Treatment of osteoarthritis is directed primarily at relieving the symptoms of the disease (eg, pain in the joints), as well as to prevent the development of disease (further joint damage), and the preservation of the ability to maintain a normal life. Cure osteoarthritis as such is not possible, but alleviate the symptoms, to maintain viability of the joints and a normal life with the help of the treatment of osteoarthritis can be.

Self-treatment of osteoarthritis

One of the main treatments for osteoarthritis - a measure to maintain good physical shape and normal weight maintenance lifestyle, do not impact on the joints. Lifting weights, overweight (obesity), sedentary lifestyle - all this leads to additional stress on the joints and can aggravate symptoms of osteoarthritis.

• Therapeutic exercises

A set of exercises - one of the most important areas of the treatment of osteoarthritis, regardless of age or level of fitness of the patient. Therapeutic exercise program for osteoarthritis Exercises for knee and hip osteoarthritis: the movement - Mrs.   - A combination of exercises to strengthen the muscles and exercises that improve overall physical human form.

If osteoarthritis is pain, "stiffness" of the joints, it may seem that exercise, on the contrary, will exacerbate these symptoms. But in fact even doctors recommend the treatment of osteoarthritis to maintain an active lifestyle, regular exercise Myths about exercise: do not believe   strengthen muscles and joints, correct posture Posture - a few helpful tips for those who want to walk straight Help fight obesity - and all this, in turn, relieves the symptoms of osteoarthritis. Certainly, to pick their own set of exercises is not necessary - it is best to consult a physiotherapist.

• Weight Loss

Overweight, obesity greatly exacerbate the symptoms of osteoarthritis, putting additional strain on the damaged joints. Especially at risk joints hips and knees, which is the main load. Correct, gradual weight loss in osteoarthritis - a combination of physical activity and a healthy, balanced diet.

Medication

• Analgesics

The choice of anesthetic drugs (especially analgesics) depends on how quickly the disease progresses, and how strong the pain caused by osteoarthritis. To suppress the symptoms may apply:

1. Paracetamol (acetaminophen)
2. Nonsteroidal anti-inflammatory drugs: Maps, usually in those cases when paracetamol and similar analgesics not help suppress pain caused by osteoarthritis. Nonsteroidal anti-inflammatory drugs are divided into two categories: traditional drugs (ibuprofen, naproxen or diclofenac) and cyclooxygenase-2 inhibitors (etoricoxib, celecoxib). Some come in the form of funds for external use, the other - in the form of tablets or capsules that are sold only by prescription.
3. Opioids: narcotic painkillers shown with intense pain and can cause a number of unpleasant side effects (drowsiness, lethargy, nausea, constipation). This group of drugs used to treat osteoarthritis - codeine, tramadol Tramadol: kills the pain Dihydrocodeine in the form of tablets or injection.
4. Kapsaitsinovy ​​cream or ointment: recommended mainly for osteoarthritis of the hands or knees. Capsaicin blocks the activity of the nerve fibers that transmit pain impulse, and thus suppresses the painful symptoms of osteoarthritis. Apply the drug must be on the area of ​​skin around the affected joint once a day.

• Intra-articular injection

If rapidly progressive osteoarthritis led to the defeat of numerous joints, only one treatment painkillers may not be sufficient to suppress the pain. In such cases, usually assigned intra-articular injection - the injection of corticosteroid directly into the affected joint. Corticosteroids reduce the swelling of the joint and relieve pain.

Alternative Treatment

• Transcutaneous electrical nerve stimulation - a procedure that helps relieve pain caused by osteoarthritis due to the impact of the electric pulse to the spinal nerves that transmit pain signals to the brain.
• Thermotherapy and Cryotherapy - the impact of heat or cold to the joints, which in some cases helps to relieve pain and other symptoms of osteoarthritis. At home, such treatments can be replaced by a conventional hot or cold compress.
• Manipulation: allows you to increase mobility, joint flexibility and thus prevent irreversible damage to their osteoarthritis.

Surgical treatment of osteoarthritis

Surgery is the treatment of osteoarthritis is required in rare cases - when other treatments have not been effective or one of the joint is badly damaged. Surgery may be indicated in cases where osteoarthritis has caused joint damage hips, knees and small joints of the fingers. Surgical treatment of osteoarthritis can significantly alleviate the symptoms and improve joint mobility and quality of life in general. However, the surgeon is not able to guarantee the final disappearance of the symptoms.

Basic surgical treatment of osteoarthritis:

• Arthroplasty - surgery to replace the damaged joint (usually performed on the hip or knee joint). The damaged joint is replaced with an artificial joint (prosthesis) made of special plastic and metal. Shelf life of the prosthesis can be up to two decades.
• Arthrodesis - operation, which allows to fix the damaged joint in position. Fixing it prevents further joint damage and eases the pain caused by osteoarthritis, but the consolidation of the joint in the same position means that it can no longer be moved.
• Osteotomy - the operation, appointed in rare cases (such as osteoarthritis of the knee at a young age when arthroplasty is contraindicated for age restrictions). Osteotomy involves cutting and removing a small portion of the bone above or below the knee joint, due to which the damaged part of the joint is no longer load. This procedure allows you to temporarily relieve the symptoms of osteoarthritis.

Nimesulide - a drug that belongs to a group of non-steroidal anti-inflammatory drugs (NSAIDs). The drug has a pronounced anti-inflammatory, analgesic and antipyretic activity moderate. Because of this it is widely used in the treatment of diseases of the musculoskeletal system and other conditions involving pain.

The mechanism of action of nimesulide

Nimesulide inhibits the production of cyclooxygenase-2 (COX-2) - the enzyme that is involved in the formation of prostaglandins. Prostaglandins - a hormone-like substances are synthesized in almost all tissues of the body. They play a major role in the development of inflammation and the rise in temperature.

Nimesulide also reduces the production of cyclooxygenase-1 (COX-1), but to a much lesser extent. COX-1 is a factor in protection of the gastric mucosa and prevent its deterioration.

The preparation reduces the formation of enzyme myeloperoxidase and oxygen free radicals and in this way protects the cells at the site of inflammation from damage. It also prevents thrombus formation, and cartilage destruction.

Nimesulide ingestion rapidly absorbed in the gastrointestinal tract and into the blood. This drug is excreted from the body mainly in the urine within the first days after the application. The drug does not accumulate in the tissues, even when administered for a prolonged period.

Indications and contraindications

Nimesulide apply if you have the following conditions:

• Joint diseases like inflammatory and degenerative diseases (rheumatoid arthritis Arthritis - a variety of forms and complications , Osteoarthritis);
• Myalgia (muscle pain);
• Inflammation of the tendons (tendonitis);
• Gout;
• Algomenorrhea (abdominal pain during menstruation);
• Toothache;
• Headache;
• Inflammation and pain in the postoperative period and after the injury;
• Fever of any origin.

But we must not forget about those diseases in which the drug taking is prohibited. Nimesulide is contraindicated in:

• Hypersensitivity to the drug, and also to other NSAIDs, including aspirin and;
• Gastric ulcer or duodenal ulcer during its exacerbation;
• Inflammatory bowel disease (Crohn's disease, ulcerative colitis);
• Acute bleeding from the blood vessels of the stomach or intestines;
• Hemophilia, as well as other bleeding disorders;
• Chronic heart failure, when there are signs of its decompensation (progressive shortness of breath, swelling, weakness);
• Severe disorders of the kidneys and liver;
• Pregnancy, breast-feeding;
• Alcoholism, drug addiction;
• Simultaneously taking drugs that adversely affect the liver;
• The age of twelve.

The drug reduces the pain and inflammation only at the time of its use. It has no effect on the course of diseases where applicable.

Nimesulide with extreme caution should be applied to people who have diseases of the cardiovascular system, diabetes Diabetes - threatening and incurable disease   the second type. This category also includes smoking patients.

Side effects

Despite the fact that nimesulide is relatively safe drug, in rare cases, when applied side effects may occur:

• Skin and mucous membranes - rash, itching, increased sweating. Even more rarely can appear swelling of the face, hives, dermatitis, angioedema.
• On the part of the digestive tract - heartburn, nausea, vomiting, diarrhea, and constipation. Very rarely have ulcerative defect in the stomach or duodenum and bleeding from the stomach or bowel vessels.
• On the part of the bronchopulmonary system - dyspnea, bronchospasm.
• From the nervous system - dizziness, anxiety, headache, nightmares, drowsiness.
• From the senses - blurred vision;
• Liver and biliary system - in very rare cases jaundice, bile stasis (cholestasis), hepatitis Hepatitis - the scourge of our time ;
• From the urinary system and kidneys - edema, or urinary retention, hematuria (blood in urine).
• From the side of blood - decrease in the number of red blood cells, platelet count, prolongation of bleeding.

With prolonged use of nimesulide is recommended to donate blood for the biochemical analysis. It is necessary to monitor changes in the liver and kidneys.

Overdose nimesulide and emergency measures

Symptoms of overdose may be drowsiness, lethargy (a condition in which a person is at rest and does not react to the stimuli of the environment), nausea, vomiting, pain, which occur in the epigastric region. Large doses of the drug adversely affects the mucous membrane of the stomach and intestines, and the damage it can provoke bleeding. In some cases, acute renal failure, when the kidneys no longer perform their excretory function. In the blood begin to accumulate a large amount of toxic materials - products of nitrogen metabolism. Nimesulide at high doses also increase blood pressure, respiratory depression, causing anaphylactic reactions (expressed allergic reactions that develop over a short period of time).

If you have symptoms of an overdose of nimesulide, in the first four hours after their appearance is necessary to wash the stomach and then take activated charcoal Activated carbon - old but indispensable .

Nimesulide is a safe and effective drug. The probability of side effects is much lower than when using non-selective (equally reduces the production of COX-1 and COX-2) NSAIDs. Therefore, the drug can be used for a long time with the defeat of the joints and spine, which is very important for people who suffer from chronic diseases of the musculoskeletal system.