Arthrosis of the hip joint is the most common type of arthrosis.Because the hip joint (HJ) is larger than all others and has a multi-vector axis of rotation, it is subjected to enormous loads throughout a person's life - walking, running, jumping, climbing stairs, playing sports and doing everyday activities.
Patients often have to worry about the symptoms and treatment of arthrosis of the hip joint already at the age of 25-35.The disease can progress rapidly as a result of injury, decompensated physical activity (failure to perform sports exercises, "standing" work, overweight), hereditary factors, infectious and chronic diseases.
However, effective treatment of hip osteoarthritis can preserve mobility and prevent bone breakdown.In old age, it helps to avoid even more dangerous pathologies - for example, 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.
- Section 1.Patients feel mild pain in the groin area, which appears after physical activity, prolonged standing or sudden joint movements, and then disappears completely at rest.
- Section 2.The pain syndrome intensifies and disturbs the patient even during normal household activities.The pain may radiate to the lower back or inner thigh.Stiffness and creaking appear, and the range of motion of the joint decreases.The muscle-ligament system begins to weaken, which causes increased fatigue.
- Section 3.The pain is constant and patients find it difficult to move without a cane or walker.Movement in the joint is severely limited.Climbing stairs is a serious challenge.There are gait disturbances (lameness, falling on one or both legs).In the case of unilateral coxarthrosis, the distortion of the pelvis and the curvature of the spine can be seen with the naked eye.
- Section 4.The joint gap closes due to the growth 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 arthrosis of the hip joint
In the case of successful lifelong treatment, the pain resulting from arthrosis of the hip joint may be completely absent or only rarely bother the patient.The outlook for this therapy depends on the patient's compliance with the rheumatologist's rules and personal self-discipline.Please note that only the attending physician can make the most accurate prognosis of the disease.
With timely and regular treatment
If chronic diseases do not contribute to the progression of the disease, and the treatment of hip arthrosis has begun in stage 1 or 2, hip replacement can be avoided.Disability and loss of work ability, if the doctor's recommendations are followed, are postponed by 20 years, and sometimes the patient has almost unlimited range of motion in the joint until old age.The best prognosis is the so-calledbenign arthrosis - when cartilage wear depends on external factors (professional activity, health violations).In this case, it is worth excluding them and performing restorative therapy to slow down further degeneration of the joint.
Timely surgical treatment of stage 3 osteoarthritis of the hip joint helps to avoid immobility of the joints, consequences for the entire musculoskeletal system and many years of pain.In the absence of contraindications, prosthetics will help you return to your previous activities.
When self-medicating
When choosing a treatment method for arthrosis of the hip joint, the doctor takes into account the patient's age, constitution, physical fitness, health status, specific symptoms and stage of the disease.In this case, they examine 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.
Self-treatment of arthrosis 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 serious aggravation, metabolic disorders and worsening of the stage of the disease.But the worst thing is the time spent with the illusion that such a serious chronic disease as hip arthrosis can only be cured by traditional methods.Avoid taking anti-inflammatory drugs without a doctor's prescription - this can cause serious problems in the digestive system and endocrine system!
There is no treatment
Without treatment, arthrosis of the hip joint develops 2-4 times faster on average.Deterioration of the quality of life and the development of disability in this case are already possible at a relatively young age - around 45-50 years old.Patients' sleep deteriorates, physical activity decreases, psycho-emotional disorders are observed.The 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
The primary treatment for grade 1 arthrosis of the hip joint is outpatient conservative therapy.It includes drug treatment of hip arthrosis, physiotherapy, diet therapy, wearing bandages and adjustable orthoses.This approach makes it possible to relieve pain, maintain muscle function and increase the mobility of the joint.The treatment of grade 2 arthrosis of the hip joint is carried out similarly.
If conservative treatment of arthrosis of the hip joint is delayed or ineffective, cartilage degeneration progresses rapidly and surgery is performed.In some cases, the doctor may decide on osteotomy or arthrodesis, but in most cases, when treating grade 3 arthrosis of the hip joint, endoprosthesis is prescribed - partial or complete replacement of the diseased joint.A prosthesis made of metal and ceramic or polymer lining lasts 15-25 years, after which it needs to be replaced.The most effective treatment for hip arthrosis is total arthroplasty (total joint replacement).It allows you to fully restore your functionality with a minimal incision of up to 8 cm and the ability to walk with support within a day.Complete rehabilitation takes 1-3 months.
Physiotherapy methods for the treatment of arthrosis of the hip joint
Physiotherapy for arthrosis of the hip joint is carried out in courses, according to the indications of the doctor.With the exception of magnetic and cryotherapy, almost all techniques are allowed only during 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;
- magnet 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
Physiotherapy 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 result, the treatment of osteoarthritis of the hip joint with exercises helps relieve pain and inflammation, improves mobility, slows cartilage wear and ensures the supply of nutrients to the synovial fluid.The following exercises will help strengthen your legs:
- Starting position - sitting on the floor, focusing on the outstretched arms behind you.Feet straight in front of you.We bend and straighten our 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 your legs at the knees, pull them towards you along the mat or with weights.After finishing the movement, it is advisable to touch the floor only with your toes.
- Starting position - lying on your back, legs bent at the knees, feet on the floor.We perform the "frog" exercise - spread our bent knees and hold for 20 seconds.Then we put it back together.
- Starting position - lying on your back, one leg straight, the other bent and lying on the side.We lie like this for a minute, then switch legs.
- Starting position - lying on your back, straight legs, lying freely.We bring the socks inside, touch them, then spread them out.Repeat 10 times on the beat.
- Starting position - lying on your back, one leg (from the side of the affected joint) crossed over the other.We move the foot of the lower leg as in the exercise above.
- Starting position - lying on your back.Pull the knee towards the stomach, holding the back of the thigh with clasped fingers.Do for 30 seconds on each leg.
- The starting position is the same.We pull our legs bent at the knees towards the stomach and hold them under the knees with the fingers clasped together.Do for at least 30 seconds.
- The starting position is the same.We move the straightened leg to the side above the floor.20-30 times on both legs.
- Starting position - standing position.Place a chair on its side with its back facing you.Holding 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 hip arthrosis in the early stages.As a treatment for 1st degree (as well as 2nd - in the absence of pain and swelling) arthrosis of the hip joint, it can 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 ligaments, normalizes gait, and allows rapid warming up when switching from rest to active activity and vice versa.
In case of hip arthrosis, a professional therapeutic massage is desirable (at least 10-12 times).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 arthritis, the manipulations are temporarily stopped - with the permission of the attending physician, they can be continued after anti-inflammatory therapy.
Even in cases where the patient suffers from one-sided coxarthrosis, massage is performed on both sides.How to do it right?
- Start by getting into a comfortable position that allows you to relieve stress on your hips and lower back.For example, if you lie on your back, side or stomach.
- Start gently massaging the area around the affected joint.If you have a helper, ask them to stroke your back from the shoulder blades to the sacrum for 7-10 minutes to improve circulation.
- Continue by stroking the lower back slowly, then warming the sacrum region in a circular motion with two fingers.
- Use your thumb to massage the spine as much as the pose allows, gradually moving down to the lower back.
- Press your palms into the sacrogluteal area and begin to rub and stretch the muscles.This completes the preparation.
- Rub your thighs with the palm of your hand, then massage well in circular motions with your thumb.
- Knead the inner thigh without applying pressure (so as not to constrict the blood vessels).It is better to grab the fold of fat between your thumb and other fingers and knead it thoroughly.
- Important!Finish the procedure with relaxing movements and stroking.
During the thigh massage, transverse, longitudinal, gripping and squeezing movements are used.Rubbing is done with different parts of the palm or with fingers bent towards the lumbar area.
After surgical treatment of stage 3 osteoarthritis of the hip joint and removal of sutures, massage is used for rehabilitation and restoration of motor functions.
Treatment of arthrosis of the hip joint with diet
The main principle of nutrition in the treatment of arthrosis of the hip joint is the diversity and balance 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.Among the vitamins, group A and B (have an anti-inflammatory effect), vitamins C, D, and E are of primary importance.A low-protein diet is contraindicated in the treatment of osteoarthritis of the hip joint.Therefore, make sure to include in the menu:
- Dietary meat, poultry, fish.
- Egg.
- Milk and milk products.
- Fruits, vegetables and fresh herbs.
- Whole grains and oilseeds (such as flax) and nuts.
- Foods and products containing natural chondroprotectors (jelly, jelly, cartilage, pork leg, ear, etc.).
But it is better to reduce the consumption of carbohydrates - after all, even a slight excess of weight causes a huge load on the painful joint.It is not for nothing that rehabilitation specialists joke that the most effective treatment for arthrosis of the hip joint is to lose a few kilos.You should also exclude salty, spicy, sweet and fried foods, which cause the body to retain water.Minimize your intake of:
- fast food and semi-finished products;
- baked goods, sweets and confectionery;
- sausages and pickles.
Don't forget to drink at least 2.5 liters of water a day!
Drug treatment of arthrosis of the hip joint
Drug treatment of arthrosis of the hip joint is carried out strictly as prescribed by the doctor.In case of exacerbation and severe pain, it is allowed to take traditional pain relievers or mild anti-inflammatory drugs (ibuprofen), but no more than 10 days before contacting a specialist.Otherwise, the picture of the disease will be unclear, and it will be difficult for the doctor to choose an appropriate treatment for arthrosis of the hip joint.
There are several groups of drugs for the treatment of arthrosis of the hip joint.5 main drug groups are used in the medical treatment of arthrosis of the hip joint.
Anti-inflammatory drugs in the treatment of osteoarthritis of the hip joint
Swelling, stagnation of blood and other fluids, local fever and pain - these common symptoms of inflammation of arthrosis not only poison the patient's life, but also aggravate the course of the disease.Over time, they lead to tissue starvation, the depletion and disruption of the synovial fluid that "nourishes" the cartilage (due to which friction destroys the surface of the joint membrane!), muscle 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 create a build-up of enzymes that "eat away" the surface of the articular cartilage.
Therefore, to relieve inflammatory symptoms and restore tissue metabolism, two groups of anti-inflammatory drugs are used: non-steroidal (NSAIDs, NSAIDs) and glucocorticosteroids.
NSAIDs are considered gentler, although they can also affect the digestive system.That is why they are appointed in the first place.In the treatment of grade 2 arthrosis of the hip joint - in courses or as needed.
These include: Nimesulide, Ibuprofen, Meloxicam, Ketoprofen, Indomethacin, Diclofenac.
If NSAIDs are unsuccessful, 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 all 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 chosen for the treatment of grade 3 arthrosis of the hip joint are the following: hydrocortisone, prednisolone, methylprednisolone.
Chondroprotectors for arthrosis 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 chondroitin and glucosamine sulfate drugs, which provide the body with building material for the formation of new cartilage cells.
Since the metabolism in cartilage tissue is very slow, chondroprotectors must be taken for a long time - 3-6 months a year.But with lifelong preventive use, they help achieve drug-free remission.
Chondroprotectors are: glucosamine, chondroitin.
Angioprotectors and microcirculation correctors
The inflammations and microtraumas accompanying arthrosis disrupt the blood supply around the affected joint.But the capillaries bring the nutrients to the border of the joint capsule.
The following help to relieve swelling and improve tissue trophism: Troxerutin, horse chestnut extract, Diosmin in combination with other drugs, Pentoxifylline.
Muscle relaxants
If the supporting function of the joint is damaged, the body tries to compensate with muscles and ligaments that are not suitable for such almost continuous load.Chronic overuse causes pain and spasms in the muscles.These spasms can interfere with sleeping or walking.
To eliminate these, the following are prescribed in the treatment of osteoarthritis of the hip joint: Baclofen, Tizanidine, Tolperisone.
External and warming agents
Medicines belonging to this group have a vasodilating effect.They help reduce swelling, reduce pain and psychologically distract from joint discomfort.
Usually, products based on animal venoms or pungent plant extracts are used to treat arthrosis of the hip joint.
Release form 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 various forms of osteoarthritis of the hip joint.
Tablets, capsules, powders
These products for the treatment of hip arthrosis are easy to administer and take with you.Just drink a glass of water.In addition, the blister or packaging allows you to track how many days the course has already lasted.Such drugs have good bioavailability.But anti-inflammatory tablets can have a negative effect on the mucous membrane of the stomach and intestines - in case of gastritis, ulcer, 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 given by injection.This guarantees maximum bioavailability and is gentle on the gastric mucosa, 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
The bioavailability of external agents for the treatment of arthrosis of the hip joint is low (about 5%), which limits their use in therapy to an auxiliary role only.But there are much fewer contraindications to their use.
Liquid preparations for the treatment of arthrosis of the hip joint are less common - in the form of balms, poultice solutions.