What's This?

Osteoarthritis is the wear and tear disease of the joints. It is a joint disease caused by overstressing, malpositioning or injuries in which the joint cartilage is worn out and the joint is permanently damaged due to permanent mechanical overstressing and overstressing. Osteoarthritis has not yet been reversible. Unfortunately, there are still no healing methods to bring the damaged joint with the destroyed cartilage back to the condition it was in before the disease. 

Osteoarthritis is a condition that progressively destroys the affected joints. The first signs of osteoarthritis are a thinner layer of cartilage in the affected joint and changes in the underlying bone (sclerotherapy). While the cartilage layer continues to decrease as the bones grow bald, joint structures such as the inner skin of the joint, joint capsule, muscles near and to the joints, tendons and bones can also be severely attacked. Restrictions on movement up to stiffness, severe inflammation, swelling and deformation of the joint-forming bones characterize the further course of the disease. This progressive tissue destruction is accompanied by very severe pain.

Do you know the preliminary stage of osteoarthritis?

Cartilage damage can develop for a variety of reasons: for example, a ligament injury can make the joint unstable, and meniscus damage can cause the shock-absorbing buffer between the cartilage surfaces of the knee joint to be lost. A sports accident can cause deep cartilage damage (red).

The cartilage damage (red) from the accident itself is not yet arthrosis. It is possible that the broken piece of cartilage can be surgically fixed again and the outbreak of the arthrosis disease prevented. If this does not succeed, a process of wear and tear can start - which fulfills the characteristics of osteoarthritis.

In the many cases in which osteoarthritis cannot be assigned to a single event such as an accident, it develops almost unnoticed depending on which previous illness led to cartilage damage. Many sufferers do not notice anything of the happening at this stage- although the diagnosis of pre-arthrosis (pre-arthrosis) would be detectable.

Osteoarthritis stage I: an early stage of osteoarthritis:

The cartilage surface (blue) roughened at first and got ever deeper cracks. Gradually, the area of ​​the bones (ocher, brown) under the affected cartilage surface also changes, compressing and hardening (subchondral sclerotherapy). The cartilage layer itself is getting thinner and thinner, the joint gap in the x-ray is getting narrower.

With these first changes to the joint, the characteristics of osteoarthritis have already been fulfilled: there is wear-related cartilage damage with changes to the underlying bone.

How the degradation processes in articular cartilage take place has not yet been scientifically clarified in detail. It is known that abraded cartilage particles in the joint are broken down by enzymes. These enzymes themselves now begin to break down healthy cartilage from the cartilage layer. As a result, enzymes are released again, which accelerate the breakdown. These processes can cause inflammation of the inner skin of the joint - which in turn releases cartilage-degrading enzymes.

The transition from the early phase of the disease to the advanced stage is fluid. Frequently, it is individual events such as overloading the joint, for example during a hiking holiday or renovation work, which the affected person then perceives as the first stressful pain and the beginning of their illness.  These symptoms often go away after a few days and the next attack only takes months.

Osteoarthritis stage II: advanced stage

The cartilage surface (blue) has partly been lost down to the bone (ocher). In some places, a bald patch (black) has developed on which bones rub against bones. Cysts have formed in the bone itself (brown). Cartilage and bone abrasion are released into the joint cavity - the inner skin of the joint (violet) is inflamed and swollen as a result.

The arthrosis now gradually works beyond the inside of the joint. Due to the inflammation and the pain, a gentle posture is unconsciously taken, resulting in muscle tension and muscle pain in the area near the joints. The shortened muscles can lead to an increased tensile load on the tendons on the neighboring bones. Muscle tension, muscle shortening, and muscle hardening can lead to severe start-up and movement pain. The inflammation can lead to severe swelling of the joint and joint effusion. The pressure in the knee area can become so great that a baker's cyst forms.

Osteoarthritis stage III: late stage of osteoarthritis

In the further development, the joint begins to deform - hence the arthrosis is called the medical term arthrosis deformans. The cartilage has now been largely lost. Bony outgrowths (black) (osteophytes) form, which further greatly reduce the mobility of the joint. Severe, persistent movement and now also rest pain, shortened and hardened muscles around the joint, muscle wasting, severe movement restrictions up to stiffness, severe inflammation (red) of the inner skin of the joint (violet) and deposits of tissue fluid in the area of ​​the joint capsule (gray) to capsular edema. The joint becomes unstable. In individual cases in the knee area, swelling in the size of a football has been reported

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What are the symptoms of osteoarthritis?

Starting pain is typical of osteoarthritis. The first movements after a rest phase are particularly painful, but the pain subsides when the joints have broken in. As the disease progresses, rest pain and sleep problems occur. The cause can be an overload of the joint or an already advanced cartilage damage.

All in all, painless and painful phases can alternate over a long period of time until the disease gradually leads to permanent pain. In this middle phase, osteoarthritis often runs in waves, wave-like and gradually subsides on its own. Activated arthrosis is present when the joint has become inflamed. The calm phase between the relapses is called silent osteoarthritis.

The activated arthrosis arises from the fact that abraded cartilage or bone material ignites, causing acute and severe pain in the joint.

Typical complaints of osteoarthritis are

• Stress pain

• Start-up pain

• Morning stiffness

• Joint grinding (crepitus)

• Resting pain in the advanced stage

• Tense muscles and tendons

• Restricted movement

• Schonhaltung

• Inflammation of the joints (activated arthrosis)

• Joint effusion (especially for knee osteoarthritis)

• Joint swelling

• Muscle weakness

• Joint instability

Risk factors of osteoarthritis

The time factor

The time factor is one of the most important and unfortunately also the most reliable factors for any type of wear. 'Constant drip hollows the stone' says a proverb. The time factor is so important that it is highlighted separately in the symbolic formula of the factors influencing osteoarthritis. So it's about:

• Duration of the damaging effect of a pre-arthrosis (e.g. cruciate ligament tear with an unstable knee joint for how many years)

• Lifetime or age with the age-related reduced regeneration ability

Factors that can contribute to osteoarthritis

Depending on the form of arthrosis, individual risk factors can favor the development of arthrosis. The following factors are known:

• Overweight

• unfavorable sports, with a high risk of injury and high impulse loads (e.g. football)

• unfavorable repetitive joint loads, e.g. in the work assembly line work, jackhammer, etc.

• occupational overload of the joints due to heavy physical work (mining, shipyards, agriculture, construction)

• hereditary inherent stress 

• Lack of exercise (poor cartilage nutrition)

• lack of joint stability due to weak muscle development

• Imbalance of muscle groups around the joint (muscular imbalance)

• increasing age

• Simultaneous stress caused by multiple preararthroses. Example: Sports accident with cartilage damage to the knee with strong bow legs and therefore one-sided stress in the knee at the point of cartilage damage

• If the affected joint is a heavily used joint, for example a weight-bearing joint like the knee joint

• Pre-operations (e.g. knee joint, meniscus removal)

Treatments for osteoarthritis

Osteoarthritis finally curable - and similar headlines in the media repeatedly give the impression that there are healing methods to bring the destroyed cartilage back to the condition it was before the arthrosis disease. Unfortunately, this is not possible today.

Where the strong desire for healing, freedom from pain, and quality of life of those affected on the one hand and economic pursuit of vanity but also vanities from alleged osteoarthritis healers on the other come together, many half-truths about therapy success are spread. This thicket of reports of success is contrasted by the many millions of osteoarthritis sufferers who, after an often expensive odyssey, continue to suffer from their disease after attempting therapy.

Variety of therapy offers - which is the right one?

Osteoarthritis therapy must be individual and based on the type of osteoarthritis, its cause, stage and symptoms. So there is no general right or even a generally best therapy. The treating doctor will suggest the most appropriate therapy in his opinion. Therapy measures aim to reduce pain and restrictions and prevent consequential damage. When proposing major surgical interventions, it is always advisable to get a 'second opinion' from another doctor.

Herbal Remedies For Osteoarthritis

Herbal remedies have traditionally been used in monastery pharmacies and as home remedies for a long time against joint problems. Anti-inflammatory and analgesic effects have been reported, particularly in the case of osteoarthritis.

If other pharmaceutical active ingredients with stronger side effects can be reduced by herbal products, this is already a great success. Conventional anti-inflammatory drugs are known to have side effects on the stomach lining, heart and circulatory system.

From experience reports, however, it can also be clearly concluded that the various means work very differently for the individual concerned.

In the case of arthrosis, the following herbal remedies or active ingredients derived from them are used:

• Arnica

• Avocado

• Beinwell

• Birch

• Braunhirse

• Nettle

• Cayenne pepper

• Ash bark

• Goldrutenkraut

• Hagebutten

• Hay flowers

• Millet

• Ginger

• Cabbage (for wrist wraps)

• Lycopene (red dye from tomatoes)

• Devil's claw

• Weidenrinde

• Incense

• Aspen

Herbal remedies, the technical term is phytopharmaceuticals, but cannot heal the damaged cartilage. However, they can be an alternative and support for osteoarthritis treatment in the context of pain therapy and for the relief of other rheumatic complaints in individual cases.

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