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Arthrosis is a degenerative process characterised by lesions of the cartilage in joints. A joint is the area where a bone connects with another bone, allowing movement. Cartilage is a tissue that covers the joints, acts as a shock absorber for impacts, and also allows the joints to move without friction. Normally, this condition appears in the spinal column, neck, hip, knees, and hands.
Symptoms
The most common manifestation is pain that improves with rest, stiffness when initiating movement, deformities, and difficulty moving the affected joints. There can be a certain degree of inflammation, which will cause swelling due to the excessive accumulation of liquid in the joint.
However, it must be differentiated from arthritis, which is a rheumatic inflammatory disease rooted in joint inflammation that can cause pain which does not improve with rest. Arthrosis is often also called osteoarthritis, which can create some confusion.
Prevalence
This disease is very prevalent and has a high social and health impact. The EPISER2016 study, by the Spanish Society of Rheumatology, showed that the prevalence in the population over 40 years of age is 29%.
Causes
Age is the main risk factor. It is more frequent in women. A deterioration of the cartilage is clearly associated with obesity and a lack of regular physical exercise. A misaligned joint or poor posture can also be predisposing factors. Sometimes the cause is a traumatic injury or previous disorder of the affected joint. It has a genetic component (especially arthrosis of the hands).
Diagnosis
A diagnosis is obtained by looking at the symptoms, physical examination, and the imaging tests.
Treatment
Treatment for this disease is aimed at improving symptoms and quality of life for patients while slowing down its clinical evolution. A treatment plan must be individually prepared for each patient and type of joint.
Non-pharmaceutical treatment is essential. We recommend:
Pharmacological treatment normally consists of conventional pain relievers such as paracetamol, which is the analgesic treatment of choice. There are slow-acting treatments, such as chondroitin sulphate (taken orally) or hyaluronic acid (given as an injection), which can improve pain, especially in arthrosis of the knees. Surgery (joint replacement) is reserved for cases in which the joint is destroyed and other measures have failed.
In this disease, which has no symptoms, the most important thing is the prevention of its most dreaded complication, fractures. Both treatment and prevention must be supervised by a primary care doctor or specialist.
To prevent osteoporosis and the risk of fracture, a diet rich in calcium, magnesium, and vitamin D, found in legumes, avocados, and nuts, is recommended.
If you don't get enough calcium in your diet, taking supplements may be necessary. The National Osteoporosis Foundation recommends a daily calcium intake of 1000 mg for most adults and 1200 mg for women over 50 and men over 70.
This vitamin is important to help the body absorb calcium from the foods we eat. The recommended daily dose is between 400 and 800 international units (IUs) for adults under 50, and 800 to 1000 IUs for those over 50. These are the current guidelines from the National Osteoporosis Foundation. You may need a different dose, depending on the levels of vitamin D in your blood, sometimes up to 50,000 units per week for 12 weeks.
There are also medications containing antiresorptive or bone-forming agents, such as bisphosphonates, parathyroid hormone (PTH), monoclonal antibodies, and others, which can be prescribed by a doctor based on a patient's comorbidities (what other disorders or diseases they have) and preferences.
Doing a moderate physical activity with some impact is recommended, such as jumping, walking, or dancing, along with other activities like yoga and tai chi, which have additional benefits when it comes to preventing falls and fractures.
Exercise slows muscular atrophy, improves joint mobility, directly promotes bone formation, and improves neuromuscular coordination.
The locomotor system, also known as the musculoskeletal system, consists of a person’s bones, muscles, joints, tendons and ligaments. It is a highly structured system whose purpose is to move and support the rest of the body's structures. Rheumatology deals with disorders and diseases of the musculoskeletal system and connective tissue. It is a very wide-reaching speciality that covers almost 200 diseases.
The Vall d’Hebron University Hospital's Rheumatology Service is an adult and paediatric care service for patients with rheumatic illnesses. It serves a reference population of 450,000 inhabitants and 18 primary care centres in the AIS Nord area. We work in the hospital environment and in primary care, and outpatient activity is clearly predominant.
Guia o itenerari formatiu (GUIF) - CAS - Reumatologia
Rheumatology, Traumatology, Rehabilitation and Burns Hospital
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