Arthritis- a disease that develops over many years with predominant damage to certain joints.Most often, painful changes affect large joints - knee, hip, shoulder, etc.Pain and difficulty moving in them complicates a person's life physically and emotionally, and since arthritis often occurs at a young age, it can affect the achievement of professional and personal goals.That is why it is important to diagnose the disease as early as possible and start comprehensive treatment of arthropathy.
Treatment of arthritis
In the initial stage of arthropathy, conservative methods are used that do not involve surgery.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 arthropathy and generally improve a person's quality of life.
- Drug treatment:
- NSAIDs?
- GCS?
- chondroprotectors.
- PRP treatment.
- Therapeutic exercise.
- Massage and manual therapy.
- Traction therapy.
- Physiotherapy.
Physiotherapy techniques widely used for arthropathy:
- magnetic therapy;
- UHF?
- induction heat?
- ultrasound therapy;
- spa therapy?
- surgical treatment.
Drug treatment
There is a widespread belief among patients that taking drugs with an analgesic effect (orally in the form of tablets or by injection - intramuscularly) is the most important method of pain relief in arthropathy.In fact, the use of drugs is a method of rapid pain relief, which should be prescribed only in the acute period.The fact is that the drugs widely prescribed for these purposes have serious side effects, which increase with long-term and especially with uncontrolled use.We are talking about adverse effects from the digestive, cardiovascular, nervous system, which with a high probability will lead the patient to a hospital bed (stomach bleeding, heart rhythm disorders, effects on the liver and kidneys, etc.).
Non-steroidal anti-inflammatory drugs
NSAIDs- non-steroidal anti-inflammatory drugs, many of them are available without a prescription and are widely taken by patients on their own.This group includes drugs of various chemical structures.Medicines have a strong 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 in all stages of the disease.Effective for concomitant arthritis (accumulation of fluid in the joint).
GS— Glucocorticosteroids have a strong anti-inflammatory and analgesic effect.It is appropriate and effective to administer peri-articularly.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 surface and cartilage degeneration.But with peri-articular administration, the risk of these complications is minimal.
Carboprotectors— 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 quick analgesic effect.improvement develops with long-term use of drugs based on them, which is associated with partial restoration of cartilage tissue.It is recommended in all stages of the disease.
PRP treatment
One of the most modern methods of restorative medicine, used for sports injuries and degenerative-dystrophic joint diseases, is PRP therapy (PRP - platelet-rich plasma) or plasma biorejuvenation, autoplasm therapy.The technique is actively used abroad.
The essence of the processconsists of injecting platelet-rich plasma directly into the site of injury, in this case the joint.The drug for administration is taken 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 peri-articularly and directly into the affected joint, thus achieving a partial restoration of the tissue, mainly the cartilage.
The technique is most applicable to stages 1-2 of osteoarthritis.It shows good results and allows you to delay the rapid development of the disease due to the release of growth factors from platelets.The method is relatively new, but it has proven to be highly 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 autoplasm therapy allows you to increase the life of the joint without other aggressive interventions.
Synovial fluid protectors- a group of drugs based on hyaluronic acid, which are injected directly into the joint cavity (injection) and play the role of a thick lubricating fluid in the event that the natural synovial fluid is almost completely absent (this is what provides the role of lubricating the articular surfaces).It is used in the last stages of arthrosis.
Medicines of this group are also called "synovial fluid prostheses", "biological synovial fluid substitutes".The effect after administration of the 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) doses, but all have only auxiliary value in the treatment of arthritis.
Therapeutic exercise
Special therapeutic exercises can and should be used even in an exacerbation, in all stages of arthritis.Such measures can reduce pain and prevent severe limitations in joint movement.However, the method is not popular among patients with arthropathy, as most of them mistakenly believe that in case of pain it is necessary to limit any movements.Early initiation of physical exercise, on the contrary, promotes faster recovery and reduction of symptoms, especially pain.
Particularly effective are physical therapy in the water, movements of the joints in an unloading position (lying, sitting, hanging) and moderate walking on a flat surface.If necessary, for example, in case of severe pain, a special bandage can be applied to the joint, but physical therapy 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 area of the affected joints, relieve muscle spasms and normalize muscle function.
Traction therapy
In a hospital environment or medical sanatorium, it is possible to carry out traction therapy - this is the traction of the joint (hip, knee) using a special technique using various loads.The typical pull-up plan is designed for 28 days, with a gradual increase in load and exposure time.Classical techniques and more modern ones using simulators are used.Their 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 arthritis can achieve significant pain relief and increased mobility in the affected joints.Physiotherapy classes help to slow down the pathological process and prolong the period without exacerbations.
Physiotherapy techniques widely used for arthropathy:
Magnetic therapy— local exposure to a constant or alternating low-frequency magnetic field.In the area of the affected joint, metabolic processes are accelerated, blood circulation and the supply of nutrients to the joint structures are increased, the processes of regeneration and synthesis of the same 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 huge advantage for patients with arthropathy is the possibility of conducting independent courses of magnetic therapy 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 occurrence of an exacerbation or carry out a preventive course - that is, to 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 the fact that most patients with arthropathy are middle-aged and elderly with an existing set of chronic diseases (arterial hypertension, coronary disease, atherosclerosis, etc.), the mild sedative and stabilizing effect of magnetic therapy will be very useful.
Ultrasound therapyit is most often used in combination with the effects of drugs with anti-inflammatory, analgesic, restorative effects - hyperphonophoresis or phonophoresis.Ultrasound increases the permeability of tissues for drugs, therefore their main effect is enhanced.Even without a medicinal component, the method is highly effective for arthropathy: 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 strong analgesic and anti-inflammatory effect.
Laser treatment– 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.Laser therapy, due to its small penetration depth, has a minimal systemic effect, while enhancing the therapeutic effect of other procedures.
Shock wave therapy– high energy influence method.It is based on the piezoelectric effect.By applying a piezoelectric discharge to a pathological focus, a number of effects are achieved.Non-viable cells are destroyed, which leads to the activation of local immunity.Dormant (dormant) 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 once every 4-7 days.
Cross-dynamic therapy– method of therapeutic effects on the body with transpotential pulsating currents.The transpotential currents used in this method rhythmically stimulate the skin receptors, which indirectly leads to the activation of cationic physiological mechanisms of pain suppression and leads to a reduction of the patient's pain, up to complete analgesia.Therefore, such procedures are effective for severe pain.
Electromyostimulation– exposure to electric current of the muscle tissue.With arthropathy of the large joints, the work of the surrounding muscles is disturbed, which leads to atrophy of some and overloading of others.Gait disorder develops.When exposed to an alternating electric current according to a special program, the muscles contract rhythmically, producing a certain work, which leads to the restoration of their volume and function.
Cryotherapy- a simple and effective method of treatment, 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, a 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.
Bath therapy.In sanatorium-resort conditions, hydrotherapy is carried out - medical baths, among which radon baths are especially effective for arthropathy.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, although less pronounced effect is characteristic of therapeutic mud baths (peloids), hydrogen sulfide and carbon dioxide.
Surgical treatment
Surgical techniques are used in the last stages of arthropathy, when joint mobility is severely limited or absent, which affects the patient's quality of life.Around the world, various methods of joint replacement are used, which make it possible to fully restore the range of motion and return the patient to an active life at any age.
The tactics and scope of surgery are determined by the attending physician.the choice is based on parameters such as the general condition of the patient, age and the presence of concomitant diseases, excess weight and others.The best results after endoprosthetics were achieved in young and middle-aged patients (almost complete restoration of the range of motion), but also in the elderly, a significant improvement in their condition is observed, since after a successful operation and recovery they can fully take care of themselves in everyday life and move not only inside the apartment, but also go out, without limiting communication.
Prevention
Arthropathy belongs to the group of diseases of upright walking and develops mainly as a result of age-related changes in the joints, enhanced by the influence of external negative factors.Attention to the condition of the musculoskeletal system, prevention of joint diseases and treatment of arthropathy in the initial stages allows you to maintain physical activity and avoid massive medical intervention in the future.