Treatment of knee joints- Frankly speaking, this is not the easiest task.So before you start your hard fight with this disease, make sure to find a good doctor, check him out and develop a treatment plan with him.
In any case, don't try to establish a diagnosis for yourself!
The fact is that joint lesions similar to joints occur in many other diseases, and low-level people are often mistaken for determining the diagnosis.It is best not to save time and money for medical consultation, because in every way, mistakes can make you pay a higher price.
But that doesn't mean you have to blindly trust any doctor and should not delve into the nature of his advice to understand the mechanism of action of the medicine prescribed to you.Patients should understand the meaning of medical prescriptions and indicate why certain treatment procedures are performed.
Therefore, through the treatment of therapeutic provocative diseases, it is important to combine multiple treatments to solve several problems at once:
- Eliminate pain;
- Improve nutrition of articular cartilage and accelerate its recovery;
- Activate blood circulation in the affected joints;
- Reduce stress on damaged joints of bones and increase distance between them;
- Strengthen the muscles around the patient's joints;
- Increase joint mobility.
Below, we will consider how this treatment can help achieve your goals:
1.Nonsterol anti-inflammatory drugs:
Non-replacement anti-inflammatory drugs - NSAIDS: diclofenac, pyranose, ketoprofen, indomethacin, supramycin, legume, meloxicam, healing, nimulide and its derivatives.
Through arthritis, non-hormonal, anti-inflammatory drugs have been traditionally used to eliminate joint pain and inflammation because normal treatment cannot be initiated in the context of severe pain.Only by eliminating acute pain with anti-inflammatory drugs can you then undergo massage, gymnastics and physical therapy procedures that are intolerable due to the pain.
However, long-term use of drugs in this group is not desirable because they can "mask" the manifestations of the disease.
After all, when the pain is relieved, a deceptive impression is created that healing begins.Meanwhile, arthritis continues to progress: NSAID only eliminates individual symptoms of the disease, but does not treat it.
Furthermore, in recent years, data have been obtained showing the harmful effects of prolonged use of non-replacement anti-inflammatory drugs on the synthesis of proteoglycans.Proteoglycan molecules are responsible for the flow of water in the cartilage and invading its function can cause dehydration of the cartilage tissue.As a result, cartilage that has been affected by arthritis begins to collapse faster.Therefore, the patient's medication to relieve joint pain can accelerate the damage of the joint.
Furthermore, when using non-replacement anti-inflammatory drugs, it is important to remember that they all have serious contraindications and that long-term use can have significant side effects.
2.Cartilage Protectants - Glucosamine and Chondroitin Sulfate:
Cartilage protectors - glucosamine and chondroitin sulfate - These substances feed cartilage tissue and restore the structure of damaged cartilage in joints.
Cartilage protectors are the most useful medicine for treating joints.
Unlike nonsteroid anti-inflammatory drugs (NSAIDs), cartilage protectors do not eliminate the symptoms of arthritis, but are the "basis" of the disease: the use of glucosamine and chondroitin sulfate helps to restore the cartilage surface of the hip joint, thus restoring its variable and normal properties.
The similar complex effects of cartilage protectors on joints make them essential in the initial stages of the joint.However, there is no need to exaggerate these drugs.
When the cartilage is almost completely destroyed, the cartilage protectant has little effect in the third stage of arthritis.After all, it is impossible to plant a new cartilage fabric or return the former form to the knee-deformed bone with glucose and chondroitin sulfate.
In the first or second stage of gonadotropism, the cartilage protector works very slowly and immediately improves the patient's condition.To get real results, you need to use these medications for at least 2-3 treatments, which usually take six months to a year and a half.
3.Therapeutic ointments and creams:
Therapeutic ointments and facial creams are never curable for arthritis in the knee joint (even if their ads are approved the opposite).However, they can relieve the patient's condition and relieve pain in knee pain.In this sense, ointments are sometimes very useful.
Therefore, since knee arthritis without synovitis is not present, I recommend heating the patient with ointment to improve blood circulation in the joints.
To do this, use pepper fruit extract, etc.The ointments listed usually create pleasant heat and comfort in the patient.They rarely have any side effects.
In the case of agnatis disease course, ointments based on non-replacement anti-inflammatory substances are used.Unfortunately, they are not as effective as we want - because the skin passes no more than 5-7% of the active substance, which is obviously not enough to produce a complete anti-inflammatory effect.
4.Reduce funds:
Compared with ointments, the compresses have a slightly greater therapeutic effect.
In my opinion, three drugs should receive the most attention of the local funding used in our time: Dimexide, Bishopytus and Medical Bile.
Polyoxides- Chemicals, liquids with colorless crystals have good anti-inflammatory and analgesic effects.Meanwhile, unlike many other external substances, Dimexide does penetrate the skin barrier.That is, the polyoxide agents applied to the skin are indeed absorbed by the body and act in it, thus reducing the inflammation that is key to the disease.Furthermore, polyoxide oxides have absorbable properties and improve metabolism in the application field, which makes them most useful in arthritis treatment, which occurs in synovitis.
bishop- Oil derivatives, brine is extracted during drilling of oil wells.He became his reputation as a driller, and they were the first to focus on his therapeutic effects on arthritis.Articular nodules occur while working on the well that is constantly in contact with the drilling.In the future, it turns out that bileafal plants have moderate anti-inflammatory and analgesic effects and are very enthusiastic, which arouses pleasant enthusiasm.
Medical bile- Natural bile mined from bile bubbles in cattle or pigs.Bile has an absorbable and warming effect and is used in the same situation as the two plants, but there are some contraindications: it cannot be used for pustule diseases of the skin, inflammatory diseases of lymph nodes and catheters, fever states, and body temperature rise.
5.Intra-articular injection (articular injection):
- Intra-articular injection is often used to provide emergency care for the emergency department of knee joints.In many cases, intra-articular injections can indeed alleviate the patient’s condition.But at the same time, the frequency of joint injections is much more than necessary.It seems to me that this is about this incorrect trend and I want to talk about it in more detail.
Typically, drugs of corticosteroids are introduced into the joints: trianidone, betamethasone, hydrocortisone.
Corticosteroids are good because they quickly and effectively inhibit synovitis (joint edema and swelling).It is the speed at which the therapeutic effect is achieved, which is why corticosteroid injections are particularly popular among doctors.
But this leads to the fact that intra-articular injection of hormones begins even if there is no real need.For example, I have repeatedly faced the fact that hormones were introduced for prevention purposes to prevent further development of arthritis.
However, the problem is that only treating the articular corticosteroids themselves cannot be treated.Therefore, they cannot stop the development of arthritis!Corticosteroids cannot improve the condition of joint cartilage, do not enhance bone tissue, and will not restore normal blood circulation.
They can reduce the body's response to one or the other damage in the joint cavity.Therefore, it is meaningless to use intra-articular injections with hormonal drugs as a stand-alone treatment: they should be used only for complex therapies of the joints.
For example, the patient detects a provocative effect of stage II, where the joints swell due to the accumulation of fluid therein.The accumulation of fluids (synovitis) makes it difficult to perform medical procedures: manual therapy, gymnastics, physical therapy.In this case, the doctor will give an intra-articular injection of hormonal medications to eliminate synovitis and start taking other proactive treatment measures within a week - this is the right way.
Now imagine another situation.The patient also had a stage II provocative disease, but no accumulation of fluid and joint edema.In this case, is it necessary to enter corticosteroids into the joints?Of course, no.No inflammation - Corticosteroids have no "exposed points".
However, even if it does need to be observed with obvious introduction of many regular corticosteroids, many rules must be observed.First, it is impossible to perform such injections in the same joint more frequently over 2 weeks than once.The fact is that the drug introduced will immediately "go out" and doctors will be able to finally evaluate the effectiveness of the procedure after 10-14 days.
You also need to know that the first injection of corticosteroids will usually be easier to relieve than the subsequent syrup.Furthermore, if the first intra-articular administration of the drug has no results, it is unlikely that the same drug will be introduced into the same location second or third.If the first intra-articular injection is ineffective, you need to change the medication, or if the replacement of the medication does not help, more accurately, choose the injection site.
Even after that, introducing corticosteroids into the joint did not give the desired result, and it would be better to give up the idea of treating the joint with hormonal drugs.In addition, the injection of hormones in the same joint is usually more than four to five times, which is extremely different and has different possibilities for side effects.
Unfortunately, in fact, you have to face excessive “determining” of doctors who introduce corticosteroids into the same joint over and over again, achieving at least minimal results in at least the first three injections.Two such cases are more attractive to me than others.
One of the patients had only "only" injections of Kenalog, and the surgery was performed daily, even if there was no ten-day rest time to evaluate the injection results.The second patient was introduced into hormones in the knee joint, with an observation interval (although only 3 to 5 days), but at the same time, poor fellows received twenty to twenty-five times of corticosteroids in one joint for treatment!
It seems that the doctor "goes too far" - it's OK.Will this treatment cause any harm?As it turns out, maybe!
First, the joints are slightly subjected to needles at each injection.Secondly, there is always a risk of some joint infection when intra-articular injection.Third, frequent hormone introductions can cause invasion of joints and surrounding muscle joint structures, resulting in a relatively "decayed" joint.
Most importantly, frequent injections of corticosteroids can worsen the condition of those patients who combine with diabetes, hypertension, obesity, renal failure, stomach or gastrointestinal ulcers, tuberculosis, pustule infections, and mental illness.Even if only the joint cavity is introduced, corticosteroids can affect the entire body and may exacerbate the course of these diseases.
It is more useful to administer hyaluronic acid drugs in knee joints affected by joints (hyaluronic acid - sodium hyaluronate).They were sold about 15 years ago.
Hyaluronic acid preparations (sodium hyaluronate) are also called "liquid prosthesis" or "liquid implants" because they act as healthy synovial fluid on the joints, i.e., natural "joint lubrication."
Hyaluronic acid preparations are very useful and effective drugs: sodium hyaluronate forms a protective film on damaged cartilage, protecting cartilage tissue from further damage and improving sliding contact with cartilage surfaces.
Additionally, hyaluronic acid preparation penetrates deep into the cartilage, thereby improving its elasticity and elasticity.Thanks to hyaluronidase, the cartilage “dry” and as the joint changes, the cartilage restores its shocking absorption properties.Due to the weakening of mechanical overload, the patient's knee pain decreases and his mobility increases.
Meanwhile, the joint is correctly applied to the joint cavity and the hyaluronic acid preparation does not actually give side effects.
Treatment of hyaluronic acid preparations in the course: 3-4 injections are required in total to perform each painful knee treatment process, with the interval between injections usually ranging from 7 to 14 days.If necessary, the course will be repeated within six months or one year.
From my point of view, the main and only serious disadvantage of hyaluronic acid drugs is their high price.Therefore, in 2020, hyaluronic acid is represented by major imported drugs in our market.
But back to the issue of savings, I would like to point out that despite the relatively high cost of hyaluronic acid preparations, their use actually allows many patients to come from previous patients, which must have been done before these drugs.
Given the cost of the joints, it turns out that hyaluronic acid is timely (even in any case) in any case and in any case makes the patient’s intra-knee disease much cheaper.Of course, as long as the doctor who performs this injection has the introduction technique.
It is important to know that in joints that are undergoing a significant inflammatory process, the hyaluronic acid preparation is immediately destroyed.Therefore, it is almost useless to introduce them to patients who are undergoing the active stage of arthritis.However, it is useful to use them with persistent arthritis relief to treat secondary antoplastic phenomena.
With major contributions, you also need to be aware of such moments.For example, if a patient's joint "explosion" due to excessive, pathological fluid accumulation, it makes sense to first "extinguish" the phenomenon of synovitis (inflammatory) (inflammatory) and to help remove excessive pathological fluid with the help of hormone injection or taking nonsteroid anti-anti-hormone-anti-anti-inflammatory drugs.Only in this way is hyaluronic acid introduced into the joints and released from the inflammatory elements.
In addition to corticosteroid hormones and hyaluronic acid preparations, various cartilage protective agents are also attempted to introduce into the joints.
However, these drugs are less effective in hyaluronic acid drugs.They are helpful to patients from 50% intensity and guess whether the impact of their use is impossible in advance.Furthermore, the treatment process requires 5 to 20 injections in the joints, which, as we said, can be harmful to the joints and various complications.
6.Manual therapy and physical therapy:
Manual therapy for provocative diseases in stages I and II usually leads to good results.Sometimes, there are several procedures that are sufficient to give the patient a clear relief.If you combine it with joint extension, cartilage protector intake and intra-articular injection, it is especially helpful for manual treatment of random joints.
From my point of view, this combination of this treatment procedure is much more effective than the numerous physical therapy measures proposed in any clinic.I will give an example in practice.
A case of doctor practice.
A 47-year-old woman with stage II arthritis of the right knee joint was received.By the time we had a meeting, she had been sick for 5 years.Over the years, this woman has managed to experience all the possible physical therapy methods that can be proposed in our regional clinics: laser, magnetic therapy, ultrasound, volume photoelectric, and more.Appointed.Short courses.
The woman decided in total despair to take extreme measures – according to the Eastern method, she was treated for a squirming worm cigarette.As a result, the knee was covered with Burns' scars, but it didn't improve.Yes, despite my respect for Eastern medicine, I can’t be impossible, I know that worm burns can’t eliminate bone deformation and increase the distance between bones indicated by bones on the knee.
After the woman did not help numerous physical therapy procedures and even burned in worm cigarettes, she almost agreed to undergo surgery.But then she still changed my mind and decided to try the complicated approach I proposed.
As they said, the first treatment course passed the “squeak” – we only managed to “churn” the joints with the help of manual mobilization.Therefore, we arranged the next session after preliminary preparation: within 3 weeks the woman picked up the cartilage protectant, made self-quality and compressed with Dimexide.After 3 weeks, I started mobilizing the joints again and then repositioned the joints using manual manipulation ("restore").Clicked, and suddenly, the joints start to move easier and more freely.The woman felt obvious relief.
Using mobilization in the next two sessions, we fixed the improvements achieved, and thereafter we fixed the success of two intrapoint injections.After one and a half months from the beginning of our less intense treatment (after all, we only need six meetings), the woman was finally able to discard the wand that was bored of her and began to move very freely.
Two years have passed since then.Twice a year, patients take cartilage protective agents in short courses, occasionally entering my control technology, and I was pleased to note that knee condition can only be better each year.And now, even the first stage of arthritis is hard to assume - the patient's knee joint is almost completely restored.
Therefore, only six treatment courses (manual treatment plus O'Ninir's intracontraceptive injection) combined with the process of cartilage protective agents is more effective than five years of physical therapy.
From this story (never the only one like this), it is obvious why I think physical therapy is important and just another part of the medical plan for pro-adrenitis.In this sense, I like laser therapy, thermal therapy (Ozokerite, paraffin therapy, therapeutic mud), and especially cryotherapy (local cooling).
7.diet:
The diet for arthritis is also very important.
8.Use sugar cane:
Based on the stick when walking, patients with knee arthritis are very helpful in treatment because the stick takes 30-40% of the load targeting the joint.
It is important to choose a stick based on your height.To do this, stand upright, lower your hands and measure the distance from your wrist to the floor to the floor (but not from your fingertips!).It should have crutches at length.When buying a wand, be aware of its end - it should be equipped with a rubber nozzle.Such sticks are amortized and do not slide when placed on them.
Remember that if your left leg is injured, the stick should be held in your right hand and vice versa.Take a step with your feet and transfer part of your weight to the stick.
9.Treatment Gymnastics:
The most important treatment method for joint joints in the knee joint is special treatment for gymnastics.There are few people with almost any gonadotropics that can achieve real improvement in the state without treatment for gymnastics.
After all, it is impossible to strengthen muscles, “draw” blood vessels and activate blood flow, achieving blood as much as possible through special exercises.
Meanwhile, doctors’ gymnastics are almost the only treatment that does not require the economic cost of purchasing equipment or drugs.All the patient needs is two square meters of available space in the room, a carpet or blanket thrown onto the floor.
There is nothing to consult a gymnastics expert, nor the patient's desire to do this kind of gymnastics by himself.Yes, it’s just that with such a desire, most patients won’t burn.I reveal that almost every patient with arthritis, I have to convince the practice of physical therapy.Moreover, it is usually only to convince a person when the surgical intervention is inevitability.
The second “gymnastics” problem is that even those who are configured for physical therapy exercises often cannot find the necessary exercise sets.Of course, there are handbooks for selling patients with arthritis, but many authors have doubts about the ability – some of them have no medical education after all.
Therefore, such a "teacher" does not always understand the meaning of a single exercise and its mechanism for joint aches.Typically, gymnastics complexes simply correspond to another booklet from one booklet to another.Meanwhile, there is a suggestion among them that it is correct to grab your head!
For example, many booklets prescribe patients with knee joints “do at least 100 squats a day and walk as much as possible.”
Often, patients follow such advice without consulting a doctor before and then sincerely bothering them why it gets worse.Well, I'll try to explain why the condition of the pathological joints in this exercise only worsens.
Let's imagine joints are a kind of bearing.Damaged by joint damage, the aching joint has lost its ideal shape.The surface of the "bearing" (or cartilage) is no longer smooth.In addition, cracks, potholes and "burrs" appeared above.In addition, lubrication inside the sphere thickens and drys, which is obviously not enough.