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 multi-vector axis of rotation, it experiences enormous load 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 to 35 years.The disease can progress rapidly under the influence of injuries, uncompensated physical activity (non-compliance with the technique of performing sports exercises, work “standing”, being overweight), hereditary factors, infectious and chronic diseases.
Effective treatment of hip osteoarthritis, however, can preserve mobility and prevent bone degradation.In old age, it helps to avoid even more dangerous pathologies - such as necrosis or fracture of the femoral head.
Symptoms of osteoarthritis of the hip joint
The 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 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 crushing appear, and the range of motion in the joint is reduced.The musculoligamentous system begins to weaken, which causes increased fatigue.
- Stage 3. Pain is felt constantly and it is difficult for patients to move around 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 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 may be completely absent or rarely bother the patient.The prospects for this therapy depend on the patient's adherence to the rheumatologist's rules and 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 treatment of hip arthrosis began in stage 1 or 2, hip arthroplasty can be avoided.Disability and loss of ability to work, if the doctor's recommendations are followed, change within 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 cartilage wear depends on external factors (professional activity, sanitary violations).In this case, it is worth deleting them and undergoing restorative therapy to slow down the 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 many years of pain.In the absence of contraindications, prosthetics will help you return to your previous activity.
When self-medicating
When choosing a method of treatment for arthrosis of the hip joint, the doctor takes into account the age, constitution, physical fitness of the patient, his health status, 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 these individual indicators into account and, instead of the desired result, can lead to severe exacerbations, metabolic disorders and worsening of the stage of the disease.But the worst thing is the time spent under the illusion that such a serious chronic disease as osteoarthritis of the hip joint can only be cured with traditional methods.Avoid taking anti-inflammatories without a prescription - this can cause serious problems with the digestive and endocrine systems!
No treatment
If left untreated, arthrosis of the hip joint progresses on average 2 to 4 times faster.Deterioration in the quality of life and the appearance of disability in this case are possible already at a relatively young age - about 45-50 years.Patients' sleep worsens, 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 of the hip joint
The priority direction of treatment for grade 1 arthrosis of the hip joint is outpatient conservative therapy.It includes drug treatment for osteoarthritis of the hip joint, physiotherapy, diet therapy, use of bandages and adjustable orthoses.This approach relieves pain, maintains muscle function and increases joint mobility.Treatment of grade 2 arthrosis of the hip joint is carried out in a similar 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, in the treatment of grade 3 arthrosis of the hip joint, endoprosthetics is prescribed - partial or complete replacement of the diseased joint.A prosthesis made of metal and ceramic or polymer coating lasts 15 to 25 years, after which it needs to be replaced.Total arthroplasty (total joint replacement) is the most effective treatment for hip osteoarthritis.It allows you to fully restore your functionality with a minimum incision of up to 8 cm in length and the ability to walk with support within a day.Complete rehabilitation lasts 1 to 3 months.
Physiotherapeutic methods for treating osteoarthritis of the hip joint
Physiotherapy for arthrosis of the hip joint is carried out in courses, according to the doctor's instructions.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 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 therapy
Physiotherapy for arthrosis of the hip joint aims to strengthen 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 osteoarthritis of the hip joint with exercise helps relieve pain and inflammation, improves mobility, slows down 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 your arms outstretched behind you.Legs straight in front of you.We bend and straighten our toes.
- The starting position is the same.Alternatively, bend and straighten your feet (toes facing you, toes away from you).
- The starting position is the same.Bend your leg at the knee, pulling it toward you along the mat or over the weight.It is advisable to touch the floor only 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 “frog” exercise - we spread our bent knees and hold them for 20 seconds.Then we put it all back together.
- Starting position - lying on your back, one leg straight, the other bent and lying on your side.We stayed like that for a minute and then switched legs.
- Starting position - lying on your back, legs straight, lying freely.We bring the socks inside, touch them, and then pull them apart.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 foot of the 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 interlaced 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 intertwined fingers.Run 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 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 osteoarthritis of the hip joint
Massage is an effective relaxation and restorative technique for treating arthrosis of the hip joint in the early stages.As a treatment for 1st degree arthrosis of the hip joint (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 down cartilage degeneration.It also eliminates spasms that interfere with sleep and movement, strengthens ligaments, normalizes gait and allows a quick warm-up when moving from rest to active activity and vice versa.
For arthrosis of the hip joint, professional therapeutic massage (at least 10-12 sessions) is desirable.But gentle self-massage at home also helps to improve the condition.It is important to avoid serious 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 performed on both sides.How to do this correctly?
- 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.
- Begin to gently massage the area around the affected joint.If you have a helper, ask him to stroke your back for 7 to 10 minutes, from your shoulder blades to your sacrum, to improve blood circulation.
- Start slowly stroking the lower back and then gently warming the sacral lumbar region with two fingers.
- Massage the spine with your thumbs as much as the posture allows, gradually moving down to the lower back.
- Press your palms into the sacrogluteal area and begin rubbing and stretching the muscles.This completes the preparation.
- Rub your thighs with your palms and massage them well in a circle with your thumbs.
- Knead the inner thigh without applying pressure (so as not to compress the blood vessels).It is best to grab the fat fold between your thumb and fingers and knead it well.
- Important!Complete the procedure with relaxing caresses and pats.
When massaging the thighs, transverse, longitudinal, grasping and squeezing movements are used.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 sutures, massage is used for rehabilitation and restoration of motor functions.
Treatment of osteoarthritis 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 consume foods rich in calcium, sulfur, zinc, magnesium and selenium.Of the vitamins, vitamins A and group B (have 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:
- Diet meat, poultry, fish.
- Eggs.
- Milk and derivatives.
- Fresh fruits, vegetables and herbs.
- Whole grains and nuts (such as flaxseed), as well as nuts.
- Dishes and products with natural chondroprotectors (jam, jelly, cartilage, pork legs, ears, etc.).
But it is better to reduce carbohydrate consumption - after all, even a slight excess weight creates a colossal load on the sore joint.It's no wonder that rehabilitation experts joke that losing a few pounds is the most effective treatment for osteoarthritis of the hip joint.You also need to exclude salty, spicy, sweet and fried foods, which cause the body to retain water.Minimize your intake:
- 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!
Drug treatment of osteoarthritis of the hip joint
Treatment of osteoarthritis of the hip joint with medications 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 consulting a specialist.Otherwise, the picture of the disease will be confused and it will be difficult for the doctor to select the appropriate treatment for arthrosis of the hip joint.
There are several medicinal groups of medicines for the treatment of arthrosis of the hip joint.In the complex treatment of arthrosis of the hip joint with medications, 5 main pharmaceutical groups are used.
Anti-inflammatories 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 aggravate 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 main danger of inflammation is the death of cartilage cells - chondrocytes.When they break down in large quantities, they create a build-up of enzymes that “eat away” the surface of the articular cartilage.
Therefore, to alleviate inflammatory symptoms and restore tissue metabolism, 2 groups of anti-inflammatory drugs are used: non-steroidal drugs (NSAIDs, NSAIDs) and glucocorticosteroids.
NSAIDs are considered milder, 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 courses or as needed.
These include: Nimesulide, Ibuprofen, Meloxicam, Ketoprofen, Indomethacin, Diclofenac.
If NSAIDs fail, rheumatologists prescribe the “heavy artillery” – corticosteroid medications.They immediately relieve even severe pain and inflammation, but they cannot be taken for a long time and in large dosages.Like any 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 medications of choice for the treatment of grade 3 osteoarthritis of the hip joint are: Hydrocortisone, Prednisolone, Methylprednisolone.
Chondroprotectors for osteoarthritis of the hip joint
Although anti-inflammatories relieve symptoms, they do not solve the problem - they do not restore the damaged cartilage surface and do not enrich 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 need to be taken for a long time - 3-6 months annually.But with lifelong preventive use, they help achieve drug-free remission.
Chondroprotectors include: Glucosamine, Chondroitin.
Angioprotectors and microcirculation correctors
The inflammation and microtrauma that accompany osteoarthritis disrupt the blood supply around the affected joint.But it is the capillaries that take nutrients to the limits of the joint capsule.
The following help to relieve swelling and improve tissue trophism: Troxerutin, horse chestnut extract, Diosmin in combination with other medicines, Pentoxifylline.
Muscle relaxants
When the support function of a joint is impaired, the body attempts to compensate by using muscles and ligaments that were not designed for near-continuous loading.Due to chronic overexertion, pain and spasms appear in the muscles.These cramps can interfere with sleeping or walking.
To eliminate them, in the treatment of osteoarthritis of the hip joint, the following are prescribed: Baclofen, Tizanidine, Tolperisone.
External and heating agents
Medicines in this group have a vasodilating effect.They help relieve swelling, reduce pain and psychologically distract from joint discomfort.
Typically, to treat osteoarthritis of the hip joint, products based on animal poisons or pungent plant extracts are used.
Release form of medication for the treatment of arthrosis of the hip joint
Depending on the clinical manifestations of arthrosis and the patient's lifestyle, the rheumatologist prescribes medications for the treatment of osteoarthritis of the hip joint in different forms.
Tablets, capsules, powders
These products for treating osteoarthritis of the hip joint are easy to dose and take with you.All you need to bring is a glass of water.Furthermore, the blister or packaging allows you to track how many days the course has lasted.Such medicines 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 intraarticular administration
Anti-inflammatories, muscle relaxants and chondroprotectors are usually administered by injection.This ensures maximum bioavailability and is gentle on the gastric mucosa, but generally requires the presence of a medical professional.It is strictly forbidden to do intra-articular injections without special qualifications!
Ointments, gels and creams
External agents for the treatment of osteoarthritis of the hip joint have low bioavailability (about 5%), which limits their use in therapy to an auxiliary function.But there are much fewer contraindications to its use.
Less common are liquid preparations for the treatment of arthrosis of the hip joint - in the form of balms, compress solutions.