Treatment of osteoarthritis in old age. Osteoarthritis of large joints in the elderly: symptoms and treatment. Causes and symptoms
Have you ever wondered why cats and dogs don't live long? The whole point turns out to be in the structure of the skull, or rather, one might even say so - how the bones of the skull are connected to each other.
And they are connected primarily by special bone tissue, forming sutures. It is these sutures that are very important in the connecting process, as they are shock absorbers and areas for bone growth.
But there is one sad “BUT” - after forty years, these seams heal.
Cervical osteochondrosis is a disease of the cervical spine with degenerative-dystrophic changes in the vertebrae and intervertebral discs.
This type of osteochondrosis is the most common due to the mobility of the cervical spine and the heavy load placed on it.
Osteochondrosis of the cervical spine - symptoms
The sooner you notice signs of cervical osteochondrosis, the greater your chances of stopping this disease.
All symptoms of cervical osteochondrosis can be grouped into three groups:
- neurological group;
- group of movement disorders;
- group of brain symptoms.
The neurological group of symptoms of cervical osteochondrosis includes: discomfort and pain in the neck, tingling and numbness in the neck, upper limbs, shoulder blades and upper chest.
Osteochondrosis is dangerous not only due to constant pain, but also to the risk of complications. Therefore, if you have prolonged and intense pain in the neck area, you should definitely consult a specialist.
In the initial stages of the disease, you will only be recommended exercises for the neck for osteochondrosis. In an advanced state, the disease requires drug therapy to eliminate inflammation and restore vascular patency.
In some cases, it is necessary to wear a special corset to support the head.
If you want to learn all the secrets of treating cervical osteochondrosis, we recommend that you familiarize yourself with this free course. A very effective technique!
Below is an example of several exercises.
- The patient lies down on the floor. Place one palm on your stomach and the other on your chest. Slow, smooth inhalation (the stomach and then the chest rise), then exhale. Repeat 8-10 times. It is necessary to consciously relax the body. The exercise is repeated 3-4 times during the day.
- Position on the floor, but this time on your stomach. Slowly raise your head and torso, placing your hands in front of you on the floor. You need to stay in this position for 1 - 1.5 minutes, then smoothly return to the original position. Important! You need to make sure that your shoulders don’t “sag” - keep your posture under control! The exercise is performed 3-4 times a day.
- Position - lying on your stomach. The arms are extended along the body. The head slowly turns to the right. You must try to press your ear to the floor. Then in the opposite direction. Important! Pain should not accompany exercise! Perform 5-6 times. You can perform this exercise 3-4 times during the day.
- Sitting position. Slowly, as you exhale, bend forward, bringing your chin as close to your chest as possible. Then, as you inhale, slowly tilt your head back, trying to look as far as possible. Repeat 10-15 times. The exercise itself is repeated 2-3 times a day.
- Without changing position, you need to press your forehead to your own palms. Applying as much pressure as possible. The exercise is done while exhaling - this is important! Repeat 5-6 times. Perform 3-4 times during the day.
- If the violation is not severe, you can perform a gentle rotation of the head in both directions.
Osteoarthritis (osteoarthritis, osteoarthritis deformans, DOA) is a very common disease in which the destruction of articular cartilage, the bones underneath them, and other elements of the joint occur. At the same time, the recovery processes in the joints slow down.
In our country, the name osteoarthritis is accepted, while in Western countries and Europe they more often say osteoarthritis.
Manifestations of osteoarthritis vary from person to person and also depend on the type of joint affected. Some people experience significant damage to the joint without any outward symptoms. In other cases, even in the presence of pronounced subjective sensations, the mobility of the joint is practically not limited.
The three main signs of osteoarthritis are:
- moderate inflammation in and around the joint;
- damage to cartilage - a dense, smooth layer that covers the articular surfaces of bones and allows them to move easily and without friction;
- the formation of bone outgrowths - osteophytes around the compounds.
All this can lead to pain, stiffness and dysfunction of the joints.
Osteoarthritis most often affects the knees, spine, small joints of the hands, thumb and hip joints. However, the disease can affect any other joint in the body.
In Russia, 10% to 12% of the total population suffers from osteoarthritis, which is more than 14,000,000 people. Osteoarthritis usually develops in people over 50 years of age and is more common in women than men.
It is commonly believed that osteoarthritis is an inevitable part of aging, but this is not entirely true. In older people, when performing an X-ray examination, tissue changes associated with the disease are visible, however, these disorders do not always cause pain or problems with joint mobility. Young people can also suffer from osteoarthritis, often due to injury or other joint disease.
There is no complete cure for osteoarthritis, but symptoms can be relieved with various medical treatments, as well as exercise or comfortable shoes. However, more advanced cases of the disease may require surgery.
Symptoms of osteoarthritis (osteoarthritis)
The main symptoms of osteoarthritis are pain and stiffness of the joints. You may have difficulty moving the affected joints or discomfort when performing certain activities. However, osteoarthritis may cause no symptoms at all, or the pain may be sporadic. Most often one or more joints are affected. The disease may progress slowly.
Other symptoms characteristic of osteoarthritis:
- pain in the joints;
- increased pain and stiffness in joints that have been immobile for some time (after being in a sitting position for a long time, for example);
- joints become slightly larger than usual or take on a “knobby” shape;
- bothered by the feeling of clicking or cracking in the joints when moving;
- limitation of range of motion in joints;
- muscle weakness and atrophy (loss of muscle mass).
The knee, hip, arm and spine joints are most susceptible to osteoarthritis. 
Symptoms of osteoarthritis of the knee joints
With osteoarthritis of the knee joints, the process is usually bilateral. Symptoms appear first in one knee, and over time in the other. An exception is post-traumatic osteoarthritis, when only the previously injured knee is affected by the disease.
Knee pain may be most intense when walking, especially when walking uphill or up stairs. Sometimes the knee joint may “pop out” under the weight, or it may be difficult to fully straighten the leg. You may also hear slight clicking sounds when you move the affected joint.
Symptoms of osteoarthritis of the hip joint
Osteoarthritis of the hip often causes difficulty moving the hip. There may be difficulty putting on socks and shoes, getting in and out of the car. With osteoarthritis of the hip joint, pain is felt in the groin area or on the outside of the thigh, which intensifies with movement.
Sometimes, due to the way the nervous system works, pain may be felt not in the hip, but in the knee.
In most cases, pain will occur while walking, but at the same time pain can also occur at rest. If you experience severe pain at night (while sleeping), your doctor may refer you to an orthopedic surgeon to consider joint replacement (joint replacement).
Symptoms of spinal osteoarthritis
The parts of the spine most susceptible to osteoarthritis are the neck and lower back, since these are its most mobile parts.
If the cervical spine is affected, the mobility of the neck joints may be reduced, which affects the ability to turn the head. Pain may occur if the neck and head are in the same position for a long time or in an uncomfortable position. A spasm of the neck muscles is possible, pain can be felt in the shoulders and forearms.
If the lumbar spine is affected, pain occurs when bending or lifting heavy objects. Stiffness is common when resting after exercise or bending over. Pain in the lower back can sometimes move to the hips and legs.
Symptoms of osteoarthritis of the hand joints
Osteoarthritis primarily affects three areas of the hand: the base of the thumb, the middle knuckles, and the knuckles closest to the fingertips.
Your fingers may lose mobility, become swollen and painful, and you may also develop lumps on your knuckles. However, over time, finger pain may decrease and eventually disappear altogether, although lumps and swelling may remain.
Your fingers may be slightly curved to the side at the affected joints. You may develop painful cysts (fluid-filled lumps) on the back of your fingers.
In some cases, a lump may form at the base of the big toe. It can be painful and limit certain activities, such as writing, opening a jar, or turning a key in a keyhole.
Causes of osteoarthritis
Osteoarthritis occurs when there is damage in or around a joint that the body cannot repair. The exact causes are not known, but there are several factors that increase the risk of developing the disease.
In everyday life, the joints of your body are regularly exposed to stress and receive microtrauma. In most cases, the body is able to cope with the damage on its own. Typically, the recovery process is silent and you do not experience any symptoms. Types of injuries that can lead to the development of osteoarthritis:
- problems with ligaments or tendons;
- inflammation of the cartilage and bone tissue of the joint;
- damage to the protective surface (cartilage) that allows your joints to move with the least amount of friction.
Your joints may develop lump-like nodules where marginal bony growths called osteophytes form on the bones. Due to thickening and enlargement of the bones, your joints will become less flexible and painful. Inflammation can cause fluid to accumulate in the joints, leading to swelling.
Factors contributing to the occurrence of osteoarthritis
It is not known why repair of damaged joint tissue is impaired in osteoarthritis. However, a number of factors are thought to contribute to the development of the disease. They are presented below.
- Joint damage – Osteoarthritis can develop due to injury or surgery to the joint. Excessive load on a joint that has not yet fully recovered from injuries may be the cause of the development of osteoarthritis in the future.
- Other diseases (secondary osteoarthritis) - sometimes osteoarthritis can be a consequence of another past or existing disease, for example, rheumatoid arthritis or gout. Options for the development of osteoarthritis after a long period of time after the initial damage to the joint cannot be excluded.
- Age – The risk of developing osteoarthritis increases with age due to weakening muscles and wear and tear on joints.
- Heredity - in some cases, osteoarthritis can be inherited. Genetic studies have not identified a specific gene responsible for osteoarthritis, so it is likely that a whole group of genes is responsible for the transmission of this disease by inheritance. This means that a genetic test for osteoarthritis susceptibility is unlikely to be developed anytime soon.
- Obesity - Research has found that obesity puts excessive stress on the knee and hip joints. Thus, in obese people, osteoarthritis is often more severe.
Diagnosis of osteoarthritis
See your doctor if you suspect you have osteoarthritis. There is no specific test to detect this condition, so your doctor will ask you about your symptoms and examine your joints and muscles. The likelihood of developing osteoarthritis increases in people:
- over 50 years old;
- experiencing constant pain in the joints, aggravated by exercise;
- suffering from joint stiffness in the morning for more than 30 minutes.
If your symptoms are somewhat different from those listed above, your doctor may think you have another form of arthritis. For example, if you have a feeling of stiffness in your joints in the morning that lasts more than an hour, this may be a sign of an inflammatory form of arthritis.
Additional tests, such as x-rays or blood tests, may be used to rule out other causes of symptoms, such as rheumatoid arthritis or a fracture. However, they are not always required to diagnose osteoarthritis.
Treatment of osteoarthritis
Osteoarthritis treatment aims to relieve pain, reduce disability, and maintain an active lifestyle in people with osteoarthritis for as long as possible. Osteoarthritis cannot be completely cured, but treatment can relieve symptoms and prevent them from affecting daily life. First of all, it is recommended to try to cope with the disease without medications, for which:
- use reliable sources of information about osteoarthritis (this site and the organizations we link to are reliable sources);
- regularly perform exercises to improve physical fitness and strengthen muscles;
- Lose weight if you are overweight.
If you have mild or moderate osteoarthritis, you may not need additional treatment. Your doctor can give you advice on how to manage your symptoms with lifestyle changes. This may be enough to control the disease.
Lifestyle changes
Osteoarthritis can be controlled by improving your overall health. Your doctor can give you advice on ways you can help yourself, such as losing weight and staying active.
Physical exercise is the main way to treat osteoarthritis, regardless of the patient’s age and level of physical fitness. Your physical activity should include a range of exercises to strengthen your muscles and improve your overall fitness.
If osteoarthritis is causing you pain and stiffness, you may think that exercise will make the condition worse, but this is not the case. As a rule, regular physical exercise improves joint mobility, strengthens the body's muscular system and reduces the symptoms of the disease. Exercise is also good for relieving stress, losing weight, and improving posture, which together will greatly improve osteoarthritis.
Your doctor or physical therapist can create a personalized exercise plan that includes exercises you can do at home. It is important to follow this plan because in some cases, overuse or improper exercise can cause joint damage.
Being overweight or obese worsens osteoarthritis. Excess weight increases the load on damaged joints, the ability of which to recover is reduced. Particular stress is placed on the joints of the lower extremities, which bear the bulk of the weight.
The best way to lose weight is a proper exercise routine and a healthy diet. Before starting classes, you should discuss your training plan with your doctor. He will help you create an exercise program that is optimal for you. Your doctor will also advise you on how to lose weight slowly and safely.
Medicines for the treatment of osteoarthritis
Your doctor will discuss with you a list of medications that can help control the symptoms of osteoarthritis, including pain relievers. You may need a combination of several treatment options: physical therapy, medications, and surgical correction.
The type of pain reliever (analgesic) your doctor may recommend depends on how severe your pain is and whether you have other illnesses or health problems. If you are experiencing pain caused by osteoarthritis, your doctor may first suggest taking paracetamol. It can be bought in pharmacies without a prescription. It's best to take it regularly rather than wait until your pain becomes unbearable.
Important! When taking paracetamol, always follow the dosage as recommended by your doctor and do not exceed the maximum dose indicated on the package.
If paracetamol is not effective, your doctor may prescribe stronger painkillers. These may be non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs are painkillers that reduce inflammation. There are two types of NSAIDs, and they work differently. The first type is traditional NSAIDs (for example, ibuprofen, naproxen or diclofenac), the second type is COX-2 (cyclooxygenase 2) inhibitors, which belong to the group of coxibs (for example, celecoxib and etoricoxib).
Some NSAIDs come in the form of creams that are applied directly to the affected joint area. Most NSAIDs are available in pharmacies without a prescription. They may be especially effective if you have osteoarthritis in the knees or hands. The drugs relieve pain and at the same time reduce swelling in the joints.
NSAIDs may be contraindicated in people with certain medical conditions, such as asthma, stomach ulcers, or angina. It is also not recommended to take NSAIDs soon after a heart attack or stroke. Do not take ibuprofen or diclofenac without a doctor's prescription if you have at least one of the contraindications listed above. If you are taking low-dose aspirin, talk to your doctor about whether you should use an NSAID.
If a doctor prescribes an NSAID, he will usually also prescribe the concomitant use of so-called proton pump inhibitors (PPIs). The fact is that NSAIDs can damage the gastric mucosa, which protects it from the damaging effects of hydrochloric acid. PPIs reduce the amount of hydrochloric acid produced by the stomach, reducing the risk of damage to the lining. There is little risk of stomach problems when taking COX-2 inhibitors, but you should still take a PPI if you use COX-2 on a regular basis.
Opioid analgesics such as codeine are another type of painkiller that can provide pain relief if paracetamol does not provide the desired effect. Opioid analgesics can relieve severe pain, but they can also cause side effects such as drowsiness, nausea, and constipation.
Codeine is found in common drugs in combination with paracetamol - for example, in Codelmixt. Other opioid analgesics that can be prescribed for osteoarthritis include tramadol and dihydrocodeine (DHA Continus). Both drugs are available in the form of tablets and injection solutions. Tramadol is contraindicated if the patient has epilepsy. Dihydrocodeine is not recommended for patients with chronic obstructive pulmonary disease (COPD). Pregnant women are contraindicated in taking opioid analgesics. Opioid analgesics are sold in pharmacies strictly according to a doctor's prescription.
When prescribing opioid analgesics, your doctor may prescribe a laxative to prevent constipation.
If you have osteoarthritis in the joints of your hands or knees and NSAIDs do not relieve the pain, your doctor may prescribe capsaicin ointment. Ointments with capsaicin block the transmission of nerve impulses that cause pain. The effect of the drug develops after some time from the start of use. The pain should subside slightly within the first two weeks of using the ointment, but it may take up to a month before the treatment is fully effective.
To achieve the effect, apply a small amount of ointment (the size of a pea) to the skin in the affected joints no more than four times a day. Do not apply capsaicin cream to damaged or inflamed skin and always wash your hands after treatment.
Avoid contact of capsaicin cream with sensitive areas of the skin such as the eyes, mouth, nose and genitals. Capsaicin is derived from chili peppers, so if it comes into contact with sensitive areas of the body, it can be very painful for several hours. However, this will not cause serious harm to health.
You may notice a burning sensation on your skin after applying capsaicin ointment. There is nothing wrong with this, and the longer you use it, the less often such sensations will appear. However, be careful not to use too much ointment or take a hot bath or shower before or after applying it, as this may increase the burning sensation.
Intra-articular injections
In severe forms of osteoarthritis, treatment with painkillers may not be enough to control the symptoms of the disease. In this case, it is possible that the medicine is injected directly into the joint affected by osteoarthritis. This procedure is known as an intra-articular injection.
The most common treatment for osteoarthritis is intra-articular injections of corticosteroids to reduce swelling and pain. Also in our country, hyaluronic acid is used for injection, which is a natural component of intra-articular fluid and reduces joint pain for a period of 2 to 12 months after the procedure. While the UK National Institute for Health and Clinical Practice does not recommend intra-articular injections of hyaluronic acid.
Supportive therapy (physiotherapy)
Transcutaneous electrical nerve stimulation (TENS) uses a machine to help relieve pain caused by osteoarthritis. The procedure numbs the nerve endings in the spinal cord that control the perception of pain, so you stop feeling pain.
TENS treatment is usually performed by a physical therapist. Small electrical pads (electrodes) are placed on the skin over the affected joint. These electrodes transmit small electrical impulses from the TENS machine. The physiotherapist selects the optimal impulse strength and duration of sessions for the patient.
Applying hot or cold compresses (sometimes called thermotherapy or cryotherapy) to the joint area can relieve pain and symptoms of osteoarthritis in some people. A heating pad filled with hot or cold water and applied to the osteoarthritis affected area can effectively relieve pain. You can also purchase special hot and cold compresses that can be cooled in the freezer or heated in the microwave - they work in a similar way.
Joint stiffness can lead to muscle atrophy and increased symptoms of stiffness caused by osteoarthritis. Manual therapy sessions are performed by a physical therapist or chiropractor. The therapy uses stretching techniques to keep your joints elastic and flexible.
If osteoarthritis causes a patient to have reduced mobility or difficulty performing daily tasks, there are various assistive devices available. The attending physician may refer the patient to an orthopedic physician for advice or assistance.
If a patient has osteoarthritis of the joints of the lower extremities, such as the hip, knee, or foot joints, the podiatrist may suggest special shoes or insoles for shoes. Shoes with shock-absorbing soles are designed to reduce pressure on your foot joints while walking. Special insoles help distribute weight more evenly. Orthoses and braces work in the same way.
If a patient has osteoarthritis of the hip or knee joint, which negatively affects mobility, he may need auxiliary support when walking - for example, a cane or stick. Use a cane on the side of your affected leg to relieve some of the pressure on the affected joint.
A splint (a piece of hard material used to support a joint or bone) can also be helpful if you need to take pressure off a sore joint. Your doctor should tell you and show you how to use it correctly.
If your hand joints are affected, you may need help with everyday tasks that involve your hands, such as turning on a faucet. Devices such as specialized attachments for the mixer handle can make such actions much easier. Your healthcare provider can provide advice and tips on using special devices in your home or workplace.
Surgery for osteoarthritis 
Osteoarthritis requires surgery in very rare cases. Sometimes surgery is effective for osteoarthritis of the hip, knee joints or the joint of the base of the thumb. Your doctor may suggest surgery if other treatments have not been effective or if one of your joints is severely damaged.
If a patient requires surgery, the doctor refers him to a surgeon. Surgery can significantly reduce the symptoms of osteoarthritis and improve mobility and quality of life. However, surgery does not guarantee complete relief from all symptoms, and pain and joint stiffness may vary depending on your condition.
There are several different types of surgical treatment for osteoarthritis. During surgery, it is possible to restore the surface of the articular cartilage, replace the entire joint, or return it to its correct position.
Arthroplasty- joint replacement surgery, most often performed for damage to the hip and knee joints.
During this operation, the surgeon removes the affected joint and replaces it with an artificial prosthesis made of special plastic and metal. An artificial joint can last up to 20 years, but will need to be replaced after some time.
There is also a new type of joint surgery called resurfacing. During this operation, through a small incision in the joint area, the damaged part of the articular surfaces is removed and replaced with implants. When performing this type of operation, exclusively metal components are used. The operation is well suited for young patients.
Arthrodesis of the joint carried out if joint replacement is not possible. This is a procedure to fix the joint in a permanent position. The joint will become stronger and will hurt much less, but mobility in the joint will be completely lost.
Osteotomy is considered in cases where the patient has osteoarthritis of the knee joints, but is too young for surgical prosthetics (arthroplasty). The surgeon adds or removes a small piece of bone either below or above the knee joint. This helps redistribute the load on the knee joint and reduce pressure on the damaged part. Osteotomy relieves the symptoms of osteoarthritis, although knee replacement may still be required in the future.
Complementary and alternative treatments
Many people suffering from osteoarthritis use alternative treatments. There is evidence that some of the treatments can relieve symptoms, but experts disagree that alternative methods can actually help slow the progression of the disease.
Acupuncture, aromatherapy, and massage are the most commonly used complementary treatment options for osteoarthritis. Some people find that these types of treatments help, although they can be expensive and time-consuming.
There are several dietary supplements available to treat osteoarthritis, with the two most common being chondroitin and glucosamine. Glucosamine hydrochloride has not been shown to be beneficial, but there is evidence that glucosamine sulfate and chondroitin sulfate can relieve symptoms with little to no side effects.
The cost of these supplements can be high. The UK's National Institute for Health and Clinical Practice does not recommend medical prescription of chondroitin or glucosamine, but recognizes that patients often take them on their own.
There are also medications containing chondroitin and glucosamine sulfates. In our country, they are used by official medicine to treat osteoarthritis.
Irritating drugs exist in the form of gels and ointments; when rubbed into the skin, such drugs cause a warming effect. Some of them can be used to treat joint pain caused by osteoarthritis. Research has shown that irritants have little or no effect in treating osteoarthritis. For this reason their use is not recommended.
Prevention of osteoarthritis
It is impossible to guarantee protection against the development of osteoarthritis. However, you can minimize your risk of developing the disease by avoiding injury and maintaining a healthy lifestyle.
Exercise regularly, but try not to put too much stress on your joints, especially your hips, knees and arms. Avoid exercises that place excessive stress on your joints, such as running or strength training. Instead, try swimming and cycling, which keep your joints more stable and their movements easier to control.
Try to maintain good posture at all times and avoid staying in the same position for long periods of time. If you have a desk job, make sure your chair is the right height and take regular breaks to stretch.
Your muscles help support your joints, so having strong muscles will help your joints stay healthy. Aim for at least 150 minutes (2 hours 30 minutes) of moderate-intensity aerobic activity (biking or brisk walking) each week to increase muscle strength. Working out should be fun, so do what you enjoy, but try not to overload your joints.
Lose weight if you are overweight or obese. Being overweight or obese can make osteoarthritis worse.
Living with osteoarthritis
By taking certain steps, you can lead a healthy, active lifestyle with a diagnosis of osteoarthritis. Osteoarthritis does not always progress and lead to disability.
Self-care is an integral part of everyday life. This means you take responsibility for your own health and well-being, with the support of those who also care for you. Self-care is everything you do every day to stay fit and in good physical and mental health. This is the prevention of diseases, accidents, timely treatment of prescribed ailments and chronic diseases.
The lives of people living with chronic illness can be greatly improved if they receive the right support. They can live longer, experience less pain and anxiety, not become depressed, less tired, have a higher quality of life, and be more active and independent.
Following a diet and regular exercise will help keep your muscles toned and control your weight - this will help treat osteoarthritis and improve your overall health.
It is important to continue taking your medications if prescribed, even if you start to feel better. Continuous use of medications can help prevent pain, but if the medications were prescribed with an “as needed” note, there is no reason to take the medications during remission.
If you have questions or are concerned about the medications you are taking or side effects, talk to your doctor about it.
The instructions for use of the drug may also be useful, it describes interactions with other medications and supplements. Check with your doctor if you are considering purchasing pain medications or nutritional supplements, as they may not be combined with the medications prescribed for your treatment.
Osteoarthritis is a chronic disease and you will be in constant contact with your doctor. A good relationship with your doctor will ensure that you feel comfortable discussing any concerns or symptoms you have. The more your doctor knows, the better he can help you.
Complications of deforming osteoarthritis
If you have osteoarthritis, you may have difficulty moving and may have an increased risk of injuries and accidents, such as bruises or falls.
Osteoarthritis of the feet most often affects the joint at the base of the big toe. This can lead to pain while walking and the development of bunions, which is accompanied by the formation of a bone growth in the area of the affected joint. This may be caused by improper footwear, so high heels should be avoided. A foot brace may help relieve symptoms.
If you have had joint replacement surgery (arthroplasty), the new joint may become inflamed. Septic arthritis (infectious arthritis) is a serious complication that requires urgent treatment in hospital.
Many people find benefits in talking to people who suffer from the same condition. You can talk in a group or individually with someone who suffers from osteoarthritis. And there are groups in your city where you can connect with other people with osteoarthritis.
A diagnosis of osteoarthritis can be overwhelming and confusing. Like many people with chronic illnesses, people with osteoarthritis may experience anxiety or depression. There are people whose communication can be useful. Talk to your healthcare provider if you feel you need support to cope with your condition.
Severe osteoarthritis can affect your ability to work. In some cases, difficulties in performing work duties can be overcome through some changes in the workplace. However, if due to an illness you are unable to work or work only during periods of remission, you have the right to sick leave payments, as well as disability registration.
Which doctor should I consult for deforming arthrosis (DOA)?
With the help of the NaPopravku service, you can, which deals with both conservative and surgical treatment of osteoarthritis. If you only need medication, .
Localization and translation prepared by site. NHS Choices provided the original content for free. It is available from www.nhs.uk. NHS Choices has not reviewed, and takes no responsibility for, the localization or translation of its original content
Copyright notice: “Department of Health original content 2020”
All site materials have been checked by doctors. However, even the most reliable article does not allow us to take into account all the features of the disease in a particular person. Therefore, the information posted on our website cannot replace a visit to the doctor, but only complements it. The articles have been prepared for informational purposes and are advisory in nature.
Arthrosis of the hip joint is a progressive chronic disease that develops in older people after suffering injuries, infections, or spinal damage. Most elderly people are affected by this disease. Almost 75% of people find signs of arthrosis. The affected area may affect the left or right joint. Modern means stop the destruction of the joint and cure it in the early stages of the disease.
Treatment of hip arthrosis in the elderly is carried out in several ways (the use of traditional and alternative medicine). In order to detect the disease in time and not lead to surgical intervention, you need to establish the correct diagnosis. Treatment should be carried out under the supervision of a doctor, using a set of measures to prevent the disease.
Diagnostic methods include magnetic resonance imaging, computed tomography, and x-rays. In combination, the methods allow you to find out the condition of the tissues and consider individual symptoms. The task will be to establish pathology in bone tissue and the causes of arthrosis in older people.
When treating hip arthrosis in older people, it is worth identifying measures that help improve the immune system:
- Compliance with the requirements for a balanced diet;
- Getting rid of excess body weight;
- Massage;
- Use of drugs;
- Therapy using folk remedies.
It is worth following a proper, healthy diet. Products must contain sufficient amounts of vitamins and macroelements. The body will receive substances that can stop further destruction of cartilage.
If you are overweight in old age, it is difficult to deal with. Excess weight is the main enemy for sore joints and adds stress to the bones.
When using medications (chondroprotectors), the result is not immediately visible.
Treatment with massage and physical exercise improves blood circulation in the body, relieves pain and swelling, which will allow the cartilage to receive the required amount of nutrients. Exercises will allow you to stretch your joints without allowing them to stiffen. Massage several times a day. Types of massage and exercises are prescribed by a doctor.
Treatment helps solve problems:
- Reduced pain;
- Restoration of normal blood circulation;
- Strengthening muscles;
- Reducing the load on the sore joint;
- Slowing down the destructive process in bone tissue, the restoration process;
- Increased gap in the joint;
- Improving metabolic processes in muscles;
- Improvement of the patient's condition;
Treatment with orthopedics is an important branch in providing care for arthrosis in older people. It is varied and depends on the condition of the hip joint.
In addition to the measures taken to treat the disease, studies are prescribed:
- Clinical blood test;
- Biochemical analysis;
- General clinical urine analysis;
- Tissue analysis by biopsy;
- Study of cartilage tissue;
- Ultrasonography.
To determine the causes and course of the disease, it is enough to see the general indicators of clinical and radiological data.
Treatment of the disease at the first stage will be effective. Fixing garters are used to maintain the position of the joint. In subsequent stages, the effectiveness decreases. The third stage is characterized by complete destruction of cartilage; medications do not work. Complications in such cases are:
- Complete immobility of the patient with damage to the hip;
- Constant pain in the joint area;
- Development of concomitant diseases (pneumonia).
Hip fusion can occur at home. Surgery is stressful for the patient, especially when it is performed in old age. In order for the patient to recover faster, he is sent to health procedures in a sanatorium or rest home.
The operation is prescribed when the disease reaches stage 3; the destroyed joint can only be restored by replacing it with a prosthesis. Surgical intervention can be prescribed at the second stage of the disease for speedy reconstruction of the body. In the future, the disease will no longer bother the person, which will help return him to his everyday environment.
The operation allows you to restore the functional abilities of the hip joint; the prostheses last for many years before their subsequent replacement. You should follow your doctor's recommendations - violations associated with improper handling of the implanted joint can lead to injury and re-operation. If the operation is successful, joint mobility returns to normal and constant pain disappears.
There are ways to eliminate hip joint disease through surgery:
- Application of intra-articular surgery;
- Surgery outside the joints;
- Use of combined methods;
After using one of the methods, the patient’s pain is eliminated and mobility is lost for some time. This makes it difficult to work after leaving the hospital. When the load is placed on the lower back, back pain may occur. Therefore, at the first suspicion of arthrosis of the hip joint, you should immediately seek help.
Treatment with unconventional methods
For older people, this method of treatment is close. Traditional methods of treating hip arthrosis are divided into several categories:
- External use – natural ingredients that help relieve pain (compresses, health baths, rubbing, ointments from aloe, eucalyptus, and other plants). The composition includes medicinal plants;
- Internal use - various infusions, decoctions.
Honey is an assistant in activating restoration processes. Contains many vitamins and microelements necessary for the body. Relieves joint pain.
Herbs and decoctions produce an anti-inflammatory effect. During use, there is a possibility of contraindications and acceleration of destructive processes in the joints, so before use you should find out your doctor’s recommendations. It is more effective to use unconventional methods of treatment together with pharmaceutical methods. Treatment with the help of comprehensive measures will avoid disability and death.
Medicines for arthrosis of the hip joint
A course of medications for the treatment of arthrosis in older people includes drugs:
- Glucosamine;
- Rumalon;
- Mydocalm;
- Sirdalud.
This group of drugs relieves muscle pain and restores blood supply to damaged tissues. Promotes saturation of tissues with microelements.
It is difficult to advise older people on expensive operations to replace a diseased joint with an implant. The procedure is difficult to tolerate at this age. It is worth paying attention to strengthening measures that can freeze the process of tissue destruction:
- Increase walking, provided there are no exacerbations of hip joint disease. Help with arthrosis of the joint is provided by: swimming, skiing, cycling.
- To avoid overstraining the musculoskeletal system, use additional means - a cane, a stick.
- Do not get carried away with painkillers - they temporarily relieve severe pain and accelerate the process of destruction of cartilage tissue. Medicines negatively affect intestinal function; they should be replaced with folk remedies.
- Perform exercises to improve the condition with caution, each of them has a specific effect (the intensity of implementation should depend on the patient’s condition) and can increase pain.
A new achievement in the treatment of arthrosis is the use of oriental medicine. Helps improve metabolic processes in the body, balances blood flow, and muffles pain. You should not be treated only on the basis of traditional medicine in order to relieve pain and eliminate the disease.
Treating arthrosis with the right diet
A properly chosen diet is the key to restoring the body during the breakdown of cartilage tissue. The main goal is to fill the body with proteins, lose excess weight, and limit the consumption of salty foods. The diet allows you to relieve stress on the joints, eliminate pain, discomfort, and restore damaged areas of the joint.
During the diet, adhere to the following diet:
- Eat enough protein foods (fish, meat);
- Use dairy products (cottage cheese, fermented baked milk);
- Cook porridge in water;
- There are vegetables;
- Avoid alcoholic and strong drinks.
Osteoarthritis of the hip joint is a complex, serious disease. More often, its development is the patient’s experience of a chronic disease with pathology. Prevention is the right way to avoid joint disease. Its measures allow you to prevent injuries, adjust your diet, and avoid heavy physical activity. By ignoring arthrosis in elderly patients, they can become disabled.
Osteoarthritis occurs almost everywhere in older people. According to statistics, more than 70% of people aged 65 have some signs of osteoarthritis of the joints. Almost anyone who has undergone the diagnosis can receive a diagnosis of arthrosis by the age of 75 in an elderly person. What is the danger of the disease for advanced age, what are the features of treatment, how does this disease of a degenerative-dystrophic nature proceed - we will try to tell you today.
Progression of the disease in the elderly
Like any disease, arthrosis of the joints in old age is much more difficult than in younger years. Most often, more than one disease is added to the ailment that affects cartilage tissue, joint fluid and bone surface: an elderly person experiences problems with the cardiovascular system, gastrointestinal tract, metabolism, etc. When other organs and systems of the body do not work properly, the course and process of treatment becomes more labor-intensive.
Another problem with osteoarthritis in older people is weak bones for their age. Calcium leaching, nutritional imbalance, problems with the metabolic system, excess body weight, and lack of physical activity lead to brittle bones and frequent injuries. Post-traumatic arthrosis is much more difficult for an elderly person to endure than for young bones to heal and recover.
Treatment of an “aged” patient causes certain difficulties due to the intake of several groups of medications, often contradicting each other. It is difficult for a doctor to choose the appropriate course of therapy so as not to harm the diseased organ or system.
Treatment of arthrosis in old age
Taking into account the above nuances, a competent doctor, first of all, will prescribe a course of measures to improve immunity and improve the health of the body as a whole for an elderly patient with arthrosis:
- Compliance with healthy eating standards;
- Loss of body weight;
- Course of chondroprotectors;
- Exercise therapy, yoga;
- Massage and manual therapy sessions;
- Treatment with traditional methods of arthrosis of the joints;
First you need to establish nutrition, which is subtle, but one of the important factors in healing degrading cartilage. The diet must include foods rich in a variety of vitamins and natural microelements. Proper nutrition will saturate the body with useful substances that boost immunity, nourish cartilage, and protect it from further destruction.
If there are problems with excess weight, then it is difficult to fight arthrosis in an elderly person if it is not solved. Excess body weight has the most negative effect on the health of diseased joints, since every extra kilogram increases the load on the bones. This is especially harmful for patients with coxarthrosis of the hip joints, spondyloarthrosis of the spine, arthrosis of the lower extremities (gonarthrosis, osteoarthritis of the foot, lower leg).
Chondroprotectors are medications designed to protect affected joints, namely, to stop degenerative processes in articular cartilage, restore its elasticity, integrity and full functionality. Unlike popular NSAIDs and painkillers, chondroprotectors do not act on external signs (pain, inflammation, swelling), but on the root of the problems that caused them. True, treatment of arthrosis with chondroprotectors takes many months, and the effect is not immediately noticeable, which is why, unfortunately, most people stop continuing the course of taking the drugs.
Therapeutic physical training will allow an elderly patient to increase not only the overall tone of the body, but also, which is very remarkable, to improve blood circulation, which means that the cartilage will not suffer from a lack of nutrients. Gymnastic exercises will help increase the amplitude of rotation of the joints, preventing them from stiffening. The set of exercises depends on the specific type of arthrosis and the stage of the chronic disease; it should be suggested by the attending physician. But in general, even an ordinary 15-minute, which was spent at school during physical education lessons, will be of great benefit. 
A massage will have a similar effect, which can be done either by yourself or with the help of a specialist or relatives. Massage is convenient because it does not require any special environment, conditions or equipment. It will increase microcirculation in capillaries and vessels, improve metabolic processes, and relieve mild pain and swelling. To correct deviations caused by dislocations, fractures and other injuries, it will be useful to attend sessions with a chiropractor, who will put the joint in place and can non-surgically make corrections for the correct position of the bones.
Alternative medicine
Non-traditional methods of treating elderly patients with arthrosis will be most understandable to this age category of people. They have not yet forgotten how they were treated in their youth, how their grandparents saved themselves several generations ago, when there was no such a developed chemical industry, and they used recipes suggested by Nature itself and life experience. Traditional methods of treating osteoarthritis in older people are so diverse that it is impossible to describe them.
However, they can be divided into two large groups:
- External exposure;
- Internal influence.
External applications include health baths, compresses, rubbing, ointments, bee stinging, acupuncture. The active substance usually includes natural components found in medicinal herbs and plants of animal origin.
Tinctures, decoctions, all kinds of potions - recipes for internal effects. For the treatment of arthrosis in the elderly, a large number of tips include gelatin, egg yolk, bischofite, cinquefoil, ordinary table salt, burdock, and honey. Read more about them in separate articles devoted to one or another method of folk treatment of joints.
What can be advised to older people diagnosed with arthrosis of the joints? Since it is difficult for elderly people to recommend expensive operations to replace diseased joints with artificial analogues or other types of surgical intervention, due to the difficulty of such operations for patients, emphasis should be placed on general strengthening measures that inhibit the process of destruction of cartilage tissue.
Daily walking for an hour will be useful if there is no exacerbation of the pathology. Swimming, skiing and cycling will also provide invaluable help to affected joints. For coxarthrosis and gonarthrosis, it would be appropriate to use auxiliary means (cane, stick) that will prevent overstraining the musculoskeletal system. Modern industry has created a wide variety of all kinds of orthopedic products to alleviate arthrosis - mattresses, pillows, bandages, collars, knee pads. 
You should not get carried away with strong painkillers for arthrosis, which often only accelerate the destruction of cartilage, temporarily saving you from pain. Steroid drugs have a negative effect on a number of body systems, but especially on the mucous membrane of the stomach and intestines. Instead, you should try to save yourself with folk recipes for pain relief. In any case, before using any prescription or drug, be sure to consult with your doctor and listen to your body - he will tell you the best solution on how to prolong the health of your joints.
O.B. Ershova
Department of FPDO Therapy with a Course of Gerontology, Yaroslavl State Medical Academy
Osteoarthritis is a heterogeneous group of diseases of different etiologies with similar biological, morphological and clinical outcomes, which are based on damage to all components of the joint (articular cartilage, subchondral bone, ligaments, capsule, synovial membrane and periarticular muscles). Osteoarthritis is the most common disease of the musculoskeletal system. It is also one of the main causes of premature loss of ability to work and disability. The most important risk factor for the development of osteoarthritis is age. There are studies showing that signs of the disease are detected in 90% of people over 50 years of age. It is obvious that people in the older age group, as a rule, suffer from not one, but several diseases at the same time, including gastrointestinal and cardiac diseases. This makes it difficult to select adequate therapy for osteoarthritis, since it becomes necessary to take into account numerous side effects and interactions between a number of drugs.
The causes of osteoarthritis are diverse, they are often combined, and the contribution of many factors to the formation of the disease at the stages of its development may be different. There are mechanical effects, biological (genetic) characteristics of joint structures, and inflammation. The pathological process in osteoarthritis is characterized primarily by the degradation of cartilage. Histological changes in cartilage concern two main components of the matrix - collagen and proteoglycans, and are detected already in the early stages of the disease. Cartilage degradation is caused by changes in the structure of proteoglycans, aggregated proteoglycans and a decrease in the aggregation properties of monomers. Damage to articular tissue is not limited to the destruction of cartilage, but is accompanied by inflammation of the synovial membrane, since as a result of damage to the cartilage matrix by proteolytic enzymes, its degradation products enter the synovial fluid in excess, causing an inflammatory reaction of the synovial membrane, which in turn leads to the synthesis of cytokines: interleukin-1 , tumor necrosis factor-a, etc.
The most striking clinical manifestations and consequences of osteoarthritis are: pain and dysfunction of the joint, which force the patient to reduce physical activity.
The action of most drugs is aimed primarily at treating the symptoms of the disease, although some of them are considered as drugs that affect the catabolic and anabolic processes that occur when cartilage is damaged. These medications are classified as disease-modifying drugs. The choice of drugs and the selection of combinations of various treatment methods remain strictly individual. Knowledge of the mechanisms of action, effectiveness, contraindications when prescribing drugs, and the safety profile of drugs is extremely important.
Chondroprotectors are currently one of the main prescriptions for patients with osteoarthritis. However, the effectiveness of only certain chondroprotectors (chondroitin sulfate and glucosamine) has been proven in multicenter randomized studies, and their use in osteoarthritis has a high (A1) degree of evidence. More often they are classified as symptomatic slow acting drugs for osteoarthritis (SYSADOA).
Chondroitin sulfate is a sulfated glycosaminoglycan, which is found in the extracellular matrix of articular cartilage, is a high-grade polyanionic glycosaminoglycan, which is an integral part of the aggrecan molecule of cartilage and is responsible for its cellular and physicochemical properties. In patients with osteoarthritis, the concentration of chondroitin sulfate in the synovial fluid is lower than normal. Chondroitin sulfate therapy is essentially replacement therapy. The results of pharmacokinetic studies indicate that, when taken orally, it is well adsorbed and is found in high concentrations in synovial fluid. In vitro studies have provided evidence that this drug has anti-inflammatory activity, aimed mainly at the cellular component of inflammation, stimulates the synthesis of hyaluronic acid and proteoglycans and inhibits the action of proteolytic enzymes. In experimental studies in vivo, it was found that the administration of chondroitin sulfate orally or intramuscularly to rabbits (with artificial chemical degeneration of cartilage) significantly increased the content of cartilage proteoglycans compared to control animals. This indicates that chondroitin sulfate protects cartilage when damaged and has the ability to support resynthesis of matrix proteoglycan.
There is evidence of the ability of chondroitin sulfate to suppress the formation of superoxide radicals and the synthesis of nitric oxide, which explains the analgesic effect that develops quite quickly during treatment with it. Another mechanism that could potentially underlie its structure-modifying effect is associated with the suppression of catabolic (cytokine-dependent cartilage destruction, inactivation of matrix metalloproteinases) and stimulation of anabolic (proteoglycan synthesis) processes in cartilage, as well as slowing down chondrocyte apoptosis.
A published meta-analysis covering studies up to 1999 is devoted to the study of chondroitin sulfate and glucosamine sulfate. The authors conclude that chondroitin and glucosamine have moderate to significant effects on pain and functional joint mobility in OA compared with placebo.
In a randomized controlled comparative study of chondroitin sulfate and diclofenac, conducted in 146 patients, a more rapid reduction in clinical symptoms was observed in patients treated with nonsteroidal anti-inflammatory drugs (NSAIDs), but a return of these symptoms was noted immediately after discontinuation of therapy. Chondroitin sulfate was characterized by a slower onset of therapeutic action, which lasted up to 3 months after the end of treatment.
The level of evidence for the effectiveness of the original glucosamine sulfate was high (1A). In the multifaceted complex mechanism of action of this drug, the anti-inflammatory component is represented by the ability to inhibit the factor activating pro-inflammatory genes - NF-kb. Glucosamine sulfate is a component of articular cartilage. In vitro, this substance, added to cultured chondrocytes, has been shown to stimulate proteoglycan synthesis. Early short-term studies suggest the effectiveness of oral glucosamine sulfate. Glucosamine monosulfate is a substrate for the synthesis of proteoglycans by chondrocytes, participates in the synthesis of glucuronic acid (a substance that ensures the viscosity of intra-articular fluid), and also inhibits the activity of metalloproteinases (collagenase, phospholipase). It is believed that glucosamine monosulfate has a dual effect - anti-inflammatory and chondroprotective. According to available data obtained from randomized multicenter studies, 1500 mg/day of glucosamine sulfate improved the condition of patients when used alone. In cases where the disease occurred with an unexpressed inflammatory component, the effectiveness of glucosamine sulfate was not inferior to that of NSAIDs. Additionally, data were obtained indicating the presence of an additive effect with the combined use of glucosamine sulfate and NSAIDs.
For all chondroprotectors E.L. Nasonov notes the following common features:
- their anti-inflammatory effect is comparable to that of NSAIDs;
- they allow you to reduce the dose of NSAIDs;
- the effect persists after the end of treatment;
- they are combined with paracetamol and NSAIDs;
- there are practically no side effects when using them,
- they slow down the progression of osteoarthritis (?).
And although the last point needs confirmation, a number of studies have shown the ability of some chondroprotectors to slow down structural changes in joints. As for their real analgesic, anti-inflammatory effect and reducing the need for NSAIDs, this study is almost unanimous, and we, taking into account personal experience and the results of clinical trials, also join this opinion.
There are combination drugs containing chondroitin sulfate and glucosamine sulfate). The duration of taking these chondroprotectors is usually up to 3-4 months; Such courses are recommended 2 times a year. New chondroprotectors consisting of these components are appearing on the market. Several clinical studies have evaluated the effectiveness of a combination of glucosamine and chondroitin (often with other components) compared with placebo. These combinations have not been compared with each other, or with monotherapy, so it is impossible to draw conclusions about the advantages or disadvantages of this approach. Drugs from other groups with a chondroprotective effect are appearing, but the data is still insufficient and, accordingly, the degree of evidence for treatment with these drugs is lower than that of chondroitin sulfate and glucosamine. As an example, let us take piascledine 300, a complex of active phytostyrenes (g-tocopherol and b-sitostyrol) and saturated fatty acids (fraction H), obtained by molecular distillation. In the mechanism of its action, three points should be noted:
- stimulation of collagen synthesis through an anabolic effect by increasing the expression of the transforming growth factor TGF-b1;
- inhibition of collagenolytic activity of chondrocytes by increasing the synthesis of an inhibitor of plasminogen activity, which leads to a decrease in the activity of metalloproteinases;
- decreased production of pro-inflammatory cytokines and PGE.
However, the methods used to treat osteoarthritis cannot be considered perfect, so the search continues for new drugs that could not only reduce pain, but also slow down the progression of joint destruction, and thereby prevent or delay joint dysfunction and the development of disability. Along with this, local (local) therapy, including the use of ointments and gels, is of great importance in the treatment of articular syndrome in osteoarthritis.
Let us recall the existence of such a method of treatment as intra-articular injection of lubricants, which has its own history (many rheumatologists remember the use of polyvinylpyridone for this purpose), but this direction has become popular only since the end of the last century. Currently, hyaluronic acid preparations are used as “artificial lubricant” of the joint. They are usually injected into the knee joint once a week, the course is 3-5 injections, the duration of improvement is 4-6 months. It should be borne in mind that a clearer effect is observed only in the early stages of arthrosis. The domestic drug of this group is a synthetic polymer, the allergenicity of which, due to the fact that it does not contain ingredients of animal origin, is negligible; its entry into soft periarticular tissues does not cause reactions and, therefore, it is possible to inject it into different joints, not just the knee . This drug also has certain antibacterial properties due to the silver ions it contains and can be effective for up to 1-2 years at any stage of arthrosis.
Among the domestic products for local therapy, Chondroxide (ointment) has recently gained recognition, the active ingredient of which is chondroitin sulfate, due to which it has a stimulating effect on the regeneration of articular cartilage, which allows this drug to be classified as a replacement restorative agent, identical to mucopolysaccharides and glycosamines. Recommended for external use by applying 2-3 times a day to the skin over the lesion and rubbing for 2-3 minutes until completely absorbed.
Dimethyl sulfoxide has anti-inflammatory, analgesic and fibrinolytic effects, promotes the penetration of chondroitin through cell membranes and its entry into periarticular tissues, muscles and the joint cavity. The active substances of Chondroxide are chondroitin sulfate and dimethyl sulfoxide.
Chondroitin sulfate is a structural modulator that is not only synthesized by the body, but also, after administration, integrates into the structures of cartilage tissue, stimulating its synthesis and inhibiting destruction. Its timely administration and regular use ensure inhibition, stabilization and prevention of the development of destructive processes in the joint. When applied topically, dimethyl sulfoxide also causes a general anti-inflammatory effect and helps to enhance the direction of other drugs into inflamed organs (tissues).
Thanks to its unique composition, Chondroxide ointment has a rapid and pronounced analgesic and anti-inflammatory effect, and has a chondroprotective and regenerative effect.
With an integrated approach to the treatment of patients with osteoarthritis, physiotherapeutic methods are widely used, the use of which helps to improve microcirculation in the subchondral bone, synovium and periarticular tissues, metabolism, and slow down destructive processes. Techniques such as ultrasound, electrophoresis with drugs, laser therapy, paraffin therapy, magnetic therapy and many others in patients with osteoarthritis lead to a decrease in muscle spasm, increased lymphatic drainage, improved blood supply to tissues, reduced pain and increased functional activity of the joints. However, the widespread use of many treatment methods is limited due to the frequent presence of contraindications in patients with this disease due to concomitant pathologies, such as cardiovascular, including arterial hypertension, coronary heart disease, rhythm disturbances, as well as diseases of the thyroid gland, uterine fibroids , mastopathy, etc. Magnetotherapy, including magnetophoresis of drugs, unlike other physiotherapeutic methods, does not have side effects, which makes it possible to use it for various concomitant pathologies. An important difference between magnetic therapy is the possibility of using this method in any phase of local inflammation, including in the presence of synovitis. For magnetophoresis, the authors used the Polyus-2 apparatus for low-frequency magnetic therapy. Magnetophoresis was carried out in continuous mode with a frequency of 50 GU (stepped intensity, up to 4, duration of one procedure - 15 minutes).
According to a study conducted by V.N. Sorotskaya et al. , the use of magnetophoresis with Chondroxide ointment in the treatment of patients with osteoarthritis of large joints (knee, hip, shoulder) provided a pronounced analgesic effect. At the same time, against the background of this therapy, there was a significant improvement in the functional state of the joints, as well as a more rapid onset of the positive effect of treatment compared to patients who received only basic therapy. Along with this, magnetophoresis with Chondroxide ointment has proven itself to be not only an effective, but also a safe method of treating osteoarthritis, including in patients for whom phonophoresis is contraindicated.
According to the authors from CITO im. N.N. Priorova, for the treatment of arthrogenic pain in osteoarthritis, the use of chondroxide by ultraphonophoresis is more effective. Due to the presence of dimethyl sulfoxide in the composition of the drug, the permeability of the skin increases, which means that the penetration into the body of chondroitin sulfate, which acts in the metabolism of proteoglycans and thereby ensures an increase in the synthesis of cartilage matrix components and inhibition of the processes of cartilage destruction, is improved. This achieves an anti-inflammatory effect in recurrent synovitis, which is one of the causes of arthrogenic pain in osteoarthritis. The course of treatment includes 8-10 daily procedures. Phonophoresis should be carried out as follows: 5% chondroxide ointment is applied around the circumference of the affected joint and rubbed in for 2-3 minutes until completely absorbed (ultrasound intensity - 0.40.6 W/cm 2, technique - labile, mode - continuous, 3- 5 minutes on the field). Chondroxide phonophoresis is safe, does not cause side effects and can be recommended for complex therapy of osteoarthritis.
In general, the main advantage of Chondroxide is the combination of anti-inflammatory, analgesic and chondroprotective effects, which allows, while solving the main problem of treating osteoarthritis - the use of disease-modifying therapy with chondroprotectors, to reduce the use of non-steroidal anti-inflammatory and analgesic drugs that cause a number of serious side effects (gastrointestinal, cardiac, etc. )
Thus, the drugs used for osteoarthritis are numerous and varied. At the same time, the correct choice of the type of therapy and prescription regimen with the mandatory inclusion of drugs that have a chondroprotective effect is extremely important, since in this case not only the effectiveness of treatment increases, but also the quality of life of patients improves.
Literature
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