Arthrosis is a painful change and deformation of the joints. It occurs when articular cartilage is irreparably damaged. With conservative treatment or surgery, the symptoms of joint wear can be significantly reduced.
- The following joints are most commonly affected: knee, hip, shoulder, spine, fingers and toes, ankle joints;
- The most important signs: pain on exertion, pain at the beginning of training (at the beginning of physical activity), decreased mobility, joint deformation, periods of exacerbation: swelling, redness, persistent pain;
- Diagnoses: physical examination, radiographs, computed tomography (CT) or magnetic resonance (MR);
- Treatment: exercises, heat or cold procedures, analgesics, intra-articular injections (hyaluronic acid, chondroitin sulfate), in the later stages - joint replacement (surgery);
- Attention: many arthrosis do not need to be treated for a long time, but physical therapy and the prevention of exacerbations must be sufficiently carried out and, if necessary, the painful syndrome must be interrupted.
Osteoarthritis Treatment Methods
What helps in osteoarthritis or arthrosis? For most patients, this is the main issue. Answer: There is still no treatment for osteoarthritis that can repair damaged cartilage.
Treatment for osteoarthritis can only alleviate the symptoms of the disease. Furthermore, treatment should prevent prolonged wear of the joints.
Because the disease also leaves its imprint on the worn-out joint over time, causing damage to the joint capsule, bone and muscle.
Treatment of osteoarthritis includes conservative and surgical procedures. The attending physician will select the most suitable methods for each patient. Among other things, it assesses which joints are affected, how severe the general wear and tear is, and how severe the symptoms are.
Conservative treatments for osteoarthritis are designed to relieve pain, fight inflammation, and increase muscle strength and coordination. A large role is attributed to physical therapy procedures, which are performed both during an exacerbation and during the "calm" periods of symptoms.
Various forms of physical therapy can alleviate the symptoms of osteoarthritis. These include:
- Manual therapy;
- Thermotherapy (not in the acute phase);
- Cryotherapy (in the acute phase);
- Play sports that are good for your joints, such as Nordic walking, swimming and cycling;
- Water therapy and baths;
- Ultrasound therapy;
- Orthopedic appliances.
To treat the chronic pain of osteoarthritis, you can use heat from heating treatments, wraps, baths or infrared light. On the other hand, severe swelling and discomfort are alleviated by cold treatments or compresses.
Physical therapy is also useful 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 joints flexible. Therefore, people with osteoarthritis should include sports and exercise in their daily life. Swimming is a good example. It trains the joints without straining them too much. For the same reason, it is recommended to walk on the plain and ride a bicycle.
Sports can not only prevent but also slow down osteoarthritis and reduce its symptoms.
Less suitable for osteoarthritis are sports with abrupt and significant joint stress, extreme movement, or a high risk of injury. This includes, for example, tennis, ice skating, football, handball, karate and boxing.
Bandages, elastic bandages, soft soles and crutches facilitate joint function. Orthotics help in the same way. These are special joint support devices. They avoid painful movements. However, orthotics are not very flexible and only need to be worn for a short period of time to prevent the joint from stiffening.
If the person is overweight, try to lose weight. Thus, the joints will withstand less stress. Regular exercise and a healthy diet help with weight loss.
Medicines to treat pain and inflammation
Sore joints with osteoarthritis can be rubbed with over-the-counter pain relievers, creams, or gels.
Local anesthetics are used for pain relief: they are injected into the joint or around the affected area.
Osteoarthritis (or osteoarthritis) is usually a non-inflammatory process. However, the inflammatory process often joins tissue affected by osteoarthritis. Then they talk about osteoarthritis or arthritis activation.
For treatment, the doctor often 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 can correct problems in patients with osteoarthritis and stabilize the joints. It also relieves pain and prevents inflammation. In some cases, damaged cartilage is replaced during surgery. Osteoarthritis patients are able to move better after surgery.
Washing and treating joints
In osteoarthritis, the affected joint is sometimes flushed with saline. This is most often done, for example, with the knee joint.
Bursa lavage removes damaged cartilage and tissue fibers, as well as other particles that float in the synovial fluid. In addition, the procedure should alleviate any existing inflammation in the joint.
Reorganization means a complex treatment of the joint capsule. The rough surfaces of cartilage in the joint are removed with instruments. It also removes areas or tissue that can impede joint mobility. Acute pain, at least temporarily, disappears as a result of treatment.
Joint treatment is performed as part of arthroscopy. Surgical instruments are inserted into the joint through very small incisions.
Stimulate cartilage growth
During arthroscopy, small injections of the remaining surface of the cartilage are made for therapeutic purposes. This should stimulate cartilage cells to form replacement tissue. However, this new cartilage tissue has a different structure than the original cartilage and does not fully meet the requirements of the joint.
For several years of the disease, in some cases, cells can also be transplanted into the damaged joint.
Corrective osteotomy repositions the articular bones for a more even distribution of load over the articular surfaces: part of the pressure is transferred from the osteoarthritic zone to healthy areas of cartilage and bone. In most cases, this type of treatment for osteoarthritis also includes improving the function of the joint capsule and ligaments to restore joint mobility.
If the pain cannot be relieved by any other treatment for osteoarthritis, joint replacement is possible. This means that the damaged gasket (or parts of it) is replaced with an artificial one. Basically, the operation is performed in case of arthrosis of the knee or hip joints.
Complex replacement is the last option
Strictly speaking, worn tissue and joint surfaces are surgically removed and replaced with metal, plastic and ceramic prostheses (alloarthroplasty). There are prostheses that only replace parts of the joint, and there are those that are used to replace the entire joint. They are fixed to the bone surface 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 denture can wear out. The moment at which this happens depends on several factors: age, sex, clinical presentation of arthrosis, infections, type of joint and type of prosthesis.
A lightweight prosthesis needs to be replaced more often. Prosthesis wear can be detected in a timely manner with regular radiographs.
Arthrodesis can help control the pain of osteoarthritis. This is a strengthening of the affected joint: it is more stable, but also less mobile. Thus, arthrodesis is usually only performed in joints where the least mobility does not interfere with the patient's daily life. This includes the finger and toe joints and the small wrist joints.
In this form of osteoarthritis treatment, the 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 (rizarthrosis), especially if conservative treatment of osteoarthritis has not been successful. One of the affected metacarpals is removed and replaced by the body's own tendon tissue. The tendons of the long muscle of the thumb or flexor flexor tendons are often used. This form of therapy for rhizarthrosis is not considered a standard method.
Resection arthroplasty is also performed for arthrosis of the big toe or arthrosis between the clavicle and humerus.
Alternative Treatment for Osteoarthritis
What helps with osteoarthritis other than orthodox medical procedures? This question is of interest to many patients. They want to support treatment with simple, "natural" methods. Although many alternative methods have not been scientifically proven to be effective, they are a good relief for osteoarthritis in some patients. Homeopathy, herbal medicine, magnetic therapy and acupuncture are widely used to alleviate the symptoms of arthritis.
Salts and homeopathy
In many cases, patients with osteoarthritis rely on these two alternatives: salts and homeopathic granules to alleviate the symptoms of osteoarthritis. Furthermore, salt baths and compresses should also prevent osteoarthritis. Proponents say both treatments have no side effects and are therefore suitable for self-medication.
Experts recommend using minerals in combination with an ointment or cream gel. Homeopathic remedies for osteoarthritis should be discussed with an experienced therapist.
For centuries, the treatment of osteoarthritis was also based on medicinal plants. These include African devil's claw, nettle, comfrey, willow, dandelion, cayenne, 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 usage and dosage.
magnetic field therapy
The treatment of arthrosis with magnetotherapy aims to relieve pain, restore joints and improve the patient's quality of life. The magnetic field is generated by a natural magnetic stone or an electrical coil.
Medical research has shown that magnetic therapy can be especially helpful for knee osteoarthritis. But patients with chronic complaints in multiple joints (polyarthritis) should also benefit. No side effects were seen with this alternative treatment for osteoarthritis.
X-ray treatment of osteoarthritis is designed to inhibit inflammation and improve blood circulation. Irradiation must be carried out 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.
Stimulation of certain skin points with acupuncture to normalize disturbed processes in the body again. Typically, 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 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 Diet for Osteoarthritis?
In general, some foods cannot cause osteoarthritis. However, the type of diet can really influence its course: what matters is how much we eat and how our meals are prepared.
As you gain weight, the load on your joints increases and, as a result, they wear out more quickly. Therefore, overweight people are at higher risk for osteoarthritis.
If osteoarthritis is already present, obesity contributes to combined wear and tear, especially in the knee.
Obesity has a big impact on joints. An excess of pounds at a young age is especially critical.
Therefore, nutrition for osteoarthritis should be adjusted by counting calories if the person tends to be overweight. A healthy body weight relieves 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. Why: 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 consume more 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 oily fish such as herring, mackerel and salmon.
Therefore, the following guidelines apply to a proper diet for arthritis:
- Reduce meat and egg consumption;
- Fish in the diet twice a week (eg salmon, mackerel, herring);
- Use vegetable oils such as canola oil, flaxseed oil, sunflower oil or olive oil;
- Eat lots of fruits and vegetables;
- Whole grains and pulses are preferred;
- Drink at least 1. 5 liters of water or unsweetened tea daily;
- Low-fat dairy calcium to strengthen bones
- Avoid caffeine, alcohol and nicotine.
Such an osteoarthritis diet cannot replace other therapeutic measures, but it can intelligently complement them. This means that while diet does not cure osteoarthritis, it does have a positive effect on the patient's condition.
Despite the possible pain, "immobility" in treating osteoarthritis is not a good idea - in fact, it speeds up the process of destruction.
Only during joint work and during movement of the joint surfaces is a lubricant, called synovial fluid, formed, which reduces friction in the joint and supplies nutrients to the cartilage.
Ideal movements where the joint is not too stressed: swimming, cycling, Nordic walking and gymnastics.