Treatment methods of arthrosis

Arthrosis- a disease that develops over many years and is associated with predominantly damage to certain joints.Painful changes most often affect large joints - knees, hips, shoulders, etc.Pain and movement difficulties make a person's life physically and emotionally difficult, and given that arthrosis often appears at a young age, it can hinder the achievement of professional and personal goals.Therefore, it is important to diagnose the disease as soon as possible and start comprehensive treatment of arthrosis.

Treatment of arthrosis

At the initial stage of arthrosis, conservative methods are used, which do not require surgical intervention.Meanwhile, the applied correction methods 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.

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

Physiotherapy techniques widely used for the treatment of arthrosis:

• magnet therapy;
• UHF;
• inductive heat;
• ultrasound therapy;
• balneotherapy;
• surgical treatment.

Drug treatment

There is a widespread belief among patients that taking pain-relieving drugs (orally, in the form of tablets or injections - intramuscularly) is the most important way to relieve pain in the case of arthrosis.In fact, the use of drugs is a way to quickly relieve pain, which should be prescribed only in the acute period.The fact is that the drugs that are widely prescribed for this purpose have serious side effects, which increase with long-term and especially uncontrolled use.We are talking about undesirable effects of the digestive system, the cardiovascular system, and the nervous system, which can most likely land the patient in a hospital bed (stomach bleeding, heart rhythm disorders, liver and kidney effects, etc.).

Nonsteroidal anti-inflammatory drugs

1. NSAIDs- nonsteroidal anti-inflammatory drugs, many of which are available without a prescription and are widely taken by patients on their own.This group includes drugs with different 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.It is used only to reduce symptoms in all stages of the disease.Effective in simultaneous synovitis (accumulation of fluid in the joint).

2. GKS— glucocorticosteroid drugs have strong anti-inflammatory and pain-relieving effects.It is advisable and effective to administer periarticularly.However, patients often have a negative attitude to the use of these drugs during treatment, which is associated with possible side effects: infectious complications, ligaments, joint surface, cartilage degeneration.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, normalize its density and elasticity.These active ingredients are usually used in combination and are included in various medicines and auxiliary products.Chondroprotectors do not have a rapid analgesic effect;improvement develops with the long-term use of drugs based on them, which is associated with the partial restoration of cartilage tissue.It is recommended in all stages of the disease.

PRP therapy

One of the most modern methods of restorative medicine used in the case of 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 medicine intended for administration is obtained from the patient's own blood, so the method is considered not only extremely effective, but also safe for humans.Growth factors and other biologically active substances (serotonin, bradykinin, prostaglandins, etc.) found in platelet-rich plasma contribute to the activation of regeneration processes and the synthesis of their own raw materials.

The platelet-rich plasma obtained in this way is injected periarticularly and directly into the affected joint, thereby achieving a partial restoration of the tissues, primarily the cartilage.

The technique is mostly used for osteoarthritis 1-2.can be used in sectionIt shows good results and allows delaying the rapid development of the disease due to the release of growth factors by platelets.The method is relatively new, but it has proven to be extremely 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.Carrying out autoplasma therapy allows you to increase the life of the joint without any other aggressive intervention.

Synovial fluid protectors- a group of hyaluronic acid-based drugs that are injected directly into the joint cavity (injection) and act as a viscous lubricating fluid in the event that the natural synovial fluid is almost completely absent (it provides the role of lubricating the joint surfaces).It is used in the later stages of arthrosis.

Medicines belonging to this group are also called "joint fluid prostheses", "joint fluid biological substitutes".After administration of the drugs, the effect lasts for a long time - 6-13 months, depending on the drug used.

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

Therapeutic practice

Special therapeutic exercises can and should be used even during exacerbations, at all stages of arthrosis.Such measures can reduce pain and prevent severe restrictions on joint movement.However, the method is not popular among arthrosis patients, as most people are mistaken in the belief that movement should be restricted in case of pain.On the contrary, starting exercise in time helps to heal faster and reduce symptoms, especially pain.

Physical therapy in water, joint movements in a stress-relieving 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 should be started as early as possible.

Massage and manual therapy

Mechanical effects on joints, muscles and ligaments can reduce the severity of pain, increase mobility, improve blood circulation and metabolism in the area of the affected joints, relieve muscle spasms, and normalize muscle function.

Traction therapy

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

Physiotherapy

The use of different physical therapy techniques in the initial stages of arthrosis can result in significant pain relief and increased mobility in the affected joints.Physiotherapy courses help to slow down the pathological process and prolong the period without aggravation.

Physiotherapy techniques widely used for the treatment of arthrosis:

1. Magnetotherapy— local exposure to permanent or alternating low-frequency magnetic fields.In the area of the affected joint, the metabolic processes are accelerated, the blood circulation and the delivery of nutrients to the joint structures are increased, the regeneration processes necessary for the functioning of the joint and the synthesis of its own substances are activated.

   Magnet therapy has an edema, pain-relieving, and anti-inflammatory effect almost from the first time, which positively affects the patient's general condition.Magnetic therapy is successfully used in hospitals and sanatoriums, where various modifications of medical equipment are used.

   A huge advantage for patients with arthrosis is that they can take independent magnetic therapy courses at home, according to the instructions and under the supervision of the attending physician.Timely use of portable magnetic therapy devices makes it possible to stop the development of pain, the development of exacerbation or to carry out a preventive course - that is, to maintain normal health.

   The beneficial effect of the procedures on the state of the cardiovascular system and nervous system can also be called a positive aspect of magnet therapy.Taking into account the fact that the majority of patients with arthrosis are middle-aged and elderly people who suffer from chronic diseases (arterial hypertension, coronary heart disease, atherosclerosis, etc.), the mild sedative and stabilizing effect of magnetic therapy will be very useful.

2. Ultrasound therapyit is more often used in combination with the effect of anti-inflammatory, pain-relieving, restorative drugs - ultraphonophoresis or phonophoresis.Ultrasound increases the permeability of tissues to drugs, thus enhancing their main effect.Even without a medical component, the method is extremely effective in the case of arthrosis: ultrasound has a mechanical effect on tissues (micromassage), activates local immune and regeneration processes in the joint area and adjacent muscles, and has a pronounced pain-relieving 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 hypooxidized metabolic products and reduction of pain intensity.Due to the small penetration depth of laser therapy, it has a minimal systemic effect, while enhancing the therapeutic effect of other procedures.

4. Shock wave therapy– a high-energy influencing method.This is based on the piezoelectric effect.Several effects can be achieved by applying piezoelectric discharge on the pathological focus.Viable cells die, which leads to the activation of local immunity.Hibernating (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– the method of therapeutic effect on the body with diadynamic pulse currents.The diadynamic currents used in this method rhythmically excite the skin receptors, which indirectly leads to the activation of the descending physiological mechanisms of analgesia and leads to a decrease in the patient's pain, up to complete analgesia.Therefore, such procedures are effective for severe pain.

6. Electromyostimulation– exposure to electrical current on muscle tissue.With arthrosis of the large joints, the work of the surrounding muscles is disrupted, which leads to atrophy of some and overloading of others.Traffic jam develops.Exposed to alternating electric current according to a special program, the muscles contract rhythmically, performing a certain amount of work, which leads to the restoration of their volume and function.

7. Cryotherapy- a simple and effective treatment method, unfortunately 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, 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 - spas, of which radon baths are particularly effective in 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 medicinal mud (peloids), hydrogen sulphide 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.Various joint replacement methods are used all over the world, which allow the complete restoration of the range of motion and the return of the patient to an active life at any age.

The tactics and scope of the surgical intervention are determined by the attending physician;the choice is based on parameters such as the patient's general condition, age and the presence of accompanying diseases, overweight and others.The best results after the endoprosthesis were achieved by young and middle-aged patients (almost complete restoration of the range of motion), but there is also a significant improvement in the elderly, since after a successful operation and recovery, they can fully support themselves in everyday life and can not only move inside the apartment, but also go out, without limiting themselves in communication.

Prevention

Arthrosis belongs to the group of diseases of straight walking and develops mainly as a result of age-related changes in the joints, which are exacerbated by external negative factors.Paying attention to the condition of the locomotor system, preventing joint diseases and treating arthrosis in the early stages makes it possible to maintain physical activity and avoid massive medical intervention in the future.