Osteoarthritis of the hip joint - symptoms and complex treatment

Osteoarthritis of the hip joint (coxarthrosis) is a chronic, gradually progressive disease, in the absence of timely and proper treatment, can result in complete loss of movement in it. The end suggests that it is not an inflammatory but a degenerative process that 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 a 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 and is characterized by a gradual change in cartilage with subsequent bone deformation and loss of joint functionality. It mainly affects people after the age of 40, but there are also very young patients.

Causes

Why does hip arthrosis 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 that becomes thinner and loses its ability to absorb loads. The body compensates for the stratification of cartilage tissue by creating bone growths along the edge of the joint surfaces, leading to deformation of the joints and bones of varying degrees.

The main causes of this joint disease:

1. Injuries. Such a cause may not be a 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 rupture of the joint capsule, leading to the accumulation of many injuries. Recurrent microtrauma is a precursor to the onset of such a disease.
2. Excessive loads, leading to systemic microtrauma as well as joint injuries. It most often occurs in people who do hard physical work or professional athletes. In this case, treatment without lifestyle changes or exercise restrictions is also ineffective and is often accompanied by relapses.
3. Hereditary predisposition. These include abnormalities in the development of the femoral head itself, underdevelopment of the joint elements, etc. In that case, the so-called dysplastic arthrosis of the hip joint occurs.
4. Diseases. For example, arthritis, if not treated properly, can develop into osteoarthritis over time. This is due to the fact that during arthritis the properties of the cartilage tissue change and there is damage to the blood circulation. This gradually leads to the development of a degenerative process.
5. Overweight. Being overweight, even when walking, puts a strain on joints that exceed their physiological limits of strength.

Depending on the cause of the disease and its pathogenesis, there are 2 main types of hip arthrosis.

1. 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 older than 50 years. Primary osteoarthritis of the hip joint is most commonly diagnosed.
2. Secondary coxarthrosis. In this case, the disease develops against the background of systemic inflammatory lesions of many joints in the body. Inflammation can be contagious and autoimmune in nature.

In the initial stage of coxarthrosis, patients are concerned only with minor pain or discomfort in the joint area. Such signs are often ignored, resulting in disease progression.

Symptoms of hip arthrosis

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 that depend on the stage of the disease:

1. Joint pain is the most obvious symptom by which any hip disease can be assumed. The intensity and nature of the sensation usually depends on the stage.
Restriction 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 exertion.
2. Weakening of the thigh muscles can be noticed already in the second stage of the disease, reaching complete atrophy in the third stage.
3. Changes in leg length due to pelvic deformity are characteristic of “advanced” osteoarthritis.
4. Lameness or a change in gait is a very likely sign of bone deformity.
5. A pronounced crunch in the joint is not always a sign of osteoarthritis. It is usually taken into account when other symptoms are present.

The main symptom of coxarthrosis is pain whose nature, duration, localization and intensity depend on the stage of the disease.

Osteoarthritis of the hip joint 1 degree

This stage of the disease is characterized by joint and hip pain, sometimes in the knee, which occurs after physical exertion and relaxation after rest. The mobility of the joints is not limited and there are no gait disorders.

Coxarthrosis of the 1st degree is the initial phase of the disease, the beginning of which treatment is still possible to stop the process of destruction and deformation of the joint and completely preserve its functions. But, unfortunately, many do not consider it necessary to consult a doctor because of mild joint pain, while the disease progresses in the meantime.

Osteoarthritis of the hip joint 2nd degree

It is more clearly manifested - 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 difficulties in pronation (rotation of the hip inward) and abduction, and a contracture is formed.

X-ray examination shows narrowing of the joint space and the appearance of bone growths on the surfaces. The acetabulum and femoral head are deformed. The thigh muscles begin to atrophy on the affected side, and the pain syndrome spreads lower, covering 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

Signs of the disease are pronounced and permanent. The pain syndrome catches up at night. The patient uses support while walking. The muscles of the lower leg and thigh gradually atrophy, and the sick leg of the sick person becomes much shorter.

Often, by grade 3, the joint space disappears completely, and the joints grow together into a single bone structure, the photo shows. As a result, there is complete immobility of the joint.

Radiographs show extensive bony outgrowths from the roof of the acetabulum and femoral head, a sharp narrowing of the joint space. The neck of the femur is significantly enlarged and shortened.

Diagnostics

Before you can figure out how to treat hip osteoarthritis, you need to make the 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, globulin, immunoglobulin and seromucoids.

The next step in detecting osteoarthritis is an X-ray. Discovery:

• cartilage ossification,
• bony outgrowths at the border of cartilage,
• narrowing the distance between the joints,
• thickening of the bone tissue below the cartilage.

Unfortunately, X-ray does not allow to see the joint capsule and cartilage, if it is necessary to get information about these soft tissues, the patient will be referred for tomography.

Treatment of hip arthrosis

When hip arthrosis is diagnosed, treatment will directly depend on the stage of the disease. The general treatment regimen envisages the achievement of the following goals:

• eliminate pain and discomfort in the area of ​​the painful joint;
• adjust the diet of intra-articular cartilage and start the process of its renewal;
• eliminate intra-articular fluid deficiency;
• activate microcirculation in joint tissues;
• eliminate increased load on the hip joint;
• strengthen the muscles that surround, protect and support the joint;
• prevent deformations and increase the mobility of the hip joint.

All this can only be achieved with the help of an integrated approach, which should include not only drug therapy but also lifestyle changes to address the risk factors for coxarthrosis.

• In the third stage of the disease, treatment includes surgery, during which the joint is replaced with an endoprosthesis, while part of the prosthesis is implanted in the femur and part in the pelvis. The operation is quite complex, time consuming and requires a long period of rehabilitation.
• In stage I and II osteoarthritis of the hip joint, treatment is carried out without surgery. Used: nonsteroidal anti-inflammatory drugs, muscle relaxants, chondroprotectors, vasodilators, hormonal steroids, topical drugs - ointments, lotions, compresses.

All of these medications are prescribed exclusively by a doctor. Some are effective by injecting directly into the affected joint area. Such injections may only be given by qualified medical personnel. Therefore, self-medication is not strictly recommended.

Non-medical methods

In addition to the use of medications, doctors also recommend medications that do not deal with medications. These include the following treatments for this disease:

• physiotherapy;
• massage;
• co-breeding;
• diet.

Physiotherapy for osteoarthritis includes the following treatments:

• magnetic therapy;
• UHF and ultrasound therapy;
• aeroion and electrotherapy;
• inductothermy;
• light therapy;
• application of laser technology.

All of these methods can only be used to improve blood supply to the joints and relieve cramps.

Drug Therapy

Combination treatment of hip osteoarthritis includes the appointment of the following groups of drugs:

1. Nonsteroidal anti-inflammatory drugs, all relieve pain, relieve inflammation, but do not regenerate cartilage tissue.
2. Chondroprotectors. Nutritional preparations for cartilage. Accelerate her recovery. Important in 1, 2 stage of arthrosis treatment. In stage 3 disease the cartilage is already destroyed, these drugs will be useless. It takes a long time to take medication, take a few courses.
3. Muscle relaxantseliminate muscle cramps in the area of ​​diseased joints, improve blood circulation.
4. Ointments and creams. Medicinal ointments are ways to alleviate the condition of a sick person, but they do not contribute to complete recovery. Warming fats work well. They irritate skin receptors and thus reduce pain. Warming fats also work to restore increased blood circulation in the tissues and muscles around the affected joint.
5. Injections of steroids into the joint cavity, injections of these drugs are prescribed to alleviate the worsening of the disease and eliminate severe pain.
6. Vasodilators, dilate blood vessels in and around the joint cavity, thereby improving the delivery of nutrients necessary for tissue regeneration.

You don't have to rely on folk remedies. But some healers recommend a tincture of lemon, garlic or celery root to treat joints and bones.

Massage in the treatment of coxarthrosis

In case of deforming hip arthrosis, massage treatment gives good results. Massage for coxarthrosis is a very effective and useful method. It is desirable that the massage is performed by a good expert and as often as possible.

Its action is aimed at improving blood circulation, strengthening muscles, relieving painful cramps, swelling and muscle tension, as well as increasing diastase between the articular elements of the joint.

In the absence of a professional masseur, you can do the massage yourself. Massage for osteoarthritis can be performed both manually and with the help of various massage devices, and even a jet of water (hydrokinesis therapy).

Gymnastics

The treatment of hip arthrosis with physical education consists of achieving two goals: increasing leg mobility and preventing muscle atrophy. All standard exercise therapy complexes for coxarthrosis also generally have a strengthening character and a positive effect on the whole body.

The complex of gymnastic exercises is prescribed by a specialist. The first few sessions of physical therapy should be under the supervision of a physician. It will show you how to perform each movement properly and will also monitor the proper loading of the hip joints.

Diet

Key recommendations:

1. Prefer porridge on water.
2. Eat enough animal protein: fish (except salted), poultry, beef.
3. Eat at least 5 servings of vegetables a day (one serving is 100 grams, can be used as a side dish).
4. Dairy products needed: cottage cheese, yogurt, fermented baked milk.
5. Remove alcohol, coffee and strong black tea.
6. Remove sweet, starchy foods.
7. Eat small meals, but often.

The diet will reduce stress on the hip joints and provide them with everything they need to rebuild tissue.