.
The doctor at the exercise therapy office will show you exercises and gymnastics for arthrosis of the knee joint, which the patient should do at home. Regular exercise improves blood circulation in a sore joint, helps heal arthrosis or reduce negative symptoms.
Many orthopedists and rheumatologists believe that the treatment method with limited joint mobility for gonarthrosis is outdated. Most modern clinics offer rehabilitation using special gymnastics. With regular exercise, flexibility and mobility of cartilage tissue and joints are maintained.
Proven Home Remedies:
To effectively treat arthrosis at home, it is important to adhere to certain nutritional rules. A nutritionist will tell you which dishes and products will keep your musculoskeletal system healthy.
Minimum quantity allowed:
Find out effective methods for treating foot arthritis with folk remedies at home.
The symptoms and treatment of arthrosis of the knee joint are written on this page.
Follow the link http://vseosustavah.com/bolezni/bursit/loktevogo-sustava.html and read about the treatment of elbow bursitis with folk remedies.
Take care of your joints while such an unpleasant disease as gonarthrosis does not bother you. If you identify symptoms of pathology, contact your doctor at an early stage, before the mobility and elasticity of the joint tissue is completely lost. Untimely treatment in advanced cases leads to disability.
Prevent joint diseases:
Medical video - reference book. Traditional recipes for the treatment of arthrosis of the knee joint at home: