Osteoarthritis of the hip joint is the most common type of osteoarthritis.Since the hip joint (HJ) is larger than all others and has a multivector axis of rotation, it experiences a huge load throughout a person's life: when walking, running, jumping, climbing stairs, playing sports and performing 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 injuries, decompensated physical activity (failure to comply 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 breakage.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 osteoarthritis depend on the stage of the disease.
- Stage 1. Patients feel mild pain in the groin area, which occurs after physical activity, prolonged standing or sudden movements of the joint, and then disappears completely 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 creaks appear, and the range of motion of the joint is reduced.The musculo-ligament system begins to weaken, causing increased fatigue.
- Stage 3. Pain is felt constantly and it is difficult for patients to move without a cane or walker.Movement of the joint is severely limited.Climbing stairs is a serious challenge.Gait disturbances are present (lameness, falls on one or both legs).In unilateral coxarthrosis, pelvic distortion 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 arthrosis of the hip joint
With permanent and successful treatment, pain due to arthrosis of the hip joint can be completely absent or rarely bother the patient.The prospects of 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 osteoarthritis 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, are shifted by 20 years, and sometimes the patient retains an almost unlimited range of motion of the joint until old age.The best prognosis is possible with the so-called.benign arthrosis - when the wear of the cartilage 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 arthrosis of the hip joint will help avoid joint immobility, consequences for the entire musculoskeletal system and many years of pain.In the absence of contraindications, prostheses will help you return to your previous activity.
When he self-medicates
When choosing a treatment method for arthrosis of the hip joint, the doctor takes into account the age, constitution, physical form 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 speed of progression of arthrosis, the quality of 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 serious exacerbations, metabolic disorders and worsening 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 prescription: this can cause serious problems with the digestive and endocrine system!
No treatment
If left untreated, osteoarthritis 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 are possible already at a relatively young age - approximately 45-50 years.Patients' sleep deteriorates, physical activity decreases, and 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 for grade 1 arthrosis of the hip joint is outpatient conservative therapy.It includes pharmacological treatment of arthrosis of the hip joint, physiotherapy, diet therapy, the use of bandages and adjustable orthoses.This approach helps 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 arthrosis of the hip joint is delayed or ineffective, cartilage degeneration progresses rapidly and surgical intervention is performed.Occasionally, 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 a ceramic or polymer coating lasts 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 your functionality with a minimal incision of up to 8cm in length and the ability to walk with support within one day.Complete rehabilitation lasts 1-3 months.
Physiotherapeutic methods for the treatment of arthrosis of the hip joint
Physiotherapy for arthrosis of the hip joint is carried out in cycles, according to the doctor's instructions.Almost all techniques, with the exception of magnetic and cryotherapy, are allowed only during the period of remission, in the complete absence of inflammatory symptoms.The following measures are used to treat arthrosis of the hip joint:
- very high frequency therapy;
- ultrasound therapy;
- laser therapy;
- magnetotherapy;
- therapeutic exercises (therapeutic gymnastics);
- therapeutic massage and manual therapy;
- ozone therapy;
- cryotherapy;
- acupuncture;
- traction therapy (traction);
- paraffin applications and compresses;
- balneotherapy and mud therapy;
- hydromassage.
Treatment of arthrosis of the hip joint with physical 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 physiologically correct position.As a result, treating arthrosis of the hip joint with exercises helps relieve pain and inflammation, improves mobility, slows down the wear of the cartilage 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 your arms stretched behind you.Legs straight in front of you.We bend and straighten our toes.
- The starting position is the same.Alternately bend and straighten your feet (toes toward you, toes away from you).
- The starting position is the same.Bend your leg at the knee, pulling it towards you along the mat or onto the weight.It is recommended to touch the floor only with the toe 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 our bent knees and hold them for 20 seconds.Then we bring it together again.
- Starting position: lying on your back, one leg straight, the other bent and extended to the side.We lie like this for a minute, then we switch legs.
- Starting position: lying on your back, legs straight, lying freely.We bring the socks inwards, touching them and then widen them.Repeat at a pace 10 times.
- 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.We pull the knee towards the stomach, holding the back of the thigh with clasped 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 clasped fingers.Run 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 the 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 arthrosis of the hip joint
Massage is an effective relaxation and restorative technique for treating osteoarthritis of the hip joint in the initial stages.As a treatment for arthrosis of the hip joint of the 1st degree (as well as 2nd - in the absence of pain and swelling), it can prolong remission, relieve discomfort and pain without drugs, improve tissue trophism and slow down the degeneration of cartilage.It also eliminates spasms that interfere with sleep and movement, strengthens ligaments, normalizes gait and allows you to quickly warm up when switching 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 even a gentle self-massage at home 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 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 to do it correctly?
- To begin, get into a comfortable position that allows 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, ask them to stroke your back for 7 to 10 minutes from your shoulder blades to your sacrum to improve blood circulation.
- Proceed with a light caress of the lower back, then with a circular warming of the sacrolumbar region with two fingers.
- Massage your spine with your thumbs, as far as the pose allows, gradually moving towards your lower back.
- Press your palms into the sacrogluteal area and begin massaging and stretching the muscles.This completes the preparation.
- Rub your thighs with the palms of your hands and then massage them well in a circular motion with your thumbs.
- Knead the inner thigh without applying pressure (so as not to compress the blood vessels).It is best to grasp the fold of fat between your thumb and other fingers and knead it thoroughly.
- Important!Complete the procedure with soothing strokes and caresses.
In the thigh massage, transverse, longitudinal, gripping and squeezing movements are used.Rubbing is performed with different parts of the palm or with the fingers bent towards the groin area.
After surgical treatment of grade 3 arthrosis 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 fundamental 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.Among vitamins, vitamins A and group B (give an anti-inflammatory effect), C, D, E are of primary importance.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.
- Egg.
- Milk and dairy products.
- Fresh fruits, vegetables and herbs.
- Whole grains and oilseeds (like flax), as well as nuts.
- Dishes and products with natural chondroprotectors (gelatin, gelatin, cartilage, pork legs, ears, etc.).
But it is better to reduce the consumption of carbohydrates: even a slight excess weight creates a colossal load on the sore joint.It is not for nothing that rehabilitation experts joke that losing a couple of kilos is the most effective treatment for arthrosis of the hip joint.It is also necessary to exclude salty, spicy, sweet and fried foods, which cause water retention in the body.Minimize your intake:
- 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!
Pharmacological treatment of arthrosis of the hip joint
Treatment of arthrosis of the hip joint with drugs is carried out strictly as prescribed by the doctor.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 clouded and it will be difficult for the doctor to select an 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 arthrosis 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, depletion of synovial fluid, which "nourishes" the cartilage and disruption of its viscosity (due to which friction destroys the surface of the joint membrane!), muscular dystrophy and persistent 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 buildup of enzymes that “corrode” the surface of the joint cartilage.
Therefore, to relieve inflammatory symptoms and restore tissue metabolism, 2 groups of anti-inflammatory drugs are used: non-steroidal drugs (NSAIDs, NSAIDs) and glucocorticosteroids.
NSAIDs are considered gentler, although they can also affect the digestive system.That's why they are named first.In the treatment of grade 2 arthrosis of the hip joint - in cycles or as needed.
These include: Nimesulide, Ibuprofen, Meloxicam, Ketoprofen, Indomethacin, Diclofenac.
If NSAIDs fail, rheumatologists prescribe "heavy artillery" - corticosteroid drugs.They also immediately relieve pain and severe inflammation, but 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 of choice for the treatment of grade 3 arthrosis of the hip joint 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 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 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 include: Glucosamine, Chondroitin.
Angioprotectors and correctors of the microcirculation
The inflammation and microtraumas that accompany osteoarthritis interrupt the blood supply around the affected joint.But it is the capillaries that bring nutrients to the borders of the joint capsule.
They 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 compromised, the body tries to compensate by using muscles and ligaments that are not designed for such almost continuous loading.Due to chronic overload, pain 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, the following are prescribed: Baclofen, Tizanidine, Tolperisone.
External and heating agents
Drugs from this group have a vasodilatory effect.They help relieve swelling, reduce pain and psychologically distract from joint discomfort.
Usually products based on animal poisons or pungent plant extracts are used to treat arthrosis of the hip joint.
Form of drug release 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 to treat arthrosis of the hip joint in various 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 bring is a glass of water.In addition, the blister or packaging allows you to keep track of 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: with gastritis, ulcer, colitis, it is better to prefer injections for the treatment of arthrosis of the hip joint.
Injections for intramuscular and intraarticular 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 doctor.It is strictly forbidden to carry out intra-articular injections without special qualifications!
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 to their use.
Less common are liquid preparations for the treatment of arthrosis of the hip joint - in the form of balms, compress solutions.