Treatment methods for arthrosis

arthrosis- a disease that develops over many years and causes dominant damage to certain joints.Most often, painful changes affect large joints (knee, hip, shoulder, etc.).Pain and difficulty moving complicate a person's life physically and emotionally and, given that arthrosis often occurs at a young age, can interfere with the achievement of professional and personal goals.Therefore, it is important to diagnose the disease as early as possible and begin comprehensive treatment of arthrosis.

arthrosis treatment

At the initial stage of arthrosis, conservative methods that do not require surgical intervention are used.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 person's quality of life.

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

Physiotherapy techniques commonly used in arthrosis:

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

Treatment with drugs

There is a widespread belief among patients that taking medications with an analgesic effect (orally in the form of tablets or by injection - intramuscularly) is the most important method of relieving pain in arthrosis.In fact, the use of medication is a quick method of pain relief that should only be prescribed in the acute phase.The fact is that drugs commonly prescribed for this purpose have serious side effects, which increase in the long term and especially with uncontrolled use.We are talking about undesirable effects (stomach bleeding, heart rhythm disturbances, effects on the liver and kidneys, etc.) that arise from the digestive, cardiovascular and nervous systems and can most likely lead the patient to a hospital bed.

Non-steroidal anti-inflammatory drugs

1. NSAIDs- non-steroidal anti-inflammatory drugs;Many of these are available without a prescription and are commonly taken by patients on their own.This group includes drugs of various chemical structures.Medicines 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.It is effective for accompanying synovitis (fluid accumulation in the joint).

2. GKS— glucocorticosteroid drugs have a strong anti-inflammatory and analgesic effect.Their periarticular application is recommended 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, disruption of ligaments, degeneration of the joint surface and cartilage.However, with periarticular application, the risk of this complication is minimal.

3. chondroprotectors— substances are natural components of cartilage tissue, which, when taken orally, contribute to the gradual regeneration of cartilage, normalizing its density and elasticity.These active ingredients are often used in combination and are included in various drugs and auxiliary products.Chondroprotectors do not have a rapid analgesic effect;Recovery improves with long-term use of drugs based on them, which is associated with partial restoration of cartilage tissue.It is recommended at all stages of the disease.

PRP treatment

One of the most modern methods of regenerative medicine used for sports injuries and degenerative-dystrophic diseases of the joints 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 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 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 their own essential substances.

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

This technique is most commonly used in stages 1-2 of osteoarthritis.It can be applied in stages.It gives 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 quite effective.PRP treatment was first used in surgeries;Today, the technique is successfully used in many fields of medicine, including rheumatology and orthopedics, neurology and cosmetology.The application of autoplasm therapy allows you to extend the life of the joint without other aggressive interventions.

Synovial Fluid Protectors- A group of drugs based on hyaluronic acid, which is injected directly into the joint cavity (injection) and plays the role of a viscous lubricating fluid in cases where the natural synovial fluid is almost completely absent (it is this that provides the role of lubrication of the joint surfaces).It is used in advanced stages of arthrosis.

Drugs in this group are also called "synovial fluid prostheses" or "biological substitutes of synovial fluid".The effect after administration of drugs is long-lasting, from 6 to 13 months, depending on the drug used.

Some are validother drug groups- antispasmodics, muscle relaxants, B vitamins in therapeutic (high) dosages, but they all 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 exacerbation.Such measures can reduce pain and prevent severe restrictions in joint movements.However, this method is not very popular among patients with arthrosis, since many are mistaken in the belief that in case of pain any movement should be limited.On the contrary, timely initiation of physical exercise ensures faster recovery and reduction of symptoms, especially pain.

Physical therapy in water, joint movements in the unloading position (lying, sitting, hanging) and moderate walking on a flat surface are especially effective.If necessary, for example, in case of 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 the joint, muscles and ligaments can reduce the severity of pain, increase mobility, improve blood circulation and metabolism in the affected joint area, relieve muscle spasms, normalize muscle function.

Traction therapy

It is possible to carry out traction therapy in a hospital setting or a medical sanatorium - 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.Its effectiveness is almost 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 significantly reduce pain and increase mobility in the affected joints.Physiotherapy courses help slow down the pathological process and prolong the period without exacerbations.

Physiotherapy techniques commonly used in arthrosis:

1. magnetotherapy- local exposure to a constant or alternating low-frequency magnetic field.Metabolic processes in the affected joint area are accelerated, blood circulation and the delivery of nutrients to the joint structures are increased, the processes of regeneration and synthesis of their own substances necessary for the functioning of the joint are activated.

   Magnetic therapy has antiedematous, 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 equipment of 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 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.Considering that most patients with arthrosis are middle-aged and elderly people with existing chronic diseases (arterial hypertension, coronary heart disease, atherosclerosis, etc.), the mild sedative and stabilizing effect of magnetic therapy will be very beneficial.

2. ultrasound therapyIt is more 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, thereby increasing their main effect.Even without a medical component, the method is quite 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 pathological process.This leads to improvement in local blood flow, activation of metabolism, removal of under-oxidized metabolic products and reduction of pain intensity.Laser therapy, due to its shallow depth of penetration, has a minimally pronounced systemic effect, while enhancing the therapeutic effect of other procedures.

4. shockwave therapy– high energy impact method.It is based on the piezoelectric effect.A number of effects are achieved by applying a piezoelectric discharge to a pathological focus.Non-viable cells are destroyed, which leads to activation of local immunity.Hibernating (inactive) cells are stimulated, which supports 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 that it is used every 4-7 days.

5. diadynamic therapy– method of creating a therapeutic effect on the body with diadynamic pulse currents.Diadynamic currents used in this method rhythmically stimulate skin receptors, which indirectly leads to the activation of reduced physiological mechanisms of pain suppression and leads to a decrease in the patient's pain up to complete analgesia.Therefore, such procedures are effective in severe pain.

6. Electromyostimulation– exposure to electrical 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 disturbance develops.When exposed to alternating electric current according to a special program, the muscles contract rhythmically, producing a certain amount of work, leading 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 temperature 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 is accelerated and healing processes are activated.This method is especially effective in combination with shockwave therapy.

8. balneotherapy.Hydrotherapy is carried out in sanatorium-resort conditions - medical baths, in which radon baths are especially effective for arthrosis.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, but 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, where joint mobility is severely restricted or absent and the patient's quality of life is negatively affected.Various joint replacement methods are used all over the world, allowing full range of motion to be restored and the patient to return 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, his age and the presence of concomitant diseases, excess weight and others.The best results after endoprosthesis were achieved in young and middle-aged patients (almost complete restoration of range of motion), but also in older people there is a significant improvement in their condition, since after a successful operation and recovery they can fully afford themselves in everyday life and go out not only in the apartment, but also without limiting themselves in communication.

Prevention

Arthrosis belongs to the group of upright walking diseases and develops as a result of age-related changes in the joints, which are aggravated mainly by the influence of external adverse factors.Paying attention to the condition of the musculoskeletal system, prevention of joint diseases and treatment of arthrosis in the early stages will allow you to maintain physical activity and avoid major medical interventions in the future.