Arthrosis is a painful change and deformity of the joints. Occurs when 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, ankles;
- The main signs are: pain during exercise, pain at the beginning of training (beginning of physical activity), decreased mobility, joint deformity, periods of exacerbation: swelling, redness, persistent pain;
- Diagnosis: physical examination, X-ray, computed tomography (CT) or magnetic resonance imaging (MRI);
- Treatment: exercise, hot or cold procedures, analgesics, intraarticular injections (hyaluronic acid, chondroitin sulfate), later stages - joint replacement (surgery);
- Caution: Many arthrosis do not need to be treated for long periods of time, but physiotherapy and prevention of exacerbations should be performed appropriately and, if necessary, pain syndrome should be stopped.
Osteoarthritis treatment methods
What helps with osteoarthritis or arthrosis? This is the main issue for most patients. Answer: There is still no treatment for arthrosis that can repair damaged cartilage.
Treatment of osteoarthritis can only relieve the symptoms of the condition. In addition, the treatment should prevent prolonged wear of the joints.
Because over time, the disease also makes its mark on the worn joint, damaging the joint capsule, bone and muscles.
Treatment of osteoarthritis involves conservative and surgical interventions. The treating physician selects the most appropriate methods for each patient. It assesses, among other things, which joints are affected, how severe the general wear and symptoms are.
Conservative treatment
Conservative osteoarthritis treatments aim to relieve pain, fight inflammation, and improve muscle strength and coordination. They play a huge role in physiotherapy procedures that are performed during both "worsening" periods of both exacerbation and symptoms.
Physiotherapy treatment
Various forms of physiotherapy can relieve the symptoms of osteoarthritis. These include:
- Physiotherapy;
- Manual therapy;
- heat therapy (non-acute stage);
- Cryotherapy (acute stage);
- Sports that benefit the joints include nordic walking, swimming and cycling;
- Water therapy and baths;
- Electrotherapy;
- Ultrasound therapy;
- Orthopedic appliances.
You can use heat from warm-ups, wraps, baths, or infrared light to treat chronic osteoarthritis pain. On the other hand, severe swelling and discomfort are relieved by cold treatments or compresses.
Physiotherapy is also useful in treating arthrosis because it strengthens muscles. Massage is also recommended: it relieves tension and improves blood circulation.
Joint movement during exercise
Regular exercise keeps your joints flexible. Therefore, people with osteoarthritis need to integrate sports and exercise into their daily lives. Swimming is a good example of this. It trains the joints without overloading them. For the same reason, it is recommended to walk and cycle on the plains.
Exercise can not only prevent but also slow down arthritis and reduce symptoms.
Sports that are sudden, with significant joint strain, extreme movement, or a high risk of injury are less suitable for osteoarthritis. These include tennis, ice skating, football, handball, karate and boxing.
Joint fixation
Bandages, elastic bandages, soft soles and crutches make the joints easier to function. Orthoses help in the same way. These are special support devices for the joints. They prevent painful movements. However, the orthoses are not very flexible and only need to be worn for a short time to prevent joint stiffness.
If the person is overweight, try to lose weight. This puts less strain on the joints. Regular exercise and a healthy diet will help you lose weight.
Medicines for the treatment of pain and inflammation
Painful joints in osteoarthritis can be rubbed with painkillers, creams or gels at the pharmacy.
Local anesthetics are used to relieve pain: they are injected into or around the joint.
Osteoarthritis (or arthrosis) is usually a non-inflammatory process. However, the inflammatory process is often associated with the tissue affected by osteoarthritis. Then they talk about osteoarthritis or activation of arthritis.
For treatment, your doctor will often prescribe non-steroidal anti-inflammatory drugs (NSAIDs). Glucocorticoids are also sometimes injected into the joint against inflammation.
Some patients receive hyaluronic acid or chondroitin sulfate in the joint due to osteoarthritis. These are glycosaminoglycans and natural components of synovial fluid. Hyaluronic acid is injected directly into the affected joint to restore its motility.
Surgery
Surgery can improve the problems of 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 better able to move after surgery.
Joint washing and treatment
In osteoarthritis, the affected joint is sometimes washed with saline. This is most often done with the knee joint, for example.
Rinsing the bursa removes damaged cartilage and tissue fibers as well as other particles floating in the synovial fluid. In addition, the procedure should alleviate the inflammation in the joint.
Reorganization involves the complex management of the joint capsule. The rough surfaces of the cartilage in the joint are removed using instruments. It also removes areas or tissues that may impede joint mobility. The acute pain resolves, at least temporarily, as a result of the treatment.
Joint treatment is done as part of arthroscopy. Surgical instruments are inserted into the joint through very small incisions.
Stimulation of cartilage growth
During arthroscopy, small injections are made of the remaining surface of the cartilage for therapeutic purposes. This should stimulate the formation of tissues to replace cartilage cells. However, this new cartilage tissue has a different structure than the original cartilage and does not fully meet the requirements for the joint.
During several years of the disease, cells can be implanted into the damaged joint in some cases.
Repair
Corrective osteotomy shifts the joint bones to distribute the load more evenly on the joint surfaces: some of the pressure is transferred from the osteoarthritis zone to the healthy cartilage and bone areas. In most cases, this type of treatment for osteoarthritis also involves improving the function of the joint sheath and ligaments to restore joint mobility.
Joint replacement
If the pain cannot be relieved by other treatments for osteoarthritis, 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 the case of arthrosis of the knee or hip joint.
Complex exchange is the last resort
Strictly speaking, worn joint tissues and joint surfaces are surgically removed and replaced with metal, plastic and ceramic prostheses (alloarthroplasty). There are prostheses that replace only parts of the joint, and there are some that replace the entire joint. It is fixed to the surface of the bone or with screws. With this method of treating osteoarthritis, it is possible to improve the condition of the joint if necessary.
After a while, all dentures may wear out. The timing of this depends on a number of factors: age, gender, clinical picture of arthrosis, infections, type of joint, and type of prosthesis.
Lightweight dentures need to be replaced more often. Wear of the prosthesis can be detected in time by regular X-rays.
Arthrodesis
Arthrodesis can help treat the pain of osteoarthritis. This is to strengthen the affected joint: it is more stable but also less agile. Thus, arthrodesis is usually performed only on joints in which lower mobility does not interfere with the patient's daily life. These include the joints of the fingers and toes, as well as the small joints of the wrist.
Resection
In this form of treatment for osteoarthritis, damaged joint bodies are removed without prosthesis and surgically repaired. However, resection arthroplasty is now rarely used.
This option may be considered for thumb arthrosis (rhizarthrosis), especially if conservative treatment of osteoarthritis has failed. One of the affected metacarpals is removed and replaced with the body’s own tendon tissue. The tendons of the long muscle of the thumb or the flexor flexor tendons are often used. This form of treatment for rhizarthrosis is not considered a standard method.
Resection joint surgery is also performed for big toe arthrosis or arthrosis between the collarbone and humerus.
Alternative treatment for osteoarthritis
What helps with osteoarthritis in addition to orthodox medical procedures? Many patients are interested in this issue. Treatment is intended to be supported by "natural", simple methods. Although the effectiveness of many alternative methods has not been scientifically proven, good relief of osteoarthritis is provided in some patients. Homeopathy, herbs, magnetic therapy, and acupuncture are widely used to relieve the symptoms of arthritis.
Salts and homeopathy
Patients with osteoarthritis often rely on these two alternatives: salts and homeopathic granules to relieve the symptoms of osteoarthritis. In addition, salt baths and compresses should also prevent arthritis. Proponents say 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.
Plant materials
For centuries, the treatment of osteoarthritis has also been based on herbs. These include African devil’s claws, nettles, rosehips, willows, dandelions, cayenne and rosehips. However, the symptoms of arthrosis are relieved if you use herbs for a long time. Your doctor or pharmacist will advise you on the exact use and dosage.
Magnetic field therapy
Magnetic therapy for arthrosis is designed to relieve pain, repair joints, and improve a patient’s quality of life. The magnetic field is created by a natural magnetic stone or electric coil.
Medical research has shown that magnetic therapy can be especially helpful for knee inflammation. But patients with chronic complaints (polyarthritis) with multiple joints are also beneficial. No side effects have been observed with this alternative treatment for osteoarthritis.
X-ray therapy
The goal of X-ray treatment of arthrosis is to inhibit inflammation and improve blood circulation. Irradiation should be performed at regular intervals and only very low doses should be used.
X-rays are used, for example, to treat rhizarthrosis and Heberden's osteoarthritis.
Acupuncture
Stimulation of certain points of the skin with acupuncture to re-normalize the disturbed processes in the body. Usually, the treatment process requires several sessions.
Acupuncture for the treatment of osteoarthritis is not widely accepted. However, some patients report that acupuncture may indeed help relieve inflammatory joint pain. Especially with combined wear on the knee structures, acupuncture can reduce chronic pain.
Osteoarthritis and nutrition
The link between arthritis and diet is often disputed: can an unfavorable diet contribute to the development of osteoarthritis? Do you need to change your diet because of osteoarthritis?
In general, certain foods do not cause osteoarthritis. However, the type of diet can actually affect the way it works: what matters is how much we eat and how the food is prepared.
Less calories
During weight gain, the load on the joints increases, resulting in faster wear. 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 huge effect on the joints. Being overweight is especially critical at a young age.
Therefore, the diet for osteoarthritis should be adjusted with calorie counting if the person is prone to being overweight. A healthy weight relieves the joints, relieves discomfort during the disease, and slows down the progress of change.
Less animal fat
Adequate diet for osteoarthritis means reducing the consumption of meat and other animal products. Cause: Inflammation develops more easily in osteoarthritis in damaged joints. Many metabolites mediate these inflammatory reactions in the body and are made from arachidonic acid (an omega-6 fatty acid). These are mainly products of animal origin.
Therefore, the diet for osteoarthritis should limit the use of arachidonic acid. Instead, you are more likely to eat foods that contain more omega-3 fatty acids because they inhibit inflammatory reactions. Omega-3 fatty acids are found, for example, in rapeseed and flaxseed oil, as well as in oily fish such as herring, mackerel and salmon.
Therefore, the following guidelines apply to a proper diet for arthritis:
- Reduce your consumption of meat and eggs;
- Twice a week fish in the diet (e. g. salmon, mackerel, herring);
- Use vegetable oils such as rapeseed oil, flaxseed oil, sunflower oil or olive oil;
- Eat a lot of fruits and vegetables;
- Whole grains and legumes are preferred;
- Drink at least 1. 5 liters of water or unsweetened tea daily;
- Calcium from low fat dairy products to strengthen bones
- Avoid caffeine, alcohol and nicotine.
Such a diet for arthrosis cannot replace other therapeutic measures, but can intelligently supplement them. This means that although diet does not cure osteoarthritis, it has a positive effect on the patient’s condition.
Move!
Despite the potential pain, "immobility" in the treatment of osteoarthritis is not a good idea - it actually speeds up the process of decay.
It is only during the work of the joint and the movement of the joint surfaces that a lubricant, called joint fluid, is formed, which reduces joint friction and supplies cartilage with nutrients.
Ideal movements where the joint is not overused: swimming, cycling, nordic walking and gymnastics.