Is finger arthritis treated

Rheumatoid arthritis is a chronic disease that affects the cartilage of small and large bone joints. The inflammatory process can capture muscles and tendons, disrupt the functioning of internal organs.

Diagnosis is complicated by the fact that the etiology of the disease is not fully understood. To find out the cause of the disease, a whole complex of laboratory and instrumental studies is carried out. How to treat rheumatoid arthritis of the fingers? It depends on the age of the patient and the stage of the disease.

Effective Therapies

Drug treatment stabilizes the patient’s condition and stops the inflammatory process, but it is impossible to completely cure rheumatoid arthritis of the fingers.

The main task of doctors is to achieve a stable remission, in which the patient will be able to lead a full life without resorting to potent drugs.

Comprehensive treatment includes: taking medications, physiotherapy, massage, special exercises for the fingers, acupuncture, folk remedies.

If the bone tissue is so fused that the fingers no longer move, then a decision is made on surgical intervention. Endoprosthetics are performed using modern high-precision equipment – the implant replaces a part of the bone, including the head of one phalanx and the base of another.

Thus, the functions of flexion-extension and rotation of the joint are preserved.

Conservative methods

Nonsteroidal anti-inflammatory drugs (NSAIDs) are used for treatment. They have analgesic and anti-inflammatory effects.

With them, therapy almost always begins – with relative harmlessness, the drugs are effective in attacks of rheumatoid arthritis, when the pain becomes unbearable.

But they cannot cure the disease. The medication is prescribed: Ketoprofen, Ibuprofen, Indomethacin, Piroxicam, Butadion.

Treatment should begin with less toxic drugs.

To treat hands, they take a long time, while some drugs contain substances that gradually accumulate in the body.

They cause ulceration of the mucous membrane of the digestive organs, pain in the stomach.

Over time, the patient may develop iron deficiency anemia. Vitamin complexes, chondroprotectors, a special diet partially eliminate this problem.

If arthritis of the hands continues to progress, the doctor may prescribe corticosteroids – hormones of artificial and natural origin. Used: prednisone, triamcinolol, dexamethasone, methylprenisolone.

The drugs give instant relief: the pain subsides, swelling and irritation disappear, the motor activity of the fingers returns. But not everything is as wonderful as it seems at first glance.

Hormonal drugs are addictive on a physical level. That is, well-being will depend entirely on whether there is a medicine in the blood or not. If the order of taking the tablets is disrupted, withdrawal syndrome will occur.

On the other hand, long-term treatment with hormonal drugs leads to the accumulation of harmful chemicals in the body and to malfunctions of the endocrine system.

The adrenal gland is disturbed, pressure drops or rises, the patient experiences an unreasonable sense of fear or severe apathy and chronic fatigue. Therefore, the use of hormonal drugs is justified only in severe forms of the disease, when other drugs can not alleviate the patient’s condition.

External products

Ointments and creams for external use contain non-steroidal anti-inflammatory and analgesic components.

For treatment, they are used for mild and severe forms of the disease, but if at stage 1 it is enough to rub the cream into the affected joint to relieve pain, then with advanced arthritis, the ointment is used as an adjuvant. These are: Fastum gel, Dolgit cream, Heparin ointment.

Important! You can not use warming creams and ointments for acute attacks, accompanied by swelling and redness of the fingers, fever. This will only strengthen the inflammatory process.

Preparations for external use are effective in the subacute period of the disease and in its chronic form, when it was possible to achieve stabilization of the condition, and the disease does not progress.

Before applying the product and after using it, wash your hands thoroughly.


How to treat a patient when the main course of therapy is completed and the inflammatory process is stopped? To consolidate the results and achieve stable remission, a course of physiotherapy is carried out.

Important! It is advisable to carry out measures when an exacerbation has passed, there are no swelling and redness, body temperature indicators and blood tests are normal. Until an exacerbation has passed, only laser and cryotherapy are used.

The list of physiotherapy includes:

  • mud treatment;
  • infrared radiation;
  • UHF;
  • diathermy;
  • paraffin applications;
  • X-ray therapy.

A pronounced anti-inflammatory effect gives phonophoresis. A small amount of the drug is injected into the subcutaneous layers, and under the influence of currents it penetrates deep into the tissue.

The treatment options for rheumatoid arthritis are also explained in this video:

How to cope with the disease at home?

After discharge from the hospital, the patient continues to be treated at home. He regularly conducts supportive activities that prevent the disease from developing further.

These are: massage, bathing, drinking broths and infusions, rubbing ointments. But folk remedies can only be used with the permission of a doctor.

Excellent results can be achieved using the following methods:

  • The leaves of coltsfoot, white cabbage, burdock are wrinkled in the hands, gently beat off with a hammer or cut with a knife blade, so that the juice of the plant begins to ooz. Wrap around the brushes at night, fasten with a wide bandage, wrap on top with a warm cloth. You can grind the plants first, and then put the slurry of them into your hands, wrap them with a thin natural fabric, then a film and a bandage.
  • Medicinal herbs: oregano, calendula, St. John’s wort, birch leaves (proportions are arbitrary) in an amount of 1 kg pour into a large container, pour 10 liters of water, leave for 10 minutes, pull out the cake or strain, pour the infusion into a bath of warm water. After the procedure, the patient feels relaxed and rested, pain in the hands goes away. If you wish, you can do hand baths separately – 100 liter of boiling water falls on 1 g of grass. The water is cooled to a warm state.

You can read more about how to treat rheumatoid arthritis of the fingers using various decoctions and tinctures in this article.

It is not recommended to use herbs that contain poison (for example, hellebore, hemlock) for infusions. Their effectiveness is in doubt, but poisoning after their use is far from uncommon.

Features of the diet

Medications used for a long time negatively affect the activity of the gastrointestinal tract.

The gastric mucosa is irritated, ulcerations may appear on it. The process of secretion of gastric juice is disrupted.

In addition to arthritis, a patient may be diagnosed with gastritis or an ulcer.

Therefore, you need to remove cabbage, peas, legumes, spicy spices, pickles and vinegar fillings from food.

Alcohol and sparkling water should be excluded from drinks.

The diet is supplemented by the intake of vitamin complexes and dietary supplements containing useful minerals and trace elements.

Briefly about the causes

Rheumatoid arthritis of the fingers occurs against the background of:

  • infectious disease;
  • weakened immunity;
  • genetic predisposition;
  • tedious labor associated with fine motor skills of the hands.

It is important to recognize the disease in time, which at the 1st stage successfully “disguises itself” as a common cold or flu.

A person experiences a similar feeling of malaise and aching in the joints, as at the onset of an infectious disease, and, in fact, arthritis is already progressing in the bone tissue.

Arthritis of the joints of the fingers: symptoms and proper treatment

Many of us have seen older people with disfigured fingers. And in all likelihood they thought it was the fault of old age. But, alas, this is not entirely true. What causes such terrifying deformations of the joints? And can this be prevented? Let’s figure it out!

Arthritis is an inflammatory process in the joints. It affects any of them, but the small joints of the fingers most often suffer. Women suffer from arthritis twice or even three times more often than men, and statistics say that every seventh citizen of the planet Earth feels all the “charms” of this disease. But in patients with a problem of arthritis of the joints of the fingers of the hands – treatment can be successful, if it is started in a timely manner, it is carried out promptly and comprehensively. Such an attitude can save the patient from impending immobility and, as a consequence, disability. Therefore, at the first signs of the disease, it is necessary not to engage in self-medication, but to immediately consult a doctor.

The photo is not very pleasant, but it can happen if you do not monitor your health

Signs of Hand Arthritis

Arthritis is a very insidious disease, because it can break into your life completely unexpectedly, against the background of relative health. This is its acute form. But even worse is chronic arthritis, which proceeds almost imperceptibly, slowly and can progress for years. Symptoms of the disease:

  • acute arthritis is accompanied by severe pain, fever and swelling of the joints;
  • rheumatoid arthritis appears symmetrically, with numbness and tingling of the wrist;
  • general signs appear: fatigue, malaise, prolonged morning pain and stiffness;
  • the appearance of subcutaneous nodules;
  • creak in the joints;
  • joint deformation.

At first, the disease affects a small number of joints, most often it is the fingers and toes. Fingers can take several forms typical of rheumatoid arthritis: a spindle-shaped shape of the fingers, a type of swan neck and contracture of the fingers with skin necrosis. With such curvature of the fingers, a person sometimes cannot even fasten buttons or hold a glass in his hand, in a word – serve himself.

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In a disease of the arthritis of the fingers, the symptoms depend on the type of disease. Inflammatory pain can be quite pronounced and intensify with any movements in the joints, often occurs in the second half of the night. With inflammation of the tissues surrounding the joint, it appears with certain movements, “starting” pains also appear. The shape and shape of the joints change, they become swollen, the skin above them becomes hot, sometimes turns red.

Patients may have swollen hands

Causes of the disease

The causes of the disease may be as follows:

  • common metabolic disorders cause non-infectious arthritis. This form of the disease often affects older people with occupational diseases, disorders of the endocrine glands, which had microtraumas;
  • infectious diseases: brucellosis and gonorrhea, flu and scarlet fever, syphilis and tuberculosis, dysentery and chlamydia. Also, small focal lesions, such as chronic tonsillitis. The causative agents are staphylococci and streptococci.
  • Past injuries of joints, bruises and operations on them;
  • You can not discount the hereditary predisposition, although it is also wrong to say that arthritis is inherited.


Arthritis of the joints of the hands is very important to diagnose at an early stage and choose an individual treatment. Only in this case can the patient be cured. Proper diagnosis will determine the cause of the disease and the type of arthritis (and there are up to 150).

If you detect an infectious arthritis, then a course of antibiotics, vaccines, corticosteroids will be prescribed. Treatment is directed to the process that caused arthritis. To relieve inflammation and pain in the acute form of the disease, non-steroidal anti-inflammatory drugs, analgesics with an antispasmodic effect are used. Chondroprotectors will help stop the development of the degenerative process and restore cartilage. If these funds do not give the expected result, basic antirheumatic drugs and biological response modifiers are prescribed.

The progression of the disease is closely associated with impaired blood supply in the joints, therefore, correction of diseases associated with a change in blood vessels (vasospasm, normalization of blood pressure) is carried out. For short-term, arising after significant loads and “starting” pains, it is advisable to prescribe nitrates.

The severe course of the disease is accompanied by irritability, tearfulness, sleep disturbance. To improve the patient’s psyche, sedatives and sleeping pills are used, as well as drugs that relieve feelings of longing, anxiety and “improve the quality of life.”

Also, the treatment of finger arthritis involves the use of distracting agents – these are painkillers and anti-inflammatory ointments, creams, tinctures and rubbing.

It should be remembered that arthritis also affects the nerves, because the body must be supported with vitamins. The most effective ones are thiamine or vitamin Bı, which is a metabolism catalyst. Most often it is prescribed in the form of injections, but you can use it in tablets or use brewer’s yeast rich in this vitamin.

In case of a disease, arthritis of the hands should be treated in combination with physiotherapy methods. This can be electrophoresis, through which antibiotics, novocaine and various complex medicinal compounds are introduced into the body through the skin, diadynamic therapy – exposure to low-frequency pulse currents, UHF, magnetotherapy, ultrasound. Hydrotherapy and mud applications are also used in remission. All these methods are assigned purely individually.

Mud applications on the hands – an element of complex therapy

When the aggravation is removed, the doctor prescribes therapeutic exercises, usually in the supine position or in the pool, as in water the greatest muscle relaxation is achieved. But at the same time, no exercise should cause you discomfort, much less pain. 90% metabolic dysfunction occurs due to malnutrition. Therefore, you must enrich your body with vitamins E and D, antioxidants and omega-3 fatty acids. All this can be obtained from fresh vegetables and fruits, salmon and herring, liver, walnuts, pumpkin and sunflower seeds, bran.

Along with drug therapy, treatment with folk remedies can also be carried out. These are compresses and ointments with mustard, blue clay, mummy and, of course, infusions and decoctions of medicinal herbs, turpentine baths. However, before using any of them, be sure to consult your doctor.

In especially neglected cases, when conservative treatment can no longer give positive results, resort to surgery and prosthetics of the joints.

So we figured out how to treat this disease. But to this you need to add the rules of conduct during the illness, which will help to transfer it easier:

  • in no case do self-medication;
  • reduce stress on the joints of the fingers;
  • do daily exercises and stretching exercises, but no load:
  • objectively evaluate your condition, without fear and tantrums;
  • punctually carry out all doctor’s appointments
  • you can not lift weights and make sudden movements, jump and run;
  • ensure a good night’s rest;
  • use special assistive devices to facilitate movement;
  • limit the intake of food and liquid – this is natural in acute conditions in the entire animal world.

In the video below, exercises for arthritis of the hands:


Do not suffer colds “on your feet” and treat infectious diseases on time. Go in for sports and temper your body. Do not overload the joints, for this, monitor your own weight. Minimize the intake of salt and sugar, alcohol and tobacco. Eat a few cloves of garlic daily. Replace black tea and coffee with green tea or herbal drinks. Ginger tea is very good for arthritis. Avoid hypothermia and joint injuries.

Remember that movement is life, and giving up excesses is reducing deprivation!

Finger Arthritis Signs and Treatment

In medical practice, under the diagnosis of arthritis, there are a number of inflammatory diseases of the joints. Almost any joint of a person can undergo an inflammatory process, but arthritis of the fingers is most difficult to occur. With a disease, the amount of synovial fluid in the joint cavity begins to increase, however, its composition changes and the formation of exudate, a pathological effusion, begins. Under its influence, the joint suffers.

Ultimately, if there is no competent treatment, pathology with characteristic deformation of the fingers, thinning of the cartilage and changes in the shape of the joint capsule and ligaments can cause loss of household skills, performance and the onset of disability. Thus, as with other diseases, in order to avoid negative consequences, treatment should be started in the early stages.

Causes of the problem

The joints of the fingers of each person are quite vulnerable. With their help, many complex tasks, functions and works are performed daily. In practice, a number of reasons can provoke arthritis, among which some basic ones stand out:

  • genetic predisposition;
  • rheumatism and other connective tissue diseases;
  • all kinds of septic infections;
  • finger injury (bruise or fracture);
  • some specific infections, including syphilis, tuberculosis;
  • systematic adverse environmental influences, including hypothermia, exposure to vibrations, increased humidity;
  • inevitable changes in cartilage of an age-related nature;
  • disruption of the immune system;
  • abuse of bad habits.

What are the signs of a disease?

Today, modern medicine has about 150 types of arthritis. The most common can be called infectious arthritis, osteoarthritis, purulent and rheumatoid arthritis. Various types of diseases can occur in the form of an acute or chronic form, and each type has its own symptoms and characteristics. They may also vary depending on the form of the disease. For example, an acute form of finger pathology is accompanied by symptoms such as fever, swelling, and severe pain. All symptoms tend to appear suddenly and grow very quickly.

In the chronic form, the symptoms of arthritis are almost invisible, they appear in a mild form and are periodic. The main feature of this form of the course of the disease is the feeling of stiffness of the joints of the fingers. In addition, it should be noted that in view of the individual characteristics of each individual patient and his age, arthritis of the fingers can occur in different ways, with its own symptoms.

Regardless of the type of disease, you can highlight some characteristic symptoms characteristic of arthritis in general:

  • pain in the joints of the fingers, which may intensify with movement or after a prolonged state of rest;
  • an increase in temperature, sometimes to fairly high rates, especially in acute form;
  • a feeling of stiffness in the joints of the fingers, impaired mobility;
  • the formation of swelling, as well as redness of the skin at the locations of the affected joints;
  • an increase in the size of joints and noticeable violations of its structure.

Finger Arthritis Treatment

Treatment should be carried out only after a thorough diagnosis. In addition to the traditional examination by a specialist, identifying symptoms, examining complaints, collecting a medical history, patients may be offered an additional examination. For example, an X-ray examination is considered a sufficiently informative method for detecting arthritis. Using x-rays, you can determine the degree and stage of the disease. In addition, a differential diagnosis is carried out, which allows to determine the type of arthritis, since treatment may depend on this indicator.

As a rule, treatment (regardless of form and type) will be aimed at solving the following problems:

  • removal of the inflammatory process and reduction of pain;
  • improvement of metabolic processes in the joint tissues and their blood supply;
  • removal of exudate from the cavity of the diseased joint;
  • restoration of lost range of motion.

Treatment is carried out using methods such as medication, physiotherapy, therapeutic massage, diet and proper nutrition of the patient in the future.

As for drug treatment, it involves such a main group of pharmacological drugs as non-steroidal anti-inflammatory drugs, for example, acetylsalicylic acid, voltaren, diclofenac, ibuprofen, etc. The action of these drugs is aimed at inhibiting the inflammatory process by exerting influence on the course of enzymatic reactions. Means have not only anti-inflammatory, but also analgesic effect.

Another pharmacological group of drugs that treat arthritis is steroid hormones, such as diprospan or kenalog. As a rule, they are used intraarticularly after removal of the accumulated exudate. The drugs have an excellent anti-inflammatory effect.

If arthritis is of an infectious nature, the treatment involves a course of antibiotic therapy. In this situation, predominantly broad-spectrum antibiotics are used, for example, meronem, bigaflon or ceftriaxone.

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To restore the damaged structure of the articular cartilage, patients are prescribed chondoprotectors, for example, chondroitin, chondroxide or rumalon in the form of injections, tablets or ointments. The action of these drugs improves metabolic processes in the cartilage of the joints of the fingers.

After the removal of the acute symptoms, further treatment is carried out with the help of massage and physiotherapeutic procedures, including UHF, magnetotherapy, electrophoresis with drugs. Also at home, you can use traditional methods of treatment: compresses, infusions from decoctions of herbs, ointments from propolis and honey, turpentine baths. You can strengthen your body with the help of various vitamin complexes.

A radical measure of treatment is surgery. Prosthetics of diseased joints is carried out when traditional treatment does not give the desired effect and visible results.

Which products are better to refuse?

Arthritis of the hands does not imply strict food restrictions. However, diet in this case is the key to successful treatment and prevention of the disease in the future. Clinical nutrition in this case should be agreed with the attending physician or specialist nutritionist.

As a rule, the diet has some specific differences depending on the type of disease. So, with the rheumatoid form of arthritis, you should abandon the broths (meat, fish and mushroom), reduce the amount of sugar, pickles, canned food, marinades, smoked meats, spicy and spicy.

With reactive arthritis, it is important to limit the intake of fats, flour products and carbohydrates, and enrich your diet with fruits, berries, vegetables and other sources of vitamins, dietary fiber and antioxidants. As for gouty arthritis, the taboos are sausages and smoked meats, salted fish, legumes, alcohol.

Symptoms and treatments for arthritis of the fingers and toes

Arthritis of the fingers and toes is an inflammatory process that affects the joints of the phalanges of the fingers, leading to severe pain, inability to bend the arms. Often, damage to the fingers is accompanied by damage to the wrist joints and elbows.

Inflammation of the joints with arthritis can be the result of many factors, for example, developed gout, and physical damage. Further in the article, full explanations about the symptoms, causes and treatment options will be given.


The most typical consequences of arthritis are severe joint pain, which first appears at night, then the pain becomes constant, in addition, inconvenience when walking (foot arthritis), gait changes, the skin over the joints turns red, and the muscles degrade, with extensive damage, during pain, one to two degrees the temperature rises. At dawn and after sleep, a feeling of constrained hands or feet comes, as a rule, the dawn time is the peak of the pain syndrome.

Symptoms of arthritis of the fingers

The first signs of finger arthritis include:

  • Pain that worsens or appears, for the first time, in the fall. In addition, exacerbation is seen in wet weather, cold snap.
  • The sensation of aches is typical, the fingers swell and redden, the mobility of the fingers is significantly reduced.
  • At night the pain intensifies, at times it becomes impossible. There are frequent cases when with advanced arthritis of the hands, hospitalization is performed.

Conventionally, the defeat of arthritis for the limbs can be divided into three categories: metabolic, rheumatoid and infectious.

Each of the species has its own reasons. Infectious arthritis can be caused by infectious lesions in the body. Often arises on fists that stray from blows (knocked down knuckles), etc.

All age categories are susceptible to rheumatoid arthritis. It is sometimes found in children, but, nevertheless, in the bulk, the elderly suffer from it. The main reasons can be attributed to severe hypothermia of the hands and feet, injuries, especially slippery, gene heredity, age criteria, and sometimes infection. Typical symptoms include night pain and stiffness, and the disease progresses with age.

Reactive arthritis is very dangerous symptoms and treatment methods, which are similar to other types. The main causative agent of rheumatoid arthritis are various infectious diseases.

Exchange-type arthritis, which is called gout, usually occurs after 50 years in diabetics and people with metabolic disorders. It is characterized by pain in the phalanges, seals in the joints and small growths can occur.

Symptoms of arthritis of the toes

Osteoarthritis is the most common form of arthritis that affects the feet. Under its influence, the articular cartilage between the phalanges and the foot radial bones is completely destroyed. Cartilage destruction is accompanied by pain. The pain intensifies while walking, which changes gait. In motionless position fetters a foot. Often, pain radiates to the patella and groin.

Developed arthritis of the feet (gout) is also very common. Since when walking the main load is communicated to the thumbs, they are the ones who are the first to get the disease. Symptoms include flexion pain, swelling, and joint deformities. The skin turns red.

With arthritis of the thumbs, polyarthritis or rheumatoid arthritis of the feet may begin. Rheumatoid damage manifests itself in the same way as on the fingers. And polyarthritis is a multiple lesion of the joints of the toes, if you do not diagnose it in time and start taking medications, which will be discussed later, then a person will become an invalid with a very severely impaired movement.

Arthritis Diagnosis

Arthritis, as a joint lesion and typical symptoms, has two forms of course:

  • acute, which is characterized by a sharp focal manifestation of pain, which lasts several hours with overwork or “weather”;
  • the chronic form arises from acute manifestations, characterized by constant pain and short moments of relief when taking painkillers or after taking cartilage tissue repair drugs.

The easiest, from the point of view of diagnosis, is the second form, since it can be detected as soon as possible. In addition, patients rarely immediately go to the hospital when joint pain occurs, but treatment is very advisable right away.

The most reliable way to detect arthritis of any degree and form is x-ray.

Arthritis treatment of fingers and toes with medicine. Therapeutic treatment

There are many ways that are used to treat arthritis, but all of them should be prescribed by a doctor after studying the history.

It will be impossible to cure a disease if the wrong methods are applied to its treatment.

Means of the following pharmacological types:

  • ointments and gels. The most common remedies include ointments “diclofenac” and “Sustangel”, which are used as a focal pain medication, relieve swelling, help reduce redness;
  • antibiotics. Antibiotic drugs are prescribed when damage to the membranes of the joint or destruction of the cartilage due to the absence of enzymatic tissues is diagnosed, with infectious lesions of the tissues. Antibiotic substances accumulate in the joint, replacing the necessary substances, and the joint begins to recover;
  • drugs or dietary supplements are aimed at increasing the level of substances from which the “body” builds joint tissues. Useful and used in the early stages of the disease. In addition, the drugs are anti-inflammatory in nature, the main drug is “COX-2” in ampoules, the drug is not a steroid type, but its use is not recommended for pregnant women. The course consists of 10 injections once a year. In addition, the tool gives an impetus to the beginning of recovery work.

Therapeutic treatment should be combined with physiotherapy, spa treatment and physiotherapy, the use of massage, which is often an effective prevention. Exercises or additional types of treatment are prescribed by the doctor, leading a medical history – medical history. With a complex form of treatment, analgesics and a diet that includes the consumption of calcium-rich foods can be used. What else can be treated for pain in the joints of the fingers, let’s find out a little lower.


There are very effective means of traditional medicine, which are confirmed by classical medical science.

  • Since inflammation is a very important damaging factor, it is possible to prepare a tincture of anti-inflammatory action. 5 garlic heads are chopped and poured with 100 grams of vodka, infused for 10 days in a warm, dry place that is protected from the sun. One spoon is taken half an hour before meals, three times a day. The use does not end until the tincture of this composition ends in a container.
  • A similar recipe, which is prescribed for arthritis of the thumbs, includes the same proportion of vodka and garlic, twisted in a meat grinder. But you still need to add the juice of three lemons, this will saturate the body with vitamin C, which is absorbed with vodka – this speeds up the process of absorption and assimilation in the blood.

This article is an explanation and recommendation, but it is extremely undesirable to make an independent diagnosis and make a diagnosis without contacting specialists.

For the treatment of arthritis, folk remedies are also used, about several such remedies, you can find out below:

Shishkevich Vladimir
Shishkevich Vladimir
Orthopedic doctor, traumatologist
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I have been treating joints for many years. I can say with confidence that the joints are always treatable, even in the very ripe old age.

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Morozov Georgiy

Rheumatologist. For more than 20 years, he has been involved in the diagnosis, treatment and prevention of joint diseases. Specialization: diagnosis, treatment and prevention of diseases and deformations of the musculoskeletal system.