Osteoarthritis of the hip joint is the most common osteoarthritis.Since the hip joint (HJ) is larger than all others and has a rotation axis with several vectors, it experiences enormous stress throughout a person's life - when walking, running, jumping, climbing stairs, playing sports and everyday activities.
Often, patients have to worry about symptoms and treatment of arthrosis in the hip joint already at the age of 25-35.The disease can quickly develop under the influence of injury, decompensated physical activity (non-compliance with the technique of performing sports exercises, "standing" work, overweight), hereditary factors, infectious diseases 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 - such as necrosis or fracture of the femoral head.
Symptoms of osteoarthritis in the hip joint
Symptoms and treatment of hip arthrosis depend on the stage of the disease.
- Phase 1. Patients feel mild 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 bothers the patient even during normal household activities.The pain may radiate to the lower back or inner thigh.Stiffness and creasing occur and the range of motion in the joint is reduced.The muscle-ligament system begins to weaken, which leads to increased fatigue.
- Step 3. The 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 (lameness, falling on one or both legs).In unilateral coxarthrosis, pelvic distortion and spinal curvature are visible to the naked eye.
- Stage 4. The joint space closes due to the spread 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 osteoarthritis of the hip joint
With successful lifelong treatment, pain due to arthrosis in 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 development of the disease, and the treatment of hip arthrosis began at stage 1 or 2, hip replacement can be avoided.Disability and loss of working ability, if the doctor's recommendations are followed, are postponed 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-called.benign 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 to slow down further degeneration of the joint.
Timely surgical treatment of grade 3 osteoarthritis in the hip joint will help to 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 self-medicating
When choosing a treatment method for arthrosis of the hip joint, the doctor takes into account the age, constitution, physical condition 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 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 aggravation, metabolic disturbances and worsening of the disease stage.But the worst thing is the time spent on the illusion that such a serious chronic disease as osteoarthritis of the hip joint can only be cured 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
Untreated, osteoarthritis in the hip joint progresses 2-4 times faster on average.A deterioration in the quality of life and onset of disability in this case is possible already at a relatively young age - around 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 osteoarthritis in the hip joint
The priority line of treatment for grade 1 arthrosis in the hip joint is outpatient conservative therapy.It includes drug treatment of osteoarthritis of the hip joint, physiotherapy, diet therapy, wearing bandages and adjustable orthoses.This approach allows you to relieve pain, maintain muscle function and increase mobility in the joint.Treatment of grade 2 osteoarthritis of the hip joint is carried out in the same way.
If conservative treatment of osteoarthritis of the hip joint 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 is prescribed - partial or complete replacement of the diseased joint.A prosthesis made of metal and a ceramic or polymer liner lasts from 15 to 25 years, after which it must be replaced.Total arthroplasty (total joint replacement) is the most effective treatment for hip osteoarthritis.It allows you to fully restore its functionality with a minimal incision of up to 8 cm in length and the ability to walk with support within a day.Complete rehabilitation lasts 1-3 months.
Physiotherapy methods for the treatment of arthrosis in the hip joint
Physiotherapy for arthrosis of the hip joint is carried out in courses, according to the doctor's indications.Almost all techniques, except 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 osteoarthritis of the hip joint:
- ultra high frequency therapy;
- ultrasound treatment;
- 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 therapy
Physiotherapy for arthrosis in 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 the physiologically correct position.As a result, treating osteoarthritis of the hip joint with exercises helps to relieve pain and inflammation, improves mobility, slows the wear and tear of cartilage 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 outstretched arms behind you.Legs right in front of you.We bend and straighten the 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, pull it towards you along the mat or onto the weight.It is advisable to only touch the floor with your toe after completing the movement.
- Starting position - lying on your back, legs bent at the knees, feet on the floor.We do the exercise "frog" - we 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 switch legs.
- Starting position - lying on the back, legs straight, lying freely.We bring the socks inside, touch them, and then spread them apart.Repeat at a pace 10 times.
- Starting position - lying on the 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 the back.We pull the knee towards the stomach and hold the back of the thigh with tense fingers.Perform for 30 seconds on each leg.
- The starting position is the same.We draw our legs bent at the knees towards the stomach and hold them under the knees with folded fingers.Perform for at least 30 seconds.
- The starting position is the same.We move the right leg to the side over the floor.20-30 times on each leg.
- Starting position - standing.Place a chair to the side with its back towards you.Hold the back of a chair and stand on one leg, swing the other back and forth like a pendulum.20-30 times.
Massage in the treatment of osteoarthritis in the hip joint
Massage is an effective relaxation and restorative technique for treating osteoarthritis of the hip joint in the early 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 medication, improve tissue trophism and slow cartilage degeneration.It also eliminates spasms that disturb sleep and movement, strengthens ligaments, normalizes gait, and allows you to quickly warm up when you switch from rest to active activity and vice versa.
For arthrosis of the hip joint, 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 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 performed on both sides.How to do it correctly?
- To begin, assume 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 gently massaging the area around the affected joint.If you have a helper, ask them to 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, then a circular heating of the sacrolumbar area with two fingers.
- Massage the spine with the thumbs as far as the position allows and gradually move 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 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 fold of fat between the thumb and other fingers and knead it thoroughly.
- Important!Complete the procedure with relaxing strokes and pats.
When massaging the thighs, transverse, longitudinal, grasping and 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 osteoarthritis in the hip joint and removal of sutures, massage is used for rehabilitation and restoration of motor functions.
Treatment of osteoarthritis in the hip joint with diet
The main principle of nutrition in the treatment of osteoarthritis 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 high in calcium, sulphur, zinc, magnesium and selenium.Of the vitamins, vitamin A and group B (gives 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, make sure to include in the menu:
- Lean meat, poultry, fish.
- Egg.
- Milk and dairy products.
- Fruit, 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 bone, ears, etc.).
But it is better to reduce carbohydrate consumption – even a little excess weight creates a colossal strain on the tender joint after all.It is 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 food, which causes the body to retain water.Minimize your intake:
- fast food and semi-finished products;
- pastries, sweets and confectionery;
- sausages and marinades.
Don't forget to drink at least 2.5 liters of water a day!
Medicinal treatment of osteoarthritis in 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 permissible to take conventional analgesics or gentle anti-inflammatory drugs (ibuprofen), but no more than 10 days before contacting a specialist.Otherwise, the disease picture will be blurred, and it will be difficult for the doctor to choose suitable treatment for osteoarthritis of the hip joint.
There are several medical groups of drugs for the treatment of osteoarthritis of the hip joint.In the complex treatment of arthrosis in the hip joint with drugs, 5 main pharmaceutical groups are used.
Anti-inflammatory drugs for 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 osteoarthritis 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 "feeds" the cartilage and disruption of its viscosity (due to which friction destroys the surface of the articular membrane!), muscular dystrophy and persistent deterioration of mobility.
But the biggest danger of inflammation is the death of cartilage cells - chondrocytes.When broken down in large quantities, they create a build-up of enzymes that "eat away" 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 (NSAID, NSAID) and glucocorticosteroids.
NSAIDs are considered milder, although they can also affect the digestive system.That is why they are appointed first.When treating grade 2 arthrosis in the hip joint - in progress or as needed.
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 preferred drugs for the treatment of grade 3 arthrosis in the hip joint are: Hydrocortisone, Prednisolone, Methylprednisolone.
Chondroprotectors against osteoarthritis in 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 osteoarthritis in the hip joint is unthinkable without the substances chondroitin and glucosamine sulfate, which supply the body with building material for the formation of new cartilage cells.
Since the metabolism of cartilage tissue is very slow, chondroprotectors must be taken for a long time - 3-6 months annually.However, with lifelong preventive use, they help achieve drug-free remission.
Chondroprotectors include: Glucosamine, Chondroitin.
Angioprotectors and microcirculatory corrective agents
Inflammation and microtraumas that accompany osteoarthritis disrupt the blood supply around the affected joint.But it is the capillaries that bring nutrients to the boundaries 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 a joint's support function is weakened, the body tries to compensate with the help of muscles and ligaments that are not designed for such almost continuous loading.Due to chronic overload, pain and spasms occur in the muscles.These cramps can interfere with sleep or walking.
To eliminate them, in the treatment of osteoarthritis of the hip joint, the following are prescribed: Baclofen, Tizanidine, Tolperisone.
External and heating means
Medicines in this group have a vasodilating effect.They help relieve swelling, reduce pain and psychologically distract from joint discomfort.
Usually, products based on animal poisons or sharp plant extracts are used to treat osteoarthritis of the hip joint.
Release form of drugs for the treatment of osteoarthritis of the hip joint
Depending on the clinical manifestations of osteoarthritis 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 in the hip joint are easy to dose and take with you.All you need to take is a glass of water.The blister or packaging also 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, ulcers, colitis, it is better to prefer 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 administered by injection.This guarantees maximum bioavailability and is gentle on the gastric mucosa, but usually requires the presence of a doctor.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 to their use.
Less common are liquid preparations for the treatment of arthrosis in the hip joint - in the form of balms, solutions for compresses.