Hip joint arthrosis is the most common type of arthrosis.Since the hip joint (HJ) is larger than the others and has a multi-vector rotation axis, it experiences a large 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 25-35 years.This disease can develop rapidly under the influence of injuries, hacked physical activity (failure to comply with the technique of performing sports exercises, "standing" work, excess body weight), hereditary factors, infectious and chronic diseases.
Effective hip osteoarthritis treatment, however, can maintain mobility and prevent bone damage.In old age, it helps to avoid more dangerous pathologies - such as necrosis or fracture of the femoral head.
Symptoms of arthrosis of the hip joint
Symptoms and treatment of hip arthrosis depend on the stage of the disease.
- Level 1.
- Stage 2. The pain syndrome is increasing and bothering the patient even with normal household activities.The pain can radiate to the lower back or inner thigh.Stiffness and stiffness appear, and the range of motion in the joints is reduced.The muscle-ligament system begins to weaken, which causes increased fatigue.
- Level 3. The pain is felt constantly, and it is difficult for the patient to move without a cane or walker.Movement in the joint is very limited.Climbing stairs is a serious challenge.There is a gait disorder (lameness, falling on one or both legs).With unilateral coxarthrosis, pelvic deviation and curvature of the spine can be seen with the naked eye.
- Stage 4. The joint space is closed due to the proliferation of osteophytes and any movement in the joint is almost impossible.It loses its function and becomes severely deformed due to bone destruction.
Prognosis for hip joint arthrosis
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 compliance with rheumatology rules and self-discipline.Please note that the most accurate prognosis for this 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 hip arthrosis treatment begins at stage 1 or 2, hip replacement can be avoided.Disability and loss of ability to work, if the doctor's recommendations are followed, shift by 20 years, and sometimes the patient maintains an almost unlimited range of motion in the joints until old age.The best prognosis is possible with the so-called.Benign Arthrosis - When wearing cartilage depends on external factors (professional activity, sanitary violations).In this case, it is to exclude them and undergo a course of rehabilitation therapy to slow down further degeneration.
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 former activities.
When treating yourself
When choosing a treatment method for arthrosis of the hip joint, the doctor takes into account the age, constitution, physical fitness of the patient, his state of health, certain 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 development of arthrosis, the quality of the synovial fluid and other indicators are checked.
Self-treatment of osteoarthritis of the hip joint with traditional methods does not take into account these individual indications and, instead of the desired result, can cause severe aggravation, metabolic disorders and worsen the stage of the disease.But the worst thing is the time spent on the illusion that a serious chronic disease such as arthrosis of the hip joint can be cured only 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
Left untreated, arthrosis of the hip joint progresses on average 2-4 times faster.Deterioration of the quality of life and the onset of disability in this case may already be possible at a relatively young age - about 45-50 years.The patient's sleep deteriorates, physical activity decreases, and psycho-emotional disturbances are observed.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 preferred direction of treatment for grade 1 arthrosis of the hip joint is outpatient conservative therapy.It includes drug treatment of hip joint arthrosis, physiotherapy, diet therapy, wearing bandages and adjustable orthoses.This approach allows you to relieve pain, maintain muscle function and improve joint mobility.Treatment of grade 2 arthrosis of the hip joint is done the same.
If conservative treatment of hip joint arthrosis is delayed or ineffective, cartilage degeneration develops rapidly, and surgery is performed.Sometimes, the doctor can decide on osteotomy or arthrodesis, but in most cases, when treating grade 3 arthrosis of the hip joint, endoprosthetics are prescribed - partial or complete replacement of the diseased joint.Prostheses made of metal and ceramic or polymer liners last from 15 to 25 years, after which they need replacement.Total arthroplasty (total joint replacement) is the most effective treatment for hip arthrosis.It allows you to fully restore its function with a minimum cut of up to 8 cm in length and the ability to walk with support in a day.Complete recovery takes 1-3 months.
Physiotherapy methods for treating arthrosis 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 magnets and cryotherapy, are allowed only during the period of remission, in the 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;
- Attraction therapy (attraction);
- paraffin application and wrapping;
- Balneotherapy and mud therapy;
- Hydromassage.
Treatment of hip joint arthrosis with exercise therapy
Physical therapy for hip joint arthrosis aims to strengthen muscles and ligaments - they are natural orthoses that reduce the load on the joint and keep it in the correct physiological position.As a result, treating osteoarthritis of the hip joint with exercise helps to relieve pain and inflammation, improve mobility, slow down cartilage wear and ensure the supply of nutrients to the synovial fluid.The following exercises will help strengthen your legs:
- Starting Position - Sit on the floor, focusing on arms outstretched behind you.Legs straight in front of you.We bend and straighten our toes.
- The starting position is the same.Always bend and straighten your legs (toes towards you, toes away from you).
- The starting position is the same.Bend your legs at the knees, pulling them towards you along the mat or body weight.It is advisable to touch the floor only with your feet after completing the movement.
- Starting Position - Lie 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 together again.
- Starting Position - Lie on your back, one leg straight, the other bent and placed to the side.We lay like this for a minute, then switch legs.
- Starting Position - Lie on your back, legs straight, lying freely.We bring the socks inside, touch them, and then spread them.Repeat at the rate of 10 times.
- Starting Position - Lying on your back, one leg (from the side of the affected joint) is crossed towards the other.We move the lower leg as in the exercise above.
- Starting Position - Lie on your back.We pull the knees towards the stomach, holding the back of the thigh with the fingers cut.Do it for 30 seconds on each leg.
- The starting position is the same.We pull our legs bent at the knees towards the stomach and hold them below the knees with the fingers cut.Do it for at least 30 seconds.
- The starting position is the same.We move the straightened legs to the upper part of the floor.20-30 times on each leg.
- Starting Position - Standing.Place the chair on its side, with its 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 rehabilitation technique for the treatment of hip joint arthrosis in the early stages.As a treatment for arthrosis of the hip joint in the first stage (as well as -2 - if there is no pain and swelling), it can prolong remission, relieve discomfort and pain without medication, increase tissue trophism and slow down cartilage degeneration.It also eliminates spasms that interfere with sleep and movement, strengthens ligaments, normalizes gait, and allows you to quickly warm up when changing from rest to active activity and vice versa.
For hip joint arthrosis, professional therapeutic massage is desirable (at least 10-12 sessions).But a gentle self-massage at home also helps improve the situation.It is important to avoid severe pain and discomfort.At the slightest signs of inflammation in the joints, 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 has unilateral coxarthrosis, massage is performed on both sides.How to do it right?
- To begin, take a comfortable position that will allow you to relieve pressure on your hips and lower back.For example, lie on your back, side or stomach.
- Start gently massaging the area around the affected joint.If you have a helper, ask him to stroke your back for 7-10 minutes from your shoulder blades to your sacrum to increase blood circulation.
- Continue gently stroking the lower back, and then circular warming the Sacrolumbar region with two fingers.
- Massage the spine with your thumb, as far as the pose allows, gradually moving to the lower back.
- Press your palms to the sacrogluteal area and begin to rub and stretch the muscles.This completes the preparation.
- Rub your thighs with your palms and then massage well in circles with your thumbs.
- Inner thighs without applying pressure (so as not to squeeze blood vessels).It is better to grab the fold of fat between your thumb and other fingers and knead it thoroughly.
- Important!Complete the procedure with relaxing strokes and PATS.
In thigh massage, transverse, longitudinal, grasping, 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 of the hip joint and suture removal, massage is used for recovery and restoration of motor function.
Treatment of hip joint arthrosis with diet
The main principle of nutrition in the treatment of arthrosis of the hip joint is variety and balance in the main 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 B group (provide anti-inflammatory effects), C, D, E are of primary importance.A low protein diet is contraindicated in the treatment of osteoarthritis of the hip joint.Therefore, be sure to enter in the menu:
- Diet meat, chicken, fish.
- Eggs.
- Milk and dairy products.
- Fresh fruits, vegetables and herbs.
- Seeds and oils (such as flax), as well as nuts.
- Dishes and products with natural chondroprotectors (jelly, jelly, cartilage, pig's feet, ears, etc.).
But it is better to reduce the consumption of carbohydrates - after all, a little excess body weight creates a colossal load on painful joints.It is not for nothing that rehabilitation experts joke that losing a few kilos is the most effective treatment for arthrosis of the hip joint.You also need to exclude salty, spicy, sweet and fried foods, which cause the body to retain water.Reduce your intake:
- fast food and semi-finished products;
- baked goods, sweets and confectionery;
- sausage and fireplace.
Don't forget to drink at least 2.5 liters of water every day!
Drug treatment of hip joint arthrosis
Treatment of osteoarthritis of the hip joint with drugs is carried out strictly as prescribed by the doctor.In cases of severe severity and pain, it is allowed to take conventional analgesics or mild anti-inflammatory drugs (ibuprofen), but not more than 10 days before contacting a specialist.Otherwise, the picture of the disease will be blurred and it will be difficult for the doctor to choose an adequate treatment for arthrosis of the hip joint.
There are several groups of drugs for the treatment of arthrosis of the hip joint.In the complex treatment of arthrosis of the hip joint with drugs, 5 main pharmaceutical groups are used.
Anti-inflammatory drugs in the treatment of osteoarthritis of the hip joint
Swelling, stagnation of blood and other fluids, local fever and pain - common symptoms of inflammation in arthrosis not only poison the patient's life, but also worsen the disease.Over time, they lead to tissue starvation, reduction of synovial fluid, which "eats" the cartilage and disorders of its viscosity (caused by friction that destroys the surface of the articular membrane!), muscle dystrophy and a continuous decline in mobility.
But the main danger of inflammation is the death of cartilage cells - chondrocytes.When they break down in large quantities, they create an accumulation of enzymes that "eat" the surface of the articular cartilage.
Therefore, to relieve the symptoms of inflammation and restore tissue metabolism, 2 groups of anti-inflammatory drugs are used: non-steroidal (NSAIDs, NSAIDs) and glucocorticosteroids.
NSAIDs are considered gentler, although they can also affect the digestive system.That is why they were appointed in the first place.In the treatment of grade 2 arthrosis of the hip joint - in the course or as needed.
These include: nimesulide, ibuprofen, meloxicam, ketoprofen, indomethacin, diclofenac.
If NSAIDs fail, rheumatologists prescribe "heavy artillery" - corticosteroid drugs.They immediately relieve severe pain and inflammation, but they cannot be taken for a long time and in large doses.Like any hormonal drugs, they can affect the weight and condition of internal organs, and if the therapeutic dose is exceeded, they can worsen arthrosis.
The drugs of choice for the treatment of grade 3 arthrosis 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 hip joint arthrosis is unthinkable without chondroitin and glucosamine sulfate drugs, which supply the body with building materials 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 every year.But, with the use of lifelong prevention, they help achieve drug-free remission.
Chondroprotectors include: glucosamine, chondroitin.
Angioprotectors and correction of microcirculation
Inflammation and microtraumas that accompany arthrosis disrupt the blood supply around the affected joint.But it is the capillaries that bring the nutrients to the joint capsule boundary.
The following help relieve swelling and increase tissue trophism: troxerutin, horse chestnut extract, diosmin in combination with other drugs, pentoxifylline.
Muscle relaxants
When joint support functions are impaired, the body tries to compensate using muscles and ligaments that are not designed for near-constant loads.Because of chronic overstrain, 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 agents and heating
Drugs in this group have a vasodilating effect.They help relieve swelling, reduce pain and psychologically distract from joint discomfort.
Usually, to treat arthrosis of the hip joint, products based on animal venom or spicy plant extracts are used.
Drug form release for the treatment of arthrosis of the hip joint
Depending on the clinical manifestations of arthrosis and the patient's lifestyle, rheumatologists prescribe drugs for the treatment of osteoarthritis of the hip joint in various forms.
Tablets, capsules, powder
These products for the treatment of hip joint arthrosis are easy to dose and carry with you.All you need to take is a glass of water.Also, the blister or packaging allows you to track how many days the course has lasted.Such drugs have good bioavailability.But anti-inflammatory tablets can have a negative effect on the mucous membrane of the stomach and intestines - for gastritis, ulcers, colitis, it is better to choose injections for the treatment of osteoarthritis 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 gastric mucosa, but usually requires the presence of a medical professional.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 additional role.But there are many fewer contraindications to its use.
Less common are liquid preparations for the treatment of arthrosis of the hip joint - in the form of balms, solutions for compresses.