Osteoarthritis is a painful change and deformation of the joints. It occurs when the articular cartilage is irreparably damaged. With conservative treatment or surgery, the symptoms of joint wear can be significantly reduced.
Review of the disease
- The following joints are most commonly affected: knee, hip, shoulder, spine, fingers and toes, ankle joints;
- The most important signs: pain during exercise, pain at the beginning of training (at the beginning of physical activity), reduced mobility, deformity of the joints, periods of exacerbation: swelling, redness, constant pain;
- Diagnosis: physical examination, X-rays, computed tomography (CT) or magnetic resonance imaging (MRI);
- Treatment: exercises, heat or cold procedures, painkillers, intra-articular injections (hyaluronic acid, chondroitin sulfate), in the later stages - joint replacement (surgery);
- Caution: many osteoarthritis do not require long-term treatment, but physiotherapy and prevention of exacerbations should be carried out sufficiently and, if necessary, the pain syndrome should be stopped.
Methods of treating osteoarthritis
What helps with osteoarthritis or osteoarthritis? For most patients, this is the main question. Answer: There is still no cure for osteoarthritis to repair damaged cartilage.
Treating osteoarthritis can only alleviate the symptoms of the condition. In addition, treatment should prevent prolonged joint wear.
Because the disease also leaves its mark on the worn joint over time, causing damage to the joint capsule, bones and muscles.
Treatment of osteoarthritis includes conservative and surgical procedures. The attending physician will select the most appropriate methods for each patient. Among other things, he assesses which joints are affected, how severe the general wear is, and how severe the symptoms are.
Conservative treatment
Conservative treatments for osteoarthritis are designed to relieve pain, fight inflammation and improve muscle strength and coordination. A huge role is given to physiotherapy procedures, which are performed both during exacerbations and during periods of "calming" of symptoms.
Physiotherapeutic treatment
Various forms of physical therapy can relieve the symptoms of osteoarthritis. They include:
- Physiotherapy;
- Manual therapy;
- Thermotherapy (not in the acute stages);
- Cryotherapy (in the acute stages);
- Do sports that are good for the joints, such as Nordic walking, swimming and cycling;
- Water therapy and baths;
- electrotherapy;
- Ultrasound therapy;
- Orthopedic appliances.
For the treatment of chronic pain in osteoarthritis you can use the heat of heating procedures, packages, baths or infrared light. On the other hand, severe swelling and discomfort are alleviated with cold procedures or compresses.
Physical therapy is also useful in the treatment of osteoarthritis, as it strengthens muscles. Massage is also recommended: it relieves tension and improves blood circulation.
Movement of the joints during exercise
Regular exercise keeps your joints flexible. That's why people with osteoarthritis should include sports and exercise in their daily lives. Swimming is a good example. He trains the joints without putting much strain on them. For the same reason, it is recommended to walk on the plain and ride a bike.
Sport can not only prevent but also slow down osteoarthritis and reduce symptoms.
Less suitable for osteoarthritis are sports with sharp, significant joint stress, extreme movements or a high risk of injury. These include, for example, tennis, ice skating, football, handball, karate and boxing.
Fixation of the joints
Bandages, elastic bandages, soft soles and crutches facilitate the functioning of the joints. Orthoses help in the same way. These are special support devices for the joints. They prevent painful movements. However, orthoses are not very flexible and should only be worn for a short time to prevent the joint from hardening.
If the person is overweight, try to lose weight. This will make the joints less tense. Regular exercise and a healthy diet help with weight loss.
Medicines to treat pain and inflammation
Painful joints with osteoarthritis can be rubbed with painkillers, creams or gels from the pharmacy.
Local anesthetics are used to relieve pain: they are injected into the joint or around the affected area.
Osteoarthritis (or osteoarthritis) is not usually an inflammatory process. However, the inflammatory process often joins the tissue affected by osteoarthritis. Then they talk about osteoarthritis or activating arthritis.
For treatment, the doctor often prescribes nonsteroidal anti-inflammatory drugs (NSAIDs). Sometimes glucocorticoids are also injected into the joint against inflammation.
Some patients receive injections of hyaluronic acid or chondroitin sulfate inside the joint 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 patients with osteoarthritis and stabilize joints. It also relieves pain and prevents inflammation. In some cases, damaged cartilage is replaced during surgery. Patients with osteoarthritis may move better after surgery.
Flushing and treatment of joints
In osteoarthritis, the affected joint is sometimes washed with saline. This is most often done, for example, with the knee joint.
Bursa lavage removes damaged cartilage and tissue fibers, as well as other particles floating in the synovial fluid. In addition, the procedure should soothe any existing inflammation in the joint.
Reorganization means complex treatment of the joint capsule. The rough surfaces of the cartilage in the joint are removed with the help of tools. It also removes areas or tissues that can impede joint mobility. The acute pain, at least temporarily, disappears as a result of treatment.
Joint treatment is performed as part of arthroscopy. Surgical instruments are inserted into the joint through very small incisions.
Stimulating cartilage growth
During arthroscopy, small injections are made on the remaining surface of the cartilage for therapeutic purposes. This should stimulate the cartilage cells to form replacement tissues. However, this new cartilage tissue has a different structure from the original cartilage and does not fully meet the requirements for the joint.
During several years of the disease, in some cases, the cells can be transplanted into the damaged joint.
Correction
Corrective osteotomy repositions the articular bones for a more even distribution of the load on the articular surfaces: part of the pressure is transferred from the area of osteoarthritis to healthy areas of cartilage and bone. In most cases, this type of osteoarthritis treatment also involves improving the functioning of the joint capsule and connections to restore joint mobility.
Joint replacement
If the pain cannot be relieved with another treatment for osteoarthritis, joint replacement is possible. This means that the damaged joint (or parts of it) is replaced with an artificial one. In general, the operation is performed in case of osteoarthritis of the knee or hip joints.
Complex replacement is the last option
Strictly speaking, worn joint tissues and joint surfaces are surgically removed and replaced with metal, plastic and ceramic prostheses (alloarthroplasty). There are prostheses that replace only parts of the joint, and there are those that are used to replace the entire joint. They are fixed 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 some time, each prosthesis can wear out. The time at which this occurs depends on various factors: age, sex, clinical picture of osteoarthritis, infections, type of joint and type of prosthesis.
A light prosthesis should be changed 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. Thus, arthrodesis is usually performed only on joints in which lower mobility does not interfere with the patient's daily life. These include the joints of the fingers and toes and the small joints of the wrist.
Resection
In this form of osteoarthritis treatment, the damaged joint bodies are removed and surgically reconstructed without a prosthesis. However, resection arthroplasty is rarely used today.
This option may be considered in osteoarthritis of the thumb (rhizarthrosis), especially if conservative treatment of osteoarthritis has not been successful. One of the affected metacarpal bones is removed and replaced with the body's own tendon tissue. The tendons of the long muscle of the thumb or the tendons of the flexor are often used. This form of therapy for rhizarthrosis is not considered a standard method.
Resection of arthroplasty is also performed in arthrosis of the big toe or arthrosis between the clavicle and the humerus.
Alternative treatment for osteoarthritis
What helps with osteoarthritis besides 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 scientifically proven to be 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. .
Salts and homeopathy
In many cases, patients with osteoarthritis rely on these two alternatives: salts and homeopathic granules to relieve the symptoms of osteoarthritis. In addition, salt baths and compresses should also protect against osteoarthritis. Proponents say both treatments have no side effects and are therefore suitable for self-medication.
Experts recommend the use of minerals in combination with ointment or cream gel. Homeopathic remedies for osteoarthritis should be discussed with an experienced therapist.
Herbal substances
For centuries, the treatment of osteoarthritis has also been based on medicinal plants. These include the African devil's claw, nettle, comfrey, willow, dandelion, cayenne pepper and rose hips. However, the symptoms of osteoarthritis improve if you use herbs for a long period of time. Your doctor or pharmacist will advise you on the exact use and dosage.
Magnetic field therapy
Magnetic therapy for osteoarthritis 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 stone or by an electric coil.
Medical research shows that magnetic therapy can be especially helpful in osteoarthritis of the knee. But patients with chronic complaints in multiple joints (polyarthritis) should also benefit. No side effects have been observed with this alternative treatment for osteoarthritis.
X-ray therapy
X-ray treatment of osteoarthritis is designed to inhibit inflammation and improve blood circulation. Irradiation should be performed at regular intervals and only very small doses of irradiation should be used.
X-rays are used, for example, in the treatment of rhizarthrosis and in the treatment of Heberden's osteoarthritis.
Acupuncture
Stimulation of certain points on the skin with acupuncture in order to normalize again the disturbed processes in the body. The course of treatment usually 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 combined wear and tear on knee structures, acupuncture can reduce chronic pain.
Osteoarthritis and nutrition
The link between arthritis and diet is often discussed: can an unfavorable diet contribute to osteoarthritis? Do you need to change your diet for osteoarthritis?
In general, it cannot be said that some foods cause osteoarthritis. However, the type of diet can actually affect its course: what matters is how much we eat and how our meals are prepared.
Less calories
As you gain weight, the load on the joints increases and as a result, they wear out faster. Therefore, overweight people have a higher risk of osteoarthritis.
If osteoarthritis is already present, obesity contributes to combined wear and tear, especially in the knee.
Obesity has a huge impact on the joints. Excess weight at a young age is especially critical.
Therefore, nutrition in osteoarthritis should be adjusted by counting calories if the person tends to be overweight. A healthy body weight relieves joints, can relieve discomfort during illness and slow the progression of changes.
Less animal fat
Proper diet for osteoarthritis means reducing the intake of meat and other animal products. Cause: In damaged joints, inflammation develops more easily in osteoarthritis. Several metabolic products mediate these inflammatory reactions in the body and are made from arachidonic acid (omega-6 fatty acid). These are mostly animal products.
Therefore, the osteoarthritis diet should limit the use of arachidonic acid. Instead, you should be more likely to eat foods high in omega-3 fatty acids because they inhibit inflammatory reactions. Omega-3 fatty acids are found, for example, in rapeseed 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 (eg salmon, mackerel, herring);
- Use vegetable oils such as rapeseed oil, linseed 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 unsweetened tea daily;
- Calcium from low-fat dairy products to strengthen bones
- Avoid caffeine, alcohol and nicotine.
Such a diet for osteoarthritis cannot replace other therapeutic measures, but can intelligently supplement them. This means that although diet does not cure osteoarthritis, it has a positive effect on the patient's condition.
Keep moving!
Despite the possible pain, "immobility" in the treatment of osteoarthritis is not a good idea - it actually speeds up the destruction process.
Only during the work of the joint and during the movement of the joint surfaces a lubricant is formed, the so-called synovial fluid, which reduces the friction in the joint and supplies the cartilage with nutrients.
Ideal movements in which the joint is not overloaded: swimming, cycling, Nordic walking and gymnastics.