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Osteoarthritis (osteoarthritis deformans) - is the most common Arthritis And is a chronic disease that affects the joints, articular cartilage, joint capsule, bone, muscle and ligaments. Thus cartilage hardens and loses its elasticity, whereby it is destroyed, and the sliding joint surfaces deteriorates. Cartilage may be thinner, resulting in a violation of their amortization functions during strikes.
The disease most often develops in the large joints of the human body - the knee, hip, spine and joints small joints of the hands, especially in the big toe. During joint disease may be deformed.
Osteoarthritis susceptible men and women, and hip joints often affects males and carpal and knee - in women. The disease progresses with age and can result in loss of efficiency.
The disease usually manifests itself in two forms. The most common Primary osteoarthritis Which develops after 45 years and has been steadily progressing over the years. Primary arthritis affects primarily hip and knee joints. The reasons for it are the excessive stress on joints.
Secondary osteoarthritis most often affects young people with recurring injuries or damage to the joints, as well as joint infection, congenital joints, metabolic disorders, obesity.
Osteoarthritis is caused by the fact that in cartilage metabolism is disturbed, leading to its gradual destruction. As a result of the initial damage to the joint cartilage degradation begins. It loses its elasticity, it formed microcracks That lead to the separation of cartilaginous fragments, up to the complete destruction of cartilage. This can lead to that the bone can begin to come into contact with each other while walking.
The reasons for the development of osteoarthritis, doctors and include:
- age, because age cartilage tends to lose elasticity;
- overweight, which can accelerate the process of destruction of cartilage;
- cartilage damage excessive loads - namely, injuries, fractures, dislocations, sprains ligament replacement unit, as well as regular joint microtrauma - dislocations, subluxations, for example, professional athletes and members of certain professions;
- intoxication organism as alcohol . smoking . viral infections It leads to the fact that the toxins accumulate in the cartilage;
- vascular disease - atherosclerosis. For example, if the walls of the arteries supplying the head and the hip joint bone struck atherosclerosis, this leads to disruption of the power head and the development of osteoarthritis;
- endocrine disorders - diabetes . hypothyroidism , Menopause;
- phlebeurysm tibia that results in venous stasis and tissue hypoxia, which promotes disruption of metabolic processes in the joints;
- hereditary weakness of cartilage, resulting in some form of osteoarthritis occur in families.
Symptoms of Osteoarthritis
The main symptom of osteoarthritis is pain in the affected joint, which increases when walking. First pain occurs periodically, after stress, and disappears at rest, but if the disease is not treated, the pain becomes constant, even with minimal activity. Patients describe the pain as it " aching ".
If osteoarthritis amazed knee joints , The pain occurs when the knee is bent, for example, when descending the stairs. In osteoarthritis hips most often observed hip pain, but can also disturb and pain in the groin, buttocks.
Initial Osteoarthritis of the spine It causes pain in the neck and in the lumbar region. Pain intensity varies depending on changes in the weather and atmospheric pressure. Over time, this can all lead to reduced mobility of the joint, stiffness of movements can occur " joint blockade "When the pieces fall between the cartilage surfaces of the joint, which is accompanied by severe pain and limitation of motion. Frequently observed krepitsiya joint - Crunching and crackling can be confusing when driving, the cause of which is the friction of the articular surfaces of bones.
There may also be symptoms of osteoarthritis, such as the joint stiffness and increased pain when they bend, typically lasting up to 15 minutes, especially after a period of immobility, such as in the morning after sleep long sitting, or after a period of increased activity. Relief comes after a physical workout.
Also, the joint can change the appearance - increase in volume, there may be a rise in temperature of the joint, its redness. The joint fluid may accumulate due to the constant irritation of the synovial membrane (the inner layer of the joint capsule).
One and the most difficult complications of osteoarthritis is the appearance of bony protuberances in the joints of hands, is more common in women after the age of 40 years. These growths can be painful, and may not be accompanied by painful sensations, and then people will continue to lead an active life.
Often secondary osteoarthritis may be asymptomatic, even when X-rays show changes in the joint.
Diagnosis of osteoarthritis
The diagnosis can be made on the basis of survey data, and examination of the patient, as well as the results of laboratory tests. In addition, the patient is usually prescribed X-rays and ultrasound joint.
The doctor will be interested injuries that cause the symptoms of osteoarthritis in the joint, the way of life. Inspection will focus on careful study of the appearance of disturbing joints.
Also appointed by X-ray examination of joints, as It can help you see the changes that accompany osteoarthritis, for example, the proliferation of marginal bone, joint space narrowing. X-rays It shows how seriously damaged joints. To estimate the thickness of the articular cartilage, the state of the joint capsule and tissue around the joint and detect inflammation in them, carried ultrasound joints. As an additional diagnosis of osteoarthritis, to confirm the diagnosis may be carried out artrotsentez - Arthrocentesis or Magnetic resonance imaging .
Special laboratory tests for the detection of osteoarthritis does not exist. Due to the absence of inflammatory changes, blood test is usually carried out in order to rule out other forms of arthritis, such as rheumatoid arthritis . gout .
Treatment of osteoarthritis
Underlying osteoarthritis are measures to protect the joints from the impact of the factors that contribute to the progression of the disease. Unfortunately, at present there is no drug that could restore the articular cartilage.
The goals of treatment are:
- reduction in joint pain;
- improving the functioning of the joint, increasing its mobility;
- reduce the risk of disease progression;
- work with the patient to ensure that he has learned to cope with the disease, avoid prolonged standing on his feet, long distance, lifting and carrying, sports, contributing to increased stress on the joints.
The goal of drug therapy is to eliminate the symptoms of the disease, namely the reduction in pain and improvement in joint cartilage. To reduce the pain, doctors prescribe painkillers and non-steroidal anti-inflammatory agents.
For moderate pain use Ksefokam ( lornoxicam ) Ibuprofen . Ortophenum ( Voltaren ) meloxicam ( movalis ) Surgut State University . Nimesulide . paracetamol . Tylenol . Appointed as local drugs with analgesic and anti-inflammatory action. These creams, gels or sprays - finalgon . Kapsikam . Fastum gel . indovazin . feloran applied to the joint of 2-3 times per day.
If the pain is severe appoint diclofenac ( diklonat ). In their application need to be careful, because these drugs have side effects, such as prolonged use of paracetamol may increase blood pressure. Nonsteroidal anti-inflammatory agents negative effect on the gastrointestinal tract and can lead to inflammation of the gastric mucosa, to the development of stomach ulcers, renal failure. To improve the blood supply to the joint elements are also appointed by cardiovascular drugs, for example, agapurin . trental . ksantinola nicotinate .
At the initial stage of osteoarthritis drugs are also used to help improve the condition of the cartilage - chondroprotectors , eg, chondroitin sulfate and glucosamine sulfate . diacerein . hyaluronic acid . With their constant admission, patients may experience improved joint mobility, as is introduced into the body material for cartilage repair. These drugs are slow, so you need to take them for a long time.
For improvement a slip joint and to relieve the inflammation, your doctor may prescribe, and intra-articular injection glucocorticoid . Kenalogum . diprospana . solution of sodium hyaluronate . At the same time introduced painkillers - eg Lidocaine . This treatment acts very quickly, which leads to the fact that patients are beginning to use it, however, this method does not cure the disease, but only removes the symptoms of osteoarthritis. Also, frequent use of this method can result in damage to the cartilage and bone. So often you can not use this method.
With a high degree of joint disease, which is accompanied by a sharp restriction of mobility in severe pain syndrome that does not respond to medical treatment, prescribe total joint replacement - Joint replacement with a mechanical prosthesis. In most cases, this operation is carried out on the hip and knee joints. After this operation, the patient can increase their physical activity. It may also be carried out arthroplasty - Plastic surgery on the joint to restore or correct function of joints by replacing the joint surfaces of artificial materials.
In secondary osteoarthritis is appointed as Sanitary and spa treatment osteoarthritis. The resort can be carried out a comprehensive rehabilitation, which includes mud , Physical therapy, physiotherapy, baths and massage. For physiotherapy treatments include ultraviolet irradiation, electrophoresis , Alternating magnetic field. Also useful are various heat treatments, application of ozocerite, peat and silt mud. The beneficial effects have medicated bath , namely sea . Sulphide and bromine .
To strengthen the muscles around the joints are used electrostimulation . Positively affect the course of the disease a permanent stay in the fresh air and the absence of stress. However, such treatment is indicated outside the period of exacerbation.
It is very important to change your lifestyle, weight control, and be sure to give yourself exercise. Special exercises will help shape around the joint strong muscular corset and sufficient blood circulation throughout the limb. At home, in front of sports activities can be applied to painful joints a heating pad or a special warming lamp . It is important not supercool joints.
Prevention of osteoarthritis
Disease prevention is aimed at reducing the load on the joints, ie to avoid the factors that increase the likelihood of developing the disease.
It is important to monitor their weight, to organize meals and have regular exercise. In sports you need to be careful and to use possible means of protection, for example, Knee . Physical activities help to reduce pain, increase mobility and strengthen muscles.
The most favorable for patients with osteoarthritis are three types of physical activity - exercises to increase joint mobility, exercises to increase mobility of the muscles and dynamic exercises.
It is recommended to sail at least 2 times a week. It is advisable not to choose the sports that are dangerous for the joints - such as football, tennis, athletics, especially if a family history of the disease osteoarthritis. Avoid prolonged walking, finding on his knees, stair climbing, jogging undesirable.
Damage to the joints in youth increases the risk of osteoarthritis in old age, so prevention is the prevention of osteoarthritis of injuries can cause disease. For injuries of the joints must be an emergency their treatment under medical supervision, and osteoarthritis is recommended to take a comprehensive medical examination at least 2 times a year.
Osteoarthritis affects the internal organs do not, however, progresses without proper early treatment, the disease can significantly impair quality of life, bring human suffering, but also lead to the loss of their ability to work.
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