After reading this article you will know:
- what is arthrosis;
- that in case you will live over 70 years then you’ll have only one of 3 possible chances not to get this disease;
- the way of the arthroidal cartilage nourishing;
- for whom it is easier to go upstairs rather then downstairs;
- why the weightlifting is considered to be in the risk group;
- why the patient feels no pain at the primary disease stage;
- skating rink and the pool – what is the healthier?
What is the arthrosis
Arthrosis is the degenerative disease of the joints with possible inflammation processes in it. It is one of the most widespread joint diseases. About 30-35% of the people experience the signs of this disease from 45 to 64 years of age. This number increases to 60-70% after the age of 65. Thus you may probably get this disease in the future.
The former name of this disease was the “deforming arthrosis” as this disease was concerned only to age-specific degenerative alterations of the arthroidal cartilage. However today the approach is different. Arthrosis – is the disease of the whole joint, its capsule, adjacent bones, muscles and cords. Nevertheless only the arthroidal cartilage experiences the most of the changes.
The healthy arthroidal cartilage is 2-3 mm thick it provides articular surfaces sliding and distributes the load on the corresponding bone equally. Muscles help to the arthroidal cartilage: for instance throughout the jump from the certain height the work that is done by the leg muscles softens the blow. But the touching-down on the straightened legs leads to great overloads of the arthroidal cartilages. Any trauma affects complete mutual correspondence of the contiguous joint surfaces forms and thus becomes the cause of the arthrosis in the future.
What the arthroidal cartilage consists of
Healthy cartilaginous tissue includes a great number of the albumin and carbohydrates compounds and the most important of them is the chondroitin sulfate. It preserves water molecules on its surface that is quite important for the normal work of the joint. However in case of arthrosis the chondroitin sulfate is being replaced by the cerotan sulfate that is unable to keep liquid and thus makes the joint dry, causes it splitting and finally leads to the total loss of the shock-absorbing joint features.
Cartilaginous tissue has no vessels and thus nutritive materials are delivered and the metabolic products are being removed throughout the compression-stretching cycles. There are no nerves in the cartilaginous tissue thus the patient feels nothing and don’t visit doctor at the primary stage of the disease when the joint already suffers due to the lack of the materials required for the normal metabolic processes. When the pain appears it means that the process has already spread over the arthroidal cartilage borders to synovial joint membrane or adjacent bone.
The arthrosis classification and causes
There exist the primary and secondary osteoarthrosis.
The primary one – 50% of the patients possesses genetically unbalanced cartilaginous tissue. And the physical exercises only worsen the situation. For instance in case the grandmother had curved big toe then her daughter or granddaughter will have the big toe of the same form. The disease reveals itself for some years earlier with every new generation and thus “grows younger”. Today arthrosis is quite often in patients of 40 years.
Secondary arthrosis – the disease occurs throughout the life time due to certain external factors:
- traumas caused by fractures as well as quite slight traumas like disjunctions, subluxations, and etc.
- constant physical exercises; especially those concerned with heavy weights lifting (certain jobs, sports). Here I wouldn’t advise you to discharge coaches and lift other heavy things.
- intoxications caused by viral infections, alcohol, smoking, heavy metal salts and uncontrolled drugs use. Toxic materials accumulate easily in the cartilaginous tissue but are quite difficult washed out from these tissues as there are no vessels.
- endocrine disorders (diabetes, thyroid gland disorders, menopause). Cartilage is quite sensitive to the lack of estrogen (female sex hormone) that is quite important in metabolic processes, thus as soon as women experience climax the “sudden” joint aches occur.
- inherent joint deformations. Caused by the dislocation of the load onto only one half of the joint (internal or external one) it becomes overloaded and thus got injured sooner. Here we can also add such situations as inherent hip joint dysplasia.
- excessive weight. Try to carry a bucket of water for several hours. Many patients experiencing arthrosis have more than one “bucket” of excessive weight and may even equal to the half of the whole body mass.
- vessel disorders (atherosclerosis). For instance, only one artery supplies the joint and whirlbone. In case the artery walls will be damaged by the atherosclerosis then the whirlbone supply is being misbalanced and thus arthrosis develops. In case of frank blood circulation disorder an aseptic necrosis and whirlbone destruction may take place. (Necrosis means the dying off. Aseptic means sterile one; it arises from two words – “a” – the denial, and “sepsis” – contamination).
- shin varicose veins (it is a kind of vessel disorders). The venous standstill peculiar to such conditions causes the lack of oxygen and thus tissues hypoxia that contributes to the metabolic misbalance in knee and talocrural joints and finally leads to arthrosis.
Arthrosis pathogeny (development of the disease)
The process of the tissue decay is greater than the process of its synthesis in the patients experiencing arthrosis thus the cartilage is unable to recover. Arthroidal cartilage experiences certain defects that cause even greater load on the rest cartilage parts thus making them to wear out more faster. The joint gets destructed and the process becomes uncontrolled. Muscles try to fix the joint in its previous position thus making the load on its parts and the muscles themselves unequal. The overload and the muscles spasm cause certain ache. The next step of this process is the muscles atrophy that implies certain and irreversible alterations of these muscles. A bone tissue appears on edges of the damaged cartilage thus contributing to the certain pathologic tumors growth.
In some patients experiencing arthrosis caused by the physical load it may be worsened by the inflammation in the joint cavity (arthritis) accompanied by the accumulation of the liquid. Scientists consider that the inflammation appears as the body reaction to the products of the cartilage decay (cartilaginous detritus). Special hormones – glucocorticosteroids that may suppress any inflammation are being injected into the joint in such type of the autoimmune inflammation.
Symptoms and diagnostics of the arthrosis
Big joints (knee-, hip- and ankle-joints) that have greater functional load are being affected first of all. Please note that common ache in the shoulder joints are usually caused not by the certain damage of the joint itself but by the damage of the juxta-articular tissues. The ache in the shoulder joints quite often appears due to certain problems of the cervical spine.
First arthrosis sign is the pain in large joints occurring especially after the excessive loads or uncommon exercises. It is over quite soon – in a day or two. But the rontgenologic picture made at this stage will already reveal the arthrosis signs, such as bone tissue induration under the arthroidal cartilage. A bit later the pains become more severe and occur at every move of the joint and sometimes even in the period of the rest. The joint X-ray photograph will show the bone tumors on the edges of the cartilages.
The pains are quite common in arthrosis however they may be quite different. The pains the patient may experience in the morning after the sleep are brief and are usually called – start ones. The patient wakes up in the morning with certain discomfort. But after 2 or 3 steps this discomfort passes away. The cause of the start pains are the products of the cartilage decay that accumulates between the joint surfaces throughout the night. These products are being ejected when moving and thus the pain disappears.
Common arthrosis pains are concerned to the physical exercise. A bit of exercises increases the pain and the rest makes it to decrease. In contrast to the start pains these one are more long lasting. The damage of the hip joints may cause pain in the groin (it may cause the patient to visit gynaecologist or urologist). The knee joint affection causes the pain in the area of the knee-pan and the spread of it down the shin. These cause the quite typical symptom – it is easier for the patient to go upstairs rather than downstairs.
The development of the disease makes the pains almost constant ones and almost independent to these or that exercises. The joint affected may get deformed and thus the limb corresponding may become shorter. Continuous everyday pain may be quite often eased only by the intake of the certain antidepressants or antianxiety (calming) drugs.
Arthrosis pain is multicomponent one.
- the damage of the synovial membrane or the adjacent bone causes the pains during the physical exercises;
- the muscles irritation caused by the pathologic tumors leads to the pain after certain moves;
- the appearance of the cartilage microfragments in the joint cavity causes sharp sudden and piercing pain (the joint blockade symptom);
- the blood standstill and the growth of the endosteal pressure in the varicose veins leads to night pains (“joint migraine”).
Thus the arthrosis diagnosis requires the symptoms study and X-ray photography. The global blood analysis is the same as it is done with the aim to exclude other diseases.
The arthrosis prophylaxis and treatment requires the taking care of ones muscles. One of the best way-out is the swimming pool. Swimming makes the joints to work without static load (in optimal conditions).
Swimming prevents the pathologic process and strengthens the muscles at the primary stage and helps to ease the muscles spasm and pain correspondingly at the later stages of the disease. A certain physical exercises complex (at least 2 times a week) is being prescribed to the patients except of swimming. These exercises should be done in the reclining position with the aim to decrease the load onto the joints.
Why the joints should be in move?
- it strengthens the muscles frame
- cartilage gets nourished primarily in the time the joint is in move
- the continued rest of the joint causes its stiffness. For instance, the plaster cast applied after the arm fracture causes such stiffness and after the cast is removed a long period of time is required to train the arm.