Methods of treatment for arthrosis

Arthrosis- a disease that develops over many years with primary damage to certain joints.Often, painful changes affect large joints - knees, hips, shoulders, etc.Pain and difficulty moving in it complicates a person's life physically and emotionally, and given the fact that arthrosis often occurs at a young age, it can interfere with the achievement of professional and personal goals.That is why it is important to diagnose the disease as early as possible and start a comprehensive treatment of arthrosis.

Treatment of arthrosis

In the early stages of arthrosis, conservative methods are used that do not involve surgical intervention.Meanwhile, the corrective methods used make it possible to stop the progression of the disease, maintain motor activity, reduce the severity of the main symptoms of arthrosis and generally improve a person's quality of life.

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

Physiotherapy techniques are widely used for arthrosis:

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

Treatment with drugs

There is a widespread belief among patients that taking drugs with an analgesic effect (orally in the form of tablets or injections - intramuscularly) is the most important method to relieve pain in arthrosis.In fact, the use of drugs is a method of quick pain relief, 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 with uncontrolled use.We are talking about the undesirable effects of the digestive, cardiovascular, nervous system, which with a high probability can lead the patient to a hospital bed (abdominal bleeding, heart rhythm disorders, effects on the liver and kidneys, etc.).

Nonsteroidal anti-inflammatory drugs

1. NSAIDs- non-steroidal anti-inflammatory drugs, most of which are available without a prescription and are widely taken by patients themselves.This group includes drugs of various chemical structures.Medicines have a clear 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.Effective for concomitant synovitis (accumulation of fluid in the joint).

2. GKS— glucocorticosteroid drugs have strong anti-inflammatory and analgesic effects.It is advisable and effective to administer it periarticularly.However, patients often have a negative attitude towards the use of these drugs in treatment, which is associated with possible side effects: infectious complications, deterioration of ligaments, articular surfaces, and cartilage degeneration.But with periarticular administration, the risk of these complications is minimal.

3. Chondroprotectors— the substance is a natural component of cartilage tissue, which, when taken orally, contributes to the gradual restoration of cartilage, normalizing its density and elasticity.These active components are usually used in combination and are included in various medicines and supplement products.Chondroprotectors do not have a quick analgesic effect;improvement develops with long-term use of drugs based on them, which is associated with partial restoration of cartilage tissue.Recommended at all stages of the disease.

PRP therapy

One of the most modern rehabilitation medical methods, used for sports injuries and degenerative-dystrophic diseases of the joints, is PRP therapy (PRP - platelet-rich plasma) or plasma biorevitalization, autoplasma therapy.Teknik ini digunakan secara aktif di luar negara.

The essence of the procedureconsists 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 very 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 the regeneration process and the synthesis of their own basic substances.

The resulting platelet-rich plasma is injected periarticularly and directly into the affected joint, thereby achieving partial tissue recovery, especially cartilage.

This technique is best used in stage 1-2 osteoarthritis.Shows good results and allows you to slow down the rapid development of the disease due to the release of growth factors by platelets.This method is relatively new, but has proven to be very effective.PRP therapy was first used in surgery;today this technique is successfully used in many fields 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 Protector- 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 when the natural synovial fluid is almost completely absent (this is what provides the role of lubricating the articular surface).Used in the final stage of arthrosis.

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

Some are applyingother drug groups- antispasmodic, muscle relaxant, B vitamins in therapeutic (high) doses, but all of them have only additional value in the treatment of arthrosis.

Therapeutic exercise

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 in joint movement.However, this method is not popular among patients with arthrosis, because most of them are mistaken in the belief that in case of pain it is necessary to limit any movement.Timely initiation of physical training, on the other hand, promotes faster recovery and reduction of symptoms, especially pain.

Especially effective is physical therapy in water, joint movement in unloading positions (lying, sitting, hanging), and moderate walking on a flat surface.If necessary, for example, in cases of severe pain, special bandages can be applied to the joints, but physical education should be started as early as possible.

Massage and manual therapy

Methods of mechanical impact on joints, muscles and ligaments can reduce the severity of pain, improve mobility, improve blood circulation and metabolism in the affected joint area, relieve muscle spasms, and normalize muscle function.

Attraction therapy

In the conditions of a hospital or medical sanatorium, it is possible to carry out traction therapy - this is the traction of the joints (hips, knees) using special techniques using various loads.The standard grip scheme is designed for 28 days, with a gradual increase in load and exposure time.Classical and more modern techniques using simulators are used.Their effectiveness is almost the same, but the simulator is more comfortable for the patient.

Physiotherapy

The use of various physical therapy techniques in the early stages of arthrosis can achieve significant pain relief and increased mobility in the affected joints.Physiotherapy courses help to slow down the pathological process and prolong the period without exacerbation.

Physiotherapy techniques are widely used for arthrosis:

1. Magnetotherapy— localized exposure to continuous or intermittent low-frequency magnetic fields.In the affected joint area, metabolic processes are accelerated, blood circulation and delivery of nutrients to the joint structure increases, regeneration processes and the synthesis of own substances necessary for the functioning of the joint are activated.

   Magnetic therapy has an anti-edematous, analgesic, anti-inflammatory effect 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 big advantage for arthrosis patients is the ability to conduct an independent course of magnetic therapy at home, as prescribed and under the supervision of the attending physician.The timely use of a portable magnetic therapy device allows you to stop pain, the beginning of an aggravation, or to carry out a preventive course - that is, to maintain normal health.

   The positive aspects of magnetic therapy can also be called the beneficial effect of the procedure on the state of the cardiovascular and nervous systems.Taking into account the fact that most patients with arthrosis are middle-aged and elderly people with an existing set of chronic diseases (arterial hypertension, coronary heart disease, atherosclerosis, etc.), the mild sedative and stabilizing effect of magnetic therapy will be very useful.

2. Ultrasound therapyused more often in combination with the effects of drugs with anti-inflammatory, analgesic, restorative effects - ultraphonophoresis or phonophoresis.Ultrasound increases tissue permeability for drugs, so its main effect is enhanced.Even without a medical component, this method is very effective for arthrosis: ultrasound has a mechanical effect on tissue (micromassage), activates local immune and regenerative processes in the joint area and adjacent muscles, and has a clear 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 an increase in local blood flow, activation of metabolism, removal of less oxidized metabolic products, and a decrease in pain intensity.Laser therapy, due to its shallow penetration depth, has a significant systemic effect, while enhancing the therapeutic effect of other procedures.

4. Shock wave therapy– high energy methods of influence.It is based on the piezoelectric effect.By applying piezoelectric discharge to the pathological focus, several effects are achieved.Non-viable cells are destroyed, which leads to the activation of local immunity.Hibernating (inactive) cells are stimulated, which promotes the regeneration process.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 once every 4-7 days.

5. Diadynamic therapy– method of therapeutic effect on the body with diadynamic pulse current.The diadynamic current used in this method rhythmically stimulates the skin receptors, which indirectly leads to the activation of physiological mechanisms of decreased pain suppression and leads to a reduction of the patient's pain, until complete analgesia.Therefore, such a procedure is effective for severe pain.

6. Electromyostimulation– exposure to electric current in muscle tissue.With arthrosis of large joints, the work of the surrounding muscles is disturbed, which leads to atrophy of some and overloading of others.A progressive gait disorder.When exposed to alternating electric currents according to a special program, the muscles contract rhythmically, producing a certain amount of work, which leads to the recovery of their volume and function.

7. Cryotherapy- simple and effective treatment methods, unfortunately, are rarely used.Local exposure to low temperatures 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 is accelerated, and the recovery process is activated.This method is especially effective in combination with shock wave therapy.

8. Balneotherapy.In sanatorium-resort conditions, hydrotherapy is carried out - medicinal baths, among which radon baths are especially effective for arthrosis.There is a general effect on the body of radioactive decay products of radon dissolved in water.The most important effect is the activation of metabolic processes.

   A similar effect, although less pronounced, is characteristic of therapeutic mud (peloids), hydrogen sulfide and carbon dioxide baths.

Surgical treatment

Surgical techniques are used in the final stages of arthrosis, when joint mobility is very limited or absent, which affects the patient's quality of life.All over the world, various methods of joint replacement are used, which make it possible to fully restore a wide range of motion and return patients 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 patient's general condition, age and the presence of concomitant diseases, overweight and others.The best results after endoprosthetics are obtained in young and middle-aged patients (almost complete recovery of various movements), but also in older people there is a significant improvement in their condition, because after the operation and successful recovery they can fully provide for themselves in everyday life and move not only in the apartment, but also go outside, without limiting themselves in communication.

Prevention

Arthrosis belongs to the group of upright walking diseases and develops mainly as a result of age-related changes in the joints, enhanced by the influence of external negative factors.Attention to the state of the musculoskeletal system, prevention of joint diseases and treatment of arthrosis in the early stages allows you to maintain physical activity and avoid massive medical interventions in the future.