Polyarthrosis, a special form of osteoarthritis, is multiple cartilage damage and the most common joint disease worldwide. In Germany, about 5 million people are affected.
What is polyarthrosis?
Schematic diagram difference between healthy joint, arthritis and osteoarthritis. Click to enlarge. The term is composed of the Greek words for “many” (-poly) and “joint” (athron). It defines a multiple breakdown of joint substance that exceeds age-related joint wear. At least three different joint types must be affected, otherwise it is osteoarthritis. A common example is finger joint arthrosis. The symptoms are pain in the affected joints. However, a distinction must be made here between pain of the non-inflammatory type and pain of the inflammatory type. The non-inflammatory pain occurs when the affected areas are stressed and regularly disappears during periods of rest. The opposite is true for pain of the inflammatory type. They increase when the joint is at rest. This case is called activated polyarthrosis. Visually, deformities and inflammatory swellings determine the symptomatic appearance of the disease. Accompanying is the occurrence of a proliferation of synovial fluid. The consequence is a limited mobility, which can develop into an inability to function. Morning stiffness may occur in addition, but is more indicative of a rheumatic disease if it is intense.
Causes
The reasons for a development of polyarthrosis are largely unexplained. Whether its causes depend on increased stress on the articular cartilage is controversial. It is possible that injury-related and congenital deformities of the joints, called dysplasias, may promote the development of polyarthrosis. They prevent optimal distribution of weight during movement because the area of spread intended for it is minimized. The load must focus on a reduced point of contact. At this point, it accelerates cartilage wear. Other reasons for an unnaturally high load on the joints can be overweight and a permanent, uniform stress on the affected body parts. A genetically determined susceptibility, on the other hand, is considered to be proven. Rheumatic diseases, gout, endocrine gland diseases, diabetes mellitus and hemophilia are suspected as further favoring factors.
Symptoms, complaints, and signs
The first signs of polyarthrosis usually appear in the finger joints. Both the terminal and middle joints as well as the thumb saddle joints are affected. Initially, they only hurt with unaccustomed movements, later they hurt with every movement, and eventually even the resting position is painful. Patients often complain that their fingers crack or that rubbing noises can be heard. If the joints are overloaded over a longer period of time, they can become inflamed. Then the corresponding region is reddened, feels warm, hurts and is swollen. However, polyarthrosis can also proceed completely without these signs. Frequently, the fingers become stiff and their ability to move is significantly restricted. In the further course, joint effusion is possible. The symptoms often also spread to the muscles and tendons. It is typical for polyarthrosis that the symptoms also appear in many other joints. The toe joints can be affected, but also large joints such as the hip and knee joints. Less commonly, the disease affects the shoulder joints and the joints between the collarbone and sternum. In exceptional cases, the small vertebral joints may also be involved. The metacarpophalangeal joints of the fingers and toes, the wrist and elbow joints, and the ankle joints are almost never affected by this disease.
Diagnosis and course
To make a diagnosis of polyarthrosis, the affected parts of the body are checked for the typical swelling. An image of the joints is then taken with the help of an imaging technique. X-rays show a narrowing of the joint space, as well as other changes that indicate overuse. These include small cysts caused by increased accumulation of synovial fluid, bone compression and cracks. Cartilage wear cannot yet be traced here. An MRI must be performed for this purpose.This makes arthritic changes visible at an early stage. A joint endoscopy, a so-called arthroscopy, can be used alternatively to view the joint. Its advantage is that it simultaneously allows treatment of the damage found. Activated arthrosis is fundamentally more difficult to diagnose than non-inflammatory arthrosis because it has strong similarities to other clinical pictures. In the course of the disease, development into a chronic rheumatic manifestation, rheumatoid arthritis, is possible and should be prevented at all costs.
Complications
Due to polyarthrosis, patients suffer from various joint complaints. As a rule, irreversible damage to the cartilages occurs. Furthermore, polyarthrosis leads to severe pain in the patient’s joints. As a result, the patient experiences various limitations in everyday life and also movement restrictions. The quality of life is considerably reduced as a result and those affected are then not infrequently dependent on the help of other people. Severe pain occurs, especially when high loads are applied. Polyarthrosis can also lead to water retention in various parts of the body. The joints themselves often crack and may also be swollen. In many cases, polyarthrosis also has a very negative effect on the patient’s psyche, so that depression or other psychological complaints can occur. Due to the permanent pain, those affected are not infrequently also irritable. As a rule, polyarthrosis is treated with the help of medication. Complications do not occur. However, the affected person is dependent on a healthy lifestyle to avoid further complaints. Life expectancy is usually not affected by polyarthrosis.
When should one go to the doctor?
Problems or limitations in joint activity should be clarified with a doctor. If the complaints occur in direct connection with a physical overload or heavy strain on the musculoskeletal system, the affected person normally needs sufficient rest and protection. After a restful night’s sleep or some time of regeneration, the complaints ease until a complete recovery occurs. A doctor is not needed in these cases because there is no worrisome condition. On the other hand, if the irregularities persist or increase in intensity, a visit to the doctor is advised. In the case of morning stiffness, repeated disturbances in movement patterns as well as pain in the joints, an examination is needed to clarify the cause. If the patient is no longer able to perform the usual sporting activities, or if he or she is finding it difficult to cope with everyday life, it is advisable to consult a doctor. Pain medication should generally only be taken in consultation with the attending physician in order to avoid further deterioration of health due to side effects. If mental or emotional abnormalities occur in addition to physical complaints, the changes should be discussed with a physician. In the event of a lowered mood or a tendency to depressive phases, a doctor should be consulted. Withdrawal behavior, irritability or mood swings are further indications of impaired health.
Treatment and therapy
Polyarthrosis is incurable. The cartilage wear cannot be reversed. Therefore, treatment of the symptoms is given. Anti-inflammatory pain medications are prescribed for the pain, such as ibuprofen or diclofenac. An ointment containing cortisone can also provide short-term relief. For severe pain, a local anesthetic or cortisone medication may be injected. In addition, physical therapy measures can be used to alleviate discomfort. Heat or cold treatments and contracture treatments that use traction to stimulate the affected joints can be helpful. Activation through gentle movements performed in occupational therapy or simple manual activities has a mobilizing effect. Special splints can stabilize the joints and compensate for possible malpositions. Direct injection of hyaluronic acid into the affected joint has an analgesic effect. Due to its composition, it improves the lubricity of the fluid in the joint and causes a short-term regeneration phase.Symptomatic therapy options should include a reduction to avoidance of the favoring factors for polyarthrosis. These include weight reduction and relief of the affected body parts. In addition, the musculature can be strengthened with sports activities that are easy on the joints, which is also beneficial to the overall physical well-being. Sports that place a high degree of stress on the joints should be avoided.
Prevention
For the prevention of an arthritic disease, a gentle and regularly performed sport can contribute. Thus, on the one hand, the muscles are strengthened. On the other hand, the joints are mobilized, which has a supportive effect on the function of the bile and regulates the metabolism at the joint. A good blood circulation of the joints should be guaranteed, e.g. by regular heat or cold applications. Risk factors such as obesity and overuse should be minimized. In addition, care must be taken to avoid accidents that can result in joint injuries.
Aftercare
In most cases, those affected by polyarthrosis have very few, if any, special aftercare measures available to them. First and foremost, a doctor should be consulted very early and, above all, very quickly to prevent further complications or other complaints in the affected person. Self-healing cannot occur with polyarthrosis. The treatment itself is usually carried out by taking various medications. Patients should pay attention to the correct dosage and regular use of the medication in order to permanently alleviate the symptoms. Physiotherapy measures can also be useful. Many of the exercises from such therapies can also be performed in the patient’s own home, which in most cases accelerates the healing process. In general, a healthy lifestyle with a healthy diet also has a very positive effect on the further course of the disease. Likewise, those affected should reduce weight to alleviate the discomfort of polyarthrosis.
What you can do yourself
Polyarthrosis cannot be cured, but the course of the disease can be favorably influenced by a few simple measures. Regular exercise counteracts cartilage degradation, and strong muscles also stabilize the joints. Gentle sports such as cycling, Nordic walking or swimming are well suited, and runners do not have to give up their sport either: However, they should pay attention to high-quality running shoes with good cushioning, run little uphill and downhill and, if possible, prefer forest paths to asphalt roads. In everyday life, too, comfortable shoes are preferable to high-heeled ones; in the case of advanced disease, insoles or shoe height compensation can bring relief. Standing for long periods and carrying heavy loads puts a strain on the joints and should be avoided as far as possible. A healthy diet helps to reduce excess weight and can alleviate inflammatory reactions in the body. A low-fat and vitamin-rich diet has a favorable effect; animal fats in particular should rarely be on the menu. Leeks, onions and garlic as well as many spices and herbs have an anti-inflammatory effect. Fruits, vegetables, salads, potatoes, brown rice and skimmed milk products contribute to an adequate supply of vitamins and trace elements. Mackerel and sardines, as well as cold-pressed oils, are rich in valuable omega-3 fatty acids, which protect blood vessels and can inhibit joint inflammation. Sugar, saturated and hydrogenated fats, as well as citrus fruits, coffee, alcohol and black tea should be enjoyed only in moderation.
