Hip arthrosis is the most common type of arthrosis.Since the hip joint (HJ) is larger than all others and has multiple vector axes of rotation, it experiences enormous loads throughout a person's life - during walking, running, jumping, climbing stairs, sports and daily activities.
Often, patients at the age of 25-35 have to think about the symptoms and treatment of arthrosis of the hip joint.The disease can progress rapidly under the influence of trauma, decompensated physical activity (failure to perform sports exercises, "standing on your feet", overweight), hereditary factors, infectious and chronic diseases.
However, effective treatment for osteoarthritis of the hip can preserve mobility and prevent bone breakdown.In old age, it helps prevent even more dangerous pathologies – such as necrosis or fracture of the femoral head.
Symptoms of arthrosis of the hip joint
Symptoms and treatment of hip arthrosis depend on the stage of the disease.
- Stage 1. Patients feel a slight pain in the groin area, which appears after physical exertion, long standing or sudden movements in the joint, and then disappears completely at rest.
- Stage 2. The pain syndrome intensifies and bothers the patient even with ordinary household activities.The pain may radiate to the lower back or inner thigh.Stiffness and cramping appear, and the range of motion in the joint decreases.The musculo-ligamentous system begins to weaken, which leads to increased fatigue.
- Stage 3. Pain is felt constantly and patients find it difficult to move without crutches or walkers.Movement in the joint is severely limited.Climbing stairs is a serious challenge.There is a walking disorder (lameness, falling on one or both legs).With one-sided coxarthrosis, distortion of the pelvis and curvature of the spine are visible to the naked eye.
- Stage 4. The joint space closes due to the proliferation of osteophytes and any movement in the joint is almost impossible.It loses its functions and is severely deformed due to bone destruction.
Prognosis of hip joint arthrosis
In the case of successful continuous treatment, the pain due to arthrosis of the hip joint may be completely absent or rarely bother the patient.The prospects of this therapy depend on the patient's adherence to the rheumatologist's rules and his personal self-discipline.Please note that the most accurate prognosis of the disease can be made only 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 hip arthrosis is started at stage 1 or 2, hip replacement can be avoided.Disability and loss of working capacity, if the doctor's recommendations are followed, will be postponed by 20 years, and sometimes the patient will maintain an almost unlimited range of motion in the joint until old age.The best forecast is possible with the so-calledBenign arthrosis - when cartilage wear depends on external factors (professional activity, sanitary violations).In this case, it is worth excluding them and undergoing a course of restorative therapy to slow down further degeneration of the joint.
Timely surgical treatment of grade 3 osteoarthritis of the hip joint will help prevent immobility of the joint, consequences for the entire musculoskeletal system and many years of pain.In the absence of contraindications, prosthetics will help you return to your former activities.
in self-medication
When choosing a treatment method for arthrosis of the hip joint, the doctor takes into account the patient's age, constitution, physical fitness, health, specific symptoms of the disease and its stage.In this case, 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 were studied.
Self-treatment of osteoarthritis of the hip joint with traditional methods does not take into account these individual indicators, and instead of the desired result, it can lead to severe exacerbations, metabolic disorders and worsening of the disease stage.But the worst thing is the time spent on the illusion that such a serious chronic disease as arthrosis of the hip joint can be cured only by traditional methods.Avoid taking anti-inflammatory drugs without a doctor's prescription - this can cause serious problems with the digestive and endocrine systems!
No treatment
Without treatment, arthrosis of the hip joint progresses on average 2-4 times faster.Deterioration of the quality of life and the onset of disability in this case is possible already at a relatively young age - around the age of 45-50 years.Patients' sleep worsens, physical activity decreases, psycho-emotional disorders are observed.Pain prevents them from getting out of bed in the morning, walking with their grandchildren or going to work.
Treatment of osteoarthritis of the hip joint
Outpatient conservative therapy is the priority direction in the treatment of arthrosis of the 1st degree of the hip joint.It includes medical treatment of arthrosis of the hip joint, physical therapy, diet therapy, bandage and wearing adjustable orthoses.This approach allows you to relieve pain, maintain muscle function and increase mobility in the joint.Treatment of 2nd degree arthrosis of the hip joint is carried out in the same way.
If conservative treatment of arthrosis of the hip joint is delayed or ineffective, cartilage degeneration progresses rapidly and surgery is performed.Sometimes the doctor may decide on osteotomy or arthrodesis, but in most cases, in the treatment of arthrosis of the 3rd degree of the hip joint, endoprosthesis is prescribed - partial or complete replacement of the diseased joint.Dentures made of metal and a ceramic or polymer liner last 15 to 25 years, after which they need 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 minimal incision of up to 8 cm and walking with support for a day.Full rehabilitation lasts 1-3 months.
Physiotherapy methods for the treatment of hip joint arthrosis
Physiotherapy for arthrosis of the hip joint is carried out in courses, according to the doctor's instructions.Almost all techniques, except for magnetic and cryotherapy, are allowed only in the period of remission, in the complete absence of inflammatory symptoms.The following measures are used to treat osteoarthritis of the hip joint:
- ultra high frequency therapy;
- ultrasound therapy;
- laser therapy;
- magnetic therapy;
- therapeutic exercises (therapeutic gymnastics);
- therapeutic massage and manual therapy;
- ozone therapy;
- cryotherapy;
- acupuncture;
- traction therapy (traction);
- Paraffin applications and wraps;
- Balneotherapy and mud therapy;
- Hydromassage.
Treatment of arthrosis of the hip joint with exercise therapy
Physical therapy for arthrosis of the hip joint is aimed at strengthening muscles and ligaments - they are natural orthoses that reduce the load on the joint and keep it in a physiologically correct position.As a result, treatment of osteoarthritis of the hip joint with exercises helps to relieve pain and inflammation, improves mobility, slows cartilage wear and ensures the supply of nutrients to the synovial fluid.The following exercises will help you strengthen your legs:
- Starting position - sitting on the floor, focus on the outstretched arms behind you.legs straight in front of you.We bend and straighten the toes.
- The starting position is the same.Alternately bend and straighten your legs (toes toward you, toes away from you).
- The starting position is the same.Bend the leg at the knee, pull it towards you along the mat or with a weight.After completing the movement, it is desirable to touch the floor only with the toe.
- Starting position - lying on your back, legs bent at the knees, feet on the floor.We do the "frog" exercise - we hold the bent knees with an apple and hold them for 20 seconds.Then we collect again together.
- Starting position - lie on your back, one leg straight, the other bent and lying on the side.We lie like this for a minute, then we switch legs.
- Starting position - lying on the back, legs straight, lying freely.We touch the socks from the inside and then separate them separately.Repeat at pace 10 times.
- Starting position - lie on your back, one leg (on the side of the affected joint) is crossed over the other.We move the leg of the lower leg, as in the above exercise.
- Starting position - lying on the back.We pull the knee towards the stomach, we hold the back of the thigh with stretched fingers.Do 30 seconds on each leg.
- The starting position is the same.We move the legs bent at the knees towards the stomach and hold them with the fingers under the knees.Perform at least 30 seconds.
- The starting position is the same.We raise the straightened leg above the floor.20-30 times on each leg.
- Starting position - standing.Place the chair on its side with its back towards you.Hold the back of the chair and stand on one leg, swing the other back and forth like a pendulum.20-30 times.
Massage for the treatment of osteoarthritis of the hip joint
Massage is an effective relaxation and restorative technique for the treatment of early stage arthrosis of the hip joint.As a treatment for arthrosis of the hip joint of the first degree (as well as the 2nd - in the absence of pain and swelling), it can prolong remission, relieve discomfort and pain without drugs, improve tissue trophism and slow down cartilage degeneration.It also eliminates spasms that prevent sleep and movement, strengthens ligaments, normalizes walking and allows you to quickly warm up when transitioning from rest to active activity and vice versa.
Professional therapeutic massage (at least 10-12 sessions) is recommended for arthrosis of the hip joint.But gentle self-massage at home also helps to improve the condition.It is important to avoid pain and severe discomfort.At the slightest sign of inflammation in the joint, 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 to do it right?
- To begin with, get into a comfortable position that will allow you to release stress on your hips and back.For example, lying on your back, side or stomach.
- Begin by gently massaging around the affected joint.If you have a helper, have them rub your back from your shoulder blades to your sacrum for 7-10 minutes to improve circulation.
- Continue stroking the lower back slowly, then warm in circular motions with two fingers.
- Massage the spine with your fingers as far as the pose allows, gradually moving into the lower back.
- Press your palms into the sacro-flat area and begin to rub and stretch the muscles.This completes the preparation.
- Massage your thighs with your palms and then massage well in circular motions with your fingers.
- Massage the inner part of the thigh without pressure (so as not to stretch the blood vessels).It is better to hold the fold of fat between your thumb and other fingers and massage it well.
- Important!Finish the procedure with soothing strokes and palms.
When massaging the thigh, transverse, longitudinal, squeezing, tight movements are used.Rubbing is performed with different parts of the palm or bent fingers in the groin area.
After surgical treatment and suture removal of grade 3 osteoarthritis of the hip joint, massage is used to rehabilitate and restore motor function.
Treatment of arthrosis of the hip joint with diet
The main principle of nutrition for the treatment of arthrosis of the hip joint is its diversity and balance in the main indicators (vitamins, minerals, proteins, including essential amino acids).It is important to eat foods containing calcium, sulfur, zinc, magnesium and selenium.Among vitamins, vitamins of group A and B (provide anti-inflammatory effect), C, D, E first of all.A low-protein diet is contraindicated in the treatment of osteoarthritis of the hip joint.Therefore, be sure to enter in the menu:
- Dietary meat, poultry, fish.
- eggs.
- Milk and milk products.
- Fruits, vegetables and fresh herbs.
- Whole grains and oilseeds (such as flax), as well as nuts.
- Dishes and products with natural chondroprotectors (jelly, jelly, cartilage, pig's feet, ears, etc.).
But it is better to reduce the consumption of carbohydrates - after all, even a slight excess weight creates a colossal load on the painful joint.It is not for nothing that rehabilitation experts joke that losing a few kilograms is the most effective treatment for osteoarthritis of the hip joint.You should also avoid salty, spicy, sweet and fried foods that cause water retention in the body.Reduce your intake of:
- fast food and semi-finished products;
- baked goods, sweets and confectionery;
- Sausages and marinades.
Don't forget to drink at least 2.5 liters of water a day!
Medical treatment of arthrosis of the hip joint
Osteoarthritis of the hip joint is treated with drugs strictly according to the doctor's prescription.In case of exacerbation and severe pain, it is permissible to take ordinary analgesics or mild anti-inflammatory drugs (ibuprofen), but not more than 10 days before contacting a specialist.Otherwise, the picture of the disease will be vague and it will be difficult for the doctor to choose an adequate treatment for arthrosis of the hip joint.
There are several drug groups 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 for the treatment of osteoarthritis of the hip joint
Swelling, stagnation of blood and other fluids, local fever 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, a decrease in synovial fluid that "nourishes" the cartilage, and a violation of its viscosity (because of which friction destroys the surface of the articular membrane!), muscular dystrophy and permanent deterioration of mobility.
But the main danger of inflammation is the death of cartilage cells - chondrocytes.When they break down in large quantities, they form an accumulation of enzymes that "eat" the surface of the articular cartilage.
Therefore, 2 groups of anti-inflammatory drugs are used to relieve inflammatory symptoms and restore tissue metabolism: non-steroidal (non-steroidal anti-inflammatory drugs, non-steroidal anti-inflammatory drugs) and glucocorticosteroids.
NSAIDs are considered gentler, but they can also affect the digestive system.That is why they are engaged in the first place.In the treatment of arthrosis of the 2nd degree of the hip joint - in courses or as needed.
These are: nimesulide, ibuprofen, meloxicam, ketoprofen, indomethacin, diclofenac.
If non-steroidal anti-inflammatory drugs fail, rheumatologists prescribe "heavy artillery" - corticosteroid drugs.They immediately relieve even severe pain and inflammation, but they cannot be taken for a long time and in large doses.Like any hormonal drugs, they can affect the weight and condition of internal organs, and in case of exceeding the therapeutic dose, they can worsen the course of arthrosis.
Drugs selected for the treatment of 3rd degree arthrosis of the hip joint are: hydrocortisone, prednisolone, methylprednisolone.
Chondroprotectors for osteoarthritis of the hip joint
Although anti-inflammatory drugs relieve the symptoms, they do not solve the problem - they do not restore 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 cartilage tissue is very slow, it is necessary to take chondroprotectors for a long time - 3-6 months every year.But, with continuous preventive use, they help to achieve remission without drugs.
Chondroprotectors include: glucosamine, chondroitin.
Angioprotectors and microcirculation correctors
Inflammation and microtraumas accompanying arthrosis disrupt the blood supply around the affected joint.But it is the capillaries that bring nutrients to the border of the joint capsule.
Helps to remove swelling and improve tissue trophism: troxerutin, horse chestnut extract, diosmin with other drugs, pentoxifylline.
Muscle relaxants
When the supporting function of the joint is disturbed, the body tries to compensate it by using muscles and ligaments that are not designed for such almost continuous loading.Due to chronic overload, pain and spasm appear in the muscles.These spasms can interfere with sleeping or walking.
To eliminate them, the following are prescribed for the treatment of osteoarthritis of the hip joint: baclofen, tizanidine, tolperisone.
External and heating agents
Drugs of this group have a vasodilating effect.They help with swelling, reduce pain and psychologically distract from joint discomfort.
Usually, products based on animal poisons or sharp plant extracts are used to treat arthrosis of the hip joint.
Drug release form 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 different ways.
Tablets, capsules, powders
These products for the treatment of osteoarthritis of the hip joint are easy to dose and take with you.All you need is a glass of water.Also, the blister or packaging allows you to track how many days the course lasted.Such drugs have good bioavailability.But anti-inflammatory tablets can have a negative effect on the mucous membranes of the stomach and intestines - in gastritis, ulcers, colitis, it is better to give preference to injections for the treatment of osteoarthritis of the hip joint.
Injections for intramuscular and intra-articular administration
Anti-inflammatory drugs, muscle relaxants and chondroprotectors are usually prescribed by injection.This ensures maximum bioavailability and is gentle on the stomach lining, but usually requires the presence of a medical professional.It is strictly forbidden to make intra-articular injections without special qualifications!
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 to an auxiliary role in therapy.But there are much less contraindications to their use.
Liquid preparations for the treatment of arthrosis of the hip joint are less common - in the form of balms, solutions of compresses.