Treatment of osteoarthritis: drugs, surgery, folk remedies
Characteristic symptoms and the treatment of different types of osteoarthritis
Osteoarthritis (OA) is an irreversible progressive disease of the joints, characterized by the development of degenerative process with the defeat of all joint components.
OA is the most common joint pathology.
First, it affects the cartilage and bones oculography areas, then involve the ligaments, capsule and periarticular muscles. Often the degenerative changes combined with the inflammation of the joint that allows us to treat the disease as osteoarthritis.
Cartilage acts as a shock absorber in the joint: its smooth surface reduces friction between the bones and provides good movement to them. In this disease the cartilage surface becomes rough, uneven, it can wear away to the bone.
Features of osteoarthrosis
OA always leads to deformation of the joint, which allows the pathology to refer to as deforming osteoarthritis (DOA). In the ICD (international classification of diseases) is synonymous terms: osteoarthritis, osteoarthritis, arthrosis, arthrosis deformans.
- Pain syndrome is the most common manifestation of the disease. First, the characteristic rhythm of pain: the appearance of them after the load and the disappearance after a night of rest. The pain may appear after prolonged fixed postures («starting pain») and take place after active movements. Subsequently pain become constant bother at night.
- Morning stiffness in the morning, limited mobility lasting up to 30 min.
- The sensation of crunching, crackling during movement in the joint, friction between the bones.
- Swelling, increased temperature over the joint appear when inflammation of it.
- Gradually progressing stiffness and deformity of the joint.
- With the defeat of the spine gradually compressed nerves, resulting in numbness, disturbance of sensation in various parts of the body might experience dizziness, vomiting, etc. symptoms.
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OA is registered in the world: it affects about 16% of the population. The incidence and prevalence of osteoarthritis in different countries.
In USA sore about 7% of the population (more than 21 million people), and 2% of those under 45 years; in Sweden – 5.8% of residents (aged 50-70 years); in Russia – about 15 million people.
With age, the incidence sharply increases in elderly and senile age sick every third. Among the cases of young persons dominated by men, among older women.
The most common is the osteoarthritis hip and knee joint, also affects the inter-vertebral joints, at least – the carpal-metacarpal and interphalangeal.
According to the severity of functional disorders of predominant lesion of knee, hip and shoulder joints.
The destruction begins with one joint, then involves the other, accepting the compensatory load. Often the first signs appear at the age of 40-45 years.
Classification of violations
There are several types of classification of the disease.
There are primary and secondary osteoarthritis (associated with dysplasia, incorrect posture, diseases of joints, injury, etc.), with the phenomena of synovitis and without it.
Distinguished clinical forms:
- monarcas – 1 affected joint;
- oligoelementos – defeat 2 of the joints;
- the polyosteoarthrosis – involves more than 3 joints.
Depending on the localization:
- gonarthrosis of the knee joint;
- coxarthrosis of the hip joint;
- martres shoulder joint;
- OA of other joints.
On the basis of radiological manifestations there are 5 stages of DOA.
There are functional disorders of the joints:
- FN 1 – temporary disability;
- FN 2 – bravely lost earning capacity;
- FN 3 – the need for nursing care for patients.
What caused the destruction of joints?
Until the end of causes destruction of cartilage is not clear. Changes in the cells of the tissue lead to softening of the cartilage, reducing its thickness, narrowing of the joint space, thickening of the bone of the division, the formation of osteophytes (bone spikes) and cysts.
The risk factors include:
- age: with age, the risk increases;
- gender: women OA is more common;
- congenital deformity of the joints and bones;
- sedentary lifestyle;
- increased load on the joints (sports, heavy lifting);
- surgery on the joints;
- hormonal disturbances.
Not ruled out a genetic predisposition to the disease associated with the mutation of the type II collagen (protein cartilage).
For the diagnosis can be used:
- the survey patient’s complaints;
- examination of the joints: configuration, swelling, redness, pain at palpation, range of motion;
- radiograph reveals narrowing of the joint space, presence of bone spikes;
- MRI gives clearer than renthenznimky, images of joints and surrounding tissues;
- a blood test allows us to differentiate OA from other lesions of the joints;
- analysis of fluid from joint for the exclusion of inflammation in it.
Effective treatment of osteoarthritis is able to stop the progression of the process, no.
Existing therapeutic methods aimed at achieving the objectives:
- unloading joints;
- the reduction of pain and inflammation;
- the decrease in rate of progression;
- improving joint function.
There are the following methods of treatment:
- methods of folk medicine;
- surgical treatment.
A wide range of medicines
Drug therapy in the treatment of osteoarthritis involves the administration of drugs, anti-inflammatory, analgesic, chondroprotective action:
- Anti-inflammatory and analgesic action have drugs from the group of NSAIDs (Naproxen, Ibuprofen, Diclofenac, Xefocam, Melbek, etc.). They can be used inside, injections, topically in the form of gels, creams, ointments (Deep relief, Fastum, Diklak). With prolonged use of drugs can cause side-effects from the digestive tract (pain in the stomach, nausea, diarrhea). Contra-indication is peptic ulcer disease. The local external use of preparations of this group allows you to avoid side effects.
- In the fight against pain can help heat or cold. Used locally-irritating, distracting means (Capsicum, Deep heat, Apizatron, Finalgon, etc.), cold compresses.
- Reduction of pain and inflammation contributes to intra-articular injection of corticosteroids (Kenalog, Diprospan, Metipred). Because of the side effects of such injections are rarely used (3-4 per year). The relief is not long lasting: lasts a maximum of several months.
- The joint can be injected hyaluronic acid that help restore the properties of the intra-articular lubricant, improve nutrition to the cartilage. These include Hyalgan, Ostenil, Singiel, Sinokor. Reducing the friction of bones, they reduce the intensity of pain for several months. Use them effectively in the early stages (I-II century). Spend 1 injection per week, at the rate prescribed 3-5 introductions to 1-2 years. Opinions among experts about the effectiveness of intraarticular injections of corticosteroids and hyaluronic acid are mixed.
- The drugs that promote the regeneration of cartilage (chondro) are Chondroitin sulfate, Alflutop, Glucosamine. In many Western States, these funds are used only in the form of supplements, as their therapeutic effect is not proven.
Physiotherapy and lifestyle
- the Spa treatment.
Physiotherapy reduce pain intensity, muscle spasm, inflammation, stimulate the microcirculation and metabolic processes in the joints. The doctor selects them individually depending on the stage of the disease and major symptoms.
You can use these types of thisprocedure:
- diadynamic therapy;
- magnetic therapy;
- laser therapy;
- hyperbaric oxygenation;
Physical therapy and massage to remove muscle spasm of the muscles to improve the tone of weakened muscle groups, improve the trophism and function of the affected joints.
The principle of the therapy: light dynamic load and full static discharge. The doctor recommended special exercises and tools supports while moving (crutches, cane, corset), elastic clips (knee), special shoes or tab for her.
Recommended walking (at least 30 minutes) on level ground, Cycling, swimming. It is necessary to exclude the presence in a fixed posture for a long time, weight lifting, sitting in soft chairs. The bed should be rigid chairs with a straight back.
Acupuncture reduces pain, improves joint function. With the same purpose in some Western countries used treatment yoga and tai Chi instructor.
The diet of the patient should be directed to the normalization of body weight. Without exacerbation may incorrecta resorts with curative mud, hydrogen sulfide, sulfur, radon sources.
Effective iodine-bromine, sulfide, bishofite, sea baths, application of peat and muds, ozokerite.
The best recipes for the treatment of osteoarthritis folk remedies:
- mix dry mustard, vegetable oil and honey in equal parts and bring to the boil, decoction to make a compress 2 hours;
- in OA knee joints replaced domestic pork fat, cover with plastic, secure with a bandage and keep the clock 1 week;
- rubbing can be made from infusions of hell, flowers of lilac or chestnut, sprouts, potatoes (50 g of flowers at 0, 5 liters of vodka);
- take 2 tbsp. l. flowers of clover and St. John’s wort, hops, mix and grind with 50 g of butter; to attach to the joint for 2 hours;
- take 4 tbsp of needles of any tree in a glass of water, simmer on low heat for 30 minutes, drain the broth, to make a compress for 1 hour.
It is recommended to include in the diet the frequent use of aspic. Normal joint function contributes to the use of crushed egg shell, containing 27 minerals.
Surgery, as an extreme measure
Surgical treatment: developed and applied several types of operations:
- Arthroscopic debridment or «cleaning» of the joint using the arthroscope through special punctures are removed destroyed part of the cartilage. Operation gives an improvement in the early stages of 1-2 years.
- Osteotomy or reconstruction of bone: the bone is fixed at a different angle to redistribute the load. Health improvement is noted up to 5 years.
- Joint replacement joint: damaged joint is replaced with prosthesis of high strength plastic or metal. The operation is usually performed on knee and hip joints with marked pain and dysfunction.
Degenerative changes in the tissues supporting apparatus in OA lead to the complete destruction of the cartilage, significant dysfunction of the joint.
Stiffness and pain can be so pronounced that the patient is unable to work and needs assistance in everyday life.
Prevention of OA includes the following methods:
- Weight control and getting rid of excess body weight. «Hard» diet for joints not less harmful than overeating. If overweight, the diet should choose a nutritionist.
- Motor mode must be balanced. Weight training with exercises is necessary to exclude, to do cardiac profile (walking, running, swimming, etc.).
- The exception injuries.
- To avoid overcooling of the joints. You can use knee pads, belt of dog hair.
- Wearing shoes with a comfortable stacked heel.
- Chondroprotectors by the doctor orthopedist, although preventive benefits are not supported by all experts.
Osteoarthritis is a chronic, progressive joint damage causing impaired function and disability.
Effective treatment of the disease there. Early access to a doctor at the first symptoms of the disease will allow you to obtain treatment to slow the progression of the process.
In the later stages the only possibility to ease the condition – surgery to joint replacement.