Knee pain is common. For some people, discomfort occurs periodically, after high loads on the legs, for others, the pain syndrome increases every day.
Deforming osteoarthritis (DOA) of the knee joint, grade 2, is a difficult-to-treat pathology, accompanied by pain and limited mobility. The sooner the patient pays attention to the signs of impending trouble, the lower the risk of complications.
Degenerative-dystrophic changes in cartilage do not develop in one day. Under the influence of negative factors, tissues lose elasticity, become thinner, and gradually collapse. After the partial or complete disappearance of the cartilage pad, the diseased joint cannot fully function, and it is difficult for the patient to move, bend and straighten the knee.
Osteoarthritis in the knee joint is more often diagnosed by doctors in elderly patients. In recent years, the disease has become “younger”: middle-aged patients present for appointments with signs of DOA. The reason is a combination of negative factors affecting the legs and knee joint.
Degenerative-dystrophic changes in cartilage occur under the influence of many components:
The combination of excess weight with endocrine pathologies and age-related tissue changes accelerates the development of a severe form of joint disease in the knee area.
Look at a selection of effective methods for treating osteochondrosis of the cervical spine using folk remedies.
How to remove tophi with gout? Treatment options for painful nodules are described on this page.
Deforming osteoarthritis is a severe pathology of a progressive nature. After the onset of the pathological process, cartilage destruction occurs constantly. With increased stress on the legs, poor nutrition, and lack of attention to one’s health, it is almost impossible to stop the process.
The danger of osteoarthritis - negative changes over time affect not only cartilage, but also other elements of the joint. The thinning of the cartilage increases the friction of the articular heads, synovial fluid is not produced in sufficient volume, the abrasion of dense tissue increases, and the cartilage is gradually destroyed.
Osteoarthritis is divided into two types:
Doctors distinguish three stages of joint pathology:
Knowing the main signs of DOA will help you recognize articular pathology in a timely manner:
The success of therapy depends on the stage at which the patient visited the doctor. The first degree of deforming osteoarthritis after procedures and taking medications goes away almost without leaving a trace, degenerative changes do not have time to develop, and the likelihood of relapse if the rules are followed is quite low.
The second degree of DOA is characterized by active destructive processes inside the elements of the joint. At this stage, osteoarthritis can still be stopped: taking chondroprotectors, NSAIDs, using traditional methods, exercise therapy and massage gives good results. The main thing: the patient’s discipline, regular monitoring of the course of the pathology by the doctor.
Complex therapy for grade 2 osteoarthritis includes the following groups of medicinal compounds with diverse effects on joint tissues:
During the period of remission, procedures that support the positive dynamics of therapy and preserve joint health are effective:
A good addition to main types of therapy. In the first and second stages, homemade formulations are most effective. The opinion of the attending physician regarding the selected prescriptions is important.
Useful remedies for treating joints:
Moderate loads preserve the elasticity of cartilage, maintain muscle tone, and prevent the problem joint from becoming ossified. An experienced doctor will show you a set of exercises and self-massage techniques. A rheumatologist, orthopedist or arthrologist is the best adviser when choosing a training program.
First, the patient studies the rules, basic techniques, and listens to the sensations after training. The doctor allows physical activity at home when the patient is completely ready to work on himself independently. Video instructions for performing physical therapy are useful.
Why do elbow joints hurt and how to deal with unpleasant sensations? We have the answer!
Effective methods for treating knee arthrosis at home are described in this article.
Go to http://vseosustavah.com/bolezni/lechenie/hondroprotektory-novogo-pokoleniya.html and see the list of chondroprotectors for new generation joints.
In severe, third-degree deforming osteoarthritis, replacement of damaged areas of hyaline cartilage is recommended. The surgeon performs endoprosthetics: in place of the damaged cartilage tissue, he installs an endoprosthesis - a joint made of biologically inert material.
The operation is not performed on patients in extreme old age, if there are contraindications. The impossibility of surgical treatment and the low effectiveness of conservative therapy often leads to disability.
Considering the recurrent nature of the pathology, the complexity of therapy, and the rapid progression of negative changes, it is important to listen to the body’s signals in a timely manner. It is easier to prevent the development of the disease than to spend many years of time and money on procedures, medications, or give up hobbies and the usual rhythm of life.
Medical video - a guide to the symptoms and treatment of deforming osteoarthritis of the knee:
Osteoarthritis of the knee joint (sometimes also called gonarthrosis) is a degenerative disease manifested by damage to the joint structures and leading to deformation and, ultimately, complete loss of mobility in the knee.
Unfortunately, this disease is quite common and according to statistics, up to 30% of the world's population suffer from osteoarthritis of the knee joint of varying degrees. The disease is chronic and may be accompanied by inflammatory processes.
The peculiarity of this disease is that the problem identified in the early stages can be treated quite effectively, and the person will live a life filled with movements for a very long time. There is another side to the coin: since the disease is chronic, it will not be possible to completely get rid of it. Treatment only slows down the process of wear and tear of the joint, but this will be quite enough for a full life.
Ignoring the problem can lead not only to pain and restrictions in movement, but also to a complete loss of functionality of the joint due to wear and tear of the cartilage tissue in the knee.
Reasons that provoke the development of osteoarthritis of the knee:
Naturally, the diagnosis must be made by the attending physician, but in order to seek help from him, you need to know the main symptoms that indicate the development of deforming osteoarthritis of the knee joint.
This will help you seek medical help in time and not miss the moment in order to start treatment in a timely manner to preserve and maintain normal joints and their cartilage tissue.
So, the following signs may indicate the development of osteoarthritis:
But that’s not all, since advanced osteoarthritis of the knee joint grades 2 and 3 may be accompanied by some other symptoms:
Each stage of arthrosis is accompanied by characteristic symptoms. Thus, in medicine there are three degrees of development of osteoarthritis of the knee joint.
The first stage is characterized by the following symptoms:
In the photographs of the 1st stage of the development of the disease, one can observe a narrowing of the articular cavity (so far insignificant).
The second stage is characterized by the following manifestations:
The photographs of the second stage will show a significant narrowing of the articular cavity, bone growths, and bone thickening. It is at this stage that patients often seek medical help.
Stage 3 of the disease is the most severe and cannot be treated. A patient with grade 3 osteoarthritis of the knee joint receives disability. The situation can be corrected at this stage only by implanting an artificial joint.
As a rule, a person, having discovered symptoms of destruction of the knee joint, goes to see not a specialist - an orthopedist, but a surgeon or therapist. But even these specialists will prescribe the necessary minimum of research, the results of which will require an appointment with an orthopedist:
After these mandatory studies, the orthopedist can add a few more points to confirm or clarify the diagnosis:
Treatment of osteoarthritis of the knee joint (if its cause is precisely known) is aimed, first of all, at getting rid of the provoking factor.
If the disease develops as a result of metabolic failure, it is necessary to use a diet and normalize nutrition. If the cause of the disease is excess weight, it needs to be lost. It is necessary to treat a disease that has arisen due to hard work only after changing the workplace to a more gentle one.
Drug treatment of osteoarthritis of the knee joint occurs through the use of several groups of drugs:
To achieve an effect, drug therapy should be supported by some other methods:
At home, treatment of osteoarthritis can be supported and strengthened with the help of folk remedies and methods.
Decoctions for oral administration:
A bath with sea salt and turpentine has proven itself well in the treatment of arthrosis of the knee joint. This composition helps to get rid of pain and inflammatory processes, while restoring motor function to the diseased joint.
An advanced disease is fraught not only with increased pain, which simply will not allow you to perform everyday activities and lead a normal lifestyle, but can also ultimately lead to disability (complete immobilization of the knee joint).
In order to reduce the likelihood of developing osteoarthritis, you need to monitor your weight and lifestyle. Do not carry heavy objects and overload your legs.
It is important to perform simple physical exercises that are not aimed at the knee joint - this will strengthen the body and its resistance to various diseases. This prevention should be supported by folk methods in the form of decoctions, ointments and baths, which will reinforce the effect.
Deforming arthrosis, or defarthrosis, is a joint disease that develops against the background of a primary degenerative process or damage to the articular surfaces. The disease is characterized by severe pain, joint deformation and limited range of motion. Treatment of arthrosis deformans is based on the use of anti-inflammatory, painkillers and chondroprotectors, which help get rid of unpleasant symptoms and stop the destruction of articular cartilage. In advanced cases, the patient may undergo endoprosthetics. The disease is characterized by a progressive chronic course resulting in ankylosis or pathological instability of the joint.
The disease is characterized by disruption of regeneration processes in cartilage and connective tissue, which leads to damage to the articular surfaces. Cracks and roughness form on them, and a pronounced thinning of the cartilage is observed, which ultimately leads to the formation of osteophytes (bone tissue in the cartilage area), cystic formations and the development of subchondral sclerosis.
All cases of deforming arthrosis of the knee joint and lesions of other localizations are usually divided into primary and secondary. In the primary variant, the pathological process develops in healthy articular cartilage. The secondary version of defarthrosis affects those joints that already have damage, for example, as a result of injuries, hormonal disorders, etc.
The ICD-10 code for deforming arthrosis is M15-M19, depending on the affected joint.
To answer how deforming arthrosis is treated, it is necessary to understand the reasons for its occurrence in the patient. Doctors highlight the following factors:
Against the background of these reasons, the patient may have provoking factors: inadequate physical activity, excess body weight, old age and pathologies of the endocrine system. All of them negatively affect the condition of cartilage tissue, contributing to the development of defarthrosis.
Depending on the patient’s signs of deforming arthrosis and X-ray data, it is customary to distinguish three stages of the disease:
A number of experts identify the zero stage of defarthrosis, characterized by the presence of clinical manifestations of the disease, but the absence of any radiological signs.
Deforming arthrosis of the 1st degree and subsequent stages are characterized by pain in the area of the affected joint. These arthralgia are initially noted only against the background of physical activity, which is associated with the condition of the articular surfaces. The pain completely disappears after a period of rest and at night.
Some patients have “starting” pain - severe pain in the first few seconds or minutes after the start of movements. Their appearance is associated with swelling of the periarticular tissues and reactive synovitis.
With a long course of the disease, patients complain of “blockade” pain, which occurs during movement and leads to “jamming” of the joint as a result of pinching of the articular cartilage between the bone intra-articular formations.
Other manifestations of deforming arthrosis of the ankle and other joints:
Most often, defarthrosis affects the joints of the lower limb, the joints of the spinal column and the phalanges of the fingers. With coxarthrosis, patients note pain in the groin area, which spreads down the leg, as well as long periods of “jamming” of the joint. With this deforming arthrosis, the patient’s photo shows noticeable wasting of the femoral and gluteal muscles. The person begins to limp, and with further progression of the disease and lack of treatment, complete immobility in the hip joint is possible. Deforming arthrosis of the joints of the feet is characterized by the formation of dense nodules along the edges of the interphalangeal joints. These nodules are painful on palpation and are growths of bone tissue along the edges of the articular surface of the bones.
Deforming arthrosis is characterized by damage to single joints, which is constantly progressing due to the intensification of degenerative processes in cartilage and bone tissue.
Understanding what deforming arthrosis is allows you to organize a proper examination of the patient. Patients with such complaints consult a traumatologist or rheumatologist. In addition to the standard collection of complaints, information about the patient’s life and general clinical tests, all patients are shown an X-ray examination of the affected joint.
Radiographs reveal: the formation of multiple osteophytes, narrowing of the joint space, the appearance of cysts and osteosclerosis under the cartilaginous surfaces. Computer and magnetic resonance imaging, as well as ultrasound, can be used as additional methods.
In difficult diagnostic cases, arthroscopy and puncture of the affected articular surface are performed. Its subsequent study, as well as studying the composition of the intra-articular fluid, allows the doctor to obtain accurate information about the pathological process and make an accurate diagnosis.
Treatment of deforming arthrosis is carried out comprehensively and must necessarily include the elimination of the primary causative factor. All patients are shown a reduction in physical activity to relieve stress on the affected joint, as well as the use of canes or crutches while walking.
The analgesic and anti-inflammatory effect is achieved through the use of drugs from the NSAID class: Indomethacin, Ketorolac, Nise. In the presence of severe pain, intra-articular injection of local anesthetics mixed with glucocorticoids is used. Nonsteroidal anti-inflammatory drugs are used both orally and in the form of ointments or gels to enhance the effect.
With early diagnosis of the disease, the treatment of deforming arthrosis must include chondroprotectors (Arthra, Chondroetin sulfate, etc.), which help stop the destruction of cartilage tissue and improve its regeneration. In addition to medications, treatment is supplemented with various types of physiotherapy, therapeutic exercises, massage, balneotherapy and other non-drug treatment methods.
If there is severe deformation in the joint, conservative therapy is not effective. Patients undergo endoprosthetics to restore leg mobility.
It is not recommended to use methods of traditional healers, homeopathy and other remedies not approved by official medicine to treat arthrosis, since all of them do not have proven effectiveness and safety.
Speaking about deforming osteoarthritis, it is important to understand that it is impossible to completely cure the patient even in cases where treatment is started at the initial stages of the disease. The rate of progression of the disease is individual for each patient, which is determined by the characteristics of the human body, the presence of concomitant diseases and the location of the lesion. Adequate therapy allows you to stop the progression of defarthrosis and achieve stable remission.
Arthrosis deformans is a serious disease that leads to severe symptoms, a decrease in the patient’s quality of life and gradual disability. Due to the fact that effective treatment is possible only in the initial stages of the disease, a person should immediately contact a medical facility when the first symptoms of pathology appear. A traumatologist or rheumatologist will prescribe the necessary examination for the patient and, based on it, select a comprehensive treatment to stop the destructive processes.
Osteoarthritis of the knee joint is a disease that is manifested by damage to all structures of the joint, leading to its deformation and, as a result, loss of mobility.
Dystrophic joint disease, which is caused by damage to articular cartilage, is called osteoarthritis (gonarthrosis). This disease causes the articular cartilage to thin out, become soft, lose its elasticity, and cracks form in it.
Deforming osteoarthritis of the knee can be called a disease of people over the age of 40 who suffer from excess weight. The higher the body weight, the faster joint pathology will begin to develop and the more severe it will become. When a person is obese, it is often the legs that suffer because they have to bear the weight.
The disease begins to develop with pathological changes in cartilage tissue. At first, everything happens at the micro level and does not manifest itself clinically. But when exposed to certain reasons, the nutrition of cartilage cells is disrupted and they begin to die. Then the destructive process reaches the menisci, joint ligaments and periarticular bursa.
Knee osteoarthritis is a degenerative disease and leads to damage to all joint structures and serious deformities.
This disease is widespread, especially among older people. Statistics say that older people suffer from osteoarthritis of the knee in one out of ten cases.
In advanced cases, without proper monitoring by specialists and competent treatment, osteoarthritis can lead to disability.
In the process of destruction of the underlying bone cartilage tissue, bone compaction (osteosclerosis) develops and a pathological bone growth is formed, which is called an osteophyte.
All these changes are accompanied by constant aching pain. In addition to the above pathological deformations, changes also occur in the periarticular tissues, which are characterized by thickening of the capsule, spastic muscle contraction, and inflammation of the tendon sheaths. All these processes increase the pain of the sore spot and lead to disruption of joint functions.
The prevalence of the disease is often determined by a minimal amount of physical activity or even its complete absence, which is quite typical for the lifestyle of a modern person.
In the knee joint, cartilage connects 2 bones. Around the cartilage there is a fluid (synovial), which ensures smooth and painless sliding of the 2 bones relative to each other. Over time, with osteoarthritis, the cartilage of the knee joint is completely worn away, and this leads to the formation of bone outgrowths, growths and severe deformities of the knee joint.
Regarding the causes of osteoarthritis of the knee joint, there are still no exact and unambiguous formulations. However, it is believed that the prerequisites for the development of this disease are a combination of some external and internal factors.
In modern medicine, it is customary to distinguish several risk groups:
This disease is very rarely observed in those under 30 years of age. However, age-related changes in the body reduce the ability of articular cartilage to self-heal after damage.
Many women experience osteoarthritis after menopause. It is believed that most often this disease affects the fair sex.
The risk group also includes those people whose parents suffered from this disease.
As for overweight people, the higher the body weight, the faster the development of this pathology, and the more difficult it is to bear.
With obesity, it is the joints of the legs that experience constant excessive stress, which is why they suffer most often. However, not only weight is the cause of the development of gonarthrosis in those who are overweight, but also significant metabolic disorders and hormonal changes, which are constant companions of obesity.
The presence of painful sensations is explained by the fact that the exposed bones inside the joint rub against each other when walking. Over time, bone “spikes” form in the joint and not only deformities in the knee area can occur, but also curvature of the entire leg.
The main manifestations of osteoarthritis are, first of all, a feeling of stiffness and pain in the knee joint. Unpleasant sensations occur in the morning when getting out of bed; when staying in a “sitting” position for a long time; during a long walk.
At first, the pain is short-lived, but over time, it intensifies and becomes long-lasting. Later stages of the disease are characterized by unpleasant sensations even at night, when there is no load on the joint.
The development of the disease occurs gradually. Over time, the mobility of the diseased joint is limited, extension and bending of the leg becomes difficult, a crunching sensation occurs in the joint, and the diseased knee swells. All this leads to lameness on the affected leg, and in the most advanced cases, even to the inability of a person to move without the help of crutches and a wheelchair.
Symptoms of osteoarthritis vary depending on the stage of the disease. So, at the first stage, osteoarthritis of the knee has the following characteristic signs:
At this stage, few people go to the doctor, so identifying pathology is quite difficult. As a rule, it can be detected when the patient seeks medical help for some other reason.
At the second stage, the disease progresses very clearly and is difficult to miss. This stage has the following symptoms:
This stage of the disease no longer goes unnoticed, so many sick people consult a doctor.
At the third stage, the disease is already considered advanced and often leads to disability.
Manifestations of this level of the disease are as follows:
If the disease has developed to this stage, then this only means disability. The situation can only be corrected by an artificial prosthesis, which is implanted into the diseased joint.
The disease goes through several stages of development. Osteoarthritis of the knee joint grade 1 has the following symptoms:
At the first stage, a slight narrowing of the articular cavity can be observed in the photographs.
Osteoarthritis of the knee joint of the 2nd degree will already be more pronounced. The patient will feel discomfort constantly, even at rest, especially in the morning.
Movements in the knee will be difficult, the gait will become slow, a characteristic crunch will be heard during movements, if you palpate the knee, the patient will also feel pain, subsequently deformation of the joint will develop, swelling and an inflammatory process may appear. If you take an x-ray, it will clearly show a strong narrowing of the articular cavity, thickening of the bone and bone growths. Often a doctor is consulted at this stage.
Stage 3 of the disease is even more severe and therefore difficult to treat. This stage may already be characterized by the patient’s disability. In this case, only implantation of an artificial joint can prevent the destructive process.
Osteoarthritis treatment requires very serious, and most importantly comprehensive. It is very important to eliminate the cause of osteoarthritis. If it develops as a result of excess weight, then the first thing the patient needs to do is lose weight. If he abused sports activities, then their regime must be replaced, and if hormonal levels are disrupted, it must be normalized.
All medications that are used for complex therapy can be divided into several groups:
Medicines help effectively relieve joint pain, because this is the most common complaint with which patients usually consult a doctor. Also, one of the main tasks of medications is to eliminate the inflammatory process that provokes pain.
For acute pain, intra-articular administration of drugs such as:
It is mandatory to have a course of therapy with chondroprotectors, which are usually administered intramuscularly or intraarticularly. This is chondrotin sulfate, glucosamine. Hyaluronic acid is often used, intended only for intra-articular administration.
The effectiveness of drug treatment directly depends on the accuracy of its prescription, concomitant therapy, and the patient’s responsible attitude towards unquestioningly following all the doctor’s instructions.
The doctor prescribes dietary supplements rich in collagen and chondroitin to the patient. The patient is recommended to eat a diet that consists of preferential consumption of lean meat, turkey, salmon and various seafood. The daily menu should include fresh herbs, yellow and green vegetables, and fruits.
It is necessary to exclude spicy, over-salted, fatty and carbohydrate-rich foods from the diet, since such foods interfere with the absorption of amino acids by cartilage tissues and contribute to excess weight gain.
Additional treatments for this severe disease include yoga, physical therapy, massage, acupuncture, ultrasound, laser and magnetic therapy. Spa therapy is definitely recommended for patients with osteoarthritis.
The most harmless methods of treatment are folk remedies. There are a sufficient number of them, but the effectiveness in each case is different. The main goal of therapy is pain relief.
The first available method is celandine oil. This plant has been encountered by every person, so finding it is not difficult at all. You need to take three tablespoons of crushed stem and leaves, infuse the mixture in vegetable oil for two weeks, then rub the resulting medicine into the joint every day.
Treatment with folk remedies lasts a month, even if the pain disappeared earlier.
Burdock is also an excellent remedy; its healing properties are known all over the world; it is very effective in relation to osteoarthritis. You need to fold 5-7 medium-sized burdock leaves with the bottom side up and place a pan of hot water on them. After the leaves have steamed, lubricate the knee joint with vegetable oil and apply the bottom side to the leg. Next, you need to wrap your knee with cling film, then with a warm cloth.
Compresses should be done daily for two weeks.
Camphor rubbing and mountain resin - mumiyo - will be no less effective. These natural remedies will help you cope with severe joint pain.
Clay compress. The compress is made from blue pharmaceutical clay. So, to prepare the mixture, you need to grind the clay powder in a glass or porcelain bowl with a wooden spoon or your hands until it becomes creamy. The finished mixture should be applied to linen or cotton cloth and applied to the sore joint, wrapping the compress on top with a bandage. A woolen scarf is wrapped around the knee over the bandage. The duration of this compress is 2 hours.
Clay compresses are one of the most effective methods of treatment.
Dandelion tincture. In mid-May you need to collect yellow dandelion flowers. They should be placed inside a dark glass container. The container is more than half filled. Then, triple cologne is poured into the bottle. Keep the closed container in a dark place, shaking occasionally, for 14 days. This tincture should be used to wipe sore joints three times a day.
Apple cider vinegar (3 tablespoons) is mixed with honey (1 tablespoon). The resulting mixture is applied with rubbing movements to the sore spot, a cabbage leaf is placed on top, which is covered with a bag, secured with a bandage and wrapped in a warm cloth. The course of such treatment is 1 month.
It is advisable to leave the apple cider vinegar bandage on the leg for about 12 hours.
In addition to the remedies described above, a diet that involves eating certain foods rich in collagen and chondroitin will help cope with the disease. Such nutrition will help restore articular cartilage, thereby alleviating the symptoms of the disease.
A sufficient amount of chondroitin is found in seafood, more precisely, crustaceans. It could be shrimp, crabs. To saturate the body with collagen, it is necessary to eat lean meat.
The following products will help stimulate the production of your own collagen:
To achieve a greater effect, it is recommended to exclude fatty, spicy, salty dishes, and foods rich in simple carbohydrates from your usual diet. They interfere with the absorption of amino acids that are beneficial for cartilage tissue, promote weight gain, and have a detrimental effect on the joints of the knees.
An excellent addition to medications, compresses and proper nutrition will be gymnastics (exercises), which will help develop the joint and give it greater mobility.
Sets of special exercises should be performed regularly, in a lying or sitting position, to prevent stress on the knee joint. None of the exercises should be accompanied by pain, it should be aimed at strengthening the periarticular muscles. This will help when walking and reduce pain.
Any therapeutic exercises are carried out only under the supervision of a doctor or qualified trainer. Improperly performing exercises or prescribing them independently can only aggravate the situation.
Before starting any physical activity, you should definitely visit a physiotherapist, who will assess the patient’s general condition and determine the need and characteristic features of therapeutic exercises.
The loads a person receives during exercise should increase at a slow pace in order to increase the mobility of the joint without causing harm to it.
Position: lying on the floor, on your back. The sore leg must be slowly straightened and carefully raised above the floor level by 20 cm. In this “suspended” state, the leg must be held for as long as possible.
Body position – lying on the floor and on your back. The straightened, sore leg must be raised above the floor by 15–20 cm. Having raised it, it should be immediately lowered down. The exercise should be repeated 10 times.
Find an orthopedist and make an appointment
Osteoarthritis or deforming osteoarthritis is a joint disease that is one of the most commonly diagnosed ailments. If we consider its manifestation by region of the Earth, the number of identified patients will be from 20 to 40 percent, which in itself is alarming. A significant proportion of cases of deforming osteoarthritis are among the female part of the world's population. At the age of 50 years and older, the disease can be detected in 50% of people, and after 70 years this figure rises to 80-90%.
Long-term observations of the development of the disease made it possible to obtain statistical data on various joints. About 42% of all diagnoses occur in the hip, knees suffer from osteoarthritis in 34%, the shoulder accounts for 11%, and about 13% is the number of lesions occurring in other human joints. By introducing deforming osteoarthritis into the ICD, experts identified the disease as arthrosis, designating it with codes M15-M19. What is deforming osteoarthritis of the joints, how does it form in the body, what causes it, and is it possible to get rid of it?
Joint deformation occurs due to an imbalance between the amount of mechanical loads on cartilage tissue and the ability to compensate for them. Progressive imbalance leads to cartilage destruction and degeneration. Doctors consider serious sports activities, extra pounds and heavy physical labor to be mechanical stress.
Disturbed equality between the articular surfaces and the load on them damages the joint and pathological changes occur. The biologically destructive process is explained quite simply. Hyaline cartilage of the joint consists of chondrocytes and matrix located between the cells of the cartilage tissue. The purpose of the matrix is to provide elasticity to cartilage tissue and protect it from damage.
When metabolic changes begin in cartilage, the cellular structure is destroyed, matrix production decreases, and the tissue loses water molecules. The surface of the cartilage becomes rough and microcracks appear. In severe cases, cartilage tissue is completely destroyed, bone tissue is exposed, and joints are subject to deformation. The sclerotic process progresses, cystic cavities appear, negative destruction spreads to the bones, forming painful joints. This is what it looks like:
In an attempt to compensate for joint stiffness, the human body builds up osteophytes, worsening the situation. Cartilage tissue protrudes beyond the limits designated by nature, causing ankylosis of the joint and loss of its motor ability. In order to prevent such a development of the disease scenario, it is necessary to begin treatment of deforming osteoarthritis on time. Complete information on the disease is perfectly presented in this video:
Having collected a clinical and radiological picture of the disease, doctors were able to identify and describe the stages of its development. Today there are three main stages:
According to the classification of the disease developed by Kellgren and Lawrence, stage 0 of deforming osteoarthritis, which is not detectable by x-ray, has been established.
In medicine, there is a division of deforming osteoarthritis into primary and secondary. The causes of primary osteoarthritis have not been precisely established, so doctors point only to risk factors:
The following reasons are indicated for secondary osteoarthritis:
At the very beginning of its negative impact, the disease does not reveal itself. Destructive processes in cartilage tissues occur slowly, and only a sharp external impact can reveal the problem. After this, a pain syndrome begins to appear, occurring during motor activity of the diseased limb. Let's consider the increase in symptoms using the example of the knee joint.
The first signs of knee joint disease are noticed by a person while walking. At first, the patient has difficulty going up and down the stairs, then the usual walking causes discomfort. The pain makes itself felt especially clearly in the morning, after sleep. During the day, a person does not feel pain, but in the evening it returns to the strained joint.
The progression of osteoarthritis is slow, but invariably ends with the destruction of cartilage and then articular tissue. The joint becomes overgrown with osteophytes, the integrity of the synovial capsule is compromised, interarticular fluid is lost, and the painful load increases. Severe thinning of cartilage tissue occurs, cracks appear, muscle tissue becomes inflamed, and mobility is significantly lost.
The expressed symptoms look like this:
The cause of the pain syndrome is detritus, a process in which pieces break off from the affected cartilage. When a person moves, fragments of dead cartilage tissue penetrate into the joint cavity, the pain disappears, which leads to temporary relief, but not the disappearance of the disease.
Tenobursitis also becomes a companion to synovitis, when pain occurs at the very beginning of movement when the tendons contract. Reflex pain syndrome affects the muscles, and now every movement of the affected limb causes a person special pain.
Every doctor knows that without correct diagnosis it is difficult to develop competent treatment for the disease. In the case of deforming osteoarthritis, a number of studies are carried out to look deeply into the disease and understand the degree of its development. The first priority is a radiographic procedure. The resulting image should be examined by an orthopedic surgeon or traumatologist. A specialist can easily see in the image a narrowing of the joint space, bone growths in the joint area, and a violation of the integrity of the bone tissue. X-rays also show cystic cavities. In addition, other studies are being conducted:
If one specialist cannot resolve the issue of an accurate diagnosis, or he requires additional information, the patient is referred to a rheumatologist, surgeon and other specialists.
For a person faced with deforming osteoarthritis, it is important to know about the characteristics of the disease that affects various joints.
Most often the disease forms in the hip and knee joints. Deforming arthrosis of the hip joint (ICD code M16) is called coxarthrosis. It is characterized by severe symptoms that cause the patient excruciating suffering and serious discomfort. The main pain sensations are concentrated in the groin, radiating to the lumbar region and knees. If a person tries to walk, the pain intensifies and a feeling of joint blocking appears. A decrease in joint activity leads to hypotrophy of the gluteal muscles and thigh, which is clearly noticeable upon palpation. The protracted form of the disease leads to shortening of the limb and lameness.
Deforming osteoarthritis under code M17 according to ICD 10 is gonarthrosis or arthrosis of the knee joint. The pathology is accompanied by pain in the knees, ankles and hip joints. The pain intensifies with prolonged walking and climbing stairs. A crunching sound can be clearly heard, and the immobility of the limb increases, up to its complete blocking.
Osteoarthritis of the hands is characterized by the formation of dense nodules on the fingers and their deformation. There is also a generalized form of the disease, in which many nodular joints and joints are subject to deformation.
Localization of osteoarthritis in the ankle area can occur due to injury. Ordinary dislocation or subluxation also leads to the development of the disease. The progression of the disease leads to deformation of the lower leg, which significantly reduces the function of the limb.
In osteoarthritis of the elbow joint, discomfort manifests itself in limited mobility of the arm in flexion and extension. In addition to the usual symptoms of the disease, the patient may experience tingling in the elbow joint.
The priority task facing the doctor in the treatment of deforming osteoarthritis is to return the patient’s quality of life. To solve it, it is necessary to relieve pain, restore joint mobility, and prevent the development of the disease. Treatment is comprehensive and includes:
The plan for non-drug treatment of the disease includes the patient's compliance with certain rules applicable to everyday life. With osteoarthritis, it is very important to monitor your weight. If you have extra pounds, you need to lose them to reduce physical stress on sore joints. It is worth paying attention to a balanced and low-calorie diet, special exercises and massage are useful. A dietitian will help you develop a special diet.
In the treatment of DOA, doctors use medications with different effects:
As a rule, doctors practice a combination of several drugs, for example, taking Curantil and Diclofenac together. Medicines are produced and accepted in different dosage forms. Tablets, injections, intravenous injections, sometimes, if the situation requires it, the medicine is administered by injection directly into the joint cavity.
The value and benefits of special exercise therapy in the treatment of deforming arthrosis of any joint are recognized by all doctors. It is important that performing therapeutic exercises does not cause discomfort and pain to the patient. The set of exercises itself is developed and prescribed by a specialist, and is carried out under mandatory supervision.
A physical therapy complex may consist of walking at a moderate pace, performing exercises on special machines, and swimming. Exercises are also performed to strengthen the muscle group adjacent to the sore joint. Shoulder girdle for upper limbs, lumbar girdle for hip joint. Treatment and therapeutic exercises are well described in this video:
In the treatment of the disease, one cannot do without physiotherapeutic procedures, the action of which is aimed at improving the blood supply to diseased tissues and joints, reducing the inflammatory processes occurring in them, and, ultimately, restoring mobility. The patient may be prescribed:
The procedures strengthen the muscle frame, allowing the diseased limb to more easily bear the load.
Surgical treatment of deforming osteoarthritis is carried out in exceptional cases when conservative methods did not produce a significant positive result or the disease was in an advanced stage. Surgeons use endoprosthesis replacement and arthrodesis methods. In the first method, artificial restoration of damaged bones is carried out; in the second, doctors rigidly fix the joints, eliminating pain.
It is quite obvious that folk remedies have also been found to treat a disease that has long plagued people. Traditional medicine offers decoctions, ointments, compresses, and homemade rubs to combat deforming osteoarthritis. Here are the most effective of them:
As it progresses, deforming osteoarthritis aggravates its negative impact on the joints, leading them to critical destruction. If the patient does not receive proper treatment, his physical and psychological condition worsens. The disease leads to the formation of secondary synovitis. It especially often affects the knee joint, muscle atrophy, osteophyte growth are observed, and the mobility of the limb is completely lost.
The progression of the disease and necrosis of bone tissue is dangerous. Osteoarthritis turns into ankylosis, and the person loses the ability to use the limb. Blood begins to accumulate in the joint, swelling increases. All negative manifestations lead to disability, and the lifestyle changes radically. Having fallen ill with deforming osteoarthritis, it is necessary to urgently begin treatment in order to maintain health and the usual rhythm of life, especially since modern medicine has developed effective ways to combat the disease.