Osteoarthritis of the hip joint (coxarthrosis) is a chronic disease, gradually progressive, in the absence of a timely and correct treatment, it can result in complete loss of movement in it. The end suggests that an inflammatory process prevails, but a degenerative one.
The symptoms of this disease vary depending on the stage. At first, this is a barely noticeable discomfort that occurs when walking and exercising. Perhaps manifestation in the form of mild pain in the thigh area, which disappears at rest. In this case, the pain can be felt not only in the thigh, but also in the groin or knee.
As a general rule, coxarthrosis is a process that has been developing for many years, characterized by a gradual change of the cartilage with the consequent deformation of the bones and loss of joint function. It mainly affects people over 40, but there are also very young patients.
Causes of occurrence
Why does osteoarthritis of the hip joint occur and what is it? The causes of coxarthrosis may 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 bony growths along the edge of the joint surfaces, which leads to deformation of the joints and bones to varying degrees.
The main causes of this joint disease:
- Injuries. Such a cause may not be a major injury, but in many cases the development of the disease is influenced by chronic microtraumas that contribute to the cracking and thinning of the cartilage. They also affect the tear of the joint capsule, which causes the accumulation of many injuries. Repetitive microtrauma is often a precursor to the development of this disease.
- Excessive loads, causing systematic microtrauma as well as joint injuries. Most of the time it occurs in people who perform intense physical work or in professional athletes. In this case, treatment without lifestyle changes or exercise limitation is also ineffective and is often accompanied by relapses.
- hereditary predisposition. These include abnormalities in the development of the femoral head itself, underdevelopment of the elements of the joint, etc. In this case, the so-called dysplastic osteoarthritis of the hip joint occurs.
- 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 cartilage tissue change and blood circulation is affected. This gradually leads to the development of a degenerative process.
- Overweight. Excessive body weight, even when walking, places 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 osteoarthritis 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 osteoarthritis have their origin in metabolic disorders, which are more frequent in people over 50 years of age. Primary osteoarthritis of the hip joint is the most frequently diagnosed.
- Secondary coxarthrosis. In this case, the disease develops against the background of systemic inflammatory lesions of many joints of the body. Inflammation can be both infectious and autoimmune in nature.
In the early stage of coxarthrosis, patients are only concerned with minor aches or pains in the joint area. These signs are often ignored, with the result that the disease progresses.
Symptoms of osteoarthritis of the hip joint
Coxarthrosis of the hip joint, the symptoms of which cannot be ignored, can have serious consequences. There are several main signs of the disease, depending on the stage of the disease:
- Pain in the joint area is the most obvious symptom by which any disease of the hip joint can be assumed. The intensity and nature of the sensations usually depend on the setting.
- Limitation of limb mobility is also a symptom of coxarthrosis. The initial stage is characterized by a feeling of "stiffness" of the joint, which passes after some effort.
- The weakening of the thigh muscles can be observed already in the second stage of the disease, reaching complete atrophy in the third stage.
- 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 distinctive crack in the joint is not always a sign of osteoarthritis. It is generally taken into account when other symptoms are present.
The main symptom of coxarthrosis is pain, the nature, duration, location and intensity of which depend on the stage of the disease.
Osteoarthritis of the hip joint 1 degree
This stage of the disease is characterized by pain in the joint and hip, sometimes in the knee, which arises after physical exertion and disappears 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, when starting treatment, it is still possible to stop the process of destruction and deformation of the joint and preserve its functions in its entirety. But sadly, many do not find it necessary to see a doctor for mild pain in the joint while the disease progresses.
Osteoarthritis of the hip joint of the second degree
It manifests itself 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 a contracture is formed.
X-ray examination shows a narrowing of the joint space and the appearance of bony growths on the surfaces. The acetabulum and the femoral head are deformed. The thigh muscles begin to atrophy on the side of the injury and the pain syndrome spreads downward, capturing both the knee joint and the groin area (it is important to understand that this will not be accompanied by degenerative changes in theknee joint).
Grade 3 hip osteoarthritis
The signs 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 in the third degree, the joint space disappears completely and the joints grow together into a single bony structure, as shown in 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, an acute narrowing of the joint space. The femoral neck is significantly widened and shortened.
Diagnosis
Before discovering how to treat osteoarthritis of the hip joint, it is necessary to make a correct diagnosis. If coxarthrosis is suspected, a person will be referred for a biochemical blood test; in the presence of disease, patients have a slight increase in ESR, globulins, immunoglobulins, and seromucoid.
The next step in detecting osteoarthritis is an X-ray photo. It will reveal:
- cartilage ossification,
- bony growths on the edge of the cartilage,
- reducing the distance between the joints
- thickening of the bone tissue under the cartilage.
Unfortunately, the X-ray photo does not allow to see the joint capsule and the cartilage itself, if it is necessary to obtain information about these soft tissues, the patient will be referred for CT.
Treatment of osteoarthritis of the hip joint
When you are diagnosed with osteoarthritis of the hip joint, the treatment will depend directly on the stage of the disease. The general treatment regimen provides for the achievement of the following objectives:
- eliminate pain and discomfort in the sore joint area;
- adjust the nutrition of the intra-articular cartilage and begin the process of its restoration;
- eliminate intra-articular fluid deficiency;
- activate microcirculation in the joint tissues;
- eliminate increased load on the hip joint;
- strengthen the muscles that surround, protect and support the joint;
- to prevent deformities and increase mobility in the hip joint.
All of this can only be achieved with the help of an integrated approach, which should include not only drug therapy, but also lifestyle changes to eliminate risk factors for coxarthrosis.
- In the third stage of the disease, treatment involves surgery, during which the joint is replaced with a stent, while part of the prosthesis is implanted in the femur and part in the pelvic bone. The operation is quite complicated, time-consuming and requires a long period of rehabilitation.
- With I and II degrees of osteoarthritis of the hip joint, the 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 these drugs are prescribed exclusively by the attending physician. Some are effective by injecting directly into the affected joint area. These injections can only be performed by qualified medical personnel. Therefore, self-medication is not strictly recommended.
Non-pharmacological methods
In addition to the use of medications, doctors also recommend non-pharmacological methods to treat the disease. These include the following treatments for this disease:
- physiotherapy;
- massage;
- co-parenting;
- diet.
Physiotherapy for osteoarthritis includes the following treatments:
- magnetic therapy;
- ultrasound and UHF therapy;
- aeroionics and electrotherapy;
- inductothermia;
- light therapy;
- application of laser technology.
All of these methods can only be used to improve the blood supply to the joints and relieve spasms.
Drug therapy
The combined treatment of hip osteoarthritis involves the appointment of the following groups of drugs:
- Non-steroidal anti-inflammatory drugs, all relieve pain, relieve inflammation, but do not restore cartilage tissue.
- Chondroprotectors. Nutritional cartilage preparations. Speeds up your recovery. Important in phase 1. 2 of osteoarthritis treatment. In grade 3 of the disease, the cartilage is already destroyed, these drugs will be useless. It takes a long time to take medication, 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 full recovery. Hot ointments work well. They irritate the receptors in the skin and, therefore, reduce pain. Hot ointments also work to restore increased blood circulation to the tissues and muscles around the affected joint.
- Steroid Injections Into Joint Cavity, injections of these medications are prescribed to relieve disease flare and eliminate severe pain.
- Vasodilators, dilate the vessels in and around the joint cavity, thus improving the delivery of nutrients necessary for tissue repair.
You don't have to rely on home 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 osteoarthritis of the hip joint, massage treatment gives good results. Massage for coxarthrosis is a very effective and useful method. It is recommended that the massage be performed 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 joint elements of the joint.
In the absence of a professional masseuse, the massage can be done 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 osteoarthritis of the hip joint through physical education consists of achieving two objectives: increasing the mobility of the legs and preventing muscle atrophy. All standard complexes of exercise therapy for coxarthrosis also have a general strengthening character and a positive effect on the whole body.
The gymnastic exercise complex is prescribed by a specialist. The first two sessions of physical therapy must be supervised by a doctor. He will show you how to perform each movement correctly and will also monitor the proper load on the hip joints.
Diet
Key Recommendations:
- Give preference to porridge in water.
- Get enough animal protein: fish (except salted), poultry, beef.
- Eat at least 5 servings of vegetables a day (one serving equals 100 grams, can be used as a garnish).
- Dairy products are required: cottage cheese, yogurt, fermented baked milk.
- Eliminate alcohol, coffee, and strong black tea.
- Cut out sweet and starchy foods.
- Eat small but frequent meals.
The diet will reduce the stress on the hip joints and provide them with everything they need for tissue repair.