Osteoarthritis is a painful change and deformity of the joints. It occurs when joint cartilage is irreparably damaged. With conservative treatment or surgery, symptoms of joint wear can be significantly reduced.
Presentation of the disease
- The following joints are most commonly affected: knee, hip, shoulder, spine, fingers and toes, ankle joints;
- The most important signs: pain on exertion, pain at the start of training (at the start of physical activity), reduced mobility, deformation of the joints, periods of exacerbation: swelling, redness, persistent pain;
- Diagnosis: physical exam, x-rays, computed tomography (CT) or magnetic resonance imaging (MRI);
- Treatment: exercise, heat or cold procedures, pain relievers, intra-articular injections (hyaluronic acid, chondroitin sulfate), at later stages - joint replacement (surgery);
- Please note: many arthritis do not need to be treated in the long term, but physiotherapy and prevention of exacerbations should be carried out sufficiently, and if necessary, the pain syndrome should be stopped.
Methods of treating 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 for osteoarthritis can only alleviate the symptoms of the disease. In addition, treatment should prevent prolonged wear and tear on the joints.
Because the disease also leaves its mark on the worn joint 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, it assesses which joints are affected, the severity of general wear and tear, and the severity of symptoms.
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 symptoms.
Physiotherapy treatment
Various forms of physical therapy can relieve the symptoms of osteoarthritis. These include:
- Physiotherapy;
- Manual therapy;
- Thermotherapy (not in the acute stage);
- Cryotherapy (in the acute stage);
- Take part in sports that are good for the joints, such as Nordic walking, swimming and cycling;
- Aquatic therapy and baths;
- Electrotherapy;
- Ultrasound therapy;
- Orthopedic appliances.
To treat chronic osteoarthritis pain, you can use heat from heat treatments, compresses, baths, or infrared light. On the other hand, severe swelling and discomfort is alleviated by treatments or cold compresses.
Physiotherapy is also useful in the treatment of osteoarthritis 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 should include sports and exercise in their daily life. Swimming is a good example. It trains the joints without weighing them down too much. For the same reason, it is recommended to walk in the plain and to ride a bicycle.
Sport can not only prevent but also slow down osteoarthritis and reduce symptoms.
Sports with sudden and significant joint constraints, extreme movements or a high risk of injury are less suited to osteoarthritis. These include, for example, tennis, ice skating, football, handball, karate and boxing.
Joint fixation
Bandages, elastic bandages, soft soles and crutches facilitate the functioning of the joints. Orthotics help in the same way. These are special support devices for the joints. They prevent painful movements. However, orthotics are not very flexible and should only be worn for a short time to prevent the joint from stiffening.
If the person is overweight, try to lose weight. Thus, the joints will experience less stress. Regular exercise and a healthy diet help you lose weight.
Medicines to treat pain and inflammation
Painful joints with osteoarthritis can be rubbed with pain relieving ointments, creams or gels from the drugstore.
Local anesthetics are used to relieve pain: they are injected into the joint or around the affected area.
Osteoarthritis (or osteoarthritis) is generally a non-inflammatory process. However, the inflammatory process often reaches the tissue affected by osteoarthritis. Then they talk about osteoarthritis or activation of arthritis.
For treatment, a doctor often prescribes nonsteroidal anti-inflammatory drugs (NSAIDs). Sometimes glucocorticoids are also injected into the joint against the inflammation.
Some patients receive injections of hyaluronic acid or chondroitin sulfate inside the joint for osteoarthritis. They are glycosaminoglycans and natural components of synovial fluid. By injecting hyaluronic acid directly into the affected joint, its mobility is restored.
Surgery
Surgery can correct problems in patients with OA and stabilize the joints. It also relieves pain and prevents inflammation. In some cases, damaged cartilage is replaced during surgery. Patients with osteoarthritis may move better after surgery.
Washing and treatment of joints
In osteoarthritis, the affected joint is sometimes washed with saline solution. This is most often done, for example, with the knee joint.
Rinsing the bursa removes damaged cartilage and tissue fibers, as well as other particles floating in the synovial fluid. Additionally, the procedure should soothe any existing inflammation in the joint.
Reorganization means complex treatment of the joint capsule. Rough surfaces of cartilage in the joint are removed with the help of instruments. It also removes areas or tissues that can hamper the mobility of the joint. The acute pain, at least temporarily, goes away as a result of 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 tissue. 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 also be transplanted into the damaged joint.
Correction
The corrective osteotomy reposition the articular bones for a more homogeneous distribution of the load on the articular surfaces: part of the pressure is transferred from the osteoarthritis area to the healthy areas of the cartilage and bone. In most cases, this type of osteoarthritis treatment also includes improving the function of the joint capsule and ligaments to restore joint mobility.
Joint replacement
If the pain cannot be relieved by any other treatment for osteoarthritis, joint replacement is possible. This means that the damaged joint (or parts of it) is replaced with an artificial joint. Basically, the operation is performed in cases of osteoarthritis of the knee or hip joints.
Complex replacement is the last option
Strictly speaking, worn joint tissue and joint surfaces are surgically removed and replaced with metal, plastic and ceramic prostheses (alloarthroplasty). There are prostheses that only replace parts of the joint, and there are those that are used to replace the entire joint. They are fixed either to 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, each prosthesis can wear out. When this happens depends on a number of factors: age, gender, clinical picture of osteoarthritis, infections, type of joint and type of prosthesis.
A light prosthesis should be replaced more often. The wear of the prosthesis can be detected in time by a regular X-ray.
Arthrodesis
Arthrodesis can help manage the pain of osteoarthritis. This is a strengthening of the affected joint: it is more stable, but also less mobile. Thus, arthrodesis is generally only performed on joints whose 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, damaged joint bodies are surgically removed and reconstructed without prosthesis. 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 own tendon tissue. Often used are the tendons of the long thumb of the thumb or the flexor flexor tendons. This form of therapy for rhizarthrosis 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 in addition to orthodox medical procedures? This question is of interest to many patients. They want to support the treatment with "natural", simple methods. Although many alternative methods have not been scientifically proven to be effective, they are good relief for osteoarthritis in some patients. Homeopathy, Herbal Medicine, Magnetic Therapy, and Acupuncture are widely used to relieve symptoms of arthritis.
Salts and homeopathy
In many cases, patients with osteoarthritis rely on these two alternatives: salts and homeopathic granules to relieve symptoms of osteoarthritis. In addition, salt baths and compresses should also prevent osteoarthritis. Proponents say that both treatments have no side effects and are therefore suitable for self-medication.
Experts recommend using minerals in combination with an ointment or cream gel. Homeopathic remedies for osteoarthritis should be discussed with an experienced therapist.
Plant substances
For centuries, the treatment of osteoarthritis has also relied on medicinal plants. These include African devil's claw, nettle, comfrey, willow, dandelion, cayenne pepper, and rose hips. However, the symptoms of osteoarthritis improve if you use herbs for a long time. Your doctor or pharmacist will advise you on the exact use and dosage.
Magnetic field therapy
Magnetotherapy treatment for osteoarthritis is designed to relieve pain, restore joints and improve the patient's quality of life. The magnetic field is generated either by a natural magnetic stone or by an electric coil.
Medical research has shown that magnetic therapy can be particularly helpful for osteoarthritis of the knee. But patients with chronic disorders of several joints (polyarthritis) should also benefit. No side effects have been observed with this alternative treatment for osteoarthritis.
X-ray therapy
X-ray treatment for osteoarthritis is designed to inhibit inflammation and improve blood circulation. Irradiation should be carried out at regular intervals and only very low 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 in order to normalize again the disturbed processes in the body. Usually the course of treatment requires 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 combined wear and tear on the knee structures, acupuncture can reduce chronic pain.
Osteoarthritis and nutrition
The link between osteoarthritis and diet is often debated: can an unfavorable diet contribute to osteoarthritis? Should you change your diet for osteoarthritis?
In general, certain foods cannot be said to cause osteoarthritis. However, the type of diet can actually influence how it works: what matters is how much we eat and how our meals are prepared.
Less calories
As you gain weight, the load on your joints increases and, as a result, they wear out more quickly. Therefore, overweight people have a higher risk of osteoarthritis.
If osteoarthritis is already present, obesity contributes to combined wear and tear, especially in the knee area.
Obesity has a huge impact on the joints. Especially critical is excess kilograms at a young age.
Therefore, OA nutrition should be adjusted by counting calories if the person tends to be overweight. A healthy body weight relieves the joints, can ease discomfort during illness, and slow the progression of changes.
Less animal fat
Eating the right diet for osteoarthritis means reducing your intake of meat and other animal products. Reason: In damaged joints, inflammation develops more easily in osteoarthritis. Several metabolic products are involved in 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 should be more likely to eat foods that contain more omega-3 fatty acids because they inhibit inflammatory responses. Omega-3 fatty acids are found, for example, in canola 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 (for example, salmon, mackerel, herring);
- Use vegetable oils such as canola oil, flaxseed 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 diet does not cure osteoarthritis, it has a positive effect on the patient's condition.
Keep moving!
Despite the possible pain, "standing still" in the treatment of osteoarthritis is not a good idea - it actually speeds up the process of destruction.
It is only during the work of the joint and during the movement of joint surfaces that a lubricant, called synovial fluid, is formed, which reduces friction in the joint and supplies the cartilage with nutrients.
Ideal movements in which the joint is not strained too much: swimming, cycling, Nordic walking and gymnastics.