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 given that arthritis often occurs at a young age, it can interfere with achieving professional and personal goals.Therefore, it is important to diagnose the disease as soon as possible and start a comprehensive treatment of arthritis.
Treatment of arthritis
In the initial stage of arthritis, conservative methods are used that do not involve surgery.At the same time, the corrective methods used make it possible to stop the development of the disease, maintain motor function, reduce the severity of the main symptoms of arthritis and generally improve the quality of life of the individual.
- Medication:
- anti-inflammatory drugs;
- GCS;
- chondroprotectors.
- PRP treatment.
- Therapeutic training.
- Massage and hand treatment.
- Traction therapy.
- Physiotherapy.
Physiotherapy methods that are widely used for arthritis:
- magnetic therapy;
- UHF;
- inductothermy;
- ultrasound treatment;
- balneotherapy;
- surgery.
Treatment with drugs
It is widely believed among patients that taking pain-relieving drugs (orally in the form of tablets or by injection - into a muscle) is the most important method of relieving pain in arthritis.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 that are widely prescribed for this purpose have serious side effects that increase with long-term and especially uncontrolled use.We are talking about undesirable effects from the digestive system, the cardiovascular system, the nervous system, which with a high probability can lead the patient to a hospital bed (stomach bleeding, cardiac arrhythmias, effects on the liver and kidneys, etc.).
Nonsteroidal anti-inflammatory drugs
NSAID drugs- non-steroidal anti-inflammatory drugs, many of which are available without a prescription and are widely taken by patients on their own.This group includes drugs of various chemical structures.The drugs have a pronounced anti-inflammatory and analgesic effect, can reduce pain in the joints and adjacent muscle tissue, but do not affect the development of the disease.They are only used to relieve symptoms at all stages of the disease.Works with concomitant arthritis (fluid accumulation in the joints).
GKS- glucocorticoids have a strong anti-inflammatory and analgesic effect.It is advisable and effective to give them in stages.However, patients often have a negative attitude towards the use of these drugs in treatment, which is related to possible side effects: infectious diseases, atrophy of ligaments, joint surface and cartilage degeneration.But with transdermal delivery, the risk of these complications is minimal.
Chondroprotectors— substances are natural components of cartilage tissue, which, when taken orally, contribute to the gradual restoration of cartilage, normalizing its density and elasticity.These active ingredients are usually used in combination and are included in various medicines and supplements.Chondroprotectors do not have a quick analgesic effect;recovery develops with long-term use of drugs based on them, which is partially associated with the restoration of cartilage tissue.It is recommended at all stages of the disease.
PRP treatment
One of the modern methods of regenerative medicine, used for sports injuries and degenerative and muscular diseases of the joints, is PRP therapy (PRP - platelet-rich plasma) or plasma organic resuscitation, autoplasma therapy.The technology is actively used abroad.
The essence of the procedureinvolves 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 procedure is considered not only very effective but also safe for humans.Growth factors and other biologically active substances (serotonin, bradykinin, prostaglandin, etc.) contained in platelet-rich plasma contribute to the activation of regenerative processes and the formation of their own basic substances.
The resulting platelet-rich plasma is injected both extra-articularly and directly into the affected joint, so that tissue, mainly cartilage, is partially restored.
The technique is best suited for stages 1-2 osteoarthritis.Shows good results and allows you to delay the rapid development of the disease due to the release of growth factors by platelets.The method is relatively new but has proven to be very effective.PRP therapy was first used in surgery;today, the technology is successfully used in many areas of medicine, including rheumatology, orthopedics, neurology, and cosmetology.Carrying out autoplasma treatment allows you to increase the life of the joint without other aggressive interventions.
Synovial fluid shields- a group of drugs based on hyaluronic acid, which is injected directly into the joint cavity (injection) and acts as a viscous lubricating fluid when natural synovial fluid is almost completely absent (this is responsible for the lubrication of joint surfaces).Used in the later stages of arthritis.
Medicines in this group are also called 'synovitis', 'biological synovial fluid substitutes'.The effects after drug administration are long-lasting - from 6 to 13 months, depending on the drugs used.
Some applyother groups of drugs- anticonvulsants, muscle relaxants, B vitamins in therapeutic (high) doses, but all of them are only of secondary value in the treatment of arthritis.
Therapeutic training
Specific therapeutic exercises can and should be used even during exacerbations, at all stages of arthritis.Such measures can reduce pain and prevent severe limitations in joint movement.However, the method is unpopular among patients with arthritis, as most of them mistakenly believe that during pain it is necessary to limit all movements.Timely start of physical training, on the contrary, contributes to faster recovery and reduction of symptoms, primarily pain.
Especially effective are physical therapy in water, joint movements in unloading positions (lying, sitting, hanging) and moderate walking on a flat surface.If necessary, for example in the case of severe pain, a special bandage can be applied to the joint, but physical activity should be started as soon as possible.
Massage and hand treatment
Methods of mechanical impact on joints, 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 hospitals or sanatoriums, traction therapy can be performed - this is traction on the joints (hip, knee) with a special technique using various loads.A standard traction system is designed for 28 days, with a gradual increase in load and exposure time.Classic techniques are used and more modern ones are using simulators.Their effectiveness is almost the same, but the simulators are more comfortable for the patient.
Physiotherapy
The use of various physical therapy methods in the early stages of arthritis 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 methods that are widely used for arthritis:
Magnetic therapy— local exposure to constant or alternating low-frequency magnetic fields.In the area of the affected joint, metabolic processes are accelerated, blood circulation and transport of nutrients to the joint structures are increased, 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 devices of various modifications are used.
A great advantage for patients with arthritis is the ability to conduct independent courses of magnetic therapy at home, as prescribed and under the supervision of the doctor.Timely use of portable magnetic therapy devices allows you to stop the development of pain, the beginning of an aggravation or to carry out preventive courses - that is, to maintain normal health.
The positive side of magnetic therapy can also be called the positive effect of the procedures on the condition of the cardiovascular system and the nervous system.Taking into account the fact that most patients with arthritis are middle-aged and elderly with the existing group of chronic diseases (arterial hypertension, coronary artery disease, atherosclerosis, etc.), the mild sedative and stabilizing effect of magnetic therapy will be very useful.
Ultrasound therapyused more often together with the effect of drugs with anti-inflammatory, analgesic, rejuvenating effect - ultraphonophoresis or phonophoresis.Ultrasound increases tissue permeability to drugs, so their main effect increases.Even without a drug component, the method is very effective in arthritis: ultrasound has a mechanical effect on tissues (needle massage), activates local immune and regenerative processes in the joints and adjacent muscles, and has a pronounced analgesic and anti-inflammatory effect.
Laser treatment– one of the most common and widely used methods.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.Laser therapy, due to the shallow depth of penetration, has a minimally noticeable systemic effect, but increases the therapeutic effect of other procedures.
Shock wave therapy– energetic impact method.It is based on the piezoelectric effect.By applying piezoelectric discharge to the pathological focus, a number of effects are achieved.Non-viable cells are destroyed, leading to the activation of local immunity.Dormant (inactive) cells are stimulated, which promotes regeneration.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.
Diadynamic therapy- a method of therapeutic effect on the body with diadynamic pulse currents.Diadynamic currents used in this method rhythmically stimulate skin receptors, which indirectly leads to the activation of descending physiological mechanisms of analgesia and leads to a reduction of the patient's pain, up to complete analgesia.Therefore, such methods are effective for severe pain.
Electrical muscle stimulation- exposure to electric current on muscle tissue.With arthritis in large joints, the work of surrounding muscles is disturbed, leading to atrophy of some and overloading of others.Gait disturbances develop.When exposed to alternating current according to a specific program, the muscles contract rhythmically, producing a specific work that leads to the restoration of their volume and function.
Cryotherapy- a simple and effective treatment method, unfortunately rarely used.Local exposure to low temperature reduces the sensitivity of pain receptors and the formation of biologically active substances that stimulate the development of inflammation.After cryotherapy, reactive vasodilation occurs, local blood flow accelerates and a recovery process is activated.This method is particularly effective in combination with shock wave therapy.
Balneotherapy.In sanatoriums, hydrotherapy is carried out - medical baths, including radon baths are especially effective for arthritis.It 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, though less pronounced effect is characteristic of therapeutic muds (peloids), hydrogen sulphide and carbon dioxide baths.
Surgery
Surgery is used in the late stages of arthritis, when joint mobility is severely limited or absent, affecting the patient's quality of life.Around the world, various methods of joint replacement are used, which make it possible to completely restore mobility and return the patient to an active life at any age.
The methods and extent of surgery are determined by the attending physician;the choice is based on parameters such as the patient's general condition, age and presence of co-morbidities, excess weight and more.The best results after prosthetics were achieved in young and middle-aged patients (almost complete recovery of movement), but also in older people there is a significant improvement in their condition, since after a successful operation and recovery, they can fully envision themselves in everyday life and move not only inside the apartment, but also go out, without limiting themselves in communication.
Prevention
Arthritis belongs to the group of diseases of upright walking and develops mainly due to age-related changes in the joints, aggravated by the influence of external negative factors.Attention to the condition of the musculoskeletal system, prevention of joint diseases and treatment of arthritis in the early stages will allow you to maintain physical activity and avoid large-scale medical interventions in the future.