Treatment methods for arthrosis

Osteoarthritis- a disease that develops over many years with predominant damage to certain joints.Most often, painful changes affect large joints - knee, hip, shoulder, etc.Pain and difficulty moving complicate a person's life physically and emotionally and, as osteoarthritis often occurs at a young age, it can interfere with achieving professional and personal goals.That is why it is important to diagnose the disease as early as possible and begin comprehensive treatment of arthrosis.

Osteoarthritis treatment

At the initial stage of arthrosis, conservative methods are used that do not involve surgical intervention.However, the correction methods used make it possible to halt the development of the disease, maintain motor activity, reduce the severity of the main symptoms of osteoarthritis and generally improve the person's quality of life.

1. Drug treatment:
   • NSAIDs;
   • GCS;
   • chondroprotectors.
2. PRP therapy.
3. Therapeutic exercise.
4. Massage and manual therapy.
5. Traction therapy.
6. Physiotherapy.

Physiotherapy techniques widely used for osteoarthritis:

• magnetic therapy;
• UHF;
• inductothermy;
• ultrasound therapy;
• balneotherapy;
• surgical treatment.

Drug treatment

There is a widespread belief among patients that the use of medications with an analgesic effect (orally in the form of tablets or by injection - intramuscularly) is the most important method for relieving pain in osteoarthritis.In fact, the use of medication is a method of quick pain relief, which should only be prescribed in the acute period.The fact is that medications widely prescribed for these purposes have serious side effects, which increase with prolonged use and especially with uncontrolled use.We are talking about undesirable effects on the digestive, cardiovascular and nervous systems, which with great probability can lead the patient to a hospital bed (bleeding in the stomach, heart rhythm disturbances, effects on the liver and kidneys, etc.).

Nonsteroidal anti-inflammatory drugs

1. NSAIDs- non-steroidal anti-inflammatory drugs, many of which are available without a prescription and are widely taken by patients on their own.This group includes medicines of different chemical structures.Medicines have a pronounced anti-inflammatory and analgesic effect, can reduce pain in the joint area and adjacent muscle tissue, but do not affect the development of the disease.They are only used to reduce symptoms at all stages of the disease.Effective for concomitant synovitis (accumulation of fluid in the joint).

2. GKS— glucocorticosteroid medicines have a strong anti-inflammatory and analgesic effect.It is advisable and effective to administer them periarticularly.However, patients often have a negative attitude towards the use of these drugs in treatment, which is associated with possible side effects: infectious complications, deterioration of ligaments, articular surface and cartilage degeneration.But with periarticular administration, the risk of these complications is minimal.

3. Chondroprotectors— the substances are natural components of cartilage tissue which, when administered orally, contribute to the gradual restoration of cartilage, normalizing its density and elasticity.These active components are usually used in combination and are included in various medicines and auxiliary products.Chondroprotectors do not have a rapid analgesic effect;improvement develops with prolonged use of drugs based on them, which is associated with partial restoration of cartilaginous tissue.Recommended at all stages of the disease.

PRP Therapy

One of the most modern methods of restorative medicine, used for sports injuries and degenerative-dystrophic diseases of the joints, is PRP therapy (PRP - platelet-rich plasma) or plasma biorevitalization, autoplasma therapy.The technique is actively used abroad.

The essence of the procedureconsists of injecting platelet-rich plasma directly into the site of the injury, in this case the joint.The medicine for administration is obtained from the patient's own blood, which is why the method is considered not only highly effective, but also safe for humans.Growth factors and other biologically active substances (serotonin, bradykinin, prostaglandins, etc.) contained in platelet-rich plasma contribute to the activation of regeneration processes and the synthesis of their own basic substances.

The resulting platelet-rich plasma is injected periarticularly and directly into the affected joint, thus achieving partial restoration of the tissue, mainly cartilage.

The technique is most applicable in stages 1-2 of osteoarthritis.It presents good results and allows the rapid development of the disease to be delayed due to the release of growth factors by platelets.The method is relatively new but has proven to be highly effective.PRP therapy was first used in surgery;Today the technique is used successfully in many areas of medicine, including rheumatology and orthopedics, neurology and cosmetology.Carrying out autoplasmotherapy allows you to increase the useful life of the joint without any other aggressive interventions.

Synovial fluid protectors- a group of drugs based on hyaluronic acid, which are injected directly into the joint cavity (injection) and play the role of a viscous lubricating fluid in the case when natural synovial fluid is almost completely absent (it is it that plays the role of lubricating the articular surfaces).Used in the later stages of osteoarthritis.

Medicines in this group are also called “synovial fluid prostheses”, “biological synovial fluid substitutes”.The effect after taking the medicines is long-lasting - from 6 to 13 months, depending on the medicine used.

Some applyother groups of drugs- antispasmodics, muscle relaxants, B vitamins in therapeutic (high) dosages, but all of them have only auxiliary value in the treatment of osteoarthritis.

Therapeutic exercise

Special therapeutic exercises can and should be used even during an exacerbation, at all stages of arthrosis.Such measures can reduce pain and prevent severe restrictions in joint movement.However, the method is unpopular among patients with osteoarthritis, as most of them are mistaken in believing that in case of pain it is necessary to limit any movements.The timely start of physical exercise, on the contrary, promotes faster recovery and reduction of symptoms, especially pain.

Particularly effective are physiotherapy in water, joint movements in an unloading position (lying down, sitting, hanging) and moderate walking on a flat surface.If necessary, for example, in case of severe pain, a special bandage can be applied to the joint, but physical education should be started as early as possible.

Massage and manual therapy

Methods of mechanical impact on joints, muscles and ligaments can reduce pain intensity, increase mobility, improve blood circulation and metabolism in the area of affected joints, relieve muscle spasms and normalize muscle function.

Traction therapy

In a hospital or medical sanatorium, it is possible to carry out traction therapy - this involves traction of the joint (hip, knee) using a special technique with various loads.The standard traction regimen is designed for 28 days, with a gradual increase in load and exposure time.Classical and more modern techniques are used using simulators.Their effectiveness is almost the same, but simulators are more comfortable for the patient.

Physiotherapy

The use of various physiotherapeutic techniques in the early stages of osteoarthritis can provide significant pain relief and increased mobility in affected joints.Physiotherapy courses help to slow down the pathological process and extend the period without exacerbations.

Physiotherapy techniques widely used for osteoarthritis:

1. Magnetotherapy— local exposure to a constant or alternating low-frequency magnetic field.In the area of the affected joint, metabolic processes are accelerated, blood circulation and the supply of nutrients to the joint structures are increased, the processes of regeneration and synthesis of the very substances necessary for the functioning of the joint are activated.

   Magnetic therapy has anti-edematous, analgesic and anti-inflammatory effects almost from the first session, which has a positive effect on the patient's general condition.Magnetic therapy is successfully used in hospitals and sanatoriums, where medical equipment of various modifications is used.

   A big advantage for patients with osteoarthritis is the possibility of carrying out independent courses of magnetic therapy at home, as prescribed and supervised by the attending physician.Timely use of portable magnetic therapy devices allows you to stop the development of pain, the onset of an exacerbation or carry out a preventive course - that is, maintain normal health.

   A positive aspect of magnetic therapy can also be called the beneficial effect of the procedures on the state of the cardiovascular and nervous systems.Taking into account that the majority of patients with osteoarthritis are middle-aged and elderly people with an existing set of chronic diseases (arterial hypertension, coronary disease, atherosclerosis, etc.), the slight sedative and stabilizing effect of magnetic therapy will be very useful.

2. Ultrasound Therapyused most often in combination with the effects of drugs with anti-inflammatory, analgesic and restorative effects - ultraphonophoresis or phonophoresis.Ultrasound increases the permeability of tissues to drugs, so their main effect is enhanced.Even without a medicinal component, the method is highly effective for osteoarthritis: ultrasound has a mechanical effect on the tissue (micromassage), activates local immunological and regenerative processes in the joint region and adjacent muscles and has a pronounced analgesic and anti-inflammatory effect.

3. laser therapy– one of the most common and widely used procedures.The therapeutic effect is based on the reflex expansion of blood vessels above the site of the pathological process.This leads to an improvement in local blood flow, activation of metabolism, removal of under-oxidized metabolic products and a decrease in pain intensity.Laser therapy, due to its small depth of penetration, has a minimally pronounced systemic effect, while enhancing the therapeutic effect of other procedures.

4. Shock wave therapy– high energy influence method.It is based on the piezoelectric effect.By applying a piezoelectric discharge to a pathological focus, several effects are achieved.Non-viable cells are destroyed, which leads to the activation of local immunity.Hibernating (inactive) cells are stimulated, which promotes regeneration processes.At the same time, the intensity of the pain syndrome is significantly reduced (although the procedure itself is painful).The undoubted advantage of the method is its use once every 4-7 days.

5. Diadynamic therapy– a method of therapeutic effects on the body with diadynamic pulse currents.The diadynamic currents used in this method rhythmically excite skin receptors, which indirectly leads to the activation of descending physiological mechanisms of pain suppression and leads to the reduction of the patient's pain, up to complete analgesia.Therefore, such procedures are effective for severe pain.

6. Electromyostimulation– exposure to electrical current in muscle tissue.With arthrosis of large joints, the work of the surrounding muscles is disrupted, which leads to atrophy of some and overload of others.Gait disorders develop.When exposed to alternating electrical current according to a special program, the muscles contract rhythmically, producing a certain amount of work, which leads to the restoration of their volume and function.

7. Cryotherapy- a simple and effective treatment method, unfortunately rarely used.Local exposure to low temperatures 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, local blood flow accelerates and recovery processes are activated.This method is especially effective in combination with shock wave therapy.

8. Balneotherapy.In sanatorium conditions, hydrotherapy is carried out - medical baths, among which radon baths are especially effective for arthrosis.There is a general effect on the body of the radioactive decay products of radon dissolved in water.The most important effect is the activation of metabolic processes.

   A similar, albeit less pronounced, effect is characteristic of therapeutic mud baths (peloids), hydrogen sulfide and carbon dioxide.

Surgical treatment

Surgical techniques are used in the late stages of osteoarthritis, when joint mobility is severely limited or absent, which affects the patient's quality of life.All over the world, various methods of joint replacement are used, which make it possible to completely restore range of motion and return the patient to an active life at any age.

The tactics and scope of surgical intervention are determined by the attending physician;The choice is based on parameters such as the patient's general condition, age and presence of concomitant diseases, excess weight and others.The best results after endoprosthetics were obtained in young and middle-aged patients (almost complete restoration of range of motion), but also in elderly people there is a significant improvement in their condition, because after a successful operation and recovery they can fully support themselves in everyday life and move not only within the apartment, but also outside, without limiting themselves in communication.

Prevention

Arthrosis belongs to the group of diseases of upright gait and develops mainly as a result of age-related changes in joints, enhanced by the influence of external negative factors.Attention to the state of the musculoskeletal system, prevention of joint diseases and treatment of arthrosis in the early stages make it possible to maintain physical activity and avoid massive medical interventions in the future.