Osteoarthritis - When the joints wear out

Almost five million people in Germany wake up in the morning with stiff limbs, can hardly move at first and often suffer from sometimes severe pain. The reason: Due to the wear of the articular cartilage, the bones rub against each other causing pain and discomfort. The bones become denser and harder through this process. At the edges of the joints, prongs may form, which thicken the joint and make movements even more painful. This degenerative bone disease is called "osteoarthritis".

Arthritis or osteoarthritis?

Osteoarthritis is a non-inflammatory, chronic disease of the articular cartilage. Arthritis is an inflammation of the joint. Osteoarthritis can lead to arthritis. Above all, joint inflammation promotes cartilage deterioration and aggravates osteoarthritis. In fact, arthritis is one of the most common causes of disability and early retirement. The cause of the disease is seen in the wrong physical stress and bad posture at work and leisure. All 200 joints in humans can be affected by osteoarthritis, but in fact it mostly affects them:

  • Osteoarthritis of the hip joint (coxarthrosis)
  • Osteoarthritis of the knee (gonarthrosis)
  • Arthrosis of the spine (spondylarthrosis)
  • Osteoarthritis of the shoulder joint (osteoarthrosis)

Slow start

Normally you do not notice the friction in the joints. Because the cartilage tissue has no nerves, the early stage of the disease is not noticed. At this time, the cartilage gets a little less elastic. Single cartilage cells die and are not replicated. The cartilage surface breaks down and tiny pits form in the bone, which then become deeper and deeper over time.

Ultimately, the actually smooth surface of the cartilage becomes rough and scarred, the joint can not be moved without problems and pain. This process affects the entire joint - ie bone, joint capsule, synovial membrane and tendons. The severity of the disease is reported by physicians in four stages from I - IV, with cartilage damage of the fourth degree describing severe joint damage with bone damage.

Osteoarthritis affects (almost) all vertebrates

With the degenerative joint disease, we are not alone: ​​Almost all vertebrates, even whales, can get sick. The only exceptions are the two mammal species that hang overhead: bats and sloths. But unlike our animal fellow sufferers, we humans can do a lot to relieve arthritic ailments.

Although there are no preventive measures such as a vaccine. But already the check-up in infants, which is to exclude a congenital hip deformity, is considered a preventive measure against a later hip osteoarthritis.

Treatment is possible

Basically, the following factors promote osteoarthritis:

  • overweight
  • lack of exercise
  • Smoke
  • Competitive sport of certain sports such as weightlifting
  • arthritis

Accordingly, the procedure for alleviating osteoarthritis complaints, namely a nutritional change that omits nicotine and alcohol, largely dispensed with animal fat and fish and a Mediterranean diet in the foreground. Particularly important is a reasonable exercise program that includes stretching exercises and avoids the wrong load on the joints.

All sports that cause impact on asphalt and concrete must be avoided or at least practiced with shoes with a soft sole and cushioning effect. Swimming, walking, cycling and gymnastics are recommended. Targeted physiotherapy can prevent the patients to take a restraint to avoid pain, which only leads to further muscle tension and more pain.

Because only by movement, the environment of the articular cartilage can continue to be supplied with nutrients. This is where the strict ban on smoking comes in: Smoking reduces the oxygen content of the blood and thus worsens the chances of good nutrition.

Treatment with drugs

Osteoarthritis can be treated but not cured. For the most part, medication therapy focuses on pain therapy, which, together with effective physiotherapy, should reduce the fear of further movement. If the joints are no longer moving, there is a risk that they will stiffen completely in the future.

In mild, occasional pain patients can resort to over-the-counter painkillers from the pharmacy. However, these should be taken at most ten days a month and a maximum of three days in a row. For more severe pain and advanced osteoarthritis, stronger analgesics must be taken under medical supervision.

A study conducted at the Berlin Charité has shown success with acupuncture in the treatment of arthritic knee pain. In addition, the Berlin study also demonstrated progress in the mobility and functionality of the knee joint. However, the scientific explanation for the positive result is still missing. That acupuncture helps with knee osteoarthritis, has been proven with the study. Why the Chinese cure does not help. If acupuncture and pain therapy do not help, there remains an operation in which the affected joint is replaced by an artificial joint. Whether and to what extent a prosthesis can be used must be decided jointly by the doctor and the patient.

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