Osteoarthritis - A disease that has developed in many years with damage predominant to certain joints.Most often, painful changes affect large joints - knee, hip, shoulders, etc.The pain and the difficulty of moving in it complicates a person's life in a physical and emotional plan, and taking into account the fact that osteoarthritis is often at a young age, it can intervene to achieve professional and personal goals.This is why it is important to diagnose the disease as soon as possible and to start the complex treatment of osteoarthritis.
Osteoarthritis
At the initial stage of osteoarthritis, conservative methods are used that do not involve surgery.Meanwhile, the methods of method used to suspend the development of the disease, maintain motor activity, reduce the severity of the main symptoms of osteoarthritis and generally improve human quality.
- Drugs
Groups of drugs used
- NSAIDs;
- GKS;
- Chondroprotectors.
- PRP therapy
- Medical physical education
- Manual massage and therapy
- Extension therapy (traction)
- Physiotherapy
Physiotherapy methods widely used for osteoarthritis:
- Magnetotherapy;
- UHF;
- Inductothermia;
- Ultrasound therapy;
- Balneotherapy;
- Surgical treatment.
Treatment of osteoarthritis with drugs
Among the patients, it is common for the use of drugs with an analgesic effect (orally in the form of tablets or injectively - intramuscular) is the most important method for eliminating pain in osteoarthritis.In fact, the use of drugs is a quick pain relief method, which should only be prescribed in the acute period.The fact is that drugs largely prescribed for these objectives have serious side effects that intensify with prolonged contribution and especially with an uncontrolled contribution.We are talking about undesirable effects of digestive, cardiovascular and nervous systems which, with a high probability, can bring the patient to a hospital bed (gastric bleeding, disruption of heart rate, effects on the liver and kidneys, etc.).
Non-steroidal anti-inflammatory drugs
Groups of drugs used:
NSAID -Non-steroidal anti-inflammatory drugs, many of them are released without a prescription and are widely accepted by patients by themselves.This group includes drugs from various chemical structures, the most famous of them are diclofenac, indomethacin, nenproxen (classic NSAIDs), more modern in Meloxicam, Nimesulide, Ketorolac.The drugs listed have a pronounced anti-inflammatory and analgesic effect, reduce pain in joint and adjacent muscle tissue, but do not affect the development of the disease.They are used only to reduce symptoms to all stages of the disease.Effective with concomitant synovitis (accumulation of liquid in the joint).
Gks - Glucocorticosteroid drugs (hydrocortisone, triamcinone, betamethasone) have the strongest anti-inflammatory and analgesic effects.It is advisable and effective for their introduction percentage.However, patients are often negatively linked to the use of these drugs in treatment, which is associated with possible side effects: these are infectious complications, deterioration in the state of ligaments, the articular surface and degeneration of cartilage.But with the peri-human risk of these complications, the risk of these complications is minimal.
Chondroprotector - glucosamine and chondroitin are natural components of cartilage which, when administered orally, contribute to the progressive restoration of cartilage, normalize its density and elasticity.These active components are generally used in the complex, are part of various drugs and auxiliary products.Chondroprotectors have no rapid analgesic effect, improvement is developing with prolonged use of drugs based on them, which is associated with partial restoration of cartilage.Recommended at all stages of the disease.
PRP therapy
One of the most modern methods of recovery medicine, which is used for sports injuries and mono-dystrophic diseases of the joints, is the PRP (Plasma rich in PRP-Platelet) treatment or mobravitization in plase, autoplasmic therapy.
The essence of the procedure It consists of the introduction of plasma enriched by platelets, directly instead of damage, in this case in the articulation.The drug for administration is obtained from the patient's blood, so the method is considered not only very effective, but also safe for humans.The growth factors and other biologically active substances (serotonin, bradykinin, prostaglandins, etc.) contained in plasma thrombocus enriched by thrombocytes, contribute to the activation of the processes of regeneration and synthesis of their own fundamental substances.
The resulting plasma, enriched with platelets, is introduced both especially and directly into the affected joint, due to which a partial restoration of the tissues is obtained - mainly cartilage.
The methodology at 1-2 stages of osteoarthrosis is the most applicable.It shows good results and allows you to delay the rapid development of the disease due to the release of growth factors by platelets.The method is relatively new, but has proven its great efficiency.PRP therapy was first used in surgery, today technique is successfully used in many areas of medicine, including rheumatology and orthopedics, neurology and cosmetology.Driving autoplasmic therapy allows you to increase the functioning of the joint without any other aggressive intervention.
Synovial liquid steps - A group of drugs based on hyaluronic acid, which are introduced directly into the joint cavity (injection) and play the role of a knitting lubricating liquid in the event that the natural synovial fluid is almost completely absent (it provides the role of lubrication of joint surfaces).They are used in the late stages of osteoarthritis.
The medical remedies of this group are also called "synovial liquid prostheses", "biological substitutes for synovial fluid".The effect after the administration of drugs is long - from 6 to 13 months, depending on the medical product used.
Some are used Other drugs - Antispasmodic, muscle relaxing, group B vitamins in therapeutic (high) doses, but all have only auxiliary value in the treatment of osteoarthritis.
Medical physical education
Special therapeutic gymnastics exercises can and should be used even during exacerbation, at all stages of osteoarthritis.These measures can reduce pain and prevent restrictions on the movement of the joints.However, among patients with osteoarthritis, the method is unpopular, because most of them are wrong, believing that with pain, it is necessary to limit any movement.The appropriate start of physical exercises, on the contrary, contributes to a faster recovery and decrease in symptoms, mainly pain.
Particularly effective physiotherapy exercises in water, joint movements in unloading position (elongated, seated, in suspended position), moderate walking on a flat surface.If necessary, for example, with a pronounced pain syndrome, a special bandage can be imposed on the joint, but you should start physical education as soon as possible.
Manual massage and therapy
The methods of mechanical effects on the joint, muscles and ligament devices make it possible to reduce the severity of pain, increase mobility, improve blood circulation and metabolism in the area of affected joints, relieve muscle spasms, normalize muscle function.
Extension therapy (traction)
In a hospital or medical sanatorium, traction therapy is possible - it is a joint traffic (hip, knee) according to a special method using various cargoes.The standard traction scheme is designed for 28 days, with a gradual increase in charging time and exposure.Classic techniques are used and more modern using simulators.Their efficiency is almost the same, but the simulators are more comfortable for the patient.
Physiotherapy
The use of various physiotherapy techniques in the first stages of osteoarthritis allows us to obtain significant relief from pain syndrome and increase mobility in affected joints.Physiotherapy courses contribute to a slowdown in the pathological process and to extend the period without exacerbations.
Widely used for osteoarthritis of physiotherapy methodology
Magnetotherapy - Local effects by magnetic field at low frequency constant or alternated.In the area of affected articulation, metabolic processes are accelerated, blood circulation and the delivery of nutrients to joint structures increase, theprocess of regeneration and synthesis of the own substances necessary for joint work is activated.Magnetotherapy has anti-altitude, analgesic and anti-inflammatory effects of almost the first session, which positively affects the patient's general condition.Magnetotherapy is used successfully in hospitals and sanatoriums, where medical equipment of various modifications are used.An enormous advantage for patients with osteoarthritis is the possibility of independent courses of magnetotherapy at home, aimed and under the control of the attending physician.The timely use of portable devices for magnetotherapy allows you to stop developing pain, the start of exacerbation or to take a preventive course-that is to say to maintain normal well-being.A positive moment of magnetotherapy can also be called the beneficial effect of procedures on the condition of cardiovascular and nervous systems.Given that most patients with osteoarthritis are average and advanced people, with an existing set of chronic diseases (high blood pressure, coronary disease, atherosclerosis, etc.), a slight sedative and stabilizing effect of magnet therapy will be very useful.
Ultrasound therapy It is used more often in combination with the effects of drugs with an anti -inflammatory, analgesic, catering effect (hydrocortisone, chondroitin sulfate, indomethacin, etc.) - ultrafonophoresis or phonophoresis.Ultrasound increases the permeability of tissues for drugs, so their main action is improved.Even without a medicinal component, the method is very effective for osteoarthritis: ultrasound has a mechanical effect on tissues (microomassage), activates local immune processes and catering in joint and adjacent muscles, an analgesic and anti-inflammatory effect is expressed.
Laser therapy - One of the most common and most used procedures.The therapeutic effect is based on the reflex expansion of blood vessels above the focus of the pathological process.This leads to an improvement in local blood circulation, the activation of metabolism, the elimination of underestimated metabolism and a decrease in the intensity of pain.Laser therapy due to the shallow penetration depth has a minimally pronounced systemic effect, while improving the therapeutic effect of other procedures.
Shock waves therapy - The high energy exposure method.It is based on a piezoelectric effect.The influence of the piezoelectric discharge on pathological focus is obtained by a number of effects.Non -viable cells are destroyed, which leads to the activation of local immunity.Gybernic cells (inactive) are stimulated, which contributes to regeneration processes.At the same time, the intensity of pain syndrome is considerably reduced (although the procedure itself is painful).The undeniable advantage of the method is the use of the method once every 4 to 7 days.
Diadinamotherapy - The therapeutic effect method on the body with diadynamic pulse currents.The diadynamic currents used in this method rhythmically excite the skin receptors, which indirectly lead to the activation of the descendant physiological mechanisms of the deleted pain and leads to a decrease in patient's pain, up to analgesia.Therefore, such procedures are effective for intense pain.
Electromeostimulation - Exposure to electric current on muscle tissues.With osteoarthritis of large joints, the work of the surrounding muscles is disturbed, this leads to the atrophy of some and the overload of others.The process of the approach develops.When exposed to an alternated electric current according to a special program, the muscles decrease rhythmically, doing a certain work, which leads to the restoration of their volume and their function.
Cryotherapy - A simple and effective treatment method, unfortunately, is rarely used.The local effect of low temperature reduces the sensitivity of pain receptors and the synthesis of biologically active substances that stimulate the development of inflammation.After cryotherapy, a reflex expansion of blood vessels occurs, the local blood circulation is accelerated and the recovery processes are activated.This method is particularly effective in combination with shock wave therapy.
Balneotherapy
Under the conditions of sanatorium and resort, hydrogenation is made of medical baths, among which radonary osteoarthritis is particularly effective for osteoarthritis.A general effect on the body is carried out by the radioactive decrease products of the radon dissolved in the water.The most important effect is the activation of metabolic processes.
A similar effect, although less pronounced, is characteristic of therapeutic mud (peloids), hydrogen sulfide and carbon dioxide.
Surgical treatment
Surgical methods are collected in the late stages of osteoarthritis, when joint mobility is strongly limited or absent, which affects the quality of the patient's life.All over the world, various methods of joint endoprothetics are used, which allows you to completely restore the volume of movements and make the patient to active life at any age.
The tactics and the volume of the surgical intervention are determined by the attending physician, the choice is based on parameters such as the general condition of the patient, the age and the presence of concomitant, overweight and others.The best results after the endoprothetics were obtained in youth and middle age patients (almost complete restoration of the volume of movements), but the elderly also have a significant improvement in the disease, because after the operation and recovery successfully executed, they can be fully provided in the domestic plane and move not only in the apartment, but also to go out, do not limit themselves to communication.
Prevention
Arthrosis belongs to the group of simplicity diseases and develops mainly as a result of age -related changes in the joints, improved by the influence of external negative factors.Paying attention to the state of the musculoskeletal system, the prevention of joint diseases and the treatment of osteoarthritis in the early stages make it possible to maintain motor activity and avoid massive medical intervention in the future.