The human musculoskeletal system is often affected by diseases such as arthritis and arthrosis. Because of the similar names, patients confuse these diagnoses, although in fact 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 the symptoms, specific development and methods of treatment of arthrosis and arthritis in detail.
Features of the mechanism of disease development
Development of arthrosis
Arthrosis (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 entails degenerative processes: bone growths ("salt deposits"), friction and trauma to cartilage, replacement of articular tissues with connective or ossified ones. The disease develops slowly, gradually, at first only slight discomfort and crunching in the joint are felt.
Osteoarthritis is most 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 arthrosis, is inflammatory in nature and can occur in a person 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 inflammation in the joints is caused by the activity of pathogenic bacteria or an infection, then the disease most often begins abruptly, can affect a large number of joints at the same time, and involves both large and small joints in the process.
Both diseases can lead to acquired chronic pain, which today is considered as an independent clinical syndrome.
Comparison of arthrosis and arthritis
| Comparative characteristics | Arthrosis | Arthritis |
|---|---|---|
| Age of cases | In most cases - 65-75 years | Any |
| Cause | Degenerative-dystrophic changes due to metabolic disorders, deterioration of blood supply to the joint | Inflammatory process caused by an infectious, bacterial or autoimmune spectrum disease |
| Joints involved | One or more large joints | A large number of joints, both large and small, often symmetrically affected |
| Blood test results | Average statistical indicators have not changed | An inflammatory process is detected, sometimes an increased 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 migrating nature, and from the very beginning of the disease the sensations are intense |
| External changes | In the early stages - no, in post-traumatic cases swelling is possible | Sometimes there is redness of the skin over the joint, there may be swelling |
| Picture of the joint | Deformation, narrowing of the joint space, bone spines, growths can be traced; most often, x-ray diagnostics give a clear picture of the changes occurring | In the initial stages, no changes are visible; in advanced cases, bone erosion and ankylosis are possible |
| Drug treatment | Preparations with chondroitin and glucosamine, symptomatically - NSAIDs, with rapid progression - corticosteroids. | Symptomatically - NSAIDs, sometimes - antibiotics, for autoimmune diseases - corticosteroids |
Causes of disease development
Causes of arthrosis
Arthrosis 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 its structure, becomes rough, and friction occurs. The main carriers of this disease are elderly people, 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 joints in most cases affect older women who are overweight. Most often, such patients have a genetic predisposition to diseases of this type.
In addition to old age, in rare cases, arthrosis can occur in middle-aged and even young people. The most common reasons include:
- professional sports with heavy loads on the joints;
- hard physical labor;
- advanced arthritis;
- previous injuries or surgeries.
In the cases listed above, arthrosis will be secondary. A predisposing factor in 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. In addition, the disease can be caused by systemic damage to 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 the joints symmetrically.
- Infectious- characterized by inflammation of the joints due to the activity of pathogenic bacteria and infections. Also among the adult population you can find arthritis that occurs against the background of viral hepatitis.
- Gouty- manifests itself 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 approximately 10-15% of people with this diagnosis.
- Traumatic- may occur due to injury to the joint or periarticular tissues.
- Rheumatic- is a consequence of rheumatism, most often provoked by streptococcal infection.
In addition, there are types of disease 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 arthrosis
Joint pain, which directly depends on the intensity of movement and physical activity, is the main symptom of arthrosis. The disease often manifests 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 is not worried about anything else; there is no elevated body temperature, fever or joint swelling. Over time, with arthrosis, crunching and clicking in the joints is heard more and more clearly, and movement is gradually limited.
Arthritis symptoms
Prolonged inflammation of the joint can provoke arthrosis and, conversely, without proper 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 arthrosis. Firstly, these diseases have different types of pain in the joints. 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. 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.
Treatment approach
Pain relief
For both arthritis and arthrosis, the main goal of drug treatment remains the relief of pain symptoms. According to research, the most effective are non-steroidal anti-inflammatory drugs based on phenylacetic acid, which are successfully used in the treatment of musculoskeletal diseases. In addition, these NSAIDs have fewer side effects and complications compared to other drugs in 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.
In addition, several years ago, a study was published in the Lancet medical journal that compared the effects of various non-steroidal 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 medications are used in the treatment of arthritis and arthrosis.
Arthritis treatment
Proper 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, are treated only in a hospital setting. To eliminate the causes and depending on the origin of the disease, broad-spectrum antibiotics, antimycotic drugs, and analgesics are used.
In the treatment of reactive arthritis, the main task also remains the destruction of the infection that caused it. Most often the cause is an intestinal or urogenital disease: chlamydia, salmonellosis, etc.
Gouty, rheumatic and psoriatic arthritis occur 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 medications 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 dosages of medications. In 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 arthrosis
In the case of arthrosis, 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.
At 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 arthrosis
If arthrosis is at the first stage, when the disease has not yet progressed, a local therapist or general practitioner can provide treatment.
At the initial stage of this disease, the joint needs improved blood supply and increased production of synovial fluid. In addition, while the disease has not progressed, it is necessary to strengthen the surrounding muscles and ligaments in order to stabilize the joint. Drug treatment includes taking chondroprotectors, non-steroidal anti-inflammatory drugs and drugs that have a vasodilator effect. Therapeutic gymnastics, physiotherapy sessions and massage have proven successful. For overweight patients, a diet is recommended to reduce body weight and ease 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, arthrologist, orthopedic traumatologist and 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 surgical intervention and endoprosthetics.
If you have been diagnosed with arthritis
In the case of arthritis, the list of treating doctors increases noticeably, since there are many more causes for this disease. However, in this case, the first person to be examined should be the local therapist, who, based on the medical history, will determine which specialist should be contacted next.
Autoimmune pathologies such as systemic lupus erythematosus or rheumatoid arthritis are always managed by rheumatologists and immunologists. In the case of psoriasis, a dermatologist is added to these doctors.
A vertebrologist specializes in diseases of the spinal column and treats patients with arthritis of the spine.
For rheumatism, consultation and observation of a cardiologist is required. 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 years of age and men over 55 years of age 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 joints worsens. 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 also needs to be shown to people whose work is closely related to physical activity that negatively affects the joints.
The main measures of primary prevention are:
- body weight control: excess weight provokes 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;
- giving up 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, which are prescribed by a doctor and performed outside of periods of exacerbation;
- use of special orthopedic devices: canes, insoles, bandages, corsets;
- course or continuous drug treatment;
- regular preventive examinations by specialists.