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12/14/2020
Arthrose ist einfach eine Gelenkabnützung, die mehr als üblich für ein bestimmtes Alter ist.
Es gibt die primäre Arthrose und die sekundäre Arthrose.
Die primäre Arthrose ist oft genetisch bedingt. Man sieht sie ausserdem öfters bei Frauen oder im Alter. Faktoren wie Überbelastung der Gelenke z.B. bei Übergewicht oder Übermässiger Gebrauch im Beruf oder Sport und Fehlbelastung der Gelenke (wenn die Gelenke nicht achsengerecht belastet werden) z.B. bei X-Beinen, schlechter Körperhaltung, Beinlängen-Differenz etc… begünstigen die Entstehung der primären Arthrose.
Von sekundärer Arthrose spricht man, wenn die Arthrose auf Grund einer anderen Gelenk-Erkrankung oder -Trauma z.B. nach Entzündungen oder Frakturen oder Operationen entsteht.
Symptome: Patientinnen und Patienten haben anfänglich oft aber nicht immer Schmerzen, die beim Anlaufen auftreten und belastungsabhängig sind. Bei übermässiger Belastung beschreiben sie oft den Schmerz als ein Ermüdungsschmerz.
Eine Arthrose gilt als aktiviert, wenn Knorpel und Knochen im Gelenk so sehr aufeinander reiben, dass es zu einer Entzündungsreaktion der Gelenkkapsel (genauer gesagt der Gelenkinnenhaut) kommt. Es gibt einen Erguss im Gelenk und es wird warm und tut auch im Ruhezustand weh. Aus diesem Grund sagen wir Therapeutinnen, dass arthrotische Gelenke nicht übermässig belastet werden sollen. Gelenkschonende Bewegung auf der anderen Seite ist ein absolutes Muss bei Arthrose, um den Knorpel mit Nährstoffen zu versorgen und die Gelenkschmiere gleichmässig überall ins Gelenk und in den Knorpel zu verteilen.
Bei Arthrose heisst es “viel bewegen, wenig belasten“.
Typische Gelenke, die von Arthrose betroffen sein können, sind die Knie- und Hüftgelenke, die Fingermittel- und Endgelenke, das Daumensattelgelenk, das Grosszehengrundgelenk und die kleinen Wirbelgelenke der Hals- und Lendenwirbelsäule.
Wie kann Ihnen die Physiotherapie und die Handtherapie helfen?
Eine typische Physiotherapie und Handtherapiebehandlung der Arthrose beinhaltet folgendes:
INFORMATION: Aufklärung des Patienten über die Erkrankung, wie der natürliche Verlauf aussehen könnte und wie man die Arthrose durch Therapie beeinflussen kann. Der Ansatz “Was weg ist, ist weg!” stimmt nicht ganz. Gelenke haben eine Möglichkeit (obwohl begrenzt) sich zu regenerieren.
GELENKSCHUTZSTRATEGIEN: Auf das Verhalten im Alltag und im Beruf und Sport muss ganz individuell eingegangen werden. Wir empfehlen einen schonenden Umgang mit den Gelenken, den die Patientinnen und Patienten erlernen und automatisieren sollen.
ALTERNATIVE MEDIZIN und PFLANZLICHE MITTEL BERATUNG: Für gewisse pflanzliche Mittel gibt es gute wissenschaftliche Kenntnisse in der medizinischen Literatur. Hier geht das Ausprobieren von verschiedenen pflanzlichen Mitteln über das Studieren. Jeder Körper ist anders!
HILFSMITTELBERATUNG: Je nach den Bedürfnissen der Patienten empfehlen wir Therapeutinnen individuelle angefertigten Schienen für die Hände und das Handgelenk, Gehstöcke beziehungsweise Unterarmgehstützen, Pufferabsätze, Keilkissen, Sitzerhöhungen, Arthrodesen-Sitz oder -Stühle, Entlastungsorthesen und Bandagen.
BEWEGUNGSTHERAPIE: Die klassische Physiotherapie aus Mobilisierung, Muskelkräftigung, Dehnen und Koordinationsschulung und insbesondere das Heimtraining ist ein grosser und sehr wichtiger Teil der Arthrose-Behandlung. Die muskulären Defizite werden durch Training ausgeglichen und die Gelenke werden ernährt. So werden sie wieder schmerzfrei.
SCHMERZLINDERNDE MASSNAHMEN: Wärmetherapie, Kältetherapie, Elektrotherapie, Massage, Ultraschall- und Lasertherapie sind ein wichtiger und angenehmer Teil der Hand- und Physiotherapie. Es gibt sehr gute wissenschaftliche Kenntnisse insbesondere für die Lasertherapie. In einer grossen systematischen Review im 2019 hat die American College of Rheumatology/Arthritis Foundation herausgefunden, dass eine regelmässige Applikation des Laserlichts gleich effektiv ist wie eine Cortison-Spritze, aber ohne deren Nebenwirkungen.
Als Patientin oder Patient können Sie viel selber tun, um Ihre Gelenke gesund zu erhalten oder das Fortschreiten der Arthrose zu entschleunigen. Wir Therapeutinnen helfen Ihnen gerne auf diesem Weg.
Disclaimer:
Die Informationen in diesem Blog ersetzen keine ärztliche Beratung oder Therapie.
Links und Literatur:
Kolasinski S. L. et al. (2020) 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheumatol, 72 (2), 220-233
https://pubmed.ncbi. … lm.nih.gov/31908149/
https://de.wikipedia.org/wiki/Arthrose
http://www.rheumatologie.usz.ch/fachwissen/seiten/arthrose.aspx
https://www.was-tun-bei.ch/arthrose/was-ist-arthrose.html
https://flexikon.doccheck.com/de/Arthrose
Amisha - 23:33:42 | 22 Kommentare
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