Arthrosis of the knee joint combines two processes: the destruction of cartilage and the growth of osteophytes or bone spurs.The stage of the process is determined by the radiograph.It is believed that arthrosis is the destruction of the knee joints with age, the natural process of aging.The causes are muscle weakening and poor blood supply to tissue.How to treat yourself without surgery?Eliminate factors that reduced muscle tone.
Causes
The causes of arthrosis are still not determined by medicine,Only risk factors are named:Age over 45 years old, knee injuries and overweight.Almost 50% of the adult population has ever complained about the knee joint.
With arthrosis, the cartilage lining the edges of the bones is abrasion or completely absent.Damaged tissue is not a source of pain, because it does not have receptors.Inflammation in nearby structures causes characteristic symptoms.
The body continues the regeneration of damaged tissues, but the cartilage grows unevenly.As a result, irregularities are formed that injure other elements of the joint.The nature of osteophytes is explained by compensation for smooth joint cartilage.Another version indicate that the growth of "spurs"It is associated with an attempt to stabilize the joint medially or lateral due to muscle weakening.
What is the chronic arthrosis of the knee joint?Pain occurs in tendons and ligaments only when muscle forces cease to hold the bones and control them.Therefore, biomechanical causes of pain and arthrosis are distinguished:
- Against the backdrop of a long seatThere is a compression between the inguinal ligament and the iliac-lingering muscle of the femoral artery and nerve, which weakens the strength of the front of the thigh and leads to the appearance of tension in the tendon-under the knee cup.
- Long -term sitting squeezes the gluteal musclesWeakening them.Instead, pear -shaped muscles begin to work, under which the sciatic nerve passes.During its compression, the double -headed muscle weakens, the angle of thigh and lower leg changes changes.The knee is injured.
- Heeled walkingIt causes tension of the calf muscles, unfolds the pelvis, weakens the average gluteal muscles.The femoral bone turns inside, ligaments are loaded along the inside of the knee, a medial meniscus, osteophytes grow.
- Flat feetassociated with the wearing of uncomfortable shoes, weakening of the leading muscles and increased lordosis, unfolds the tibial bone outward, which leads to pain in the knee due to violation of biomechanics, the development of a baker's cyst.
The pathological chains affecting the knee are associated with a fall on the tailbone in childhood, scoliosis caused by diseases of the internal organs.People who have a different shoulder height,Over time, they begin to complain on the knee, since the fascial chains on the front of the body include the extensor of this joint - the rectus muscle of the thigh.
Symptoms
The degenerative process disrupts the function of the joint, leads to pain and stiffness.It is believed that it isFrom the cartilage and bone, the effect on the muscles begins.Practice shows the opposite -pain in the knee joint occurs in places of tendons- fasteners of the weakened muscles of extensors, flexors and knee stabilizers.
The main signs of the threat of wear of the cartilage:
- From time to time, the discomfort associated with walking, the sensation of "not so set the leg."
- The appearance of pain with a direct load on the joint and muscles, bending and extending it - squat, climb the stairs.
- The pain in the knee and stiffness after prolonged inaction or rest, for example, when getting out of bed in the morning, which is associated with stagnation of venous blood.
The main signs of arthrosis are caused by the load on the weakened muscles:
- The knees in the knees are related to the fact that the gluteal and double -headed muscle that extends the thigh does not function, and the rectus thigh muscle is stretched excessively, creating discomfort in the knee.
- The pain when bending the joint is associated with the weakness of the flexors - the double -headed muscle and tension of the tendon of the quadriceps.
Swelling is caused by injury to soft tissues, inflammation of the tendons and joint bag.The appearance of heat in the knee, swelling indicates the accumulation of inflammatory exudate -Arthrosis is often accompanied by bursitis, synovites, tendinitis.
The crunch in the knee is painless and traumatic.Clinkles and other sounds do not say that the bones are abrasion.Signs of violation of the stability of the knee -The weakness of one of the control of the muscles.
Creeding caused by friction of the bone on the bone does not occur at the beginning and end of the amplitude of movement, but in the middle,Even with passive flexion of the joint.The joint blocking is caused by wear of the cartilage and tendons, which creates a feeling of fixation.Bones with any movement are controlled by muscles.Their untimely reduction leads to a changed direction of bone movement, blocking.
1 degree
Determination of the degree of arthrosis occurs by x -rayrevealing participation in the pathological process of bone structures.Their change indicates that the muscle system has been in an imbalance for 5-10 years.As a rule, peopleFor several years they experience aching pains.
At the first stage of arthrosis, which is detected by accident, a slight increase in bone spurs occurs.The growths appear in places of the greatest instability of the joint.Typically, patients rarely experience pain or discomfort during movement.
The weakness of some muscles is compensated by the function of others, without causing severe spasms and overloads.The run and training with weights provoke symptoms, since the weakened muscles are loaded.The weakness (hypotension) of muscles is associated with impaired blood supply and innervation.
2 degrees
The second stage of arthrosis is considered easy.The radiograph reveals significant bone spurs, but the cartilage is not affected.The amount of synovial fluid is reduced, but symptoms of pain appear after long walking and running, stiffness in the joint and soreness when bending and in the position on the knees.
Early X -ray features of the second stage of knee arthrosis:
- the pointed edges of the inter -crib tubercles on the tibia, where the cross -shaped ligament is attached;
- narrowing of the joint gap on the medial side;
- The pointed edges of the condyles of bones on the medial sides, less often in lateral - depending on the development of the valgus or varior joint deformation.
For the second stage in LarsenThe narrowing of the joint gap by more than 50% is characteristic, but this can only be checked in dynamics or comparison with an unlikeed joint.
3 degrees
At the third stage of arthrosisPain during flexion and extension of the joint become constant.During the exacerbation, the joint blushes and swells, aching pains do not stop at rest.Around the knee, swelling appears, noticeable deformation of the joints of the joint.
Signs of moderate arthrosis of the knee joint in the third stage:
- The joint gap is significantly narrowed;
- the presence of subchondral sclerosis in the loaded sections;
- numerous osteophytes at the edges;
- a rare appearance of subchondral cysts;
- synovites, the appearance of a baker's cyst under the knee;
- uneven surfaces of the femoral and tibia, the loss of the joints of the joint;
- change in the shape of the patella;
- foci of calcification and chondromation;
Rarely the fourth stage is complemented by necrotic lesions.Why is arthrosis dangerous?The disease violates the ability to move, creates dependence on others.
Diagnostics
The orthopedist studies signs of edema, palpates the joint for soreness, studies the active and passive range of movement.Necessarily inspects the lumbar spine, becauseIt is there that nerves pass, which provide the function of the muscles of the thigh.
The radiograph shows the presence of osteophytes, a change in the space between the femoral and tibia bones, which indicates the loss of cartilage in the knee.Sometimes the x -ray of the knee joints shows significant signs of cartilage wear, but patients do not experience significant pain.On the contrary, arthrosis of the first stage can disrupt the function of the knee, since the cause of pain is hypotonic muscles.
If an X -ray does not show big changes, thenThe doctor prescribes an MRI of the knee joint and lumbar.Diagnostics visualizes ligaments, tendons and muscles, meniscus to find other sources of pain.
Laboratory diagnostics is necessaryIf you suspect an infectious damage to the joint or gout.
Treatment
Arthrosis therapy should be comprehensiveaimed at the cause of the disease.With endocrine dysfunctions capable of affecting connective tissues, appropriate treatment is carried out.Overweight patients are recommendedgo to proper nutrition.Exacerbations are removed with medicines.
Drug treatment
Drug treatment of pain consists inprescription of anti -inflammatory drugs.Non -steroidal anti -inflammatory drugs with prolonged useNegatively affect the function of the stomach.
The treatment regimen includes chondroprotectors, which help only when taking long courses during3-6 months.The pharmacies represent a large number of drugs of this group.
It is believed that the components of these drugs help to regenerate the structure of the cartilage, have an analgesic effect.
Controlled studies have been conducted by little, and they concerned complex treatment - arthroplasty, physiotherapy, diet.
Attention!Chondroprotectors are drunk in courses - you can drink one course of one drug, and the second course - the other, and compare the effect.However, the uncontrolled medication is not the best idea.Before you start taking drugs, consult your attending physician.
How and what to relieve pain and swelling?Intra -articular injections are more popular:
- Steroid drugsInhibit inflammatory reactions at the level of immune cells, removing acute pain, joints of the joint and swelling.
- Hyaluronic acidIncreases the viscosity of the joint fluid, reducing friction of the articular surfaces.
Important!The effect of drugs is enough for 6-12 months, but at the same time degenerative processes do not stop.
Surgical treatment
With low effectiveness of drugs, patients are offered arthroscopy- a minimally invasive procedure for the removal of bone growths, audit of the joint.If necessary, surgeons carry out ligaments and cartilage plastic, remove the foci of worn -out fabric.
Bone osteotomy is aimed at changing the axis of the load on the joint.The doctor cuts the femoral or berets to change areas of contact of the joint surfaces.The operation is often carried out in young patients.
Total replacement of the knee joint or arthroplastyIt is required in the severe stage of arthrosis (third or fourth degree).Surgical treatment does not always solve the problem, since it requires diligent and daily rehabilitation, muscle strengthening.
Changes in the knee can be compensatory in relation to the pelvis, therefore, without restoration of muscle balance, the hip joint suffers next.
Physiotherapeutic treatment
In the environment of physiotherapy, mud applications, phonophoresis and magnetic therapy are used.The action of external factors is aimed atstimulation of blood supply and tissue regeneration, relief of inflammation and swelling.
Treatment with folk and non -traditional methods
Recipes of folk remedies for the treatment of arthrosis of the knee joints at home usuallyaimed at removing swelling and eliminating pain.Most often, horseradish leaves and potato gruel are used, sometimes mix and vodka for compresses are mixed.
It is impossible to completely stop degeneration.You can affect the exchange in the kidneys using celery juice.The kidneys are associated with the iliac-luxury muscle, which is associated with pathologies of the hip joint.Normalization of the function of the gallbladder and liver improves the condition of the knees.
Methods of treating the initial stage of the initial stage of arthrosis of the knee include decoctions of anti -inflammatory herbs:Chamomile, St. John's wort, immortality.Ground rubbish, sea salt and kerosene are used.Baths with magnesium salts, pine infusions are used.
Manual therapy and massage
Manual therapy for osteoarthrosis of the knee joint helps, if a specialist understands the sole-muscular imbalances.Muscle tests help to find weakened muscles that stabilize the knee, determine the cause of dysfunction and eliminate it.
The source can be not only the joint block in the lumbar region,but also dysfunctions at the level of blood supply, internal organs, endocrine and biochemical failures.Therefore, the manual therapist must have osteopathy skills, applied kinesiology in order to influence many factors.
Massage is an auxiliary tool for manual therapy, self -help.A patient with arthrosis of the knee joint can independently knead the tendons of muscles that control the movement of the limb:
- the area around the large gluteal muscle;
- lines on the front surface of the thigh - from the pelvis to the patella;
- The side surface of the thigh from the large swing to the condyles of the thigh;
- The groin area along the inguinal ligament;
- The inner surface of the thigh (along the line of the leading channel).
Massage is performed spot, without a lot of pressing.
Therapeutic gymnastics
The cause of arthrosis is the weakening of muscles caused by problems in the lower back, basin, abdominal cavity.Perform exercises for the prevention of arthritis and arthrosis of the knee joints for the elderlyit is possible to increase strength, but not tone.
Without work on the factors of their weakening with the help of manual therapy, it is difficult to achieve a complete restoration of biomechanics.Yoga further deprives the joints of stability.Among the methods of treatment, it is better to preferPilates and Scandinavian walking.
Diet
Food is adjusted, first of all, to fight overweight.It is important to abandon sugar and simple carbohydrates, add products with fiber, magnesium, vitamins of group B and calcium with arthrosis of the knee joint, which are important for muscle activity.TryExclude dairy products, since almost 80% of the population have lactose intolerance.
Prevention of arthrosis of the knee joints
Attempts to strengthen muscles do not always help, since innervation and blood supply are not restored.The function of the hip muscles depends on the lumbar plexus.
Changes in the lower back associated with the weakness of the abdominal muscles also affect the knees.Therefore, in men with a “beer belly”, arthrosis is more common, as in women after multi -guide, several genera with diastasis - a weakening of the muscles of the abdominal wall.
Operations in the pelvis and internal organs form adhesions that affect the vertebrae of the lumbar region, violating the innervation of the muscles around the knee.
Which doctor to contact with arthrosis of the knee joint?The diagnosis will help to make an orthopedistwho will insist on the operation.The best results are given by the work of multidisciplinary teams in rehabilitation centers.
The best that can be done for the joints:Eat right, monitor weight, walk more, visit a massage therapist or osteopath once every three months.
Reviews about treatment
Positive reviews can only provide comprehensive treatment of deforming arthrosis of the knee joint or gonarthrosis.Anesthesia, intra -articular injections act temporarily, suppressing a natural inflammatory reaction.
Conclusion
The problem of arthrosis is that drug therapy temporarily eliminates only pain syndromes.The reasons are left without identification and influence.Ergotherapists who teach how to live with arthrosis of the knee joint can come to help and how to use a cane correctly.But the service is available only in private clinics conducting rehabilitation.