The human musculoskeletal system is often affected by diseases such as arthritis and osteoarthritis. Because of the similar names, patients confuse these diagnoses, although in reality there is little in common between them.
Despite all the differences, only a specialist can accurately determine the disease after a series of examinations and tests, so do not postpone a visit to the clinic at the first signs of joint pathology. Let us consider in detail the symptoms, specific development and methods of treatment of arthrosis and arthritis.
Features of the mechanism of development of the disease
Development of arthrosis
Osteoarthritis (or osteoarthritis) is a chronic degenerative disease of the joints, which most often occurs due to age-related changes in the body. Wear and tear of the joint involves degenerative processes: bone growths ("saline deposits"), friction and trauma to the cartilage, replacement of joint tissues with connective or ossified tissues. The disease develops slowly, gradually, at first only slight discomfort and creaks in the joint are felt.
Osteoarthritis is more common in older people, but professional athletes and people who have suffered injuries are also at risk. The disease usually affects one or more large joints.
Development of arthritis
Arthritis, unlike osteoarthritis, is inflammatory in nature and can occur in people of any age. This disease is systemic and can affect both joints and other human organs: heart, kidneys, nervous system. Arthritis manifests itself very clearly: even a non-specialist will notice it.
Arthritis most often occurs against the background of an infectious or bacterial disease, but can also be a sign of autoimmune pathologies.
If joint inflammation is caused by the activity of pathogenic bacteria or an infection, the disease most often begins suddenly, can affect a large number of joints at once, and involves both large and small joints in the process.
Both diseases can lead to chronic acquired pain, which today is considered an independent clinical syndrome.
Comparison between arthrosis and arthritis
| Comparative characteristics | Arthrosis | Arthritis |
|---|---|---|
| Age of cases | In most cases - 65-75 years | Anyone |
| Cause | Degenerative-dystrophic changes due to metabolic disorders, deterioration of blood supply to the joint | Inflammatory process caused by a disease of the infectious, bacterial or autoimmune spectrum |
| Joints involved | One or more large joints | A large number of joints, both large and small, often affected symmetrically |
| Blood test results | Average statistical indicators have not changed | An inflammatory process is detected, sometimes an increase in the value of rheumatoid factor |
| Painful sensations | The pain increases, appears after exercise, at the beginning of the disease there is only discomfort and crunching | The pain can appear immediately after sleep, often has a migratory character and from the beginning of the disease the sensations are intense |
| External changes | In the initial stages no, in post-traumatic cases swelling is possible | Sometimes there is redness of the skin over the joint, there may be swelling |
| Image of the joint | Deformation, narrowing of the joint space, bone spines, growths can be traced; very often, X-ray diagnostics gives a clear picture of the changes that occur | In the initial stages, no changes are visible; in advanced cases, bone erosion and ankylosis are possible |
| Pharmacological treatment | Preparations with chondroitin and glucosamine, symptomatic - NSAIDs, rapidly progressing - corticosteroids. | Symptomatically - NSAIDs, sometimes - antibiotics, for autoimmune diseases - corticosteroids |
Causes of the development of the disease
Causes of osteoarthritis
Osteoarthritis is a chronic process and always develops slowly. The blood supply to the joint gradually deteriorates, as a result of which the tissues do not receive the necessary nutrition. The cartilage changes structure, becomes rough and friction occurs. The main carriers of this disease are the elderly, whose metabolism in the body slows down with age, and overload, excess weight and injuries also make themselves felt.
The disease that occurs due to metabolic disorders is called primary arthrosis.
According to statistics, degenerative changes in the joints most often affect overweight elderly women. Very often, these patients have a genetic predisposition to diseases of this type.
In addition to old age, in rare cases, arthrosis can occur in middle-aged people and even young people. The most common reasons include:
- professional sports with heavy loads on the joints;
- hard physical work;
- advanced arthritis;
- previous injuries or surgeries.
In the cases listed above the arthrosis will be secondary. A predisposing factor for the development of the disease is obesity. Sometimes this type of disease can be a consequence of damage to the nervous system, which leads to insufficient sensitivity of the joint. Additionally, the disease can be caused by systemic damage to the connective tissue.
Causes of arthritis
Arthritis, unlike arthrosis, has many different forms and manifestations, which only an experienced specialist can distinguish. Each type has its own cause:
- Reactive- occurs as a complication of infectious and bacterial infections, most often intestinal and genitourinary.
- Rheumatoidis a separate autoimmune disease that affects joints symmetrically.
- Infectious- characterized by inflammation of the joints due to the activity of pathogenic bacteria and infections. Even among the adult population it is possible to find arthritis that occurs against the background of viral hepatitis.
- Gouty- occurs as a consequence of gout due to the accumulation of uric acid salts in the joint tissues.
- Psoriatic- a consequence of the manifestations of psoriasis, which is observed in about 10-15% of people with this diagnosis.
- Traumatic- can occur due to injury to the joint or periarticular tissues.
- Rheumatic- is a consequence of rheumatism, most often caused by a streptococcal infection.
In addition, there are types of diseases that are characteristic only of children, for example, juvenile arthritis, which often occurs against the background of an infection, fungal or bacterial disease.
Symptoms
Symptoms of osteoarthritis
Joint pain, which directly depends on the intensity of movement and physical activity, is the main symptom of osteoarthritis. The disease often manifests itself in the knee, hip and ankle joints. Small joints are rarely affected.
Discomfort and pain with this disease pass at rest and gradually increase when trying to move. Apart from pain in the joint area, the patient does not worry about anything else, neither high body temperature, nor fever nor swelling in the joints is felt. Over time, with arthrosis, creaks and clicks in the joints are heard more and more clearly, and movement is gradually limited.
Symptoms of arthritis
Prolonged inflammation of the joint can provoke arthrosis, and, conversely, without adequate treatment of degenerative-dystrophic changes in the joint cavity, an inflammatory process can occur. The symptoms of arthritis are completely different from the signs of osteoarthritis. First, these diseases cause different types of joint pain. With arthritis, pain is often independent of physical activity and may appear at rest or at night. Pain sensations can be paroxysmal, "flying", moving from one joint to another. The inflammation in this disease also extends to the periarticular tissues.
Secondly, arthritis can be distinguished from arthrosis by a number of other symptoms: general malaise, weakness, increased body temperature, involvement of small joints (fingers, wrists) in the process.
Therapeutic approach
Pain relief
For both arthritis and osteoarthritis, the main goal of pharmacological treatment remains the relief of pain symptoms. According to research, the most effective are non-steroidal anti-inflammatory drugs based on phenylacetic acid, successfully used in the treatment of musculoskeletal diseases. Furthermore, these NSAIDs have fewer side effects and complications than other drugs of the same spectrum.
The study of NSAIDs is based on a drug from the group of phenylacetic acid derivatives, which has become the standard for the treatment of acute and chronic pain. The drug appeared more than 45 years ago, but during this time it has not lost its effectiveness compared to even the latest painkillers.
Furthermore, several years ago, a study was published in the Lancet medical journal that compared the effects of different nonsteroidal anti-inflammatory drugs in the treatment of osteoarthritis. The most effective drug was from the group of phenylacetic acid derivatives, which not only relieved pain, but also improved joint function.
In addition to nonsteroidal anti-inflammatory drugs, other drugs are used in the treatment of arthritis and osteoarthritis.
Arthritis treatment
Adequate treatment of arthritis is always complex, long-term and systematic. It should be aimed at eliminating its cause, relieving pain and inflammation.
Some of its types, including infectious ones, are treated only in a hospital setting. To eliminate the causes and, depending on the origin of the disease, broad-spectrum antibiotics, antifungal drugs and analgesics are used.
In the treatment of reactive arthritis, the main task also remains the destruction of the infection that caused it. Very often the cause is an intestinal or urogenital disease: chlamydia, salmonellosis, etc.
Gouty, rheumatic and psoriatic arthritis occurs against the background of exacerbation of chronic diseases of the same name, so first of all it is necessary to achieve stable remission. For this purpose, special drugs are used to treat these diseases, as well as physical therapy methods and a special diet.
Treatment of rheumatoid disease includes drugs from the sulfonamide group and immunosuppressants. In the treatment of this autoimmune disease it is important to maintain precise dosage of medications. In more severe cases of the disease, corticosteroids are used - hormonal drugs that can slow the progression of rheumatoid arthritis, but have many side effects.
Treatment of osteoarthritis
In case of arthrosis, the cartilage needs additional nutrition and restoration, so chondroprotective drugs containing chondroitin and glucosamine are often prescribed for treatment. This is the main drug therapy prescribed to patients with this diagnosis.
In its initial stage, the main role is played by physiotherapeutic procedures: electrophoresis, magnetic therapy, as well as therapeutic exercises, diet and massage.
Which doctor should I contact?
If you have been diagnosed with osteoarthritis
If arthrosis is in the first stage, when the disease has not yet progressed, treatment can be carried out by a local therapist or general practitioner.
In the initial stage of this disease, the joint needs better blood supply and increased production of synovial fluid. Additionally, until the disease has progressed, strengthening the surrounding muscles and ligaments is necessary to stabilize the joint. Pharmacological treatment includes taking chondroprotectors, non-steroidal anti-inflammatory drugs and drugs that have a vasodilatory effect. Therapeutic gymnastics, physiotherapy sessions and massages have proven effective. For overweight patients, a diet is recommended to reduce body weight and relieve the load on the joints.
The second and third degrees of arthrosis, in which degenerative-dystrophic changes are strongly expressed, are always monitored by a rheumatologist, an arthrologist, an orthopedic traumatologist and a surgeon. Most often, at these stages the process begins to progress rapidly, and conservative treatment has only a symptomatic effect.
The last degree of the disease, in which the limb with the diseased joint can be completely immobilized, usually implies the need for surgery and an endoprosthesis.
If you have been diagnosed with arthritis
In the case of arthritis, the list of treating doctors increases significantly, since the causes of this disease are many more. However, in this case, the first person to visit should be the local therapist, who, based on the medical history, will determine which specialist to contact next.
Autoimmune diseases such as systemic lupus erythematosus or rheumatoid arthritis are always managed by rheumatologists and immunologists. In the case of psoriasis, the dermatologist is added to these doctors.
A vertebrologist specializes in diseases of the spine and treats patients with arthritis of the spine.
For rheumatism, consultation and observation of a cardiologist is necessary. If arthritis is caused by an intestinal or urogenital infection, the main treating specialist will be a gastroenterologist, urologist or gynecologist.
Prevention
First of all, women over 45 and men over 55 need to think about the prevention of arthrosis and arthritis: it is at this time that hormonal changes begin in the body, metabolism slows down and blood flow in the le joints worsen. Preventive measures are especially relevant for those who have a hereditary predisposition to endocrine and metabolic disorders, autoimmune diseases and diseases of the musculoskeletal system.
Particular caution should also be given to people whose work is closely related to physical activity that negatively affects the joints.
The main primary prevention measures are:
- body weight control: excess weight causes additional stress on the joints and the entire musculoskeletal system as a whole;
- a balanced diet that contains the correct balance of fats, proteins and carbohydrates, as well as vitamins, minerals, antioxidants;
- moderate physical activity: gymnastics, daily exercises, swimming, walking;
- abandon bad habits: alcohol and tobacco products disrupt the body's metabolism and suppress the immune system.
If symptoms of joint disease have already been detected, secondary prevention measures apply:
- compliance with primary prevention measures;
- therapeutic exercises, prescribed by a doctor and performed outside periods of exacerbation;
- use of special orthopedic devices: sticks, insoles, bandages, corsets;
- continuous course or drug treatment;
- regular preventive examinations by specialists.