Methods of treating 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 in movement in them complicates a person's life physically and emotionally, and given the fact that arthrosis often appears at a young age, it can prevent 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.Meanwhile, the correction methods used allow stopping the development of the disease, maintaining motor activity, reducing the severity of the main symptoms of arthrosis and generally improving the quality of life of the person.

1. Treatment with drugs:
   • NSAIDs;
   • GCS;
   • chondroprotectors.
2. PRP therapy.
3. Physical therapy.
4. Massage and manual therapy.
5. Traction therapy.
6. Physiotherapy.

Physiotherapy techniques widely used in arthrosis:

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

Drug treatment

It is widely believed among patients that taking drugs with an analgesic effect (orally in the form of tablets or intramuscularly by injection) is the most important method of pain relief in arthrosis.In fact, the use of drugs is a method of quick pain relief that should be prescribed only in the acute period.It is a fact that the drugs massively prescribed for these purposes have serious side effects that intensify with prolonged and especially uncontrolled use.We are talking about adverse reactions from 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.).

Nonsteroidal anti-inflammatory drugs

1. NSAIDs- non-steroidal anti-inflammatory drugs, many of them are available without a prescription and are widely taken by patients themselves.This group includes drugs with a different chemical structure.Medicines 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 the symptoms of all stages of the disease.Effective in accompanying synovitis (accumulation of fluid in the joint).

2. GKS— glucocorticosteroid drugs have a strong anti-inflammatory and analgesic effect.Their periarticular application is recommended and effective.However, patients often have a negative attitude to 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 application, the risk of these complications is minimal.

3. Chondroprotectors— the substances are natural components of cartilage tissue, which, 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 for all stages of the disease.

PRP therapy

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

The essence of the procedureconsists 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 regeneration processes and the synthesis of their own basic substances.

The resulting platelet-rich plasma is injected both peri-articularly and directly into the affected joint, thereby achieving a partial restoration of tissue, mainly cartilage.

The technique is most applicable for stage 1-2 arthrosis.It shows good results and allows you to slow down the rapid development of the disease due to the release of growth factors from 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 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 the event that the natural synovial fluid is almost completely absent (namely, it performs the role of lubricating the joint surfaces).It is used in the later stages of arthrosis.

Medicines from this group are also called "synovial fluid prostheses", "biological synovial fluid substitutes".The effect after taking the preparations is long-lasting - from 6 to 13 months, depending on the medication used.

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

Physical therapy

Special therapeutic exercises can and should be used even during an exacerbation, at all stages of arthrosis.Such measures can reduce pain and prevent serious limitations in joint movement.However, the method is unpopular among patients with arthrosis, because most of them are mistaken that in case of pain it is necessary to limit any movements.Timely initiation of physical exercises, on the contrary, promotes faster recovery and reduction of symptoms, above all pain.

Physical therapy in water, joint movements in a unloading position (lying, sitting, hanging) and moderate walking on a flat surface are particularly effective.If necessary, for example, in case of severe pain, a special bandage can be applied to the joint, but physical education should be started as early as possible.

Massage and manual therapy

Methods of mechanical impact on joints, muscles and ligaments can reduce the intensity 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 a medical sanatorium, it is possible to carry out traction therapy - this is traction on the joint (hip, knee) using a special technique with different loads.The standard traction scheme is designed for 28 days, with a gradual increase in load and exposure time.Classical techniques and more modern ones using simulators are used.Their effectiveness is almost the same, but simulators are more convenient for the patient.

Physiotherapy

The use of various physiotherapy techniques in the initial stages of arthrosis can achieve significant pain relief and increased mobility in the affected joints.Physiotherapy courses help to slow down the pathological process and prolong the period without exacerbations.

Physiotherapy techniques widely used in arthrosis:

1. Magnetotherapy— local exposure to a permanent or alternating low-frequency magnetic field.In the area of the affected joint, metabolic processes are accelerated, blood circulation and the supply of nutrients to the joint structures are increased, 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 has a positive effect on the general condition of the patient.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 to conduct independent courses of magnetic therapy at home, as prescribed and under the supervision of the attending physician.The timely use of portable magnetic therapy devices allows you to stop the development of pain, the occurrence of an exacerbation or to conduct a preventive course - that is, to maintain normal health.

   A positive aspect of magnetotherapy can also be called the beneficial effect of the procedures on the state of the cardiovascular and nervous systems.Considering the fact that most patients with arthrosis are middle-aged and elderly people with an existing set 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 therapyit is used more often in combination with the effects of drugs with anti-inflammatory, analgesic, restorative effects - ultraphonophoresis or phonophoresis.Ultrasound increases the permeability of tissues to drugs, so their main effect is enhanced.Even without a drug component, the method is highly effective in arthrosis: ultrasound has a mechanical effect on tissues (micromassage), activates local immune and regenerative processes in the joint area and adjacent muscles, 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 its small penetration depth, has a minimal systemic effect, while enhancing the therapeutic effect of other procedures.

4. Shock wave therapy– high-energy impact method.It is based on the piezoelectric effect.By applying a piezoelectric discharge to a pathological focus, a number of 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 impact on the body with diadynamic impulse currents.The diadynamic currents used in this method rhythmically excite the skin receptors, which indirectly leads to the activation of descending physiological mechanisms to suppress pain and leads to a reduction of the patient's pain, to complete analgesia.Therefore, such procedures are effective in severe pain.

6. Electromyostimulation– exposure of electric current to the muscle tissue.In arthrosis of large joints, the work of the surrounding muscles is disturbed, which leads to atrophy of some and overloading of others.Gait disorder develops.When exposed to an 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, rarely used.Local exposure to low temperature reduces the sensitivity of pain receptors and the synthesis of biologically active substances that stimulate the development of inflammation.After cryotherapy, reflex expansion of blood vessels occurs, 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 is carried out - medicinal baths, among which radon baths are particularly effective for arthrosis.There is a general effect on the body of the products of radioactive decay of radon dissolved in water.The most important effect is the activation of metabolic processes.

   A similar, albeit less pronounced effect is characteristic of healing 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 joint replacement methods are used around the world, allowing full recovery of range of motion and returning the patient to an active life at any age.

The tactics and scope of the surgical intervention are determined by the attending physician;the choice is based on parameters such as the general condition of the patient, age and presence of concomitant diseases, overweight, etc.The best results after endoprosthesis were obtained in young and middle-aged patients (almost complete recovery of the range of motion), but also in older people there is a significant improvement in their condition, because after a successful operation and recovery, they can fully provide themselves in everyday life and move not only in the apartment, but also go outside without being limited 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, enhanced by the influence of external negative factors.Attention to the state of the musculoskeletal system, the prevention of joint diseases and the treatment of arthrosis in the early stages allows you to maintain physical activity and avoid massive medical intervention in the future.