What is osteoarthritis? Causes, symptoms and treatment of the pathology

Osteoarthritis is a chronic pathology that aims to damage the joint structures of the locomotor system. The main reason that leads to chronic diseases is metabolic imbalance, which leads to a progressive process of a degenerative-dystrophic nature. The targets of the harmful reaction are articular cartilage, connective tissue, bursae, tendons, bones and muscular corset. In the chronic form of the pathology, the periarticular muscles are involved in the inflammatory process, losing anatomical elasticity due to deformation and swelling of the joints. To eliminate the complications associated with the blockage of skeletal biomotility and not become disabled, you need to arm yourself with information about osteoarthritis - what it is, what the causes, symptoms and treatment are.

Causes and risk factors for the development of pathology

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

• Joint injury (fracture, meniscal injury, ligament rupture, dislocation, compression + hematoma, bone fracture).
• Dysplasia (abnormal intrauterine development of joint components).
• Violation of material metabolism.
• Autoimmune pathologies (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).
• Pathologies of the endocrine glands (diabetes mellitus, toxic goiter, pathology of the adrenal glands and pituitary gland).
• Hormonal dysfunction (decreased levels of estrogens, androgens).
• Degenerative + dystrophic reactions (multiple sclerosis, Perthes disease).
• Oncological diseases.
• Blood diseases (hemophilia, anemia, leukemia).

Risk factors that provoke and lead to osteoarthritis:

1. Age-related changes.
2. Obesity (excess body weight leads to constant vertical loads, which overload the joints, which wear out quickly, losing cartilaginous plates).
3. Professional costs, that is, the load on a certain group of joints, which leads to their inflammation or premature destruction before other groups.
4. Postoperative consequences: highly traumatic surgery with extirpation of affected tissues (soft, cartilaginous, bone). After restorative manipulations, the joint structure does not show the same consolidation, therefore any load leads to arthrosis.
5. A hereditary factor, that is, osteoarthritis can affect one or more family members.
6. Hormonal imbalance during menopause or after extirpation of the ovaries in women, prostate in men.
7. Violation of water-salt balance.
8. Neurodystrophic damage to the spine is a trigger for glenohumeral, lumbosacral, and hip arthritis.
9. Poisoning with pesticides, heavy metals.
10. Temperature variations with sudden changes plus hypothermia.
11. Permanent trauma to a specific group of joints.

Risk factors include the environment, which has recently been saturated with high background radiation, toxic substances (air pollution over industrial cities and in industrial zones, as well as frequent tests of military equipment or interstate wars, the result of which are ozone holes + strong ultraviolet radiation radiation). Dirty drinking water + foods rich in preservatives lead to the development of osteoarthritis.

The mechanism of development of arthrosis

The basis for the triggering mechanism of arthrosis is the interruption of the chain of restoration processes of cartilage cells and the correction of the affected areas of connective tissue by young cells. Cartilaginous plates tightly cover the terminal surfaces of the bones that form part of the locomotor joints. Normal cartilages anatomically have a strong structure, are smooth, elastic and, thanks to synovial fluid, which is a biological material to lubricate the intra-articular components, they glide. It is the synovial fluid that provides the unhindered movement of the joint components between them.

Cartilaginous tissue and synovial lubrication play the main role of shock absorption effect, reducing abrasion of bones covered by cartilage. The bone ends are separated by pockets of fluid, and a corset of ligaments and muscles firmly stabilizes them. A certain configuration and plexus of the musculoligamentous apparatus allows this structure to perform precise biomechanical movements such as flexion, extension, rotation + rotation. The design, thanks to the intertwining of ligaments, allows you to remain firmly in a certain position, as well as carry out coordinated movements, maintaining the body's balance.

High stress or hormonal imbalance leads to the destruction of collagen plates, exposing the bones. Sharp osteophytes appear in these areas and create pain with any movement of the musculoskeletal joints. The bones thicken and false joints develop between the osteophytes, which completely alter the functionality of the movement organ. There is less synovial fluid due to trauma to the bursa (its rupture), and the entire joint structure begins to suffer, along with the corset of ligaments + muscles. Swelling appears in the joints and a microbial infection may also occur. Zones of ossification lead to limited movement and ankylosis of the joint.

Stages of clinical manifestation of joint pathology: stages

Arthrosis is characterized by three stages of development, consisting of:

• Stage I:there are no special morphological changes, trophism is not disturbed, synovial fluid is produced in sufficient quantities. The stability of the joint structure corresponds to average physical activity. With forced work, pain and swelling appear in the joints.
• Stage II:depletion of the cartilaginous plate is observed, foci of osteophyte islands develop and ossification appears along the edges of the joint. The pain syndrome intensifies, swelling increases and discomfort appears when moving. As the pathology progresses to the chronic phase, the pain is constant and is accompanied by inflammation with periods of exacerbation/remission. Biomechanics are partially impaired, the patient spares the joint.
• Stage III:the cartilaginous plate is completely worn away, instead of cartilage, a system of osteophytes + fixed interosteophytic false joints develops at the bone ends. The anatomical shape is completely disturbed. Joint ligaments and muscles are shortened and thickened. The slightest injury can cause dislocations, fractures and cracks. The trophism of the locomotor organs is damaged, as a result of which they do not receive the necessary amount of blood and nutrients. Compressed nerves lead to a strong pain reaction, which only disappears after the administration of strong analgesics or drugs from the COX1/COX2 group.

Conventionally, one more stage can be added: the final fourth stage with a vivid clinical picture of inflammation, infection, unbearable pain, immobilization of diseased joints, high fever and serious condition. This phase is the most serious and can lead to sepsis and death.

Osteoarthritis pain syndrome

Pain is characteristic of osteoarthritis. They intensify with movement, physical activity, changes in weather conditions, changes in temperature, humidity levels and atmospheric pressure. The pain can be triggered by any body position or sudden movements. Walking, running and standing for a long time vertically put a certain load on painful joints, after which sharp or aching pain begins. In the first and second stages of pathology, the pain syndrome disappears without a trace after a night's rest, but in the advanced stage the pain is constant and does not go away. The affected shock-absorbing layer, compressed nerves and blood vessels lead to a stagnant process with impaired trophism and accumulation of interstitial fluid. The swelling causes sharp throbbing pain.

Specific to osteoarthritis is pain after a long rest with a sharp motor impulse; this condition is called onset pain. The mechanism for the development of these pains is osteophyte zones covered with destructive remnants of cartilaginous tissue, fibrin and viscous fluid. When joints move, a film of these components or debris covers the exposed areas, lubricating them and thus absorbing pain. Blocking pain occurs after products of destruction of the intra-articular space, that is, bone debris or a large film of connective tissue, enter the muscles. There is another type of pain: constant, aching, explosive + independent of movement, these are characteristics of reactive synovitis.

Attention!Blocking-type pain can only be treated with surgical intervention followed by restoration of the affected joint. Treatment with folk remedies is not recommended, as it is fraught with the development of purulent arthrosis with the spread of infection throughout the body, and after sepsis, obvious morphological changes occur in all organs and systems.

Symptoms of joint inflammation

Symptoms are divided depending on the degree of development of the pathology. Arthrosis makes itself felt after 38-40 years, when the joint cushioning system begins to wear out and renewed or young cartilaginous pads do not appear in its place. With a hormonal imbalance, "chaos" sets in in all vital systems, this also applies to the locomotor system, as in the affected areas the tissues do not regenerate, but destruction + deformation occurs.

Osteoarthritis symptoms:

Degrees and periods of arthrosis	Description of symptoms
I graduated	Weak, short-lasting pain with precise location. Rapid fatigue of the painful joint. The pain intensifies after long walks, runs or lifting weights and disappears after rest. A slight click is heard when bending or making other movements. There are no visual + palpable changes, the anatomical shape of the joint is preserved, no swelling is observed.
II degree	Discomfort in affected joints, stiffness after rest. Partial traffic restrictions. Nighttime 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 become enlarged and shortened and, when pressure is applied, the patient responds abruptly to the acute pain.
III degree	Complete discomfort is observed in the affected joints, joint instability or ankylosis. The movement is paralyzed. There are constant sharp or aching pains at night. The anatomical shape of the joints is lost: thickening/shortening and displacement of the axis of the joint structure. There is swelling + pain when pressing. The gait is changed, due to the preservation of the organ of movement, the shape of the bone skeleton changes. The movement is carried out with the aid of a cane or crutches. With morphological changes with an infectious factor or compressed nerves, an elevated temperature appears (37-38 degrees).
Periods of exacerbation and remission	With arthrosis, exacerbations alternate with remissions. The pathology is aggravated by physical activity. Exacerbations are caused by synovitis. The pain syndrome covers all affected areas, including the muscular corset. It has reflexive spasms, forming painful contractures. Osteoarthritis is characterized by muscle cramps. As the destruction increases, the pain syndrome becomes more pronounced. In reactive synovitis, the joint increases in size and takes on a spherical shape. Fluid appears in the joints, which upon palpation creates a floating effect. During a short remission, the pain subsides, but movement is difficult.

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

Diagnostic measures

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

The study list consists of:

• General and biochemical blood tests.
• Blood test for rheumatoid agent.
• Analysis of urine and feces.
• Radiographic examination: image in three positions.
• Computed tomography of the joint to clarify the bone structure.
• Magnetic resonance imaging of the joint: study of ligaments and muscles.
• Computed tomography.

Important!Patients with osteoarthritis need to consult an orthopedist, rheumatologist, endocrinologist, hematologist, oncologist and it is recommended that female patients consult a gynecologist.

Treatment regimen

Therapeutic tactics include a whole range of measures aimed at eliminating the main cause, correcting the nutritional diet, restoring lost function + a gentle lifestyle, i. e. without special physical activity (long walking, running, carrying heavy objects) . The therapeutic treatment regimen consists of drug therapy, local treatment, physiotherapeutic procedures and exercise therapy. In parallel with these methods, folk remedies are used.

Drug therapy for arthrosis

Complex therapy consists of:

1. Medicines from the NSAID group;
2. Painkillers (tablets + injections);
3. Medicines that relieve muscle spasms (muscle relaxants);
4. Cartilaginous tissue restorers (chondroprotectors);
5. Antibiotics;
6. Antihistamines;
7. Medicines that improve blood circulation;
8. Vitamins: B2, B12, PP and A;
9. Antioxidants: vitamin C;
10. Medicines based on hormonal substances.

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

• Gold-based medicines;
• Immunosuppressants;
• Antimalarial medicines;
• Medicines that inhibit malignant cells.

Attention!During remission of the pathology, non-steroidal anti-inflammatory drugs are not recommended, as they affect the gastrointestinal tract, causing numerous ulcers, in addition to inhibiting the nutrition process of cartilaginous tissue.

Ointments for local use for arthrosis

Local treatment has a direct effect. Gels and ointments come into direct contact with the affected tissues, quickly reaching the location, eliminating pain and inflammation. Preparations in the form of gels are widely used to restore the cartilage layer. Warming + anti-inflammatory ointments are used for local application.

Physiotherapy

Spasmodic pain relief with reduced inflammation + improved trophism and innervation is achieved with the help of physiotherapy. Exacerbation phases are eliminated or shortened by laser therapy, magnetic fields and ultraviolet irradiation. In the remission phase of arthrosis, that is, in the calm phase, electrophoresis procedures with dimethyl sulfoxide and anesthetics are useful. Destructive and inflammatory processes are affected by phonophoresis with glucocorticosteroids, inductothermy, thermal applications of ozokerite or paraffin, as well as sulfide, radon and sea baths. The muscular corset is strengthened by electrical stimulation.

Surgery

The problem of a deformed/ankylosed joint is finally resolved by surgical operations such as endoprosthetics, as well as by a palliative method of unloading the joint structure (chadarthrosis is eliminated by transtrochanteric osteotomy + fenestration of the femoral fascia; gonarthrosis is corrected by arthrotomy with cleaning of the intra-articular space of the remains of destruction plus artificial cartilage augmentation). If the bone is completely incapacitated, it is replaced with an artificial graft and the tibial shaft is corrected.

Folk remedies

Traditional medicine helps eliminate pain and inflammation, temporarily eliminates pain and restores lost function. There are isolated cases of complete cure through traditional methods using the following tinctures, ointments and compresses:

1. Garlic + onion and honey tincture: 100 g of garlic pulp + 100 g of chopped onion + 2 large spoons of honey + 200 ml of vodka. Infuse for 3-5 days. Apply in the form of compresses and rub.
2. Sabelnik in tincture form: 200 g of dry powder or fresh gruel + 200 ml of diluted medical alcohol, leave for 24 hours. Drink a spoonful before meals, 3 times a day.
3. Ointment based on badger fat and propolis: rub into joints, apply twice a day.
4. Horseradish + honey: 100 g of horseradish + 100 g of honey + 100 ml of vodka. Infuse for 24 hours, drink 20 drops. This tincture can be applied to painful joints 3-5 times a day.
5. Pepper ointment + pork fat: 1 teaspoon of powder + 200 g of fat. Infuse for 2-3 days. Used as a local warming medicine. Apply 1-2 per day.
6. Compress: oak bark + spruce needles: 200 g of oak bark + 200 g of crushed spruce needles + 100 ml of alcohol.

All listed recipes from traditional healers are recommended for use only after consulting a doctor. If the patient is allergic to certain medications, their use is strictly prohibited, as they can cause anaphylactic shock.

Prevention features

Prevention is an effective tool for preventing disease, destruction and deformation of joints. For preventive purposes, you need to do the following:

• Adjust the menu, from which exclude fried, fatty, spicy, salty, alcohol + nicotine.
• Add jams and jellies to your daily menu.
• Avoid tiring loads.
• Increase safety precautions to avoid injuries.
• Constantly perform a special set of exercises for the locomotor system.
• Try taking vitamins B and C.
• For preventive purposes, take chondroprotectors, calcium, potassium and other mineral supplements once every six months.
• After a joint sprain or mechanical injury, be examined by a doctor.

The list is complemented by constant physical exercise to improve blood supply, innervation and restoration of the cartilaginous layer of the joints. These exercises are prescribed by a doctor.

Summary

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