Arthrosis is a painful change and deformation of the joints. It occurs when articular cartilage is irreparably damaged. With conservative treatment or surgery, the symptoms of joint wear can be significantly reduced.
Overview 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 exertion, pain at the beginning of training (at the beginning of physical activity), decreased mobility, deformation of the joints, periods of exacerbation: swelling, redness, persistent pain;
- Diagnostics: physical examination, x-rays, computed tomography (CT) or magnetic resonance imaging (MRI);
- Treatment: exercise, heat or cold procedures, pain relievers, intra-articular injections (hyaluronic acid, chondroitin sulfate), in the later stages - joint replacement (surgery);
- Attention: many arthrosis does not need to be treated for a long time, but physiotherapy and prevention of exacerbations should be sufficiently carried out, and, if necessary, the pain syndrome should be stopped.
Osteoarthritis treatment methods
What helps with osteoarthritis or arthrosis? For most patients, this is the main question. Answer: There is still no treatment for arthrosis that can repair damaged cartilage.
Osteoarthritis treatment can only relieve the symptoms of the condition. In addition, the treatment should prevent prolonged wear and tear on the joints.
Because the disease also leaves its mark on the worn out joint over time, causing damage to the joint capsule, bone and muscle.
Osteoarthritis treatment includes conservative and surgical procedures. The attending physician will select the most appropriate methods for each patient. Among other things, it evaluates which joints are affected, how severe the general wear and tear are, and how severe the symptoms are.
Conservative treatment
Conservative osteoarthritis treatments are designed to relieve pain, fight inflammation, and enhance muscle strength and coordination. A huge role is assigned to physiotherapeutic procedures, which are carried out both during an exacerbation and during periods of "calm" of symptoms.
Physiotherapy treatment
Various forms of physical therapy can relieve symptoms of osteoarthritis. These include:
- Physiotherapy;
- Manual therapy;
- Thermotherapy (not in the acute stage);
- Cryotherapy (in the acute stage);
- Doing sports that are good for the joints, such as Nordic walking, swimming and cycling;
- Water therapy and baths;
- Electrotherapy;
- Ultrasound therapy;
- Orthopedic appliances.
To treat chronic osteoarthritis pain, you can use heat from heating treatments, packs, baths, or infrared light. On the other hand, severe swelling and discomfort is mitigated by cold treatments or compresses.
Physical therapy is also helpful in treating arthrosis because it strengthens the muscles. Massage is also recommended: it relieves tension and improves blood circulation.
Joint movement during exercise
Regular exercise keeps your joints flexible. Therefore, people with osteoarthritis should incorporate sports and exercise into their daily lives. Swimming is a good example. It trains the joints without overloading them. For the same reason, it is recommended to walk on the plain and ride a bike.
Sports can not only prevent but also slow down osteoarthritis and reduce symptoms.
Less suitable for osteoarthritis are sports with abrupt, significant joint stress, extreme movement, or a high risk of injury. These include, for example, tennis, ice skating, football, handball, karate and boxing.
Joint fixation
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 joints. They prevent painful movements. However, orthoses are not very flexible and only need to be worn for a short time to prevent the joint from stiffening.
If the person is overweight, try to lose weight. Thus, the joints will carry less stress. Regular exercise and a healthy diet help in weight loss.
Medicines to treat pain and inflammation
Painful joints in osteoarthritis can be rubbed with pain relieving ointments, creams, or gels from the pharmacy.
Local anesthetics are used for pain relief: they are injected into the joint or around the affected area.
Osteoarthritis (or arthrosis) is usually a non-inflammatory process. However, the inflammatory process often joins the tissue affected by osteoarthritis. Then they talk about osteoarthritis or activation of arthritis.
For treatment, a doctor often prescribes non-steroidal 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 osteoarthritis patients and stabilize joints. It also relieves pain and prevents inflammation. In some cases, the damaged cartilage is replaced during surgery. Osteoarthritis patients are able to move better after surgery.
Joint lavage and treatment
In osteoarthritis, the affected joint is sometimes washed with saline. This is most often done, for example, with the knee joint.
Flushing the bursa 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 a complex treatment of the joint capsule. The rough surfaces of the cartilage in the joint are removed using instruments. It also removes areas or tissues that can hinder the mobility of the joint. Acute pain, at least temporarily, disappears as a result of treatment.
The 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 of the remaining surface of the cartilage are made for therapeutic purposes. This should stimulate cartilage cells to form replacement tissues. However, this new cartilage tissue has a different structure than the original cartilage and does not fully meet the requirements for the joint.
During several years of the disease, in some cases, it is also possible to transplant cells into the damaged joint.
Correction
Corrective osteotomy repositions the articular bones for a more even distribution of the load over the articular surfaces: part of the pressure is transferred from the osteoarthritis zone to healthy areas of cartilage and bone. In most cases, this type of osteoarthritis treatment also includes improving the functioning of the joint capsule and ligaments to restore joint mobility.
Joint replacement
If the pain cannot be relieved by any other treatment for osteoarthritis, joint replacement is possible. This means that the damaged joint (or parts of it) is replaced with an artificial one. Basically, the operation is performed in the case of arthrosis of the knee or hip joints.
Complex replacement - the last option
Strictly speaking, worn-out 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 a while, each prosthesis can wear out. The time when this happens depends on various factors: age, gender, the clinical picture of arthrosis, infections, the type of joint and the type of prosthesis.
A lightweight prosthesis needs to be replaced more often. The wear of the prosthesis can be detected in a timely manner with regular radiography.
Arthrodesis
Arthrodesis can help manage the pain of osteoarthritis. This is a strengthening of the affected joint: it is more stable, but also less mobile. Thus, arthrodesis is usually only performed on joints where lower mobility does not interfere with the patient's daily life. These include the joints of the fingers and toes, and small joints in the wrist.
Resection
In this form of osteoarthritis treatment, the damaged articular bodies are removed and surgically reconstructed without a prosthesis. However, resection arthroplasty is rarely used today.
This option can be considered for arthrosis of the thumb (rhizarthrosis), especially if conservative treatment of osteoarthritis has not been successful. One of the affected metacarpals is removed and replaced with the body's own tendon tissue. The tendons of the long muscle of the thumb or flexor flexor tendon are often used. This form of therapy for rhizarthrosis is not considered a standard method.
Resection arthroplasty is also performed for 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 the treatment with "natural", simple methods. Although many alternative methods have not been scientifically proven to be effective, they are good relief for osteoarthritis in some patients. Homeopathy, herbal medicine, magnetic therapy, and acupuncture are widely used to relieve the symptoms of arthritis.
Salts and homeopathy
In many cases, osteoarthritis patients rely on these two alternatives: salts and homeopathic granules should relieve osteoarthritis symptoms. In addition, salt baths and compresses should also prevent osteoarthritis. Proponents say both treatments have no side effects and are therefore suitable for self-medication.
Experts recommend using minerals in combination with an ointment or cream gel. Homeopathic remedies for osteoarthritis should be discussed with an experienced therapist.
Plant substances
For centuries, the treatment of osteoarthritis has also been based on medicinal plants. These include African devil's claw, nettle, comfrey, willow, dandelion, cayenne, and rose hips. However, the symptoms of arthrosis 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
Arthrosis treatment with magnetotherapy 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 has shown that magnetic therapy can be especially helpful for 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
Arthrosis treatment with X-rays is designed to inhibit inflammation and improve blood circulation. Irradiation should be performed at regular intervals, and only very small doses of radiation are 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 disturbed processes in the body again. Usually, the course of treatment 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 on the knee structures, acupuncture can reduce chronic pain.
Osteoarthritis and nutrition
The link between arthritis and diet is often debated: can an unfavorable diet contribute to osteoarthritis? Should you change your diet for osteoarthritis?
In general, some foods cannot be said to cause osteoarthritis. However, the type of diet can actually influence its course: what matters is how much we eat and how our meals are prepared.
Less calories
As you gain weight, the load on your 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 joints. An excess of kilograms at a young age is especially critical.
Therefore, osteoarthritis nutrition should be adjusted by calorie counting if a person tends to be overweight. A healthy body weight relieves joints, can alleviate discomfort during illness, and slow the progression of changes.
Less animal fats
A proper diet for osteoarthritis means reducing your intake of meat and other animal products. Reason: 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 (an omega-6 fatty acid). These are mainly animal products.
Therefore, the diet for osteoarthritis should limit the use of arachidonic acid. Instead, you should be more likely to consume foods with more omega-3 fatty acids because they inhibit inflammatory responses. Omega-3 fatty acids are found, for example, in canola 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 (for example, salmon, mackerel, herring);
- Use vegetable oils such as canola 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 arthrosis cannot replace other therapeutic measures, but it can intelligently complement them. This means that although diet does not cure osteoarthritis, it does have a positive effect on the patient's condition.
Keep moving!
Despite the possible pain, "immobility" in treating 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 articular surfaces is a lubricant, the so-called synovial fluid, formed, which reduces friction in the joint and provides the cartilage with nutrients.
Ideal movements in which the joint is not too stressed: swimming, cycling, Nordic walking and gymnastics.