Cartilage damage is a joint disease that occurs in different joints in the body. Depending on the extent of the damage and the cartilage involved, appropriate therapy can restore cartilage function without pain.
What is cartilage damage?
By cartilage damage, as the name suggests, physicians understand damage to the cartilage. In the joints, the bones meet each other. To prevent unpleasant friction of the same, the ends of the bones are covered with the so-called cartilage tissue. This can absorb shocks when walking and thus protect the bones or the joint. If this layer is worn away, for example due to disease or wear, the smooth movement of the joint is restricted. Pain also occurs, but only when the cartilage tissue is completely destroyed. Knee and hip joints are particularly frequently affected. If detected at an early stage, the cartilage can be regenerated by medical measures. Once the layer has been completely ablated, it is no longer possible to restore it.
Causes
The causes of cartilage damage can be varied. Experts distinguish between mechanical and biochemical causes. The former may be the result of an accident or other injury, for example. A severe sprain can also lead to cartilage damage. Bad postures such as so-called bow legs or knock knees can lead to the cartilage layer being damaged due to the permanent incorrect stresses. The same applies to severe overweight, which places excessive stress on the joints when walking. Biochemical causes of cartilage damage include metabolic diseases. Diseases such as gout, rheumatism or circulatory disorders can cause lasting damage to the cartilage layer. Ultimately, age-related calcification can also cause the cartilage to gradually degrade.
Symptoms, complaints and signs
Cartilage damage is manifested primarily by pain when walking and with general stress on the affected joint. The pain can lead to blockage of the joint, which in turn results in restricted movement. In individual cases, swelling occurs as a result of bleeding or fluid accumulation in the tissue. Initially, the pain occurs only after extensive loading of the joint. Particularly when running, climbing stairs or going for a walk, complaints occur, which usually lead to a protective posture. Many sufferers complain of pain especially in the morning and after prolonged sitting. The so-called start-up pain is accompanied by a noticeable crunching or cracking of the damaged joints. Prolonged deformity can lead to joint wear, pressure sores, nerve pain and other complaints. Some sufferers are also sensitive to the weather. Untreated cartilage damage can lead to the development of chronic pain. This is usually accompanied by severe malaise. Athletes in particular suffer from severe cartilage damage and feel restricted in their quality of life. In the long term, this can lead to the development of psychological complaints, such as depressive moods, irritability and changes in character. If the cartilage damage is treated early, the complaints usually subside after a few weeks.
Diagnosis and course
If cartilage damage is suspected, it is usually diagnosed by the attending physician on the basis of an X-ray examination. This can already provide information about a degenerative change in the cartilage tissue. An MRI (magnetic resonance imaging) can also be performed to determine the extent to which the cartilage has already been damaged and the chances of recovery. In principle, cartilage damage can be treated well medically; however, the stage of the damage is important here. If the disease is detected at an early stage, the chances are good that the cartilage layer can regenerate almost completely. However, once complete degradation of the same has occurred, there is no way to restore it.
Complications
In most cases of cartilage damage, the further course of the disease depends very much on the affected region of the body, so no general prediction is possible.Most patients suffer from severe joint pain due to the cartilage damage. This pain can significantly restrict the patient’s everyday life and reduce the quality of life. Furthermore, there are also restrictions in movement and general limitations in everyday life. It is not uncommon for swelling or bruising to occur. If the cartilage damage is not treated, arthrosis develops in most cases. This can lead to irreversible consequential damage. In most cases, cartilage damage is treated with the help of medication. This does not lead to further complications. In some cases, however, surgery is necessary to correct the symptoms. If necessary, the patient must take antibiotics after the operation to prevent inflammation. In most cases, life expectancy is not reduced or limited by this condition. After treatment, the affected person can usually use the joints normally again.
When should you see a doctor?
People who experience joint pain after a sprain or in connection with a medical condition should see a doctor the same day. Symptoms such as limited motion, swelling and bruising indicate cartilage damage. Medical advice is required if the symptoms do not subside on their own or even become more severe. If further symptoms develop, a medical professional must be consulted immediately. Cartilage damage can be treated well, but it also progresses rapidly and causes increasing pain. Before irreversible consequential damage develops, the injury must be clarified and treated. People who suffer from bow legs or knock knees are particularly at risk. So are people who are overweight, have a rheumatic disease, gout or circulatory disorders. Anyone who is part of these risk groups is best advised to inform their doctor if they experience any of the symptoms mentioned above. A visit to the family doctor is indicated at the latest when painful swellings or restrictions in the mobility of the affected body part are noticed. Other points of contact are the orthopedist or a specialist in joint and bone diseases.
Treatment and therapy
If cartilage damage has been clearly diagnosed, the attending physician will initiate appropriate therapy. This depends in particular on the severity of the damage and also on the location of the joint in the body. The conservative form of therapy usually involves drug treatment, in which existing pain is first relieved. At the same time, anti-inflammatory drugs are administered to eliminate or reduce any inflammatory processes in the joint. The administration of drugs designed to stimulate the metabolism in the cartilage can help to increase the mobility of the joint. Hyaluronic acid, for example, which is also found in the natural synovial fluid, can be administered here. If the cartilage damage is too far advanced or if the drug therapy does not work, a surgical intervention may be advisable. In this case, the cartilage can be surgically smoothed. This leads to a reduction of possible inflammations and to a frictionless and largely painless movement of the joint. If the cartilage is not yet too far damaged, only a thin layer can be removed, whereupon the cartilage tissue regenerates itself and leads to a subsiding of the complaints.
Outlook and prognosis
The prognosis of cartilage damage depends on the affected joint as well as the possibility of therapy. In some cases, restoration of the functional activity of the joint and thus cartilage function can be achieved. The cartilage is rebuilt by administering medication. If, at the same time, movement sequences are optimized and reorganized, there is the prospect of complete freedom from symptoms. The more advanced cartilage damage is, the less likely recovery is. Without changes in movement patterns and physical stress or seeking medical care, the prognosis worsens. Pain, musculoskeletal irregularities and limitation of movement increase. In some patients, surgical intervention is necessary as a last resort, since the administration of medication is not sufficient in the case of advanced cartilage damage. Surgery is associated with the usual risks and side effects and can lead to permanent deterioration of health.If an operation proceeds without further complications, the patient experiences an improvement in his or her health afterwards. Relief of existing complaints is documented in most cases. Nevertheless, there may be a need for restructuring of everyday processes, as the physical resilience does not correspond to that of a person with a natural physique. Sports activities or occupational activities cannot always be continued as the patient did before his or her surgery.
Prevention
Cartilage damage can be prevented in several ways. Preventing or reducing excess weight takes pressure off the joints and prevents potential damage to the cartilage. Incorrect postures such as knock knees or bow legs should be corrected if possible to prevent subsequent cartilage damage. Cartilage damage caused by metabolic diseases or injuries cannot be prevented. If there is the first suspicion of corresponding damage to the joints, it is advisable to consult a doctor (usually orthopedist.
Aftercare
Cartilage damage requires consistent aftercare. A massively damaged cartilage is thereby per se no longer reversible, but the respective joint can be stabilized with targeted’m training of the surrounding musculature purposeful. Aftercare is usually carried out in consultation with the treating orthopedist or physiotherapist. Specialized rehabilitation sports with exercise instructors qualified for this clinical picture are also a professional address in this context. Muscles that can stabilize a joint are specifically strengthened during aftercare. Patients often learn exercises during physiotherapy or rehabilitation sports, which they can then continue on their own at home or in a gym. Here, the correct execution of the exercises and an individually dosed load are particularly important. Aftercare for cartilage damage is also an important issue in everyday life. Ideally, the joint affected by the disease should no longer be subjected to non-physiological loads. This means, for example, that shear stress or excessive bending should be avoided in the knee joint. However, the joint does not generally need to be spared. The synovial fluid, which is formed during movement, protects the joint. Here also a sufficient drinking quantity can have a positive influence. Long persistence in unhealthy postures should also be replaced by regular exercise.
What you can do yourself
With existing cartilage damage, there are many ways to slow the progression of the disease. Self-help measures cannot completely avoid surgical intervention, but they can often postpone it by many years. It is particularly important to get enough exercise – preferably in the form of sports that are easy on the joints, such as swimming, cycling or Nordic walking. The patient decides which type of sport is most suitable in consultation with the attending physician. Those who do not want to actively engage in sports should at least integrate more movement into their daily routine. Even avoiding elevators and escalators has a positive effect on overall health and can delay the further spread of cartilage damage. To reduce the strain on the joints, it is also advisable to avoid or reduce excess weight. Here, too, exercise is of great importance, as is a healthy, balanced and low-fat diet. For acute pain, pain ointments containing cortisone-free antirheumatic drugs (ketoprofen, indometacin) have proved particularly effective, but many sufferers also find warming ointments containing the active ingredients nicoboxil and nonivamide beneficial. In the case of acute joint inflammation, however, cooling compresses and ointments are recommended. Herbal medications containing frankincense or devil’s claw can also be used to accompany therapy.
