Arthrosis of the hip joint (coxarthrosis) is a chronic, gradually progressive disease, in the absence of timely and correct treatment, it can result in a complete loss of movement in it. The end suggests that not an inflammatory, but a degenerative process prevails.
The symptoms of this disease vary depending on the stage. At the very beginning, this is a barely noticeable discomfort that occurs when walking and exercising. Perhaps manifestation in the form of mild pain in the hip region, which disappears at rest. In this case, pain can be felt not only in the thigh, but also in the groin or knee.
As a rule, coxarthrosis is a process that has been going on for many years, characterized by a gradual change in cartilage with subsequent deformation of the bones and loss of joint functionality. It mainly affects people after 40 years of age, but there are also very young patients.
Causes of occurrence
Why does arthrosis of the hip joint occur, and what is it? The causes of coxarthrosis can be different, but the picture of the disease is always the same. It all starts with a change in the articular cartilage, which becomes thinner and loses its ability to absorb loads. The body compensates for the stratification of cartilage tissue by the formation of bone growths along the edge of the articular surfaces, which leads to deformation of the joints and bones of varying degrees.
The main causes of this joint disease:
- Injuries. Such a cause may not be some major lesion, but in many cases the development of the disease is influenced by chronic microtraumas that contribute to cracking and thinning of the cartilage. They also affect the tearing of the joint capsule, leading to the accumulation of many injuries. Often, repetitive microtrauma is a precursor to the appearance of such a disease.
- Excessive loads, leading to systematic microtraumas, as well as joint injuries. Most often it occurs in people engaged in hard physical labor or professional athletes. In this case, treatment without lifestyle changes or exercise limitation is also ineffective and often accompanied by relapses.
- Hereditary predisposition. These include abnormalities in the development of the femoral head itself, underdevelopment of the elements of the joint, and so on. In this case, the so-called dysplastic arthrosis of the hip joint occurs.
- Diseases. For example, arthritis, if not treated correctly, can develop into arthrosis over time. This is due to the fact that during arthritis, the properties of the cartilage tissue change, and blood circulation is impaired. This gradually leads to the development of a degenerative process.
- Overweight. Excess body weight, even when walking, exerts a load on the joints that exceeds their physiological strength limits.
Depending on the cause of the disease and its pathogenesis, there are 2 main types of arthrosis of the hip joint.
- Primary coxarthrosis. In this case, the disease develops very slowly and begins with a violation of the blood supply to the tissues. The reasons for the development of this type of arthrosis are rooted in metabolic disorders, which are more common in people over 50 years old. Primary arthrosis of the hip joint is the most commonly diagnosed.
- Secondary coxarthrosis. In this case, the disease develops against the background of systemic inflammatory lesions of many joints in the body. Inflammation can be both infectious and autoimmune in nature.
At the initial stage of coxarthrosis, patients are concerned only with minor pain or discomfort in the articulation area. Often such signs are ignored, with the result that the disease progresses.
Symptoms of arthrosis of the hip joint
Coxarthrosis of the hip joint, the symptoms of which cannot be ignored, can lead to serious consequences. There are several main signs of the disease, which depend on the stage of the disease:
- Pain in the joint area is the most obvious symptom by which any hip disease can be assumed. The intensity and nature of the sensations usually depend on the stage.
- Limitation of limb mobility is also a symptom of coxarthrosis. The early stage is characterized by a feeling of "stiffness" of the joint, which passes after some exertion.
- Weakening of the thigh muscles can be observed already at the second stage of the disease, reaching at the third stage to complete atrophy.
- Changes in leg length due to pelvic deformity are characteristic of "advanced" osteoarthritis.
- Lameness or change in gait is a very likely sign of bone deformity.
- A distinct crunch in the joint is not always a sign of arthrosis. Usually taken into account when other symptoms are present.
The main symptom of coxarthrosis is pain, the nature of which, its duration, localization and intensity depend on the stage of the disease.
Arthrosis of the hip joint 1 degree
This stage of the disease is characterized by pain in the joint and hip, sometimes in the knee, arising after physical exertion and subsiding after rest. Joint mobility is not limited and there are no gait disturbances.
Coxarthrosis of the 1st degree is the initial stage of the disease, starting the treatment of which, it is still possible to stop the process of destruction and deformation of the joint and preserve its functions in full. But, unfortunately, many do not consider it necessary to consult a doctor because of mild pain in the joint, while the disease is progressing in the meantime.
Arthrosis of the hip joint 2nd degree
It appears more clearly - the intensity of pain increases, it occurs not only after exercise, but also at rest, there is a limitation of motor functions. In particular, coxarthrosis is characterized by difficulty in pronation (inward rotation of the hip) and abduction, and contracture is formed.
X-ray examination shows a narrowing of the joint space and the appearance of bone growths on the surfaces. The acetabulum and the femoral head are deformed. The muscles of the thigh begin to atrophy on the side of the lesion, and the pain syndrome spreads below, capturing both the knee joint and the groin area (it is important to understand that this will not be accompanied by degenerative changes in the knee joint).
Grade 3 hip arthrosis
The symptoms of the disease are pronounced and permanent. Pain syndrome catches up at night. When walking, the patient uses support. The muscles of the lower leg and thigh gradually atrophy, and the diseased leg of a sick person becomes much shorter.
Often, by the 3rd degree, the joint space completely disappears, and the joints grow together into a single bony structure, this is demonstrated by the photograph. As a result, complete immobility of the joint occurs.
Radiographs show extensive bony growths on the side of the roof of the acetabulum and the head of the femur, a sharp narrowing of the joint space. The femoral neck is significantly widened and shortened.
Diagnostics
Before figuring out how to treat arthrosis of the hip joint, it is necessary to make a correct diagnosis. If coxarthrosis is suspected, the person will be referred for a biochemical blood test - in the presence of the disease, patients have a slight increase in ESR, globulins, immunoglobulins and seromucoid.
The next step in detecting arthrosis is an X-ray photo. It will reveal:
- cartilage ossification,
- bone growths on the border of cartilage,
- narrowing the distance between joints,
- thickening of bone tissue under cartilage.
Unfortunately, the X-ray photo does not allow to see the articular capsule and the cartilage themselves, if it is necessary to obtain information about these soft tissues, the patient will be referred for tomography.
Treatment of arthrosis of the hip joint
When diagnosed with arthrosis of the hip joint, treatment will directly depend on the stage at which the disease is. The general treatment regimen provides for the achievement of the following goals:
- eliminate pain and discomfort in the area of the sore joint;
- to establish nutrition of the intra-articular cartilage and start the process of its restoration;
- eliminate the deficiency of intra-articular fluid;
- activate microcirculation in the tissues of the joint;
- eliminate the increased load on the hip joint;
- strengthen the muscles that surround, protect and support the joint;
- to prevent deformity and increase mobility in the hip joint.
All this can be achieved only with the help of an integrated approach, which should include not only drug therapy, but also lifestyle changes in order to get rid of the risk factors for coxarthrosis.
- At the third stage of the disease, treatment involves surgery, during which the joint is replaced with an endoprosthesis, while part of the prosthesis is implanted into the femur, and part - into the pelvic bone. The operation is rather complicated, time-consuming and requires a long rehabilitation period.
- With I and II degrees of arthrosis of the hip joint, treatment is carried out without surgery. Used: non-steroidal anti-inflammatory drugs, muscle relaxants, chondroprotectors, vasodilators, hormonal steroid drugs, topical drugs - ointments, lotions, compresses.
All of these drugs are prescribed exclusively by the attending physician. Some are effective by injecting directly into the affected articular area. Such injections can only be done by qualified medical personnel. Therefore, self-medication is strictly not recommended.
Non-drug methods
In addition to the use of drugs, doctors also recommend non-drug methods of dealing with the disease. These include the following treatments for this disease:
- physiotherapy;
- massage;
- joint breeding;
- diet.
Physiotherapy for arthrosis includes the following treatments:
- magnetic therapy;
- UHF and ultrasound therapy;
- aeroionic and electrotherapy;
- inductothermy;
- light therapy;
- application of laser technology.
All these methods can only be used to improve the blood supply to the joints and relieve spasms.
Drug therapy
Combined treatment of hip arthrosis involves the appointment of the following groups of medicines:
- Non-steroidal anti-inflammatory drugs, all of them relieve pain, relieve inflammation, but do not restore cartilage tissue.
- Chondroprotectors. Cartilage nutritional preparations. Accelerate her recovery. Important in the 1. 2 phase of arthrosis treatment. At grade 3 of the disease, the cartilage is already destroyed, these drugs will be useless. It takes a long time to take medications, go through several courses.
- Muscle relaxantseliminate muscle spasms in the area of diseased joints, improve blood supply to tissues.
- Ointments and creams. Healing ointments are ways to alleviate the condition of a sick person, but they do not contribute to complete recovery. Warming ointments work well. They irritate the receptors in the skin and thereby reduce pain. Warming ointments also work to restore increased blood circulation to the tissues and muscles around the affected joint.
- Injections of steroids into the joint cavity, injections of these drugs are prescribed to relieve exacerbation of the disease and eliminate severe pain.
- Vasodilatorsdilate blood vessels in and around the articular cavity, thereby improving the delivery of nutrients needed for tissue repair.
There is no need to rely heavily on folk remedies. But some healers recommend tincture of lemon, garlic or celery root for the treatment of joints and bones.
Massage in the treatment of coxarthrosis
In case of deforming arthrosis of the hip joint, massage treatment gives good results. Massage for coxarthrosis is a very effective and useful method. It is advisable that the massage is carried out by a good specialist and as often as possible.
Its action is aimed at improving blood circulation, strengthening muscles, relieving painful spasms, swelling and muscle tension, as well as increasing diastasis between the articulating elements of the joint.
In the absence of a professional masseur, massage can be done by yourself. Massage for arthrosis can be performed both manually and with the help of various massage devices and even a stream of water (hydrokinesis therapy).
Gymnastics
Treatment of arthrosis of the hip joint by physical education consists in achieving two objectives: to increase the mobility of the legs and prevent muscle atrophy. All standard complexes of exercise therapy for coxarthrosis also have a general strengthening character and a positive effect on the entire body.
The complex of gymnastic exercises is prescribed by a specialist. The first couple of physical therapy sessions should be supervised by a doctor. He will show you how to perform each movement correctly and also monitor the proper load on the hip joints.
Diet
Key Recommendations:
- Give preference to porridge on the water.
- Eat enough animal protein: fish (except salted), poultry, beef.
- Eat at least 5 servings of vegetables a day (one serving is 100 grams, can be used as a side dish).
- Dairy products are required: cottage cheese, yogurt, fermented baked milk.
- Eliminate alcohol, coffee, strong black tea.
- Eliminate sweet, starchy foods.
- Eat small but frequent meals.
The diet will reduce the stress on the hip joints and provide them with everything necessary for tissue repair.