Treatment methods for osteoarthritis

Osteoarthritis- a disease that develops over many years, mainly causing damage to certain joints.Most often, painful changes affect large joints - knee, hip, shoulder, etc. Pain and difficulty moving in them complicate a person's life physically and emotionally, and given that arthrosis often occurs at an early age, this can hinder the achievement of professional and personal goals.Therefore, it is important to diagnose the disease as early as possible and begin comprehensive treatment of osteoarthritis.

Treatment of osteoarthritis

In the initial stages 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 life of a person.

1. Drug treatment:
   • NSAIDs;
   • GCS;
   • chondroprotectors.
2. PRP therapy.
3. Therapeutic exercise.
4. Massage and manual therapy.
5. Traction therapy.
6. Physiotherapy.

Physiotherapy techniques that are commonly used for osteoarthritis:

• magnetic therapy;
• UHF;
• inductothermy;
• 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 main method of relieving pain in arthrosis.In fact, the use of drugs is a method of rapid pain relief, which should be prescribed only in the acute period.The fact is that the drugs widely prescribed for these purposes have serious side effects, which increase with long-term and especially with uncontrolled use.We are talking about undesirable effects of the digestive, cardiovascular and nervous systems, which with a high probability can lead the patient to a hospital bed (gastric bleeding, cardiac arrhythmias, effects on the liver and kidneys, etc.).

Nonsteroidal 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 with different 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 concurrent synovitis (fluid accumulation in the joint).

2. GKS— glucocorticosteroids have a strong anti-inflammatory and analgesic effect.It is advisable and effective to administer them periarticularly.However, patients often have a negative attitude to the use of these drugs in treatment, which is fraught with possible side effects: infectious complications, deterioration of the ligaments, articular surface and degeneration of the cartilage.But with periarticular administration the risk of these complications is minimal.

3. Chondroprotectors— substances are natural components of cartilage tissue, which, when taken orally, contribute to the gradual recovery of cartilage and 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 rapid analgesic effect;improvement develops with long-term use of drugs based on it, which is accompanied by partial restoration of cartilage tissue.Recommended at all stages of the disease.

PRP therapy

One of the most modern methods of restorative medicine, used for sports injuries and degenerative-dystrophic joint diseases, is PRP therapy (PRP - platelet-rich plasma) or plasma biorevitalization, autoplasma therapy.The technology 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 very 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, achieving partial repair of tissue, mainly cartilage.

The technique is most applicable in stages 1-2 of osteoarthritis.Shows good results and allows you to slow down the rapid development of the disease due to the release of growth factors by platelets.The method is relatively new, but appears 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.By performing autoplasma therapy, you can extend 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 case when natural synovial fluid is almost completely absent (this is that performs the role of lubrication of the joint surfaces).Used in the later stages of osteoarthritis.

Medicines from this group are also called 'synovial fluid prostheses', 'biological replacements 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 (high) doses, but all have only a supportive value in the treatment of osteoarthritis.

Therapeutic exercise

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 not popular among patients with arthrosis, because most of them are mistaken in the belief that in case of pain it is necessary to limit all movements.Early initiation of exercise, on the other hand, promotes faster recovery and reduction of symptoms, especially pain.

Particularly effective are physiotherapy in water, joint movements in a relaxing position (lying, sitting, hanging) and moderate walking on a flat surface.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 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 environment or a medical sanatorium it is possible to perform traction therapy - this is traction of 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 techniques using simulators are used.Their effectiveness is almost the same, but the simulators are more comfortable for the patient.

Physiotherapy

The use of various physiotherapy techniques in the initial stages of osteoarthritis 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 that are commonly used for osteoarthritis:

1. Magnetotherapy— local exposure to a constant 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 its own substances necessary for the functioning of the joint are activated.

   Magnetic therapy has an anti-edematous, analgesic and anti-inflammatory effect 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 with various modifications is used.

   A great advantage for patients with arthrosis is the ability to conduct independent magnetic therapy courses 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 condition of the cardiovascular and nervous system.Taking into account 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 calming and stabilizing effect of magnetic therapy will be very useful.

2. Ultrasound therapymore often used in combination with the effects of drugs with anti-inflammatory, analgesic, restorative effects - ultraphonophoresis or phonophoresis.Ultrasound increases the permeability of tissues to drugs, enhancing their main effect.Even without a medicinal component, the method is very effective in osteoarthritis: ultrasound has a mechanical effect on tissue (micromassage), activates local immune and regenerative processes in the joint area and adjacent muscles and 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 an improvement in local blood flow, activation of metabolism, removal of underoxidized metabolic products and a decrease in the intensity of pain.Laser therapy, due to the small depth of penetration, has a minimally pronounced systemic effect, while the therapeutic effect of other procedures is enhanced.

4. Shockwave therapy– high-energy influencing 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, leading to 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 for therapeutic effects on the body with diadynamic pulse currents.The diadynamic currents used in this method rhythmically excite 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 in severe pain.

6. Electromyostimulation– exposure to electric current on muscle tissue.With arthrosis of large joints, the work of the surrounding muscles is disrupted, leading to atrophy of some and overload of others.A gait disorder develops.When exposed to electrical alternating current according to a special program, the muscles contract rhythmically, performing a certain amount of work, which leads to the restoration of their volume and function.

7. Cryotherapy- a simple and effective method of treatment that is 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 the blood vessels takes place, local blood flow accelerates and recovery processes are activated.This method is especially effective in combination with shock wave therapy.

8. Balneotherapy.In sanatorium-resort conditions, hydrotherapy is carried out - medical baths, including radon baths, are especially effective in arthrosis.There is a general effect on the body of the radioactive decay products of radon dissolved in water.The main effect is the activation of metabolic processes.

   A similar, although less pronounced effect is characteristic of therapeutic mud (peloids), hydrogen sulfide and carbon dioxide baths.

Surgical treatment

Surgical techniques are used in the late stages of osteoarthritis, when joint mobility is severely limited or absent, which affects the patient's quality of life.Various methods of joint replacement are used all over the world, which make it possible to fully restore range of motion 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 general condition of the patient, age and the presence of concomitant diseases, excess weight and others.The best results after endoprostheses were obtained in young and middle-aged patients (almost complete recovery of range of motion), but also in older people there is a significant improvement in their condition, because after successful surgery and recovery they can fully take care of themselves in everyday life and move not only in the apartment, but also go outside, without limiting themselves in communication.

Prevention

Osteoarthritis belongs to the group of diseases of upright walking and occurs mainly due to age-related changes in the joints, amplified by the influence of external negative factors.Paying attention to the condition of the musculoskeletal system, prevention of joint diseases and treatment of arthrosis in the early stages, you can maintain physical activity and avoid massive medical interventions in the future.