Chondroprotectors for joints
Jul 04, 2018
Gradual destruction of cartilaginous tissue underlies the mechanism of development of the most part of degenerative-dystrophic pathologies of the joints.The severity of arthrosis symptoms depends on the extent of intraarticular cartilage damage.Stop the process of their destruction and stimulate regeneration( recovery) can be done with the help of modern drugs - chondroprotectors( CP).
Drugs in this category are helpful when the process of degradation of cartilage tissue has just begun.With advanced arthroses, they are practically ineffective.Table of contents: What are articular cartilages?How do chondroprotectors work?Indications and contraindications Types of chondroprotectors Choosing the optimal drug Recommendations for patients undergoing treatment with chondroprotective agents
What are articular cartilages?
All articular surfaces of bones( including vertebrae) are covered with cartilaginous tissue.The contacting cartilages are normally perfectly smooth.Friction between them reduces the natural lubrication - intraarticular fluid with a high content of hyaluronic acid.From it, nutrients enter the cartilage.
The main function of intraarticular cartilage is to ensure the mobility of the joint in the required volume.
Cartilage tissue consists of cells - chondrocytes and chondroblasts - and matrix.The intercellular substance is formed by collagen fibers and the chondromucoid, the structural units of which are glucosamine and chondroitin.
For arthrosis of any etiology of cartilage destruction begins with a drop in the content of chondroitin and glucosamines. A direct consequence of the process is the disintegration of the fabric.The intraarticular cartilage is thinner;On its surface appear rough areas and microcracks.In many pathologies, there is also a decrease in the level of synovial fluid biosynthesis.This circumstance aggravates the process of tissue degradation, since the cartilage trophy is sharply limited, and the lack of lubrication leads to friction accelerating its destruction.
Initially, the patient develops a pain syndrome against the background of physical exertion.As the process progresses, it intensifies, and begins to disturb, including and at rest.Pain in motion is caused by the fact that the bones "bare" and rub against each other.
How do chondroprotectors work?
If arthrosis or osteochondrosis is diagnosed at the initial stage, and chondroprotective therapy is started in time, the process of tissue destruction can be slowed down.In a number of cases, even an almost complete restoration of the damaged cartilage is possible.
Glucosamines and( or) chondroitin are active active ingredients in most CPs.Entering the body in the right concentration, they are able to be built into the affected cartilage, which ensures the restoration of the integrity of their structure.
Indications and contraindications
Chondroprotectors are worth taking if the first( maximum - second) stage of degenerative-dystrophic lesion of one or more joints is diagnosed.With arthrosis or osteochondrosis of 3-4 degrees, they are ineffective, since the cartilaginous tissue is already practically destroyed, and it can not be restored.
Indications for the appointment of chondroprotectors:
- osteochondrosis( intervertebral disc damage);
- deforming osteoarthritis;
- prophylaxis in patients with a high risk of developing arthrosis.
Risk factors for the development and progression of degenerative cartilage pathologies:
- age over 50;
- metabolic disorders;
- endocrine pathology;
- frequent and significant physical exertion( including when doing sports);
- injuries of the joints in the anamnesis;
- excess weight;
- physical inactivity;
- diseases of the musculoskeletal system.
CP is often prescribed during rehabilitation after operations on the joints.
Chondroprotectors can not be used by women during childbearing, as well as by nursing mothers.These drugs are contraindicated in patients who have an individual hypersensitivity( allergy) to the active substance or auxiliary ingredients.
Important! People suffering from diseases of the digestive system, CP are appointed with caution after consulting a gastroenterologist.
Types of chondroprotective agents
Drugs belonging to this clinical pharmacological group differ in the active substance, the method of administration and generation, i.e., the time of commencement of widespread use.
The first generation of HP relate to based on biological material.They are extracts from the cartilage of some animals( in particular - marine fish).The main drawback of such drugs is the high probability of developing hypersensitivity reactions in response to the introduction of foreign antigens.Now in clinical practice only one chondroprotector belonging to the 1st generation - Alflutop is used.
2nd generation - preparations that are purified hyaluronic acid, chondroitin sulfate or glucosamine.
Please note : in the USA in 2002 - 2006A large-scale, randomized study was conducted in which no statistically significant glucosamine efficacy and glucosamine / chondroitin combination were compared with placebo.However, when glucosamine concentration was studied after glucosamine intake in the form of glucosamine sulphate crystals, more than six-fold difference in glucosamine concentration in the intra-articular fluid among volunteers was detected, so there is an assumption that glucosamine sulfate is more effective than the more common glucosamine hydrochloride.
Chondroprotectors of the 3rd generation are combined preparations comprising simultaneously glucosamine with chondroitin sulfate, sometimes in combination with other compounds( vitamins or polyunsaturated fatty acids).
HP with glucosamine:
- Flexamine glucosamine;
- Arthron flex.
Monohydrates of chondroitin sulfate:
- Arthron chondreex;
Combined products( chondroprotectors of the new generation):
- Arthron complex;
- Chondroitin complex.
Complex products with NSAIDs:
Pharmaceutical industry also produces preparations of hyaluronic acid - Suplazin, Sinocrom, Viscosil, etc. They are used in conditions of medical institutions for injections into the joint cavity.
The disadvantage of HP for oral administration can be considered as their low efficiency.A significant volume of active ingredients is lost in the process of biotransformation, so it is difficult to create the right concentration in the body.
For the injection of ( into the muscle or joint) Don Chondroprotectors, Alflutop and hyaluronic acid based products are designed.Their disadvantage is the high risk of complications associated with the injection.Their undoubted advantage is high efficiency.Course treatment should be repeated every six months.
Drugs with hyaluronic acid are designed for insertion into the joint cavity.They replace the synovial fluid.Usually, the course of treatment involves 3-5 injections, but in some cases a pronounced positive effect develops after only one injection.
Complex therapy of arthrosis and osteochondrosis often involves additional administration of CP for topical application - gels, ointments and creams with hyaluronic acid.
Selection of the optimal preparation
Chondroprotectors are used only for the prescribing physician.He chooses the drug that is optimal for each particular case, based on clinical and laboratory data.
Now on the market there is a wide range of products designed to improve the state of cartilage tissue.They are intended for course treatment, which in many cases should last a year or more.The cost of such drugs is high enough, especially if you take into account the necessary duration of therapy.
Important: The therapeutic effect of taking chondroprotectors is not developed immediately.As a rule, positive changes are noted only after several months of regular admission, as the process of cartilage regeneration is rather slow.
According to a number of specialists, mono drugs have greater efficacy.But there is also a diametrically opposite point of view.Publications about the benefits of this or that HP are often paid for by pharmaceutical companies interested in promoting their products on the market.In this regard, their objectivity should be questioned. When choosing a drug, it is recommended to rely on the experience of specialists-arthrologists who use a certain tool for a number of years.Only a qualified doctor can make an objective opinion about the real effectiveness of a specific chondroprotector. It is also advisable to get acquainted with the reviews of patients taking the drug.
Note: is an absolute advantage of combined preparations with NSAIDs - it is an opportunity to reduce the severity of one of the leading symptoms of arthrosis and osteochondrosis, namely, pain syndrome.
It is recommended not to purchase generic products, but branded chondroprotectors from major manufacturers with a good reputation .In this case, you can be sure that the drug has passed all clinical trials using modern equipment, and is not a "dummy".
The most effective( according to doctors) chondroprotectors:
Teraflex is effective for the treatment of gonarthrosis.It can accelerate the process of matrix synthesis.For complex effects on the joint, chondroxide is frequently prescribed in parallel, stimulating the metabolism in the cartilage.With osteochondrosis, the drugs of choice are Dona, Structum and Arthra.
By purchasing non-certified medications, and supplements for the treatment of joints, it is important to consider that clinical trials before their release on the market are not carried out in the proper volume of .The active substance, as a rule, does not differ in chemical purity.In addition, it is not known in what quantity it is present in the next advertised dietary supplement.
Please note: was one of the few nutritional supplements that received a lot of positive feedback from patients suffering from arthrosis, phytopreparation based on the extract of the curative plant "toadstone" or "catnip".It is available in the form of ointments and capsules for oral administration.
Recommendations for patients undergoing treatment with chondroprotective agents
Patients assigned with chondroprotective agents should perform a set of exercise exercises on a regular basis.The load should not fall on the affected joint, but on the surrounding muscles.Gymnastics increases the effectiveness of HP.Exercises should be done in a horizontal or sitting position.
Periods of physical activity should alternate with a full rest( relaxation time - at least 10 minutes).
General supercooling of the body and the area in the patient joint can not be tolerated.
It is strongly recommended that physical activity be metered, for example walking on a level road for 30 minutes.daily.
If you have excess weight, you need to take measures to reduce it( showing restrictive diets and exercise).
It is important to avoid sudden movements and lifting weights as much as possible.
Vladimir Plisov, medical reviewer