Treatment methods for arthritis

Arthritis- a disease that develops over many years with the greatest damage to a particular joint.Painful changes often affect the large joints - knees, hips, shoulders, etc.Pain and difficulty moving in them make a person's life more complicated physically and emotionally, and because arthritis often occurs at a young age, it can interfere with the achievement of professional and personal goals.That is why it is important to diagnose the disease as soon as possible and start a comprehensive treatment of arthrosis.

Treatment of arthritis

At the initial stage of arthrosis, conservative methods are used that do not involve surgical intervention.Meanwhile, the corrective methods used can stop the development of the disease, maintain motor activity, reduce the severity of the main symptoms of osteoarthritis and generally improve a person's quality of life.

1. Drug treatment:
   • NSAIDs;
   • GCS;
   • chondroprotectors.
2. PRP therapy.
3. Therapeutic exercise.
4. Massage and manual therapy.
5. Traction therapy.
6. Physiotherapy.

Physiotherapy techniques widely used for arthritis:

• magnetic therapy;
• UHF;
• induction thermal;
• ultrasound therapy;
• balneotherapy;
• surgical treatment.

Drug treatment

It is widely believed among patients that drugs with an analgesic effect (orally in the form of tablets or injection - intramuscularly) are the most important means of relieving the pain of arthrosis.In fact, the use of medications is a method of rapid pain relief, which should only be prescribed in the acute period.The fact is that the drugs that are widely prescribed for these purposes have serious side effects, which increase with long-term use and especially with uncontrolled use.We are talking about undesirable effects from the digestive, cardiovascular, nervous systems, which could lead the patient to a hospital bed with a high probability (stomach bleeding, heart rhythm disturbances, effects on the liver and kidneys, etc.).

Nonsteroidal anti-inflammatory drugs

1. NSAIDs- non-steroidal anti-inflammatory drugs, many of which are available without a prescription and are widely accepted by patients on their own.This group includes drugs of different chemical structures.The drugs have a pronounced anti-inflammatory and analgesic effect, they can reduce pain in the joint area and nearby muscle tissue, but they do not affect the development of the disease.They are only used to reduce symptoms at all stages of the disease.Effective for concomitant synovitis (accumulation of fluid in the joint).

2. GKS- Glucocorticosteroid drugs have a strong anti-inflammatory and analgesic effect.Administering them periarticularly is advisable and effective.However, patients often have a negative attitude towards the use of these drugs in treatment, related to possible side effects: infectious complications, deterioration of the ligaments, articular surface, and cartilage degeneration.But with periarticular administration, the risk of these complications is minimal.

3. Chondroprotectors— substances are natural components of cartilage tissue, which, when taken orally, contribute to the gradual rehabilitation of cartilage, normalizing its density and elasticity.These active components are usually used in combination and are included in various medicines and auxiliary products.Chondroprotectors do not have a rapid analgesic effect;Improvement develops with the long-term use of drugs based on them, which involves partial restoration of cartilage tissue.Recommended at all stages of the disease.

PRP therapy

One of the most modern methods of restorative medicine, used for sports injuries and degenerative-dystrophic diseases of the joints, is PRP therapy (PRP - plasma rich in platelets) or plasma bio-revitalization, autoplasma therapy.The technique is actively used abroad.

The essence of the procedurecomposed of platelet-rich plasma that is injected directly into the site of injury, in this case the joint.The drug for administration is obtained from the patient's own blood, so this method is considered not only very 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 basic substances.

The resulting platelet-rich plasma is injected periarticularly and directly into the affected joint, thereby restoring part of the tissue, mainly cartilage.

The technique is applicable at 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 it has proven to be very effective.PRP therapy was first used in surgery;today the technique is used successfully in many fields of medicine, including rheumatology and orthopedics, neurology and cosmetology.Autoplasma therapy allows you to increase the life of the joint without any other aggressive interventions.

Synovial Fluid Protectors- a group of drugs based on hyaluronic acid, which is injected directly into the joint cavity (injection) and plays the role of a viscous lubricating fluid in a situation where natural synovial fluid is almost completely absent (this provides the role of lubrication of the articular surfaces).It is used in the later stages of arthritis.

Medicines in this group are also called "synovial fluid prostheses", "biological substitutes for synovial fluid".The effect after the administration of the drug is long-lasting - from 6 to 13 months, depending on the medication used.

Some of them belongother groups of drugs- antispasmodics, muscle relaxants, B vitamins in therapeutic (high) doses, but all of them have only auxiliary value in the treatment of arthritis.

Therapeutic exercise

Special therapeutic exercises can and should be used even during exacerbations, at all stages of arthrosis.Such measures can reduce pain and prevent serious restrictions on joint movement.However, the method is unpopular among patients with arthrosis, since most of them mistakenly believe that in case of pain it is necessary to limit any movements.On the contrary, the timely start of physical exercise promotes faster recovery and reduction of symptoms, mainly pain.

Physical therapy in water, joint movements in an unloaded position (lying, sitting, hanging), and moderate walking on a flat surface are particularly effective.If necessary, for example, in case of severe pain, a special bandage can be applied to the joint, but physical education should be started as soon as possible.

Massage and manual therapy

Methods of mechanical impact on the joint, muscles and ligaments can reduce the intensity 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 or medical sanatorium setting, traction therapy can be performed - this is the traction of the joint (hips, knees) using a special technique using different loads.The standard draw scheme is designed for 28 days, with a gradual increase in load and exposure time.Classic techniques are used and more modern ones that use simulators.Their effectiveness is almost the same, but the simulators are more comfortable for the patient.

Physiotherapy

The use of various physical therapy techniques in the early stages of arthrosis 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 techniques widely used for arthritis:

1. Magnetotherapy— 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 delivery of nutrients to the joint structures are increased, processes of regeneration and synthesis of the substances necessary for the functioning of the joint are activated.

   Magnetic therapy has anti-edematous, analgesic, anti-inflammatory effects 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 arthritis is the ability to do independent courses of magnetic therapy at home, as prescribed and under the supervision of the attending physician.The timely use of portable magnetic therapy devices allows you to stop pain from developing, worsening, or taking a preventive course - that is, maintaining 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 that most patients with chronic diseases (arterial hypertension, coronary heart disease, atherosclerosis, etc.) are middle-aged and elderly people, the mild sedative and stabilizing effect of magnetic therapy will be very useful.

2. Ultrasound therapymore often used in combination with the effects of drugs with anti-inflammatory, analgesic, restorative effects - ultraphonophoresis or phonophoresis.Ultrasound increases tissue permeability for drugs, thus enhancing their main effect.Even without a medicinal component, the method is very effective for arthrosis: ultrasound has a mechanical effect on tissue (micromassage), activates local immune and regeneration processes in the joint area and nearby muscles, and has a pronounced analgesic and anti-inflammatory effect.

3. Laser therapy– 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 results in improved local blood flow, activation of metabolism, removal of poorly oxidized metabolic products, and reduction in pain intensity.Laser therapy has a pronounced minimal systemic effect, due to its shallow depth of penetration, while improving the therapeutic effect of other procedures.

4. Shock wave therapy– high energy impact mode.It is based on the piezoelectric effect.By applying a piezoelectric discharge to a pathological focus, several effects are achieved.Non-viable cells are destroyed, resulting in the activation of local immunity.Hibernating (inactive) 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 to use it once every 4-7 days.

5. Diadynamic therapy– method of therapeutic effects on the body with diadynamic pulse currents.The diadynamic currents used in this method rhythmically stimulate skin receptors, which indirectly leads to the activation of descending physiological mechanisms to suppress pain and reduce the patient's pain, up to total analgesia.Therefore, such procedures are effective for severe pain.

6. Electromyostimulation– exposure to electrical current on muscle tissue.With arthrosis of the large joints, the work of the surrounding muscles is affected, which leads to atrophy of some and overloading of others.A gait disturbance develops.When exposed to an alternating electric current according to a special program, the muscles contract rhythmically, producing a certain amount of work, thus restoring their volume and function.

7. 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, 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.

8. Balneotherapy.In sanatorium holiday conditions, hydrotherapy is performed - medical baths, in which radon baths are especially effective for arthrosis.There is a general effect on the body of the radioactive decay products of radon dissolved in water.The most important effect is the activation of metabolic processes.

   A similar effect, although less pronounced, is characteristic of therapeutic muds (peloids), hydrogen sulphide and carbon dioxide baths.

Surgical treatment

Surgical techniques are used in the late stages of arthrosis, 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, making it possible to fully restore range of motion and return the patient to an active life at any age.

The attending physician determines the tactics and scope of the surgical intervention;The choice is based on parameters such as the patient's general condition, age and the presence of concomitant diseases, overweight and others.The best results after endoprosthetics were found in young and middle-aged patients (almost complete restoration of range of motion), but also in elderly people there is a significant improvement in their condition, since after a successful operation and recovery they can fully provide for themselves in daily life and move not only inside the apartment, but also go outside, without limiting themselves in communication.

Prevention

Arthrosis belongs to the group of diseases related to walking upright and develops mainly as a result of age-related changes in the joints, enhanced by the influence of negative external factors.By paying attention to the condition of the musculoskeletal system, preventing joint diseases and treating arthritis in the early stages, you can maintain physical activity and avoid massive medical intervention in the future.