Arthrosis of the hip joint is the most common type of arthrosis.Since the hip joint (HJ) is larger than all others and has a multi-vector axis of rotation, it experiences enormous loads throughout a person's life - when walking, running, jumping, climbing stairs, playing sports and everyday activities.
Often, patients 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 under the influence of injuries, decompensated physical activity (non-compliance with the technique of performing sports exercises, "standing" work, excess weight), hereditary factors, infectious and chronic diseases.
Effective treatment of hip osteoarthritis, however, can preserve mobility and prevent bone breakdown.In old age, it helps to avoid 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 occurs after physical activity, prolonged standing or sudden movements in the joint, and then disappears completely at rest.
- Stage 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 in the joint is reduced.The muscle-ligament system begins to weaken, which causes increased fatigue.
- Stage 3. Pain is felt constantly, and patients find it difficult to move without a cane or walker.Movements in the joint are very limited.Climbing stairs is a serious challenge.There are disturbances in walking (lameness, falling on one or both legs).In unilateral coxarthrosis, the distortion of the pelvis and the 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 becomes severely deformed due to bone destruction.
Prognosis for arthrosis of the hip joint
With successful lifelong treatment, pain due to arthrosis of the hip joint can be completely absent or rarely bother the patient.The prospects for this therapy depend on whether the patient adheres to the rheumatologist's rules and his personal self-discipline.Keep in mind that only a doctor can give the most accurate prognosis for a disease.
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 in stage 1 or 2, hip replacement can be avoided.Disability and loss of working ability, if the doctor's recommendations are followed, is delayed by 20 years, and sometimes the patient retains an almost unlimited range of motion in the joint until old age.The best prognosis is possible with the so-calledbenign arthrosis - when wear and tear of cartilage depends on external factors (professional activity, sanitary violations).In this case, it is worth excluding them and undergoing a course of restorative therapy in order to slow down further degeneration of the joint.
Timely surgical treatment of osteoarthritis of the hip joint of the 3rd degree will help to avoid immobility of the joint, consequences for the entire musculoskeletal system and long-term pain.In the absence of contraindications, prosthetics will help you return to your previous activity.
During self-treatment
When choosing a treatment method for arthrosis of the hip joint, the doctor takes into account the age, constitution, physical fitness of the patient, his state of 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 the synovial fluid and other indicators are examined.
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, can lead to serious deterioration, metabolic disorders and deterioration of the stage of the disease.But the worst part 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!
There is no treatment
If left untreated, osteoarthritis of the hip joint progresses 2-4 times faster on average.Deterioration of the quality of life and the onset of disability in this case is already possible at a relatively young age - around 45-50 years.Patients' sleep worsens, physical activity decreases, and psychoemotional 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 priority line of treatment for stage 1 hip arthrosis is outpatient conservative therapy.It includes medication therapy for hip joint arthrosis, physiotherapy, diet therapy, wearing bandages and adjustable orthoses.This approach allows you to relieve pain, maintain muscle function and increase joint mobility.Treatment of hip joint arthrosis of the 2nd degree is carried out in a similar way.
If the conservative treatment of arthrosis of the hip joint is delayed or ineffective, cartilage degeneration progresses rapidly, and a surgical procedure is performed.Occasionally, the doctor may decide on osteotomy or arthrodesis, but in most cases, in the treatment of stage 3 hip arthrosis, endoprosthetics are prescribed - partial or complete replacement of the diseased joint.A prosthesis made of metal and ceramic or polymer coating 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 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.Almost all techniques, except 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;
- ozonotherapy;
- cryotherapy;
- acupuncture;
- traction therapy;
- paraffin applications and dressings;
- balneotherapy and mud therapy;
- hydromassage.
Treatment of arthrosis of the hip joint with exercise
Physical therapy for arthrosis of the hip joint is aimed at strengthening 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, treating osteoarthritis of the hip joint with exercises helps to relieve pain and inflammation, improves mobility, slows cartilage wear and ensures the supply of synovial fluid nutrients.The following exercises will help you strengthen your legs:
- Starting position - sitting on the floor, focusing on the outstretched arms behind you.Legs straight ahead.We bend and straighten the toes.
- The starting position is the same.Alternately bend and straighten your feet (toes towards you, toes away from you).
- The starting position is the same.Bend the leg at the knee, pulling it towards you along the mat or on the weight.It is recommended to touch the floor only with the toe after the movement is finished.
- Starting position - lying on your back, legs bent at the knees, feet on the floor.We do the "frog" exercise - spread our bent knees and hold them for 20 seconds.Then we put it back together.
- Starting position - lying on your back, one leg straight, the other bent and laid to the side.We lie like this for a minute and then change our legs.
- Starting position - lying on your back, legs straight, lying freely.We bring the socks inward, touching them, and then spread them.Repeat at pace 10 times.
- Starting position - lying on your back, one leg (on 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.We pull the knee towards the stomach, holding the back of the thigh with joined fingers.Perform 30 seconds on each leg.
- The starting position is the same.We pull the legs bent at the knees towards the stomach and hold them under the knees with joined fingers.Perform 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 each leg.
- Starting position - standing.Place a chair on its side, with its back facing you.Holding the back of the 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 relaxing and restorative technique for treating arthrosis of the hip joint in the early stages.As a treatment for hip joint arthrosis of the 1st 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 interfere with sleep and movement, strengthens ligaments, normalizes gait and allows you to warm up quickly when transitioning from rest to active activity and vice versa.
Professional therapeutic massage (at least 10-12 sessions) is recommended for hip joint arthrosis.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, the manipulations are temporarily stopped - they can be continued with the permission of the doctor, after a course of anti-inflammatory therapy.
Even in cases where the patient suffers from unilateral coxarthrosis, the massage is performed on both sides.How to do it right?
- To begin with, take a comfortable position that will allow you to relieve stress on your hips and lower back.For example, lying on your back, side or stomach.
- Start gently massaging the area around the affected joint.If you have a helper, ask them to rub your back for 7-10 minutes from the shoulder blades to the sacrum to improve blood circulation.
- Continue with slow stroking of the lower back and then circular heating of the sacrolumbar region with two fingers.
- Massage the spine with your thumbs, as far as the pose allows, gradually going down towards the lower back.
- Press your palms into the sacrogluteal area and begin to rub and stretch the muscles.This is the end of the preparation.
- Rub your thighs with your palms, then massage them well in a circular motion with your thumbs.
- Knead the inside of the thigh without applying pressure (so as not to squeeze the blood vessels).It is better to grasp the fat fold between the thumb and other fingers and knead it well.
- Important!Finish the procedure with relaxing strokes and pats.
In thigh massage, transverse, longitudinal, grasping, squeezing movements are used.Rubbing is performed with different parts of the palm or bent fingers towards the groin 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 its diversity and balance in key indicators (vitamins, minerals, proteins, including essential amino acids).It is important to eat foods rich in calcium, sulfur, zinc, magnesium and selenium.Vitamins of primary importance are vitamins A and group B (provide 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:
- 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.
- Foods and products with natural chondroprotectors (jellies, jellies, cartilage, pork leg, 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 painful joint.It's not for nothing that rehabilitation experts joke that losing a few pounds is the most effective treatment for osteoarthritis of the hip joint.You must also exclude salty, spicy, sweet and fried foods, which cause the body to retain water.Minimize input:
- fast food and semi-finished products;
- bakery products, sweets and confectionery;
- sausages and marinades.
Don't forget to drink at least 2.5 liters of water a day!
Treatment of arthrosis of the hip joint with drugs
Treatment of osteoarthritis of the hip joint with drugs is carried out strictly according to the doctor's recommendation.In case of worsening and severe pain, it is allowed to take conventional 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 blurred and it will be difficult for the doctor to choose an adequate treatment for arthrosis of the hip joint.
There are several medical 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
Swelling, stagnation of blood and other fluids, local temperature and pain - these common symptoms of inflammation in arthrosis not only poison the patient's life, but also worsen the course of the disease.Over time, they lead to tissue starvation, depletion of synovial fluid, which "nourishes" the cartilage and disruption of its viscosity (because of which friction destroys the surface of the articular membrane!), muscle dystrophy and permanent deterioration of mobility.
But the main danger of inflammation is the death of cartilage cells - chondrocytes.When they are broken down in large quantities, they create 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 (NSAIDs) and glucocorticosteroids.
NSAIDs are considered milder, although they can also affect the digestive system.That's why they were installed first.In the treatment of hip joint arthrosis of the 2nd degree - on courses or as needed.
These include: nimesulide, ibuprofen, meloxicam, ketoprofen, indomethacin, diclofenac.
If NSAIDs 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 all hormonal drugs, they can affect the weight and condition of internal organs, and by exceeding the therapeutic dose, they can worsen the course of arthrosis.
The drugs of choice for the treatment of grade III hip arthrosis 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 cartilage surface 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 creation 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 remission without medication.
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 the nutrients to the borders of the joint capsule.
The following help to reduce swelling and improve tissue trophism: troxerutin, horse chestnut extract, diosmin in combination with other drugs, pentoxifylline.
Muscle relaxants
When the supporting function of the joint is disturbed, the body tries to compensate with muscles and ligaments that are not designed for such an almost continuous load.Due to chronic overexertion, pain and spasms occur in the muscles.These spasms can interfere with sleep or walking.
To remove them, in the treatment of osteoarthritis of the hip joint, the following are prescribed: Baclofen, Tizanidine, Tolperisone.
External means and heating means
Medicines of this group have a vasodilating effect.They help relieve swelling, reduce pain and psychologically prevent discomfort in the joints.
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 forms.
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 to drink is a glass of water.Also, 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 - for 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 use
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 give intra-articular injections without special qualifications!
Ointments, gels and creams
External means for the treatment of arthrosis of the hip joint have low bioavailability (about 5%), which limits their use in therapy to an auxiliary role.But there are much fewer contraindications for their use.
Less common are liquid preparations for the treatment of arthrosis of the hip joint - in the form of balms, solutions for dressings.