Osteoarthritis of the hip joint is the most common type of osteoarthritis. Because the hip joint is the largest of all and has a multi-vector axis of rotation, a person experiences great stress throughout his life - walking, running, jumping, climbing stairs, sports and daily activities.
Patients often have to seek treatment for the symptoms and treatment of hip arthritis between the ages of 25 and 35. The disease can develop rapidly under the influence of trauma, decompensated physical activity (sports, non-compliance with the technique of "work on foot"), hereditary factors, infectious and chronic diseases.
An effective treatment for hip osteoarthritis can maintain mobility and prevent bone loss. In old age, it helps prevent more dangerous pathologies such as necrosis or fracture of the femoral head.
Symptoms of osteoarthritis of the hip joint
Symptoms and treatment of hip osteoarthritis depend on the stage of the disease.
- Stage 1. Patients experience mild pain in the groin area after physical exertion, prolonged standing, or sudden movements in the joint, and then disappear completely at rest.
- Stage 2. The pain syndrome worsens and bothers the patient even with normal household loads. The pain may be in the lower back or inner thigh. Hardness, crackling is visible, the range of motion in the joint is reduced. The musculoskeletal system begins to weaken, so fatigue increases.
- Stage 3. Pain is always felt, it is difficult for patients to move around without sticks or walking. Joint movement is severely limited. Climbing stairs is a big problem. There are gait disorders (lameness, falling on one or both legs). With unilateral coxarthrosis of the naked eye, pelvic flexion and curvature of the spine are noticeable.
- Stage 4. Due to the proliferation of osteophytes, the joint space closes and any movement in the joint is almost impossible. It loses its function due to the destruction of bone and is severely deformed.
Prognosis for hip arthrosis
With successful lifelong treatment, pain in the hip joint may be completely absent or rarely bother the patient. The prospects of this therapy depend on the patient's adherence to the rules of rheumatology and personal discipline. We draw your attention to the fact that the most accurate prognosis of the disease can be made only by the attending physician.
With timely and regular treatment
If chronic disease does not contribute to the progression of the disease and treatment of osteoarthritis of the hip joint begins in stage 1 or 2, thigh replacement can be avoided. Disability and disability are changed for 20 years if the doctor's recommendations are followed, and sometimes the patient maintains an almost limited state of mobility in the joint until old age. The best prognosis is possible with the so-called. benign osteoarthritis - when cartilage erosion depends on external factors (professional activity, sanitary violations). In this case, it is worth removing them and switching to a course of rehabilitation therapy to slow joint degeneration.
Timely surgical treatment of grade 3 osteoarthritis of the hip joint will help to avoid joint immobility, consequences for the entire musculoskeletal system, and pain for many years. If there are no contraindications, prostheses will help you return to your previous activities.
When choosing a method to treat osteoarthritis of the hip joint, the doctor takes into account the patient's age, constitution, physical shape, health status, specific symptoms and stage of the disease. At the same time, the narrowing of the lumen of the joint cavity, the presence of osteophytes, the rate of development of osteoarthritis, the quality of synovial fluid and other indicators are studied.
Folk remedies for hip arthrosis do not take into account these individual indicators and, instead of the desired result, can lead to acute inflammation, metabolic disorders and aggravation of the disease stage. But the worst thing is the time spent on the illusion that a serious chronic disease such as osteoarthritis of the hip joint can be treated only by folk remedies. Avoid taking anti-inflammatory drugs without a doctor's prescription - it can cause serious problems in the digestive and endocrine systems!
When left untreated, osteoarthritis of the hip joint progresses on average 2-4 times faster. In this situation, the deterioration of quality of life and the onset of disability is possible at a relatively young age - about 45-50 years. Patients experience poor sleep, decreased physical activity, and psychoemotional disorders. The pain prevents you from getting out of bed in the morning, walking with your grandchildren, and going to work.
Treatment of osteoarthritis of the hip joint
Outpatient conservative therapy is a priority in the treatment of grade 1 hip arthrosis. Includes medications for hip joint, physiotherapy, diet therapy, dressings and adjustable orthoses. This approach can reduce pain, maintain muscle function, and increase joint mobility. Treatment of grade 2 hip arthrosis is similar.
If conservative treatment of the hip joint is delayed or ineffective, cartilage degeneration progresses rapidly and surgery is performed. Sometimes the doctor may decide on an osteotomy or arthrodesis, but in most cases arthroplasty is prescribed in the treatment of grade 3 osteoarthritis - a partial or complete replacement of the patient's joint. The addition of a prosthesis made of metal and a ceramic or polymer lasts from 15 to 25 years, after which it must be replaced. Total arthroplasty (replacement of common joints) is the most effective treatment for hip arthrosis. With an incision of at least 8 cm in length and the ability to walk with support in a day, it allows you to fully restore its functionality. Full rehabilitation lasts 1-3 months.
Physiotherapy treatments for osteoarthritis of the hip joint
Physiotherapy for osteoarthritis of the hip joint is carried out in courses according to a doctor's prescription. With the exception of magnetic and cryotherapy, almost all methods are allowed only in remission in the absence of signs of inflammation. The following measures are used to treat osteoarthritis of the hip joint:
- ultra high frequency therapy;
- ultrasound therapy;
- laser therapy;
- therapeutic gymnastics (exercise therapy);
- therapeutic massage and manual therapy;
- ozone therapy;
- traction therapy (traction);
- paraffin applications and wraps;
- balneotherapy and mud therapy;
Treatment of osteoarthritis of the hip joint with exercise therapy
Physical treatment of the hip joint is aimed at strengthening the muscles and ligaments - a natural orthosis that reduces the load on the joint and keeps it in a physiologically correct position. As a result, treatment of hip osteoarthritis with gymnastics helps relieve pain and inflammation, improves mobility, slows cartilage erosion, and provides nutrients for synovial fluid. The following exercises will help strengthen your legs:
- Starting position - sit on the floor, support the arms extending from behind. Your feet are right in front of you. Bend and open your toes.
- The starting position is the same. We bend and bend our legs in turn (finger to ourselves, finger to ourselves).
- The starting position is the same. We bend our knees by pulling ourselves towards the carpet or weight. It is recommended to touch the floor with your finger only at the end of the movement.
- Starting position - lying on your back, legs bent at the knees, feet on the ground. We do the "frog" exercise - spread the bent knees and hold for 20 seconds. Then mix again.
- Starting position - lying on your back, one leg straight, the other bent and placed on the side. We lie like that for a minute, then we change legs.
- Starting position - lie on your back, legs straight, lying freely. We bring the socks in by touching them and then separate them from each other. We repeat 10 times at a tempo.
- Starting position - lying on your back, one foot (by the affected joint) is thrown on top of the other. Move the lower leg as in the exercise above.
- Starting position - lying on your back. We pull your knee to your stomach and hold the back of your thigh with your locked fingers. Exercise for 30 seconds on each leg.
- The starting position is the same. We pull the legs bent at the knees to the stomach and hold them under our knees with locked toes. Exercise for at least 30 seconds.
- The starting position is the same. We take the straightened leg to the side above the floor. 20-30 times for each foot.
- The starting position is standing. Place the chair side to side with the back. Holding one chair from behind, stand on one leg and 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 the treatment of osteoarthritis of the hip joint in the early stages. As a treatment for grade 1 hip arthrosis (as well as 2 - in the absence of pain and swelling), it is possible to prolong remission, relieve anxiety 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, allows you to warm up quickly during the transition from rest to active activity, and vice versa.
Professional therapeutic massage with arthrosis of the hip joint is desirable (at least 10-12 sessions). But a gentle self-massage at home also helps to improve the situation. At the same time, it is important to avoid pain and severe anxiety. At the slightest sign of inflammation in the joint, the manipulation is temporarily stopped - it can be continued with the permission of the attending physician after a course of anti-inflammatory therapy.
Even if the patient suffers from unilateral coxarthrosis, massage is performed on both sides. How do you do it right?
- First, take a comfortable position that will allow you to relax your hips and back. For example, lie on your back, side or stomach.
- Start by gently massaging around the affected joint. If you have an assistant, ask them to pat you on the back for 7-10 minutes from the shoulder blades to the sacrum to improve blood circulation.
- Continue to gently stroke the back, and then with two fingers make a circular warming of the sacro-lumbar spine.
- Massage the spine with your fingers as much as possible, gradually lowering it to the waist.
- Squeeze your palms into the sacro-gluteal region and begin to rub and stretch the muscles. This completes the preparation.
- Rub your thighs with your palms, then massage thoroughly in a circle with your thumb.
- Knead the inner leg without pressure (not to squeeze the blood vessels). It is better to hold a layer of oil between your thumb and other fingers and knead well.
- It is important! Finish with soothing strokes and pats.
Thigh massage uses transverse, longitudinal, grip and squeezing movements. Rubbing is done with different parts of the palm or with your fingers towards the groin area.
Massage is used to restore and restore motor function after surgical treatment of grade 3 osteoarthritis of the hip joint and removal of sutures.
Dietary treatment of osteoarthritis of the hip joint
The main principle of nutrition in the treatment of osteoarthritis of the hip joint is the diversity and balance in terms of key indicators (vitamins, minerals, proteins, including essential amino acids). It is important to eat foods rich in calcium, sulfur, zinc, magnesium and selenium. Vitamins of groups A and B are of primary importance (anti-inflammatory effect), C, D, E. Low-protein diets are contraindicated in the treatment of osteoarthritis of the hip joint. So make sure you include it in the menu:
- Dietary meat, poultry, fish.
- Milk and dairy products.
- Fruits, vegetables and fresh herbs.
- Whole grains and oilseeds (like flax) and nuts.
- Natural chondroprotective foods and products (jelly, jelly, cartilage, pork legs, ears, etc. )
But it is better to reduce carbohydrate intake - finally, even a small amount of excess weight creates a large load on the painful joint. Rehabilitation therapists do not say in vain 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 because the body retains water. Minimize consumption:
- fast food and convenience foods;
- baked goods, confectionery and confectionery;
- sausages and marinades.
Remember to drink at least 2. 5 liters of water a day!
A drug for osteoarthritis of the hip joint
Drug treatment of osteoarthritis of the hip joint is carried out strictly according to the doctor's prescription. In case of exacerbation and severe pain, it is allowed to take traditional analgesics or anti-inflammatory drugs (ibuprofen) less, but only 10 days before contacting a specialist. Otherwise, the picture of the disease will be blurred and it will be difficult for the doctor to find a suitable treatment for osteoarthritis of the hip joint.
There are several groups of drugs for the treatment of osteoarthritis of the hip joint. 5 main pharmaceutical groups are used in the complex treatment of osteoarthritis of the hip joint with drugs.
Anti-inflammatory drugs in the treatment of osteoarthritis of the hip joint
Swelling, stagnation of blood and other fluids, localized fever and pain - these common inflammatory symptoms in osteoarthritis not only poison the patient's life, but also aggravate the course of the disease. Over time, it leads to tissue starvation, depletion of synovial fluid that "feeds" cartilage, and impaired viscosity (because friction destroys the surface of the articular membrane! ), Muscular dystrophy, and persistent deterioration of mobility.
However, the main danger of inflammation is the death of cartilage cells - chondrocytes. When degraded in large quantities, enzymes "eat" the surface of the articular cartilage.
For this reason, 2 groups of anti-inflammatory drugs are used to relieve the symptoms of inflammation and restore tissue metabolism: non-steroidal (NSAIDs, NSAIDs) and glucocorticosteroids.
Although NSAIDs can affect the digestive system, they are considered milder. Therefore, they are appointed first. In the treatment of grade 2 hip arthrosis - in courses or as needed.
These include: Nimesulide, Ibuprofen, Meloxicam, Ketoprofen, Indomethacin, Diclofenac.
If NSAIDs fail, rheumatologists prescribe "heavy artillery" - corticosteroids. Severe pain and inflammation are relieved even immediately, but can not be taken for a long time and in high doses. Like any hormonal drug, it can affect the weight and condition of the internal organs, and if the therapeutic dose is exceeded, it can aggravate the course of osteoarthritis.
The drugs of choice 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 repair the damaged surface of cartilage and do not enrich the synovial fluid with glycosaminoglycans. Therefore, an effective treatment for osteoarthritis 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.
Because the metabolism in cartilage tissue is very slow, chondroprotectors should be taken for a long time - every year for 3-6 months. However, with lifelong prophylaxis, they help to achieve remission without medication.
Chondroprotectors include: Glucosamine, Chondroitin.
Angioprotectors and microcirculatory correctors
Inflammation and microtrauma accompanied by osteoarthritis disrupts the blood supply around the affected joint. However, they are the capillaries that bring food to the boundaries of the joint capsule.
Help eliminate edema and improve tissue trophism: Troxerutin, horse chestnut extract, Diosmin in combination with other drugs, Pentoxifylline.
When the supporting function of the joint is impaired, the body tries to compensate for it at the expense of muscles and ligaments that are not designed for such an almost constant load. Pain and spasm occur due to chronic excessive tension in the muscles. These cramps can interfere with sleep or walking.
To eliminate them, in the treatment of osteoarthritis of the hip joint are prescribed: Baclofen, Tizanidine, Tolperisone.
External and heating substances
Drugs in this group have a vasodilating effect. They help to relieve swelling, relieve pain and psychologically distract from joint discomfort.
Generally, substances based on animal poisons or burning plant extracts are used to treat osteoarthritis of the hip joint.
Form release 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 in various forms for the treatment of osteoarthritis of the hip joint.
Tablets, capsules, powders
This is a dose of hip arthritis treatments and easy to carry with you. You only need to take a glass of water. In addition, a blister or packaging allows you to track how many days the course lasts. Such drugs are distinguished by good bioavailability. However, anti-inflammatory tablets can adversely affect the mucous membranes of the stomach and intestines - with gastritis, ulcers, colitis, it is better to prefer needles for the treatment of osteoarthritis of the hip joint.
Intramuscular and intraarticular injection
In the form of injections are usually used anti-inflammatory drugs, muscle relaxants and chondroprotectors. This ensures maximum biological availability, preserves the gastric mucosa, but generally requires the presence of a medical professional. Intra-articular injections without special skills are strictly prohibited!
Ointments, gels and creams
External substances for the treatment of osteoarthritis of the hip joint have a low bioavailability (about 5%), which limits their use in therapy with an auxiliary role. However, there are fewer contraindications to its use.
Less commonly, liquid preparations for the treatment of osteoarthritis of the hip joint - in the form of balms, solutions for compresses.