Arthrosis - symptoms

• One of the earliest symptoms of osteoarthritis is joint pain. At the beginning of the disease at rest, it is practically absent, but appears with a load on the joint. Most often, osteoarthritis affects the knee (gonarthrosis) and hip (coxarthrosis) joints.
• Dry and rough crunch in the affected joints is another symptom of arthrosis, it occurs when the worn articular surfaces are rubbed, in the second and third stages the crunch becomes clearer and louder.
• Next symptom arthrosis - a violation of joint mobility, a gradual reduction in the amplitude of movement associated with muscle spasms, a decrease in the joint space and the appearance of osteophytes (bone growths, spikes).
• Symptoms of deforming arthrosis (osteoarthritis) are a modification of the affected joints, deformation of the joint tissue and articulating bones, the development of osteophytes, "bursting" with a large volume of synovial fluid that presses on the joint from the inside.

Pain in arthrosis differs from pain in arthritis mainly in that in the first case, pain occurs during movement and mainly during the day, and in the second case, it does not depend on movement and usually occurs at night. Arthritis pain is more acute and intense.

Causes of arthrosis

One of the causes of arthrosis leading to the disease is aging of chondrocytes, cartilage cells. Gradually, the total amount of cartilage in the joint may decrease, especially noticeable with the approach of old age, as well as after injuries, post-traumatic inflammation, professional constant stress on certain joints (for example, in football players and agricultural workers).

Causes of arthrosis:

• arthrosis as a consequence of trauma, - post-traumatic arthrosis;
• flat feet;
• sports loads, weight transfer, - loaders, weightlifters, football players, ballet dancers are at risk;
• arthrosis can be caused endocrine diseases, for example, diabetes mellitus;
• One of the most common causes of arthrosis and arthritis is infectious and viral diseases.

Arthrosis - treatment

The treatment of arthrosis largely depends on which joint is affected and at what stage of the disease it is. Apply anti-inflammatory drugs, physiotherapy, intra-articular oxygen therapy (saturation of the joint with oxygen), intraosseous blockade. It is also possible to treat arthrosis in sanatoriums in favorable climatic conditions with the use of mineral waters and mud. Massage can help with osteoarthritis of the knee lower extremities, but at the same time, direct exposure to the diseased joint should be avoided, as this can increase the inflammatory reaction in it.

Treatment of arthrosis should take into account the causes of the disease: if there is excess weight, then it is necessary to adjust the diet; if the cause is endocrine disorders (in diabetes), then treat the underlying disease. Be sure to adjust physical exercise on the joints: for example, replace football with swimming.

Preparations for the treatment of arthrosis of the joint

To decline pain syndrome and inflammatory processes, the doctor usually immediately after the diagnosis prescribes the "gold standard" in the treatment of arthrosis - non-steroidal anti-inflammatory drugs, or NSAIDs. As a rule, they are administered intravenously or intramuscularly, so as not to irritate the gastric mucosa and get faster healing effect. Local application of these agents (ointments and gels) can only be considered as an addition to the treatment of arthrosis, since their effectiveness is extremely low.

During periods of exacerbation of arthrosis, hormonal corticosteroids are used - hydrocortisone, kenalog or diprospan intraarticularly. Additionally, local capsacin, an alkaloid, is sometimes used. hot pepper- in the form of a patch, ointment or alcohol tincture.

The drugs listed above relieve pain and inflammation, that is, the symptoms of arthrosis. Treatment must be supplemented with chondroprotective preparations that nourish the tissues of the joint and start the process of cartilage restoration.

Chondroprotectors for arthrosis

Chondroprotectors used for arthrosis are, as a rule, biologically active additives. They contain substances that promote the restoration of cartilage and improve the quality of synovial fluid. These include chondroitin sulfate and glucosamine. Their feature is a long course of reception until the first effect is obtained. The problem lies in the low degree of digestibility of these drugs. Although there are also dietary supplements that are not inferior in their effectiveness to chondroprotectors in injections. It is these effective dietary supplements that will be discussed below.

• Chondromarin - chondroprotector, restores the cartilaginous tissue of the joint. It is a source of plastic materials (glucosamine, chondroitin sulfate, soluble collagen, amino acids and trace elements). Due to the oligonucleotides in its composition, it reduces inflammation and pain.
• Chondromarin Cryptos - activates the work of osteoblasts, starts the mechanism of active self-renewal of cartilage tissue.

Despite the fact that these drugs are registered as dietary supplements, they distinguishing feature and the advantage over other chondroprotectors is that the drugs are in capsules, but the active substances are not destroyed in gastrointestinal tract, a (thanks to Axis technology) flow through the bloodstream to the joint as if the drug had been injected.

Axis technology made it possible to endow biologically active substances with a very important property for biocorrection: the ability to penetrate biological barriers, while being "invisible" to immune system and "non-toxic" to the whole organism.

Plastic materials (glucosamine, chondroitin sulfate, soluble collagen, amino acids and trace elements) contained in Chondromarin are in their natural state, which ensures efficient absorption. All these substances, thanks to Axis technology, are delivered directly to the cells of the body. Those cells that need this plastic and mineral material absorb it or convert it into an energy source. The protein-mineral complex of salmon cartilage contains the necessary components for the restoration of the collagen matrix and the formation of a cartilage structure from it, is able to support and direct recovery processes in the right direction.

A disease in which there is a progressive destruction of the cartilage of the joint is called arthrosis. Destructive changes affect both the bone and the joint capsule. Rheumatoid arthrosis is a pathology that develops against the background of rheumatoid arthritis.

A distinctive feature of the disease is slow destruction, almost imperceptible to the patient. The peculiarity of the morphology is the degenerative processes occurring in the cartilaginous zones. They can manifest themselves under the influence of external and internal harmful influences.

Varieties of rheumatoid arthritis

There are several varieties of rheumatoid arthrosis in accordance with the reasons for its appearance:

• primary arthrosis. The form of the disease is due to the aging process in the human body, the presence of any stage of obesity, as well as a predisposition on the part of genes.
• Secondary. The disease occurs after an injury. The etiology of joint inflammation in the knee may be a previous fracture.
• Generalized form (polyarticular, polyarthrosis) - a type of arthrosis, characterized by numerous damage to the joints.
• deforming form. Deforming osteoarthritis is characterized by severe destruction and hyperplastic transformations of the articular ends of the bone. Clinically, the disease is caused by severe pain, a pronounced change in the shape of the joints and an aggravated functional disorder. The knee joint and the hip joint are more susceptible to pathological changes, which makes it possible to determine the presence of gonarthrosis and coxarthrosis.
• Uncovertebral form - deforming osteoarthritis, additionally formed between the processes on the posterolateral planes of the cervical vertebrae. It is characterized by symptoms of shoulder or cervical neuritis and other neurological pathology.

Stages of arthrosis

According to the clinical picture and the processes of the development of the disease, four stages of rheumatoid arthrosis can be distinguished.

• First stage. Early stage of arthrosis. It is characterized by a latent course, due to negative changes in the structure of the synovial fluid and weakening of the muscle fibers.
• Second stage. Pain appears due to the destruction of the bone joint, reflex neurotrophic regulation is interrupted, and a barely audible crunch is observed.
• Third stage. The course of the disease is due to serious degeneration of the joint. A visible deformity is formed with the curvature of the axis of the entire limb, shortening of the ligaments occurs, and the joint itself acquires unnatural mobility.
• Fourth stage. Complete immobility, limited passive movements in the joint, severe pain at rest. At all stages, both spontaneous relapses and periods of remission of symptoms are possible.

Soreness in the first stage of arthrosis, if it occurs, then during physical activity

The reasons

The disease can manifest itself both in one joint and cover several. Rarely, this pathology develops at a young age, since the natural forces of the body are enough for tissue regeneration. Any age corresponds to certain causes that have a negative impact to one degree or another: external (caused by damage), internal (bad habits, poor nutrition, certain diseases).

Causes of an internal nature, entailing negative changes in the joint, are manifested by inflammation of the joint. Inflammation can be of different etiology, caused by the following pathologies: psoriasis, gout, purulent arthritis, autoimmune inflammation, rheumatoid arthritis.

The causes of internal exposure include congenital or acquired disorders of the structure of cartilage tissue, not proper nutrition which can help:

• Genetic interruptions and anomalies.
• Anomalies in the development of the fetus. This also includes perinatal injuries.
• Advanced age.
• Diseases caused due to muscle weakness.
• Prolonged intoxication internal exposure.
• Insufficient amount of vitamins and minerals entering the body.
• Metabolic disorder.
• Disorder of the hormonal sphere, menopause.

The recurrence of most bone diseases also leads to cartilage degeneration.

To external factors diseases include:

• Fracture.
• Multiple cooling of the body.
• Dislocation.
• Operations on the joint.
• Serious load on the body (weight lifting).
• Sports training.
• heavy blows.

Osteoarthritis is most often the result of arthritis.

Symptoms of rheumatoid arthritis

Clinical manifestations of rheumatoid arthrosis are somewhat similar to the clinic of arthritis. The patient notes the occurrence pain, loss of passive movements in the damaged part of the body. Arthrosis may be the basis for the occurrence of an inflammatory epicenter in the joint. In the morning, stiffness in the limbs is observed, the temperature can rise to subfebrile numbers, which is why the patient experiences weakness.

Arthrosis causes swelling and swelling of the affected areas. Damage is uniform, leading to a change in the shape of the limbs. For rheumatoid osteoarthritis, a manifestation of general intoxication of the body is characteristic. Symptoms of rheumatoid arthritis include leg pain, stiffness, and swelling.

Soreness is manifested by attacks, at first the duration of each of them is short, in the future it increases. Observation of an impressive number of patients showed that the disease does not completely affect the limb, the processes of destruction, changes in shape are located on a certain area.

Diagnostics

To make a diagnosis of osteoarthritis, it is enough to conduct an X-ray examination. On the radiograph, it is noticeable whether the gap between the joints is narrowing, whether there are damage to the bone tissue, namely osteophytes. But not every time the image on the radiograph is correlated with the current signs of the disease.

And with a strongly pronounced pain syndrome in the joint, the changes can be mildly expressed. In the reverse order - with severe destruction of the joint, the patient may not complain of pain. The final diagnosis is made based on the results of the examination, complaints, examination results and the history of the disease. Other studies are possible if necessary.

Ultrasound of the joints allows you to find out the presence and volume of fluid in the joint cavity, examine the cartilage and bone tissue around the joint, which is impossible with an X-ray examination. Arthroscopy is an indication for carrying out when combining joint damage and arthrosis, it is used to conduct a biopsy of the joint. With a typical course of arthrosis, they are performed less frequently than others.

MRI is considered the most accurate way to see even small changes in the joint. Holding differential diagnosis with rheumatoid arthritis is necessary due to the presence of the same symptoms. Arthrosis differs from rheumatoid arthritis by short stiffness in the morning, which lasts no more than an hour, the absence of rheumatoid factor in the blood test, and the presence of marginal erosions.

Treatment

The treatment of patients with rheumatoid arthrosis combines various combinations of medicinal and non medicinal methods. Therapeutic tactics are set to fulfill the following goals: the damaged joint should not be loaded with work, the removal of pain and synovitis, and the prevention of the development of the disease.

Treatment without medication

Non-drug therapies include:

• Physiotherapy.
• Maintain normal body weight.
• Use of orthoses (knee protection, orthopedic insoles).
• Physiotherapy procedures.
• Acupuncture.
• Massage.

With the low effectiveness of these methods, medications are prescribed.

Medical therapy

Remedies for rheumatoid arthritis can be divided into 3 groups, which are discussed below.

Painkillers

NSAIDs (non-steroidal anti-inflammatory drugs): Ketorolac, Nimesulide. It is prescribed to patients in the absence of a reaction to Paracetomol. Medicines are prescribed in tablet form, orally or as a cream, ointment. It also includes opioid painkillers (Tramadol). Used for a short period of time when NSAIDs are not effective.

Symptomatic drug for the treatment of joints fast action(Paracetamol)

Symptomatic delayed action drugs

These include: hyaluronic acid, Hyalgan Phidias. These drugs favor the reduction of joint pain, reduce the amount of NSAIDs and are well accepted by the patient. The analgesic effect remains for two months after the end of therapy.

Drugs that change cartilage composition

Glucosamine sulfate. Participates in the production of mucopolysaccharides. Input medicinal product activates the production of glycosaminoglycans and proteoglycans in cartilage. Chondroitin sulfate is a component of the cartilage matrix. The drug enters the matrix and affects the metabolic processes.

When reactive synovitis begins in rheumatoid arthritis, it is necessary to treat it with intra-articular glucocorticosteroids with a slow release and an extended duration of action (Hydcortisone).

Prevention of arthrosis

AT preventive measures Movement and physical activity will be important. They cannot be based on lifting heavy weights, heavy loads on the joint. Normal skiing, light running, swimming are most suitable. With frequent movement, microcirculation increases blood flow and oxygen supply improves. The main preventive method is to protect the joints from cold and damage.

Women need to change their heels to more comfortable and comfortable shoes. Prevention of arthrosis will also be a refusal to sit on a chair, throwing one leg over the other. After a hard day, the legs should take a few minutes before going to bed to do a lying exercise that imitates cycling. It will relieve tension in the joints in a short period of time.

Water aerobics is a great way to lose weight, relieve overwork of the joints.

Examinations for preventive purposes will be important - at least once a year

The most important

The property of rheumatoid arthrosis is sluggish destruction processes, almost invisible to the patient. To reduce the risk of pathology, it is necessary not to forget about great opportunity the appearance of joint disease, monitor all negative changes in the state of health, consult a doctor at the right time. Healthy rest and sleep, proper nutrition, clean air, excellent mood, adherence to the daily routine - the key to joint health.

review of drugs for the treatment of osteoarthritis and rheumatoid arthritis

Roza Ismailovna Yagudina, d. farm. n., prof., head. department of organization drug supply and pharmacoeconomics and head. Laboratory of Pharmacoeconomic Research of the First Moscow State Medical University named after A.I. I. M. Sechenov.

Evgenia Evgenievna Arinina, Candidate of Medical Sciences, Leading Researcher, Laboratory of Pharmacoeconomic Research, First Moscow State Medical University. I. M. Sechenov.

Joint lesions are widespread in all age groups, especially in the older ones. The cause of arthralgia may be various diseases, which is sometimes difficult to differentiate. Today we will talk about the two most common joint pathologies, namely osteoarthritis of the joints and rheumatoid arthritis.

Etiology and course of osteoarthritis

Osteoarthritis (OA) is a chronic degenerative-dystrophic disease of the joints, which is based on a violation of the processes of synthesis and degradation of the articular cartilage matrix, while the pathological process, as a rule, involves all structures of the joint. There are several reasons for the development of osteoarthritis. The most common is mechanical damage to the articular surfaces associated with prolonged static load on the joint, as well as a violation of regional hemodynamics. The most significant risk factors for the development of osteoarthritis (OA) are female gender and elderly age sick. Also at risk are athletes, people with obesity, and those whose activities are associated with a long stay on their feet.

There are primary (idiopathic) and secondary OA. The etiology of primary OA is still unknown. The causes of secondary OA are joint and bone dysplasia, trauma, metabolic diseases (ochronosis, hemochromatosis, gout, etc.), endocrine (hypothyroidism, acromegaly, etc.) and other factors.

Joint damage in OA can be local (less than three different articular groups) and generalized (more than three articular groups). Generalized OA is more common in women and is inherited.

Ochronosis (alkaptonuria) is a hereditary disease caused by excessive deposition of homogentisic acid in various tissues due to the absence of the homogentisinase enzyme.

The compensated stage of OA can proceed for a long time without clinical manifestations and can only be detected by X-ray examination of the joints. As a rule, this form is observed in more than 80% of people over the age of 60 years. However, in certain stages of OA, clinical manifestations occur.

The main symptoms of osteoarthritis:

• joint pain (starting pain);
• restriction of movements;
• morning stiffness (up to 30 minutes);
• crepitus (crunching) in the joints during movement;
• pain on palpation;
• defiguration or deformity of the joints;
• instability/instability of the joint;
• dysfunction of the joints.

Leading clinical symptom in OA - pain in the joint, the source of which can be: the synovial membrane, joint capsule, periarticular ligaments and muscles, periosteum and subchondral bone. In OA, pain is heterogeneous and is one of the early symptoms of the disease. The disease may be accompanied by morning stiffness, swelling of the joint, and a local increase in temperature. Joining synovitis aggravates the course of the disease. Gradually develop deformity and stiffness of the joints.

The most disabling forms of the disease are gonarthrosis (lesion knee joint) and coxarthrosis (arthrosis of the hip joint). The third most important localization is arthrosis of the distal and proximal interphalangeal joints of the hand (Heberden's and Bouchard's nodes).

Treatment of osteoarthritis

Treatment of patients with osteoarthritis includes various combinations of drug and non-drug methods. Therapeutic tactics is aimed at solving the following problems:

• mechanical unloading of the affected joints;
• relief of synovitis and pain syndrome;
• prevention of disease progression.

Non-drug methods of treating OA include: exercise therapy, swimming, body weight correction, the use of orthoses (knee braces, orthopedic insoles etc.), physiotherapy, acupuncture, massage, balneotherapy (sulfide, radon baths, etc.). With insufficient effectiveness of these measures, drug therapy is prescribed.

Drugs for osteoarthritis used in the treatment can be divided into 3 groups:

1. Symptomatic drugs for the treatment of fast-acting joints:

• analgesics. Paracetamol is the drug of first choice for the relief of pain in OA.
• non-steroidal anti-inflammatory drugs (NSAIDs) - ketorolac, nimesulide, naproxen, etc. Shown in patients who have not responded to paracetamol therapy. The drugs are prescribed orally, as well as parenterally or topically in the form of ointments, creams, gels (more on this can be found in the article).
• opioid analgesics (tramadol). They are used for a short period with ineffectiveness and / or poor tolerability of NSAIDs.

2. Symptomatic delayed action drugs:

• diacerein, hyaluronic acid, avocado and soy unsaponifiable compounds. These drugs help to reduce joint pain, allow you to reduce the dose of NSAIDs and are well tolerated. The analgesic effect persists for several months after completion of treatment.

3. Drugs that modify the structure of cartilage:

• chondroitin sulfate, glucosamine sulfate. Glucosamine sulfate takes part in the synthesis of mucopolysaccharides, the administration of the drug stimulates the synthesis of glycosaminoglycans and proteoglycans in the cartilage. Chondroitin sulfate is a component of the articular cartilage matrix, which penetrates into the matrix structures and affects metabolic processes.
• derivatives of hyaluronic acid for intraarticular injection. They have a prolonged symptom-modifying (analgesic) effect, and also improve joint mobility due to the effect of lubrication and stimulation of the production of their own hyaluronic acid by synovial cells.

If reactive synovitis develops in OA, intra-articular administration of prolonged glucocorticosteroids (hydrocortisone, triamcinolone, methylprednisolone, etc.)

You can also note those not yet included in the wide clinical practice structure-modifying drugs containing glucosamine sulfate, inhibitors of matrix metalloproteinases, inhibitors of the enzyme convertase interleukin 1b and cathepsin K.

Etiology and course of rheumatoid arthritis

Rheumatoid arthritis(RA) is a chronic autoimmune disease with a primary lesion of peripheral joints by the type of erosive-destructive arthritis.

Group A and B streptococci, mycoplasmas, viruses (Epstein-Barr, cytomegalovirus, retroviruses, etc.), intoxications, etc. are considered as etiological factors. The disease develops in people with a genetic predisposition to RA, and is more common in middle-aged women. and old age.

The development of RA is based on a generalized defect in the immune mechanisms that regulate cellular and humoral responses, which leads to chronic progressive inflammation that affects not only the joints, but also the internal organs.

The main manifestation of RA is persistent arthritis of the small joints of the hands and feet. RA is characterized by a feeling of morning stiffness, symmetry of the lesion, pain, swelling of the joints, and an increase in skin temperature in the joint area. In most cases, RA develops gradually, characterized by an undulating course and slow progression of the articular syndrome. Clinical picture with RA - deformation of the metacarpophalangeal (flexion contractures, subluxations), proximal interphalangeal, radiocarpal joints with deviation of the hand to the outside, as well as metatarsophalangeal joints. Extra-articular manifestations of rheumatoid arthritis include: subcutaneous (rheumatoid) nodules in the area elbow joint, serositis (pleurisy and pericarditis), lymphadenopathy, peripheral neuropathy, cutaneous vasculitis, etc. In 70–80% of patients, rheumatoid factor (RF) is detected in the blood serum, such RA is called seropositive.

There are several degrees of activity of rheumatoid arthritis:

A) Grade 0 - inactive rheumatoid arthritis. There are no pains in the joints. Temperature, ESR, C-reactive protein and other parameters are normal.

B) Grade I - minimal activity. Moderate joint pain and slight stiffness in the morning. ESR and C-reactive protein are slightly elevated.

C) Grade II - medium activity. Pain in the joints, not only during movement, but also at rest. Exudative phenomena (swelling, effusion, bursitis) and severe limitation of mobility in the joints. Subfebrile temperature, ESR 30-40 mm/h, a significant increase in the level of C-reactive protein.

D) Grade III - high activity. Severe morning stiffness, severe pain at rest, pronounced exudative phenomena in the joints (swelling, hyperemia and increased skin temperature over the joints), severe limitation of mobility. Signs of an active inflammatory process in internal organs(pleurisy, pericarditis, myocarditis). Body temperature is high. A significant increase in ESR (40–60 mm/h) and C-reactive protein.

Table 1 - Treatment of rheumatoid arthritis: drugs

Treatment of RA is aimed at suppressing the symptoms of arthritis and extra-articular manifestations, preventing bone destruction and joint deformity, maintaining the quality of life of patients and achieving remission of the disease.

The mainstay of treatment for rheumatoid arthritis is medical immunosuppression. The group of immunosuppressive drugs used for treatment includes disease-modifying anti-inflammatory drugs (DMARDs), biological preparations(see table 1) and glucocorticosteroids (GC).

Disease-modifying anti-inflammatory drugs (DMARDs) are currently the mainstay of treatment and are prescribed after a diagnosis of RA has been made. DMARDs inhibit the activity and proliferation of immunocompetent cells, slow down the progression of the erosive process in the joints, inhibit the activity of the process (i.e., have an immunosuppressive effect), as well as the proliferation of synoviocytes and fibroblasts, which is accompanied by a pronounced decrease in the clinical and laboratory activity of RA and causes a stable clinical remission.

DMARDs are distinguished by the mechanism of action and application features. Conventionally, they are divided into first-line and second-line drugs. First-line DMARDs include methotrexate, leflunomide, and sulfasalazine. Second-line drugs (cyclophosphamide, azathioprine, cyclosporine A) are more toxic and less effective, so they are usually prescribed for intolerance to first-line DMARDs.

Glucocorticosteroids in RA, they are applied systemically and locally. They have a pronounced anti-inflammatory effect, have a rapid dose-dependent effect, but do not affect the main pathogenetic links of RA and do not provide full control over the course of the disease. As a rule, they are prescribed together with DMARDs. With high inflammatory activity, a large number of affected joints, insufficient effectiveness of DMARDs, systemic therapy with low doses of GCs (prednisolone, methylprednisolone) is prescribed for a long period. For the treatment of severe systemic manifestations of rheumatoid arthritis (effusive serositis, hemolytic anemia, skin vasculitis, fever, etc.) prescribe medium and high doses of glucocorticosteroids orally, as well as pulse therapy with glucocorticosteroids.

Non-steroidal anti-inflammatory drugs - adjuncts in the treatment of RA. Action of NSAIDs associated with suppression of the activity of cyclooxygenase (COX) and a decrease in the synthesis of prostaglandins. NSAIDs have a pronounced anti-inflammatory and analgesic effect, but do not affect the course of the disease. They are used as symptomatic therapy, usually in combination with DMARDs.

Rheumatoid arthritis and osteoarthritis cause pain and. Both medical conditions are forms of arthritis, but they have different causes and are treated with different therapeutic strategies.

There are over 100 types of arthritis and related diseases. Rheumatoid arthritis and osteoarthritis are among the most common. Osteoarthritis develops in people more often than rheumatoid arthritis.

Fever can develop with rheumatoid arthritis

People with rheumatoid arthritis may experience the following:

• fatigue;
• loss of appetite;
• inflammation outside of the joints, such as in the lungs or eyes

Osteoarthritis is not associated with systemic symptoms, but people with this condition may develop bone spurs or other structural bone abnormalities.

For example, osteoarthritis of the hands often results in the development of small bumps in the knuckle area.

Diagnostics

When diagnosing rheumatoid arthritis and osteoarthritis, doctors use a physical examination, take a patient's medical history, and perform a series of special tests.

Diagnosis of both conditions is often difficult. This is especially common in early stages when the symptoms do not yet appear or appear so weakly that people do not attach importance to them.

Helps detect or rule out rheumatoid arthritis because it medical condition leaves certain biomarkers in the blood, for example antibodies to cyclic citrullinated peptide (ACCP) or rheumatoid factor.

In addition, doctors can check. This is a marker that indicates the presence of an inflammatory process and the degree of inflammation.

Doctors may use imaging tests, such as x-rays, magnetic resonance imaging (MRI), or computed tomography (CT), to determine the location and severity of lesions in rheumatoid arthritis and osteoarthritis.

Treatment

Rheumatoid arthritis and osteoarthritis - chronic diseases.

Currently considered incurable, however, some therapeutic strategies help people manage symptoms, improve quality of life, and slow the rate of joint damage.

In both cases, treatment may include non-steroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation. When inflammatory process weakens, the degree of pain usually decreases. In addition, stiffness is eliminated, as a result of which people observe an improvement in mobility.

Ibuprofen and other NSAIDs help reduce inflammation in both rheumatoid arthritis and osteoarthritis

For patients with rheumatoid arthritis and osteoarthritis, doctors may recommend steroid medications, which also help fight inflammation. Steroids may be given as an injection directly into the affected joint. Usually, doctors resort to such a measure when it is necessary to immediately reduce inflammation.

Doctors sometimes prescribe disease-modifying antirheumatic drugs (DMARDs) to treat rheumatoid arthritis. Patients may take them along with NSAIDs, steroids, or biological agents. The action of DMARDs is aimed at suppressing the function of the immune system and reducing the degree of tissue damage in the joints.

Therapy for both types of arthritis often involves physical therapy. Working closely with a physical therapist usually helps people improve joint mobility and flexibility.

A proper diet can also help. A healthy weight prevents unnecessary stress on affected joints.

In addition, people with arthritis can significantly improve their condition by quitting smoking. This is especially true for those who suffer from rheumatoid arthritis.

Conclusion

Rheumatoid arthritis and osteoarthritis are chronic diseases that cause pain and stiffness in the joints. Both in the first and in the second case, the symptoms can worsen without proper treatment. At different people the degree of their manifestation is different - from mild to severe.

These types of arthritis have some common symptoms, but they occur for different reasons and are treated differently. In general, osteoarthritis is easier to treat because it usually affects fewer joints and does not affect other body structures. The development of rheumatoid arthritis is more difficult to predict than the progression of osteoarthritis.

With the advent of new treatments, the outlook for people with rheumatoid arthritis has improved significantly in recent times. With help effective therapy doctors are often able to stop or slow the progression of this disease.

“It’s already been a month of pain in the knee in the evening”, “... when I fall asleep I can’t put my leg down, I rub it with various ointments, nothing helps ...”, “my back hurts, I don’t have any strength ...” - these are typical complaints that are addressed to the attending physician doctor. The doctor determines such patients “from the threshold”, usually it is a gentle gait, a cane in the hands, rubbing of diseased joints ....

Many people live with it for many years, especially in old age. Pain in the hip joints, pain when walking in the ankle joint, pain in the hands, in the shoulders when moving. All this can be attributed to chronic changes in the joints, which are united by one diagnosis - deforming osteoarthritis or osteoarthritis. According to official data, 5-7 percent of men and women worldwide are ill. Men get sick earlier, at the age of 45, women after 55 years, this is due to hormonal characteristics, women get sick more often after menopause.

What happens to the joints in osteoarthritis

Normally, the cartilages covering the articular surfaces are elastic, they are actively renewed, and withstand heavy loads. This is achieved by the fact that cartilage molecules are saturated with water. With age, everything changes, elasticity decreases, the body loses fluid, “dries out”.

The amount of lubrication inside the joint decreases, the cartilage is less updated. With intense loads, injuries, microfractures, torn ligaments occur, and erosions form on the cartilage. Excess weight can also cause stress, which increases pressure on the joints. Hypothermia, arthritis in the past cause damage to bone and cartilage tissue. Osteoporosis (leaching of calcium from the bones) also increases the effects of arthrosis.

Any violation of the integrity of bone and cartilage tissue causes an inflammatory process, and inflammation contributes to the growth of bone tissue, but already wrong. This is clearly visible on the phalanges of the fingers of older people - “bones”, scientifically, Heberden's nodules become visible. Large joints are also often deformed, their mobility decreases, and surrounding tissues, tendons and even muscles are involved. And such an affected joint can no longer function normally, in the morning it is very difficult to “diverge”, in the evening the pain and swelling increase. With an exacerbation, signs of arthritis appear - i.e. active inflammation.

The diagnosis is obvious. Deforming osteoarthritis differs from rheumatoid arthritis, arthritis in autoimmune diseases or reactive arthritis in that changes in the blood are minimal. There is no autoimmune component. The main tests we use to detect inflammation in general analysis blood is the erythrocyte sedimentation rate (ESR), the number of leukocytes. AT biochemical analysis blood tests such as C-reactive protein, rheumatoid factor are prescribed, with osteoarthritis they almost do not differ from the norm.

An X-ray examination of the joint is required to determine the stage of the disease. Because changes in the joint may not correspond to the symptoms of the disease. Severe changes in the joint can occur almost without pain, at the same time, the patient may complain of severe pain, although the changes in the joint itself are minimal. To identify violations of the ligamentous apparatus, inflammation of the synovium - the articular membrane, an ultrasound of the joint is prescribed. CT or MRI is prescribed to clarify the changes. And also when surgery is required.

Different joints can be affected, both large - hip, knee, shoulder, elbow, and small joints - hands and feet. Depends on which joint was overloaded. If you are overweight, the joints of the legs, hips, and spine suffer more. If the load on the hands during work, the phalanges of the fingers and the wrist joint are affected.

Treatment of osteoarthritis

It is important for the patient to reduce the load on the affected joint, be sure to reduce body weight, while walking it is better to use canes, walkers.
exercise therapy ( physiotherapy) - is simply necessary for the joints. There are many different systems for strengthening muscles and increasing mobility. Of course, if the joints hurt, without special exercises in no way possible. There are many exercises for the joints in the Eastern tradition, for example, Daruma-taiso is one of the effective and simple systems.

Warming or anti-inflammatory ointments and gels, such as capsicam, quick gel, fastum gel, are used as an auxiliary and distracting agent. They cannot be completely cured, but they can alleviate the condition. Of the old proven methods, compresses with dimexide help, especially in the early days during an exacerbation.

For pain, the doctor prescribes a group of non-steroidal anti-inflammatory drugs in tablets and injections. In the form of injections more often - diclofenac, ketoprofen. In tablets or capsules - ketoprofen, nimesulide, ibuprofen and more modern drugs- nalgesin, dilaxa. NSAIDs have to be taken for a long time, but we must not forget that long-term use can provoke an ulcer of the mucous membrane of the stomach and duodenum and bleeding from these ulcers. Therefore, usually taking NSAIDs is combined with taking drugs from the omeprazole group (rabeprazole, pantoprazole) or antacids (almagel).

Long courses from 2 to 6 months take chondroprotectors. These are preparations containing chondroitin and glucuronic acid - building materials for cartilage (arthra, dona, alflutop). It can be medications or dietary supplements (biologically active additives). There may be drugs both in tablets and in injections. Surgeons inject chondroprotectors into the joints.

The effectiveness of chondroprotectors has not been proven by science. From my experience, people with heart disease, especially those on complex drug regimens, should avoid them. For the rest, it’s good to take 1-2 courses per year, especially for those who suffer from a defect. connective tissue, provided that they themselves see the effect of the treatment.

As an auxiliary anti-inflammatory agent, hormones are used - glucocorticoids, most often in the form of injections into the joints.
For severe pain, the doctor prescribes combined preparations pentalgin type. If these drugs are ineffective, stronger opioid analgesics (tramadol, zoldiar) are prescribed.

Physiotherapy, specifically ultrasound, has been researched to be the most effective treatment for osteoarthritis. With its help, small growths on the surfaces of the joints and salt deposits are broken. For an anti-inflammatory effect, ultrasound is done with hormonal ointments.

According to the results of the same studies, the magnet is ineffective, and in many cases harmful, especially for people of age. Its frequent and uncontrolled use can stimulate the oncological process.
The diet is aimed at reducing excess body weight. It should also include substances containing chondroprotectors - cartilage, especially fish, jelly, jelly.

Surgical treatment of osteoarthritis is arthroplasty, that is, joint replacement. Indications for surgery may be a violation of the function of the joint, the severity of pain that does not go away with the treatment of physiotherapy, analgesics.

Much in terms of joint health depends on us, you need not be lazy to do gymnastics, monitor your weight, spare your joints, see a doctor in time, undergo an examination and start treatment.