From overloading to the wearing out of the joints

Problems in the joints are caused by many factors. Often these cannot be traced back to an accident but develop slowly over time. Gradually, there is a build up of pain, interrupted by periods of apparent, but unfortunately usually only temporary improvement or even remission from all symptoms.
Even smaller accidents, which may not even have involved the joint which is later affected by pain or excess strain on one side of the body caused at work or during leisure time activities can have a lasting detrimental affect on the body's natural patterns of movement. This can lead to a chronic overloading in one or more of the body's joints

The smallest amount of damage in the inner spaces of a joint, e.g. in the cartilage or the menisces may represent the beginning of the development of the wearing out of the joint. Early, consistent diagnostics of and therapy for the joint troubles can prevent later damage arising, or at least considerably slow down its onset. The restoration of normal conditions within the joint or the achieving of the smallest amount of residual damage possible is the goal of therapy today. It is above all treatment using physiotherapy exercises in combination with, for example, the application of heat or cold, and sparing the joint with subsequent planned build-up of load which help to improve the functioning of the joint. The changing of working methods, a change in the types of sport, especially for injuries to the leg joints and the specific wearing of certain types of shoe and insoles all play a decisive part in the effectiveness of the therapy.

The preconditions for the successful implementation of the therapies mentioned above are often achieved only by the operative restoration of or improvement in the function of a joint. Today, these operations are mostly carried out arthroscopically, that is by using a joint endoscopy. The spectrum of treatments ranges from the simple partial removal of a meniscus or the smoothing out of a frayed-out joint cartilage up to a ligament replacement operation. If the wearing out of the joints is too far advanced, the only remedy is, however, the implantation of an artificial joint.

Dr. med. Gert Kamjunke
MEDICUS Issue 1/2005