Arthrosis of the hip joint is the most common type of arthrosis. Because the hip joint (hip joint) is larger than all others and has a multi-vector axis of rotation, it experiences tremendous stress throughout a person's life - walking, running, jumping, climbing stairs, playing sports and everyday activities.
Often, patients have to attend to the symptoms and treatment of arthrosis of the hip joint already at the age of 25-35 years. The disease can progress rapidly under the influence of trauma, decompensated physical activity (non-observance of the technique of performing sports exercises, "standing" work, excess weight), hereditary factors, infectious and chronic diseases.
Effective treatment of osteoarthritis of the hip, however, can maintain mobility and prevent bone destruction. In old age, it helps to avoid even more dangerous pathologies, such as necrosis or a fracture of the femoral head.
Symptoms of arthrosis of the hip joint
Symptoms and treatment of arthrosis of the hip joint depend on the stage of the disease.
- Stage 1. Patients feel mild pain in the groin area, which occurs after physical exertion, prolonged standing or sudden movements in the joint, and then completely disappears at rest.
- Stage 2. The pain syndrome intensifies and bothers the patient even with ordinary household loads. Pain can be given to the lower back or inner thigh. Stiffness, crunching appears, the range of motion in the joint is reduced. The muscular-ligamentous apparatus begins to weaken, which is why there is increased fatigue.
- Stage 3. The pain is felt all the time, without a cane or walker, it is difficult for patients to move around. Joint movement is severely limited. Climbing stairs is a major challenge. There are gait disturbances (lameness, falling on one or both legs). With unilateral coxarthrosis with the naked eye, a pelvic skew and a curvature of the spine are noticeable.
- Stage 4. The joint gap is closed due to the proliferation of osteophytes and any movement in the joint is almost impossible. It loses its function and is severely deformed due to the destruction of the bone.
Predictions for arthrosis of the hip joint
With successful lifelong treatment, pain in arthrosis of the hip joint may be completely absent or rarely bother the patient. The prospects for this therapy depend on the patient's adherence to the rules of the rheumatologist and his personal self-discipline. We draw your attention to the fact that the most accurate prognosis for the disease can only be made by the attending physician.
With timely and regular treatment
If chronic diseases do not contribute to the progression of the disease and the treatment of arthrosis of the hip joint began at stage 1 or 2, hip replacement can be avoided. Disability and disability, if the doctor's recommendations are followed, is shifted by 20 years, and sometimes the patient retains an almost unlimited range of motion in the joint until old age. The best forecast is possible with the so-called. benign arthrosis - when the wear of the cartilage depends on external factors (professional activity, sanitary violations). In this case, it is worth excluding them and undergoing a course of rehabilitation therapy in order to slow down further joint degeneration.
Timely surgical treatment of grade 3 osteoarthritis of the hip joint will help to avoid joint immobility, consequences for the entire musculoskeletal system and long years of pain. In the absence of contraindications, prosthetics will help you return to your former activity.
When choosing a method for treating arthrosis of the hip joint, the doctor takes into account the age, constitution, physical form of the patient, his state of health, specific symptoms of the disease and its stage. At the same time, the narrowing of the lumen of the joint space, the presence of osteophytes, the rate of progression of arthrosis, the quality of synovial fluid and other indicators are investigated.
Self-treatment of osteoarthritis of the hip joint by folk methods does not take into account these individual indicators and, instead of the desired result, can lead to severe exacerbation, metabolic disorders and aggravation of the stage of the disease. But the worst is the time spent on the illusion that such a serious chronic disease as arthrosis of the hip joint can be cured only by folk methods. Avoid taking anti-inflammatory drugs without a doctor's prescription - this can lead to serious problems with the digestive and endocrine systems!
Left untreated, arthrosis of the hip joint progresses on average 2-4 times faster. The deterioration of the quality of life and the onset of disability in this case is possible already at a relatively young age - about 45-50 years. In patients, sleep worsens, physical activity decreases, and disorders in the psychoemotional sphere are observed. Pain prevents them from getting out of bed in the morning, walking with their grandchildren, going to work.
Treatment of osteoarthritis of the hip joint
Outpatient conservative therapy is considered the priority direction of treatment for arthrosis of the hip joint of the 1st degree. It includes medication for arthrosis of the hip joint, physiotherapy, diet therapy, wearing bandages and adjustable orthoses. This approach can relieve pain, maintain muscle function, and increase joint mobility. Treatment of arthrosis of the hip joint of the 2nd degree is carried out in a similar way.
If conservative treatment of arthrosis of the hip joint is delayed or ineffective, cartilage degeneration progresses rapidly, an operation is performed. Occasionally, the doctor may decide on an osteotomy or arthrodesis, but in most cases, in the treatment of grade 3 hip arthrosis, arthroplasty is prescribed - partial or complete replacement of the diseased joint. A prosthesis made of metal and a ceramic or polymer insert lasts from 15 to 25 years, after which it needs to be replaced. Total arthroplasty (total joint replacement) is the most effective treatment for hip arthrosis. It allows you to fully restore its functionality with a minimum incision of up to 8 cm in length and the ability to walk with support in a day. Full rehabilitation lasts 1-3 months.
Physiotherapy methods of treating arthrosis of the hip joint
Physiotherapy for arthrosis of the hip joint is carried out in courses, according to the testimony of a doctor. Almost all methods, except for magnetic and cryotherapy, are allowed only during the period of remission, in the absence of inflammatory symptoms. For the treatment of osteoarthritis of the hip joint, the following measures are used:
- ultra high frequency therapy;
- ultrasound therapy;
- laser therapy;
- remedial gymnastics (exercise therapy);
- therapeutic massage and manual therapy;
- ozone therapy;
- traction therapy (traction);
- paraffin applications and wraps;
- balneotherapy and mud therapy;
Treatment of arthrosis of the hip joint with exercise therapy
Physical therapy for arthrosis of the hip joint is aimed at strengthening the muscles and ligaments - they are a natural orthosis that reduces the load on the joint and maintains it in a physiologically correct position. As a consequence, the treatment of hip osteoarthritis by gymnastics helps relieve pain and inflammation, improves mobility, slows down cartilage wear and provides nutrients to the synovial fluid. The following exercises will help strengthen your legs:
- Starting position - sitting on the floor, support on outstretched arms from behind. Legs straight in front of you. Bend and unbend your toes.
- The starting position is the same. We alternately bend and unbend the feet (toe to ourselves, toe from ourselves).
- The starting position is the same. We bend the knee, pulling it towards us on the rug or on the weight. It is advisable to touch the floor only with the toe after the movement is completed.
- Starting position - lying on your back, legs are bent at the knees, feet are on the floor. We do the "frog" exercise - we spread the bent knees and hold them for 20 seconds. Then we mix again.
- The starting position is lying on your back, one leg is straight, the other is bent and laid to the side. We lie like this for one minute, then we change legs.
- Starting position - lying on your back, legs are straight, lie freely. We bring the socks inward, touching them, and then spread them apart. We repeat at a pace 10 times.
- Starting position - lying on your back, one leg (from the side of the affected joint) is thrown over the other. Move the foot of the lower leg as in the exercise above.
- Starting position - lying on your back. We pull the knee to the stomach, holding the back of the thigh with fingers locked into the lock. Perform 30 seconds on each leg.
- The starting position is the same. We pull the legs bent at the knees to the stomach and hold them under the knees with fingers locked into the lock. Perform at least 30 seconds.
- The starting position is the same. We take the straightened leg to the side above the floor. 20-30 times for each leg.
- The starting position is standing. Place the chair on the side with its back to you. Holding on to the back of a chair and standing on one leg, swing the other back and forth like a pendulum. 20-30 times.
Massage in the treatment of osteoarthritis of the hip joint
Massage is an effective relaxation and restorative technique for the treatment of arthrosis of the hip joint in the early stages. As a treatment for arthrosis of the hip joint of the 1st degree (as well as the 2nd - in the absence of pain and swelling), it is able to prolong remission, relieve discomfort and pain without drugs, improve tissue trophism and slow down cartilage degeneration. It also eliminates spasms that interfere with sleep and movement, strengthens the ligaments, normalizes gait, allows you to quickly warm up when changing from rest to active activity and vice versa.
With arthrosis of the hip joint, professional therapeutic massage is desirable (at least 10-12 sessions). But gentle self-massage at home also helps to improve the condition. At the same time, it is important to avoid pain and severe discomfort. At the slightest signs of inflammation in the joint, the manipulations are temporarily stopped - they can be resumed with the permission of the attending physician, after a course of anti-inflammatory therapy.
Even in cases where the patient suffers from unilateral coxarthrosis, massage is performed on both sides. How do you do it right?
- First, take a comfortable position that will allow you to relieve your hips and lower back. For example, lying on your back, side or stomach.
- Begin to massage gently around the affected joint. If you have an assistant, ask them to stroke your back for 7-10 minutes from the shoulder blades to the sacrum to improve blood circulation.
- Move on to slowly stroking the lower back, and then a circular warm-up of the sacro-lumbar spine with two fingers.
- Massage the spine with your thumbs, as far as the pose allows, gradually lowering to the lower back.
- Press your palms into the sacro-gluteal region and start rubbing and stretching the muscles. This completes the preparation.
- Rub your thighs with your palms, then massage them well in a circle with your thumbs.
- Knead the inner thigh without pressure (so as not to pinch the blood vessels). Better to grab a fold of fat between your thumb and other fingers and knead it thoroughly.
- Important! Finish with relaxing strokes and pats.
The thigh massage uses transverse, longitudinal, grasping, squeezing movements. Rubbing is performed with different parts of the palm or bent fingers towards the groin area.
After surgical treatment of grade 3 osteoarthritis of the hip joint and removal of stitches, massage is used to rehabilitate and restore motor functions.
Treatment of arthrosis of the hip joint with a diet
The main principle of nutrition in the treatment of arthrosis of the hip joint is its diversity and balance in terms of the main indicators (vitamins, minerals, proteins, including essential amino acids). It is important to eat foods high in calcium, sulfur, zinc, magnesium and selenium. Of the vitamins, vitamins A and group B are of primary importance (they give an anti-inflammatory effect), C, D, E. Low-protein diets are contraindicated in the treatment of osteoarthritis of the hip joint. Therefore, be sure to include in the menu:
- Diet meat, poultry, fish.
- Milk and dairy products.
- Fruits, vegetables and fresh herbs.
- Whole grains and oilseeds (such as flax) and nuts.
- Dishes and products with natural chondroprotectors (jellies, jellies, cartilage, pork legs, ears, etc. ).
But it is better to reduce the consumption of carbohydrates - after all, even a small excess weight creates a colossal load on the sore joint. It is not for nothing that rehabilitation therapists joke that losing a couple of kilos is the most effective treatment for arthrosis of the hip joint. You also need to exclude salty, spicy, sweet and fried foods, due to which the body retains water. Minimize consumption:
- fast food and convenience foods;
- baked goods, sweets and pastries;
- sausages and pickles.
Remember to drink at least 2. 5 liters of water a day!
Medication for arthrosis of the hip joint
Treatment of osteoarthritis of the hip joint with drugs is carried out strictly according to the doctor's prescription. In case of exacerbation and severe pain, it is allowed to take conventional analgesics or sparing anti-inflammatory (ibuprofen) drugs, but no more than 10 days before contacting a specialist. Otherwise, the picture of the disease will be blurred and it will be difficult for the doctor to find an adequate treatment for arthrosis of the hip joint.
There are several drug groups of drugs for the treatment of arthrosis of the hip joint. In the complex treatment of arthrosis of the hip joint with drugs, 5 main pharmaceutical groups are used.
Anti-inflammatory drugs in the treatment of osteoarthritis of the hip joint
Edema, stagnation of blood and other fluids, a local increase in temperature and pain - these common symptoms of inflammation in arthrosis not only poison the patient's life, but also aggravate the course of the disease. Over time, they lead to tissue starvation, depletion of synovial fluid that "feeds" the cartilage and a violation of its viscosity (due to which friction destroys the surface of the articular membrane! ), Muscular dystrophy and persistent deterioration of mobility.
But the main danger of inflammation is the death of cartilage cells - chondrocytes. When decomposed in large quantities, they create accumulations of enzymes that "eat away" the surface of the articular cartilage.
Therefore, to relieve inflammatory symptoms and restore tissue metabolism, 2 groups of anti-inflammatory drugs are used: non-steroidal (NSAIDs, NSAIDs) and glucocorticosteroids.
NSAIDs are considered to be more gentle, although they can affect the digestive system. Therefore, they are prescribed in the first place. In the treatment of arthrosis of the hip joint of the 2nd degree - in courses or as needed.
These include: Nimesulide, Ibuprofen, Meloxicam, Ketoprofen, Indomethacin, Diclofenac.
If NSAIDs fail, rheumatologists prescribe "heavy artillery" - corticosteroids. They urgently relieve even severe pain and inflammation, but they cannot be taken for a long time and in high dosages. Like any hormonal drugs, they can affect the weight and condition of internal organs, and if the therapeutic dose is exceeded, they can aggravate the course of arthrosis.
The drugs of choice in the treatment of grade 3 hip arthrosis are: Hydrocortisone, Prednisolone, Methylprednisolone.
Chondroprotectors for osteoarthritis of the hip joint
Although anti-inflammatory drugs relieve symptoms, they do not solve the problem - they do not repair the damaged surface of the cartilage and do not enrich the synovial fluid with glycosaminoglycans. Therefore, effective treatment of arthrosis of the hip joint is unthinkable without the drugs chondroitin and glucosamine sulfate, which supply the body with building material for the formation of new cartilage cells.
Since the metabolism in the cartilaginous tissue is very slow, chondroprotectors need to be taken for a long time - 3-6 months annually. But, with a lifelong prophylactic admission, they help to reach a drug-free remission.
Chondroprotectors include: Glucosamine, Chondroitin.
Angioprotectors and microcirculation correctors
Inflammation and microtrauma that accompany arthrosis disrupt the blood supply around the affected joint. But it is the capillaries that bring nutrients to the borders of the joint capsule.
Help relieve edema and improve tissue trophism: Troxerutin, horse chestnut extract, Diosmin in combination with other drugs, Pentoxifylline.
When the supporting function of the joint is impaired, the body tries to compensate for it at the expense of muscles and ligaments, which are not designed for such an almost continuous load. Due to chronic overstrain in the muscles, pain and spasms appear. These cramps can interfere with sleep or walking.
To eliminate them, in the treatment of osteoarthritis of the hip joint, they are prescribed: Baclofen, Tizanidine, Tolperisone.
External and warming agents
Drugs in this group have a vasodilating effect. They help relieve swelling, relieve pain, and psychologically distract yourself from joint discomfort.
Usually, for the treatment of arthrosis of the hip joint, agents based on animal poisons or burning plant extracts are used.
Form of release of drugs for the treatment of arthrosis of the hip joint
Depending on the clinical manifestations of arthrosis and the patient's lifestyle, the rheumatologist prescribes drugs for the treatment of osteoarthritis of the hip joint in various forms.
Tablets, capsules, powders
These hip arthrosis treatments are easy to dose and take with you. All you need to take is a glass of water. Also, a blister or packaging allows you to track how many days the course has already lasted. Such drugs are distinguished by good bioavailability. But anti-inflammatory tablets can have a negative effect on the mucous membranes of the stomach and intestines - with gastritis, ulcers, colitis, for the treatment of osteoarthritis of the hip joint, it is better to prefer injections.
Intramuscular and intraarticular injection
In the form of injections, anti-inflammatory drugs, muscle relaxants and chondroprotectors are usually administered. This guarantees maximum bioavailability, spares the gastric mucosa, but usually requires the presence of a healthcare professional. Intra-articular injections without special qualifications are strictly prohibited!
Ointments, gels and creams
External agents for the treatment of arthrosis of the hip joint have a low bioavailability (about 5%), which limits their use in therapy with an auxiliary role. But there are much fewer contraindications to their use.
Less common are liquid preparations for the treatment of arthrosis of the hip joint - in the form of balms, solutions for compresses.