Arthrosis is a painful change and deformity of a joint. It occurs when the damaged articular cartilage cannot be repaired. With conservative treatment or surgery, the symptoms of joint wear can be significantly reduced.
Disease overview
- The following joints are most often affected: knees, hips, shoulders, spine, fingers and toes, ankle joints;
- The most important symptoms: pain during exercise, pain at the beginning of exercise (at the beginning of physical activity), decreased mobility, joint deformities, periods of exacerbation: swelling, redness, persistent pain;
- Diagnostics: physical examination, x-ray, computed tomography (CT) or magnetic resonance imaging (MRI);
- Treatment: exercise, hot or cold procedures, painkillers, intra -articular injections (hyaluronic acid, chondroitin sulfate), at a later stage - joint replacement (surgery);
- Caution: many arthrosis does not need to be treated for a long time, but physiotherapy and prevention of exacerbation should be carried out adequately, and, if necessary, the pain syndrome should be discontinued.
Osteoarthritis treatment methods
What helps with osteoarthritis or arthrosis? For most patients, this is a key question. Answer: There is still no treatment for arthrosis that can repair damaged cartilage.
Osteoarthritis treatment can only relieve the symptoms of the condition. In addition, treatment should avoid prolonged wear and tear on the joints.
Because the disease also leaves an impact on the joints that wear out over time, causing damage to the joint capsules, bones and muscles.
Osteoarthritis treatment includes conservative procedures and surgery. The treating physician will select the most appropriate method for each patient. Among other things, it assesses which joints are affected, how severe the general wear and tear is, and how severe the symptoms are.
Conservative treatment
Conservative osteoarthritis treatment is designed to relieve pain, fight inflammation, and improve muscle strength and coordination. A large role is given to physiotherapeutic procedures, which are carried out during the exacerbation and during the period of "calm" of symptoms.
Physiotherapy treatment
Various forms of physical therapy can relieve the symptoms of osteoarthritis. This includes:
- Physiotherapy;
- Manual therapy;
- Therapy (not in the acute stage);
- Cryotherapy (in the acute stage);
- Do sports that are good for the joints, such as Nordic walking, swimming and cycling;
- Water and bath therapy;
- Electrotherapy;
- Ultrasound therapy;
- Orthopedic appliances.
To treat chronic osteoarthritis pain, you can use heat from heating treatments, packs, baths or infrared light. On the other hand, swelling and severe discomfort are reduced with cold treatment or compresses.
Physical therapy also helps in treating arthrosis as it strengthens the muscles. Massage is also recommended: it relieves tension and improves blood circulation.
Joint movements during exercise
Regular exercise keeps your joints flexible. Therefore, osteoarthritis sufferers should incorporate sports and exercise into their daily lives. Swimming is a good example. He trains the joints without overloading them. For the same reason, it is recommended to walk on the square and ride a bike.
Exercise can not only prevent but also slow down osteoarthritis and reduce symptoms.
Less suitable for osteoarthritis are sports with sudden, significant joint pressure, extreme movement, or a high risk of injury. These include, for example, tennis, ice skating, football, handball, karate and boxing.
Joint fixation
Bandages, elastic bandages, soft soles and crutches facilitate joint function. Orthoses help in the same way. This is a special support device for joints. They prevent painful movements. However, orthoses are not very flexible and only need to be worn for a short time to prevent the joints from hardening.
If the person is overweight, try to lose weight. Therefore, the joints will carry less stress. Regular exercise and a healthy diet help in weight loss.
Medicines to treat pain and inflammation
Painful joints with osteoarthritis can be rubbed with an ointment, cream, or gel that relieves pain from a pharmacy.
Local anesthetics are used to relieve pain: they are injected into a joint or around the affected area.
Osteoarthritis (or arthrosis) is usually a non -inflammatory process. However, the inflammatory process often accompanies tissues affected by osteoarthritis. Then they talk about osteoarthritis or arthritis activation.
For treatment, doctors often prescribe nonsteroidal anti-inflammatory drugs (NSAIDs). Sometimes glucocorticoids are also injected into the joints against inflammation.
Some patients receive injections of hyaluronic acid or chondroitin sulfate in the joints for osteoarthritis. These are glycosaminoglycans and natural components of synovial fluid. By injecting hyaluronic acid directly into the affected joint, its mobility is restored.
Surgery
Surgery can correct problems in osteoarthritis patients and stabilize joints. It also relieves pain and prevents inflammation. In some cases, damaged cartilage is replaced during surgery. Osteoarthritis patients are able to move better after surgery.
Rinse together and treatment
In osteoarthritis, the affected joints are sometimes washed with salt. This is most often done, for example, with the knee joint.
Rinsing the bursa removes damaged cartilage and tissue fibers, as well as other particles floating in the synovial fluid. In addition, the procedure should relieve any existing inflammation in the joints.
Reconstruction means complex treatment of the joint capsule. The rough surface of the cartilage in the joint was removed using an instrument. It also removes areas or tissues that can impede joint mobility. Acute pain, at least temporarily, disappears as a result of treatment.
Joint treatment is performed as part of arthroscopy. A surgical instrument is inserted into the joint through a very small incision.
Stimulates cartilage growth
During arthroscopy, small injections on the surface of the cartilage residue are made for therapeutic purposes. This should stimulate the cartilage cells to form replacement tissue. However, this new cartilage tissue has a different structure than the original cartilage and does not fully meet the requirements for joints.
During the years of the disease, in some cases, cells can also be transferred into the damaged joint.
Corrections
Corrective osteotomy replaces the articular bone for a more even load distribution over the articular surface: part of the pressure is transferred from the osteoarthritis zone to the cartilage and healthy bone area. In most cases, treatment of this type of osteoarthritis also includes improving the function of the joint capsule and ligaments to restore joint mobility.
Joint replacement
If the pain cannot be relieved with any other treatment for osteoarthritis, joint replacement is possible. This means the damaged joint (or part of it) is replaced with an artificial joint. Basically, surgery is performed in cases of arthrosis of the knee or hip joint.
Complex replacement is the last resort
Specifically, worn joint tissue and joint surfaces are removed surgically and replaced with metal, plastic and ceramic prostheses (alloarthroplasty). There are prostheses that replace only parts of the joint, and some are used to replace the entire joint. They are mounted either on the surface of the bone or with screws. With this method of treating osteoarthritis, it is possible, if necessary, to correct the position of the joint.
After a while, each prosthesis can wear out. The time when this occurs depends on a variety of factors: age, gender, clinical picture of arthrosis, infection, type of joint and type of prosthesis.
Light prostheses need to be replaced more often. Prosthesis wear can be detected in a timely manner with regular radiography.
Arthrodesis
Arthrodesis can help manage the pain of osteoarthritis. This is the strengthening of the affected joint: it is more stable, but also less mobile. Therefore, arthrodesis is usually only performed on joints where lower mobility does not interfere with the patient’s daily life. These include the joints of the fingers and toes, and the small joints in the wrists.
Resection
In this form of osteoarthritis treatment, the damaged articular body is removed and reconstructed through surgery without a prosthesis. However, resection arthroplasty is rarely used today.
This option can be considered for arthrosis of the thumb (rhizarthrosis), especially if conservative treatment of osteoarthritis is not successful. One of the affected metacarpals is removed and replaced with the body’s own tendon tissue. Thumb long muscle tendons or flexor tendons are often used. This form of therapy for rhizarthrosis is not considered a standard method.
Arthroplasty resection is also performed for arthrosis of the big toe or arthrosis between the clavicle and humerus.
Alternative treatments for osteoarthritis
What helps with osteoarthritis other than orthodox medical procedures? This question is of interest to many patients. They want to support treatment with "natural", simple methods. Although many alternative methods have not been proven to be scientifically effective, they are a good relief for osteoarthritis in some patients. Homeopathy, herbal medicine, magnetic therapy, and acupuncture are widely used to relieve arthritis symptoms.
Salt and homeopathy
In many cases, osteoarthritis patients rely on these two alternatives: salt and homeopathic granules to relieve osteoarthritis symptoms. In addition, bath salts and compresses should also prevent osteoarthritis. Proponents say both treatments have no side effects and are therefore suitable for self-medication.
Experts recommend using minerals in combination with ointments or cream gels. Homeopathic remedies for osteoarthritis should be discussed with an experienced therapist.
Plant material
For centuries, the treatment of osteoarthritis was also based on medicinal plants. These include African devil claws, nettles, comfrey, willow, dandelion, cayenne, and rose hips. However, the symptoms of arthrosis improve if you use herbs for a long period of time. Your doctor or pharmacist will advise you on proper use and dosage.
Magnetic field therapy
Arthrosis treatment with magnetotherapy is designed to relieve pain, restore joints and improve the patient’s quality of life. The magnetic field is generated either by a natural magnetic rock or by an electric coil.
Medical research has shown that magnetic therapy can be especially helpful for knee osteoarthritis. But patients with chronic complaints in various joints (polyarthritis) should also benefit. No side effects have been observed with alternative treatments for this osteoarthritis.
X-ray therapy
Arthrosis treatment with X-rays is designed to prevent inflammation and improve blood circulation. Irradiation should be performed at regular intervals, and only very small doses of radiation are used.
X-rays are used, for example, in the treatment of rhizarthrosis and in the treatment of Heberden’s osteoarthritis.
Acupuncture
Stimulation of specific points on the skin with acupuncture to normalize disturbed processes in the body. Usually, a course of treatment requires several sessions.
The use of acupuncture for osteoarthritis is not widely accepted. However, some patients report that acupuncture can actually help relieve arthritis pain. Especially with the combined use on the knee structure, acupuncture can reduce chronic pain.
Osteoarthritis and nutrition
The link between arthritis and diet is often debated: can an unfavorable diet contribute to osteoarthritis? Should you change your diet for osteoarthritis?
In general, certain foods cannot be said to cause osteoarthritis. However, the type of diet can actually influence its journey: what matters is how much we eat and the way our food is prepared.
Less calories
As you gain weight, the load on your joints increases, and as a result, it wears out faster. Therefore, overweight people have a higher risk of osteoarthritis.
If osteoarthritis is already present, obesity contributes to joint wear and tear, especially in the knee.
Obesity has a huge effect on the joints. Excess kilograms at a young age is critical.
Therefore, the diet of osteoarthritis should be adjusted by counting calories if a person tends to be overweight. A healthy weight relieves joints, can reduce discomfort during pain, and slows the progression of changes.
Less animal fat
A proper diet for osteoarthritis means reducing the intake of meat and other animal products. Cause: In damaged joints, inflammation develops more easily in osteoarthritis. Some metabolic products mediate this inflammatory response in the body and are made from arachidonic acid (omega-6 fatty acids). These are mainly animal products.
Therefore, the diet for osteoarthritis should limit the use of arachidonic acid. On the other hand, you should be more likely to consume foods with more omega-3 fatty acids because they inhibit the inflammatory response. Omega-3 fatty acids are found, for example, in canola and flaxseed oils and in oily fish such as herring, mackerel, and salmon.
Therefore, the following guidelines apply to an appropriate diet for arthritis:
- Reduce consumption of meat and eggs;
- Fish in the diet twice a week (e. g. salmon, mackerel, herring);
- Use vegetable oils such as canola oil, flaxseed oil, sunflower oil or olive oil;
- Eat lots of fruits and vegetables;
- Whole grains and legumes are preferred;
- Drink at least 1. 5 liters of water or tea without sugar daily;
- Calcium from low -fat dairy products to strengthen bones
- Avoid caffeine, alcohol, and nicotine.
Such a diet for arthrosis cannot replace other therapeutic measures, but it can complement it wisely. This means that although diet does not cure osteoarthritis, it does have a positive effect on the patient’s condition.
Keep moving!
Despite the pain that may occur, "immobility" in treating osteoarthritis is not a good idea - it actually speeds up the destruction process.
Only during joint work and during movement of the articular surface is a lubricant, called synovial fluid, formed, which reduces friction on the joint and provides the cartilage with nutrients.
Ideal movements where the joints are not too stressed: swimming, cycling, Nordic walking and gymnastics.