Treatment methods for osteoarthritis

Osteoarthritis- a disease that develops over many years and predominantly damages certain joints.Most often, painful changes affect large joints - knees, hips, shoulders, etc. Pain and difficulty in movement complicate a person's life physically and emotionally and, given the fact that osteoarthritis often occurs at a young age, can interfere with the achievement of professional and personal goals.It is therefore 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 require 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 widely used for osteoarthritis:

• magnetic field therapy;
• UHF;
• inductothermal energy;
• ultrasound therapy;
• balneotherapy;
• surgical treatment.

Treatment with medication

There is a widespread opinion among patients that taking medications with an analgesic effect (orally in the form of tablets or by injection - intramuscularly) is the main method of pain relief in arthrosis.In fact, taking medication is a method of quick pain relief that should only be prescribed in the acute phase.The fact is that the drugs often prescribed for these purposes have serious side effects, which increase with long-term and especially uncontrolled use.These are undesirable effects of the digestive, cardiovascular and nervous systems, which can most likely lead to hospitalization of the patient (stomach bleeding, cardiac arrhythmia, effects on the liver and kidneys, etc.).

Nonsteroidal anti-inflammatory drugs

1. NSAIDs- non-steroidal anti-inflammatory drugs, many of which are available over the counter and are often taken by patients alone.This group includes drugs with different chemical structures.The drugs have a pronounced anti-inflammatory and analgesic effect, can relieve pain in the joint area and adjacent muscle tissue, but have no effect on the development of the disease.They are used exclusively to relieve symptoms at all stages of the disease.Effective in simultaneous synovitis (accumulation of fluid in the joint).

2. GKS— Glucocorticosteroid drugs have a powerful anti-inflammatory and analgesic effect.It is advisable and effective to administer them periarticularly.However, patients often have a negative attitude towards the use of these drugs in treatment, which is associated with possible side effects: infectious complications, deterioration of ligaments, articular surface and cartilage degeneration.However, 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 restoration of cartilage, normalizing its density and elasticity.These active ingredients are usually used in combination and are contained in various medications and auxiliary products.Chondroprotectors do not have a rapid analgesic effect;With long-term use of medications based on it, improvement occurs, which is accompanied by partial restoration of cartilage tissue.Recommended in all stages of the disease.

PRP therapy

One of the most modern methods of restorative medicine used for sports injuries and degenerative-dystrophic diseases of the joints is PRP therapy (PRP - platelet-rich plasma) or plasma biorevitalization, autoplasm 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 to be administered is obtained from the patient's own blood, therefore 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 its own basic substances.

The resulting platelet-rich plasma is injected both periarticularly and directly into the affected joint, achieving partial tissue restoration, especially cartilage.

The technique is best used in stages 1-2 of osteoarthritis.Shows good results and allows you to delay the rapid development of the disease due to the release of growth factors by platelets.The method is relatively new, but 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.By carrying out autoplasma therapy, you can extend the life of the joint without further aggressive interventions.

Synovial fluid protection- 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 when the natural synovial fluid is almost completely absent (it performs the role of lubricating the articular surfaces).Used in later stages of osteoarthritis.

Medicines in this group are also called “joint fluid prostheses”, “biological replacement for synovial fluid”.The effect after administration of the medication lasts for a long time - 6 to 13 months, depending on the medication used.

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

Therapeutic exercise

Special therapeutic exercises can and should be used even during an exacerbation at all stages of arthrosis.Such measures can relieve pain and prevent severe restrictions in joint movement.However, the method is unpopular among patients with osteoarthritis because most of them mistakenly believe that pain requires restriction of movement.On the other hand, starting physical activity on time promotes faster recovery and relief of symptoms, especially pain.

Physiotherapy in water, joint movements in a relief 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 classes 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 affected joints, relieve muscle spasms and normalize muscle function.

Traction therapy

In a hospital or a medical sanatorium, it is possible to carry out traction therapy - this is traction of the joint (hip, knee) using a special technique using various loads.The standard traction scheme is designed for 28 days, with the load and exposure time gradually increasing.Classic techniques and more modern ones with simulators are used.Their effectiveness is almost the same, but the simulators are more comfortable for the patient.

Physiotherapy

By using various physical therapy techniques in the early stages of osteoarthritis, significant pain relief and increased mobility of the affected joints can be achieved.Physiotherapy courses help slow down the pathological process and increase the period without exacerbations.

Physiotherapy techniques widely used for osteoarthritis:

1. Magnetic field therapy— local exposure to a constant or changing 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, and the processes of regeneration and synthesis of the own substances necessary for the function of the joint are activated.

   Magnetic field therapy has an anti-edematous, analgesic and anti-inflammatory effect almost from the first session, which has a positive effect on the patient's general condition.Magnetic therapy is successfully used in hospitals and sanatoriums, where medical devices of various modifications are used.

   A big advantage for patients with osteoarthritis is the possibility of carrying out magnetic field therapy independently at home as prescribed and under the supervision of the treating doctor.Timely use of portable magnetic therapy devices allows you to stop the development of pain and the onset of an exacerbation or carry out a preventive measure, i.e.h.maintain normal health.

   The beneficial effect of the procedures on the condition of the cardiovascular and nervous systems can also be mentioned as a positive aspect of magnetic field therapy.Given that most patients with osteoarthritis are middle-aged and older people with existing chronic diseases (arterial hypertension, coronary artery disease, atherosclerosis, etc.), the mild sedative and stabilizing effect of magnetic therapy is very useful.

2. Ultrasound therapymore often used in combination with the action of drugs with anti-inflammatory, analgesic and restorative effects - ultraphonophoresis or phonophoresis.Ultrasound increases the permeability of tissues to drugs, thereby enhancing their main effect.Even without a medicinal component, the method is highly effective for osteoarthritis: ultrasound has a mechanical effect on the tissue (micromassage), activates local immune and regenerative processes in the joint area and the adjacent muscles and has a pronounced pain-relieving and anti-inflammatory effect.

3. Laser therapy– one of the most common and widespread procedures.The therapeutic effect is based on the reflex expansion of blood vessels over the site of the pathological process.This leads to an improvement in local blood circulation, activation of metabolism, removal of under-oxidized metabolic products and a reduction in pain intensity.Due to its shallow penetration depth, laser therapy has a minimally pronounced systemic effect and at the same time enhances the therapeutic effect of other procedures.

4. Shock wave therapy– high energy influence 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.Overwintering (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 every 4-7 days.

5. Diadynamic therapy– a method of therapeutic effect on the body using diadynamic impulse 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 to the patient's pain relief up to complete analgesia.Therefore, such procedures are effective for severe pain.

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

7. Cryotherapy- a simple and effective treatment method that, unfortunately, is 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 blood vessels occurs, local blood flow accelerates, 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, in which radon baths are especially effective for arthrosis.The radioactive decay products of radon dissolved in water have a general effect on the body.The most important effect is the activation of metabolic processes.

   A similar, although less pronounced, effect is characteristic of healing 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, making it possible to fully restore mobility and return the patient to an active life at any age.

The tactics and scope of the surgical intervention are determined by the attending physician;The selection is based on parameters such as the general condition of the patient, age and the presence of concomitant diseases, obesity and others.The best results after endoprosthetics were achieved in young and middle-aged patients (almost complete restoration of freedom of movement), but older people also experience a significant improvement in their condition, since after a successful operation and recovery they can fully take care of themselves in everyday life and can move not only within the apartment, but also go outside without restricting themselves in communication.

Prevention

Osteoarthritis belongs to the group of diseases of upright walking and arises primarily as a result of age-related changes in the joints, aggravated by the influence of external negative factors.Attention to the condition of the musculoskeletal system, prevention of joint diseases and treatment of arthrosis in the early stages allow you to maintain physical activity and avoid massive medical interventions in the future.