Arthritis of the hip joint is the most common type of joint.Since the hip joint (HJ) is larger than all others and has a multivariate axis of rotation, it experiences a huge load throughout a person's life - when walking, running, jumping, climbing stairs, playing sports and daily activities.
Often patients have to worry about the symptoms and treatment of arthropathy of the hip joint already at the age of 25-35 years.The disease can develop rapidly under the influence of injury, uncompensated physical activity (inability to comply with the technique of performing sports exercises, "standing" work, excess weight), hereditary factors, infectious and chronic diseases.
Effective treatment of osteoarthritis of the hip, however, can preserve mobility and prevent bone destruction.In old age, it helps to avoid even more dangerous pathologies - such as necrosis or fracture of the femoral head.
Arthritis symptoms of the hip joint
Symptoms and treatment of hip arthropathy depend on the stage of the disease.
- Stage 1. Patients feel mild pain in the groin, which appears after physical activity, prolonged standing or sudden movements in the joint, and then disappears completely at rest.
- Stage 2. The pain syndrome intensifies and bothers the patient even with normal household activities.The pain may radiate to the lower back or inner thigh.Stiffness and tingling occur and range of motion in the joint is reduced.The musculo-connective system begins to weaken, which causes increased fatigue.
- Stage 3. Pain is constantly felt and it is difficult for patients to move without a cane or walker.Movement in the joint is severely limited.Climbing stairs is a serious challenge.There are gait disturbances (lameness, drop in one or both legs).With a unilateral coxarthrosis, the deformation of the pelvis and the 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 is severely deformed due to bone destruction.
Prognosis for arthropathy of the hip joint
With successful lifelong treatment, the pain due to arthropathy of the hip joint can be completely absent or rarely bother the patient.The prospects of this treatment depend on the patient's compliance with the rheumatologist's rules and his personal self-discipline.Note that the most accurate prognosis for the disease can only be made by the attending physician.
With timely and regular treatment
If chronic diseases do not contribute to the progression of the disease and treatment of hip arthropathy is started at stage 1 or 2, hip replacement can be avoided.Disability and loss of working ability, if the doctor's recommendations are followed, is shifted by 20 years, and sometimes the patient retains almost unlimited range of motion in the joint until old age.The best prognosis is possible with the so-called.benign arthropathy - when cartilage wear depends on external factors (occupational activity, hygiene violations).In this case, it is worth excluding them and undergoing a course of restorative treatment to slow down further degeneration of the joint.
Early surgical treatment of grade 3 osteoarthritis of the hip joint will help prevent immobility of the joint, consequences for the entire musculoskeletal system, and many years of pain.In the absence of contraindications, the prosthesis will help you return to your previous activity.
When you self-medicate
When choosing a method of treatment for arthropathy of the hip joint, the doctor takes into account the age, constitution, physical condition of the patient, the state of his health, the 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 progression of the joint, the quality of the 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 worsening of the disease stage.But the worst thing is the time spent on the illusion that such a serious chronic disease as arthropathy 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 cure
If left untreated, arthropathy of the hip joint progresses on average 2-4 times faster.The deterioration of the quality of life and the appearance of disability in this case is possible already at a relatively young age - about 45-50 years.Patients' sleep worsens, physical activity decreases and psycho-emotional disturbances 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 1st degree arthropathy of the hip joint is conservative outpatient treatment.It includes drug treatment of hip joint arthrosis, physiotherapy, diet therapy, use of bandages and adjustable orthoses.This approach allows you to relieve pain, maintain muscle function and increase mobility in the joint.Treatment of grade 2 arthropathy of the hip joint is carried out in a similar way.
If conservative treatment of hip joint arthrosis 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, during the treatment of grade 3 arthrosis of the hip joint, an endoprosthetic is prescribed - partial or complete replacement of the affected joint.A prosthesis made of metal and ceramic or polymer lining lasts from 15 to 25 years, after which replacement is required.Total arthroplasty (total arthroplasty) is the most effective treatment for hip arthropathy.It allows you to fully restore its functionality with a minimal incision up to 8 cm long and the ability to walk with support within a day.Full recovery takes 1-3 months.
Physiotherapy methods for the treatment of hip joint arthrosis
Physiotherapy for arthropathy of the hip joint is carried out in courses, according to the indications of the doctor.Almost all techniques, except magnetic and cryotherapy, are allowed only during the period of remission, with a complete absence of inflammatory symptoms.The following measures are used to treat osteoarthritis of the hip joint:
- extremely high frequency treatment.
- ultrasound therapy;
- laser therapy;
- magnetic therapy;
- therapeutic exercises (therapeutic gymnastics).
- therapeutic massage and manual therapy.
- ozone therapy;
- cryotherapy;
- acupuncture;
- attraction therapy (attraction);
- Paraffin applications and wraps.
- bath therapy and mud therapy.
- hydromassage.
Management of hip arthropathy with exercise therapy
Physical therapy for arthropathy of the hip joint is aimed at strengthening the muscles and ligaments - it is a physical orthosis that reduces the load on the joint and keeps it in the physiologically correct position.As a result, treatment of osteoarthritis of the hip joint with exercises helps to 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 - sit on the floor, focusing on the outstretched arms behind you.Legs straight in front of you.We bend and straighten our toes.
- The original position is the same.Alternately bend and straighten your legs (toes towards you, toes away from you).
- The original position is the same.Bend your leg at the knee, pulling it toward you along the mat or with a weight.It is recommended that you only touch the floor with your toe 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 extend our bent knees and hold them for 20 seconds.Then we put it back together.
- Starting position - lying on your back, one leg straight, the other bent and lying on the side.We lie like this for a minute and then change legs.
- Initial position - lying on your back, legs straight, lying freely.We bring the socks inside, touching them and then spread them out.Repeat at pace 10 times.
- Initial position - lying on the back, one leg (on the side of the affected joint) crossed over the other.We move the shin leg as in the exercise above.
- Starting position - lying on your back.Pull the knee towards the stomach, holding the back of the thigh with joined fingers.Perform for 30 seconds on each leg.
- The original position is the same.We pull our legs bent at the knees towards the stomach and hold them under the knees with joined fingers.Run for at least 30 seconds.
- The original position is the same.We move the straightened leg to the side above the floor.20-30 times on each leg.
- Starting position - standing.Place a chair on its side with its back facing you.Holding the back of a chair and standing on one leg, swing the other leg 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 restorative technique for the treatment of hip joint arthrosis in the initial stages.As a treatment for arthropathy of the hip joint of the 1st degree (as well as the 2nd - in the absence of 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 allows you to warm up quickly when changing from rest to active activity and vice versa.
For arthropathy of the hip joint, professional therapeutic massage (at least 10-12 sessions) is desirable.But gentle self-massage at home also helps to improve the condition.It is important to avoid pain and intense discomfort.At the slightest sign of inflammation in the joint, manipulations are temporarily stopped - they can be continued with the permission of the attending physician, after a course of anti-inflammatory treatment.
Even in cases where the patient suffers from unilateral coxarthrosis, both sides are massaged.How to do it right?
- To begin, get into a comfortable position that will allow you to relieve stress on your hips and lower back.For example, lying on your back, side or stomach.
- Begin to gently massage the area around the affected joint.If you have a helper, ask them to stroke your back for 7-10 minutes from your shoulder blades to your sacrum to improve blood circulation.
- Continue to slowly stroke the lower back and then do a circular warm-up of the sacro-lumbar region with two fingers.
- Massage the spine with your thumbs as far as the pose allows, gradually moving down to the bottom.
- Press your palms into the sacro-gluteal area and begin to rub and stretch the muscles.This completes the preparation.
- Rub your thighs with your palms and then give them a good circular massage with your thumbs.
- Knead the inner thigh without applying pressure (so as not to squeeze the blood vessels).It is better to grasp the fold of fat between your thumb and other fingers and knead it well.
- Great!Finish the process with relaxing strokes and strokes.
Thigh massage uses transverse, longitudinal, grasping, pressing movements.Rubbing is done with different parts of the palm or with bent fingers towards the groin.
After surgical treatment of grade 3 osteoarthritis of the hip joint and removal of sutures, massage is used to restore and restore motor functions.
Treatment of osteoarthritis of the hip joint with diet
The main principle of nutrition in the treatment of arthropathy of the hip joint is its diversity and balance in key indicators (vitamins, minerals, proteins, including essential amino acids).It is important to eat foods high in calcium, sulphur, zinc, magnesium and selenium.Of the vitamins, vitamins A and group B (provide anti-inflammatory effect), C, D, E are of primary importance. Diets with a low protein content are contraindicated in the treatment of osteoarthritis of the hip joint.Therefore, be sure to include in the menu:
- Dietary meat, poultry, fish.
- Eggs.
- Milk and milk products.
- Fruits, vegetables and fresh herbs.
- Whole grains and oilseeds (such as flax), as well as nuts.
- Dishes and products with natural cartilage preservatives (jelly, jelly, cartilage, pork legs, ears, etc.).
But it is better to reduce the consumption of carbohydrates - after all, even slight excess weight creates a colossal load on the painful joint.It's no coincidence that rehabilitation specialists joke that losing a few pounds is the most effective treatment for hip arthropathy.You should also exclude salty, spicy, sweet and fried foods, which cause the body to retain water.Minimize intake:
- fast food and semi-processed products.
- Pastries, sweets and confectionery.
- sausages and marinades.
Don't forget to drink at least 2.5 liters of water a day!
Pharmacological treatment of arthropathy of the hip joint
Treatment of osteoarthritis of the hip joint with drugs is carried out strictly according to the doctor's instructions.In case of exacerbation and severe pain, it is allowed to take conventional analgesics or mild anti-inflammatory drugs (ibuprofen), but not 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 choose the appropriate treatment for arthropathy of the hip joint.
There are several pharmaceutical groups of drugs for the treatment of arthropathy of the hip joint.In the complex treatment of arthrosis of the hip joint with drugs, 5 main drug groups are used.
Anti-inflammatory drugs in the treatment of osteoarthritis of the hip joint
Edema, stagnation of blood and other fluids, local fever and pain - these common symptoms of inflammation in arthropathy not only poison the patient's life, but also worsen 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 which friction destroys the surface of the synovial membrane!), muscle dystrophy and persistent deterioration of mobility.
But the main danger of inflammation is the death of cartilage cells - chondrocytes.When broken down in large quantities, they create a build-up of enzymes that "eat away" the surface of the 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 is why they are appointed first.In the treatment of arthropathy of the 2nd degree of the hip joint - in courses or as needed.
These include: Nimesulide, Ibuprofen, Meloxicam, Ketoprofen, Indomethacin, Diclofenac.
If NSAIDs fail, rheumatologists prescribe the "heavy artillery" - corticosteroid drugs.They immediately relieve even severe pain and inflammation, but they cannot be taken for a long time and 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 worsen the course of arthropathy.
The drugs of choice for the treatment of grade 3 arthrosis of the hip joint are: Hydrocortisone, Prednisolone, Methylprednisolone.
Cartilage protectors for osteoarthritis of the hip joint
Although anti-inflammatory drugs relieve the 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, the effective treatment of arthropathy of the hip joint is unthinkable without the drugs chondroitin and glucosamine sulfate, which supply 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 for a long time - 3-6 months per year.But with lifelong prophylactic use, they help achieve drug-free remission.
Chondroprotectors include: Glucosamine, Chondroitin.
Vasoprotectors and microcirculation correctors
The inflammation and microtraumas that accompany arthropathy disrupt the blood supply around the affected joint.But it is the capillaries that bring nutrients to the confines of the joint capsule.
The following help to relieve swelling and improve tissue trophism: Troxerutin, horse chestnut extract, Diosmin in combination with other drugs, Pentoxifylline.
Muscle relaxants
When the supporting function of a joint is impaired, the body tries to compensate by using muscles and ligaments that are not designed for such almost continuous load.Due to chronic overexertion, pains and spasms appear in the muscles.These cramps may affect sleeping or walking.
To eliminate them, in the treatment of osteoarthritis of the hip joint, the following are prescribed: Baclofen, Tizanidine, Tolperisone.
External and heating factors
The drugs of this group have a vasodilating effect.They help relieve swelling, reduce pain and psychologically distract from joint discomfort.
Usually, for the treatment of arthropathy of the hip joint, products based on animal poisons or spicy plant extracts are used.
Drug release form for the treatment of hip joint arthropathy
Depending on the clinical manifestations of the arthropathy and the patient's lifestyle, the rheumatologist prescribes drugs for the treatment of osteoarthritis of the hip joint in various forms.
Tablets, capsules, powders
These products for the treatment of arthrosis of the hip joint are easy to dose and take with you.All you need to take is a glass of water.Also, the blister or package allows you to keep track of 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 - for gastritis, ulcers, colitis, it is better to give preference to injections for the treatment of osteoarthritis of the hip joint.
Injections for intramuscular and intra-articular administration
Anti-inflammatory drugs, muscle relaxants and chondroprotectors are usually given by injection.This guarantees maximum bioavailability and is gentle on the gastric mucosa, but usually requires the presence of a medical professional.It is strictly forbidden to carry out intra-articular injections without special qualifications!
Ointments, gels and creams
External agents for the treatment of arthropathy of the hip joint have a low bioavailability (about 5%), which limits their use in treatment to an auxiliary role.But 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.