The temporomandibular joint is a paired joint on the front of the skull that connects the lower jaw and the base of the skull. Unique to this type of joint is that between the cartilaginous surfaces of the bones there is a cartilaginous disc, which allows movement in three directions - forward-backward, up-down and sideways.
When the load on the upper and lower jaw is incorrectly distributed, a condition called arthrosis of the jaw joint often develops. The development of arthrosis is facilitated by injuries and inflammation in the jaw joint, malocclusion, and dentition defects in the lower jaw. Under the influence of traumatic factors, a process of dystrophy, degeneration and gradual thinning of the articular surfaces occurs in it. As a result of pathological processes, when opening the mouth or chewing, pain occurs and, as a result, there is a restriction in the movement of the joint.
This disease often develops in people during the period of hormonal changes in the body, when metabolic disorders occur. But still, the most common causes of arthrosis are dental problems and joint injuries.
Quite often, the development of arthrosis is facilitated by defects in the dentition. In the absence of molars - the main chewing teeth - a significant decrease in the bite occurs, as a result not only the relationship between the upper and lower halves of the facial skull is disrupted, but also the functioning of the mandibular joint.
Another common cause is stress and dental errors during dental treatment or failure of patients to follow the recommendations of dentists. Incorrect placement of fillings on chewing teeth can lead to asymmetry in the functioning of the jaw joint and unilateral overloads.
So, arthrosis of the temporomandibular joint can develop due to:
When arthrosis of the jaw joint develops, symptoms may be absent for a long time, however, as degenerative processes develop on the articular surfaces, painful sensations begin to disturb at the beginning under heavy loads, and then under less significant loads, for example, when talking or chewing soft food.
The most common symptoms of this disease are:
Arthrosis of the maxillofacial joint has a long-term asymptomatic course, so patients consult a doctor already in advanced stages, when extensive degenerative processes have occurred, which also involve the synovial membranes of the joint. Due to the fact that many doctors do not have sufficient information about arthrosis of the maxillofacial joint, treating this disease is very difficult. Among the measures aimed at normalizing joint function, orthopedic, physiotherapeutic, medicinal and surgical treatment methods are distinguished. In addition, diet and regimen are mandatory components of therapy.
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Arthrosis of the temporomandibular joint is a chronic disease characterized by dystrophic changes in its cartilage, bone and connective tissue.
Arthrosis of the TMJ can be caused by general and local causes. General ones include metabolic, neurodystrophic, endocrine disorders, infectious diseases; Local include: long-term inflammatory process in the joint; excessive load on the articular surface of the head of the mandible, which may be associated with a neuromuscular disorder of the maxillofacial area, for example, bruxism; with the absence of teeth, especially lateral ones, deformation of the occlusal surface of the dentition and pathological abrasion. These factors can be combined with each other. Thus, bruxism, manifested by grinding teeth during sleep, is combined with pathological abrasion, which, by reducing the interalveolar height and deforming the occlusal surface of the dentition, creates unfavorable conditions for the functioning of the joint.
Dystrophic processes in the joint can develop as a result of the influence of general and local factors - disruption of both cellular and extracellular mechanisms that provide trophism.
The general mechanism for the development of arthrosis of the TMJ is that gradually the cartilage covering the articular surface of the head of the condylar process undergoes degeneration and disappears in places; dystrophic processes can lead to disc perforation. Restructuring phenomena are observed in the bone, sometimes with excess bone formation; the head is deformed - it becomes hook-shaped or club-shaped. Cartilage regeneration is weak.
The importance of occlusal-articulatory factors in the development of joint pathology should be especially emphasized. Their pathogenetic role is reduced to the acceleration or aggravation of dystrophic changes in the joint that arise as a result of general or local causes. The described mechanism can occur both in conditions of normal occlusion and in its pathology. In the latter case, a decrease in the interalveolar height, deformation of the occlusal surface of the dentition, and a change in the nature of movements of the lower jaw lead to a violation of the patterns of load distribution on the elements of the joint. Compensatory and adaptive processes develop in the joint. In the formation phase, all structural reserves and metabolic changes in the cells and tissues of the joint are included. In the next phase, a restructuring of the structure and metabolism occurs in the cells and tissues of the joint, ensuring its functioning under conditions of altered load.
Over time, the compensatory and adaptive capabilities of the joint are depleted, pathology develops: a change in the structure of the elements of the joint occurs as a result of its overload, dystrophic processes occur, thinning of the disc, deformation of the head of the mandible, asynchronous movements of the mandible.
Patients' complaints may be different. Some note a constant aching, dull pain that intensifies with load on the joint; others complain only of the appearance of pathological noises, crunching, crepitus, and clicking. Some patients complain of stiffness of the joint, especially in the morning, note limited mouth opening, and displacement of the lower jaw to the side. There may be complaints about chewing food on only one side, since chewing on the opposite side causes pain and discomfort. The disease begins gradually, a history may include: previous inflammatory processes in the joint, trauma, prolonged absence of teeth, pathological abrasion of teeth, long-term use of dentures with improperly restored occlusal surface of the dentition, interalveolar height. Some patients associate the occurrence of joint disease with the flu and its complications, with rheumatism. During the examination, signs noted by patients and symptoms that were not reflected during the survey are revealed. It should be remembered that not all signs of nosology occur simultaneously in every patient.
As a result of examination of the face, the following may be revealed: a decrease in the height of its lower part, as indicated by pronounced nasolabial folds, retraction of the lips, maceration in the corners of the mouth; facial asymmetry due to displacement of the lower jaw towards the affected joint. Palpation and auscultation reveal crunching and crepitus in the joint. Palpation of the lateral pterygoid muscle is usually painless.
Clinical assessment of mandibular movements reveals limited mouth opening, which is determined by the distance between the central incisors. In some cases it may be no more than 0.5 cm.
A characteristic disturbance in the movement of the lower jaw with arthrosis is its displacement to the side when opening the mouth, which is revealed by observing the movement of the incisal point when opening and closing the mouth. There may be various options here: the lower incisal point, when opening the mouth, forms a curve, but at the end it is set in line with the upper incisal point; The lower incisal point moves without deviation when opening the mouth, only at the end of opening the mouth does it shift to the side.
The doctor receives the necessary information when examining the teeth, dentition and assessing occlusal contacts. In patients with arthrosis of the TMJ, the following may be detected: absence of teeth, pathological abrasion of teeth, poor-quality dentures, increased or decreased interalveolar height, deformed occlusal surfaces of individual teeth and dentitions, creating premature occlusal contacts, obstacles or incorrect directions to the movement of the lower jaw.
A detailed visual examination of the occlusion is carried out on jaw models installed in the articulator.
Additional information for diagnosing arthrosis of the TMJ is obtained through laboratory and instrumental research methods: radiography, recording of movements of the lower jaw, electromyography.
Changes characteristic of arthrosis are detected by x-ray examination of the joint. Survey radiography reveals gross changes: flattening of the head and a decrease in its height, exophytic growths, changes in its shape (hook-shaped, club-shaped, pointed).
The earliest changes are detected only on tomograms: narrowing of the X-ray joint space; the appearance of erosion in the cortical layer of the articular surface of the head and articular tubercle, bone sclerosis.
The results of recording movements of the lower jaw objectively demonstrate its displacement towards the affected joint.
Arthrosis must be differentiated from arthritis and functional neuromuscular disorders. Arthritis occurs in young and middle-aged people; its course is acute, progressive, with sharp pain. Arthrosis, as a rule, is observed in middle-aged and elderly people and proceeds slowly.
Acute arthritis, unlike arthrosis, is manifested by sharp pain in the joint, which intensifies with movements of the lower jaw; during purulent processes, swelling of the periarticular tissues and hyperemia of the skin in front of the ear tragus are determined; there is general malaise, increased body temperature, loss of ability to work, sleep disturbances, and appetite.
An important differential diagnostic argument in favor of acute arthritis should be the presence of a specific cause of its occurrence. For example, purulent arthritis is characterized by the spread of the inflammatory process to the joint from neighboring areas with osteomyelitis of the lower jaw, phlegmon, mumps, and inflammation of the middle ear. For rheumatoid arthritis, the characteristic features are the systemic nature of the disease and the presence of rheumatoid factor in the blood. Immune complexes are found in synovial fluid, macrophages, neutrophils; they circulate in the blood.
Certain difficulties arise in the differential diagnosis with chronic arthritis, since a number of clinical signs are similar to the manifestations of arthrosis: pain, restrictions on the movement of the lower jaw, crunching in the joint. However, according to the course of the disease, they can be distinguished. The chronic course of arthritis can worsen, and at this stage aching, stabbing, shooting pains characteristic of arthritis appear.
In the differential diagnosis of arthrosis and neuromuscular disorders of the maxillofacial region, difficulties arise due to the lack of uniform terminology in defining these disorders. Of the well-known terms “Costen syndrome”, “musculofacial pain dysfunction syndrome”, “pain syndrome of temporomandibular joint dysfunction”, the last term, which is abbreviated as BSD, has received the most recognition.
BSD is characterized by pain in the masticatory muscles and clicking in the TMJ. These symptoms are often transient. Patients suffering from BSD experience headaches, a common cause of which is muscle tension in the buccal-occipital region. There may also be atypical facial pain and neuralgia. Restrictions in the movements of the lower jaw are usually associated with increased muscle tone and stiffness.
Some patients complain of tinnitus, hearing loss, a feeling of pressure and stuffy ears.
The nature of the noises that occur in the joint with arthrosis and BSD has a certain differential diagnostic significance. In arthrosis, their origin is mainly associated with friction of the deformed surfaces of the head and articular disc and therefore crepitus and crunching predominate.
BSD is characterized by a clicking sound, the likely cause of which is increased tone of the lateral pterygoid muscle. The mechanism for the occurrence of clicking in the joint during spastic contractions of the lateral pterygoid muscle can be represented as follows. For example, against the background of normal functioning of the lower jaw in the anterior occlusion phase, due to some factor, such as stress, a spasm of the lateral pterygoid muscle occurred. Let us assume that at this moment the head of the lower jaw and the disc were on the slope of the articular tubercle. When the mandible returns, the heads are moved back, and the discs are held in an anterior position due to spasm of the lateral pterygoid muscles. An obstacle appears in the path of the heads' movement - the rear pole of the disks, at the moment of overcoming which a clicking sound occurs. Conventionally, this clicking can be called posterior pole when closing. If at this moment you quickly open your mouth, the clicking may occur again when overcoming the posterior pole (posterior pole clicking when opening). At this moment, the movement of the lower jaw may be blocked if the head cannot overcome the posterior pole of the disc.
Palpation and radiography of the joint help to distinguish arthrosis from neuromuscular disorders. With BSD, palpation of the masticatory muscles, including the lateral pterygoid muscle, is painful, the X-ray picture is unchanged.
The results of electromyographic studies, which show an increase in muscle biopotentials at rest, also allow differentiation of arthrosis from BSD.
The muscular nature of the pain can be established using diagnostic anesthesia. In case of arthrosis of the TMJ, blocking the motor branches of the trigeminal nerve using the method of Egorov and Karapetyan does not relieve pain and does not improve mouth opening. With BSD, after the blockade, the pain decreases or stops, and the mobility of the lower jaw improves.
Deforming arthrosis with exostoses should be differentiated from condylar hyperplasia, chondroma, osteochondroma. It is possible to finally distinguish between these pathological conditions after removal of the tumor based on the results of histological examination of the postoperative material.
Treatment of arthrosis is complex. According to indications, medicinal, physical, orthopedic and surgical treatment methods are used. The orthopedic doctor needs to correctly determine the purpose, content, volume and sequence of orthopedic dental interventions in this complex of treatment and preventive measures.
The goal of orthopedic interventions for arthrosis of the TMJ is to eliminate factors that cause overload of the joint elements. Removal of traumatic overload of the elements of the TMJ is achieved by normalizing the form and function of the teeth, dentition, and their relationships.
Orthopedic treatment methods used for these purposes can be divided into the following groups:
The object of intervention when applying the first group of treatment methods is the teeth, their occlusal surface; the second group - dentition; the third - teeth, dentition, prosthetic bed, prosthesis and their relationships; fourth - muscles, joint, lower jaw.
Orthopedic methods should be used against the background of medication. When treating patients with arthrosis who have disturbances in occlusal contacts, selective grinding of teeth is indicated.
The therapeutic effect is achieved by eliminating tooth contacts that disrupt the coordinated function of the joints and neuromuscular system.
Selective grinding of teeth allows you to eliminate obstacles limiting the smooth sliding of teeth and impaired guiding function of teeth, as well as create occlusal contacts that ensure harmonious interaction of all elements of the dentofacial system, including the joint.
Before selective grinding of teeth, the patient must be explained the necessity and harmlessness of this intervention. Selective grinding of teeth involves the elimination of premature contacts identified in the centric relation of the jaws, central, anterior and lateral occlusions.
With a central jaw relationship in patients with intact dentition, it is most often necessary to eliminate premature contact between the palatal cusp of the first upper molar and the buccal cusp of the first lower premolar. In a position of central occlusion, it may be necessary to eliminate a significantly larger number of premature tooth contacts: between the vestibular slopes of the palatal tubercles of the upper molars, premolars and the oral slopes of the buccal tubercles of the same lower teeth; between the vestibular slopes of the buccal tubercles of the lower molars, premolars and the oral slopes of the buccal tubercles of the upper teeth of the same name; between the vestibular surface of the lower anterior teeth and the palatal surface of the upper teeth; between the slopes of the palatal tubercles of the upper molars, premolars and the vestibular slopes of the lingual tubercles of the lower teeth of the same name.
By eliminating these premature contacts, simultaneous bilateral multiple contact between teeth in the position of central occlusion is achieved, which is important for the normal functioning of the TMJ.
Selective grinding during anterior occlusion eliminates premature contacts that occur between the anterior teeth and contacts of the lateral teeth, which prevent the smooth and symmetrical sliding of the lower dentition along the upper one during the transition from central to anterior occlusion. Eliminating premature contacts on the working and balancing sides that occur with lateral occlusion also involves creating smooth, unimpeded glides. As a result of the procedure, contact occurs on the working side of the same cusps of antagonist teeth, and on the balancing side there is separation or contact of opposite cusps of the teeth. With this type of contact, overload of the joint during lateral movements of the lower jaw is eliminated, which is very important for reducing the intensity of degenerative processes in the joint observed with arthrosis.
The next orthopedic measure aimed at creating favorable conditions for the functioning of the joint is normalizing the shape of the dentition. It is achieved by eliminating, according to indications, anomalies and deformations of the dentition using orthodontic methods, as well as by restoring occlusal relationships with artificial crowns, bridges, and clasp dentures. It is very important to correctly restore the interalveolar height, shape and size of the tubercles and grooves of the occlusal surface of the teeth. The restored shape of the occlusal surface of the bob should not create premature contacts in all types of occlusion and cause overload of the joint tissues.
When planning orthopedic measures, it is necessary to provide for the normalization of the position of the articular heads of the SB articular fossae. This is achieved by using removable and non-removable devices: a plastic mouth guard on the dentition of the lower or upper jaw; bite block for the entire dentition or for the lateral teeth; palatal plate with an inclined plane; coronal or aligner devices with an inclined plane; mouth opening limiters.
Prosthetic measures for arthrosis of the TMJ are also carried out according to indications; the design features of dentures and the stages of treatment depend on the clinical characteristics of the disease.
In case of a decreasing bite, pathological abrasion of teeth, prosthetics are preceded by normalization of the interalveolar height and position of the lower jaw using a plastic mouth guard on the dentition. The correctness of determining the interalveolar height, and therefore the position of the heads of the lower jaw in the articular fossa, should be controlled radiographically during the manufacturing of a plastic mouth guard. Usually, after 2-4 months of using the device, pain and discomfort disappear, which indicates the final adaptation of the neuromuscular system and the newly formed interalveolar height. After this, prosthetics are performed.
Measures that normalize the movements of the lower jaw, in addition to the orthopedic interventions listed above (selective grinding of teeth, restoration of the shape of the occlusal surface of the dentition, prosthetics), include a set of exercises aimed at restoring coordination of the function of the masticatory muscles. Depending on the nature of the disorder in the movements of the lower jaw, various exercises are indicated.
In the complex treatment of arthrosis, physical and surgical treatment methods play an important role.
Physiotherapeutic methods include electrophoresis, galvanization, fluctuarization, massage, and exercise therapy. When carrying out electrophoresis, a 10% solution of potassium iodide and a 10% solution of novocaine are used.
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The joint, which is located at the junction of the upper and lower jaws, performs an important connecting function. Inflammation of the jaw joint can be caused by various factors, but most often the disease develops when an infection enters the joint. Such a disease must be promptly identified and the cause of infection established.
Treatment of the mandibular joint takes a long time. Even if the disease was diagnosed on time and treatment was started immediately, only comprehensive therapeutic measures can prevent the development of the disease and completely defeat it. Moreover, it is necessary to fight not only with inflammation of the jaw apparatus, but also with the primary infection.
In most cases, the cause of inflammation is an infection that has entered the human body. Treatment must be correct and timely. The doctor’s task is to correctly determine what triggered the development of the disease. The choice of treatment method for inflammation of the mandibular joint depends on this.
Modern medicine distinguishes between infectious and traumatic types of infection. The main infectious factors that can provoke the disease:
What does the lower jaw joint consist of?
The temporomandibular joint is usually damaged as a result of trauma to the lower part of the face. This could be the result of a blow, dislocation, fracture or crack. There are two forms of this disease: chronic and acute. The first manifests itself mainly as a result of infection or another disease.
An acute form of inflammation can occur either after an injury or due to infection in the patient’s mouth or ear.
When the mandibular joint is damaged, the patient experiences the following manifestations of the disease.
Symptoms of the chronic form of the disease may differ slightly from the general ones. The pain is usually not sharp, but long-lasting and aching. When talking or eating, it intensifies significantly. Jaw stiffness is observed mainly in the morning and during sleep. The lower jaw shifts, but swelling does not appear. The skin does not change color, but when pressed the patient feels a sharp pain.
In acute purulent form of inflammation of the maxillofacial joint, a dense neoplasm occurs in the jaw area. The skin takes on a bright red tint, becomes tense, and the pain threshold decreases. The patient experiences symptoms such as severe dizziness and decreased hearing acuity. In this case, treatment must be started immediately.
If the purulent form of the disease is allowed to develop, heart problems may begin, and arthritis of the joints, and not only the jaw, may develop. Inflammation due to tuberculosis can lead to deformation of cartilage tissue.
Inflammation of the temporomandibular joint is a complex disease that requires scrupulous treatment. Therapy includes taking the necessary medications and a number of procedures. Treatment methods can be completely different. One of the new but popular ways to combat the disease is laser therapy. With its help, you can effectively cure inflammation of the mandibular joint.
Today there are many drugs that will help in the fight against the disease, but one cannot be absolutely sure that they will not give any side effects. For inflammation of the maxillofacial joint, laser treatment will not create such problems. Such therapy will even help cope with the negative effects of traditional medications.
Laser for physiotherapy procedures
The patient may be offered to undergo laser therapy if the inflammation affects:
For any inflammatory processes, laser therapy is used to relieve tension, swelling and pain. It is necessary to treat diseased joints in several stages. The initial task is to get rid of pain. Then - overcome the root cause of inflammation. And in the end, such treatment allows you to completely get rid of the disease.
The last step is usually the most difficult. It is enough to simply eliminate the symptoms of the disease and overcome the infection that provokes them. But in order to achieve a complete recovery, a long course of rehabilitation using anti-inflammatory and painkillers is necessary.
As soon as the patient’s pain disappears, he is prescribed physiotherapeutic procedures. Treatment methods vary depending on the underlying cause of the inflammation. The patient may be prescribed intra-articular injections, non-steroidal drugs, antibacterial or antirheumatic drugs.
Only a doctor can choose the right therapeutic agents, so you should not self-medicate. The specialist prescribes medications taking into account the severity of the disease and its causative agent. Recipes from traditional medicine can be used, but it is advisable to first consult with your doctor.
It is imperative to apply a bandage to the mandibular joint. It will help reduce pain and immobilize the affected organ. This will prevent further damage.
The temporomandibular joint is the articulation of the temporal and jaw bones. It is responsible for the mobility of the lower jaw (moving it to the side, moving forward or lowering). When changes occur in the connective, bone or cartilage tissue of this joint, vital functions, such as the ability to chew food and speech, are disrupted. Therefore, these changes require urgent contact with a dentist and orthodontist.
It is necessary to immediately clarify that arthritis and arthrosis are different pathologies, differing in the causes of development and treatment methods. Arthritis of the jaw joint occurs in people of any age and is characterized by severe pain, the presence of an inflammatory process in the tissues, elevated temperature and an active rate of development. It is rarely an independent disease. Basically, this disease becomes a complication of other inflammatory processes (otitis, osteomyelitis of the lower jaw, rheumatism and others). This means that its treatment is based on eliminating the underlying pathology.
Arthrosis is a more serious and sluggish disease that leads to irreversible changes in joint tissue. It develops on the basis of:
Reasons based on dental problems lead to additional stress on the joint. Such overloads entail thinning of the cartilage tissue, the development of dystrophic processes and a change in the shape of the head of the lower jaw. Serious deformity is no longer amenable to either medication or physiotherapeutic treatment.
When making a diagnosis, the doctor takes into account symptoms such as:
In addition to identifying symptoms and examining the patient's oral cavity, the doctor may prescribe plain or contrast radiography, as well as computed tomography. These methods allow you to accurately determine the diagnosis and draw conclusions regarding the optimal treatment method.
Treatment of this disease depends on the severity of its course and the degree of deformation of the joint tissues. For example, advanced forms of arthrosis can only be treated surgically, such as:
However, a timely visit to the doctor will avoid surgical intervention and help you get by with more gentle complex therapy. It includes:
Physiotherapeutic procedures mean: laser and microwave radiation, treatment with dynamic currents, ultrasound and electrophoresis. These methods give a good therapeutic effect, relieving inflammation and stimulating restoration processes in tissues.
As for diet and daily routine, their main goal is to reduce the load on the jaw joint. And this means giving up solid foods and the habit of chewing gum. It is also recommended to talk less until the symptoms disappear completely.
In addition to the reasons listed above, the development of this serious disease is facilitated by:
Therefore, maintaining a healthy lifestyle, as well as regular visits to the dentist, will significantly reduce the risk of developing arthrosis of the jaw joint.
People who are concerned about pain and stiffness in their joints often do not know which doctor to contact. There is not a specialized arthrology hospital in every city, and not every arthrologist sees an arthrologist. But with joint diseases, you can go to other doctors. The main thing is not to turn a blind eye to alarming symptoms, do not put off visiting a doctor and do not try to cure diseased joints on your own: advanced osteoarthritis is difficult to treat. Why and how arthrosis develops, which doctor treats this disease, what is the difference between a rheumatologist, arthrologist and orthopedist, where does an arthrologist see in Moscow - this article is devoted to the answers to these questions.
Arthrosis (osteoarthrosis) is a non-inflammatory (unlike arthritis) diseases of the joints, in which the articular tissues undergo degenerative-dystrophic changes:
The hip and knee joints are most often affected; their diseases are called coxarthrosis and gonarthrosis. Other large joints of the limbs - shoulder, elbow, ankle - are also susceptible to this disease. Degenerative-dystrophic disease of the joints of the spine is called spondyloarthrosis, it is one of the three most common types of arthrosis. Less common are diseases of small peripheral joints: arthrosis of the jaw joint, facial joint, hands, and feet. It makes no sense to look for which doctors treat arthrosis of the shoulder joint and which ones treat small joints of the foot; the specialization is not so narrow. Treatment can be carried out by medical and surgical specialists, but which doctor treats osteoarthritis depends not on the location of the disease, but on its severity.
Early symptoms of arthrosis include joint pain during exercise and morning stiffness. Gradually, pain and limitation of range of motion increase. Then comes the stage of pronounced bone deformations. If the knee joint is affected, the affected limb becomes bent, deviates from the axis, shortens due to muscle wasting, and lameness develops. Coxarthrosis also leads to lameness. Weakening of the shoulder muscles due to shoulder arthrosis is fraught with shortening and loss of motor function of the arm. Osteoarthritis of the fingers leads to the fact that a person cannot perform everyday operations, and fine motor skills suffer. When the maxillary, mandibular, and facial joints are affected, the face becomes asymmetrical, making it difficult to eat and talk.
Various reasons can lead to the development of arthrosis: injuries, excessive stress, endocrine disorders, age-related changes. So among those who treat arthrosis, there may be not only specialists in joint diseases, but also doctors of other profiles, for example, an endocrinologist.
Who is at risk for osteoarthritis, which doctor treats this disease and who should be contacted first for osteoarthritis? It is especially important to know which doctor treats arthrosis for those who may need his advice and help at any time. The risk of joint disease is higher if relatives have suffered from it or if the person himself:
Such patients should undergo regular preventive examinations with a rheumatologist or at least a therapist.
A general practitioner is a general practitioner who knows best which doctors treat arthrosis. It is to the local doctor that you should go if you suspect that you are developing arthrosis of the joints and do not know which doctor to see. He will order tests, refer you to a specialist from the same clinic, and if there is an arthrology hospital in the city, he will recommend that you undergo an examination there. Post-traumatic osteoarthritis usually develops a couple of years after the injury, but sometimes the disease is separated from the injury by only a few months; it begins with acute manifestations and rapidly progresses. In this case, they usually turn to a traumatologist. He directs the patient to an X-ray and, depending on the presence of surgical pathology, carries out treatment himself or recommends another specialist.
It is difficult to unequivocally answer the question of which doctor treats arthritis and arthrosis. It could be:
Most often, a patient complaining of joint pain and limited movement consults a rheumatologist. This is a specialist who diagnoses and treats a wide range of joint and connective tissue diseases. It can treat not only arthritis and arthrosis, but also bursitis, synovitis, spondylosis, osteoporosis, and a number of systemic diseases. An arthrologist has a narrower specialization: joint diseases. Not every clinic, diagnostic center or hospital can boast of having such a specialist on staff. In the capital, they provide consultations in the SM-Clinic network; the arthrological hospital NPO SKAL also offers the services of arthrologists, orthopedists, and neurologists.
If a rheumatologist provides exclusively therapeutic treatment, then an arthrologist is a surgical specialist. There is also the specialty of rheumatologist-arthrologist, which means: this specialist can resort to both conservative and radical methods of treatment.
An orthopedist is also a surgical specialist. He deals with various pathologies of the musculoskeletal system: congenital dysplasias, developmental defects, injuries and post-traumatic conditions. A physician or rheumatologist may refer a patient to an orthopedist in the following cases:
An orthopedist deals not only with the treatment, but also with the prevention of arthrosis. Correction of dysplasia, posture, flat feet in children and adolescents, timely adequate treatment of injuries reduce the risk of developing this disease. Conservative treatment is carried out within the framework of outpatient orthopedics, operative treatment - within the framework of surgery. One of the areas of surgical orthopedics is joint replacement. Surgical treatment of arthrosis can be carried out not only by an arthrologist or an orthopedic surgeon, but also by a specialist in maxillofacial surgery - in case of damage to the temporomandibular (TMJ) facial joint.
A rheumatologist prescribes drug treatment for arthrosis and arthritis, and refers the patient to a number of specialists who develop a non-drug treatment regimen and implement it. This:
Patients are also advised to consult a nutritionist, since proper nutrition is important for successful treatment. Depending on the reasons that led to the development of osteoarthritis, treatment of the underlying disease can be carried out in parallel. An endocrinologist deals with hormonal disorders, and a phlebologist or angiologist deals with vascular diseases. Which doctor treats spondyloarthrosis? As a rule, the same as arthrosis of peripheral joints. But since this is a pathology of the spine, it can also be dealt with by a more specialized specialist - a vertebrologist. Spondyloarthrosis often occurs in combination with osteochondrosis and is accompanied by neurological disorders, in which case the help of a neurologist is necessary.
Typically, treatment of arthrosis is carried out on an outpatient basis, with the exception of sanatorium-resort treatment and operations. But with a complicated course of the disease, hospitalization in a hospital may be indicated. Such services are provided by the only specialized arthrology center in Russia, the scientific and practical association “SKAL” (this abbreviation stands for “specialized course outpatient treatment”). The hospital is located near the Proletarskaya metro station. You can get detailed information and make an appointment through the official website of the clinic. For patients:
Various specialists treat joint diseases. Patients who live in a small town with only one medical facility can contact a general practitioner. This is a generalist who knows the general principles of treating arthrosis. But it is better if a rheumatologist diagnoses, prescribes and coordinates treatment. It is usually not possible to undergo closed observation with only one specialist; arthrosis is closely related to other diseases. At the early stage of arthrosis, conservative therapy is quite effective; in advanced forms, the services of an orthopedic surgeon are required.