What is arthrosis? Pathology causes, symptoms and treatment

Arthrosis is a chronic pathology aimed at damaging the joint structures of the musculoskeletal system. The main cause leading to chronic diseases is the disruption of the metabolic balance, which leads to a progressive degenerative-dystrophic process. The targets of the damaging reaction are articular cartilage, connective tissue, bursae, tendons, bones and muscle ligaments. In the chronic form of the pathology, the periarticular muscles are involved in the inflammatory process, they lose anatomical flexibility due to deformation and swelling of the joints. In order to eliminate the complications associated with blocking the biomotility of the skeleton and to avoid disability, you should equip yourself with information about arthrosis - what it is, what are its causes, symptoms and treatment.

Causes and risk factors for the development of pathology

The inflammatory-destructive process of the joints often begins for no reason. This is how idiopathic (primary) arthrosis begins. The mechanism of the formation of secondary arthrosis begins after certain conditions and factors, namely:

• Joint injury (fracture, meniscus damage, ligament tear, dislocation, compression + contusion, bone fracture).
• Dysplasia (abnormal intrauterine development of joint components).
• Violation of metabolism.
• Autoimmune-type pathologies (rheumatoid arthritis, psoriasis, autoimmune toxic goiter, systemic lupus erythematosus).
• Non-specific destructive arthritis (with purulent component).
• Infections of various etiologies (tuberculosis, meningitis, encephalitis, gonorrhea, syphilis, hepatitis).
• Pathologies of the endocrine glands (diabetes mellitus, toxic goiter, pathology of the adrenal gland and pituitary gland).
• Hormonal dysfunction (decrease in the level of estrogen, androgens).
• Degenerative + dystrophic reactions (multiple sclerosis, Perthes' disease).
• Oncological diseases.
• Blood diseases (hemophilia, anemia, leukemia).

Risk factors provoking arthrosis and leading to its development:

1. Age-related changes.
2. Obesity (overweight leads to a constant vertical load that overloads the joints, which quickly wear out, lose cartilage plates).
3. Professional costs, that is, the load on a certain group of joints, which leads to their inflammation or premature destruction before other groups.
4. Postoperative consequences: highly traumatic surgery with destruction of the affected tissues (soft, cartilaginous, bone). After restorative manipulations, the joint structure does not have the same consolidation, therefore any load leads to arthrosis.
5. A hereditary factor, i. e. arthrosis, can affect one or more family members.
6. Hormonal imbalance during menopause or after removal of the ovaries in women, prostate gland in men.
7. Violation of the water-salt balance.
8. Neurodystrophic damage to the spinal column is the root cause of glenohumeral, lumbosacral and hip arthritis.
9. Poisoning with pesticides and heavy metals.
10. Temperature changes with sudden changes plus hypothermia.
11. Permanent trauma to a certain group of joints.

Risk factors include a recent environment saturated with high background radiation, toxic substances (smog over industrial cities and in industrial zones, and frequent testing of military equipment or interstate war resulting in ozone holes + strong ultraviolet radiation). Dirty drinking water + foods rich in preservatives lead to the development of arthrosis.

The mechanism of the formation of arthrosis

The basis of the triggering mechanism of arthrosis is the interruption of the chain of repair processes of cartilage cells and the correction of the affected connective tissue areas by young cells. The cartilaginous plates tightly cover the terminal surfaces of the bones that are part of the locomotor joints. Normal cartilage is anatomically strong, smooth, flexible, and lubricated by synovial fluid, a biological substance used to lubricate intra-articular components. It is the synovial fluid that provides unimpeded movement of joint components relative to each other.

The main function of the shock-absorbing effect is provided by the cartilage tissue and joint lubrication, reducing the wear and tear of cartilage-covered bones. The bony ends are separated by sacs of fluid and firmly stabilized by a brace of ligaments and muscles. The specific configuration and plexus of the musculo-ligamentous apparatus allows this structure to perform precise biomechanical movements such as flexion, extension, rotation + rotation. The design, thanks to the intertwining of the ligaments, allows you to firmly hold a certain position, as well as perform coordinated movements, maintaining the balance of the body.

High stress or hormonal imbalance leads to the destruction of the collagen plates and the bones become exposed. Pointed osteophytes appear in these areas, which cause pain during any movement of the musculoskeletal joints. The bones thicken, false joints are formed between the osteophytes, which completely change the functioning of the locomotor system. Less synovial fluid is produced due to the trauma (tear) of the bursa and the entire joint structure begins to suffer, along with the ligaments + muscles. Joint swelling occurs and microbial infection may occur. Ossification zones lead to limited movement and ankylosis of the joint.

Stages of clinical manifestation of joint pathology: stages

Arthrosis is characterized by three stages of development, which consist of the following:

• Section I:there are no special morphological changes, trophism is not disturbed, synovial fluid is produced in sufficient quantity. The stability of the joint structure corresponds to average physical activity. Pain and swelling of the joint occurs with strenuous work.
• II. platoon:depletion of the cartilaginous plate is observed, foci of osteophytic islands are formed, and ossification appears along the edges of the joint. The pain syndrome intensifies, the swelling increases, and discomfort appears during movement. As the pathology becomes chronic, the pain is constant, accompanied by inflammation, with periods of exacerbation/remission. The biomechanics is partially damaged, the patient spares the joint.
• III. platoon:the cartilaginous plate is completely worn out, instead of cartilage, a system of osteophytes + false fixed interosteophytic joints develops at the bone ends. The anatomical form is completely overturned. Joint ligaments and muscles shorten and thicken. Even the slightest damage can cause displacement, breakage and cracking. The trophism of the locomotor organs is damaged, so they do not receive the necessary amount of blood and nutrients. Pinched nerves lead to a severe pain reaction, which only goes away after the administration of strong painkillers or drugs belonging to the COX1/COX2 group.

Traditionally, one more stage can be added: the fourth - last stage with a vivid clinical picture of inflammation, infection, unbearable pain, immobilization of diseased joints, high fever and serious condition. This stage is the most severe and can lead to sepsis and death.

Arthrosis pain syndrome

Pain is characteristic of arthrosis. They intensify with movement, physical activity, changes in weather conditions, changes in temperature, humidity and atmospheric pressure. The pain can be triggered by any body position or sudden movements. Walking, running and standing upright for a long time puts a certain load on the painful joints, after which sharp or aching pain begins. In the first and second stages of the pathology, the pain syndrome disappears without a trace after a night's rest, but in the advanced stage, the pain is constant and does not go away. The affected shock-absorbing layer, pinched nerves and blood vessels lead to a stagnant process with impaired trophism and accumulation of interstitial fluid. The swelling causes sharp, throbbing pain.

Arthrosis is characterized by pain after a long rest, with a sharp motor impulse, this condition is called incipient pain. The mechanism of the formation of these pains is the osteophytic zones, which are covered by the destructive remains of cartilage tissue, fibrin and viscous fluid. When joints dislocate, a film or debris of these components covers the exposed areas, lubricating them and absorbing the pain. Blockade pain occurs when destruction products from the intra-articular space, i. e. bone remains or large connective tissue films, enter the muscles. There is another type of pain: constant, painful, bursting + independent of movements, typical of reactive arthritis.

Attention!Blockade-type pain can only be treated with surgical intervention followed by restoration of the affected joint. Treatment with folk remedies is not recommended, it is fraught with the development of purulent arthrosis, the spread of infection in the body, and after sepsis there are obvious morphological changes in all organs and systems.

Symptoms of arthritis

The symptoms are divided depending on the degree of development of the pathology. Arthrosis makes itself felt after 38-40 years, when the joint amortization system begins to wear out and renewed or young cartilage pads do not appear in its place. In case of hormonal imbalance, "chaos" sets in in all vital systems, this also applies to the locomotor system, so the tissues in the affected areas do not regenerate, but destruction + deformation occurs.

Symptoms of arthrosis:

Degrees and periods of arthrosis	Description of symptoms
I graduated	Weak, short-term pain with precise localization. Rapid fatigue of the painful joint. The pain intensifies after long walks, running or lifting weights, and disappears after rest. A soft clicking sound is heard when bending or during other movements. There are no visual + tactile changes, the anatomical shape of the joint remains, no swelling is observed.
Grade II	After rest, discomfort in the affected joints, stiffness. Partial traffic restriction. Pain at night and pain depending on weather conditions. A characteristic loud click appears when bending and other movements. There are visual and tactile changes: the joints enlarge and shorten, the patient reacts sharply to acute pain due to extra pressure.
Grade III	Total discomfort in the affected joints, joint instability or ankylosis. Movement is paralyzed. There are constant sharp or aching pains at night. The anatomical shape of the joints is lost: thickening/shortening and displacement of the axis of the joint structure. There is swelling + pain when pressed. The gait changes, the shape of the skeleton changes due to the sparing of the locomotor system. Movement is done using a stick or crutches. In case of morphological changes associated with an infectious factor or pinched nerves, a high temperature appears (37-38 degrees).
Exacerbation and remission periods	In arthrosis, exacerbations alternate with remissions. The pathology is aggravated by physical activity. Exacerbation is caused by synovitis. The pain syndrome extends to all affected areas, including the ligament. It spasms reflexively, forming painful contractures. Arthrosis is characterized by muscle spasms. As the destruction increases, the pain syndrome becomes more pronounced. In reactive synovitis, the joint is enlarged and spherical. Fluid appears in the joints, which causes a fluctuating effect to the touch. During a short remission, the pain eases, but movement is difficult.

Timely recognition of the pathology with diagnostic tests and consultation with the necessary specialists helps to pass the second and third stages, preserving the functionality and health of all joint groups of the musculoskeletal system until old age.

Diagnostic measures

Clarifying the diagnosis is based on laboratory/instrumental tests. Each case is examined differently, that is, with an individual approach to each patient.

The list of studies consists of:

• General and biochemical blood tests.
• Blood test to detect rheumatic agent.
• Analysis of urine and feces.
• X-ray examination: image in three positions.
• CT examination of the joint to clarify the bone structure.
• MRI of the joint: study of ligaments and muscles.
• Computed tomography.

Important!Patients suffering from arthrosis should consult an orthopedist, rheumatologist, endocrinologist, hematologist, oncologist, or gynecologist.

Treatment regimen

Therapeutic tactics include eliminating the main cause, correcting the nutritional diet, restoring the lost function + a gentle lifestyle, i. e. a whole series of measures without special physical activity (long walks, running, carrying heavy objects). The therapeutic regimen consists of drug therapy, local treatment, physiotherapy procedures and exercise therapy. In parallel with these methods, folk remedies are used.

Drug therapy of arthrosis

Complex therapy consists of:

1. Medicines belonging to the NSAID group;
2. Painkillers (tablets + injections);
3. Medicines that relieve muscle spasms (muscle relaxants);
4. Cartilage tissue restorers (chondroprotectors);
5. Antibiotics;
6. antihistamines;
7. Medicines that improve blood circulation;
8. Vitamins: B2, B12, PP and A;
9. Antioxidants: vitamin C;
10. Medicines based on hormonal substances.

It is recommended to include in the treatment regimen of rheumatoid arthritis:

• Gold-based medicines;
• Immunosuppressants;
• antimalarial drugs;
• Medicines that inhibit malignant cells.

Attention!During the remission of the pathology, non-steroidal anti-inflammatory drugs are not recommended, they affect the gastrointestinal tract, causing many ulcers, and also inhibit the nutrition process of cartilage tissue.

Ointments for local use to treat arthrosis

Local treatment has a direct effect. Gels and ointments come into direct contact with the affected tissues, quickly reaching the site, eliminating pain and inflammation. Preparations in gel form are widely used to restore the cartilage layer. Warming + anti-inflammatory ointments are used for local application.

Physiotherapy

Spasmodic pain is alleviated by reducing inflammation + improving trophism and innervation with the help of physical therapy. Exacerbation phases are eliminated or shortened by laser therapy, magnetic fields and ultraviolet irradiation. In the remission phase of arthrosis, i. e. in the calm phase, electrophoresis with dimethyl sulfoxide and anesthetics are useful. Destructive and inflammatory processes are affected by phonophoresis with glucocorticosteroids, inductothermy, thermal application of ozokerite or paraffin, as well as sulphide, radon and sea baths. The muscle ligament is strengthened by electrical stimulation.

Surgery

The problem of the deformed/ankylosed joint is finally solved with surgical interventions, such as endoprosthesis, and with the palliative method of relieving the load on the joint skeleton (coxarthrosis is corrected by transtrochanter osteotomy + femoral fascia fenestration, gonarthrosis is corrected by arthrotomy with cleaning of the remains of destruction in the intra-articular space plus artificial cartilage suturing). If the bone is completely incapacitated, it is replaced with an artificial graft and the axis of the tibia is corrected.

Folk remedies

Traditional medicine helps to get rid of pain and inflammation, temporarily eliminates pain and restores lost function. There are isolated cases of complete recovery by traditional methods using the following tinctures, ointments and poultices:

1. Garlic tincture + onion and honey: 100 g garlic pulp + 100 g chopped onion + 2 large spoons of honey + 200 ml vodka. Infuse for 3-5 days. Apply as a compress and rub.
2. Sabelnik in the form of tincture: 200 g of dry powder or fresh porridge + 200 ml of diluted medical alcohol, leave for 24 hours. Drink one spoon before meals 3 times a day.
3. Ointment based on badger fat and propolis: rub the joints, apply twice a day.
4. Table horseradish + honey: 100 g horseradish + 100 g honey + 100 ml vodka. Infuse for 24 hours, drink 20 drops. This tincture can be rubbed on painful joints 3-5 times a day.
5. Hot pepper spread + pork fat: 1 teaspoon powder + 200 g fat. Infuse for 2-3 days. It is used as a warming local medicine. Apply 1-2 times a day.
6. Compression: oak bark + spruce needles: 200 g oak bark + 200 g crushed spruce needles + 100 ml alcohol.

We recommend the listed recipes of traditional healers only after consultation with your doctor. If the patient is allergic to certain drugs, their use is strictly prohibited, as it can lead to anaphylactic shock.

Features of prevention

Prevention is an effective means of preventing joint diseases, destruction and deformation. For preventive purposes, you should:

• Set a menu that excludes fried, fatty, peppery, salty, alcohol + nicotine.
• Add jelly and jelly to your daily menu.
• Avoid strenuous exercise.
• Increase safety precautions to avoid injury.
• Continuously perform specific locomotor exercises.
• Try taking B and C vitamins.
• For preventive purposes, take dust protection agents, calcium and potassium supplements and other minerals every six months.
• After a joint sprain or mechanical injury, a medical examination must be performed.

The list is joined by performing constant physical exercises to improve blood supply, innervation and restore the cartilage layer of the joints. These exercises are prescribed by a doctor.

Summary

The destruction associated with the deformation of the joints begins after 38-40 years, so there is no need to delay the fight against the pathology. A neglected condition can lead to a wheelchair, and a timely response to the disease with effective treatment is a clear success towards recovery. Arthrosis cannot be treated by itself, this type of pathology refers to metabolic disorders that are directly related to changes in hormone levels or chronic pathologies of other systems. At the first symptoms, consult a traumatologist or surgeon, do not delay, otherwise they will only be treated in a surgical department with long rehabilitation.