What is osteoarthritis?Osteoarthritis - the most common form of arthritis. It develops slowly and usually does not cause serious loss of efficiency, especially with the relevant guidance on the management of the disease. Nearly half of people older than 60 years and virtually all older than 80 years suffer from osteoarthritis, but is now recorded cases in young people under the age of 21 years.
Osteoarthritis is the result of mechanical failure of the normal structures of the joint, changes in the capsule and cartilage damage. Osteoarthritis most commonly affects the large joints of the knee, hip and spine. The process also often affects the joints of the hands.
What happens to the joints?The joint mechanism for connecting rolling the bones, where they converge at the end of the joint capsule. Articular end of bone covered by an elastic thin layer of hyaline cartilage, which does not contain nerve endings and blood vessels. At various movements cartilage acts as a shock absorber, reducing the pressure on the mating surfaces of the bones and ensuring their smooth sliding relative to each other.
The bones of the joints are fastened to each other ligaments and tendons, which act as a powerful and flexible cables allow you to perform the movement in the right direction. They are completely surrounded by a capsule of the joint. Joint capsule is lined with a thin synovial membrane which produces a lubricating fluid in the joint space. Lubricating fluid provides nourishment hyaline cartilage and is a reliable lubrication of the articular ends of bones. Inflammation of the synovial membrane (synovitis), bleeding into the joint (hemarthrosis) contribute to the development of degenerative and inflammatory processes in the joint.
The first significant change in osteoarthritis and mitigate the formation of pits on the smooth surface of cartilage. As the progression of arthritis, a layer of cartilage covering the articular surface, becoming thinner, up to total destruction, leaving the unprotected ends of bones.
Without the normal sliding surface becomes painful and difficult to move the joint. As the cartilage continues to deteriorate, the edges of the joint formed by bony growths, as if compensating for the loss of cartilage due to the increase of the articular surfaces. This is the cause of deformities of the joints (the joint loses its shape) for arthritis. People like state called "the accumulation of salts", which is simply called illiterate osteoarthritis.
Causes of osteoarthritisFor many years thought that osteoarthritis was the result of normal wear and tear of the joint throughout life. But researchers now recognize that there are several factors leading to its development:
- Age - the age the cartilage becomes less elastic and loses its resistance to stress;
- Obesity - overweight for a long period of time speeds up the process;
- Injury (trauma) joints - facilitate the development of arthritis can be a strong one-time injury, accompanied by an injury, fracture, dislocation, damage to the ligaments of the joint, or repetitive microtrauma of the joint. Microtraumas workers exposed to a number of professions and professional athletes. An example is the development of arthritis of knee joint in miners, football players, arthritis of the elbow and shoulder joints in working with a jackhammer;
- Familial (genetic) predisposition to osteoarthritis - some form of osteoarthritis is really inherited in families, but heredity is not the main cause of osteoarthritis.
The exact causes and mechanisms leading to osteoarthritis, is still unknown.
Symptoms of osteoarthritisOsteoarthritis often occurs with little or no symptoms, even in cases where X-rays may show changes in the joint. You may be periods of instability and severe pain in the joint, alternating with long periods of stability.
Most older people experience some twinges in the joints, which will soon go away or subside with rest and heat applied to the joint. Sometimes, however, the symptoms are more pronounced and may include any of the following:
Pain and stiffnessThe first symptom, forcing contact the doctor is a pain in the joint. Patients often say that she is "nagging" and vaguely localized. The intensity of pain can vary depending on the stage of the disease - from the sharply defined, which limits the mobility of the joint, to moderate, occurring only with certain movements. Pain in the joint has a tendency to increase with load and decrease with rest. As the progression of osteoarthritis, the pain begins to occur with minimal activity, and in advanced cases it may even awaken the patient at night.
Stiffness or "starting" pain usually occur after a period of rest, especially in the morning, and after a period of low activity when it is difficult to start a movement, and soon pass on the background of physical activity. Stiffness of the joints with osteoarthritis short-lived, usually it is no longer than 15 minutes.
The increase in the volume of the joint (swelling)This occurs when the synovial membrane irritation causes an outpouring of more lubricating fluid into the joint, just as your eye produces tears to any irritation. But in the joint, additional lubricating fluid can not flow out so easily, and thus it causes swelling of the joints. This most often occurs in large joints: the hips, knees and joints of the spine.
Bony outgrowthsFairly common complication of osteoarthritis is the appearance of bony outgrowths (called nodes) in the joints of the hand. They usually occur in women and sometimes occur as early as age 40.
While these sites can make painful joints of the hand, most people continue to use their hands without any restrictions. The pain can be reduced by appropriate treatment early on. Some people feel no pain with these sites, and many people with this type of osteoarthritis had no serious problems with other joints.
DiagnosisSpecific laboratory tests for the diagnosis of osteoarthritis does not exist, but the tests can be done to exclude other forms of arthritis. In osteoarthritis, unlike other types of arthritis, there are no inflammatory changes in the clinical analysis of blood, there is no rheumatoid factor, characteristic of rheumatoid arthritis, there is increasing levels of uric acid in the blood serum is characteristic of gout. Your doctor will ask you to describe any physical stress or damage that may have led to your pain. General inspection will be carried out with close attention, particularly disturbing your joints.
X-rays help diagnose, but does not give predictions on further development of symptoms. Radiographs may show large changes, but it does not always mean a lot of pain in the clinic or the patient's disability.
From additional research methods can help thermography (thermal imaging) and ultrasound (ultrasound) study of the joints, to detect inflammation in the joints or surrounding tissues, which can not be seen on the radiograph.
TreatmentThe treatment can not fully influence the changes that have occurred in the joints, but treatment can slow disease progression and control symptoms. As a rule, the first call to the doctor, these changes are minor, and, observing a certain motor mode, the recommendations for rehabilitation, it is possible to prevent further progression of arthritis. Neglect and procrastination - the worst enemies in the fight against osteoarthritis.
The doctor will probably recommend a treatment that takes into account the stage of the disease and what joints are damaged, the symptoms that accompany chronic illness, age, profession and daily activity.
- A certain rhythm of locomotor activity to periods of stress interspersed with periods of rest during which the joint is to be unloaded;
- Special exercises that allow you to build a good muscular corset around the joint, to maintain normal mobility and adequate blood circulation in the extremities, strengthen the cartilage itself;
- Weight reduction;
- Control of pain or the use of anti-inflammatory drugs or steroid injections into the joint to reduce inflammation or the production of lubricant. Appointed during the exacerbation of the disease and are aimed at the removal of inflammation in the joint or surrounding the joint tissues. Do not try to remove yourself the aggravation. Experience shows that better and faster results can be achieved with early treatment of a doctor, preferably a specialist (rheumatologist or arthrology). Anti-inflammatory drugs are a huge number of unwanted side effects, so it is faster than the doctor will choose the most suitable.
- In patients with severe long-term pain is not transmitted when taking traditional media, as well as with significant dysfunction of the joint surgery of hip or knee replacement can bring real improvement and you should not be afraid.
Living with osteoarthritisIt is important to first try to limit the movement associated with the increased load on the articular cartilage. But at the same time lead an active lifestyle by increasing physical activity, has no negative effects on cartilage) to protect the joints (good advice a doctor, physical therapy instructor can help a lot).
Much of the disability in the early stages of osteoarthritis may be well corrected by using a special exercise program and maintain a normal body weight. Control of pain and proper relaxation are also important, as will remain active.
Perform all the above recommendations will throughout life to maintain a satisfactory function of the joints.
Due to the possibility of disability in osteoarthritis patients with osteoarthritis of the monitoring shall be with the defeat of the large joints, mainly knee and hip, starting with the early stages of the disease.