Methods of treating arthrosis

Arthrosis- a disease that develops over many years with dominant damage to certain joints.The most common painful changes affect large joints - knees, hips, shoulders, etc.Pain and difficulty moving in them complicate a person's life physically and emotionally, and considering the fact that arthrosis often occurs at a young age, it can hinder the achievement of professional and personal goals.That is why it is important to diagnose the disease as early as possible and start comprehensive treatment of arthrosis.

Treatment of arthrosis

In the initial stage of arthrosis, conservative methods are used that do not involve surgical intervention.In the meantime, the correction methods used make it possible to stop the development of the disease, maintain motor activity, reduce the severity of the main symptoms of arthrosis and generally improve the quality of a person's 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 that are widely used for arthrosis:

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

Drug treatment

There is a widespread belief among patients that taking drugs with an analgesic effect (orally in the form of tablets or by injection - intramuscularly) is the most important way to relieve pain in arthrosis.In fact, the use of drugs is a method of quick pain relief, which should be prescribed only in the acute period.It is a fact that the drugs that are widely prescribed for these purposes have serious side effects, which increase with long-term and especially uncontrolled use.These are unwanted effects from the digestive, cardiovascular, and nervous systems, which with a high probability can lead the patient to a hospital bed (bleeding in the stomach, heart rhythm disorder, effects on the liver and kidneys, etc.).

Nonsteroidal anti-inflammatory drugs

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

2. GKS— glucocorticosteroid drugs have a strong anti-inflammatory and analgesic effect.It is recommended and effective to apply 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, joint surfaces and cartilage degeneration.But with periarticular application, the risk of these complications is minimal.

3. Chondroprotectors— substances are natural components of cartilage tissue that, when taken orally, contribute to the gradual restoration of cartilage, normalize its density and elasticity.These active components are usually used in combination and are included in various drugs and auxiliary products.Chondroprotectors do not have a quick analgesic effect;improvement develops with long-term use of drugs based on them, which is associated with partial restoration of cartilage tissue.It is recommended in all stages of the disease.

PRP therapy

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

The essence of the procedureit consists of injecting platelet-rich plasma directly into the site of injury, in this case the joint.The drug for administration is obtained from the patient's own blood, so 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 the regeneration process and the synthesis of its own basic substances.

The resulting platelet-rich plasma is injected periarticularly and directly into the affected joint, which achieves partial tissue restoration, primarily cartilage.

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

Synovial fluid shields- 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 the natural synovial fluid is almost completely absent (it is precisely this that provides the role of lubricating the joint surfaces).It is used in the later stages of arthrosis.

Medicines from this group are also called "prostheses for synovial fluid", "biological substitutes for synovial fluid".The effect after the use of drugs is long-lasting - from 6 to 13 months, depending on the drug used.

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

Therapeutic exercise

Special therapeutic exercises can and should be applied even during exacerbation, in all stages of arthrosis.Such measures can reduce pain and prevent severe limitations of joint movement.However, the method is unpopular among patients with arthrosis, because most of them make the mistake of 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, primarily pain.

Especially effective are physical therapy in water, joint movements in a position for relief (lying, sitting, hanging) and moderate walking on a flat surface.If necessary, for example, in case of severe pain, a special bandage can be put on the wrist, but physical education should be started as soon as possible.

Massage and manual therapy

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

Traction therapy

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

Physiotherapy

By applying various physical therapy techniques in the initial stages of arthrosis, significant pain relief and increased mobility of the affected joints can be achieved.Physiotherapy courses help to slow down the pathological process and prolong the period without exacerbations.

Physiotherapy techniques that are widely used for arthrosis:

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 delivery of nutrients to the joint structures are increased, the processes of regeneration and synthesis of own substances necessary for the functioning of the joint are activated.

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

   A huge advantage for patients with arthrosis is the possibility of conducting independent courses of magnetic therapy at home, as prescribed and under the supervision of a doctor.Timely use of portable devices for magnetic therapy allows you to stop the development of pain, the occurrence of exacerbation or conduct a preventive course - that is, maintain normal health.

   A positive aspect of magnetotherapy can be called the beneficial effect of the procedures on the condition of the cardiovascular and nervous systems.Taking into account the fact that the majority of arthrosis patients are middle-aged and elderly with an existing series of chronic diseases (arterial hypertension, coronary heart disease, atherosclerosis, etc.), the mild sedative and stabilizing effect of magnetotherapy will be very useful.

2. Ultrasound therapyit is more often used in combination with the effects of drugs with anti-inflammatory, analgesic, restorative effects - ultraphonophoresis or phonophoresis.Ultrasound increases tissue permeability to drugs, thus enhancing their main effect.Even without a medical component, the method is very effective in arthrosis: ultrasound has a mechanical effect on tissue (micromassage), activates local immune and regenerative processes in the area of joints 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 improvement of local blood flow, activation of metabolism, removal of insufficiently oxidized metabolic products and reduction of pain intensity.Laser therapy, due to the small depth of penetration, has a minimal systemic effect, while it enhances the therapeutic effect of other procedures.

4. Shock wave therapy– high-energy influence method.It is based on the piezoelectric effect.By applying piezoelectric discharge to the pathological focus, numerous effects are achieved.Nonviable 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 action on the organism with diadynamic impulse currents.The diadynamic currents used in this method rhythmically stimulate skin receptors, which indirectly leads to the activation of descending physiological mechanisms of pain suppression and leads to a reduction of the patient's pain, up to complete analgesia.Therefore, such procedures are effective for severe pain.

6. Electromyostimulation– exposure to electric current on muscle tissue.In arthrosis of the large joints, the work of the surrounding muscles is disturbed, which leads to atrophy of some and overloading of others.A gait disorder develops.When they are exposed to alternating electric 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 method of treatment, unfortunately, is rarely used.Local exposure to low temperature reduces the sensitivity of pain receptors and the synthesis of biologically active substances that promote the development of inflammation.After cryotherapy, there is a reflex expansion of blood vessels, local blood flow is accelerated and recovery processes are activated.This method is particularly effective in combination with shock wave therapy.

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

   A similar, although less pronounced effect is characteristic of therapeutic mud (peloids), hydrogen sulphide and carbon baths.

Surgical treatment

Surgical techniques are used in the late stages of arthrosis, when joint mobility is severely limited or absent, which affects the patient's quality of life.Various methods of joint replacement are used all over the world, which allow the full range of motion to be restored and the patient to return to an active life at any age.

Tactics and extent of surgical intervention are determined by the doctor;the choice is based on parameters such as the general condition of the patient, age and the presence of accompanying diseases, excess weight and others.The best results after endoprosthetics were achieved in young and middle-aged patients (almost complete restoration of the range of motion), but also in the elderly there is a significant improvement in their condition, because after a successful operation and recovery, they can fully provide for themselves in everyday life and move not only in the apartment, but also go out, without limiting themselves in communication.

Prevention

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