Osteoarthritis of the elbow joint is a chronic disease that manifests itself in the destruction of the connective tissues of the joint and has a progressive character. If the disease is not addressed in a timely manner, it can have dangerous consequences. Cartilage tissue can be completely destroyed, and the joint deformed. The disease is more common in people over 40 years of age. Especially often people over 60 suffer from this disease.
Physiology of disease
The physiological essence of osteoarthritis of any joint is that hyaline cartilage is depleted. It begins to wear out quickly and becomes unable to perform its direct functions. The cause of joint dysfunction is its insufficient supply of nutrients. This happens when the cartilage tissue does not receive the necessary amount of nutrients for its normal functioning.
The disease has another name - epicondylosis. In the diseased joint, the amount of synovial fluid begins to decrease, this becomescause narrowing of the joint space, increased friction and the appearance of osteophytes. The mobility of the joint becomes limited, a person feels pain with any movement of the arm. In osteoarthritis, the disease affects all elements of the elbow joint.
When compared with the hip or ankle joints, the elbow is much less susceptible to the development of deforming arthrosis. This is due to the fact that he does not experience such large loads. But still the disease occurs, and most often older people suffer from it. It may be that in patients who seek medical help, the disease began to develop long before that, but as a rule, people who are over 45 years of age turn to medical institutions.
Arthrosis in women is diagnosed more often than in men, this is due to hormonal changes that occur in the female body at this age. Athletes are also at risk of getting this disease, especially those who play tennis, people whose profession is associated with a direct load on the elbow. These professions include pianists, professional drivers.
Osteoarthritis of the elbow joint according to ICD 10 is under 15-19.
Causes of disease
Osteoarthritis of the elbow joint can occur for the following reasons:
- An elbow injury that a person received in his youth. Such injuries include damage to the meniscus, bruises of varying severity, fracture of the wrist bone, dislocation, rupture of ligaments, and others.
- Measurement of body substances is disturbed. In this casethe joint does not receive the amount of elements that is necessary for its normal functioning.
- If a person suffers from rheumatoid arthritis, then this disease, progressing, goes to all joints.
- Some chronic diseases. Arthrosis can be caused by cholecystitis, gastritis, tonsillitis, caries.
- If the patient consumes very little pure water.
- Inflammatory processes in the joint caused by infection in the inside of the joint bag.
- Various diseases of the endocrine system.
- Toxic poisoning.
- Age-related changes in the patient's body.
- Genetic predisposition. If parents are diagnosed with arthrosis, then this disease can later be detected in their children.
- If a person often suffers from respiratory diseases, and also periodically hypothermia.
These are the most common reasons why this disease can develop.
Symptoms of the disease
Medicine distinguishes four main groups of symptoms by which it can be determined that the elbow joint has been affected by arthrosis:
- When a person bends or unbends his arm, turns it to the side, he feels pain in the elbow. Pain can occur even when a person is just walking. But at the first stage of the development of arthrosis, such symptoms are quite difficult to notice, since they are mild. Only after some time the patient begins to feel pain without even moving his hand. There are times when pain from the elbow jointradiates to the cervical spine.
- During the movement of the elbow, a dry and rough crunch is heard in the joint. This sound is caused by bones rubbing against each other. With further progression of the disease, the crunch becomes louder and more distinct. The pain also becomes more pronounced. Sometimes ringing clicks in the elbow are also heard in he althy people, but these sounds are not accompanied by pain. Such sounds do not indicate danger and are considered normal.
- Due to the fact that the lumen of the joint space becomes narrower, bone spikes grow and muscle spasms occur, the elbow becomes less mobile, the amplitude of rotation of the arm decreases. Often, the presence of arthrosis of the elbow joint is indicated by Thompson's symptom. The patient cannot hold a back-bent hand clenched into a fist. This position is very uncomfortable for him, and he tries to straighten his fingers as quickly as possible. It is also very difficult for the patient to bend and unbend the arm in the forearm at the level of the chin (Vetla symptom).
- The elbow joint changes visually. It swells, tubercles can also be observed. The reason for such changes is an increase in the amount of synovial fluid and the growth of osteophytes.
Stages of epicondylosis
In general, medicine distinguishes 3 stages of development of elbow arthrosis. Each of them has characteristic symptoms. It is clear that at the beginning of the disease they are not so pronounced than after a while. But many patients try not to pay attention to minor changes in the elbow and do not seek medical attention in time.help. But a timely visit to the doctor is a guarantee that the treatment will be successful.
Osteoarthritis of the elbow joint 1 degree
At the very beginning of the disease, people feel a slight pain in the elbow, which many do not pay much attention to, hoping that there is nothing dangerous and everything will go away on its own. The pain most often occurs after some hard work. It is very difficult to determine the disease outwardly, but during the examination, a specialist may notice a slight, at first glance, decrease in muscle tone. Some patients complain that they have difficulty moving their forearms.
The fact that a person has osteoarthritis of the elbow joint of the 1st degree is evidenced by the fact that it is difficult for him to bend and unbend his arm, and also to bring it back behind the thigh. In this case, additional diagnostics are necessary. An x-ray is taken to exclude carpal tunnel syndrome and cervical osteochondrosis. Also, if the disease has begun its destructive effect, it will show that the joint space has begun to decrease.
Osteoarthritis of the elbow joint 2 degrees
If the disease has passed into the second stage of its development, the patient feels a significant increase in pain in the affected joint. The pain does not go away even when the arm is at rest. That is why, at this time, most patients seek help from a specialist. When you move your hand, you can hear a dry crunch. The mobility of the arm is impaired, the patient with great difficulty bends it at the elbow or takes it back. Some people may experience slight muscle atrophy. Man becomesit is difficult to endure constant pain, they do not allow him to do his usual work, worsen the quality of his life. Everything that he used to do in ordinary life, now he succeeds with great difficulty.
Diagnosing osteoarthritis of the elbow joint of the 2nd degree is much easier than at the beginning. On x-rays, you can clearly see a lot of bone growths, cartilage tissue is deformed by multiple irregularities. But it is simply impossible to notice any changes on the elbow outwardly. Edema is observed only during an exacerbation of the disease.
Third degree pathology
How does osteoarthritis of the elbow joint of the 3rd degree manifest itself? A sick person is constantly tormented by severe aching pain, which does not allow him to rest calmly even at night. Joint movements are very limited. Often people who for some reason do not go to the doctor, in order to somehow reduce intense pain, try to fix their hand in a comfortable position.
The cartilaginous tissue is completely destroyed, it can be seen in X-ray examination. You can also observe a large number of bone growths, the joint space is completely absent. At this stage, the external signs of the disease can be seen even with the naked eye. The joint is deformed, the diseased arm may become shorter than the he althy one. Even intensive treatment at this stage does not give a positive result.
Deforming arthrosis
According to statistics, almost 50% of all elbow arthrosis is due to deforming arthrosis. This type of diseaseaccompanied by the same symptoms as ordinary epicondylosis. At first, the patient feels slight pain in the elbow, which intensifies over time. Then there is a restriction in movements.
Deforming osteoarthritis of the elbow joint also has three stages of its development, they can be determined by x-rays. The higher the degree of the disease, the smaller the lumen of the joint space, the more bone growths and the more deformed the elbow. In addition, the disease has its own characteristics:
The first degree of the disease is characterized by growths on the distal epiphysis of the humerus. But then they do not increase much. The most dangerous are growths that are located around the joint. They can be pressed into the fossa of the elbow, and therefore, already at the beginning of the development of the disease, it becomes difficult for a person to move his hand. If most of the growths are located near the coronoid process, then the patient cannot extend the joint.
When deforming arthrosis enters the second stage of its development, osteophytes surround almost the entire surface of the joint. But despite this, the limb is still able to function. Restriction in movements occurs gradually. Often growths surround the head of the radius.
At the third stage of deforming osteoarthrosis, in addition to overgrown osteophytes, sclerosis of adjacent lobes of bones is observed. The articular end of the humerus is most deformed, and the surface near the articular cavity is covered with bone growths. The patient with great difficulty performs evenvery simple movements, while he experiences a sharp pain. To make life easier for the patient, all formations inside the joint are removed through surgery.
Methods of treatment of elbow osteoarthritis
Diagnosis of the disease is carried out in a medical institution on the basis of a doctor's examination, laboratory tests and x-rays. Sometimes MRI and arthroscopy are also done.
If the disease is at an early stage, then conservative treatment is used. Its goal is to relieve pain and increase the mobility of the diseased joint. Treatment of this disease is complex and lasts a long time. As a rule, it includes several ways.
Basic principles of osteoarthritis treatment:
- it is necessary to load the diseased joint as little as possible;
- to relieve the inflammatory process and pain, courses of treatment with medications are carried out;
- special recovery exercise recommended;
- at home, you can use the treatment of folk methods;
- if conservative treatment does not lead to the desired results, then the patient is offered surgical treatment.
Drug therapy
A good result is given by drug treatment for osteoarthritis of the elbow joint of the 1st degree. Usually, to get rid of this ailment, the following drugs are used:
- NSAID;
- Chondoprotectors;
- Ointments with medicinal substances
The purpose of NSAIDs is to relieve the patient of pain and relieve the inflammatory process inside the joint. Pharmacological enterprises produce such drugs in the form of intramuscular injections, injections that are injected directly into the inside of the joint, as well as tablets and ointments. The most used drugs are Diclofenac and Indomethacin, as well as their analogues - Voltaren, Ibuprofen, Ortofen. During an exacerbation of the disease, it is desirable to receive NSAIDs in the form of injections, then switch to tablets. But at the same time, one should take into account the fact that these drugs have a great negative effect on the stomach, its mucous membrane.
Chondoprotectors are drugs that restore cartilage tissue. They can be in the form of tablets, injections and ointments. Treatment with chondoprotectors lasts a long time, at least 6 months. Of all the varieties of these drugs, glucosamine sulfate and Chondroxide are most often used. Such drugs give a positive result in the treatment of osteoarthritis of the elbow joint of the 2nd degree, and of course the 1st degree.
Ointments with special medicinal substances are applied to the sore spot. They help relieve pain and inflammation, warm, relieve swelling. The most common are Fastum-Gel, Voltaren, Diclobene, Viprosal, Epizatron and others.
Physiotherapy treatments
Physiotherapy is used inthe rehabilitation period, when acute phenomena have already been removed by medication. For osteoarthritis of the elbow, the following methods are used:
- Paraffin therapy. The application of warm paraffin helps to warm the soft tissues surrounding the affected joint, thereby stimulating blood flow.
- Laser. Thanks to this procedure, osteophytes are destroyed and new ones grow less.
- Electrophoresis. Helps drugs penetrate deeper into the joint bag.
- Therapeutic mud compresses. Eliminate atrophic changes in tissues.
Therapeutic massage
Massage, like physiotherapy, is prescribed when the disease is in remission. This manual procedure has a beneficial effect not only on the state of the joint itself, but also on the muscles that are located around it. The joint becomes more mobile, pain is reduced.
In conclusion, it can be noted that osteoarthritis of the elbow joint, like any other disease, is much easier and faster to treat at the initial stage. Therefore, at the first suspicion of this disease, you should seek help from a medical institution, where they will correctly diagnose and prescribe the necessary treatment.
