Methods of treatment of arthrosis

arthrosis- A disease that develops over many years with major damage to some joints.Often, painful changes affect large joints – knee, hip, shoulder, etc.Pain and difficulty walking in them complicate a person's life physically and emotionally, and given the fact that arthrosis often occurs at an early age, it can interfere with the achievement of professional and personal goals.That is why it is important to diagnose the disease as early as possible and begin comprehensive treatment of arthrosis.

treatment of arthrosis

At the initial stage 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 a person's life.

1. Drug Treatment:
   • NSAIDs;
   • GCS;
   • Chondroprotectors.
2. PRP therapy.
3. therapeutic exercise.
4. Massage and manual therapy.
5. Traction therapy.
6. Physiotherapy.

Widely used physiotherapy techniques for arthrosis:

• magnetic therapy;
• UHF;
• Inductothermy;
• ultrasound therapy;
• Balneotherapy;
• Surgical treatment.

drug treatment

There is a widespread belief among patients that taking drugs with analgesic effect (orally in the form of tablets or by injection - intramuscularly) is the most important method of pain relief in arthrosis.In fact, the use of medications is a method of rapid pain relief, which should be prescribed only in acute periods.The fact is that drugs widely prescribed for these purposes have serious side effects, which increase with prolonged and especially uncontrolled use.We are talking about undesirable effects from the digestive, cardiovascular, nervous systems, which with a high probability can lead the patient to a hospital bed (stomach bleeding, heart rhythm disturbances, effects on the liver and kidneys, etc.).

nonsteroidal anti-inflammatory drugs

1. NSAID-Non-steroidal anti-inflammatory drugs, many of them available without a prescription and widely taken by patients on their own.This group includes drugs of different chemical structures.The drugs have a pronounced anti-inflammatory and analgesic effect, which 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 concomitant synovitis (fluid accumulation in joints).

2. gks- Glucocorticosteroid drugs have a strong anti-inflammatory and analgesic effect.It is appropriate 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, degeneration of the articular surface and cartilage.But with periarticular administration, 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, normalizing its density and elasticity.These active ingredients are usually used in combination and are included in various medications and auxiliary products.Chondroprotectors do not have a quick analgesic effect;With long-term use of drugs based on them, improvement develops, which is associated with partial restoration of cartilage tissue.Recommended in all stages of the disease.

prp therapy

One of the most modern methods of restorative therapy used for sports injuries and degenerative-dystrophic diseases of the joints is PRP therapy (PRP - platelet-rich plasma) or plasma biorevitalization, autoplasma therapy.This technology is actively used abroad.

essence of the processThis involves injecting platelet-rich plasma directly into the injured area, in this case the joint.The drug for administration is obtained from the patient's own blood, so this method is considered not only highly effective, but also safe for humans.Growth factors and other biologically active substances (serotonin, bradykinin, prostaglandin, 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 periarticular and directly into the affected joint, leading to partial restoration of tissue, primarily cartilage.

This technique is most applicable to 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.This method is relatively new, but has proven to be highly effective.PRP therapy was first used in surgery;Today this technology is successfully used in many areas of medicine, including rheumatology and orthopedics, neurology and cosmetology.By doing autoplasma therapy you can extend the life of the joint without any other invasive intervention.

synovial fluid protector- a group of drugs based on hyaluronic acid, which are injected directly into the joint cavity (injections) and play the role of a viscous lubricating fluid in the situation when the natural synovial fluid is almost completely absent (it is it that provides the role of lubrication of the articular surfaces).Used in later stages of arthrosis.

Medicines in this group are also called "synovial fluid prostheses", "biological substitutes for synovial fluid".The effects last long after administration of the drug – from 6 to 13 months, depending on the drug used.

some people 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 at all stages of arthrosis, even during exacerbations.Such measures can reduce pain and prevent severe restrictions in joint movement.However, this method is unpopular among patients with arthrosis, since most of them have a misconception that in case of pain it is necessary to limit any activity.On the contrary, starting physical exercise in time leads to faster recovery and reduction of symptoms, mainly pain.

Particularly effective are physical therapy in water, movement of joints in unloading positions (lying, sitting, hanging), and walking at a moderate pace 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 joints, muscles and ligaments can reduce the severity of pain, increase mobility, improve blood circulation and metabolism in the area of affected joints, relieve muscle spasm and normalize muscle function.

traction therapy

In a hospital setting or 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 a gradual increase in load and exposure time.Classical techniques and more modern techniques using simulators are used.Their effectiveness is approximately the same, but simulators are more comfortable for the patient.

physiotherapy

The use of various physical therapy techniques in the early stages of arthrosis can provide significant pain relief and increase mobility in the affected joints.Physiotherapy courses help to slow down the pathological process and extend the period without exacerbations.

Widely used physiotherapy techniques for arthrosis:

1. magnetotherapy- Local exposure to constant or alternating low-frequency magnetic fields.In the area of the affected joint, metabolic processes are accelerated, blood circulation and 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 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 devices of various modifications are used.

   A huge advantage for patients with arthrosis is the ability to conduct independent courses of magnetic therapy at home, as prescribed and under the supervision of the attending physician.Timely use of portable magnetic therapy devices allows you to prevent the development of pain, the onset of 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 state of the cardiovascular and nervous systems.Taking into account the fact that most patients with arthrosis are middle-aged and elderly people suffering from existing chronic diseases (arterial hypertension, coronary heart disease, atherosclerosis, etc.), a mild sedative and stabilizing effect of magnetic therapy will be very useful.

2. ultrasound therapyMore often used in combination with the effect 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 the medicinal component, the method is highly effective for arthrosis: ultrasound has a mechanical effect on the 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 disease process.This improves local blood flow, activates metabolism, removes less oxidized metabolic products and reduces pain intensity.Laser therapy, due to the shallow depth of penetration, has minimal pronounced systemic effects, while enhancing the therapeutic effect of other procedures.

4. shock wave therapy– High-energy method of impact.It is based on piezoelectric effect.Several effects are achieved by applying a piezoelectric discharge to the pathological focus.Nonviable cells are destroyed, thereby activating local immunity.Hibernating (dormant) 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 pulse currents.The diadynamic currents used in this method rhythmically stimulate skin receptors, which indirectly activates 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 for severe pain.

6. electromyostimulation- Effect of 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.Gait disturbances develop.When exposed to alternating electric current according to a special program, the muscles contract rhythmically, performing a certain amount of work, thereby restoring their volume and function.

7. cryotherapy- A simple and effective method of treatment, unfortunately, rarely used.Local exposure to low temperatures leads to a decrease in the sensitivity of pain receptors and the synthesis of biologically active substances that provoke 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 especially effective in combination with shock wave therapy.

8. balneotherapy.In sanatorium-resort conditions, hydrotherapy is carried out - medical baths, among which radon baths are especially effective for arthrosis.Radioactive decay products of radon dissolved in water have a normalizing effect on the body.The most important 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 arthrosis, when joint mobility is severely limited or absent, which affects the patient's quality of life.All over the world, various methods of joint replacement are used, which make it possible to completely restore the 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;Selection is based on parameters such as the general condition of the patient, age and presence of concomitant diseases, overweight and others.The best results after endoprosthetics were obtained in young and middle-aged patients (almost complete restoration of range of motion), but older people also have 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 within the apartment, but also outside, without limiting themselves in communication.

Redressal

Arthrosis directly belongs to the group of diseases of the gait and develops mainly as a result of age-related changes in the joints, aggravated 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 allows you to maintain physical activity and avoid large-scale medical interventions in the future.