Osteoarthritis of the hip joint is the most common form of osteoarthritis.Because the hip joint (HJ) is larger than any other and has a multi-vector axis of rotation, it experiences enormous stress throughout life - when walking, running, jumping, climbing stairs, playing sports and doing everyday activities.
Patients often have to think about the symptoms and treatment of osteoarthritis of the hip joint as early as the age of 25-35.The disease can progress rapidly under the influence of injuries, decompensated physical activity (non-observance of the technique of performing sports exercises, “standing” work, excess weight), hereditary factors, infectious and chronic diseases.
However, effective treatment for hip osteoarthritis can preserve mobility and prevent bone loss.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
Symptoms and treatment of hip osteoarthritis depend on the stage of the disease.
- Stage 1. Patients experience mild pain in the groin area, which occurs after physical activity, prolonged standing or sudden movements in the joint, and then completely disappears 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 grinding occur and mobility in the joint is limited.The muscle-ligament system begins to weaken, leading to increased fatigue.
- Stage 3: The pain is felt constantly and it is difficult for the patient to move around without a cane or walker.Movement in the joint is severely restricted.Climbing stairs is a big challenge.Gait disorders occur (lameness, falling on one or both legs).In unilateral coxarthrosis, pelvic curvature and spinal curvature are visible to the naked eye.
- Stage 4. Due to the proliferation of osteophytes, the joint space closes 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 osteoarthritis of the hip joint can be completely eliminated or only rarely bother the patient.The chances of success of this therapy depend on the patient's compliance with rheumatological rules and his or her personal self-discipline.Please note that the most accurate prognosis of the disease can only be made by the treating doctor.
With timely and regular treatment
If chronic diseases do not contribute to the progression of the disease and treatment for hip osteoarthritis is started in stage 1 or 2, a hip joint replacement can be dispensed with.Disability and loss of ability to work are postponed by 20 years if the doctor's recommendations are followed, and sometimes the patient retains almost unlimited mobility of the joint until old age.The best forecast is possible with the so-called.Benign arthrosis - when the wear of cartilage depends on external factors (occupational activity, violations of hygiene).In this case, it is worth excluding them and undergoing restorative therapy to slow down further degeneration of the joint.
Timely surgical treatment of grade 3 arthrosis of the hip joint helps to avoid immobility of the joint, consequences for the entire musculoskeletal system and years of pain.Unless there are contraindications, prosthetics 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 patient's age, constitution, physical fitness, his health status, specific symptoms of the disease and its stage.The narrowing of the joint space lumen, the presence of osteophytes, the rate of osteoarthritis progression, the quality of the synovial fluid and other indicators are examined.
Self-treatment of arthrosis of the hip joint using traditional methods does not take these individual indicators into account and, instead of the desired result, can lead to severe exacerbation, metabolic disorders and a 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 using conventional methods.Avoid taking anti-inflammatory medications without a doctor's prescription - this can cause serious problems with the digestive and hormonal systems!
No treatment
If left untreated, osteoarthritis of the hip joint progresses 2-4 times faster on average.In this case, a deterioration in quality of life and the onset of disability are possible at a relatively young age - around 45-50 years.Patients' sleep worsens, physical activity decreases, and psycho-emotional disorders are observed.The pain prevents her from getting out of bed in the morning, going for a walk with her grandchildren, or going to work.
Treatment of arthrosis of the hip joint
The primary direction of treatment for arthrosis of the hip joint of the 1st degree is outpatient conservative therapy.These include drug treatment of arthrosis of the hip joint, physiotherapy, diet therapy, wearing bandages and adjustable orthoses.This approach allows you to relieve pain, maintain muscle function and increase joint mobility.The treatment of grade 2 osteoarthritis of the hip joint is analogous.
If conservative treatment for osteoarthritis of the hip joint is delayed or ineffective, cartilage degradation progresses rapidly and surgery is performed.Occasionally, the doctor may decide to perform an osteotomy or arthrodesis, but in most cases, when treating arthrosis of the hip joint of the 3rd degree, endoprosthetics is prescribed - a partial or complete replacement of the diseased joint.A prosthesis made of metal and a ceramic or polymer liner lasts 15 to 25 years and then needs to be replaced.Total arthroplasty (total joint replacement) is the most effective treatment for hip osteoarthritis.With a minimal incision up to 8 cm long, you can fully restore functionality and walk with support within a day.Full rehabilitation takes 1-3 months.
Physiotherapeutic methods for the treatment of arthrosis of the hip joint
Physiotherapy for osteoarthritis of the hip joint is carried out in courses as directed by a doctor.Almost all techniques, with the exception of magnetic and cryotherapy, are permitted only during the remission phase, provided there are no inflammatory symptoms.The following measures are used to treat osteoarthritis of the hip joint:
- ultra-high frequency therapy;
- ultrasound therapy;
- laser therapy;
- magnetic field 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 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 relieves the joint and keeps it in the physiologically correct position.As a result, the exercise-oriented treatment of osteoarthritis of the hip joint relieves pain and inflammation, improves mobility, slows down cartilage wear and ensures the nutrient supply to the synovial fluid.The following exercises will help strengthen your legs:
- Starting position – sit on the floor and focus on your outstretched arms 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 and pull it toward you along the mat or with a weight.It is advisable to only touch the floor with the tip of your foot 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'll put it back together.
- Starting position – lying on your back, one leg stretched, the other bent and placed to the side.We lie like this for a minute and then switch legs.
- Starting position – lying on your back, legs stretched, lying exposed.We pull the socks inwards, touch them and then spread them.Repeat 10 times at one pace.
- 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 and hold the back of the thigh with folded fingers.Perform the exercise for 30 seconds on each leg.
- The starting position is the same.We pull our legs, which are bent at the knees, towards our stomach and hold them under our knees with our fingers folded.Perform for at least 30 seconds.
- The starting position is the same.We move the stretched leg sideways across the floor.20-30 times on each leg.
- Starting position - standing.Place a chair with the back facing you.Holding the back of a chair, stand on one leg and swing the other back and forth like a pendulum.20-30 times.
Massage for the treatment of arthrosis of the hip joint
Massage is an effective relaxation and recovery technique for treating early-stage osteoarthritis of the hip joint.For the treatment of arthrosis of the hip joint of the 1st degree (as well as the 2nd degree - without 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 gait and provides a quick warm-up when switching 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 a 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 joint inflammation, manipulations are temporarily stopped - they can be resumed after anti-inflammatory therapy with the consent of the attending physician.
Even if the patient suffers from unilateral coxarthrosis, the massage is carried out on both sides.How do I do it correctly?
- First, get into a comfortable position that allows you to take pressure off 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 from shoulder blades to sacrum for seven to 10 minutes to improve blood circulation.
- Continue slowly stroking your lower back and then warm up the lower back area in a circular motion with two fingers.
- Massage the spine with your thumbs as much as the posture allows, gradually moving down toward 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 then massage them in a circular motion with your thumbs.
- Knead the inside of the thigh without applying pressure (so as not to squeeze the blood vessels).It is better to grab the fold of fat between your thumb and other fingers and knead it thoroughly.
- Important!Finish with relaxing stroking and stroking movements.
Thigh massage uses transverse, longitudinal, grasping and squeezing movements.Rubbing is done with different parts of the palm or 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 main principle of nutrition in the treatment of arthrosis of the hip joint is the diversity and balance of key indicators (vitamins, minerals, proteins, including essential amino acids).It is important to eat foods high 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 greatest importance.Low-protein diets are contraindicated in the treatment of osteoarthritis of the hip joint.Therefore, make sure the menu contains:
- Diet meat, poultry, fish.
- Eggs.
- Milk and dairy products.
- Fruit, vegetables and fresh herbs.
- Whole grain products and oilseeds (e.g. linseed) as well as nuts.
- Dishes and products with natural chondroprotectors (jelly, jelly, cartilage, pork legs, ears, etc.).
However, it is better to reduce your carbohydrate consumption - because even being slightly overweight puts enormous strain on the painful joint.It is not for nothing that rehabilitation experts joke that losing a few kilos 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;
- baked goods, sweets and confectionery;
- Sausages and marinades.
Don't forget to drink at least 2.5 liters of water per day!
Drug treatment of arthrosis of the hip joint
Drug treatment for osteoarthritis of the hip joint is carried out strictly according to a doctor's prescription.In case of exacerbation and severe pain, it is permissible to take traditional analgesics or gentle anti-inflammatory drugs (ibuprofen), but no more than 10 days before contacting a specialist.Otherwise, the clinical picture will be unclear and it will be difficult for the doctor to select an adequate treatment for arthrosis of the hip joint.
There are several groups of medicines used to treat osteoarthritis of the hip joint.In the complex drug treatment of arthrosis of the hip joint, 5 main groups of drugs 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 inflammatory symptoms in osteoarthritis not only poison the patient's life, but also worsen the course of the disease.Over time, they lead to tissue deficiency, depletion of the synovial fluid that “nourishes” the cartilage and disruption of its viscosity (as a result of which friction destroys the surface of the joint membrane!), muscular dystrophy and persistent deterioration in mobility.
However, the main danger of inflammation is the death of cartilage cells - chondrocytes.When broken down in large quantities, they form a collection of enzymes that “eat away” the surface of the articular cartilage.
Therefore, to relieve inflammatory symptoms and restore tissue metabolism, two groups of anti-inflammatory drugs are used: nonsteroidal (NSAIDs, NSAIDs) and glucocorticosteroids.
NSAIDs are considered gentler, but they can also affect the digestive system.That's why they are appointed first.In the treatment of arthrosis of the hip joint grade 2 – in courses or as needed.
These include: Nimesulide, Ibuprofen, Meloxicam, Ketoprofen, Indomethacin, Diclofenac.
When NSAIDs fail, rheumatologists prescribe the “heavy artillery” – corticosteroid drugs.They immediately relieve even severe pain and inflammation, but cannot be taken over a long period of time or in large doses.Like all hormonal drugs, they can affect the weight and condition of internal organs and, if the therapeutic dose is exceeded, aggravate the course of arthrosis.
The drugs of choice for treating grade 3 osteoarthritis of the hip joint 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, 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 over a long period of time - 3-6 months per year.However, when used preventatively for life, they contribute to drug-free remission.
Chondroprotectors include: glucosamine, chondroitin.
Angioprotectors and microcirculation correctors
Inflammation and microtrauma that accompany osteoarthritis disrupt the blood supply around the affected joint.But it is the capillaries that transport nutrients to the boundaries of the joint capsule.
The following helps to relieve swelling and improve tissue trophism: troxerutin, horse chestnut extract, diosmin in combination with other drugs, pentoxifylline.
Muscle relaxants
When the support function of a joint is compromised, the body tries to compensate by using muscles and ligaments that are not designed to handle such near-constant stress.Chronic overload causes pain and cramps in the muscles.These cramps can affect sleep or walking.
To eliminate them, the following are prescribed in the treatment of arthrosis of the hip joint: baclofen, tizanidine, tolperisone.
External and warming active ingredients
Drugs in this group have a vasodilating effect.They help relieve swelling, relieve pain and mentally distract from joint problems.
To treat osteoarthritis of the hip joint, products based on animal poisons or pungent plant extracts are usually used.
Release form of drugs 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 arthrosis of the hip joint in various forms.
Tablets, capsules, powder
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.In addition, you can use the blister or packaging 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 - with gastritis, ulcers, colitis, it is better to give preference to 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 guarantees maximum bioavailability and is gentle on the stomach lining, but usually requires the presence of a medical professional.Carrying out 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 a low bioavailability (approx. 5%), which limits their use in therapy to an auxiliary function.However, 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, solutions for compresses.