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.
Patients often have to worry about the symptoms and treatment of osteoarthritis of the hip joint already at the age of 25-35.The disease can progress rapidly under the influence of injuries, uncompensated physical activity (non-compliance with the technique of performing sports exercises, "standing" work, excess weight), hereditary factors, infectious and chronic diseases.
However, effective treatment of hip osteoarthritis can preserve mobility and prevent bone degradation.In old age, it helps 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 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 cracking appear and the range of motion of the joint is reduced.The musculo-ligamentous system begins to weaken, which causes increased fatigue.
- Stage 3. Pain is felt constantly and patients find it difficult to move without a cane or walker.Movement in the joint is very limited.Climbing stairs is a great challenge.There are gait disturbances (limping, falling on one or both legs).With unilateral coxarthrosis, pelvic distortion and curvature of the spine 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 of osteoarthritis of the hip joint.
With successful lifelong treatment, pain due to osteoarthritis of the hip joint may be completely absent or rarely bother the patient.The prospects of this therapy depend on the patient's compliance with the rheumatologist's rules and his personal self-discipline.Please note that only the treating doctor can make the most accurate prognosis of the disease.
With timely and regular treatment.
If chronic diseases do not contribute to disease progression and hip osteoarthritis treatment began in stage 1 or 2, hip replacement can be avoided.Disability and loss of the ability to work, if the doctor's recommendations are followed, move by the age of 20, and sometimes the patient retains an almost unlimited range of motion in the joint until old age.The best prognosis is possible with the call.benign osteoarthritis: when the wear of the cartilage depends on external factors (professional activity, sanitary violations).In this case, it is worth excluding them and undergoing restorative treatment to stop further degeneration of the joint.
Timely surgical treatment of grade 3 osteoarthritis of the hip joint will help avoid immobility of the joint, consequences for the entire musculoskeletal system and many years of pain.In the absence of contraindications, prostheses will help you return to your previous activity.
When you self-medicate
When choosing a method of treatment for osteoarthritis of the hip joint, the doctor takes into account the age, constitution, physical condition of the patient, his state of health, 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 osteoarthritis progression, the quality of synovial fluid and other indicators are examined.
Self-treatment of osteoarthritis of the hip joint with traditional methods does not take into account these individual indicators 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 in the illusion that a chronic disease as serious as osteoarthritis of the hip joint can only be cured with traditional methods.Avoid taking anti-inflammatory medications without a prescription;This can cause serious problems with the digestive and endocrine systems!
No treatment
If left untreated, osteoarthritis of the hip joint progresses on average 2 to 4 times faster.In this case, a deterioration in the quality of life and the appearance of disability at a relatively early age, between 45 and 50 years, is possible.Patients' sleep deteriorates, 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 osteoarthritis of the hip joint is conservative outpatient therapy.It includes pharmacological treatment of osteoarthritis of the hip joint, physiotherapy, diet therapy, use of bandages and adjustable orthoses.This approach allows you to relieve pain, maintain muscle function, and increase 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, when treating grade 3 osteoarthritis of the hip joint, endoprostheses are prescribed - partial or complete replacement of the diseased joint.A prosthesis made of metal and a ceramic or polymer coating lasts 15 to 25 years, after which it requires replacement.Total arthroplasty (total joint replacement) is the most effective treatment for hip osteoarthritis.It allows you to fully restore your functionality with a minimal incision of up to 8 cm in length and the ability to walk with support within one day.Complete rehabilitation lasts 1 to 3 months.
Physiotherapeutic methods for the treatment of osteoarthritis of the hip joint.
Physiotherapy for osteoarthritis 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:
- ultrahigh frequency therapy;
- ultrasound therapy;
- laser therapy;
- magnetic therapy;
- therapeutic exercises (therapeutic gymnastics);
- therapeutic massages and manual therapy;
- ozone therapy;
- cryotherapy;
- acupuncture;
- traction (traction) therapy;
- paraffin applications and wraps;
- balneotherapy and mud therapy;
- hydromassage.
Treatment of osteoarthritis of the hip joint with exercise therapy.
Physiotherapy for osteoarthritis of the hip joint aims to strengthen the muscles and ligaments;They are a natural orthosis that reduces the load on the joint and keeps it in a physiologically correct position.As a result, treating osteoarthritis of the hip joint with exercises helps relieve pain and inflammation, improves mobility, slows down cartilage wear, and ensures the supply of nutrients to the synovial fluid.The following exercises will help you strengthen your legs:
- Starting position: sitting on the floor, focusing on your arms extended behind you.Legs stretched out 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 and toes away from you).
- The starting position is the same.Bend your leg at the knee, pulling it toward you along the mat or onto the weight.It is advisable to touch the ground only with your toe after completing the movement.
- Starting position: lying on your back, legs bent at the knees and feet on the floor.We do the "frog" exercise: we separate our bent knees and hold them for 20 seconds.Then we put it back together.
- Starting position: lying on your back, with one leg straight and the other bent and placed to the side.We lay like that for a minute and then switched legs.
- Starting position: lying on your back, legs straight and lying freely.We bring the socks inside, touching them and then separate them.Repeat at a pace 10 times.
- Starting position: lying on your back, with one leg (on the side of the affected joint) crossed over the other.We move the foot of the calf as in the previous exercise.
- Starting position: lying on your back.We pull the knee towards the stomach, holding the back of the thigh with intertwined 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.Perform for at least 30 seconds.
- The starting position is the same.We move the stretched leg to the side on the floor.20-30 times on each leg.
- Starting position: standing.Place a chair to one 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 relaxing and restorative technique for the treatment of osteoarthritis of the hip joint in the early stages.As a treatment for osteoarthritis of the hip joint of the first degree (as well as the second, 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 rapid warm-up when moving from rest to active activity and vice versa.
For osteoarthritis of the hip joint, a professional therapeutic massage is desirable (at least 10-12 sessions).But gentle self-massage at home also helps improve the condition.It is important to avoid intense pain and discomfort.At the slightest sign of inflammation in the joint, the manipulations are temporarily stopped;They can be resumed with the permission of the treating physician, after a course of anti-inflammatory therapy.
Even in cases where the patient suffers from unilateral coxarthrosis, the massage is performed on both sides.How to do it correctly?
- To start, adopt a comfortable position that allows you to relieve tension in 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 for 7 to 10 minutes from your shoulder blades to your sacrum to improve blood circulation.
- Proceed to slowly caress the lumbar area and then circularly warm up the lumbosacral region with two fingers.
- Massage the spine with your thumbs, as far as your posture allows, gradually descending to the lower back.
- Press your palms into the sacrogluteal area and begin to rub and stretch the muscles.This completes the preparation.
- Rub the thighs with your palms and then massage them well in a circle with your thumbs.
- Knead the inner part of the thigh without applying pressure (so as not to squeeze the blood vessels).It is best to grab the fold of fat between your thumb and the rest of your fingers and knead it well.
- Important!Complete the procedure with relaxing caresses and pats.
Transverse, longitudinal, gripping and compression movements are used in thigh massage.Rubbing is done with different parts of the palm or with 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 osteoarthritis 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 (give an anti-inflammatory effect), the most important are C, D, E. Low-protein diets are contraindicated in the treatment of osteoarthritis of the hip joint.Therefore, be sure to include in the menu:
- Diet meats, poultry, fish.
- Eggs.
- Milk and dairy products.
- Fresh fruits, vegetables and herbs.
- Whole grains and oilseeds (such as flax), as well as nuts.
- Dishes and products with natural chondroprotectors (gelatin, gelatin, cartilage, pork thighs, 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 is not in vain that rehabilitation experts joke that losing a couple of kilos is the most effective treatment for osteoarthritis of the hip joint.It is also necessary 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, sweets and confectionery products;
- sausages and marinades.
Don't forget to drink at least 2.5 liters of water a day!
Pharmacological treatment of osteoarthritis of the hip joint.
Treatment of osteoarthritis of the hip joint with medications is carried out strictly as prescribed by the doctor.In case of exacerbation and severe pain, it is allowed to take conventional pain relievers or mild anti-inflammatory drugs (ibuprofen), but no more than 10 days before consulting a specialist.Otherwise, the picture of the disease will be blurred and it will be difficult for the doctor to select the appropriate treatment for osteoarthritis of the hip joint.
There are several medicinal groups of drugs for the treatment of osteoarthritis of the hip joint.In the complex treatment of osteoarthritis 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 - these common symptoms of inflammation in osteoarthritis 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 friction destroying the surface of the joint membrane!), muscular dystrophy and persistent impairment of mobility.
But the main danger of inflammation is the death of cartilage cells - chondrocytes.When broken down in large quantities, they create a buildup of enzymes that "eat away" at the surface of articular cartilage.
Therefore, to relieve inflammatory symptoms and restore tissue metabolism, 2 groups of anti-inflammatory drugs are used: non-steroidal (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 osteoarthritis of the hip joint, in courses or as needed.
These include: nimesulide, ibuprofen, meloxicam, ketoprofen, indomethacin, diclofenac.
If NSAIDs fail, rheumatologists prescribe "heavy artillery": corticosteroids.They immediately relieve even severe pain and inflammation, but cannot be taken for a long time or in large doses.Like any hormonal drug, they can affect the weight and condition of internal organs and, if the therapeutic dose is exceeded, they can aggravate the course of osteoarthritis.
The drugs 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-inflammatory drugs relieve symptoms, they do not solve the problem: they do not restore the damaged surface of the cartilage and do not enrich the synovial fluid with glycosaminoglycans.Therefore, effective treatment of osteoarthritis of the hip joint is unthinkable without the drugs chondroitin and glucosamine sulfate, which provide the body with the building material for the formation of new cartilage cells.
Since the metabolism in cartilage tissue is very slow, chondroprotectors must be taken for a long time: 3 to 6 months a year.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 bring nutrients to the limits of the joint capsule.
The following help 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 impaired, the body attempts to compensate by using muscles and ligaments that are not designed for such 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, the following are prescribed in the treatment of osteoarthritis of the hip joint: baclofen, tizanidine, tolperisone.
External and heating agents.
Drugs in this group have a vasodilating effect.They help relieve swelling, reduce pain and psychologically distract from joint discomfort.
Typically, products based on animal poisons or extracts from spicy plants are used to treat osteoarthritis of the hip joint.
Form of 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 medications for the treatment of osteoarthritis of the hip joint in various forms.
Tablets, capsules, powders.
These products for the treatment of osteoarthritis of the hip joint are easy to dose and carry with you.The only thing you need is to drink a glass of water.Additionally, the blister or packaging allows you to keep track of how many days the course has lasted.These drugs have good bioavailability.But anti-inflammatory tablets can have a negative effect on the mucous membranes of the stomach and intestines;for gastritis, ulcers and colitis, it is better to prefer injections for the treatment of osteoarthritis of the hip joint.
Injections for intramuscular and intra-articular administration.
Anti-inflammatory, muscle relaxant, and chondroprotective drugs are usually administered by injection.This ensures maximum bioavailability and is gentle on the gastric mucosa, but usually requires the presence of a medical professional.It is strictly prohibited to perform 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 osteoarthritis of the hip joint, in the form of balms and solutions for compresses.