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What is arthrosis 1st 2nd degree

16 Jul 18

Arthrosis 1st and 2nd degree. Treatment of the initial stage

Arthrosis is a fairly widespread pathology of the joints, which is associated with degenerative changes in the cartilage that is part of the joint. The disease very often attacks the hip and knee joints, as well as the joints on the big toes. Less commonly, the disease affects the ankle and fingers. Other joints are even less commonly affected.

The initial stage of arthrosis for each type has its own characteristics. But there are generalized symptoms that can be attributed to the lion’s share of arthrosis:

  • Painful sensations. This is the main symptom of the disease. They are characteristic of most joint diseases. However, they have features that make it possible to accurately determine that pain is caused exclusively by arthrosis. For example, when the knee joint is affected, the pain intensifies with physical activity and subsides with rest or a comfortable position of the limb. This is the main difference from arthritis, which causes restlessness at night. The initial stages are manifested by mild pain that occurs under heavy loads. Therefore, at such stages, patients rarely seek help, and in the meantime, grade 1-2 arthrosis develops. At the same time, pain tends to intensify even from light loads and after them. With further development of the disease, unpleasant sensations cause anxiety even at rest.
  • Crunch. Is an important symptom. Its appearance is associated with increased friction between the surfaces of the joints. However, healthy joints can also crackle. The tone of the affected joints is significantly different, having a dryish and rough crunch. The initial stages of the disease are not so pronounced by characteristic sounds, but arthrosis of stage 2 and above has a distinct and loud crunch.
  • Arthrosis has many symptoms, one of them is a crunching sound when moving the joints

    • Decreased joint mobility. In other words, a decrease in the amplitude of action of the diseased joint. The initial forms of the disease have a not very pronounced limitation of mobility. But progressive arthrosis reduces the actions of the joint to a minimum. This is associated with the growth of osteophytes, muscle spasms, and narrowing of the joint space of the knee joint.
    • Articulation deformation. This phenomenon is associated with several reasons. First of all, the formation of growths (osteophytes). Deformations and pathologies of the bones of the joint are also possible. And finally - the accumulation of excess fluid, which occurs due to inflammatory processes in the tissues of the joint.
    • They are called substances that nourish and stimulate the restoration of cartilage tissue. These drugs perfectly respond to the early stages of arthrosis. In addition to restorative functions, the products improve the production of joint fluid and normalize its properties. To achieve a noticeable result at stages 1 and 2, several courses of this drug will be required, which will require from 6 months to 1.5 years.

      Medicine considers arthrosis in three stages. There are a lot of patients who suffer from this disease. Therefore, it is not difficult to establish the degree. The most important thing is not to confuse the symptoms. The initial stage of arthrosis is characterized by metabolic disorders, the second stage is characterized by injuries and infections, and the third stage is characterized by irreversible changes in the joints.

      There are 3 main stages of joint arthrosis

      The most common culprit of arthrosis is excessive overload of the joints, as well as a decrease in their recovery capabilities. This is provoked by injuries, metabolic disorders, infections and other things. The main prerequisite for the occurrence of the disease is a metabolic disorder in the cartilage, which reduces its elasticity, regenerative functions, depletion and surface damage. The subsequent pathological process causes damage to the synovial membrane, ligaments, tendons and other elements located close to the joint.

      Common causes of the disease should also include excess body weight, hypothermia, physical overload, vitamin deficiency, and hereditary factors.

      Is it possible to cure arthrosis of the 1st degree? Unfortunately no. But stage 1 arthrosis preserves the mobility of human joints, however, only in one direction. An x-ray rarely helps to identify abnormalities, because at this stage there are practically none. The disease can be identified by the damaged surface in the area where the joints themselves are located and by their hardness. The onset of arthrosis may not cause swelling, an increase in temperature, or a change in skin color. But the patient feels a slight crunch and aching pain in the joint. Most people do not even pay attention to such manifestations, because they do not cause significant concern.

      How to treat arthrosis of the 1st degree? First of all, the patient is prescribed medications that have anti-inflammatory and analgesic effects. These can be ointments, tablets, injections. The package of measures also includes various methods of physiotherapy.

      The first degree of arthrosis cannot be cured, but with the help of medications and physiotherapy it is possible to relieve pain and stop anti-inflammatory processes

      Treatment of stage 1 arthrosis is accompanied by changes in diet and daily routine. The patient is strictly prohibited from drinking alcohol. Special physical training and a balanced diet are recommended. Diet is the most important factor in treatment, as it leads to a decrease in body weight, which has a beneficial effect on the mechanical stress experienced by the joints. However, it is difficult to identify a special diet for the first stage, so a balanced and varied diet is recommended that will not lead to an increase in body weight.

      People who do not monitor their health and do not treat grade 1 arthrosis risk getting a more severe form of the disease. Establishing the second degree is not very difficult. Any orthopedist or surgeon will do this, since articular disorders are quite obvious after an external examination. This stage of the disease does not actively attack the patient, but already seriously warns. Indirect signs: slight fatigue, a feeling of high pressure on the joints after heavy loads.

      The danger of the second degree is the beginning of partial deformation of the joint. If treatment is not started in a timely manner, the disease will accelerate its progression. Pain sensations appear in the joints with a small range of motion. They are accompanied by an obvious crunching sound, and movements of the limbs become difficult from day to day.

      If you do not see a doctor in time, then the 2nd degree of arthrosis will greatly complicate your movements.

      Arthrosis stage 2 is much more difficult to treat. In this case, folk remedies, as a rule, turn out to be useless. However, modern medicine has made great strides in the fight against the disease. The patient is prescribed chondroprotectors and agents that normalize blood flow. In addition, the use of physical therapy exercises and physiotherapeutic manipulations is mandatory. Only with this set of measures will treatment be successful for grade 1-2 arthrosis.

      Ignored treatment of the initial stage of arthrosis leads to this stage of the disease, which is characterized by severe pain. The patient experiences sharp pain not only when moving, but also when at rest. In addition, the sensitivity of the affected joints is directly affected by weather changes, during which pressure changes are not uncommon. This causes disruption of blood flow in the affected joints, which causes discomfort. But how to relieve pain with grade 3 arthrosis? This question is often asked by patients suffering from this disease. Therefore, treatment is based on maximally reducing the inflammatory response and reducing pain. In addition, the complex treatment includes physiotherapeutic procedures during periods of remission: laser, magnetic, microwave therapy; UHF, phonophoresis, treatment with mud and mineral waters in resorts and sanatoriums.

      But sometimes it happens that the symptoms of the disease are expressed so strongly that complex treatment is ineffective. Therefore, the most radical method is used - surgery. Surgeries are often performed to replace the affected joint with an endoprosthesis. Orthopedists have only recently begun to use this method. Thanks to endoprosthetics, most of the functions of the joint are restored to the patient, which helps him lead a normal life and get rid of pain. This method involves removing parts of the joint and replacing them with metal or polymer analogues. Often, complete replacement of the affected joint is performed. Patients who have undergone this procedure note its high reliability and effectiveness.

      Bilateral gonarthrosis of the knee joints

      Bilateral gonarthrosis is a common pathological process among arthrosis changes. Doctors from various countries began to study in detail bilateral arthrosis of the knee joint more than a century ago, so therapeutic measures for this pathology have become more successful. In everyday life, osteoarthritis is called salt deposits, but the processes of calcification in bilateral gonarthrosis are not a priority.

      Bilateral deforming gonarthrosis is dangerous because it reduces a person’s motor activity and makes him disabled. Bilateral gonarthrosis of the knee joint usually takes a long time to treat, and surgical intervention is often required. In order to avoid osteoarthritis before surgery, timely detection of bilateral gonarthrosis is required, and in the first degree of the knee joint, treatment of deformation changes will be successful.

      What is gonarthrosis? With bilateral gonarthrosis of the knee joints, processes of dystrophy and degeneration occur, and the cartilage joint tissue can be completely destroyed. Deformed joints will become inflamed, which will increase degenerative changes.

      If grade 1 gonarthrosis of the knee joint develops, then the molecules of the cartilage tissue change and the blood flow of small vascular tissues is disrupted. Then the hyaline cartilaginous tissue becomes cloudy, less thickened, it becomes stratified and covered with microcracks having different directions. With bilateral arthrosis, the large and small cartilage are destroyed, exposing the bone structures.

      This leads to the fact that bone tissue will grow on the periphery, thereby causing osteophytic formations to appear. Osteoarthritis will lead to joint deformation and curvature of the leg.

      What changes are happening

      The pathological process develops with the following increasing changes:

    • The process of cartilage metabolism changes: cartilage tissue is nourished by the synthesized lubricant during the mobility of the joint tissue, but osteoarthritis changes the osmotic type of pressure, and the nutrition of the cartilage is disrupted. Where the pressure is high, the cartilage tissue becomes thinner.
    • Collagen fibers change structurally: the patellar cartilage softens, the depreciation of the cartilage is impaired, it becomes unstable and less elastic.
    • The production of bone substance is activated in the joint, leading to osteophyte formations. The inner layer of the joint capsule becomes irritated, it becomes inflamed, and the joint becomes immobile.
    • Destructive changes greatly affect the internal articular zone and the area between the femoral bone and the patella.
    • Gonarthrosis can occur primary and secondary. Primary gonarthrosis, bilateral or idiopathic, is characterized by the formation of degenerative changes in healthy cartilage tissue, which has not previously been subject to destructive processes.

      Such pathological changes are a consequence of mechanical and physiological overload.

      Secondary osteoarthritis forms on articular tissue that has been affected by various diseases, and the initial manifestations of pathology are caused by reduced resistance of cartilage to physical stress. Post-traumatic gonarthrosis is a widespread type of gonarthrosis. Gonarthrosis can develop on one side (right or left, where one knee is affected) or be a bilateral process.

      Bilateral joint damage, as a rule, is more complex and dangerous, mainly occurring in elderly patients.

      The main reasons for the development of arthrosis changes in the knee are:

    • Disturbed metabolic processes.
    • Disorders of hemocirculatory processes, weak capillary walls.
    • The patient is overweight, which puts a lot of strain on the joints.
    • Injury to joints.
    • Past inflammatory diseases of bacterial and viral origin.
    • Overload of joints in athletes.
    • Endocrine pathologies.
    • Long-standing injuries that were incorrectly treated or treatment measures were not carried out completely.
    • Abnormal joint structure.
    • Compounded heredity.
    • This pathological process is dangerous because grade 1 gonarthrosis of the knee joint is not detected in a timely manner. With bilateral gonarthrosis of the 1st degree, there are no manifestations of pathology. The patient believes that minor pain at this stage is due to the fact that he is tired.

      The typical symptomatology of this pathology is that the patient feels his knee joint stiff, as if something is tightening under the knee, and if he walks for a long time, the knee hurts. Many patients find it difficult to walk in the morning after a person has slept or sat for a long time. A person must walk a little for the pain to go away.

      This is how grade 1-2 gonarthrosis manifests itself. When gonarthrosis of the knee joint of the 2nd degree and destructive processes of the 3rd degree of the knee joint develop, the pain will be persistent and appear constantly. During motor activity with a joint, a person feels the joint tissue crunching.

      Over time, the leg becomes difficult to bend and straighten. After the second degree, the third develops, characterized by the patient limping. If the pathology is not treated, then a person will not cope without the help of strangers or improvised means.

      In a horizontal position the pain will subside, but at night it worsens again. If the patient has bilateral gonarthrosis of the 1st degree, then the doctor, examining the patient to establish a diagnosis, will not find any pathological changes. As the pathology progresses, deformities of the knee, rough bone structures forming the joint, contractures, and curvature of the lower leg area will be noticeable.

      If you place your palm in front of the knee joint, you can feel how it crunches when you move, when the knee bends or straightens.

      There are the following degrees of the pathological process, consisting of three stages:

      • In grade 1 DOA, pathological changes in the joint are manifested by pulling sensations in the knee. The patient has difficulty walking and after waking up or after a long walk, as well as during physical overload. The pain subsides with a short walk and in a calm state. The first degree is characterized by the fact that severe dysfunction is not observed.
      • Bilateral gonarthrosis of the 2nd degree is characterized by the fact that the pain becomes intense and lasts a long time. With bilateral gonarthrosis of the 2nd degree, a crunching sound of the joint can be heard when moving. In the morning, the knee is inactive, bends and unbends poorly, and swells. Deformation changes are noticeable on the leg. A person's calves hurt in the evening and at night.
      • Bilateral gonarthrosis of the 3rd degree is characterized by constant pain in a calm state and during the patient’s physical activity. The joint hurts when the weather changes. Bilateral gonarthrosis of the 3rd degree is manifested by severe deformation of the joint. The patient limps when walking.
      • At the 4th degree of the third stage, strong deformation changes are noticeable, there is almost no joint space observed, and the cartilage tissue has disappeared. The person experiences continuous pain.
      • The medical history is filled out by a doctor who examines the patient, examines the joint by palpation, and checks the angularity of joint mobility. Blood and urine are examined in a laboratory. X-ray and magnetic resonance imaging studies are also performed.

        How to treat gonarthrosis? This is decided by the doctor, only he determines the degree, treatment depends on the clinical changes.

        As a rule, treatment measures are carried out comprehensively, step by step:

        1. Eliminate inflammation with non-steroidal anti-inflammatory drugs. Treat with Diclofenac, Olfen, Diclac, Ibuprofen, Indomethacin, Ketoprofen, Meloxicam, Nimesulide. As the pathology progresses, hormonal agents are administered. They are treated with Hydrocortisone, Kenalog, Diprospan. To stop the degeneration processes, enzyme inhibitors are prescribed. They treat with Contrikal, Ovomin, Gordox.
        2. Restore cartilage with chondroprotectors. They are treated with Structum, Rumalon, Alflutop, Mucosat.
        3. They normalize blood flow, locally warm and soothe with ointments, gels, and creams. They are treated with Finalgon, Nicoflex, Fastum gel, Apisatron, Feloran.
        4. Products that dilate vascular tissues improve blood flow and strengthen vascular tissue. They are treated with Trental, Cavinton, Upsavit, Ascorutin, Actovegin.
        5. Reduce muscle tension. They treat with No-shpa, Mydocalm, Tizalud.
        6. Restore synovium (thick elastic mass filling the joint cavity). They are treated with Ortovisk, Gialual, Fermatron.
        7. Severe cases of pathology are treated with additional methods: oxygen therapy, laser therapy, stem cell structures, and are also treated with the administration of Orthokine, which is based on blood serum. Advanced forms of pathology are subject to surgery. The affected tissues are replaced with prosthetics.

          Surgical methods depend on the extent of the lesion. Typically do the following:

          • Destroyed cartilage and joint tissue are removed (arthrodesis).
          • The deformed cartilage tissue is removed using an arthroscope (arthroscopic debridement).
          • The dissected bone structures are secured in a different position (osteotomy).
          • The joint is replaced using implants (endoprosthetics).
          • Treatment measures in the initial stages are carried out without medications. Therapeutic exercise will improve blood flow, strengthen muscles and ligaments, increase muscle tone, and maintain motor activity of joints. Such gymnastics is selected by the doctor individually.

            Physiotherapeutic procedures involve the use of electrophoresis, ultrasound, magnetic, and microwave influences on the joints. They also treat with paraffin, use therapeutic mud, baths with radon, hydrogen sulfide. The use of massage procedures and manual influences is effective.

            Non-traditional methods use an infusion based on garlic and lemon, adding a little celery. A tea drink containing black beans is recommended.

            With this pathology, spicy, fatty foods containing salt are contraindicated. Low-fat jellied meat and natural fruit jelly are recommended. Seafood products with fish are useful.

            Prevention recommendations:

          • When dancing, you should beware of injury.
          • There should be moderate physical activity, since physical activity has a positive effect on the trophism of joint cartilage.
          • Hypothermia should be avoided.
          • You should eat a balanced diet.
          • It is always necessary to control your body weight.
          • If you are injured, you should seek medical help.
          • After 36 years, prevention with chondroprotective agents will not hurt.
          • You should drink enough water every day.
          • A walk in the fresh air will not be superfluous; swimming will help.

          It is worth remembering that if gonarthrosis manifests itself, it requires urgent treatment by a specialist.

          Self-medication will only do harm.

          Even simple physical exercise can help one person and harm another.

          Therefore, at the slightest manifestation of symptoms, medical advice and help is needed, otherwise the complications will be serious, and the person may become disabled.

          A Russian doctor, doctor of medical sciences and professor claims that with his technique he will cure any joint diseases in a couple of months . Which will completely cure an ancient grandmother with the most advanced arthritis in 78 days. And joint pain, he says, with the right approach will go away in 4 days! And, over 48 years of activity, he confirms every statement with practice.

          Immediately after the broadcast on the Russia-1 TV channel (on the topic “how to preserve joints at any age”), he agreed to give an interview. Read the interview.

          Symptoms of arthrosis of the knee joint and degree (1, 2, 3)

          Symptoms of arthrosis of the knee joint develop gradually. In the initial stages of the disease, a person does not feel pain, so he does not pay attention to the disease. Minor swelling of the knee is “written off” as a sprain or fatigue after an intense day of work.

          Signs of grade 1 gonarthrosis are rarely detected, since the patient does not consult a doctor. If treatment is started in a timely manner, the disease will be prevented from progressing to stages 2 and 3, which we will discuss in more detail in the article.

          What is grade 1 arthrosis of the knee joint?

          Arthrosis of the knee joint 1st degree is characterized by inflammatory changes in the cartilaginous surfaces of the bones and inflammation of the interarticular menisci. The accumulation of fluid leads to widening of the joint space and tension of the muscular-ligamentous apparatus. There is no limitation in knee mobility.

          Painful sensations in stage 1 pathology are rarely observed.

          As a rule, gonarthrosis at this stage is detected on an x-ray by chance. To identify the disease, the radiologist must have sufficient qualifications. It is not easy to see the expansion of the joint space. It is necessary to evaluate the anatomical features of the patient and know the normal dimensions of the space between the bones of the joint in order to establish a diagnosis.

          In clinical language, inflammation in the first stage of gonathrosis is called “synovitis.” The term describes inflammatory changes with fluid in the kneecap. If synovitis is observed for a long time, it leads to the formation of a Becker cyst - a limited focus of fluid in the back of the knee (popliteal fossa).

          Attention! A Baker's cyst should not be confused with an oncological formation. It has nothing to do with tumors, but is only a limited accumulation of inflammatory infiltrate. Usually its size decreases during treatment with anti-inflammatory drugs or after surgical puncture (suction of fluid from the damaged joint).

          Arthrosis of the knee 2 degrees - symptoms and diagnosis

          Arthrosis of the knee 2 degrees is more often observed in women. The typical age of patients with this disease is 40 years and older. The disease is typical for athletes and people with increased body weight. The pathology is complicated by the presence of varicose veins. This combination is observed in older people and overweight patients, so obesity needs to be eliminated as soon as possible.

          Signs of grade 2 knee arthrosis on an x-ray:

        8. Narrowing of the joint space;
        9. Formation of bone growths;
        10. Decreased bone density (subchondral osteosclerosis).
        11. The above symptoms are sufficient to make a diagnosis.

          Clinical symptoms of stage 2 gonarthrosis:

        12. Painful sensations with increased load on the knee;
        13. Swelling of soft tissues in the evenings;
        14. Soreness of the popliteal cap (in the presence of edema);
        15. External deformity of the knee joint.
        16. The initial symptoms of the disease appear suddenly. When walking, a person initially experiences minor pain. The symptoms are especially pronounced when climbing stairs. The first steps when getting up from a chair are especially painful. If you “diverge,” the signs of pathology decrease. The pain goes away with rest or after rest.

          The above-described manifestations are “starting”. They form gradually, but sooner or later they lead to severe pain. These manifestations of the disease are diagnostic. With such a history, the doctor suspects gonarthrosis.

          If the patient’s pain arose suddenly, and no symptoms of pathology were observed before, traumatic injuries (fracture, ligament damage) can be assumed. In more rare cases, the cause of persistent knee pain may be tumor formations (chondromas and osteomas).

          Another clinical symptom of the pathology is crunching. This is how patients describe the sensations they experience when walking. Clinical studies have shown that such signs are more often a manifestation of damage to the musculo-ligamentous apparatus or the presence of bone fragments (osteophytes) in the articular cavity.

          The crunching does not threaten any serious pathological changes, but only if it is not combined with gonarthrosis. In the latter case, a combination of ligament weakness and damage to the interarticular meniscus leads to increased mobility of the knee.

          A diagnostic test for grade 2 knee arthrosis is the inability to fully flex the leg at the knee joint. When trying to perform a bend, the patient experiences sharp pain. At an angle of the lower limb of 90 degrees or more, the patient experiences sharp pain symptoms.

          Osteoarthritis of the knee joint 3rd degree - why does the knee hurt?

          Osteoarthritis of the knee joint grade 3 on an x-ray is manifested by a sharp narrowing of the gap. Radiologists describe this syndrome as a “thread line.” Indeed, if you look at a picture of a person with stage 3 gonatrosis, you can see a sharp rapprochement of the bones with each other.

          Any movement leads to severe pain in a person. Even in a calm position, it is difficult for the patient to fall asleep. Only when he finds a comfortable position does the pain disappear or decrease.

          Since the destruction of cartilage develops against the background of impaired blood supply, any change in atmospheric pressure leads to the fact that the legs begin to “twist”. These symptoms occur even at night. A person becomes a “barometer” because he can guess when it will rain based on his own feelings.

          Joint mobility in pathology is significantly reduced. In such a situation, a disability group is assigned, since the person cannot walk.

          A qualified doctor, upon external examination of a person, will determine that the patient has a pathology, since he walks on bent legs. If the pathology persists for a long time, you can see curvature of the bones of the lower leg with external or internal deviation.

          Early and late symptoms of joint osteoarthritis

          Early symptoms of osteoarthritis are indicative. If detected, serious complications can be prevented.

          How to detect joint damage in the initial stages:

        17. Pain in the knee when climbing stairs;
        18. Crunching when doing physical exercises;
        19. Swelling after a long walk;
        20. Aching bones when the weather changes
        21. With arthrosis, the above-described signs intensify against the background of physical activity. In any case, if at least one sign occurs, we recommend performing an x-ray of the knee joint in 2 projections. It will allow you to identify the disease and begin early treatment. Conservative methods do not allow you to completely get rid of the disease, but with their help it is possible to prevent the further development of the pathology.

          Knee arthrosis is a degenerative-dystrophic disease. Because of this, if there is a narrowing of the joint space of the knee joint on one side of the 2nd or 3rd degree, gonarthrosis of the other leg should be expected.

          To prevent such symptoms, we suggest paying attention to the following signs:

          1. “Starting pain” that occurs when walking on stairs, when getting up from a chair. When a person begins to walk, pain decreases. A person experiences minimal health problems in the evening. However, the patient rarely consults a doctor with such symptoms. Only when the symptoms of the disease increase, swelling increases, the patient cannot cope with the disease on his own;
          2. Crunching is an early symptom of a disorder of the synovial fluid. Already at this stage, chondroprotectors should be taken to restore cartilage structures;
          3. Restriction of knee mobility in the initial stage of the disease is functional. It appears due to spasmodic contractions of skeletal muscles. In the later stages, spasm appears due to anatomical obstacles - the formation of bone osteophytes, cysts, accumulation of inflammatory fluid in the popliteal fossa;
          4. Deformation of the joint due to a decrease in the volume of bone tissue, which “loses weight” due to poor blood supply against the background of degenerative-dystrophic disorders. If the pathology continues for a long time, a person develops X or O-shaped legs, since the bone tissue cannot withstand more load.

          Despite the fact that the clinical symptoms of arthrosis in the initial stages of the disease are not pronounced, over time they lead to serious deformities of the lower extremities. It is better to take an x-ray when the first signs of pathology appear than to permanently lose the functionality of the knee joints. Already at 2-3 degrees of gonathrosis, a person is given a disability. At stages 3-4 of the disease, the ability to walk is lost and the need for artificial endoprosthetics arises.

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