Osteoarthritis is a painful change and a deformation of the joints. It occurs when the articular cartilage is irretrievably damaged. With conservative treatment or surgery, symptoms of joint wear and tear can be significantly reduced.
Disease summary
- The following joints are the 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, joint deformation, periods of exacerbation - swelling, redness, persistent pain;
- Diagnosis: physical examination, x-rays, computed tomography (CT) or magnetic resonance imaging (MRI);
- Treatment: exercise, hot or cold procedures, pain relievers, intra-articular injections (hyaluronic acid, chondroitin sulfate), in the later stages - joint replacement (surgery);
- Attention: many osteoarthritis do not need to be treated for a long time, but physiotherapy and the prevention of exacerbations should be carried out sufficiently, and if necessary, the pain syndrome should be stopped.
Methods of treating osteoarthritis.
What helps with osteoarthritis or osteoarthritis? For most patients, this is the main question. Answer: There is still no treatment for osteoarthritis that can repair damaged cartilage.
Treating osteoarthritis can only alleviate the symptoms of the condition. In addition, treatment should avoid prolonged wear and tear on the joints.
Because the disease also leaves its mark on the worn joint over time, causing damage to the joint capsule, bones and muscles.
Treatment of osteoarthritis includes conservative and surgical procedures. The treating physician will select the most appropriate methods for each patient. Among other things, she assesses which joints are affected, how severe the general wear and tear is, and how severe the symptoms are.
Conservative treatment
Conservative treatments for osteoarthritis are designed to relieve pain, fight inflammation, and improve muscle strength and coordination. A very important 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 the symptoms of osteoarthritis. These include:
- Physiotherapy;
- Manual therapy;
- Thermotherapy (not in the acute stage);
- Cryotherapy (in acute stage);
- Do sports that are good for your 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 heat treatments, compresses, baths, or infrared light. On the other hand, severe swelling and discomfort are mitigated with cold treatments or compresses.
Physical therapy is also helpful in treating osteoarthritis 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 must include sport and exercise in their daily life. Swimming is a good example. Train the joints without overloading them. For the same reason, it is recommended to walk on the plain and ride a bicycle.
Sports can not only prevent but also delay osteoarthritis and reduce symptoms.
Less suitable for osteoarthritis are sports with significant and abrupt joint stress, extreme movements, or a high risk of injury. These include, for example, tennis, ice skating, soccer, handball, karate, and boxing.
Joint fixation
Bandages, elastic bandages, soft soles, and crutches facilitate joint function. Orthotics help in the same way. These are special support devices for joints. They prevent painful movements. However, orthoses are not very flexible and should only be worn for a short time to prevent the joint from stiffening.
If the person is overweight, try to lose weight. Therefore, the joints will withstand less stress. Regular exercise and a healthy diet help you lose weight.
Medicines to treat pain and inflammation.
Painful joints with osteoarthritis can be rubbed with pain reliever ointments, creams, or gels from the drugstore.
Local anesthetics are used to relieve pain: they are injected into the joint or around the affected area.
Osteoarthritis (or arthrosis) is usually a non-inflammatory process. However, the inflammatory process tends to bind to the tissue affected by osteoarthritis. Then they talk about osteoarthritis or activation of arthritis.
For treatment, a doctor usually prescribes nonsteroidal anti-inflammatory drugs (NSAIDs). Sometimes glucocorticoids are also injected into the joint against inflammation.
Some patients receive injections of hyaluronic acid or chondroitin sulfate into 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 patients with osteoarthritis and stabilize the 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 washing and treatment
In osteoarthritis, the affected joint is sometimes flushed with saline. This is most often done, for example, with the knee joint.
Rinsing the bursa removes damaged cartilage and tissue fibers, as well as other particles floating in the synovial fluid. Additionally, the procedure should alleviate any existing inflammation in the joint.
Reorganization means complex treatment of the joint capsule. Rough cartilage surfaces in the joint are removed with instruments. It also removes areas or tissues that can make it difficult for the joint to move. The acute pain, at least temporarily, disappears as a result of the treatment.
Joint treatment is done as part of an arthroscopy. Surgical instruments are inserted into the joint through very small incisions.
Stimulate the growth of cartilage.
During arthroscopy, small injections of the remaining surface of the cartilage are made for therapeutic purposes. This should stimulate the 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 of the joint.
During several years of the disease, in some cases, the cells can also be transplanted into the damaged joint.
Correction
Corrective osteotomy repositiones the articular bones for a more even distribution of load on the articular surfaces: some of the pressure is transferred from the area of osteoarthritis to the healthy areas of cartilage and bone. In most cases, this type of osteoarthritis treatment also includes improving the function of the joint capsule and ligaments to restore joint mobility.
Joint replacement
If the pain cannot be relieved with any other osteoarthritis treatment, 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 osteoarthritis of the knee or hip joints.
Complex replacement is the last option
Strictly speaking, worn 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 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. When this occurs depends on several factors: age, gender, the clinical picture of osteoarthritis, infections, the type of joint and the type of prosthesis.
A lightweight prosthesis needs to be replaced more often. Wear of the prosthesis can be detected in a timely manner with regular radiographs.
Arthrodesis
Arthrodesis can help control osteoarthritis pain. It is about strengthening the affected joint: it is more stable, but also less mobile. Therefore, arthrodesis is usually only performed in joints where the reduced mobility does not interfere with the daily life of the patient. These include the joints of the fingers and toes and the small joints of the wrist.
Resection
In this form of osteoarthritis treatment, damaged joint bodies are surgically removed and reconstructed without a prosthesis. However, resection arthroplasty is rarely used today.
This option may be considered for osteoarthritis 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 longus muscle of the thumb or the flexor flexor tendons are often used. This form of therapy for rhizarthrosis is not considered a standard method.
Resection arthroplasty is also performed for osteoarthritis of the big toe or osteoarthritis 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 treatment with simple and "natural" methods. Although many alternative methods have not been scientifically proven to be effective, they do provide good relief for osteoarthritis in some patients. Homeopathy, herbal medicine, magnetic therapy, and acupuncture are widely used to relieve arthritis symptoms.
Salts and homeopathy
In many cases, osteoarthritis patients rely on these two alternatives: homeopathic salts and granules to alleviate the symptoms of osteoarthritis. In addition, salt baths and compresses should also prevent osteoarthritis. Proponents say that both treatments have no side effects and are therefore suitable for self-medication.
Experts recommend using minerals in combination with an ointment or gel cream. Homeopathic remedies for osteoarthritis should be discussed with an experienced therapist.
Plant substances
For centuries, the treatment of osteoarthritis has also relied on medicinal plants. These include African devil's claw, nettle, comfrey, willow, dandelion, cayenne pepper, and rose hips. However, the symptoms of osteoarthritis 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
The treatment of osteoarthritis with magnetotherapy is designed to relieve pain, restore the joints and improve the quality of life of the patient. The magnetic field is generated by a natural magnetic stone or by an electric coil.
Medical research has shown that magnetic therapy can be especially helpful for knee osteoarthritis. But patients with chronic multi-joint discomfort (polyarthritis) should also benefit. No side effects have been seen with this alternative treatment for osteoarthritis.
X-ray therapy
X-ray treatment of osteoarthritis is designed to inhibit inflammation and improve blood circulation. Irradiation must be done 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 of the skin with acupuncture to normalize again the altered processes in the body. 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 the combined wear and tear of 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 Osteoarthritis Diet?
In general, it cannot be said that some foods cause osteoarthritis. However, the type of diet can influence its course: what matters is how much we eat and how our meals are prepared.
Fewer calories
As you gain weight, the load on your joints increases, and as a result, they wear out faster. Therefore, people who are overweight are at higher risk for osteoarthritis.
If osteoarthritis is already present, obesity contributes to combined wear and tear, especially on the knee.
Obesity has a great impact on the joints. An excess of kilograms at a young age is especially critical.
Therefore, nutrition for osteoarthritis must be adjusted by counting calories if the person tends to be overweight. A healthy body weight soothes the joints, can ease discomfort during illness, and slow the progression of changes.
Less animal fat
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 osteoarthritis diet should limit the use of arachidonic acid. Instead, you should be more likely to eat 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 fatty fish like herring, mackerel, and salmon.
Therefore, the following guidelines apply to a proper arthritis diet:
- Reduce the consumption of meat and eggs;
- Fish in the diet twice a week (for example, salmon, mackerel, herring);
- Use vegetable oils like canola oil, flaxseed 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 a day;
- 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 supplement 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 joint surfaces a lubricant is formed, the so-called synovial fluid, which reduces friction in the joint and provides nutrients to the cartilage.
Ideal movements in which the joint is not too stressed: swimming, cycling, Nordic walking and gymnastics.