Osteoarthritis of the knee joint( syn - gonarthrosis) is a chronic degenerative-dystrophic process that affects the cartilaginous tissue of articular surfaces. In the advanced stages in the knee joint severe irreversible structural and functional disturbances are formed. Complex treatment of arthrosis of the knee joint is aimed at preventing these disorders.
The main directions of treatment
Treatment of arthrosis of the knee joints provides:
- Elimination of pain;
- Improved nutrition of cartilaginous tissue;
- Improvement of local microcirculation;
- Elimination of concomitant inflammation - arthritis;
- Expansion of the volume of movements in the knee;
- Strengthening the muscles of the lower limb;
- Restore the original configuration of the knee joint.
With this goal different methods of treatment are used, among which:
- Massage and physiotherapy procedures;
- Therapeutic physical training( LFK);
- Special orthopedic appliances;
- Recipes of traditional medicine;
- Surgical intervention.
The medicamentous treatment of arthrosis of the knee joint includes the following main groups of drugs:
- Non-steroidal anti-inflammatory drugs( NSAIDs);
- Chondroprotectors - drugs that repair articular cartilage;
- Steroid hormones;
- distracting therapy;
- Drugs that improve blood microcirculation;
- Vitamin and mineral complexes.
It is believed that NSAIDs are the main drug group in the treatment of knee arthrosis. These remedies, mainly used locally, in the form of gels and ointments( Diklak gel, Voltaren Emulgel, Ketoprofen ointment and Indomethacin) effectively eliminate the main symptom of arthrosis - pain, and with it, associated inflammation. A similar effect has local irritating ointments - Finalgon, Gevkamen, Apizarthron. But all these funds in no way eliminate the main reason - the degeneration of cartilage. Moreover, according to some observations, NSAIDs negatively affect the metabolic processes in the joint tissues.
When combined arthrosis with inflammation( arthritis) in the joint cavity fluid( exudate) can accumulate. In these cases, a puncture( puncture) of the joint and removal of the exudate are indicated. Instead of a remote exudate, injections of antibiotics( if there is an infection) or steroid hormones( Diprospan, Kenalog), which suppress local inflammation, are made into the joint cavity. But even these drugs have a cytostatic effect( slow down cell growth), and, consequently, inhibit the restoration of articular cartilage.
The basis of medical treatment of arthrosis is the use of chondroprotectors. These remedies improve trophic articular cartilage, and thus contribute to their recovery. In this respect, the drugs based on Glucosamine and Hondrotyn, the main components of the cartilaginous tissue, - Structum, Arthra, Hondrolon, Elbona - proved themselves very well. The most effective medicine from this group is Chondroitin Complex in tablets. It should be borne in mind that to achieve the effect of all medications from the group of chondroprotectors should be taken regularly for a long time. In addition to all these drugs used in the treatment of gonarthrosis are immunostimulants, drugs that improve microcirculation in capillaries, vitamin complexes, calcium preparations.
Massage and physiotherapy procedures
Massage helps strengthen the muscles of the lower limb, improve local blood circulation, and to some extent - stabilize the knee joint. The technique of massage provides various kinds of influences on the massaged areas in the form of stroking, tapping, vibration, squeezing. Each of these effects is repeated 4 to 6 times. And first, massage the thigh, and then - the knee with circular or concentric movements. Then again pass to the thigh, but the number of repetitions is cut by half, and then they return to the knee joint, where its side surfaces are massaged. The final stage - a few flexion-extension in the knee and concentric stroking of the joint in places of greatest soreness.
Effective treatment of gonarthrosis involves the complex use of physical procedures, including muscle electrical stimulation, electrophoresis, phonophoresis, paraffin, ozocerite. All these methods lead to muscle strengthening, removal of intraarticular inflammation, external edema, to improvement of local microcirculation of blood. Magnetotherapy combined all these effects. This method involves the stay of the knee joint for 15-20 minutes. In an alternating magnetic field generated by special equipment. Instead of traditional stationary devices for magnetotherapy, special portable devices for individual use are used.
Reasons for arthrosis of knee joints
Neither drugs, nor massage, nor physiotherapy can fully strengthen the muscles of the lower extremities, stabilize the knee, and restore the motor volume. For this, we need therapeutic gymnastics. It should be borne in mind that active movements involving flexion-extension of the knees, jumps and squats, running, increase the load on the knee, and to a large extent lead to wear of the articular cartilage. Therefore, all intensive and wide-amplitude movements with knee arthrosis are unacceptable.
The main emphasis is on static loads, which strengthen the hip muscles to a greater degree. Exercises are performed in the supine position on the back. First, the straightened leg is raised by 15-20 cm above the floor, and immediately lowered. Then, the raised leg is held in a fixed position for several seconds, gradually increasing the duration of fixation. At first, the exercises last no more than 10 minutes, and then their duration can be increased to half an hour. But the patient should not experience pain.
Folk treatment of gonarthrosis mainly involves the use of various herbal preparations in the form of compresses, infusions and decoctions. Here are some of them:
- 3 lemons, 120 grams of garlic and 250 grams of celery or nettle roots. All this is mixed, pre-chopped in a meat grinder. Then put in a 3-liter jar and pour boiling water, then wrap. Insist for about a day in a wrapped form. Then drain. Take 70 g. 3 times a day for half an hour before meals.
- 3 tbsp.spoon of apple cider vinegar to mix with 1 tbsp.a spoonful of honey, and to treat a sick knee. Cover the top with fresh cabbage leaves. All this wrapped with polyethylene or a warm cloth. This compress can be kept up to several days.
- 1,5 kg.chopped Jerusalem artichoke.boiling water. The field of how the water will cool slightly and become warm, use as a bath, dropping into them a sick knee.
- Grind 1 leaf of the ficus on a meat grinder and pour it into 100 g of ordinary vodka. Infuse for 3 weeks.in a cool dark place. Then strain. Use as a kneading knife, preheated.
Contrary to the assurances of numerous "healers", it is impossible to completely cure arthrosis with folk remedies - it is a chronic irreversible process that can only be suspended. But here, in addition to folk remedies, other methods of treatment are needed.
Arthrosis can be treated with non-traditional methods, including acupuncture, manual therapy and osteopathy. Acupuncture involves the impact of needles( or laser, electrocutions) on certain points corresponding to the knee joint. Manual therapy is carried out by direct manual influence on the affected joint and on the lumbosacral spine.
Osteopathy is somewhat similar to manual therapy, but it is carried out more sparingly, and, unlike the latter, has practically no contraindications. In the period of exacerbation of pain, it is recommended to use special aids, such as a cane, crutches or orthoses, to reduce the knee load when walking, which are orthopedic products made according to the type of tires, but, unlike the latter, tightly fitting and securely fixing the knee.
Unfortunately, conservative methods do not always lead to the desired result. The pronounced structural changes of the knee, ankylosis( complete immobility) of the knee joint, atrophy of the muscles of the lower limbs - all this is an indication for prompt intervention. Now they use the newest methods of intra-articular plastic with the help of a special optical device - an endoscope. Restorative treatment of any form of knee arthrosis should preferably be carried out in climatic or mud resorts.
- Main directions of treatment
- Massage and physiotherapy
- Folk remedies
- Other methods