With increasing age, the vast majority of people are faced with the acute question of how to treat osteoarthritis of the knee joint with typical symptoms.
This disease is inherent in its various stages.These include the appearance of swelling in the knee area, redness around these swellings, creaking and rustling, clearly audible in silence when the knee moves, especially during squats, and a pronounced pain syndrome of varying intensity.Pain may occur immediately after normal, everyday physical activity or after physical activity of inappropriate duration and intensity for the age.When we look at the underlying causes of this pain, we must remember that its occurrence can also be the consequence of:
- Inflammatory process in the knee joint.That is, a result of arthritis.It occurs as an independent pathology or as a complication of other diseases.
- Osteoarthritis is a degenerative process in which the tissue of the joint is destroyed, it loses its mobility and, if the osteoarthritis lasts for a long time, also leads to deformation of the joint.
- Injuries.Most commonly, it occurs from a fall, a blow to the knee, or a blow to the knee on a hard surface.The joint may become deformed.
- Ligament damage.Ligaments hold the joint in the correct position, preventing it from moving.But if they are damaged (stretched, displaced, torn), the joint also suffers - with severe pain and the development of a tumor.In such cases, in order not to aggravate the injury, urgent medical attention and rest for the injured leg are required.
- Damage to the meniscus of the kneecap.This protruding, round, mobile cartilage in the knee can also be injured when squatting or turning sharply.Due to the swelling of the knee joint that often occurs in such cases, visual detection is not always possible.An accurate diagnosis is made by an experienced specialist using ultrasound, x-rays and palpation.
- Popliteal cyst (Becker cyst).The inflammation causes fluid to form in the joint, which collects on the inside of the back of the knee, in the area of the tendons.
- Inflammation of the ligaments and tendons (tendinitis).They cause unpleasant, painful sensations along the ligaments and are accompanied by swelling.The pain increases when the knee is strained (flexion and extension), radiates to the area along the muscles along the ligaments and nerves, above the knee, into the thigh ligaments and muscles and below - into the lower leg.
- Ischemic pain due to impaired blood circulation in the knee joints.They can result from a sudden change in the weather or severe hypothermia over a long period of time.Examples include sailors who work at high (arctic) latitudes for long periods of time.In most cases, the location of the pain is symmetrical, equally intense and does not affect joint mobility in the first stage.
The most serious mistake in such cases would be to ignore the pain and hope that if you just rest, “everything will go away on its own.”Only a specialist can give treatment recommendations and make a correct diagnosis.Therefore, treatment of arthrosis of the knee joint at home only on the basis of the advice of “knowledgeable people” and even using pure traditional medicine is unacceptable.Effective treatment is only possible with a combination of medications in the form of tablets, rubs, ointments and the use of physiotherapy.In severe or advanced cases, surgery sometimes cannot be avoided.
Make a diagnosis
The diagnosis of osteoarthritis of the knee joint can be made by an orthopedist based on movement tests and anamnesis.As a supplement to diagnostics, the following procedures are usually prescribed:
- In connection with laboratory tests such as a biochemical blood test and bacterial microflora, a smear, a puncture of synovial fluid and/or bone marrow, a serological analysis, i.e.h.a test for the presence of antibodies and antigens in the blood serum.
- Instrumental studies, which may include ultrasound, magnetic resonance imaging, densitometry and others.
- Examination of the internal joint capsule using an arthroscope - a device for minimally invasive surgery to penetrate the cavity through an incision.This method is most often used after damage to the meniscus or for tears and severe wear of the cartilage tissue, as well as to restore the anterior cruciate ligaments.Although the anthroscope has recently been rarely used as a diagnostic tool, it has been successfully replaced by a completely non-invasive diagnostic method using MRI.
- Only “by ear” – with third-degree joint damage, extraneous noises in the form of creaks, rustles and clicks are clearly audible in the joint.
The information obtained is summarized into a general anamnesis and only on this basis can comprehensive and effective treatment begin.
How to treat gonarthrosis?
Restoring joint mobility is not a matter of a month.The treatment is complex, expensive due to the high cost of drugs, and the result depends only on the patient's willingness to cooperate with the doctor and strict compliance with all medical recommendations and prescriptions.
But first.It is important to reduce the load on the affected joint(s) immediately.If the work involves such a strain, negotiate with management (if necessary with a medical certificate) about changing your type of work.For a while or forever - life will tell.Although bed rest may often be necessary initially to initially restore joint function.Remember: a joint is not a muscle, you cannot “train” it with intense exercise, it will only make it worse.Activation of life through intense movement may be required later, after the most acute inflammation has subsided.But even as the load increases, you need to use aids such as elastic elastic bandages, a cane, a crutch, etc.Sometimes you can't do without special orthopedic insoles or even custom-made orthopedic shoes.
Treatment of arthrosis of the knee joint is also possible at home with outpatient medications prescribed by a doctor - chodroprotectors, painkillers and anti-inflammatory drugs.Depending on the degree of joint damage and the type of inflammation, the doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs).However, despite their effectiveness in relieving symptoms, they do not eliminate the causes of the disease.
If you have osteoarthritis, do not warm painful joints!On the contrary, place an ice pack on the inflamed area - it will relieve swelling, redness and inflammation.
The use of chondroprotectors, on the other hand, does not relieve the pain.But the restoration of the cartilage tissue will progress slowly but surely.The only question is the effectiveness of the drug, but you should try to use proven and certified drugs for treatment.Preferably internationally recognized.
For some types and severities of joint damage, applying and permanently (or temporarily) wearing a tightening bandage that immobilizes the joint may be helpful.However, this measure should only be used if the method has been approved by the attending physician, since in some types of arthrosis, wearing such a bandage can worsen the course of the disease.
When you have knee pain, you cannot completely immobilize yourself.In addition, some forms of inflammation require moderate physical activity, which only benefits the joint.An orthopedic doctor will tell you when and how much you should exercise.In addition, complete passivity in relation to physical activity leads to weight gain, which further aggravates the situation by putting stress on the joint.
Drug treatment is usually combined with physiotherapy courses that are most favorable for the treatment of arthrosis: magnetic and laser therapy (coherent laser radiation is used at safe frequencies), mechanical vibration and ultraphonotherapy, microwave systems with deep effects on the tissue - if therapeutically justified.
When diagnosing, three degrees of arthrosis of the knee joint are distinguished.
Osteoarthritis I degree
The mildest degree of the disease.It is characterized by the fact that the treatment does not require a large amount of medication, the list of medications is small and measures such as physiotherapy, massage and exercise therapy help well.Laser therapy is considered one of the most effective methods, significantly alleviating pain, stimulating the regeneration of irradiated areas and reducing inflammation.In addition, the use of coherent radiation with a precisely defined wavelength eliminates the use of glucocorticosteroids in treatment, which cause many side effects.
Second degree osteoarthritis
It is characterized by more intense and acute processes of inflammation and degeneration of cartilage tissue.In the acute phase, special medications are prescribed, a special diet is recommended and physiotherapy tailored to such cases is recommended.Physiotherapy and massage are excluded during these periods.
Recommendations: reducing the load on the affected joint, limiting walking, avoiding movements associated with squatting.Special orthoses can be prescribed for the knee joint, which fix the joint and severely limit its mobility.
In the medical arsenal for the treatment of second degree arthrosis, in addition to chondroprotectors with glucosamine and chondroitin, steroid drugs and anti-inflammatory non-steroids may also be included.It is possible to inject hyaluronic acid and other medications into the joint capsule to facilitate sliding of the cartilage surfaces relative to each other.
A special diet with excess collagen is prescribed: jellied meat, jelly, aspic, and from confectionery - gelatin soufflé.Including fish oil in your diet is beneficial.
Osteoarthritis III.degree
If the knee joint is affected by third-degree arthrosis, treatment does not differ much from the previous disease - except that the frequency of medication intake increases with a slight shift towards glucocorticosteroid hormones.If there are no results, surgery followed by joint replacement is required.
Gonarthrosis of the knee joint
All this applies primarily to people of working age, where organic damage to the knee joint is caused by extreme circumstances and has no connection with the aging of the body.
A completely different picture emerges when a person reaches the age of 50: when the flexibility of the ligaments is lost, processes of tissue drying out begin and the metabolism slows down.
Under these conditions, the development of gonarthrosis begins - a deforming arthrosis of varying degrees of severity.In the classification recognized in medicine, gonarthrosis of the knee joint is divided into degrees I, II and III.
Once this disease starts, it progresses very quickly.Refers to acquired age-related pathologies of the musculoskeletal system.To some extent, it is inherent in all patients after 50 years - another thing is that by leading a healthy lifestyle and avoiding extreme physical activity, the integrity of the cartilage layer in the joints can be maintained both after 70 and 80 years.
Possible outbreak of the disease
The knee joint in the human body, located between the shinbone and femur, carries perhaps one of the heaviest loads.An example would be regular running on hard surfaces (usually asphalt): every step when running causes shock loads on the knee joint.
This joint also includes the largest movable sesamoid bone - the patella, which is located at the apex of the tendons of the quadriceps femoris muscle.The articular surfaces are covered with a cartilage membrane made up of chondrocytes that is up to 2.5 mm thick.Drugs under the general name chondroprotectors help restore those cartilage tissue cells, which are mainly affected by gonarthrosis.
There are primary and secondary osteoarthritis of the knee joints.The etymology of the first is not fully understood and may have different reasons.When – through a sedentary lifestyle and when, conversely, through too much physical activity.Poor ecology, obesity and addiction to smoking or alcohol can also have an impact.Doctors consider the identification of the first stage of arthrosis to be a great success, since the cause of the pathology is difficult to analyze.
Regular hypothermia of the feet can also trigger the outbreak of the disease.Therefore, for people with a tendency to such diseases, it is better not to choose professions associated with the cold (refrigerators, marines in northern latitudes), etc.
In women over 45 years of age, the frequent development of gonarthrosis is associated with long-term use of contraceptives due to a decrease in natural estrogen synthesis.It also often occurs during menopause or under the influence of gynecological diseases such as myomas, fibroadenomas, endometriosis, endometrial hyperplasia.In women, gonarthrosis is also often provoked by strict weight loss diets, which remove many useful minerals and vitamins from food.
It is much easier to decide on ways to influence secondary arthrosis, which can be a consequence of:
- defects in the development and formation of tissues;
- The influence of neurodystrophic processes in the cervical and lumbar spine;
- arthritis of the knee joint;
- His injuries and microtraumas;
- Meniscectomy, i.e. surgical removal of the meniscus;
- Hormonal imbalances and endocrine chronic diseases;
- Vigorous and constant physical activity, including sports.To prevent joint injuries after 40 years, it is better to significantly limit all exercises that involve extreme loads on the knee joint (in the form of running on hard surfaces or squats with a load) and later abandon them altogether;
- Abnormal joint mobility.This condition occurs when the ligaments that hold the joint in proper position are underdeveloped or naturally weak;
- Stress and constant nervous tension.
Signs and symptoms of disease onset (stage or degree)
- Stiffness of the knee joint in the morning;
- The appearance of pain in the knee when walking a distance of one and a half kilometers;
- Pain in the joint after standing for a long time (even without movement);
- Pain in the knee even after complete rest, up to 2 hours, while sitting;
- Pain before going to bed or in the first half of the night when sleeping.
These signs need to be paid the utmost attention, because if you do not seek medical attention during this period, the disease will begin to progress rapidly, leading to the second stage of the disease.
Grade goranthrosis II
What is typical:
- Night pain, as well as pain in the first few minutes of the morning when getting up.
- Pain when climbing stairs.
- Possibility to use public transport with restrictions.
- Mild lameness.
- The appearance of pain when moving at a distance of up to 800-1000 meters.
- Limited ability for self-care.
Measures to simply increase synovial fluid production are often an effective way to cure even second-degree gonarthrosis.
Goranthrosis grade III
Characterized by:
- Pain that begins immediately after rest or occurs after 500 meters of quiet movement;
- severe lameness, when the help of improvised means (canes, crutches) is required;
- Stiffness after waking up for up to half an hour or even longer;
- Inability to climb stairs or enter high-level vehicles independently or without assistance;
- Night pain even without moving the joint.
The affected joint develops ankylosis, a condition in which the joint ends of adjacent opposing bones fuse.The leg completely loses mobility and the only way to restore it is to replace the joint with an artificial one.
The choice of drugs and treatment methods depends not only on the degree of damage to cartilage tissue, but also on the patient's age, his tolerance to certain drugs and physiotherapeutic influence methods.
When diagnosing, a distinction is often made between unilateral and bilateral arthrosis as well as between unilateral arthrosis on the right and left side.The latter is often diagnosed in left-handed people.
Nutrition for gonarthrosis
First of all, doctors advise excluding red meat and offal such as liver from the diet.Priority should be given to fruits and vegetables, grains with a high gluten and fiber content, without salt and sugar.As well as fermented milk products, fish and nuts.
The last meal should be at 7:00 p.m. at the latest.The frequency of food intake can remain known because it has evolved over many years.But it is better to eat in portions - in small portions 5-6 times a day in the morning.
Breakfast should be as rich as possible - it prepares the body for work and keeps you strong until lunch.
If the feeling of hunger becomes unbearable, especially at the beginning, trick your stomach - eat an apple or chew a carrot.Just don't eat high-calorie bananas and grapes!
Don't give up jellied meat.Transport of collagen to the body and joints - the raw material for building cartilage tissue.
Drink at least 2 liters of fluids per day: water and/or natural juices.
Eliminate the following from your diet:
- Red meat;
- lard, smoked meats of all kinds;
- Everything is sharp;
- semi-finished products of unknown origin;
- Carbonated drinks containing sugar;
- Vegetables: white cabbage, tomatoes, red peppers.
- Potatoes because they have a lot of calories (carbohydrates!) and help with obesity.Therefore, the Dukan diet will be relevant.
Treatment of gonarthrosis in a sanatorium
To treat osteoarthritis of the knee joint, the facility uses a wide range of physiotherapy, mud therapy, acupuncture and all kinds of massages.
One of the most advanced treatment methods is intra-articular injections of hyaluronic acid.They compensate for the lack of production of our own hyaluronic acid, which serves as a lubricant for the joint surface and protects it from abrasion.The effect of this procedure is noticeable on the first day.The effects of an injection last on average for a month.Patients in advanced stages of arthrosis already in the first days feel significant relief from the pain that has tormented them for many years, and people with a moderate course of the disease, grade 1-2, after a course of 5 injections, in most cases completely forget about the pain for about six months.