Osteoarthritis is a painful change and deformation of the joints. It occurs when the articular cartilage is irreparably damaged. With conservative treatment or surgery, the symptoms of joint wear can be significantly reduced.
Overview of the disease
- The following joints are most commonly affected: knee, hip, shoulder, spine, fingers and toes, ankle joints;
- The most important signs: pain during exertion, pain at the beginning of training (at the beginning of physical activity), decreased mobility, deformation of the joints, periods of exacerbation: swelling, redness, persistent pain;
- Diagnostics: physical examination, x-rays, computed tomography (CT), or magnetic resonance imaging (MRI);
- Treatment: exercise, hot or cold procedures, pain relievers, intra-articular injections (hyaluronic acid, chondroitin sulfate), in the later stages - joint replacement (surgery);
- Attention: many osteoarthritis do not need to be treated for a long time, but physiotherapy and prevention of exacerbations should be sufficiently carried out, and if necessary, the pain syndrome should be stopped.
Methods of treatment of osteoarthritis
What helps with osteoarthritis or osteoarthritis? For most patients, this is the main question. Answer: There is still no treatment for osteoarthritis that can repair damaged cartilage.
Treatment of osteoarthritis can only relieve the symptoms of the condition. In addition, the treatment should prevent prolonged wear on the joints.
Because the disease also leaves its mark on the joint worn over time, causing damage to the joint capsule, bones and muscles.
Treatment of osteoarthritis includes conservative and surgical procedures. The attending physician will select the most appropriate methods for each patient. Among other things, evaluate which joints are affected, how severe the general wear is and how severe the symptoms are.
Conservative treatment
Conservative treatments for osteoarthritis are designed to relieve pain, fight inflammation, and improve muscle strength and coordination. A huge role is assigned to physiotherapeutic procedures, which are carried out both during an exacerbation and during periods of "calm" of the symptoms.
Physiotherapy treatment
Various forms of physical therapy can relieve the symptoms of osteoarthritis. These include:
- Physiotherapy;
- Manual therapy;
- Thermotherapy (not in the acute phase);
- Cryotherapy (in the acute stage);
- Doing sports that are good for the joints, such as Nordic walking, swimming and cycling
- Hydrotherapy and baths;
- Electrotherapy;
- Ultrasound therapy;
- Orthopedic appliances.
To treat the chronic pain of osteoarthritis, you can use the heat of warming treatments, wraps, baths, or infrared light. On the other hand, severe swelling and discomfort is mitigated by cold treatments or compresses.
Physical therapy is also useful in treating osteoarthritis because it strengthens the muscles. Massage is also recommended - relieves tension and improves blood circulation.
Joint movement during exercise
Regular exercise keeps your joints flexible. Therefore, people with osteoarthritis should include sports and exercise in their daily life. Swimming is a good example. Train your joints without putting too much weight on them. For the same reason it is advisable to walk on the plains and to ride a bicycle.
Sport can not only prevent, but also slow down osteoarthritis and reduce symptoms.
Less suitable for osteoarthritis are sports with sudden and significant joint stress, extreme movement, or a high risk of injury. These include, for example, tennis, ice skating, soccer, handball, karate and boxing.
Joint fixation
Bandages, elastic bandages, soft soles and crutches facilitate the functioning of the joints. Orthoses help in the same way. These are special support devices for the joints. They prevent painful movements. However, orthoses are not very flexible and only need to be worn for a short time to prevent the joint from stiffening.
If the person is overweight, he tries to lose weight. Therefore, the joints will bear less stress. Regular exercise and a healthy diet help in weight loss.
Medicines to treat pain and inflammation
Painful joints with osteoarthritis can be rubbed with pain relieving ointments, creams or gels at the pharmacy.
Local anesthetics are used to relieve pain: 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 the tissue affected by osteoarthritis. Then they talk about osteoarthritis or activation of arthritis.
For treatment, a doctor often prescribes non-steroidal anti-inflammatory drugs (NSAIDs). Sometimes glucocorticoids are also injected into the joint against inflammation.
Some patients receive injections of hyaluronic acid or chondroitin sulfate inside the joint for osteoarthritis. These are glycosaminoglycans and natural components of the synovial fluid. By injecting hyaluronic acid directly into the affected joint, its mobility is restored.
Surgery
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. Patients with osteoarthritis are able to move better after surgery.
Joint washing and treatment
In osteoarthritis, the affected joint is sometimes washed with saline. This is most often done, for example, with the knee joint.
Washing the bursa removes damaged cartilage and tissue fibers, as well as other particles that float in the synovial fluid. Additionally, the procedure should soothe any existing inflammation in the joint.
Reorganization means a complex treatment of the joint capsule. The rough surfaces of the cartilage in the joint are removed using tools. It also removes areas or tissues that can hinder the mobility of the joint. Acute pain, at least temporarily, disappears following treatment.
Joint treatment is performed as part of arthroscopy. Surgical instruments are inserted into the joint through very small incisions.
Stimulate the growth of cartilage
During arthroscopy, small injections of the remaining surface of the cartilage are made for therapeutic purposes. This should stimulate the cartilage cells to form replacement tissues. However, this new cartilage tissue has a different structure than the original cartilage and does not fully meet the requirements of the joint.
During several years of the disease, in some cases, cells can even be transplanted into the damaged joint.
Correction
The corrective osteotomy repositions the joint bones for a more even distribution of the load on the joint surfaces: part of the pressure is transferred from the arthritic area to the healthy areas of the cartilage and bone. In most cases, this type of osteoarthritis treatment also includes improving the functioning of the joint capsule and ligaments to restore joint mobility.
Joint replacement
If pain cannot be relieved by any other osteoarthritis treatment, joint replacement is possible. This means that the damaged joint (or parts of it) is replaced with an artificial one. Basically, the operation is performed in case of osteoarthritis of the knee or hip joints.
Complex replacement is the last option
Strictly speaking, worn joint tissues and joint surfaces are surgically removed and replaced with metal, plastic and ceramic implants (alloarthroplasty). There are prostheses that only replace parts of the joint and there are those that serve to replace the entire joint. They are fixed on the surface of the bone or with screws. With this method of treating osteoarthritis, it is possible, if necessary, to correct the position of the joint.
After a while, any prosthesis can wear out. The timing of this depends on various factors: age, sex, clinical picture of osteoarthritis, infections, type of joint and type of prosthesis.
A lightweight prosthesis needs to be replaced more often. The wear of the prosthesis can be detected promptly with a regular X-ray.
arthrodesis
Arthrodesis can help manage the pain of osteoarthritis. It is a strengthening of the affected joint: it is more stable, but also less mobile. Therefore, arthrodesis is usually performed only on joints where reduced mobility does not interfere with the patient's daily life. These include the joints of the fingers and toes and the small joints of the wrist.
Resection
In this form of osteoarthritis treatment, the damaged joint bodies are removed and surgically reconstructed without prosthetics. However, resection arthroplasty is rarely used today.
This option may be considered for osteoarthritis of the thumb (rhizarthrosis), especially if conservative treatment of osteoarthritis has not been successful. One of the affected metacarpals is removed and replaced with the body's tendon tissue. The tendons of the long muscle of the thumb or the flexor flexor tendons are often used. This form of rhizarthrosis therapy is not considered a standard method.
Resection arthroplasty is also performed for osteoarthritis of the big toe or osteoarthritis between the collarbone and the humerus.
Alternative treatment for osteoarthritis
What helps with osteoarthritis besides orthodox medical procedures? This question interests many patients. They want to support treatment with "natural", simple methods. While many alternative methods have not been scientifically proven to be effective, they are good relief for osteoarthritis in some patients. Homeopathy, herbal medicine, magnetotherapy and acupuncture are widely used to relieve the symptoms of arthritis.
Salts and homeopathy
In many cases, patients with osteoarthritis rely on these two alternatives: homeopathic salts and granules to relieve the symptoms of osteoarthritis. In addition, salt baths and compresses should also prevent osteoarthritis. Proponents claim that both treatments have no side effects and are therefore suitable for self-medication.
Experts recommend the use of minerals in combination with an ointment or cream gel. Homeopathic remedies for osteoarthritis should be discussed with an experienced therapist.
Vegetable substances
For centuries, the treatment of osteoarthritis has also been based on medicinal plants. These include African devil's claw, nettle, comfrey, willow, dandelion, cayenne, and rosehip. However, the symptoms of osteoarthritis improve if the herbs are used for a long period of time. Your doctor or pharmacist will advise you on the exact use and dosage.
Magnetic field therapy
The treatment of osteoarthritis with magnetotherapy is designed to relieve pain, restore joints and improve the patient's quality of life. The magnetic field is generated by a natural magnetic stone or by an electric coil.
Medical research has shown that magnetotherapy can be particularly useful for knee osteoarthritis. But patients with chronic multi-joint disorders (polyarthritis) should also benefit. No side effects have been observed with this alternative osteoarthritis treatment.
X-ray therapy
X-ray treatment of osteoarthritis is designed to inhibit inflammation and improve blood circulation. Irradiation should be done 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.
Acupuncture
Stimulation of certain points of the skin with acupuncture to normalize the disturbed processes in the body again. Usually, the course of treatment takes 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 and tear 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 be said to cause osteoarthritis. However, the type of diet can actually affect its course - what matters is how much we eat and how our meals are prepared.
Less calories
As you gain weight, the load on the joints increases, and as a result, they wear out faster. Therefore, overweight people have a higher risk of osteoarthritis.
If osteoarthritis is already present, obesity contributes to combined wear, especially in the knee.
Obesity has a huge impact on the joints. An excess of kilograms at a young age is especially critical.
Therefore, nutrition for osteoarthritis should be regulated by calorie counting if the person tends to be overweight. A healthy body weight relieves the joints, can relieve discomfort during illness, and slow the progression of changes.
Less animal fat
A proper diet for osteoarthritis means reducing the intake of meat and other animal products. Reason: In damaged joints, inflammation develops more easily in osteoarthritis. Several metabolic products mediate these inflammatory reactions in the body and are made up of arachidonic acid (an omega-6 fatty acid). These are mainly products of animal origin.
Therefore, the osteoarthritis diet should limit the use of arachidonic acid. Instead, you should be more likely to consume foods with more omega-3 fatty acids because they inhibit inflammatory responses. Omega-3 fatty acids are found, for example, in rapeseed and flaxseed oils and in fatty fish such as herring, mackerel and salmon.
Therefore, the following guidelines apply to an appropriate diet for arthritis:
- Reduce the consumption of meat and eggs;
- Fish in the diet twice a week (e. g. salmon, mackerel, herring);
- Use vegetable oils such as canola oil, linseed oil, sunflower oil, or olive oil;
- Eat lots of fruits and vegetables;
- Whole grains and legumes are preferred;
- Drink at least 1. 5 liters of water or unsweetened tea per day;
- Calcium from low-fat dairy products to strengthen bones
- Avoid caffeine, alcohol, and nicotine.
Such a diet for osteoarthritis cannot replace other therapeutic measures, but it can intelligently supplement them. This means that although the diet does not cure osteoarthritis, it has a positive effect on the patient's condition.
Keep moving!
Despite the possible pain, "stillness" in treating osteoarthritis is not a good idea - it actually speeds up the process of destruction.
Only during the work of the joint and during the movement of the joint surfaces is a lubricant formed, the so-called synovial fluid, which reduces friction in the joint and supplies the cartilage with nutrients.
Ideal movements in which the joint is not too stressed: swimming, cycling, Nordic walking and gymnastics.