Osteoarthritis 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 a huge load throughout a person's life - when walking, running, jumping, climbing stairs, playing sports and daily activities.
Often, patients have to worry about the symptoms and treatment of arthrosis of the hip joint already at the age of 25-35 years.The disease can rapidly progress under the influence of injury, decompensated physical activity (non-compliance with the technique of performing sports exercises, "standing" work, overweight), hereditary factors, infectious and chronic diseases.
However, effective treatment of osteoarthritis of the hip 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 slight pain in the groin area, which appears after physical activity, 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 during normal household activities.The pain may radiate to the lower back or inner thigh.Stiffness and crunching occur, and the range of motion in the joint is reduced.The musculo-ligamentous system begins to weaken, which causes increased fatigue.
- Stage 3. Pain is felt constantly and it is difficult for patients to move without a cane or walker.Movement in the joint is severely limited.Climbing stairs is a serious challenge.There are gait disturbances (limping, dropping of one or both legs).In unilateral coxarthrosis, pelvic curvature and spinal curvature are visible to the naked eye.
- Stage 4. The joint gap 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 destruction of the bone.
Prognosis for osteoarthritis of the hip joint
With successful lifelong treatment, the pain due to arthrosis of the hip joint may be completely absent or rarely bother the patient.The prospects for this therapy depend on the patient's compliance with the rheumatologist's rules and his personal self-discipline.Please note that the most accurate prognosis of 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 treatment of hip arthrosis is started at stage 1 or 2, hip replacement can be avoided.Damage and loss of working ability, 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-calledbenign arthrosis - when cartilage wear depends on external factors (professional activity, sanitary violations).In this case, it is worth turning them off and undergoing a course of restorative therapy to slow down further degeneration of the joint.
Timely surgical treatment of arthrosis of the hip joint of the 3rd degree will help to avoid the immobility of the joint, the consequences for the entire musculoskeletal system and the long-term pain.In the absence of contraindications, prosthetics will help you return to your previous activity.
In self-medication
When choosing a method for treating arthrosis of the hip joint, the doctor takes into account the age, constitution, physical fitness of the patient, his state of health, the specific symptoms of the disease and its stage.In this case, the narrowing of the lumen of the joint gap, the presence of osteophytes, the rate of progression of arthrosis, the quality of the synovial fluid and other indicators are examined.
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 can lead to severe exacerbation, metabolic disorders and deterioration of the stage of the disease.But the worst thing is the time spent in 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
If left untreated, hip arthrosis progresses 2-4 times faster on average.Deterioration of the quality of life and the appearance of disability in this case is possible already at a relatively young age - around 45-50 years.Patients' sleep worsens, 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 arthrosis of the hip joint
The priority direction of treatment of arthrosis of the hip joint of the 1st degree is outpatient conservative therapy.It includes medical treatment of osteoarthritis of the hip joint, physical therapy, dietary therapy, wearing bandages and adjustable orthoses.This approach allows you to relieve pain, maintain muscle function and increase joint mobility.The treatment of arthrosis of the hip joint 2nd degree is carried out in a similar way.
If conservative treatment of hip arthrosis 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 hip joint of the 3rd degree, endoprosthetics is prescribed - partial or complete replacement of the diseased joint.The prosthesis, made of metal and ceramic or polymer lining, 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 minimal incision up to 8 cm long and the ability to walk with support within a day.Full rehabilitation lasts 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, with the exception of 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 osteoarthritis of the hip joint with exercise
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 result, treating osteoarthritis of the hip with exercise helps relieve pain and inflammation, improves mobility, slows the wear and tear of cartilage, and keeps the synovial fluid supplied with nutrients.The following exercises will help you strengthen your legs:
- Starting position - sitting on the floor, focusing on outstretched arms behind you.Feet 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 your leg at the knee by pulling it toward you along the mat or onto the weight.It is recommended that you only touch the floor with your toes after completing the movement.
- Starting position - lying on your back, legs bent at the knees, feet on the floor.We do the "frog" exercise - we open the bent knees and hold them for 20 seconds.Then we put it back together.
- Starting position - lying on your back, one leg is extended, and the other is bent and laid to the side.We lie like this for a minute, then switch legs.
- Starting position - lying on your back, legs straight, lying freely.We put the socks inside, touching them, and then dissolve them.Repeat at a pace 10 times.
- Starting position - lying on your back, one leg (on the side of the affected joint) is crossed over the other.We move the foot of the lower leg, as in the above exercise.
- Starting position - lying on your back.We pull the knee towards the stomach, holding the back of the thigh with bent fingers.Perform 30 seconds on each leg.
- The starting position is the same.We pull our legs, bent at the knees, to the stomach and hold them under the knees with bent toes.Perform for at least 30 seconds.
- The starting position is the same.We move the straight leg to the side above the floor.20-30 times on each leg.
- Starting position - standing.Place a chair to the side with its back to you.Holding onto 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 arthrosis 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 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 quickly warm up when you go from rest to active activity and vice versa.
For arthrosis of the hip joint, a professional therapeutic massage is desirable (at least 10-12 sessions).But gentle self-massage at home also helps to improve the condition.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, the massage is performed on both sides.How do I do it right?
- To begin with, assume a comfortable position that will allow you to relieve the strain on your hips and lower back.For example, lying on your back, side or stomach.
- Begin to gently massage the area around the affected joint.If you have a helper, ask them to stroke your back for 7-10 minutes from the shoulder blades to the waist to improve blood circulation.
- Continue with a slow stroking of the lower back and then circular heating of the sacrolumbar area with two fingers.
- Massage the spine with your thumbs as far as the pose allows, gradually descending 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 your palms and then massage them well in a circular motion with your thumbs.
- Knead the inner thigh without applying pressure (so as not to squeeze the blood vessels).It is better to grasp the fatty fold between the thumb and the other fingers and knead it thoroughly.
- important!Finish the procedure with relaxing strokes and pats.
When massaging the thighs, transverse, longitudinal, grasping, squeezing movements are used.Rubbing is done with different parts of the palm or bent fingers towards the groin area.
After surgical treatment of grade 3 hip arthrosis 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 variety and balancing 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 (provide an anti-inflammatory effect), C, D, E are of primary importance. Diets with a low protein content are contraindicated in the treatment of arthrosis of the hip joint.Therefore, do not forget 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.
- Dishes and products with natural chondroprotectors (jelly, jelly, cartilage, pork legs, 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 inflamed 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 should also exclude salty, spicy, sweet and fried foods that cause the body to retain water.Minimize your intake:
- fast food restaurants and semi-finished products;
- pastries, cakes and confectionery;
- sausages and marinades.
Don't forget to drink at least 2.5 liters of water a day!
Drug treatment of arthrosis of the hip joint
Treatment of arthrosis 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 mild anti-inflammatory drugs (ibuprofen), 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 choose 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
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 worsen the course of the disease.Over time, they lead to tissue starvation, depletion of synovial fluid that "feeds" cartilage and disruption of its viscosity (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 broken down in large amounts, 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, 2 groups of anti-inflammatory drugs are used: nonsteroidal (NSAIDs, NSAIDs) and glucocorticosteroids.
NSAIDs are considered gentler, although they can also affect the digestive system.That is why they are appointed first.In the treatment of arthrosis of the hip joint of the 2nd degree - in courses or as necessary.
These include: Nimesulide, Ibuprofen, Meloxicam, Ketoprofen, Indomethacin, Diclofenac.
If NSAIDs fail, rheumatologists prescribe the "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 worsen the course of arthrosis.
The agents of choice for the treatment of grade 3 hip arthrosis are: 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 cartilage surface and do not enrich the synovial fluid with glycosaminoglycans.Therefore, the 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 cartilage tissue is very slow, chondroprotectors must be taken for a long time - 3-6 months a year.But with preventive use throughout life, they help to achieve remission without drugs.
Chondroprotectors include: glucosamine, chondroitin.
Angioprotectors and microcirculation correctors
The inflammation and microtraumas that accompany arthrosis disrupt the blood supply around the affected joint.But it is the capillaries that deliver nutrients to the boundaries 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
When the supporting function of the joint is impaired, the body tries to compensate with the help of muscles and ligaments that are not designed for such almost continuous loading.Due to chronic overstrain, pains and spasms appear in the muscles.These cramps can interfere with sleeping or walking.
To eliminate them, in the treatment of arthrosis of the hip joint are prescribed: baclofen, tizanidine, tolperisone.
External and warming means
Medicines from this group have a vasodilating effect.They help relieve swelling, reduce pain and provide psychological distraction from joint discomfort.
Usually, products based on animal poisons or pungent plant extracts are used to treat arthrosis of the hip joint.
Drug release form for the treatment of osteoarthritis of the hip joint
Depending on the clinical manifestations of arthrosis and the patient's lifestyle, the rheumatologist prescribes drugs for the treatment of arthrosis 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 carry with you.All you need to take is 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 membranes of the stomach and intestines - for gastritis, ulcer, colitis, it is better to prefer injections for the treatment of arthrosis of the hip joint.
Injections for intramuscular and intra-articular administration
Anti-inflammatory drugs, muscle relaxants and chondroprotectors are usually administered by injection.This ensures maximum bioavailability and is gentle on the gastric mucosa, but usually requires the presence of a medical professional.Performing intra-articular injections without special qualification is strictly prohibited!
Ointments, gels and creams
External means for the treatment of arthrosis of the hip joint have a low bioavailability (about 5%), which limits their use in therapy to 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.