Osteoarthritis is a disease that primarily affects the articular cartilage, which is an elastic connective tissue that is found at the ends of the bones that articulate with each other.
Articular cartilage is nourished by joint fluid or synovial fluid, so called because it is produced by synovial, a membrane rich in vessels that lines the interior of the joints. This joint fluid contributes to lubricate the joint, facilitating its movements, and allowing healthy joints to slide the cartilages on top of each other without friction, that is, without wear.
As a result of this, the ulcerative articular cartilage and the bone beneath the cartilage react, thickening and giving rise to bone growths called osteophytes. Osteophytes are known as "parrot beaks", because some of them, on radiographs, give images that resemble a parrot's beak.
In this degenerative process, joint inflammation phenomena often occur, causing pain and swelling of the joint. Hence the term "arthritis" is also used for these clinical conditions.
Arthrosis is one of the multiple rheumatic diseases and is by far the most common. It is a disease of a degenerative nature that involves the entire joint.
In Portugal there are about half a million patients with arthrosis and pain, although, in fact, this number is close to 1 million, as many patients have osteoarthritis and have no complaints.
Osteoarthritis is a very important cause of disability in the elderly and one of the most frequent causes of permanent disability and early retirement.
The climate is not a cause of osteoarthritis, although the cold and humidity aggravate the complaints of these patients, and the warm climate relieves the pain.
There are joints in which arthrosis is more common: knees, hands, hips, spine and feet. In the hands, are the joints of the fingers and, in the wrist, at the base of the thumb the most common joints. In the spine, the cervical and lumbar region. On the feet is the base of the first toe, which when deformed is often called a "bunion".
What causes arthrosis?
All those who expose their locomotor system to overload or excessive work, such as sports people and the obese, and those who have joint or limb malformations, such as deformities of the knees, hips or feet, will tend to develop arthrosis earlier. .
How are arthrosis manifested?
There is no correlation between the degree of joint damage and the intensity of pain. Many patients have advanced arthrosis and little pain, while others who are very complaining have poorly evolved arthrosis.
The main symptoms of osteoarthritis are pain, stiffness, limited movement and, in more advanced stages, deformations. Pain has a rhythm characterized by the fact that the pains get worse throughout the day, with movements and efforts, and improve when the patient rests, particularly when lying down.
As a rule, patients with osteoarthritis have no pain at night and sleep well, although in some very advanced cases of arthrosis of the hips and knees the pain may also appear at night.
The limitation of joint mobility gets progressively worse over the course of the disease.
Periods with swelling of the joint may occur due to inflammation. In the fingers this inflammation takes the form of nodules and in the knees fluid can accumulate, which coincides with an aggravation of complaints.
Limitation of movement can generate great disability in patients with osteoarthritis. Thus, for example, patients with osteoarthritis in the upper limbs, particularly at the level of the shoulders, may have great difficulty in dressing and eating. On the other hand, arthrosis of the lower limbs can make walking difficult and make certain tasks difficult or even impossible, such as putting on shoes.
In the end, the joint is unable to perform its function, without cartilage and with the bone developed in the periphery. Patients become more and more limited, to the point where they are unable to move the joint without great effort and severe pain.
Objectives of a rehabilitation program:
Improving mobility and joint movement
Relief from pain and inflammation
General physical reconditioning
Teaching and counselling of support products (orthotics, splints, etc.)
Return to work activities , daily life and sports activities
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