Methods of treatment of arthrosis

Arthrosis- a disease that has developed over many years with severe damage to some joints.Most often, painful changes occur in large joints - knees, hips, shoulders, etc.Their pain and mobility can make a person's life physically and emotionally difficult, and given that arthrosis often occurs at a young age, it can hinder the achievement of professional and personal goals.Therefore, it is important to detect the disease as early as possible and start comprehensive treatment of arthrosis.

Treatment of arthrosis

At the initial stage of arthrosis, conservative methods that do not include surgical intervention are used.At the same time, the applied correction methods allow 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. Attraction therapy.
6. Physiotherapy.

Commonly used physiotherapy methods for arthrosis:

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

Treatment with drugs

There is a widespread belief among patients that taking pain-relieving drugs (in the form of tablets or by injection - into the muscle) is the most important way to relieve pain in arthrosis.In fact, the use of drugs is a quick way to get rid of pain, which should be prescribed only in acute cases.In fact, the drugs widely used for these purposes have serious side effects, which increase with long-term and especially uncontrolled use.We are talking about adverse effects of digestive, cardiovascular, and nervous systems, which have a high probability of hospitalization of the patient (hemorrhages in the stomach, heart rhythm disorders, effects on the liver and kidneys, etc.).

Nonsteroidal anti-inflammatory drugs

1. NSAIDs- non-steroidal anti-inflammatory drugs, most of which are sold without a prescription and are taken by patients themselves.This group includes drugs with different chemical structures.Medicines have a pronounced anti-inflammatory and pain-relieving effect, can reduce pain in the joint zone and adjacent muscle tissue, but do not affect the development of the disease.They are used only to reduce symptoms in all stages of the disease.Effective for pregnancy synovitis (accumulation of fluid in the joint).

2. GKS— glucocorticosteroid drugs have a strong anti-inflammatory and pain-relieving effect.Their periarticular administration is appropriate and effective.However, patients often have a negative attitude towards the use of these drugs in treatment, which is associated with possible side effects: infectious complications, ligament deterioration, articular surface and cartilage degradation.But with periarticular management, the risk of these complications is minimal.

3. Chondroprotectors— substances that are natural components of cartilage tissue, when taken orally, contribute to the gradual restoration of cartilage, normalize density and elasticity.These active components are usually used in combination and include various drugs and auxiliary products.Chondroprotectors are not affected by fast analgesics;improvement developed with long-term use of drugs based on them, associated with partial restoration of cartilage tissue.It is recommended in all stages of the disease.

PRP therapy

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

The essence of the procedureIt consists of injecting platelet-rich plasma directly into the injured area, in this case the joint.The medicine is taken from the patient's own blood, so this 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 obtained platelet-rich plasma is injected both periarticularly and directly into the affected joint, thereby achieving a partial recovery of tissue, primarily cartilage.

The technique is best suited for osteoarthritis stages 1-2.Shows good results and allows delaying the rapid development of the disease due to the release of platelet growth factors.This method is relatively new, but very effective.PRP therapy was first used in surgery;Today, this method is successfully used in many fields of medicine, including rheumatology and orthopedics, neurology and cosmetology.Conducting autoplasma therapy allows to increase the life of generations without other aggressive interventions.

Synovial fluid protector- a group of preparations based on hyaluronic acid, which are introduced directly into the joint cavity (injection) and play the role of a viscous lubricating fluid in the absence of natural synovial fluid (it provides the role of lubricating the joint surfaces).It is used in the later stages of arthrosis.

Medicines of this group are also called "prostheses of synovial fluid", "biological substitutes of synovial fluid".After taking the drugs, the effect lasts for a long time - 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 of them have only auxiliary value in the treatment of arthrosis.

Therapeutic exercise

Special therapeutic exercises can and should be used in all stages of arthrosis.Such measures can reduce pain and prevent severe limitations in joint movement.However, this method is not popular among patients with arthrosis, because most of them are mistaken in the belief that certain movements should be restricted during pain.Timely initiation of physical training, on the other hand, contributes to faster recovery and reduction of symptoms, primarily pain.

Especially effective physiotherapy is in water, joint movements in the lowering position (lying, sitting, hanging), as well as moderate walking on a flat surface.If necessary, for example, in severe pain, a special bandage can be applied to the joint, but physical training should be started as early as possible.

Massage and manual therapy

Methods of mechanical impact on joints, muscles and ligaments can reduce pain, increase mobility, improve blood circulation and metabolism in the zone of damaged joints, relieve muscle spasms, normalize muscles.

Attraction therapy

It is possible to carry out traction therapy in a hospital or medical sanatorium - this is stretching of a joint (hip, knee) using special equipment using various loads.The standard shooting scheme is designed for 28 days with a gradual increase in load and exposure time.Classical and modern techniques using simulators are used.Their effectiveness is almost the same, but simulators are more convenient for the patient.

Physiotherapy

The use of various physical therapy methods in the initial stages of arthrosis can be achieved by significantly reducing and increasing the mobility of the affected joints.Physiotherapy courses help to slow down the pathological process and prolong the period without aggravation.

Commonly used physiotherapy methods for arthrosis:

1. Magnetic therapy— local effect of permanent or alternating low-frequency magnetic field.In the area of the damaged joint, metabolic processes are accelerated, blood circulation and the delivery of nutrients to the joint structures are increased, the processes of regeneration and synthesis of own substances necessary for the functioning of the joint are activated.

   Magnetic therapy has a positive effect on the general condition of the patient almost from the first session, it has anti-inflammatory, analgesic and anti-inflammatory effects.Magnetic therapy is successfully used in hospitals and sanatoriums where medical equipment of various modifications is used.

   A great advantage for patients with arthrosis is the ability to conduct independent courses of magnetic therapy at home, as well as under the supervision of a doctor.Timely use of portable magnetic therapy devices allows to stop the disease, its exacerbation or conduct preventive courses, that is, to improve health.

   The positive side of magnetic therapy can also be called the beneficial effect of procedures on the state of the cardiovascular and nervous systems.Taking into account that most patients with arthrosis are middle-aged and elderly people with chronic diseases (arterial hypertension, ischemic heart disease, atherosclerosis, etc.), the gentle calming and stabilizing effect of magnetic therapy is very beneficial.

2. Ultrasound therapyIt is more often used in combination with the effect of drugs with anti-inflammatory, pain-relieving, restorative effect - ultraphonophoresis or phonophoresis.Ultrasound increases the permeability of tissues for drugs, so their main effect is enhanced.Even without a medicinal component, the method is highly effective for arthrosis: ultrasound has a mechanical effect on tissues (micromassage), activates local immune and regenerative processes in the joint area and adjacent muscles, and also 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 low-oxidized metabolic products and decrease in intensity of the disease.Laser therapy, due to its shallow depth, has a little known systemic effect, while enhancing the therapeutic effect of other procedures.

4. Shock wave therapy- a high-energy method of influence.It is based on the piezoelectric effect.A number of effects are achieved by applying piezoelectric discharge to the pathological focus.Non-viable cells are destroyed, which leads to activation of local immunity.Hibernating (inactive) cells are stimulated, which promotes the regeneration process.At the same time, the intensity of the pain syndrome is significantly reduced (but the procedure itself is more painful).The undoubted advantage of the method is its use once every 4-7 days.

5. Diadynamic therapy- a method of therapeutic effect on the body with diadynamic pulse currents.The diadynamic currents used in this method rhythmically stimulate the skin receptors, which indirectly activates the physiological reduction mechanisms of pain relief, leading to a decrease in the patient's pain, up to complete analgesia.Therefore, such procedures are effective for severe pain.

6. Electromyostimulation- the effect of electric current on muscle tissue.With arthrosis of the large joints, the function of the surrounding muscles is disturbed, which leads to atrophy of some and overloading of others.A gait disorder develops.According to a special program, under the influence of alternating electric current, muscles contract rhythmically and create a certain amount of work, which leads to the restoration of their size and function.

7. Cryotherapy- a simple and effective method of treatment, unfortunately, is rarely used.The local effect of 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 accelerates, and recovery processes are activated.This method is especially effective in combination with shock wave therapy.

8. Balneotherapy.Hydrotherapy is carried out in sanatorium-spa conditions - medical baths, among which radon baths are especially effective for arthrosis.Radioactive decay products of radon dissolved in water have a general effect on the body.The main effect is the activation of metabolic processes.

   A similar, but less noticeable effect is characteristic of therapeutic muds (peloids), hydrogen sulfide and carbonic acid baths.

Surgical treatment

Surgical methods are used in the last stages of arthrosis, when joint mobility is severely limited or absent, which affects the patient's quality of life.Various joint replacement techniques are used around the world, which allow full restoration of range of motion and return the patient to an active life at any age.

Tactics and volume of surgical intervention are determined by the attending physician;selection is based on parameters such as the general condition of the patient, age and presence of concomitant diseases, overweight and others.The best result after endoprosthetics was obtained in young and middle-aged patients (almost complete recovery of the range of motion), but even in elderly people, their condition has improved significantly, because after a successful operation and recovery, they can fully support themselves in everyday life and can go out not only in the apartment, but also without restrictions in communication.

Prevention

Arthrosis belongs to the group of diseases of standing and develops as a result of age-related changes in the joints, which are aggravated by the influence of external negative factors.Paying attention to the condition of the musculoskeletal system, preventing joint diseases and treating arthrosis in the early stages will allow you to maintain physical activity and avoid massive medical intervention in the future.