With arthrosis, the joint cartilage is damaged: This acts as a shock absorber for all kinds of movements and thus ensures a pain-free movement sequence. It is located between the two ends of the bone and thus ensures an even load on the respective joint. The cartilage is damaged or disappears completely for various reasons: This includes above all incorrect loading, which leads to wear and tear. Arthrosis can occur in all joints, but it is particularly common in the hands, fingers, knees, hips or shoulder joints. It manifests itself in joint stiffness and severe pain and often provokes a relieving posture in those affected, which further intensifies the problem. This in turn leads to an even worse blood circulation of the cartilage and its further degradation. In addition, a protective posture always ensures that there is additional stress on the other joints.
The most common forms of arthrosis are hand and finger joint arthrosis, hip arthrosis, also called coxarthrosis, and knee arthrosis, also called gonarthrosis. The arthrosis usually progresses in several stages.
Joint stiffness and start-up pain
One of the first symptoms of arthrosis is joint stiffness: This is noticed by the patients at the beginning, especially when getting up in the morning. A further symptom is the so-called start-up pain, which becomes noticeable when getting up after sitting for a long time. The first few steps cause pain in the knee or hip and the joints initially feel stiff. After prolonged movement, however, the pain subsides over time.
Weakness in legs and hands
Another symptom you should be aware of is the sudden collapse of the legs when walking; in this case, the knees, hips or even the ankle joints suddenly give way. This weakness can also manifest itself in the hands: Most of those affected notice this when doing housework. Objects fall out of your hand while gripping or opening cans suddenly causes problems. Cracking or rubbing noises in the joints indicate a possible arthrosis. Movement restrictions are part of the typical clinical picture: There are difficulties in putting on and taking off clothes or problems with squatting.
If joint deformations have already occurred, permanent pain is a typical clinical picture. In the late stage, these changes are already palpable from the outside and visible to the naked eye. Patients at this stage suffer from severe movement restrictions and are restricted in their everyday life due to the severe pain.
Various factors favour the wear and tear of cartilage; these include above all monotonous movement sequences such as those found in heavy work or top-class sport. Being overweight is also a factor that promotes the occurrence of arthrosis, as the joints have to carry much more weight permanently. Various congenital misalignments of the joints caused by knock-knees or bow legs also put uneven strain on the cartilage and thus cause problems. Inflammations and injuries, such as the typical sports injury of torn ligaments, favour the development of arthrosis.
Arthrosis most frequently occurs in people over 50, as the joints have already been exposed to greater stress than in young people by this time.
However, wear and tear often occur for no apparent reason; in this case it is primary arthrosis. Genetic factors are assumed to be the main cause here.
Secondary arthrosis, on the other hand, can clearly be attributed to various factors: This includes one-sided loads, carrying heavy loads and permanent sitting.
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Arthrosis is diagnosed by means of an X-ray examination, ultrasound or magnetic resonance imaging. With the last method, early signs of wear and tear can already be detected and identified in four degrees of severity depending on the damage to the cartilage. However, the visible changes do not necessarily provide information about how severe the patient’s pain is, as pain can be reduced by building up muscles around the affected joints.
- Degree I: Discolouration and softening of the cartilage can already be seen.
- Degree II: The MRT makes the rough surface and small cracks visible.
- Degree III: A crater-shaped defect can already be detected, which extends to the bone.
- Degree IV: The cartilage has completely disappeared and the exposed bone is visible.
When pain first occurs, the medical anamnesis is first taken on the basis of questions. The doctor will ask when the pains occur and how they are manifested. It is also important to know when they first appeared and whether there are any previous diseases in the patient’s family or whether there has been an accident or surgery that could have caused the changes. In addition, the doctor analyses the patient’s gait pattern and mobility and checks the range of movement of the joint as well as pain, swelling and other changes.
The next step is an x-ray, although the cartilage cannot be seen. This procedure only shows changes in the joint space. This means that only more advanced arthrosis can be seen in the X-ray image.
Another possibility is ultrasound, which also makes capsules and muscles visible. Thus, inflammations of the joint mucosa and capsule can be reliably detected. Other diagnoses that can be made are joint effusions or cysts.
Magnetic resonance imaging (MRI) can be used to detect the initial stage of arthrosis, as all soft-tissue such as cartilage, capsules, tendons, ligaments and muscles are visible.
X-rays are also used in computer tomography (CT). In contrast to classical X-rays, however, layered images are taken, which provides a more precise view.
Furthermore, laboratory tests are used: Blood and urine tests are used to determine various inflammation values and joint fluid is obtained for examination by joint puncture.
- lack of exercise
- monotonous movement sequences
- excessive sporting activity (high-performance sport)
- poor nutrition (low in calcium and protein, but rich in phosphate and phytin)
Both the development of arthrosis and its progression can be prevented or slowed down by appropriate measures. You should therefore pay attention to the following points if you have a family predisposition:
- Do not engage in extreme sports, as this places a disproportionate strain on the joints.
- Get into the habit early on of avoiding one-sided movement sequences or consciously correcting them.
- You should also pay attention to your weight in order to protect your joints.
- If you have congenital misalignments, you should correct them in good time, for example with orthopaedic insoles.
- Make regular exercise an integral part of your daily routine: Special postural gymnastics or physiotherapeutic applications provide you with exercises that you can then do yourself at home. Through this systematic muscle build-up, you permanently relieve your joints
Make sure you maintain a good posture in everyday life, as this ensures that the joints are evenly loaded. In combination with regular movement in the form of sports that are easy on the joints, such as cycling or swimming, and a balanced nutrition, you can reduce your risk of arthrosis.
In older people, arthrosis usually occurs more often because their joints have already been exposed to longer periods of stress. Nevertheless, the disease can break out in all age groups, for example triggered by accidents or genetic predispositions.
Both diseases cause joint pain, but they are different diseases with different triggers. While arthrosis is joint wear and tear, arthritis is an inflammatory disease that is caused by various pathogens such as bacteria or occurs as a result of an autoimmune disease.
If the hip and knee arthrosis is very pronounced, it is possible to replace the hip and knee joints. These artificial joints usually have a lifespan of 15 years.