Arthrosis rheumaliga switzerland

ArthrosisArthrosis is understood as the slowly progressive degradation of Articular cartilage. each joint is a movable connection of two (or more) bones. The bones are covered with a thin layer of cartilage towards the joint space. In a healthy joint, this forms an elastic buffer with a well-lubricated, mirror-smooth surface. A completely different picture emerges under the conditions of arthrosis: the damage to the cartilage goes as far as its complete destruction – it then rubs bone on bone. Arthrosis can cause joint pain. Severe limitation of mobility.

Cartilage degradation is often accompanied by synovial inflammation. The synovium begins to proliferate, destroying cartilage tie, tendons and ligaments, and may invade bone. Nevertheless, arthrosis does not belong to the inflammatory, but to the degenerative Forms of rheumatism.

In principle, arthrosis can affect any joint. The knee joint, the hip joint and the finger joints are most commonly affected. If the thumb saddle joint is affected, it is called rhizarthrosis.

Osteoarthritis is the most widespread joint disease. 90% of people over 65 suffer from more or less advanced osteoarthritis. If younger people are affected by osteoarthritis, it is usually because of severe overweight.

First Warning signs The main symptoms of osteoarthritis are morning pain on onset, joint pain on exertion and joint swelling. See a doctor if you suspect your joint pain is from osteoarthritis.

Causes

Many arthroses can be traced back to a malposition or an excessive load of joints. Apart from this, the widespread lack of exercise seems to promote arthrosis. Joints that are not moved enough lack synovial fluid. This is the joint fluid that supplies the cartilage cells with nutrients. Dying cartilage cells die, releasing chemicals that soften the cartilage. Its surface becomes cracked. Abraded by joint movement.

These connections are obvious. Less clear are the deeper causes that set arthrosis in motion. One suspects an interaction of different factors.

Genetics

A large role seems to play the hereditary predisposition. This is indicated by the fact that osteoarthritis of the fingers and knees is much more common in some families than in others. Genetics can affect the formation of joints or the development of cartilage already during the initial development of the human body.

Overload

Excessive stress on the joints due to overweight, physical work or certain sports also contributes to the development of osteoarthritis. Some people are particularly sensitive to stress; their cartilage is not very resistant. Furthermore, a bone fracture, a sports injury, and knock knees or knock knees can promote the development of osteoarthritis.

Inflammatory underlying diseases

If inflammatory forms of rheumatism such as z.B. If the joint cartilage is affected by gout or rheumatoid arthritis, arthrosis can also develop as a result of this underlying disease. This is referred to as secondary arthrosis.

Symptoms

The first signs of osteoarthritis are dull or stabbing pains that occur when an affected joint is moved and loaded. Arthrosis differs from arthritis, in which the joints can hurt severely even when at rest. Many arthrosis sufferers are familiar with the sog. Start-up pain after a period of rest. If you move the painful joint for a while, the pain disappears.

Typical joint pain at the beginning of arthrosis

– Starting pain in the morning – fatigue pain z.B. after standing for a longer period of time – strain pain e.B. after walking or running

In advanced osteoarthritis, constant pain develops during periods of movement and at rest. Osteoarthritis pain is usually limited to the affected joint. Only in the case of hip arthrosis can there be pain in the groin that radiates into the buttocks or knees.

Stiffness of the joints

A joint affected by osteoarthritis is often stiff, especially after a period of rest. If one wants to z.B. after prolonged, immobile sitting, the affected knee may strike. These sog. Stiffness in starting or running disappears through exercise.

Restrictions of mobility

Osteoarthritis in the knee or hip makes walking and sitting difficult. Putting on socks and tying shoes can become a challenge. In the case of shoulder arthrosis, the arm can no longer be lifted far enough: Affected persons are no longer able to slip into a coat or comb their hair. Restricted movement leads to relieving postures that only worsen the situation. This is because relieving postures weaken the surrounding muscles. Thus destabilize the joint.

Other symptoms of osteoarthritis

In the case of strong cartilage degradation, the rubbing together of the bones can cause crunching or cracking sounds Sounds cause. But this says nothing about the severity of the disease. Such noises can also be made by healthy joints.

Likewise, at the edges of the joint can be Bone outgrowths (osteophytes) form. They are an attempt by the body to relieve the bearing prere by increasing the joint surface area. Bony outgrowths may limit joint mobility and press on nerves and soft ties, causing further pain.

Further it can in arthrotic joints to Irritations come, especially in the knee and fingers. The joints are warm and swell, the skin may be reddened.

At times, years of osteoarthritis can change the position of bones. Knee osteoarthritis can lead to bow legs or knock-knees, hip osteoarthritis to a difference in the length of the legs.

Diagnosis

For the diagnosis of arthrosis, the doctor performs a physical examination and, in the exclusion procedure, comes to the conclusion that the complaints cannot be attributed to any other disease. The severity and extent of the arthrosis can be detected on X-rays. They provide information about the joint space. Show changes in the bones. Blood tests are not necessary for the diagnosis of osteoarthritis.

Treatment

Osteoarthritis is considered incurable. However, arthrosis can be treated, although it should be noted that the disease can be very changeable. A good Therapy mix inhibits the pain and inflammation, preserves the mobility of the affected joint and promotes the independence of the affected person.

Ideally, the family doctor, the rheumatologist, the therapist and other specialists work together in the sense of an interdisciplinary therapy to determine an individual treatment program.

Movement

A joint attacked by arthrosis should be moved, but not strained. Affected individuals learn in physical or occupational therapy how to properly load the affected joint, keep it mobile, and strengthen the muscles and tendons around the joint. Regular exercises increase endurance. Improves coordination.

The exercise program can be supplemented with physical treatments such as heat, direct current, infrared and UV light, water treatments, massage and (in the case of inflammation) cold treatments.

Drug treatment

Pain medication

The drug treatment of osteoarthritis can combat the main complaints quite efficiently. Even simple painkillers with paracetamol can make the affected joint operational again.

If the joint is irritated, doctors prescribe non-steroidal anti-inflammatory drugs (NSAIDs), which are usually taken in tablet form. They simultaneously inhibit inflammation and pain, but can also affect the stomach and intestines. Another medication is often needed to prevent such side effects. NSAIDs can also be applied to the affected joint in the form of ointments or patches and are then better tolerated.

Cortisone preparations

In the case of severe irritation, medications with cortisone help. The doctor injects the cortisone preparation directly into the joint. This application can provide a quick. Bringing long lasting improvement. However, because of the side effects, such injections should not be given too frequently.

Chondroitin

The body's own cartilage protection substances such as chondroitin (actually chondroitin sulfate) open up a new treatment perspective. The chondroitin formed by the cartilage cells makes the cartilage resistant to prere and strain. Some initial studies indicate that chondroitin preparations are able to inhibit cartilage degradation.

Hyaluronic acid

Pain relief is promised by preparations containing hyaluronic acid, another substance produced naturally in the body. Hyaluronic acid is the main component of synovial fluid (synovia). Provides lubrication for smooth joint movement. Hyaluronic acid preparations injected directly into the affected joint by the physician are better tolerated than cortisone.

Complementary medical treatments

The market of complementary medicine is hardly to be surveyed. The Swiss Rheumatism League recommends consulting a well-trained therapist and informing the treating physician about additional treatments.

Herbal painkillers

For the gentle treatment of osteoarthritis, there are some well-tested remedies from herbal medicine (phytotherapy) and orthomolecular medicine. Herbal painkillers based on willow bark or devil's claw are popular and can relieve pain if taken regularly. Ointments can be applied locally. gels with active substances from arnica or comfrey. These preparations are usually very well tolerated. Can be easily combined with orthodox medicines.

Chinese medicine

From the range of traditional Chinese medicine, it is mainly acupuncture that can lead to a significant reduction in joint pain, according to a study (2014). The longer the treatment period, the greater the pain reduction.

Magnetic field therapy

For some time now, magnetic therapy has been promoted for the treatment of various forms of rheumatism. In osteoarthritis, it seems to have a certain pain-relieving effect.

Surgical treatments

If conventional treatments do not work, surgery may be considered. Medical laypersons mostly think of an artificial joint. However, the spectrum of surgical treatment options is broader. It ranges from joint-preserving interventions to partial prostheses to full artificial joints.

Joint preserving operations

Arthroscopy
Arthroscopic surgery is minimally invasive. They are performed with small incisions and a camera, most often in the knee joint. Arthroscopy is mainly used to flush out the joint space and clean it of detached pieces of cartilage. However, studies with placebo arthroscopies question this method.

Cartilage transplants During knee arthroscopy, a small amount of cartilage tie can be taken from a part of the knee joint that is subject to little stress, propagated in the laboratory, and injected after six weeks in a second, also minimally invasive operation. Cartilage transplantation is only useful at an early stage. For sharply limited cartilage damage ("focal early osteoarthritis"). On the other hand, this method proves that cartilage can be regenerated.

Osteotomy (axis conversion) When the knee joint is affected by osteoarthritis, either internally or externally, the axis of the main load shifts from the center of the knee and increases the prere on the side affected by cartilage degradation. In this case, a wedge-shaped piece can be removed from the shinbone. Thus shifting the load axis from the diseased to the healthy part. This corrective or conversion osteotomy slows the progression of knee osteoarthritis. Allows the affected person to walk pain-free with his own knee for many years at best. Osteotomy is also considered for congenital or injury-related leg deformities.

Joint replacement surgery

Joint replacement surgery replaces destroyed joint parts with artificial prostheses (implants) with the aim of relieving sufferers of pain and improving their mobility. In cases of severe hip or knee arthrosis, joint replacement often shows good results. However, the success of the operation is not predictable. 20% of patients who have undergone knee surgery are dissatisfied and complain of persistent pain and functional limitations. The operation also wants to be well considered because the removal of joint surfaces can no longer be reversed.

Partial artificial joints in the knee
Artificial replacement of the knee hemisphere is often a good option for sufferers over the age of 60. The implant replaces only a part of the joint surface. Patients who have undergone surgery can put full weight on the knee joint immediately after the operation. Modern partial knee joints are also available for cases of osteoarthritis of the kneecap.

Fully artificial joints
Only in the case of advanced osteoarthritis of the whole joint is a complete artificial joint implanted. Full artificial joints are used in the hips, knees and shoulders.

Whether and when to have an operation depends on the degree of personal suffering and the demands on one's own mobility and independence. Before the operation, the patient must be informed about the chances of success and the possible complications in order to be able to weigh up the benefits and risks.

Aids

In the case of osteoarthritis, it is important to exercise in a way that is gentle on the joints and to avoid excessive use of force. For this purpose, there are countless aids that make everyday life easier, such as e.g.B. Elastic shoe laces, handle brushes and style combs or various aids for opening screw caps with less effort.

Advice on aids from the Rheumaliga Schweiz: Tel. 044 487 40 10

Prevention

Whether cartilage damage can be reversed by cartilage-building substances and how far such regeneration of cartilage cells can go is a controversial question. Regardless of this, it seems a wise strategy to counteract the degradation of joint cartilage.

Gentle movement

The key to joint health lies in movement. The more the joints move, the better the cartilage is lubricated. Exercise literally massages the nutrients of the synovial fluid (synovial fluid) into the cartilage tie, thus keeping it elastic and supple. Ideal sports to prevent osteoarthritis include cycling, swimming, aqua aerobics, classical dance and hiking on flat terrain. These are all movements that do not overload the joints.

Discuss a personal exercise program with a medical or therapeutic specialist. Those who like to move in a group can attend the movement courses of the Rheumatism League. The Aquawell and Aquacura water gymnastics courses are especially suitable for arthrosis sufferers. The buoyancy in the water relieves especially the knee and hip joints.

In addition to the exercise program, training to build muscles may be useful.

Reduce excess weight

Knee joints in particular suffer from the prere of excess pounds. To prevent knee osteoarthritis, people should lose excess weight and control their weight. Other risks, especially for the knee joints, are sports such as weightlifting. football as well as hard physical work. They should be avoided. Those affected by osteoarthritis learn in physiotherapy or occupational therapy how to load the joints correctly during everyday movements such as lifting, carrying and sitting. Numerous aids are available to relieve the strain on damaged finger and wrist joints during everyday activities in the kitchen, house and garden.

Correct malpositions

Misalignments in the feet (fallen arches, splayed arches, bent arches) lead to movement patterns that place unfavorable stress on the knee and hip joints and can contribute to cartilage degradation. Foot malpositions can be corrected with shoe inserts, foot supports or special orthopedic shoes.

Give up smoking

Quitting smoking is also a preventive measure against osteoarthritis. Because there is growing evidence that nicotine use can disrupt the nutrient supply to cartilage.

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