Artrosis

Almost everyone knows the word osteoarthritis and usually have the idea that it is a serious disease, that you takeá to always and that will seriously compromise the quality of life of people who suffer from it. For this reason it is essential to know its true meaning, because although it is a disease that still’there is no cure, the benefits that are achieved with a correct treatment, can be very important, allowing in many patients a life práalmost normal.

Almost everyone knows the word osteoarthritis and usually have the idea that it is a serious disease, that you takeá to always and that will seriously compromise the quality of life of people who suffer from it. For this reason it is essential to know its true meaning, because although it is a disease that still’there is no cure, the benefits that are achieved with a correct treatment, can be very important, allowing in many patients a life práalmost normal.

&are you;QUÉ IS OSTEOARTHRITIS?

osteoarthritis is a disease caused by the alteration’re the cart’lake, one of the tissues that form the joints, which results in the appearance’n of pain and on occasions the péloss of its normal movement. Osteoarthritis is the disease reumática más frequent. Affects in más or less degree to all persons over 55 ’ 60&years, but s’it in a part of them, the disease is severe enough to give s’symptoms. It is very common for people achaquen all the pains that they suffer in the spine or extremities to the "osteoarthritis", which is often false. Although all people above a certain age have "osteoarthritis", in the largestí, s’symptoms that have not be directly to this disease, but that have their origin in problems of the ligaments, m&field muscles or tendons that surround the joints.Osteoarthritis can appear in any articulaci’n of the body but usually affects the fingers, the thumb, the knees, the hips, the first toe and the cervical and lumbar spine. Osteoarthritis of other joints such as the shoulders, elbows or mu&bath;ecas is rare and when it appears, is a result of trauma, other joint disease or previous due to improper use of the same

&are you;THAT IS WHAT HAPPENS IN OSTEOARTHRITIS?

osteoarthritis is the articulaci’n itself is altered and with time, all the tissues that surround it will seeán committed. Is más fácil to understand what happens if you compare an articulaci’n normal (Figure 1 A) with a articulaci’n artr’sica (Figure 1 B).

Articulaci’n normal

The articulaci’n normal consists of the uni’n of two ends of bone that están coated fabric firm, but theáplastic that is called the cart’lake. The cart’lake makes the contact between the bones during movement is smooth and the friction peque&bath;or. Además as theáindoors, it is able to absorb the knocks that it suffers from the articulaci’n without affecting the bones, which are much más rígidos. The articulaci’n is closed by a cácapsule that in its interior, está covered by a thin layer of células that form the synovial membrane. The synovial membrane produces a líliquid viscous, which fills the joint space and which has as its mission to’n lubricate the articulaci’n and feeding them to the cart’lake joint called líliquid synovial. The articulaci’re kept in place by ligaments, tendons, and m&number;muscles that prevent the separaci’n of the two extremes ’seos and allow movement s’it in the right directions.

Articulaci’n artr’sica 

The alterations produced by the osteoarthritis occur in several consecutive phases.

1. The first thing that occurs is an alteration’re the cart’lake. The superficial zone, which is the contact with the other cart’lake joint, it swells up and makes más soft, losing its elasticity. Little by little, the surface is eroded and with time the cart’lake wears away and may eventually disappear, leaving the ends of the bones to contact directly.

2. As you will be losing the cart’lake, the bone that está below reacts and grows by the sides, so that the articulaci’n is deformed by the so-called osteophytes or "parrot beaks".

3. The synovium thickens and produces a líliquid synovial less viscous and más abundant that lubricates less. Alsoén attempts to remove the fragments of the cart’lake that have been released and float free in the joint cavity.These fragments originate from an inflammation’n of the membrane, and the production’n of substances that pass into the articular cavity accelerate the destruction’re the cart’lake. The first changes occur without the patient note ning&number;n síntoma, since the cart’lake does not have the capacity to produce pain. In this phase, the cart’lake yet’to be recovered, and the disease is potentially reversible. When the cart’lake disappears totally the disease is very severe and the process is already irreversible.

&are you;what ARE THE CAUSES OF OSTEOARTHRITIS?

The causes of osteoarthritis are m&number;multiple and they often appear together in the same person, so that their chances of developing the disease increase.

Aging: osteoarthritis is a disease of older people. The wear and tear of the articulaci’n produced by the use during to&years, along with a reduced ability of retrieving’n of the tissues with increasing age, are important factors.

Inheritance:In some cases, for example osteoarthritis of the joints of the hands, there is a predisposici’re family, mainly among women.

obesity:Obesity predisposes to osteoarthritis in the hips and knees as the overweight just gives&bathroom;I walk the cart’lake joint.

Disorders overload:When the shape of the articulaci’re or of a member it is not normal, for example when the legs están crooked or one leg is más long as the other, produces increased wear on all the articulaci’n or the part of it that supports a higher weight.

local Lesions:When fractures occur, blows, or inflammation of any cause in a articulaci’n, the revival’n never is full and the cart’lake has predisposici’re to be altered más soon.

Excess of use: results in the development of osteoarthritis early or in places with infrequent as the shoulder in players of handball, knees in soccer players, the elbow in workers with hammers neumáticos, or the joints of the knuckles of the hands on the tillers.

&are you;what ARE THE SYMPTOMS?

sísymptoms of osteoarthritis will depend on the joints that están so affected, but have some characterífeatures common.

the Character’features in common: The s’symptoms begin gradually and the progression’n is slow. At first the pain appears while the articulaci’re moving and goes away with rest, but with time and as the arthritis is going to be más severe, the pain is más continuous. Usually pain occurs afterés of a período of rest and until the articulaci’n go into heat and re-appear with prolonged exercise. On occasion due to rest and lack of exercise, the m&number;muscles that surround the articulaci’n become stunted, while in others, the pain and deformities ’seas produce muscular contractures. In both cases, the alteration’n m&number;muscles produces más pain, alteration’n of the normal mobility of the articulaci’n and a greater tendency to the progression’n of the disease.

Osteoarthritis of the fingers of the hands: they Are más common in females and there is a great tendency to suffer several members of the same family. First appear in a articulaci’n and progressively extending to the demás in a bilateral way. Patients notice pain and inflammation’re going to be minor as they appear to sin&bath;os hard lumps (n’plugins), which are a result of the growth of the bone that is underneath. When the deformaci’n complete tend to disappear all the hassles. Usually s’it create a problem for estético since the function’n of the hand remains normal despite the fact that the articulaci’n can be slightly bent or deflected sideways.

Osteoarthritis of the thumb: it Is frequent in women. There is pain and deformity at the base of the thumb especially in the manual labor and can impede the normal use of the hand especially in the movements of prensi’re.

Osteoarthritis of the hip: there is pain in the groin and in the region’n inner thigh. Sometimes the pain can be felt in the knee without any discomfort in the groin (this is called referred pain). If the arthritis is important there may be night pain or difficulty bending the leg to put on shoes or putting on socks and limp when walking.

Osteoarthritis of the knee: Causes pain in the front or inner knee that predominates when climbing up and down stairs and getting up from a chair. You can accompany&bath;arse of clicks during the march and if it is severe, it causes lameness.

&are you;C&Rsquo;MO IS OSTEOARTHRITIS DIAGNOSED?

The diagnosis’forecast of osteoarthritis is usually simple. The médico is going to diagnose it for the location’n and the type of pain, the situations in which it improves or gets worse, and with a simple exploraci’n of the joints affected. In osteoarthritis of the hand joints s’it with see the típica deformaci’n of the fingers will be sufficient. Sometimes the reumat’logo to performá a series of tests, which on one hand confirmán the diagnosis’guide and on the other, they will give you an idea of the severity of the disease.

Aspiraci’n del líliquid articulate: When it is possible to obtain a sample (usually s’in osteoarthritis of the knee), it can be &number;useful to confirm the diagnosis’guide and rule out other diseases reumáticas.

Radiografías: Allows you to see changes típeaks of the disease and the intensity of osteoarthritis.

Análysis of blood: they Are little &field tiles to diagnose osteoarthritis, as there are no alterations in the análysis típeaks of this disease, but allows you to rule out other diseases. 

&are you;CUÁL IS THE TREATMENT OF OSTEOARTHRITIS?

there is Currently no ning&number;n treatment that can cure osteoarthritis, but sí you can relieve s’symptoms, slow its evolution’n and to improve the quality of life of the patients. A correct treatment will depend on the articulaci’re affected, the severity of osteoarthritis, degree of pain, the daily activities of the patient and the age. The strategy of treatment will consist of a combination’n of several factors: Keystone’n when it is possible, of triggering or aggravating factors: Treat obesity, and correct the difference in leg length if they exist. 

&are you;you have to rest or exercise?

There to avoid subjecting the joints to excessive strain that can cause an increase in pain or a destruction’n más ráask and will depend on the articulaci’n affects. The patient has to understand and accept their limitations and as a general rule there is that recommend that you avoid movements that produce pain, and if possible, learn to use other joints instead of the diseased. In osteoarthritis of the lower limbs is necessary to restrict the use of the joints (long walks, runs, load weights,…), but it is never advisable to immobility. The use of canes or crutches on the healthy side helps reduce the weight-bearing joints, and reduces pain. Exercising with the diseased joints is critical. The exercise should try to maintain joint movement and strengthen the m&number;muscles to prevent the articulaci’n left flácida and to reduce the rigidities. The exercise should be gentle and not cause pain, because if it is carried out without load the weight or force articulaci’re very &number;til, but if it is excessive time, carrying or forcing the articulaci’n is detrimental, and instead of improving osteoarthritis produces más pain and accelerates the evolution’re. The nataci’n, exercises on the floor or gentle rides are highly recommended, but in each day’re going to be instructed exercises that you can perform in the home, with the help of some brochures published for these situations, or if it is difícil or not there is a better’to appropriate, in a specialist center. 

&are you;it Is better the heat or the frío?

These treatments can relieve the pain and the feeling’n of joint stiffness temporarily. The fríor local, may relieve pain in some people while the heat is very effective to improve the stiffness and can be alsoén effective for the pain. When you get up by the ma&bath;ana, it is recommended a hot shower with a jet of water strong in the areas affected to remove the feeling’n of rigidity by the heat and the massage local. There are many ways to provide heat that can be used in the home such as hot water, pa&bath;os calientes or the blanket of theéctrica, while others are más sophisticated and require infrastructure más complex, like the bathrooms of paraffin wax to the hands, ultrasound, infrared, and other forms.

Medications:medications in osteoarthritis is primarily used to relieve the pain and reduce the duration’n of the stiffness and there are many different types. Sometimes there will beá to try to treat the patient with several antiinflamtorios different, that will takeán s&number;n the pain. The undesirable effect más frequent are the pains of est’magician.