Osteoarthritis- a disease that develops over many years with predominant lesions on certain joints.Most often, painful changes affect large joints - knee, hip, shoulder, etc.Pain and movement difficulties complicate a person's physical and emotional life, and because osteoarthritis often occurs at a young age, it can interfere with the achievement of professional and personal goals.This is why it is important to diagnose the disease as early as possible and begin comprehensive treatment of osteoarthritis.
Treatment of osteoarthritis
At the initial stage of osteoarthritis, conservative methods are used that do not involve surgical intervention.At the same time, the correction methods used make it possible to stop the development of the disease, maintain motor activity, reduce the severity of the main symptoms of osteoarthritis and generally improve the quality of a person's life.
- Drug treatment:
- NSAIDs;
- GCS;
- chondroprotectors.
- PRP therapy.
- Therapeutic exercise.
- Massage and manual therapy.
- Traction therapy.
- Physiotherapy.
Widely used physiotherapy techniques for osteoarthritis:
- magnetic therapy;
- Ultra-high frequency;
- inductothermy;
- ultrasound therapy;
- balneotherapy;
- surgical treatment.
Treatment with medications
There is a widespread belief among patients that taking medications with an analgesic effect (orally in the form of tablets or by injection - intramuscularly) is the most important method of relieving pain in osteoarthritis.In fact, the use of medications is a method of quick pain relief, which should be prescribed only in the acute period.The fact is that drugs widely prescribed for these purposes have serious side effects, which increase in the long term and especially with uncontrolled use.We are talking about adverse effects from the digestive, cardiovascular, nervous systems, which can most likely lead the patient to a hospital bed (stomach bleeding, heart rhythm disturbances, effects on the liver and kidneys, etc.).
Non-steroidal anti-inflammatories
NSAIDs- nonsteroidal anti-inflammatory drugs, many of which are available without a prescription and are widely taken by patients alone.This group includes drugs of various chemical structures.The drugs have a pronounced anti-inflammatory and analgesic effect, can reduce pain in the joint area and adjacent muscle tissues, but do not affect the development of the disease.They are used only to reduce symptoms at all stages of the disease.Effective in cases of concomitant synovitis (accumulation of fluid in the joint).
GKS— glucocorticosteroids have a strong anti-inflammatory and analgesic effect.It is advisable and effective to administer them periarticularly.However, patients often have a negative attitude towards the use of these drugs in treatment, which is associated with possible side effects: infectious complications, deterioration of ligaments, joint surface and degeneration of cartilage.But with periarticular administration, the risk of these complications is minimal.
Chondroprotectors— substances are natural components of cartilage tissue, which, when taken orally, contribute to the gradual restoration of cartilage, normalize its density and elasticity.These active components are usually used in combination and are included in various drugs and auxiliary products.Chondroprotectors do not have a rapid analgesic effect;improvement develops with long-term use of drugs based on them, which is associated with partial restoration of cartilage tissue.Recommended at all stages of the disease.
PRP therapy
One of the most modern methods of restorative medicine, used for sports injuries and degenerative-dystrophic diseases of the joints, is PRP therapy (PRP - platelet-rich plasma) or plasma biorevitalization, autoplasmic therapy.The technique is actively used abroad.
The essence of the procedureinvolves injecting platelet-rich plasma directly into the site of the lesion, in this case the joint.The medicine to be administered is obtained from the patient's blood.The method is therefore considered not only very effective, but also safe for humans.Growth factors and other biologically active substances (serotonin, bradykinin, prostaglandins, etc.) contained in platelet-rich plasma contribute to the activation of regenerative processes and the synthesis of their own basic substances.
The resulting platelet-rich plasma is injected both periarticularly and directly into the affected joint, allowing partial restoration of tissues, primarily cartilage.
The technique is more applicable to stages 1-2 of osteoarthritis.Shows good results and allows you to delay the rapid development of the disease due to the release of growth factors from platelets.The method is relatively new, but has proven to be very effective.PRP therapy was first used in surgery;today the technique is successfully used in many areas of medicine, including rheumatology and orthopedics, neurology and cosmetology.Carrying out autoplasmic therapy allows you to increase the lifespan of the joint without any other aggressive interventions.
Synovial fluid protectors- a group of drugs based on hyaluronic acid, which are injected directly into the joint cavity (injection) and play the role of viscous lubricating fluid in the case where the natural synovial fluid is almost absent (it is he who provides the role of lubricating the joint surfaces).Used in the late stages of osteoarthritis.
Medicines in this group are also called “synovial fluid prostheses”, “biological substitutes for synovial fluid”.The effect after administration of drugs is long-lasting - from 6 to 13 months, depending on the drug used.
Some applyother groups of drugs- antispasmodics, muscle relaxants, B vitamins in therapeutic (high) doses, but all of them have only auxiliary value in the treatment of osteoarthritis.
Therapeutic exercise
Special therapeutic exercises can and should be used even during exacerbation, at all stages of osteoarthritis.Such measures can reduce pain and prevent serious restrictions in joint movement.However, the method is unpopular among patients suffering from osteoarthritis, since most of them are mistaken in thinking that in case of pain it is necessary to limit movements.On the contrary, starting physical exercise on time promotes faster recovery and a reduction in symptoms, mainly pain.
Physiotherapy in water, joint movements in an unloading position (lying, sitting, hanging) and moderate walking on a flat surface are particularly effective.If necessary, for example, in case of severe pain, a special bandage can be applied to the joint, but physical education should be started as early as possible.
Massage and manual therapy
Methods of mechanical impact on joints, muscles and ligaments can reduce pain intensity, increase mobility, improve blood circulation and metabolism in the affected joint area, relieve muscle spasms and normalize muscle function.
Traction therapy
In a hospital setting or in a medical sanatorium, it is possible to carry out traction therapy - this is traction of the joint (hip, knee) using a special technique using various loads.The standard traction scheme is designed for 28 days, with a gradual increase in load and exposure time.Classical techniques and more modern techniques using simulators are used.Their effectiveness is almost the same, but the simulators are more comfortable for the patient.
Physiotherapy
The use of various physiotherapy techniques in the early stages of osteoarthritis can provide significant pain relief and increased mobility of affected joints.Physiotherapy courses help to slow down the pathological process and extend the period without exacerbations.
Widely used physiotherapy techniques for osteoarthritis:
Magnetotherapy— local exposure to a constant or alternating low-frequency magnetic field.In the area of the affected joint, metabolic processes are accelerated, blood circulation and the supply of nutrients to the joint structures are increased, the processes of regeneration and synthesis of the own substances necessary for the functioning of the joint are activated.
Magnetic therapy has anti-edematous, analgesic and anti-inflammatory effects almost from the first session, which has a positive effect on the general condition of the patient.Magnetic therapy is successfully used in hospitals and sanatoriums, where medical equipment of various modifications is used.
A huge advantage for patients suffering from osteoarthritis is the possibility of independent courses of magnetic therapy at home, as prescribed and under the supervision of the attending physician.Timely use of portable magnetotherapy devices allows you to stop pain, the appearance of an exacerbation or to undergo preventive treatment, that is, to maintain normal health.
A positive aspect of magnetic therapy can also be called the beneficial effect of procedures on the state of the cardiovascular and nervous systems.Taking into account the fact that most patients with osteoarthritis are middle-aged and elderly people suffering from a combination of chronic diseases (high blood pressure, coronary heart disease, atherosclerosis, etc.), the mild sedative and stabilizing effect of magnetic therapy will be very useful.
Ultrasound therapyused more often in combination with the effects of drugs with anti-inflammatory, analgesic and restorative effects - ultraphonophoresis or phonophoresis.Ultrasound increases the permeability of tissues to drugs, which enhances their main effect.Even without a medicinal component, the method is very effective against osteoarthritis: ultrasound has a mechanical effect on tissues (micromassage), activates local immune and regenerative processes in the joint area and adjacent muscles and has a pronounced analgesic and anti-inflammatory effect.
Laser therapy– one of the most common and widely used procedures.The therapeutic effect is based on the reflex expansion of blood vessels above the site of the pathological process.This leads to improvement of local blood flow, activation of metabolism, elimination of underoxidized metabolic products and a decrease in pain intensity.Laser therapy, due to its small penetration depth, has a weak systemic effect, while enhancing the therapeutic effect of other procedures.
Shock wave therapy– high-energy method of influence.It is based on the piezoelectric effect.By applying a piezoelectric discharge to a pathological focus, a number of effects are achieved.Non-viable cells are destroyed, leading to activation of local immunity.Hibernating (inactive) cells are stimulated, which promotes regeneration processes.At the same time, the intensity of the pain syndrome is significantly reduced (although the procedure itself is painful).The undoubted advantage of the method is its use once every 4-7 days.
Diadynamic therapy– a method of therapeutic effects on the body with diadynamic impulse currents.The diadynamic currents used in this method rhythmically excite skin receptors, which indirectly leads to the activation of descending physiological pain suppression mechanisms and leads to a reduction in the patient's pain, up to complete analgesia.Therefore, such procedures are effective in cases of severe pain.
Electromyostimulation– exposure to electric current on muscle tissue.With osteoarthritis of large joints, the work of the surrounding muscles is disrupted, which leads to atrophy of some and overload of others.Gait problems develop.When exposed to alternating electric current according to a special program, the muscles contract rhythmically, producing a certain work, which leads to the restoration of their volume and function.
Cryotherapy- a simple and effective treatment method, unfortunately rarely used.Local exposure to low temperatures reduces the sensitivity of pain receptors and the synthesis of biologically active substances that stimulate the development of inflammation.After cryotherapy, reflex expansion of blood vessels occurs, local blood flow accelerates and recovery processes are activated.This method is particularly effective in combination with shock wave therapy.
Balneotherapy.In sanatorium conditions, hydrotherapy is practiced - medical baths, among which radon baths are especially effective for osteoarthritis.There is a general effect on the body of radioactive decay products of radon dissolved in water.The most important effect is the activation of metabolic processes.
A similar effect, although less pronounced, is characteristic of baths with therapeutic mud (peloids), hydrogen sulfide and carbon dioxide.
Surgical treatment
Surgical techniques are used in advanced stages of osteoarthritis, when joint mobility is severely limited or absent, affecting the patient's quality of life.All over the world, various methods of arthroplasty are used, which make it possible to completely restore the range of motion and return the patient to an active life at any age.
The tactics and scope of surgical intervention are determined by the attending physician;the choice is based on parameters such as the general condition of the patient, age and the presence of concomitant diseases, excess weight and others.The best results after endoprostheses were achieved in young and middle-aged patients (almost complete restoration of range of motion), but also in elderly people there is a significant improvement in their condition, because after a successful operation and recovery they can fully support themselves in everyday life and move not only inside the apartment, but also outside, not limited to communication.
Prevention
Osteoarthritis belongs to the group of diseases of standing walking and develops mainly as a result of age-related changes in the joints, enhanced by the influence of external negative factors.Attention to the state of the musculoskeletal system, prevention of joint diseases and treatment of osteoarthritis at an early stage makes it possible to maintain physical activity and avoid massive medical intervention in the future.