Definition
is a disease caused by the alteration of cartilage, one of the tissues that form the joints, resulting in the appearance of pain and, occasionally, loss of normal movement. Osteoarthritis is the most common rheumatic disease, affecting to a greater or lesser degree to all people aged 50 years, but only a percentage of the population reached sufficient severity to cause symptoms important. Over time, progressively affecting other structures of the musculoskeletal system (disks intervertebral ligaments, tendons, muscles ...).
can affect any joint but most commonly develops in the spine (cervicoartrosis and lumbartrosis) in joints of the hand (mainly the thumb or rizarthrosis) and weight-bearing joints like the hip (coxarthrosis) and knee ( gonarthrosis).
alterations that occur in osteoarthritis in different tissues are being progressively put into place in several phases:
First, the most superficial layer of cartilage is swollen and softened, lost its elastic capacity, later eroded, may eventually disappear, resulting in direct contact between the bones. As a result, the bone reacts to form new bone on the edges of the degenerate (osteophytes). Finally, comes a thickening and swelling of the synovium, synovial fluid produce less viscous and therefore less lubrication of the joint.
In the early stages of the disease the patient may be asymptomatic, as the cartilage is not source of pain and can be potentially reversible process. In contrast, when the cartilage disappears, the disease becomes severe and irreversible.
causes are multiple and can be several of them simultaneously in the same person, raising the possibility of developing the disease.
His most often in older people is justified by the natural aging of the articular structures and reduced capacity for tissue regeneration. However, there is a hereditary predisposition that influences its appearance.
should also be taken as risk factors: obesity (overloading the joints), or malformations of the lower limb differences, joint injuries (fractures, sprains, dislocations ...), the work activities subject to the joint an overuse, excessive sports practice, etc..
Symptoms depend on the joint that is affected, however, in all cases have common features.
symptoms evolve slowly and gradually. Initially, pain occurs only with movement and subsides with rest. Over time, as the disease becomes more severe is manifested in a more continuous, coming to be present even at rest and partially relieved by movement and moderate exercise. Pain causes muscle contractures and disuse atrophy, which in turn are aggravating factors of the disease.
Other common symptoms include morning stiffness, restricted motion, creaking joints, inflammation, joint deformity, etc.
Physiotherapy physiotherapy treatment should be tailored according to what the affected joint, the severity of the process, pain intensity, degree of inflammatory component, the type of daily activities and age.
General objectives should include: pain relief, inflammation reduction, recovery or improvement of range of joint mobility, relaxation of the contractures, increased elasticity of the periarticular structures and strengthening the muscles atrophic.
To achieve these objectives using various technical means (microwave, shortwave, ultrasound, low flows and medium frequency, magnetic ...) and many manual therapy techniques (stretching, passive mobilization, massage, lymphatic drainage, myofascial release, muscle strengthening maneuvers ...).
Physical therapy also plays an important role in the field of prevention of osteoarthritis, by proper treatment of other processes that may predispose to her, spinal deformities (kyphosis, lordosis, scoliosis ...), trauma (fractures, dislocations , ...), sprains misalignment of the joints of the lower limbs (genu varus or valgus, flat feet ...), limb differences in the length of them, sharing burdens asymmetrically on diseases neurological (hemiplegia, Parkinson's, polio etc ...),., and by teaching the correct use of the spine (lifting, sitting posture, to pick things up ...).
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