What is arthrosis? Pathological causes, symptoms and treatment

Arthrosis is a chronic pathology that aims to damage the articular structure of the locomotor system. The main reason that leads to chronic diseases is a metabolic imbalance, which leads to a progressive process of a degenerative-dystrophic nature. The targets of the destructive reaction are articular cartilage, connective tissue, bursa, tendon, bone and muscle corset. In the chronic form of the pathology, the periarticular muscles are involved in the inflammatory process, losing anatomical elasticity due to joint deformation and swelling. In order to eliminate the complications associated with restricting the biomotility of the skeleton, and not become disabled, you need to equip yourself with information about arthrosis - what it is, what are its causes, symptoms and treatment.

Causes and risk factors for the development of pathology

The inflammatory-destructive process in the joints often begins for no reason. Idiopathic (primary) arthrosis has this beginning. The mechanism of development of secondary arthrosis begins after certain conditions and factors, namely:

• Joint injuries (fracture, meniscus damage, ligament rupture, dislocation, compression + contusion, fracture).
• Dysplasia (abnormal intrauterine development of articular components).
• Violation of substance metabolism.
• Autoimmune type pathology (rheumatoid arthritis, psoriasis, autoimmune toxic goiter, systemic lupus erythematosus).
• Nonspecific destructive arthritis (with a purulent component).
• Infections of various etiologies (tuberculosis, meningitis, encephalitis, gonorrhea, syphilis, hepatitis).
• Endocrine gland pathology (diabetes mellitus, toxic goiter, adrenal gland and pituitary gland pathology).
• Hormonal dysfunction (decreased levels of estrogen, androgens).
• Degenerative + dystrophic reaction (multiple sclerosis, Perthes disease).
• Oncological diseases.
• Blood diseases (hemophilia, anemia, leukemia).

Risk factors that provoke and lead to arthrosis:

1. Age-related changes.
2. Obesity (excess body weight leads to constant vertical load, which burdens the joints, which quickly wear out, loss of cartilaginous plates).
3. Professional costs, that is, the load on a certain group of joints, which leads to inflammation or premature destruction before other groups.
4. Postoperative consequences: very traumatic surgery with removal of affected tissue (soft, cartilage, bone). After the rehabilitation manipulation, the joint structure does not have the same consolidation, so any load leads to arthrosis.
5. Hereditary factors, that is, arthrosis can affect one or more family members.
6. Hormonal imbalance during menopause or after the extinction of the ovaries in women, the prostate gland in men.
7. Violation of water-salt balance.
8. Neurodystrophic damage to the spine is the trigger for glenohumeral, lumbosacral and hip arthritis-arthrosis.
9. Poisoning with pesticides, heavy metals.
10. Changes in temperature with sudden changes and hypothermia.
11. Permanent trauma to certain joint groups.

Risk factors include the environment, which has recently been saturated with high background radiation, toxic substances (fog in industrial cities and in industrial zones, as well as frequent tests of military equipment or interstate warfare, the result of which is the ozone hole + strong ultraviolet radiation). Dirty drinking water + food rich in preservatives lead to the development of arthrosis.

Mechanisms of arthrosis development

The basis for the triggering mechanism of arthrosis is the disruption of the chain process of cartilage cell regeneration and repair of affected connective tissue areas by young cells. The cartilaginous plate tightly covers the terminal surface of the bone that is part of the locomotor joint. Anatomically normal cartilage has a strong structure, they are smooth, elastic, and thanks to the synovial fluid, which is a biological substance for the lubrication of intra-articular components, they slide. It is synovial fluid that provides unimpeded movement of articular components relative to each other.

Cartilage tissue and synovial lubrication perform the main function of a shock-absorbing effect, reducing the abrasion of bones covered with cartilage. The ends of the bones are separated by a sac of fluid, and a corset of ligaments and muscles firmly stabilizes them. The specific configuration and plexus of the muscle-ligament apparatus allows this structure to perform precise biomechanical movements such as flexion, extension, rotation + rotation. The design, thanks to the interweaving of ligaments, allows you to hold firmly in a certain position, as well as perform coordinated movements, maintaining the balance of the body.

High stress or hormonal imbalance leads to the destruction of collagen plates, exposing bones. Pointed osteophytes appear in this area; they create pain with any movement of musculoskeletal joints. The bones thicken, and false joints develop between the osteophytes, which completely change the function of the organs of movement. There is less synovial fluid due to trauma to the bursa (its rupture), and the entire joint structure begins to suffer, along with the ligament + muscle corset. Joint swelling appears, and microbial infections may also occur. The ossification zone leads to limited movement and joint ankylosis.

Stages of clinical manifestations of joint pathology: stages

Arthritis is characterized by three stages of development, which consist of:

• Stage I:no special morphological changes, trophism is not disturbed, synovial fluid is produced in sufficient quantity. The stability of the joint structure corresponds to the average physical activity. With hard work, pain and swelling of the joints appear.
• Stage II:reduction of the cartilaginous plate is observed, foci of osteophytic islands develop, and hardening appears along the edges of the joint. Pain syndrome intensifies, swelling increases, and discomfort in movement appears. When the pathology progresses to a chronic stage, the pain is constant, it is accompanied by inflammation with periods of exacerbation / remission. Biomechanics is partially affected, the patient saves the joint.
• Stage III:the cartilaginous plate is completely worn, instead of cartilage, a system of osteophytes + false fixed interosteophytic joints is developed at the ends of the bones. The anatomical shape is completely disrupted. Ligaments and articular muscles are shortened and thickened. Minor injuries can cause dislocations, fractures and fractures. The tropism of the locomotor organs is damaged, so they do not receive the necessary amount of blood and nutrients. A pinched nerve leads to a severe pain reaction, which only disappears after the administration of painkillers or strong drugs from the COX1/COX2 group.

Conventionally, one more stage can be added: the fourth - the last stage with a clear clinical picture of inflammation, infection, unbearable pain, immobilization of diseased joints, high fever and severe condition. This stage is the most severe, which can lead to sepsis and death.

Arthritis pain syndrome

Pain is characteristic of arthrosis. They intensify with movement, physical activity, with changes in weather conditions, with changes in temperature, humidity levels and atmospheric pressure. Pain can be triggered by any body position or sudden movement. Prolonged walking, running, and vertical standing put a certain load on the painful joint, after which acute pain or pain begins. In the first and second stages of the pathology, the pain syndrome disappears without a trace after a night's rest, but in the advanced stages the pain is constant and does not disappear. Impaired shock absorbing layers, pinched nerves and blood vessels lead to stagnant processes with impaired trophism and interstitial fluid accumulation. Swelling causes acute throbbing pain.

Specific to arthrosis is pain after a long rest with sharp motor impulses; this condition is called onset pain. The mechanism of the development of this pain is the osteophytic zone that is covered with the remnants of damaged cartilage tissue, fibrin and viscous fluid. When the joint moves, a film of this component or detritus covers the exposed area, lubricating it and thus absorbing the pain. Restrictive pain occurs after destruction products from the intra-articular space, that is, bone debris or a large film of connective tissue, enter the muscle. There is another type of pain: constant, aching, bursting + independent of movement, they are characteristic of reactive synovitis.

Attention!Restrictive type pain can only be treated with surgical intervention followed by rehabilitation of the affected joint. Treatment with folk remedies is not recommended, this is fraught with the development of purulent arthrosis with the spread of infection throughout the body, and after sepsis there are obvious morphological changes in all organs and systems.

Symptoms of joint inflammation

Symptoms are divided depending on the stage of development of the pathology. Arthrosis makes itself felt after 38-40 years, when the joint depreciation system begins to wear out, and renewed or young cartilage pads do not appear in their place. With hormonal imbalance, "chaos" occurs in all important systems, this also applies to the locomotor system, so in the affected areas the tissue does not regenerate, instead destruction + deformation occurs.

Symptoms of arthrosis:

Stage and duration of arthrosis	Description of symptoms
I have a degree	Weak and short-term pain with precise localization. Rapid fatigue in painful joints. Pain worsens after long walks, runs or heavy lifting, and disappears after rest. A faint clicking sound is heard when bending or other movements. No visual changes + palpation, the anatomical shape of the joint is preserved, no swelling is observed.
II degree	Discomfort in the affected joint, stiffness is observed after rest. Partial traffic restrictions. Night pain, as well as pain depending on weather conditions. When bending and other movements, a characteristic loud click appears. There are visual and palpation changes: the joints are enlarged and shortened, plus when pressure is applied, the patient reacts sharply to acute pain.
III degree	Complete discomfort in the affected joint, joint instability or ankylosis is noted. Paralyzed movement. There is sharp pain or pain that persists at night. The anatomical shape of the joint is lost: thickening/shortening and axial displacement of the articular structure. There is swelling + pain when pressed. The gait changes, due to the relaxation of the organs of movement, the shape of the bone skeleton changes. Movement is done with the help of a cane or cane. With morphological changes with infectious factors or pinched nerves, a high temperature appears (37-38 degrees).
Periods of exacerbation and remission	In arthrosis, exacerbations alternate with remissions. Pathology is aggravated by physical activity. Exacerbation due to synovitis. The pain syndrome covers all affected areas, including the muscle corset. It reflexively spasms, forming a painful contracture. Arthritis is characterized by muscle spasms. As the destruction increases, the pain syndrome becomes more pronounced. With reactive synovitis, the joint increases in size and takes on a spherical shape. Fluid appears in the joint, which upon palpation produces a fluctuating effect. During a short remission, the pain decreases, but movement is difficult.

Timely detection of pathology using diagnostic tests and consultation with the necessary specialists will help to move to the second and third stages, maintaining the function and health of all joint groups of the locomotor system until old age.

Diagnostic steps

Explanation of diagnosis is based on laboratory/instrumental studies. Each case is studied differently, that is, with an individual approach for each patient.

The list of studies consists of:

• General blood and biochemical tests.
• Blood test for rheumatoid agent.
• Urine and stool analysis.
• X-ray examination: images in three positions.
• CT scan of the joint to clarify the bone structure.
• MRI of joints: study of ligaments and muscles.
• Computed tomography.

Important!Patients with arthrosis should consult with orthopedists, rheumatologists, endocrinologists, hematologists, oncologists, and female patients are recommended to consult with gynecologists.

Treatment regimen

Therapeutic tactics include various measures aimed at eliminating the main cause, correcting the nutritional diet, restoring lost functions + a gentle lifestyle, that is, without special physical activity (long walks, running, carrying heavy objects). The therapeutic treatment regimen consists of drug therapy, local treatment, physiotherapeutic procedures and exercise therapy. In parallel with this method, folk remedies are used.

Drug therapy for arthrosis

Complex therapy consists of:

1. Drugs of the NSAID group;
2. Painkillers (tablet + injection);
3. Medicines that relieve muscle spasms (muscle relaxants);
4. Cartilage tissue restorers (chondroprotectors);
5. Antibiotics;
6. Antihistamines;
7. Drugs that increase blood circulation;
8. Vitamins: B2, B12, PP and A;
9. Antioxidants: vitamin C;
10. Drugs based on hormones.

It is recommended to include in the treatment regimen for rheumatoid arthritis:

• Gold-based medicine;
• Immunosuppressants;
• Antimalarial drugs;
• Drugs that inhibit malignant cells.

Attention! During pathological remission, non-steroidal anti-inflammatory drugs are not recommended, they affect the gastrointestinal tract, cause many ulcers, and also inhibit the nutrition process of cartilage tissue.

Ointment for local use for arthrosis

Local treatment has a direct effect. Gels and ointments directly contact the affected tissue, quickly reaching the site, eliminating pain and inflammation. Preparations in gel form are widely used to restore the cartilage layer. Warming + anti-inflammatory ointment is used for local application.

Physiotherapy

Relieving spasmodic pain by reducing inflammation + increasing trophism and conservation is done with the help of physiotherapy. The exacerbation phase is eliminated or shortened by laser therapy, magnetic fields and ultraviolet irradiation. In the remission phase of arthrosis, that is, during the calm phase, the electrophoresis procedure using dimethyl sulfoxide and anesthetic is useful. Destructive and inflammatory processes are affected by phonophoresis with glucocorticosteroids, inductothermy, thermal application of ozokerite or paraffin, as well as sulfide, radon and sea baths. Corset muscles are strengthened using electrical stimulation.

Surgery

The problem of deformed/ankylosed joints is finally solved by surgical operations such as endoprosthetics, as well as palliative methods to unload the articular skeleton (coxarthrosis is removed by transtrochanteric osteotomy + femoral fascia fenestration; gonarthrosis is corrected by arthrotomy with intra-articular space cleaning from the remnants of destruction plus artificial cartilage augmentation). If the bone is not fully capable, it is replaced with an artificial graft, and the axis of the tibia is corrected.

People's recovery

Traditional medicine helps to relieve pain and inflammation, it temporarily relieves pain and restores lost function. There are isolated cases of complete healing through traditional methods using the following tinctures, ointments and compresses:

1. Colored garlic + onion and honey: 100 g of garlic pulp + 100 g of chopped onion + 2 tablespoons of honey + 200 ml of vodka. Infuse for 3-5 days. Apply as a compress and rub.
2. Sabelnik in the form of tincture: 200 g of dry powder or fresh pulp + 200 ml of diluted medical alcohol, leave for 24 hours. Drink one tablespoon before meals 3 times a day.
3. Ointment based on badger fat and propolis: apply to joints, apply twice a day.
4. Horseradish table + honey: 100 g horseradish + 100 g honey + 100 ml vodka. Infuse for 24 hours, drink 20 drops. This colored can be applied to the painful joints 3-5 times a day.
5. Hot pepper ointment + lard: 1 teaspoon powder + 200 g fat. Infuse for 2-3 days. Used as a warming local medicine. Apply 1-2 a day.
6. Compress: oak bark + fir needles: 200 g oak bark + 200 g crushed fir needles + 100 ml alcohol.

All listed recipes from traditional medicine practitioners are recommended to be used only after consulting a doctor. If the patient is allergic to a certain drug, its use is strictly prohibited, as it can cause anaphylactic shock.

Preventive features

Prevention is an effective tool to prevent joint disease, destruction and deformation. For prevention purposes, you need to do the following:

• Adjust the menu, which does not include fried, fatty, peppery, salty, alcohol + nicotine.
• Add jellies and jellies to your daily menu.
• Avoid tiring loads.
• Increase safety measures to prevent injury.
• Always do a set of special exercises for the locomotor system.
• Try taking vitamins B and C.
• For preventive purposes, take chondroprotectors, calcium, potassium supplements, as well as other minerals once every six months.
• After a joint sprain or mechanical injury, be examined by a doctor.

This list is accompanied by continuous physical exercise to increase blood supply, conservation and restoration of joint cartilage. This exercise is prescribed by a doctor.

Summary

Destruction with joint deformation begins after 38-40 years, so there is no need to delay the fight against this pathology. Neglected conditions can lead to a wheelchair, and a timely response to the disease with effective treatment is a clear success towards recovery. It is impossible to treat arthrosis on your own; this type of pathology refers to metabolic disorders directly related to changes in hormone levels or chronic pathologies of other systems. At the first symptoms, contact a traumatologist or surgeon, do not delay, otherwise you will only be treated in the surgical department with a long recovery.