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 large load throughout a person's life - when walking, running, dancing, 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 progress rapidly under the influence of injury, 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 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 slight pain in the hip area, which appears after physical activity, prolonged 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 normal household activities.The pain may radiate to the lower back or inner thigh.Stiffness and stiffness appear, and the range of motion in the joint is reduced.The muscular-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 very limited.Climbing stairs is a serious challenge.There are disturbances in walking (lameness, falling on one or both legs).With unilateral coxarthrosis, the distortion of the pelvis and the curvature of the spine are visible to the naked eye.
- Stage 4. The joint space is closed due to the spread of osteophytes and any movement in the joint is almost impossible.It loses its functions and is 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 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 on his personal self-discipline.Please note 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 hip arthrosis began in stage 1 or 2, hip replacement can be avoided.Disability and loss of ability to work, if the doctor's recommendations are followed, is shifted by 20 years, and sometimes the patient maintains an almost unlimited range of motion in the joints until old age.The best prognosis is possible with the so-called.benign 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 avoid joint immobility, consequences for the entire musculoskeletal system, and years of pain.In the absence of contraindications, the prosthesis will help you return to your previous activity.
When self-medication
When choosing a treatment method for arthrosis of the hip joint, the doctor takes into account the age, condition, physical ability 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 degree 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 severe deterioration, metabolic disorders and deterioration 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
If left untreated, arthrosis of the hip joint progresses 2-4 times faster on average.A deterioration in the quality of life and the onset of disability in this case is already possible at a relatively young age - about 45-50 years.Patients' sleep worsens, physical activity decreases and 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
The priority line of treatment for grade 1 arthrosis of the hip joint is conservative outpatient therapy.It includes drug treatment of osteoarthritis of the hip joint, physiotherapy, dietary therapy, wearing bandages and adjustable orthoses.This approach allows you to relieve pain, maintain muscle function and increase joint mobility.Treatment of grade 2 arthrosis of the hip joint is carried out in a similar way.
If conservative treatment of hip joint arthrosis is delayed or ineffective, cartilage degeneration progresses rapidly and surgery is performed.Occasionally, the doctor may decide on osteotomy or arthrodesis, but in most cases, when treating grade 3 arthrosis of the hip joint, endoprosthetics are prescribed - partial or complete replacement of the diseased joint.A prosthesis made of metal and a ceramic or polymer layer lasts from 15 to 25 years, after which it requires replacement.Total arthroplasty (total joint replacement) is the most effective treatment for hip osteoarthritis.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 during the remission period, 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 (withdrawal);
- 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 a natural orthosis that reduces the load on the joint and keeps it in the correct physiological position.As a result, treatment of osteoarthritis of the hip joint with exercise 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 you strengthen your legs:
- Starting position - sitting on the floor, focusing on the arms stretched 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 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 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 spread the 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 lying on the side.We lie like this for a minute, then switch legs.
- Starting position - lying on your back, legs straight, lying freely.We bring the socks inside touching them and then spread them.Repeat at a 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 leg of the lower part of the leg as in the exercise above.
- Starting position - lying on the back.We pull the knee towards the stomach, holding the back of the thigh with the fingers.Perform for 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 the toes clasped.Perform for at least 30 seconds.
- The starting position is the same.We move the leg pointed to the side on 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 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 relaxing 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 second - 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 walking and allows you to warm up quickly when you switch from rest to active activity and vice versa.
For hip joint arthrosis, professional therapeutic massage (at least 10-12 sessions) is desirable.But even gentle self-massage at home helps to improve the condition.It is important to avoid severe pain and 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 done on both sides.How to do it correctly?
- To begin, get into 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.
- Begin to gently massage the area around the affected joint.If you have a helper, have them stroke your back for 7-10 minutes from your shoulder blades to your sacrum to improve blood circulation.
- Continue to slowly stroke the lower back and then a circular heating of the sacrolumbar region with two fingers.
- Massage the spine with your thumbs as far as the pose allows, moving gradually down 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 together with your palms and then massage well in a circular motion with your thumbs.
- Massage the inner thigh without applying pressure (so as not to squeeze the blood vessels).It is best to grasp the fat between your thumb and other fingers and cook it thoroughly.
- Important!Finish the procedure with relaxing strokes and caresses.
Transversal, longitudinal, gripping, tightening movements are used in thigh massage.Rubbing is performed with different parts of the palm or fingers bent towards the groin area.
After surgical treatment of grade 3 osteoarthritis of the hip joint and removal of stitches, 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 the main indicators (vitamins, minerals, proteins, including essential amino acids).It is important to eat foods rich in calcium, sulfur, zinc, magnesium and selenium.Of the vitamins, the primary importance are vitamins A and group B (they have an anti-inflammatory effect), C, D, E. Diets with little protein 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.
- Fresh fruits, vegetables and herbs.
- Cereals 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 light excess weight creates a colossal load on the injured 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, which cause the body to retain water.Minimize your intake:
- fast food and semi-finished products;
- baked goods, cakes and pastries;
- sausages and marinades.
Don't forget to drink at least 2.5 liters of water a day!
Medicinal treatment of arthrosis of the hip joint
Treatment of osteoarthritis of the hip joint with drugs is carried out strictly as prescribed by the doctor.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 appearance of the disease will be unclear and it will be difficult for the doctor to choose the adequate treatment for arthrosis of the hip joint.
There are several medicinal 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, fever and local 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 breakdown of its viscosity (due to which friction destroys the surface of the articular membrane!), muscular dystrophy and continuous 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 an accumulation of enzymes that "eat" 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) and glucocorticosteroids.
NSAIDs are considered milder, although they can also affect the digestive system.That is why they are named first.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 fail, rheumatologists prescribe "heavy artillery" - corticosteroid drugs.They immediately relieve pain and severe inflammation, but they cannot be taken for a long time and in large doses.Like any hormonal drug, 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 drugs chosen for 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 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 unimaginable without the drugs chondroitin and glucosamine sulfate, which supply the body with building materials 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 achieve remission without medication.
Chondroprotectors include: Glucosamine, Chondroitin.
Angioprotectors and correctors of microcirculation
The inflammation and microtraumas 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.
The following help relieve swelling and improve tissue trophism: Troxerutin, horse chestnut extract, Diosmin in combination with other drugs, Pentoxifylline.
Muscle relaxants
When the supporting function of a joint is impaired, the body tries to compensate for it by using muscles and ligaments that are not designed for such almost constant loading.Due to chronic overload, pain and spasms appear in the muscles.These cramps can interfere with sleeping or walking.
For their elimination, the following are prescribed in the treatment of osteoarthritis of the hip joint: Baclofen, Tizanidine, Tolperisone.
External agents and heating
Drugs of this group have a vasodilating effect.They help relieve swelling, reduce pain and psychologically relieve joint discomfort.
Usually, to treat arthrosis of the hip joint, products based on animal poisons or pungent plant extracts are used.
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 is a glass of water.Also, the bubble 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 prefer injections for the treatment of osteoarthritis of the hip joint.
Injections for intramuscular and intraarticular administration
Anti-inflammatory drugs, muscle relaxants and chondroprotectors are usually administered by injection.This guarantees maximum bioavailability and is gentle on the gastric mucosa, but usually requires the presence of a medical professional.Making intra-articular injections without special qualifications is strictly prohibited!
Ointments, gels and creams
External agents 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 compresses.