Non-steroidal anti-inflammatory drugs for osteochondrosis

Form of release of drugs for osteoarthritis Pharmacological groups of drugs for arthrosis

Arthrosis is a multifactorial disease, which is also called a “lifestyle disease.”

Therefore, complex treatment is also required, with the help of medications, physiotherapy, massage, orthopedic regimen and diet. And yet, in the treatment of exacerbations and maintenance of remission, drugs for osteoarthritis play a leading role. They have both a symptomatic effect (eliminate pain and inflammation, swelling) and help restore the structural and qualitative characteristics of cartilage tissue (for example, chondroprotectors).

Don’t know what medications to take for arthrosis? Let's talk about what you need to have in your first aid kit.

Some drugs can be taken to prevent arthrosis, even before the first symptoms appear, and some are effective only at a certain stage of the disease. How to navigate the treatment of joint osteoarthritis with drugs?

What are chondroprotectors?

Chondroprotectors for joints (powders for the treatment of joints) are slow-acting preparations that contain proteins necessary for the construction of articular cartilage, bones and other functional tissues of the musculoskeletal system. Chondroprotective drugs are used in complex therapy of diseases of the musculoskeletal system together with anti-inflammatory and other drugs. However, their main task is the prevention of degenerative changes in joints. Therefore, they are effective before the onset of the disease, as well as in its early stages.

Physiotherapy

Physiotherapeutic treatment is used to reduce swelling and pain. It allows you to improve blood circulation in the area of ​​the body that is in close proximity to the damaged knee cartilage. As a result, tissue trophism improves, hypoxia decreases, and regenerative processes accelerate.

The following types of physiotherapy are used:

• electrophoresis;
• galvanization;
• phonophoresis;
• electrical stimulation;
• magnetic therapy;
• laser therapy;
• vibration massage and others.

Physiotherapy is often combined with drug treatment. Topical medications are applied to the skin. Then electrophoresis or phonophoresis is performed for better penetration into the joint cavity.

Chondroprotectors - salvation for joints?

The nourishment and hydration of cartilage in the joint occurs with the help of synovial fluid, which contains the already mentioned mono- and polysaccharides. With injury, excessive physical activity or systemic disease, the composition of the synovial fluid may be disrupted. Because of this, it becomes less viscous and can no longer provide slip. Once in the synovial fluid, the components of chondroprotectors help restore its consistency and normal activity of cartilage cells. The joints stop hurting and swelling, their mobility improves. In parallel with taking chondroprotectors, other measures are necessary for the active restoration and nutrition of cartilage - physiotherapy, exercise therapy, anti-inflammatory drugs.

ABOUT THE DRUG

NOLTREX™ is an artificial endoprosthesis based on a three-dimensional polyacrylamide mesh polymer with the addition of silver ions. The drug serves to replace the synovial fluid of the joints (the fluid that fills the joint cavity and acts as an intra-articular lubricant). Used to treat osteoarthritis.

MOLECULAR WEIGHT NOLTREX™ > 10,000,000 DALTON

Compound:

3-dimensional polyacrylamide, % 4.0 ± 1.5

Purified water, % 96.0 ± 1.5

Silver ions, % 0.0001 - 0.0025

Each disposable syringe of NOLTREX™ contains 2.5 ml of gel for injection into the joint cavity.

Unlike other intra-articular injections commonly used in the treatment of osteoarthritis, NOLTREX™ does not contain hyaluronic acid, as well as other components that are broken down by enzymes present in the human body, which ensures its long-term presence at the injection site.

NOLTREX™ is a biocompatible material that has neither immunogenic nor antigenic properties, and does not cause an allergic reaction due to its synthetic nature.

NOLTREX™ is not a pharmacological drug from the group of antibiotics or antimicrobial agents, therefore it cannot be used as the main therapeutic agent for bacterial arthritis.

WHERE TO BUY NOLTREX?

For what diseases are chondroprotectors used?

Glucosamine and chondroitin preparations help protect joints from “starvation” and chemically aggressive substances that accumulate in them as a result of inflammation. For this reason, they are recommended for adjuvant therapy of osteochondropathy - diseases that cause necrosis of spongy bone tissue (bone heads). Chondroprotective drugs are used for the treatment and prevention of:

• osteochondrosis;
• osteoarthritis (including rheumatoid and gouty arthritis);
• spondylosis (spondyloarthrosis);
• osteoporosis;
• tendonitis (dystrophic disease of the tendons);
• bursitis (inflammation of the joint capsule)

Chondroprotectors will become indispensable assistants in the fight against joint diseases

Drugs in this group are recommended for congenital and acquired pathologies of bone tissue (for example, bone deformation), hernias and protrusions. Chondroitin sulfate has proven itself as an auxiliary substance in the treatment of keratitis (inflammation of the eye cornea). Chondroprotectors for arthrosis are prescribed at stages 1-2 of the disease.

References

1. Rheumatoid arthritis. Clinical recommendations. Association of Rheumatologists of Russia, 2021. - 102 p.
2. Rheumatology: National Guide / ed. E.L. Nasonova, V.A. Nasonova. - M.: GEOTAR-Media, 2008. - 720 p.
3. Kishkun, A.A. Guide to laboratory diagnostic methods. - M.: GEOTAR-Media, 2007. - 800 p.
4. Internal diseases in 2 volumes: textbook / ed. ON THE. Mukhina, V.S. Moiseeva, A.I. Martynova, 2010. - 1264 p.
5. Kasper, D., Fauci, A., Hauseret, S. Harrison`s Principles of Internal Medicine 19/E (Vol.1). McGraw-Hill Education, 2015.

The effect of chondroprotectors for joints

The use of chondroprotectors can reduce pain, slow down the progression of the disease and improve joint mobility. They are especially effective in treating large joints - knee, elbow, hip.

The effect of chondroprotectors in arthrosis is divided into:

• symptom-modifying (reducing discomfort during wear of cartilage tissue);
• structural-modifying (improving the structure of cartilage, combating its further destruction).

The mechanism of action of chondroprotective drugs is based on the fact that they stimulate the growth of chondrocytes, increase their resistance to oxidation, and suppress the activity of enzymes that destroy cartilage tissue. Thanks to this, instead of defective cartilage tissue, stable tissue begins to grow, i.e., strong enough so that the cartilage can again perform its functions in the joint. Also, protective agents have a weak anti-inflammatory effect and reduce swelling.

Chondroprotectors for joints have a cumulative effect, act slowly and over a long period of time. Therefore, they are used to reduce patients’ need for nonsteroidal anti-inflammatory and glucocorticoid drugs and increase the duration of remission. Glucosamine also prevents the leaching of calcium from bones, and chondroitin normalizes calcium-phosphorus metabolism.

Principles of treatment

Treatment approaches depend on the exact reason for the thinning of the cartilage. This may happen as a result of:

• inflammatory diseases;
• degenerative processes;
• injuries;
• surgical operations performed.

Treatment can be aimed at eliminating symptoms, slowing down degenerative processes, stopping inflammation, and enhancing the regenerative abilities of cartilage tissue. Sometimes surgery is required. It allows you to replace defects of the cartilage surface.

Indications and contraindications for taking chondroprotectors

Although chondroprotectors are useful for diseases of ligaments and even periodontal tissue, their main use in medicine is the protection and restoration of joints. Chondroprotectors for joints are made from natural products that have been part of the human diet for centuries, so side effects and contraindications are very rare.

Who needs chondroprotectors for joints?

Joint damage is common among athletes, manual workers, and people who lead a sedentary lifestyle. People with age-related changes in hormonal levels and people over 45 years of age are also at risk. The presence of autoimmune and metabolic diseases (systemic lupus erythematosus, rheumatoid arthritis, diabetes mellitus, gout), excess weight is a good reason for the preventive use of chondroprotectors.

You need to start a course of glucosamine and chondroitin:

• at stages 1 and 2 of osteoarthritis and other rheumatic diseases;
• for diseases of ligaments and tendons;
• after injuries and joint surgeries;
• for diseases with a tendency to damage joints;
• in other cases as prescribed by a doctor.

Who should not take chondroprotectors?

Absolute contraindications to taking chondroprotectors for joints are phenylketonuria (a disorder of amino acid metabolism) and individual intolerance to their components. A preliminary consultation with a specialist before taking chondroprotective agents and further observation is necessary for:

• pregnant and lactating women;
• children under 12 years of age;
• asthmatics (if breathing is difficult, the drug should be discontinued);
• diabetics (glucosamine changes glucose tolerance);
• allergy sufferers (especially those with allergies to various types of protein and shellfish);
• patients with gastrointestinal diseases in the acute phase (gastritis, gastric or duodenal ulcers);
• people with kidney disease (including cholelithiasis, urolithiasis, renal failure) and liver failure;
• patients with vascular pathologies (including varicose veins, thrombosis and thrombophlebitis) and blood clotting disorders;
• persons with oxaluric diathesis;
• patients diagnosed with malignant tumors.

Distinctive signs of rheumatoid arthritis

Symptoms of rheumatoid arthritis are usually complex and affect more than just the joints. But most often the onset of the disease is announced by:

• pain and discomfort in fingers or toes;
• stiffness, increasing difficulty in flexing and extending joints, especially after exercise, in the morning, after a long, immobile rest;
• swelling of the affected joints, severe edema;
• redness, heated skin and other symptoms of inflammation over the affected joints;
• decreased endurance, increased fatigue - both in the affected parts of the body and in general;
• increased body temperature (37-38°C);
• weakness, chronic fatigue;
• difficulty breathing, shortness of breath at the slightest physical exertion;
• anemia, pallor of mucous membranes.

These symptoms may include pain in the abdomen and/or chest, inflammation of the uvea (uveitis), and skin rashes.

The first symptoms of the disease usually appear after a shock to the body: physical or psycho-emotional stress, infection, allergies, hormonal changes or exposure to other unfavorable factors.

Classification of chondroprotectors

In medical sources, chondroprotectors for joints are divided by generation:

• 1st generation.
  Animal and plant extracts and concentrates rich in glucosamine and chondroitin;
• 2nd generation.
  Preparations that contain purified glucosamine or chondroitin. They are absorbed faster and easier, and are less likely to cause allergies;
• 3rd generation
  . Combined products that combine glucosamine, chondroitin, sulfur preparations and other components. The composition of new generation chondroprotectors is often supplemented with anti-inflammatory drugs (ibuprofen, diclofenac), fatty acids (improves the elasticity of cartilage and protects its cells from destruction), vitamins (for better absorption of active substances and protection of cell membranes) and microelements (for building stable cartilage tissue).

New generation chondroprotectors make the patient feel better much faster and have fewer side effects.

Chondoprotectors are available in various forms. Choose what suits you.

Pills

Tablets and capsules are prescribed in courses of 3-6 months. They are especially effective for lesions of large joints or systemic diseases that affect 4 or more joints. Capsules are absorbed almost as well as liquid glucosamine, but are stored and dosed much better. The absorption of these chondroprotectors is quite high - 13-25%.

Chondroprotective ointments

Local chondroprotectors (ointments and gels) are used for arthrosis of intervertebral, small and medium-sized joints. External preparations have minimal bioavailability (less than 5%) and have virtually no effect on the structure of cartilage, especially if it lies deep under the skin. But chondroprotective ointments have a beneficial effect on periarticular tissues, relieve pain and swelling, and reduce inflammation. In the absence of an allergic reaction, they can be used continuously.

Powders for the treatment of joints

Powder chondroprotectors are the rarest form of release. Glucosamine powder is well absorbed by the body (bioavailability over 26%), but is not recommended for gastrointestinal diseases. Typically, manufacturers include additional components that improve the metabolism of cartilage tissue.

Chondroprotectors in injections

Injections of chondroprotectors are most effective in comparison with other forms of glucosamine and chondroitin. They are placed intramuscularly and intraarticularly. Injectable medications are a good alternative to oral medications if the patient has gastrointestinal diseases.

An intramuscular injection of a chondroprotector can be done independently or with the help of loved ones, but injection into the joint should only be carried out by an experienced medical professional.

Intra-articular administration of CP (usually with painkillers and anti-inflammatory drugs) is considered the most effective. Chondroprotectors in injections help with synthesis disorders - when cartilage tissue stops producing substances necessary for the growth and hydration of cartilage.

Finalgon

This ointment contains nonivamide (an analogue of capsaicin), which dilates blood vessels, warms the joint and penetrates deeper into the tissue. Finalgon relieves pain well by “distracting” nerve fibers from transmitting the pain signal to the brain. Finalgon should be used carefully so as not to overdo the warming effect and cause a burn. After rubbing with Finalgon, immediately wash your hands thoroughly with soap so as not to accidentally touch your eyes, mouth or any mucous membranes. Doctors say that with regular use of Finalgon, it is possible to restore joint mobility in case of bursitis and bruises.

Finalgon

Boehringer Ingelheim, Germany

- arthritis;
- arthralgia and myalgia of rheumatic origin; - sports injuries, bruises and damage to the ligamentous apparatus; - myalgia caused by excessive physical activity; - lumbago; - neuritis; - sciatica; - bursitis and tendovaginitis; - acute nonspecific pain in the lower back; - for preliminary “warming up” of muscles before physical exercises, sports competitions; - as part of complex vasodilator therapy for peripheral circulatory disorders. from 246

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Natural chondroprotectors in food

The human need for effective chondroprotectors is partially satisfied by food. To do this, the diet must include tendons, cartilage (joints, ears, etc.), bones, bone marrow, skin of animals and fish, rich bone broths - the best chondroprotectors among food products. It is believed that “marine” collagen has the greatest digestibility and benefits for cartilage tissue, so mollusks and crustaceans, anchovies and other small sea fish should be included in the diet in boiled form. An additional source of collagen can be dishes with the addition of edible gelatin - jelly, jellied meat, aspic. It is advisable to eat eggs (soft-boiled, not overcooked) every day, and eat beef, red fish, and cheese more often.

People with sore joints also benefit from plant collagen-like compounds, which are found in wheat sprouts, mushrooms, nuts, broccoli, and seaweed. It is worth increasing the content of citrus fruits and leafy greens in the diet.

Even daily consumption of chondroprotective products does not guarantee cartilage health if:

• metabolic disorders;
• high professional or domestic loads on the joint;
• age-related changes, when cartilage cells stop actively growing and multiplying.

In these cases, the menu should include medications - chondroprotectors with glucosamine and chondroitin. They can be taken even by patients who cannot consume fatty broths and jellied meats for health reasons.

Lifestyle correction

Initially, it is necessary to eliminate all factors that can provoke thinning of the cartilage of the knee joint. Treatment begins with the patient being advised to give up heavy physical work and sports. Because with continued mechanical irritation of the cartilage, it will be damaged, and full restoration of cartilage tissue is impossible due to its poor blood supply.

The patient needs:

• weight loss if BMI exceeds 25 kg/m2;
• reducing the load on the sore leg;
• use of orthopedic devices (orthoses, insoles);
• using a cane or crutches.