Osteoarthritis - A disease that has been developed during many years with predominant damage to certain joints.Most of the time, painful changes affect large joints: knee, hip, shoulder, etc.The pain and difficulty moving in them complicate a person's life in a physical and emotional plan, and taking into account the fact that osteoarthritis is often found at an early age, can intervene to achieve professional and personal objectives.That is why it is important to diagnose the disease as soon as possible and begin the complex treatment of osteoarthritis.
Treatment of osteoarthritis
In the initial stage of osteoarthritis, conservative methods that do not imply surgery are used.Meanwhile, the methods of method used allow to suspend the development of the disease, maintain motor activity, reduce the severity of the main symptoms of osteoarthritis and generally improve human quality.
- Drug treatment
Used drug groups
- NSAID;
- GKS;
- Condroprotectors.
- PRP therapy
- Medical Physical Education
- Massage and manual therapy
- Extension therapy (traction)
- Physiotherapy
Physiotherapy methods widely used for osteoarthritis:
- Magnetotherapy;
- UHF;
- Inductothermia;
- Ultrasound therapy;
- Balneotherapy;
- Surgical treatment
Treatment of drug osteoarthritis
Among patients, it is common for drug use with an analgesic effect (orally in the form of tablets or injectively, intramuscular) is the most important method to eliminate pain in osteoarthritis.In fact, drug use is a rapid pain relief method, which should be prescribed only in the acute period.The fact is that medications widely prescribed for these objectives have serious side effects that intensify with a prolonged intake and especially with not controlled.We are talking about undesirable effects of digestive, cardiovascular and nervous systems, which with high probability can take the patient to a hospital bed (gastric bleeding, heart rhythm disorders, liver effects and kidney, etc.).
Non -steroid anti -inflammatory drugs
They used drug groups:
Aoño -The non -steroid anti -inflammatory drugs, many of them are released without recipe and are widely accepted by patients on their own.This group includes drugs from several chemical structures, the most famous of them are diclofenac, indomethacin, Nenproxen (classic NSAIDs), more modern to Meloxicam, Nimesulide, Ketorolac.The medications listed have an anti -inflammatory and analgesic effect pronounced, reduce the pain in the adjacent articulation and muscle tissue, but do not affect the development of the disease.They are used only to reduce symptoms at all stages of the disease.Cash with concomitant synovitis (accumulation of fluid in the joint).
GKS - The drugs of glucocorticosteroids (hydrocortisone, triamcinone, betamethasone) have the strongest anti -inflammatory effects and analgesics.It is advisable and effective for its introduction percentage.However, patients are often negatively related to the use of these medications in treatment, which is associated with possible side effects: they are infectious complications, deterioration of the ligament condition, the joint surface and the degeneration of the cartilage.But with the perihuman risk of these complications, the risk of these complications is minimal.
Condroprotectors - Glucosamine and chondroitin are natural components of the cartilage, which, when administered orally, contribute to the gradual restoration of the cartilage, normalize their density and elasticity.These active components are generally used in the complex, are part of several medications and auxiliary products.Condroprotectors do not have a rapid analgesic effect, the improvement is developed with the prolonged use of drugs based on them, which is associated with the partial restoration of the 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 monodistrophic diseases of the joints, is PRP therapy (plasma rich in Plelet PRP) or the plating mobitization, autoplasmic therapy.
The essence of the procedure It consists of the introduction of plasma enriched by platelets, directly in the place of damage, in this case in the joint.The medicine for administration is obtained from the patient's blood, so the method is considered not only highly effective, but also safe for humans.Growth factors and other biologically active substances (serotonin, bradyiquinine, prostaglandins, etc.) contained in plasma thrombocus enriched by thrombocytes, contribute to the activation of the regeneration processes and synthesis of their own basic substances.
The resulting plasma, enriched with platelets, is introduced both percent and directly into the affected joint, because a partial restoration of tissues is achieved, mainly cartilage.
The methodology in 1-2 stages of osteoarthrosis is more applicable.It shows good results and allows you to delay rapid development of the disease due to the release of growth factors by platelets.The method is relatively new, but has demonstrated its high efficiency.PRP therapy was first used in surgery, today the technique is used successfully in many areas of medicine, even in rheumatology and orthopedics, neurology and cosmetology.The realization of autoplasmic therapy allows you to increase the functioning of the joint without other aggressive interventions.
Synovial fluid flats - A group of drugs based on hyaluronic acid, which are introduced directly into the joint cavity (injection) and play the role of a knit lubricant fluid in the case where the natural synovial fluid is almost completely absent (it provides the role of lubrication of joint surfaces).They are used in the last stages of osteoarthritis.
The medical remedies of this group are also called "synovial fluid prostheses", "biological substitutes for synovial fluid."The effect after the administration of medications is long, from 6 to 13 months, depending on the medical product used.
Some are used Other drug groups - Antispasmodics, muscle relaxants, group B vitamins in therapeutic doses (high), but all of them have only an auxiliary value in the treatment of osteoarthritis.
Medical Physical Education
Special exercises of therapeutic gymnastics can and should even be used during exacerbation, at all stages of osteoarthritis.These measures can reduce pain and prevent pronounced restrictions in the movement of the joints.However, among patients with osteoarthritis, the method is unpopular, since most of them are wrong, believing that in pain it is necessary to limit any movement.The timely beginning of physical exercises, on the contrary, contributes to a faster recovery and decrease in symptoms, mainly pain.
Physiotherapy exercises particularly effective in water, joint movements in the discharge position (lying, sitting, in a hanging position), walking moderate on a flat surface.If necessary, for example, with a pronounced pain syndrome, a special bandage can be imposed on the joint, but physical education should begin as soon as possible.
Massage and manual therapy
The methods of mechanical effects on the articulation, the muscles and the ligamentary apparatus allow to reduce the severity of pain, increase mobility, improve blood circulation and metabolism in the area of the affected joints, relieve muscle spasm, normalize muscle function.
Extension therapy (traction)
In a hospital or medical sanitarium, traction therapy is possible: this is an articular traffic (hip, knee) according to a special method that uses several loads.The standard traction scheme is designed for 28 days, with a gradual increase in load and exposure time.Classic techniques are used and more modern using simulators.Its effectiveness is almost the same, but simulators are more comfortable for the patient.
Physiotherapy
The use of several physiotherapy techniques in the initial stages of osteoarthritis allows us to achieve significant relief of pain syndrome and increase mobility in the affected joints.Physiotherapy courses contribute to a slowdown in the pathological process and extending the period without exacerbations.
Widely used for the osteoarthritis of the physiotherapy methodology
Magnetotherapy - Local effects by constant or alternating magnetic field of low frequency.In the area of the affected joint, the metabolic processes are accelerated, increase blood circulation and nutrient supply to articular structures, the regeneration and synthesis processes of the necessary substances for joint work are activated.Magnetotherapy has anti -high, analgesic, anti -inflammatory effects of almost the first session, which positively affects the general condition of the patient.Magnetotherapy is used successfully in hospitals and sanatoriums, where medical equipment of various modifications is used.A great advantage for patients with osteoarthritis is the possibility of independent magnetotherapy courses at home, for purposes and under the control of the treating physician.The timely use of portable devices for magnetotherapy allows you to stop developing pain, the beginning of exacerbation or performing a preventive course, that is, keeping the normal well.A positive moment of magnetotherapy can also be called the beneficial effect of procedures on the status of cardiovascular and nervous systems.Given the fact that most patients with osteoarthritis are middle -aged and advanced people, with an existing set of chronic diseases (arterial hypertension, coronary heart disease, atherosclerosis, etc.), a mild sedative effect and stabilizer of magnetotherapy will be very useful.
Ultrasound therapy It is used more frequently in combination with the effects of drugs with anti -inflammatory, analgesic, restoration effect (hydrocortisone, chondroitin sulfate, indomethacin, etc.) - ultra -ophoresis or phonoforesis.Ultrasound increases the permeability of drug tissues, so its main action is improved.Even without a medicinal component, the method is highly effective for osteoarthritis: ultrasound has a mechanical effect on tissues (micromasaje), activates local immune and restoration processes in the joint and adjacent muscles, an analgesic and anti -inflammatory effect is expressed.
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 pathological process approach.This leads to an improvement in local blood flow, metabolism activation, the elimination of underestimated metabolism and a decrease in pain intensity.Laser therapy due to low penetration depth has a minimally pronounced systemic effect, while improving the therapeutic effect of other procedures.
Shock wave therapy - The high energy exposure method.It is based on a piezoelectric effect.The influence of piezoelectric discharge on the pathological approach is achieved through a series of effects.Non -viable cells are destroyed, which leads to the activation of local immunity.Giréric (inactive) cells are stimulated, which contributes to regeneration processes.At the same time, the intensity of pain syndrome is significantly reduced (although the procedure itself is painful).The undoubted advantage of the method is the use of the method once every 4-7 days.
Diadinamotherapy - The therapeutic effect method in the body with diadernamic impulse currents.The diadnamic currents used in this method rhythmically excite skin receptors, which indirectly leads to the activation of descending physiological mechanisms of pain suppressed and leads to a decrease in patient's pain, to complete analgesia.Therefore, such procedures are effective for severe pain.
Electromyosemulation - Exposure to electric current in muscle tissue.With the osteoarthritis of large joints, the work of the surrounding muscles is disturbed, this leads to the atrophy of some and the overload of others.March disorders are developing.When it is exposed to alternative electric current according to a special program, the muscles decrease rhythmically, performing a certain work, which leads to the restoration of its volume and function.
Cryotherapy - Unfortunately, a simple and effective treatment method 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, local blood flow is accelerated and recovery processes are activated.This method is especially effective in combination with shock wave therapy.
Balneotherapy
In the conditions of the sanatorium and the resort, the hydrogenation is carried out medical baths, among which radonous osteoarthritis is especially effective for osteoarthritis.A general effect on the body is carried out by the products of the radioactive decomposition of radon dissolved in water.The most important effect is the activation of metabolic processes.
A similar effect, although less pronounced, is characteristic of the therapeutic mud (peloids), hydrogen sulfide and carbon dioxide.
Surgical treatment
Surgical methods are used in the last stages of osteoarthritis, when joint mobility is very limited or absent, which affects the quality of the patient's life.Throughout the world, several methods of joint endoprotetics are used, which allow it to completely restore the volume of movements and return the patient to the active life at any age.
The tactics and the volume of surgical intervention are determined by the attending doctor, the choice is based on parameters such as the general condition of the patient, age and the presence of concomitant diseases, overweight and others.The best results after the endoprotetics were obtained in patients with young and medium -sized (almost complete restoration of the volume of movements), but the elderly also have a significant improvement in the condition, since after the operation and recovery carried out successfully they can be completely provided in the internal plan and move not only within the apartment, but also to leave, not limit themselves in the communication.
Prevention
Arthrosis belongs to the group of righteous diseases and develop mainly as a result of changes related to joints in the joints, improved by the influence of external negative factors.Attention to the state of the musculoskeletal system, the prevention of joint diseases and the treatment of osteoarthritis in the early stages allow to maintain motor activity and avoid mass medical intervention in the future.