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

Osteoarthritis is a chronic pathology aimed at damaging the joint structures of the musculoskeletal system. The main reason leading to chronic disease is metabolic imbalance, which leads to a progressive process of a degenerative-dystrophic nature. The targets of the harmful reaction are the articular cartilage, connective tissue, bags, tendons, bones and the muscle corset. In the chronic form of the pathology, the periarticular muscles are involved in the inflammatory process, losing anatomical elasticity due to deformation and joint swelling. To eliminate complications associated with blocking the biomotility of the skeleton and not become disabled, you need to arm yourself with information about arthrosis: what it is, what the causes, symptoms and treatment are.

Causes and risk factors for the development of the pathology

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

• Joint injuries (fracture, meniscal damage, ligament rupture, dislocation, compression + contusion, 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 glands).
• Hormonal dysfunction (decreased levels of estrogens, androgens).
• Degenerative + dystrophic reactions (multiple sclerosis, Perthes disease).
• Oncological diseases.
• Blood diseases (hemophilia, anemia, leukemia).

Risk factors that cause and lead to osteoarthritis:

1. Age-related changes.
2. Obesity (excess body weight leads to constant vertical loads, which overload the joints, which quickly wear out, losing cartilaginous plates).
3. Professional costs, that is, the load on a certain group of joints, leading to their inflammation or premature destruction earlier than other groups.
4. Postoperative consequences: highly traumatic surgery with removal of the affected tissues (soft, cartilaginous, bone). After restorative manipulations, the joint structure does not have the same consolidation, so any load leads to arthrosis.
5. A hereditary factor, i. e. osteoarthritis, can affect one or more family members.
6. Hormonal imbalance during menopause or after removal of the ovaries in women, the prostate in men.
7. Violation of the sea salt balance.
8. Neurodystrophic damage to the spine is a trigger of glenohumeral, lumbosacral, and hip arthritis-arthrosis.
9. Poisoning from 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 (smog over industrial cities and industrial zones, as well as frequent tests of military equipment or interstate wars, the result of which are ozone holes + strong ultraviolet radiation). Dirty drinking water and 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 end surfaces of the bones that are part of the locomotor joints. Normal cartilages have an anatomically strong structure, they are smooth, elastic and thanks to the synovial fluid, which is a biological material for the lubrication of the intra-articular components, they slide. It is the synovial fluid that gives unhindered movement of the joint components relative to each other.

Cartilage tissue and synovial lubrication perform the main function of the shock-absorbing effect, reducing abrasion of bones covered with 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 musculo-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 firmly maintain 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 plaques, exposing bones. In these areas, sharp osteophytes appear that create pain with any movement of the musculoskeletal joints. The bones thicken and false joints develop between the osteophytes which completely change the functionality of the movement organ. There is less synovial fluid due to trauma of the bursa (its rupture), and the entire joint structure begins to suffer, along with the corset of ligaments + muscles. Joint swelling appears, and a microbial infection may also occur. The areas of ossification lead to limited movement and ankylosis of the joint.

Stages of the clinical manifestation of joint pathology: stages

Osteoarthritis is characterized by three developmental phases, consisting of:

• Phase I:there are no particular 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 labor, pain and swelling of the joint appear.
• Phase II:a depletion of the cartilaginous plate is observed, foci of osteophytic islands develop and ossification appears along the edges of the joint. The pain syndrome intensifies, swelling increases and discomfort in movements appears. As the disease progresses to the chronic stage, the pain is constant, accompanied by inflammation with periods of exacerbation/remission. The biomechanics are partially compromised, the patient spares the joint.
• Phase III:the cartilaginous plate is completely worn; instead of cartilage, a system of osteophytes + false fixed interosteophytic joints develops at the bone ends. The anatomical shape is completely upset. Joint ligaments and muscles shorten and thicken. The slightest injury can cause dislocations, fractures and cracks. The trophism of the locomotor organs is damaged, so they do not receive the necessary amount of blood and nutrients. Pinched nerves cause a strong painful reaction, which disappears only after the administration of strong painkillers 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 severe condition. This stage is the most serious and can lead to sepsis and death.

Arthrosic pain syndrome

Pain is characteristic of osteoarthritis. They intensify with movement, physical activity, with changes in weather conditions, with changes in temperature, humidity level and atmospheric pressure. The pain can be triggered by any body position or sudden movements. Walking, running and prolonged standing puts a certain load on the aching joints, after which sharp or aching 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 stage the pain is constant and does not disappear. The affected cushioning layer, pinched nerves and blood vessels lead to a stagnant process with impaired trophism and accumulation of interstitial fluid. The swelling causes a sharp, throbbing pain.

Specific to arthrosis is pain after a long rest with a strong motor impulse; this condition is called initial pain. The mechanism of development of these pains are osteophytic zones covered with destructive remnants of cartilaginous tissue, fibrin and viscous fluid. When the 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 from the intraarticular space, i. e. bone residues or a large film of connective tissue, enter the muscles. There is another type of pain: constant, aching, bursting + independent of movements, they are characteristic of reactive synovitis.

Attention!Block-type pain can only be treated with surgery followed by restoration 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 obvious morphological changes occur in all organs and systems.

Symptoms of joint inflammation

Symptoms are divided according to the degree of development of the pathology. Osteoarthritis makes itself felt after 38-40 years, when the joint depreciation system begins to wear out and no renewed or young cartilaginous pads appear in its place. With a hormonal imbalance, "chaos" is created in all vital systems, this also applies to the locomotor system, so in the affected areas the tissues do not regenerate, but rather destruction + deformation occurs.

Symptoms of osteoarthritis:

Degrees and periods of arthrosis	Description of symptoms
I graduate	Weak, short-term pain with precise localization. Rapid fatigue of the painful joint. The pain intensifies after long walks, running or lifting weights and disappears after rest. A faint clicking sound is heard when bending or performing other movements. There are no visual + palpative changes, the anatomical shape of the joint is preserved, no swelling is observed.
II degree	Discomfort in the affected joints, stiffness is noted 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. Visual and palpation changes occur: the joints widen and shorten, moreover when pressure is applied, the patient responds sharply to acute pain.
III degree	Complete discomfort in the affected joints, joint instability or ankylosis is noted. The movement is paralyzed. During the night you feel constant sharp or aching pain. 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 changes, due to sparing of the movement organ, the shape of the bone skeleton changes. The movement is carried out with the help of a cane or crutches. With morphological changes with an infectious factor or pinched nerves, a high temperature appears (37-38 degrees).
Periods of exacerbation and remission	In osteoarthritis, exacerbations alternate with remissions. The pathology is aggravated by physical activity. Flare-ups are caused by synovitis. The pain syndrome covers all affected areas, including the muscle corset. It has reflexive spasms, forming painful contractures. Osteoarthritis is characterized by muscle cramps. 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 joints which upon palpation creates a floating effect. During a short remission, the pain decreases, but movement is difficult.

Timely detection of pathology by 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 list of studies consists of:

• General and biochemical blood tests.
• Blood test for rheumatoid agent.
• Urinalysis and stool analysis.
• Radiographic examination: image in three positions.
• CT scan of the joint to clarify the bone structure.
• MRI of the joint: study of the ligaments and muscles.
• Computed tomography.

Important!Patients with osteoarthritis should consult an orthopedist, rheumatologist, endocrinologist, hematologist, oncologist, and patients are advised to consult a gynecologist.

Treatment regimen

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

Drug therapy for osteoarthritis

Complex therapy consists of:

1. Drugs from the NSAID group;
2. Painkillers (tablets + injections);
3. Medicines that relieve muscle spasms (muscle relaxants);
4. Cartilage tissue restorers (chondroprotectors);
5. Antibiotics;
6. Antihistamines;
7. Drugs 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 drugs;
• Medicines that inhibit malignant cells.

Attention!During remission of the pathology, non-steroidal anti-inflammatory drugs are not recommended, which affect the gastrointestinal tract, causing numerous ulcers and also inhibit the process of nutrition of the cartilage 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 site, eliminating pain and inflammation. Preparations in the form of gels are widely used to restore the cartilage layer. For local application, warming + anti-inflammatory ointments are used.

Physiotherapy

Relief of spasmodic pain with reduction of inflammation + improvement of trophism and innervation is carried out with the help of physiotherapy. Flare phases are eliminated or shortened by laser therapy, magnetic fields and ultraviolet irradiation. In the remission phase of arthrosis, i. e. during the calm phase, electrophoresis procedures with dimethyl sulfoxide and anesthetics are useful. Destructive and inflammatory processes are influenced by phonophoresis with glucocorticosteroids, inductothermy, thermal applications of ozocerite or paraffin, as well as sulfide, radon and sea baths. The muscle corset is strengthened by electrical stimulation.

Surgery

The problem of the deformed/ankylosed joint is finally resolved with surgical interventions such as endoprosthesis, as well as with a palliative method of unloading the joint structure (coxarthrosis is eliminated by transtrochanteric osteotomy + fenestration of the femoral fascia; gonarthrosis is corrected by arthrotomy with cleaning of the intra-articular space from the remnants of destruction plus artificial augmentation of the cartilage). If the bone is completely disabled, it is replaced with an artificial graft and the axis of the tibia is corrected.

Folk remedies

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

1. Tincture of garlic + onion and honey: 100 g of garlic pulp + 100 g of chopped onion + 2 large spoons of honey + 200 ml of vodka. Infuses for 3-5 days. Apply in the form of compresses and rubs.
2. Sabelnik in the form of tincture: 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 the joints, apply twice a day.
4. Table horseradish + honey: 100 g horseradish + 100 g honey + 100 ml vodka. Infuse for 24 hours, drink 20 drops. This tincture can be rubbed into sore joints 3-5 times a day.
5. Chilli ointment + pork fat: 1 teaspoon of powder + 200 g of fat. Infuses for 2-3 days. Used as a warming local 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.

It is recommended to use all listed recipes of traditional healers only after consulting a doctor. If the patient is allergic to certain drugs, their use is strictly prohibited as they can lead to anaphylactic shock.

Characteristics of prevention

Prevention is an effective tool to prevent diseases, destruction and joint deformations. For preventive purposes, it is necessary to carry out the following operations:

• Adapt the menu, from which to exclude fried, fatty, peppery, salty, alcohol + nicotine.
• Add jellies and jellies to your daily menu.
• Avoid tiring loads.
• Increase safety precautions to avoid injury.
• 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, see a doctor.

Added to this list is the performance of constant physical exercises 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 the joints begins after 38-40 years, so there is no need to delay the fight against this pathology. A neglected condition can lead to wheelchair, and a timely response to the disease with effective treatment is a clear success towards recovery. It is impossible to cure 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, contact a traumatologist or a surgeon, do not delay, otherwise you will only be treated in a surgical department with a long rehabilitation.