Osteoarthrosis of the elbow joint is a chronic ailment that manifests itself in the destruction of the connective tissues of the joint and has a progressive character. If you do not pay attention to the disease in a timely manner, this can have dangerous consequences. Cartilage can completely collapse, and the joint may become deformed. The disease is more common in people over 40 years old. Especially often this disease affects people after 60 years.
Physiology of the disease
The physiological essence of osteoarthritis of any joint is that hyaline cartilage is depleted. He begins to wear out quickly and becomes unable to perform his direct functions. The cause of joint dysfunction is its insufficient supply of nutrients. This occurs 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 causes a narrowing of the joint gap, increased friction and the appearance of osteophytes. The mobility of the joint becomes limited, a person feels pain with any movement of the arm. With osteoarthritis, the disease affects all elements of the elbow joint.
Compared with the hip or ankle joints, the elbow is much less likely to develop deforming arthrosis. This is because he does not experience such heavy loads. Nevertheless, the disease occurs, and most often older people suffer from it. It may be that in patients who turned to a doctor for help, the disease began to develop long before that, but as a rule, people who are over 45 years old turn to medical facilities.
Osteoarthritis 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 involved in 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 No. 15-19.
Causes of the disease
Arthrosis of the elbow joint can occur for the following reasons:
- Elbow injury that a person received in his youth. Such injuries include meniscus damage, bruises of varying severity, wrist fracture, dislocation, ligament rupture, and others.
- Violated the measurement of body substances. In this case, the joint does not receive the amount of elements that is necessary for its normal functioning.
- If a person is sick with rheumatoid arthritis, then this ailment progressing, goes to all joints.
- Some chronic diseases. The cause of arthrosis can be cholecystitis, gastritis, tonsillitis, caries.
- If the patient consumes very little clean water.
- Inflammatory processes in the joint caused by infection in the joint bag.
- Various diseases of the endocrine system.
- Toxic poisoning.
- Age-related changes in the patient’s body.
- Genetic predisposition. If arthrosis is diagnosed in parents, then this disease can later be detected in their children.
- If a person often suffers from respiratory diseases, and also periodically overcools.
These are the most common reasons why such a disease can develop.
Symptoms of ailment
Medicine distinguishes four main groups of symptoms by which it can be determined that the elbow joint was affected by arthrosis:
- When a person bends or extends his arm, turns it to the sides, he feels pain in his elbow. Pain can occur even when a person just walks. But at the first stage of the development of arthrosis, such symptoms are quite difficult to notice, since they are weakly expressed. Only after some time the patient begins to feel pain without even moving his hand. There are times when pain from the elbow joint gives into the cervical spine.
- During elbow movement, a dry and rough crunch is heard in the joint. Such a sound arises from the fact that the bones rub against one another. With further progression of the disease, the crunch becomes louder and more distinct. The pain becomes more pronounced. Sometimes voiced clicks in the elbow are heard in healthy people, but these sounds are not accompanied by pain. Such sounds do not indicate danger and are considered normal.
- Due to this, the lumen of the joint space becomes narrower, bone spikes grow and muscle cramps occur, the elbow becomes less mobile, the amplitude of rotation of the arm decreases. Often the presence of elbow arthrosis is indicated by a symptom of Thompson. The patient cannot keep his back bent hand clenched into a fist. This position is very inconvenient for him, and he tries to align his fingers as quickly as possible. It is also very difficult for the patient to bend and extend the arm in the forearm at the level of the chin (symptom of Wind).
- 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.
Stage epicondylosis
In general, medicine distinguishes 3 stages of development of ulnar arthrosis. Each of them has characteristic symptoms. It is clear that at the beginning of the disease they are not so pronounced than after some time. But many patients try not to pay attention to minor changes in the elbow and do not seek medical help on time. But a timely visit to a doctor is a guarantee that treatment will be successful.
Osteoarthrosis 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. Pain most often occurs after some hard work. It is very difficult to determine the disease outwardly, but a specialist during the examination may notice a slight, at first glance, decrease in muscle tone. Some patients complain that it is difficult for them to move 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, as well as to bring it back behind the thigh. In this case, additional diagnostics are necessary. To exclude tunnel syndrome and cervical osteochondrosis, an x-ray is taken. Also, if the disease has begun its destructive effect, it will show that the joint space has begun to decrease.
Osteoarthrosis 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 bends it with great difficulty at the elbow or takes it back. Some people may experience slight muscle atrophy. It becomes difficult for a person to endure constant pain, they do not allow him to perform the usual work, worsen the quality of his life. Everything that he used to do in ordinary life, now he does it with great difficulty.
It is much easier to diagnose osteoarthrosis of the elbow joint of the 2nd degree than at the beginning. On x-rays, you can clearly see a lot of bone growths, the cartilage is deformed by multiple irregularities. But simply outwardly it is impossible to notice any changes on the elbow. Only during an exacerbation of the disease is swelling observed.
The third degree of pathology
How is osteoarthritis of the elbow joint of the 3rd degree? A sick person is constantly tormented by severe aching pain, which does not allow him to rest calmly even at night. Very limited joint movement. Often people who, for whatever reason, do not go to the doctor to at least somehow reduce intense pain, try to fix their hand in a comfortable position.
Cartilage tissue is completely destroyed, this can be seen with 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, a sore arm may become shorter than a healthy one. Even intensive treatment at this stage does not give a positive result.
Deforming arthrosis
According to statistics, almost 50% of all elbow arthrosis occurs in deforming arthrosis. This kind of disease is accompanied by the same symptoms as ordinary epicondylosis. First, the patient feels minor 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 elbow is more deformed. In addition to this, the ailment has its own characteristics:
The first degree of the disease is characterized by growths on the distal pineal gland 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 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 near the coronoid process, then the patient cannot extend the joint.
When deforming arthrosis goes into 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.
In the third stage of deforming osteoarthrosis, in addition to overgrown osteophytes, sclerosis of adjacent 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 even very simple movements, while he experiences sharp pain. To make life easier for the patient, all formations inside the joint are removed by surgical intervention.
Methods of treatment of ulnar osteoarthrosis
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, in addition to this, MRI and arthroscopy are done.
If the disease is at an early stage, then conservative treatment is used. Its goal is to get rid of pain and increase the mobility of a diseased joint. The treatment for this disease is complex and lasts a long time. As a rule, it includes several ways.
The basic principles of treatment of osteoarthritis:
- it is necessary to load the diseased joint as little as possible;
- to remove the inflammatory process and pain, treatment courses with medications are carried out;
- special restorative physical education is recommended;
- at home, you can apply treatment with alternative 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 with medical treatment for osteoarthritis of the elbow joint of the 1st degree. Typically, these medications are used to get rid of this ailment:
- NSAIDs
- Chondoprotectors;
- Ointments with medicinal substances
The purpose of NSAIDs is to relieve the patient from pain and relieve the inflammatory process inside the joint. Pharmacological enterprises produce such drugs in the form of intramuscular injections, injections, which are injected directly into 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 advisable to receive NSAIDs in the form of injections, then switch to tablets. But it should be borne in mind the fact that these drugs have a great negative effect on the stomach, its mucous membrane.
Chondoprotectors are drugs that restore cartilage. 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 commonly used. Such drugs give a positive result in the treatment of osteoarthritis of the elbow joint 2 degrees, and of course 1 degree.
Ointments with special medicinal substances are applied to the sore spot. They help relieve pain and inflammation, warm, relieve swelling. The most common ones are Fastum Gel, Voltaren, Diclobene, Viprosal, Episatron and others.
Physiotherapeutic treatments
Physiotherapy is used in the rehabilitation period, when the acute phenomena have already been removed by the medical method. With arthrosis of the elbow, the following methods are used:
- Paraffin therapy. The use of warm paraffin helps warm the soft tissues surrounding the affected joint, and thereby stimulate blood flow.
- Laser. Thanks to this procedure, osteophytes are destroyed and new ones grow less.
- Electrophoresis Helps medicines penetrate deeper into the joint bag.
- Compresses of therapeutic mud. Eliminate atrophic changes in tissues.
Massotherapy
Massage, as well as physiotherapeutic procedures, is prescribed when the disease is in a state of remission. This manual procedure favorably affects not only the condition of the joint itself, but also 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 ailment, you should seek help from a medical institution where they will correctly diagnose and prescribe the necessary treatment.