Osteoarthritis: causes, symptoms, treatment, consequences
The content of the article:
- Types of osteoarthritis
- The reasons
-
Symptoms
- Pain sensations
- Stiffness of movement
- Swelling and redness
- Pathological changes in individual joints
- Other symptoms
- Diagnostics
-
Treatment
-
Drug therapy
- Non-steroidal anti-inflammatory drugs
- Glucocorticosteroids
- Immunosuppressants
- Chondroprotectors
- Non-drug therapy
-
- Effects
- Video
Osteoarthritis is inflammation in the joint area, and the articular ends of the articulating bones are involved in the pathological process. Most often, the disease affects large joints. It is a form of arthritis.
Osteoarthritis is characterized by the involvement of the articular ends of the articulating bones in the inflammatory process.
Inflammation can be caused by a malfunctioning immune system or infection. Unlike arthrosis, which is more common in older people, osteoarthritis occurs in people under 40. Often, with arthritis, not only the joints become inflamed, but other body tissues.
Types of osteoarthritis
The course of the disease is distinguished:
| Osteoarthritis type | Description |
| Acute | The pathology is characterized by a sharp onset, while the patient has severe joint pain |
| Chronic | The disease develops gradually, the pain is not as strong as in the acute form of the disease |
Arthritis is diagnosed by origin:
- primary: when the reason could not be found out;
- secondary: developing against the background of any disease.
The reasons
Depending on the cause of the development of the disease, there are:
- rheumatoid arthritis. It is a chronic autoimmune disease in which the immune system begins to damage body tissues because it perceives them as foreign. Changes occur symmetrically, both limbs are affected. Most often, rheumatoid arthritis affects the joints of the feet and hands. The developing erosive-destructive changes in the joints lead to the fact that the patient becomes disabled;
- psoriatic arthritis. The disease is autoimmune and develops against the background of existing psoriasis. The pathological process leads to intra-articular resorption of bone tissue. The disease is chronic;
- reactive arthritis (Reiter's syndrome). The cause of the development of degenerative changes is an infection that initially enters the respiratory, urogenital tract or intestines. There are many microorganisms that can cause a pathological process, these include chlamydia, shigella, salmonella. Most often, one-sided lesion of the small joints of the lower extremities occurs;
- gouty arthritis. The cause of the development of the disease is metabolic disorders in the body. Crystals of uric acid are deposited in the joints, which leads to the formation of tofuses (gouty nodes);
- post-traumatic arthritis. The disease occurs as a result of damage to the bones during dislocations, fractures, ligament ruptures, when the articular capsule, cartilage or muscles are involved in the pathological process.
Symptoms
With reactive arthritis, symptoms appear suddenly, they appear a day after the onset of the underlying disease. In other types of the disease, they may appear gradually. The disease affects one or more joints, in some cases symmetrical damage to both limbs occurs.
In most cases, the disease affects the small joints (fingers, feet, hands). Osteoarthritis of the hip is rare. Its manifestations, in contrast to osteoarthritis, are always obvious.
Pain sensations
Pain in the damaged area occurs already at the initial stage of the disease and requires the immediate use of pain medications. At first, soreness can only bother you when moving, and later on, the discomfort becomes permanent.
In other forms of pathology, pain increases in the evening or when walking. In some cases, this causes lameness. In addition to pain in the affected joints, regular aching muscle pain can be observed, which significantly affects the quality of life.
Stiffness of movement
At the initial stage of the disease, the patient may feel temporary joint stiffness after sleep. Unlike arthrosis, with osteoarthritis, it can persist for more than half an hour. Over time, if the disease progresses, the person's active and passive movements are limited.
During the night, inflammatory exudate accumulates in the articular cavity, which causes joint stiffness. Over time, they are deformed, the ligaments are shortened and irreversible changes occur.
Swelling and redness
In the area of the affected joints, swelling and hyperemia are observed. At this point, the skin turns red, which indicates acute inflammation and exacerbation of the chronic process.
Edema appears around the affected joint, this area increases in volume. When pressing on the lesion site, fingerprints remain. The edema caused by osteoarthritis is quite sharply marked, in contrast to arthrosis.
Pathological changes in individual joints
Over time, the disease progresses, and various deformities are added to the primary manifestations of the disease. In the area of the affected joints, thickening occurs, the fingers can bend in the phalanges, and their sensitivity is impaired.
With the progression of the disease, joint deformation occurs, accompanied by pain
Since nerves are compressed as a result of the deformation, the patient has constant aching pains that increase with movement or walking. Movement is significantly limited. Often, patients with pathological changes in the joints become disabled.
Other symptoms
Even before the onset of pronounced clinical symptoms, general signs of the disease appear, which intensify over time:
- crunch in joints when moving;
- feeling of constant tiredness, drowsiness;
- muscle pain;
- sweating;
- weight loss;
- increased body temperature;
- an increase in regional lymph nodes;
- frequent headaches;
- rashes on the skin.
Diagnostics
The doctor interviews the patient and finds out if there is internal joint stiffness that lasts more than an hour, what areas are affected and if there are additional signs of the disease.
Laboratory tests that can reveal common signs of the inflammatory process:
- general and biochemical blood test;
- rheumatoid factor in the blood;
- a test that detects the presence of citrulline peptides;
- analysis of synovial fluid;
- analysis for antinuclear antibodies.
To clarify the diagnosis and determine the degree of tissue deformation, magnetic resonance imaging is prescribed
Instrumental research methods include:
- radiography. At the initial stage of the disease, significant changes are not detected, but later, with a gradual thinning of the articular cartilage, single erosion occurs, and the inter-articular gap narrows. X-ray can reveal the fusion of the articular surfaces, which causes complete immobility of the joints;
- arthroscopy. With the help of a special device, the doctor can assess the degree of joint damage, determine the volume of surgery and take tissue for a biopsy (to exclude diseases such as tuberculosis or sarcoidosis);
- magnetic resonance imaging. This method allows you to assess the degree of tissue deformation.
Treatment
Drug therapy
In complex therapy, analgesics, non-steroidal anti-inflammatory drugs, corticosteroids and chondroprotectors are used.
To prescribe treatment, you must contact a traumatologist, orthopedist or rheumatologist
Non-steroidal anti-inflammatory drugs
Osteoarthritis is treated in two stages. Initially, it is necessary to reduce the inflammatory process, for which drugs from the group of non-steroidal anti-inflammatory drugs are prescribed. These medications inhibit the enzymes that are responsible for inflammation. The drug of choice in this case is Diclofenac (Dikloberl, Diklak, Rapten).
Diclofenac helps to quickly reduce inflammation, eliminate swelling and pain
Diclofenac allows you to quickly reduce inflammation, eliminate swelling and pain. Depending on the severity of the symptoms, Diclofenac is used in the form of tablets, injections or suppositories.
In some cases, the doctor prescribes combination drugs, which, in addition to diclofenac, contain paracetamol or serratiopeptidase (Dolaren, Doloxen, Flamidez). Since drugs of this group negatively affect the digestive system, the period of their administration is limited.
Take tablets or capsules after meals. Also, in addition to them, drugs from the group of proton pump inhibitors based on lansoprazole, omeprazole or pantoprazole are prescribed. Diclofenac is injected intramuscularly. The effect of the use of the drug occurs in 3-4 days.
When choosing a therapy, specialists are guided primarily by the criterion of safety for the patient's health. Thus, Amelotex is a selective NSAID with a high safety profile. A wide range of various forms of release allows for step therapy - quickly relieve pain with injections, while continuing treatment in a tablet form convenient for a person. Amelotex has a high anti-inflammatory and analgesic efficacy, a low incidence of gastrointestinal and cardiovascular adverse events. Unlike drugs of the 1st generation, it is well tolerated in diseases of the gastrointestinal tract, as well as cardiovascular diseases.
Glucocorticosteroids
To suppress the inflammatory process, glucocorticosteroids are used. These are hormonal preparations of synthetic or natural origin. Most often, Prednisolone, Methylprednisolone or Dexamethasone are used in practice.
Glucocorticosteroids are used as part of a complex treatment to relieve the inflammatory process
To avoid the development of side effects, it is necessary to take the drugs in the dose prescribed by the doctor, as well as observe the daily rhythm. When the therapeutic effect is achieved, the dose of the drug is gradually reduced.
In some cases, injectable corticosteroids such as Mometasone (Diprospan, Kenalog) are prescribed to treat osteoarthritis. They are administered intramuscularly or intraarticularly.
Immunosuppressants
In severe forms of reactive and rheumatoid arthritis, immunosuppressants are prescribed (Methotrexate, Sulfasalazine). This category of drugs acts directly on the immune system, suppressing it, due to which the synthesis of antibodies is disrupted and the inflammatory process subsides.
Immunosuppressants Affect the Immune System
You need to take such medications according to the scheme prescribed by the doctor, independent use is not recommended.
Chondroprotectors
In order to partially restore the cartilage tissue, chondroprotectors are used. With osteoarthritis, they are prescribed from the first days of the disease. The composition of the drugs includes chondroitin or glucosamine sulfate (Teraflex, Artiflex).
Chondroprotectors contribute to the restoration of cartilage tissue
The drugs are available in the form of capsules or ointments / creams for external use.
In order for the treatment with chondroprotectors to be effective, they must be used for a long period. The effect usually develops after a month of therapy.
In some cases, chondroprotectors are used in injections. The most effective remedies include Alflutop and Mucosat. They are injected intramuscularly. The course of treatment is usually 20 injections.
Non-drug therapy
On an outpatient basis, to restore the function of the joint, they conduct long courses of physiotherapy exercises, physiotherapy, alternating with spa treatment.
In severe cases, articulated distraction devices Volkov-Oganesyan are used
Surgical treatment is indicated for persistent contractures and ankylosis. In this case, the Volkov-Oganesyan hinge-distraction devices are used, arthroplasty and corrective osteotomies are performed.
Effects
If you do not start the treatment of the disease in time, its consequence can be:
- chronicity of the inflammatory process;
- chronic pain;
- limitation of joint mobility.
A severe form of the disease, in which osteoarthritis rapidly progresses and several large joints (hip, shoulder, knee) are deformed, can lead to the patient becoming disabled. Also, disability is assigned if internal organs are damaged or the disease often recurs, which significantly affects a person's ability to work.
In order to prevent the development of pathology, it is necessary to lead a healthy lifestyle, eat right, avoid injuries and give up bad habits. If you experience joint pain, you should seek the advice of a traumatologist, orthopedist or rheumatologist.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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