Sanatorium treatment of osteoarthritis

Patients with osteoarthritis of I-III radiologic stage according to Kellgren and Lawrence are sent to sanatorium-resort treatment without synovitis or with its uneven exacerbation. There are shown resorts on which therapeutic muds are used, as well as with chloride, sodium and other mineral waters (in Ukraine - Berdyansk, Evpatoria, Odessa, Saki), with hydrogen sulfide waters, with radon waters (in Ukraine - Khmelnik), with nitrogenous slightly mineralized siliceous thermal waters. For sanatorium treatment patients with osteoarthritis of the IV stage with sharp exacerbation of synovitis and the presence of contraindications to sanatorium treatment are not sent.

[1], [2], [3], [4], [5]

The scheme of treatment of osteoarthritis, proposed by the Association of Rheumatologists of Ukraine

1. Anti-inflammatory and analgesic treatment of osteoarthritis.

NSAIDs are non-selective COX inhibitors:

• diclofenac;
• gt;

NSAIDs are selective inhibitors of COX-2:

• meloxicam 7,5-15 mg once a day;
• nimesulide 100 mg twice daily;
• celecoxib 100-200 mg / day.

Il-1 receptor antagonists:

• diacerein - 50 mg orally 2 times a day during meals for at least 3 months;

Preparations of SET:

• Flogenzim 2 tablets 3 times a day for 3 weeks,
• Wobenzim 3-5 tablets 3 times a day for 3 weeks,

Glucocorticosteroid hormones intraarticularly (with the ineffectiveness of other anti-inflammatory drugs) no more than 4 injections per year:

• methylprednisolone (20-40 mg depending on the size of the joint),
• hydrocortisone (50-125 mg, depending on the size of the joint),
• triamcinolone (20-40 mg, depending on the size of the joint).

2. Chondroprotectors:

• glucosamine 1500 mg once a day for 2-3 months with NSAIDs,
• chondroitin sulfate 750 mg twice a day for 3 weeks, then 500 mg twice a day for a long time;
• hyaluronic acid 20 mg intraarticular once a week for 2 weeks, 3 cycles every 3 weeks,
• Alflutop - with lesions of several joints 1 ml once a day in / m 20 days, after 3 months the course can be repeated; with the involvement of large joints intraarticularly or in / m according to the scheme: 2 ml in each affected joint 1 every 3 days for 18 days (6 administrations) followed by an I / ml injection of 1 ml (up to 20 injections).

3. Local application of ointment and gel forms of NSAIDs:

• ibuprofen,
• piroxicam,
• diclofenac preparations, etc.

4. Antioxidant therapy:

• a-tocopherol acetate (vitamin E) 0.1-0.2 g per day for 1 month or 1-2 ml of 10% r-1 once a day for 20 days.

5. Drugs that improve microcirculation:

• pentoxifylline 100 mg 3 times a day,
• dipyridamole 75 mg / day.

6. Orthopedic treatment.
7. Therapeutic physical training.
8. Physiotherapeutic procedures.
9. Spa treatment.