Treatment methods for arthrosis

Arthrosis- a disease that develops over many years with predominant damage to certain joints.Most often, painful changes affect large joints: knee, hip, shoulder, etc.The pain and difficulty moving in them complicate a person's life physically and emotionally, and since 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.

Treatment of osteoarthritis

In the initial stage of arthrosis, conservative methods are used that do not involve surgical intervention.Meanwhile, 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 widely used for osteoarthritis:

• magnetotherapy;
• UHF;
• inductothermia;
• ultrasound therapy;
• balneotherapy;
• surgical treatment.

Treatment with drugs

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 method of relieving pain in arthrosis.In fact, the use of drugs is a method of quickly relieving pain, which should be prescribed only in the acute period.The fact is that drugs widely prescribed for these purposes have serious side effects, which increase with long term and especially with uncontrolled use.We are talking about side effects affecting the digestive, cardiovascular and nervous systems, which with a high probability can lead the patient to a hospital bed (stomach bleeding, heart rhythm disorders, effects on the liver and kidneys, etc.).

Non-steroidal 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 drugs of various chemical structures.The drugs 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 used only to reduce symptoms at all stages of the disease.Effective for concomitant synovitis (fluid accumulation in the joint).

2. GKS— glucocorticosteroid drugs have a strong anti-inflammatory and analgesic effect.Their periarticular administration is advisable and effective.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 surface and cartilage degeneration.But with periarticular administration, the risk of these complications is minimal.

3. Chondroprotectors— the substances are natural components of the cartilaginous tissue which, if taken orally, contribute to the gradual restoration of the cartilage, normalizing 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 rapid analgesic effect;improvement develops with long-term use of drugs based on them, which is associated with partial restoration of cartilage tissue.Recommended in 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 procedureinvolves injecting platelet-rich plasma directly into the site of the injury, in this case the joint.The drug 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, 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 both periarticularly and directly into the affected joint, thus achieving partial tissue restoration, mainly cartilage.

The technique is most applicable to 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 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 orthopaedics, neurology and cosmetology.Performing autoplasma therapy allows you to increase the life of the joint without 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 case the natural synovial fluid is almost completely absent (it is this that provides the role of lubrication of the joint surfaces).Used in the later stages of arthrosis.

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

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

Therapeutic exercise

Special therapeutic exercises can and should be used even during a flare-up, in all stages of arthrosis.Such measures can reduce pain and prevent severe restrictions in joint movement.However, the method is unpopular among patients with arthrosis, since most of them mistakenly believe that in case of pain it is necessary to limit any movement.The timely start of physical exercise, on the contrary, promotes faster recovery and a reduction of symptoms, primarily pain.

Particularly effective are physiotherapy in water, joint movements in the unloaded position (lying, sitting, hanging) and moderate walking on a flat surface.If necessary, for example, in case of severe pain, you can apply a special bandage to the joint, but you need to start physical education as soon as possible.

Massage and manual therapy

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

Traction therapy

In a hospital setting or in a medical sanatorium, traction therapy can be performed - this is traction of the joint (hip, knee) using a special technique that uses various loads.The standard traction scheme is designed for 28 days, with a gradual increase in load and exposure time.Classic techniques and more modern ones using simulators are used.Their effectiveness is almost the same, but the simulators are more comfortable for the patient.

Physiotherapy

The use of various physical therapy techniques in the early stages of osteoarthritis can achieve significant pain relief and increased mobility of the affected joints.Physiotherapy courses help to slow down the pathological process and lengthen 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 affected joint area, metabolic processes are accelerated, blood circulation and the supply of nutrients to the joint structures increase, the processes of regeneration and synthesis of the own substances necessary for the functioning of the joint are activated.

   Magnetic therapy has anti-edematous, analgesic, anti-inflammatory effects almost from the first session, which have 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 huge advantage for patients with arthrosis is the possibility of conducting independent courses of magnetotherapy at home, as prescribed and under the supervision of the attending physician.Timely use of portable magnetic therapy devices allows you to stop the development of pain, the onset of an exacerbation or conduct 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 the fact that most patients with arthrosis are middle-aged and elderly people with a number of chronic diseases (arterial hypertension, coronary heart disease, atherosclerosis, etc.), the mild 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, restorative effects - ultraphonophoresis or phonophoresis.Ultrasound increases tissue permeability to drugs, so their main effect is enhanced.Even without a medicinal component, the method is very effective for arthrosis: ultrasound has a mechanical effect on tissues (micromassage), activates local immune and regenerative processes in the joint area and adjacent muscles and has a marked 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 underoxidized metabolic products and a decrease in pain intensity.Laser therapy, due to its small penetration depth, 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, numerous 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 pulsed currents.The diadynamic currents used in this method rhythmically excite the skin receptors, which indirectly leads to the activation of descending physiological mechanisms of pain suppression and leads to a reduction in 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.With arthrosis of large joints, the work of the surrounding muscles is disrupted, which leads to atrophy of some and overloading of others.Gait disturbances develop.When exposed to alternating electric current according to a special program, 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, 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 particularly effective in combination with shock wave therapy.

8. Balneotherapy.In sanatorium-resort 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 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 baths (peloids), hydrogen sulfide and carbon dioxide.

Surgical treatment

Surgical techniques are used in the advanced stages of osteoarthritis, when joint mobility is severely limited or absent, with consequences on the patient's quality of life.Various methods of joint replacement are used around the world that allow you to completely restore mobility 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 pathologies, excess weight and others.The best results after endoprosthesis were achieved in young and middle-aged patients (almost complete restoration of mobility), but even in the elderly, a significant improvement in their condition is observed, since after a successful operation and recovery they can completely provide for themselves in everyday life and move not only inside the apartment, but also go outside, without limiting themselves in communication.

Prevention

Osteoarthritis belongs to the group of diseases of upright walking and develops mainly due to age-related joint changes, aggravated 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 initial stages allow you to maintain physical activity and avoid massive medical intervention in the future.