Osteoarthritis of the elbow joint is a disease characterized by degenerative changes in the cartilage, leading to deformation and violation of the congruence of the articular surfaces with the development of osteophytes and synovitis. These phenomena are accompanied by pain and impaired joint function.
On a global scale, approximately 12% of people from the entire population of the Earth are diagnosed. The risk of osteoarthritis is increased after 55-60 years, and in men it is higher than in women.
A disease can develop earlier if a person’s activity is associated with severe physical exertion. At risk are athletes, loaders, underground miners, drillers, builders and people of other professions using hard physical labor. Pathology leads to a deterioration in the quality of life, sometimes to disability.
The mechanism of development and causes of osteoarthrosis
Pathological changes develop due to functional overload of the joint: it causes a violation of blood circulation and a deterioration in the nutrition of cartilage. Due to the ongoing changes, it becomes thinner and deformed. Cartilage ceases to be elastic, cracks appear, articular surfaces acquire “rough” outlines. With movement and load on the joint, discomfort and pain in the elbow are felt, which over time becomes intense.
Such changes may occur as a result of the following factors:
- unbalanced nutrition, metabolic disorders;
- excessive physical exertion on the joint;
- prolonged microtraumatization and joint damage;
- postoperative pathology;
- infectious lesions, especially viral etiology;
- inflammatory processes;
- alcohol intoxication;
- harmful working conditions.
Clinic of the disease
Symptoms of osteoarthritis of the elbow joint are quite characteristic. However, in the early stages of development, the disease may not manifest in any way. In some cases, discomfort and crunch in the joint, crepitus during movements are detected.
Pain sensations intensify during exercise, reaching a peak in intensity in the evening and calming down at night during rest. Pathology is characterized by “starting” pain, which usually occurs in the morning at the first physical exertion on the elbow joint. Often there is a swelling in this area, which may be accompanied by an increase in pain. In advanced cases, deformation of the elbow is observed, sometimes – malnutrition of the soft tissues around it.
Periodically, the joint may “wedge”: a “blockade” sharp pain occurs with its simultaneous immobilization. This phenomenon is caused by the infringement of the site of the altered necrotic cartilage between the articular surfaces and is called the “articular mouse”. With subsequent movements, this blockage is removed, in parallel, the pain decreases, and the joint acquires mobility.
There are three stages of the disease.
Osteoarthrosis of the elbow joint 1 degree. This is the initial stage, which usually does not manifest itself and is detected in rare cases with radiography of the elbow joint. Cartilage becomes less smooth and supple. The patient feels a slight local discomfort and fatigue, a slight decrease in strength in the joint during exercise.
Osteoarthrosis of the elbow joint 2 degrees. As the disease develops, degenerative changes increase, which lead to a violation of the functional ability of the elbow. The cartilage tissue begins to collapse, the intraarticular gap narrows by more than 50%.
This stage is characterized by:
With grade 3 osteoarthritis, the patient is worried about intense pain that occurs with a slight movement or load, the articulation function is noticeably impaired. On examination, deformation and swelling in the affected area are revealed.
Osteoarthrosis of the elbow joint of the 3rd degree is rare, rarely leads to disability, but nevertheless such cases are not excluded in practice.
According to the degree of restriction of labor activity, depending on the stages of osteoarthritis, a classification according to A. I. Nesterov is used:
|The degree of osteoarthrosis||Ability to do work|
|First||Slightly complicates the work process|
|The second||Prevents professional duties, especially those associated with heavy physical labor|
Diagnosis and treatment
The patient is referred to a traumatologist. Diagnosis of the disease begins with the examination and questioning of the patient, clarification of complaints, medical history, prescription of the disease. During the examination, attention is drawn to the appearance of the elbows of both hands, the color of the skin, the presence of puffiness, hypertrophy (hypotrophy) of tissues in comparison with a healthy upper limb.
Next, the doctor checks the functionality of the joint, range of motion, the presence of pain in it, deformation. The limitation of mobility in the elbow, up to its complete immobility, signals clear signs of osteoarthrosis.
The main diagnostic method is radiography of the elbow joint. If necessary, computed tomography is performed.
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Table number 2. The degree of osteoarthritis in terms of x-ray and treatment effectiveness
|Power||X-ray picture||Effectiveness of treatment|
|First||There are small growths of bone tissue (osteophytes), a slight narrowing of the joint space. The beginning of the degeneration of the cartilage base of the joint into bone||It lends itself well to drug treatment, exercise therapy, physiotherapy. Sometimes the effect occurs when observing a diet, motor regimen, giving up bad habits|
|The second||Marginal bone growths are clearly visible in the picture, a narrowing of the joint gap is pronounced||The main focus is on medication (anti-inflammatory and analgesic) treatment, however previous activities are also taken into account|
|The third||Significant deformation of the joint, complete or almost complete disappearance of the joint space. Significant bone growths. The intraarticular ligaments are thickened, the amount of synovial fluid is sharply reduced||Poorly treated with conservative methods. Mostly symptomatic treatment is used to eliminate the pain syndrome. Surgical methods are effective|
The effect of drug treatment is observed only in the first and second stages of the disease. The third stage implies its symptomatic nature.
Only a doctor can prescribe medication after a detailed examination of the patient. Therapy is selected individually for each, depending on the stage of the disease and tolerance to the medication. Using drugs on your own, you can harm your health.
Of the medicines used:
Such funds have good healing properties, but they give a number of side effects. Therefore, they must be used only according to the clear instructions of a doctor.
For example, long-term use of non-steroidal anti-inflammatory drugs is not recommended because of the detrimental effect on the gastrointestinal tract (max. 2 weeks). Hormones quickly eliminate swelling and inflammation of the elbow, but they threaten the appearance of trophic ulcers and other disorders in the body.
In detail about NSAIDs:
The main methods are physiotherapy, physiotherapy, massage, dieting. They help very well in the initial stages of the disease and are carried out in periods of remission.
Physiotherapeutic procedures include electrophoresis, magnetotherapy, cryotherapy, laser, darsonvalization, diadynamic currents, etc.
Manual therapy with massage helps to carefully and gradually increase the range of movements in the affected limb. Prevent the development of atrophy of the muscles surrounding the joint. Improve blood supply and eliminate muscle spasm.
A set of exercise therapy exercises is carried out in a medical institution or independently performed by a patient at home. The technique is selected individually by the doctor, and the patient is taught to perform exercises.
It is especially important to adhere to a diet. Often people with osteoarthritis are overweight. Therefore, review your diet and adhere to the following principles:
- eat fractionally, in small portions;
- food should not be high-calorie (do not abuse carbohydrates, fats, reduce the consumption of bakery products, especially from premium flour);
- add vegetables and fruits to the diet;
- reduce the consumption of salt and spices;
- give up alcohol.
Against the background of the main therapy in the first or second stages of the disease, alternative methods can also be used. The use of a salt compress on the affected area (elbow) gained considerable popularity.
The solution is prepared at the rate of 3 tablespoons of salt per liter of water. A moistened gauze bandage is applied to the elbow joint, tied with woolen cloth and left overnight. The course is 5-7 such procedures, then a break is made.
At the 3rd stage of the disease, the patient is worried about severe pain, there is practically no effect from the drugs. Under such circumstances, only surgery will help. An osteotomy is used – excision of the bone at the site of the lesion and fixing it in a favorable position. In the presence of osteophytes, they are removed.
In advanced cases, endoprosthetics of the elbow joint or radial head are performed. It is indicated for severe contracture or ankylosis (complete immobilization at the elbow). Affected bone sites are excised, a prosthesis is installed in their place. Its parts are attached to the bone tissue operated with medical cement.
After such treatment, the patient will have a recovery period, which is carried out in rehabilitation centers or at home under the supervision of a doctor.
Osteoarthritis of the elbow joint – a disease leading to limitation of life, causes a lot of trouble to the patient. At the slightest manifestations of the disease, do not let its development go by chance and hope that the pain and crunch in the joint somehow disappear themselves.
You should immediately consult a doctor. There is no panacea for this disease, but the comprehensive treatment started on time will save you from the progression of the process in the tissues of the joint and the development of a strong pain syndrome. Be healthy!
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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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