Hip arthritis is the most common type of joint disease.Since the hip joint (HJ) is larger than all other joints and has a multi-vector axis of rotation, it is subject to enormous loads throughout a person's life - when walking, running, jumping, climbing stairs, playing sports, and everyday activities.
Usually patients have to worry about the symptoms and treatment of hip osteoarthritis at the age of 25-35.The disease can progress rapidly under the influence of trauma, decompensated physical activity (non-compliance with the technique of performing sports exercises, "standing" work, overweight), genetic factors, infectious and chronic diseases.
However, effective treatment of hip osteoarthritis can preserve mobility and prevent fractures.In old age, it helps to avoid more dangerous pathologies - such as necrosis or fracture of the femoral head.
Symptoms of hip arthritis
Symptoms and treatment of hip arthritis depend on the stage of the disease.
- Stage 1. The patient feels mild pain in the groin area, which occurs after physical activity, long standing or sudden joint movements, then disappears completely with rest.
- Stage 2. The pain syndrome is more severe and makes the patient uncomfortable even when performing normal household activities.The pain may spread to the lower back or inner thighs.Stiffness and crunching appear, the range of motion of the joint is reduced.The muscle-ligament system begins to weaken, causing more fatigue.
- Stage 3. The patient feels constant pain and has difficulty moving without a cane or walker.Movement in the joint is severely limited.Climbing stairs is a serious challenge.There is a gait disorder (limping, falling on one or both legs).With unilateral coxarthrosis, pelvic deformity and curvature of the spine are visible to the naked eye.
- Stage 4. The joint space closes due to the development of bone spurs and any movement in the joint becomes almost impossible.It loses function and is severely deformed due to bone destruction.
Prognosis of hip arthritis
With successful lifelong treatment, pain from hip osteoarthritis may completely disappear or rarely bother the patient.The prospects of this therapy depend on the patient's compliance with the rules of the rheumatologist and his personal self-discipline.Please note that the most accurate prognosis of the disease can be given only by the attending physician.
With timely and regular treatment
If chronic diseases do not contribute to disease progression and treatment of hip disease begins in stage 1 or 2, hip replacement may be avoided.Disability and loss of ability to work, if the doctor's recommendations are followed, change after 20 years, and sometimes patients retain almost unlimited range of motion in the joints until old age.The best prognosis is possible with the so-called.benign arthritis - when the wear and tear of cartilage depends on external factors (occupational activities, violations of hygiene).In this case, it is necessary to eliminate them and undergo a course of rehabilitation treatment to slow down the process of osteoarthritis.
Timely treatment of grade 3 hip osteoarthritis with surgery will help avoid joint immobility, causing consequences for the entire musculoskeletal system and lasting pain for many years.In the absence of contraindications, prosthetic limbs will help you return to your previous activities.
When self-medicating
When choosing a treatment method for hip arthritis, the doctor will take into account the patient's age, physical condition, physical strength, health status, specific symptoms of the disease, and stage of the disease.In this case, the narrowing of the lumen of the joint space, the presence of osteoporosis, the rate of progression of joint disease, the quality of synovial fluid and other indicators will be checked.
Self-treatment of hip osteoarthritis with traditional methods does not take into account these individual signs and instead of bringing the desired result, can lead to aggravation of the condition, metabolic disorders and exacerbation of the course of the disease.But the worst thing is the time spent under the illusion that such a serious chronic disease as hip arthritis can only be cured 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
If left untreated, hip arthritis will progress 2-4 times faster on average.Deterioration in quality of life and onset of disability in this case can occur at a relatively young age - about 45-50 years old.The patient's sleep is impaired, physical activity is reduced, and psycho-emotional disorders are observed.The pain prevents them from getting out of bed in the morning, going for a walk with their grandchildren, or going to work.
Treatment of hip osteoarthritis
The priority treatment for grade 1 hip osteoarthritis is outpatient conservative treatment.It includes drug treatment for hip arthritis, physical therapy, dietary therapy, and adjustable casts and orthotics.This approach allows you to reduce pain, maintain muscle function and increase mobility in the joints.Treatment of grade 2 hip osteoarthritis is also performed similarly.
If conservative treatment of hip arthritis is delayed or ineffective, cartilage degeneration will progress rapidly and surgery will be required.Sometimes the doctor may decide on osteotomy or arthroplasty, but in most cases, when treating grade 3 osteoarthritis, the doctor will prescribe arthroscopy - partial or total replacement of the diseased joint.Prosthetics made of metal and ceramic or polymer lining have a lifespan of 15 to 25 years, after which they need to be replaced.Total joint surgery (total joint replacement) is the most effective treatment for hip arthritis.It allows you to fully restore its function with a minimal incision up to 8 cm long and the ability to walk with support within a day.Full recovery lasts 1-3 months.
Physical therapy methods for treating hip osteoarthritis
Physical therapy for hip arthritis is performed according to the schedule prescribed by your doctor.Almost all techniques, except magnetotherapy and cryotherapy, are allowed only during the period of remission, in the complete absence of inflammatory symptoms.The following measures are used to treat hip osteoarthritis:
- ultra-high frequency therapy;
- ultrasound therapy;
- laser therapy;
- magnetic therapy;
- therapeutic exercises (therapeutic gymnastics);
- therapeutic massage and manual therapy;
- ozone therapy;
- cryotherapy;
- acupuncture;
- traction therapy (traction);
- paraffin application and wrapping;
- bath and mud therapy;
- hydromassage.
Treatment of hip osteoarthritis with exercise therapy
Physiotherapy for hip arthritis is aimed at strengthening muscles and ligaments - they are a natural orthopedic device that reduces the load on the joint and maintains it in the correct physiological position.Therefore, treating hip osteoarthritis with exercises helps reduce pain and inflammation, improve mobility, slow down cartilage wear and ensure nutrient supply to joint fluid.The following exercises will help strengthen your legs:
- Starting position - sit on the floor, focusing on your arms outstretched behind you.Legs straight in front of you.We flex and straighten our toes.
- The starting position is the same.Alternately flex and straighten your feet (toes toward you, toes away from you).
- The starting position is the same.Bend your leg at the knee, pulling it toward you along the mat or heavy object.You should only touch the floor with your toes after completing the movement.
- Starting position - lying on your back, legs bent at the knees, feet placed on the floor.We perform the exercise "frog" - we spread bent knees wide and hold them for 20 seconds.Then we bring it together again.
- Starting position - lying on your back, one leg straightened, the other bent and placed to the side.We lie like that for a minute and then change legs.
- Starting position - lying on your back, legs straight, lying freely.We put the socks inside, touch them, and then spread them out.Repeat at speed 10 times.
- Starting position - lying on your back, one leg (from the side of the affected joint) crossed over the other.We move the feet of the lower legs as in the above exercise.
- Starting position - lying on your back.We pull the knees towards the stomach, holding the back of the thighs with tightly clasped fingers.Do this 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 tightly clasped fingers.Do it for at least 30 seconds.
- The starting position is the same.We move the straightened leg to the top of the floor.20-30 times on each leg.
- Starting position - standing.Place a chair aside, with its back facing you.Hold the back of the chair and stand on one leg, swinging the other leg back and forth like a pendulum.20-30 times.
Massage in the treatment of hip osteoarthritis
Massage is an effective relaxation and recovery technique for treating early-stage hip osteoarthritis.As a treatment for grade 1 hip arthritis (as well as grade 2 - in the absence of pain and swelling), it can prolong the period of remission, relieve discomfort and pain without medication, improve tissue nourishment and slow down the process of cartilage degeneration.It also helps eliminate spasms that interfere with sleep and movement, strengthens ligaments, normalizes gait and allows you to quickly warm up when moving from a state of rest to active activity and vice versa.
For hip arthritis, professional massage therapy is recommended (at least 10-12 sessions).But gentle self-massage at home also helps improve the condition.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 treatment.
Even in cases where the patient has unilateral coxarthrosis, massage is performed on both sides.How to do it correctly?
- To start, choose a comfortable position so you reduce tension in your hips and lower back.For example, lie on your back, side, or stomach.
- Begin gently massaging the area around the affected joint.If you have a helper, ask him to stroke your back for 7-10 minutes from shoulder blades to sacrum to improve blood circulation.
- Slowly stroke the lower back, then start in circular motions in the lumbar area with two fingers.
- Massage the spine with your thumbs, as far as the posture allows, gradually moving down to the lower back.
- Press your palms against the tailbone area and begin massaging and stretching the muscles.This completes the preparation.
- Rub your thighs with your palms, then use your thumbs to massage in circular motions.
- Knead the inner thighs without applying pressure (so as not to squeeze the blood vessels).It's better to grab the fat between your thumb and other fingers and knead it thoroughly.
- Important!Complete the process with relaxing strokes and pats.
In thigh massage, horizontal, vertical, grasping, and squeezing movements are used.Rubbing is done with different parts of the palm or fingers bent towards the groin area.
After surgical treatment of grade 3 osteoarthritis in the hip joint and suture removal, massage is used to restore motor function.
Treat hip osteoarthritis with diet
The main nutritional principle in the treatment of hip osteoarthritis is diversity and balance of key indicators (vitamins, minerals, proteins, including essential amino acids).It is important to eat foods rich in calcium, sulfur, zinc, magnesium and selenium.Among vitamins, vitamins A and group B (have anti-inflammatory effects), C, D, E are of primary importance.Low-protein diets are contraindicated in the treatment of hip osteoarthritis.So be sure to include in the menu:
- Diet of meat, poultry, and fish.
- Egg.
- Milk and dairy products.
- Fresh fruits, vegetables and herbs.
- Whole grains and oilseeds (such as flaxseed), as well as nuts.
- Dishes and products with natural cartilage protectors (jelly, jelly, cartilage, ham hocks, ears, etc.).
But it's better to reduce carbohydrate consumption - after all, even a slight weight gain will create a huge burden on sore joints.It is not without reason that rehabilitation specialists joke that losing a few kilograms is the most effective treatment for hip arthritis.You also need to eliminate salty, spicy, sweet, and fried foods that cause your body to retain water.Minimize your intake:
- fast food and semi-finished products;
- baked goods, sweets and confectionery;
- Sausage and sauce.
Don't forget to drink at least 2.5 liters of water every day!
Drugs to treat hip osteoarthritis
Treatment of hip osteoarthritis with medication is carried out strictly according to the doctor's instructions.In case of exacerbation and severe pain, it is allowed to take regular painkillers 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 the appropriate treatment for hip arthritis.
There are several groups of medications used to treat hip disease.In the complex treatment of hip arthritis with drugs, 5 main pharmaceutical groups are used.
Anti-inflammatory drugs in the treatment of hip osteoarthritis
Swelling, stagnation of blood and other fluids, fever and local pain - these common symptoms of arthritis not only endanger the patient's life, but also aggravate the course of the disease.Over time, they lead to tissue deficiency, depletion of the synovial fluid that “feeds” the cartilage and loss of its viscosity (due to friction destroying the surface of the joint membrane!), muscular dystrophy and persistent loss of mobility.
But the main danger of inflammation is the death of chondrocytes - cartilage cells.When they decompose in large quantities, they will create an accumulation of enzymes that "corrode" the surface of joint cartilage.
Therefore, to reduce inflammatory symptoms and restore tissue metabolism, 2 groups of anti-inflammatory drugs are used: nonsteroidal (NSAID, NSAID) and glucocorticosteroids.
NSAIDs are considered gentler, although they can also affect the digestive system.That's why they were appointed first.In the treatment of grade 2 osteoarthritis of the hip joint - according to the course or as needed.
These include: Nimesulide, Ibuprofen, Meloxicam, Ketoprofen, Indomethacin, Diclofenac.
If NSAIDs fail, rheumatologists will prescribe heavy artillery - corticosteroids.They immediately relieve severe pain and inflammation, but 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 aggravate the course of arthritis.
The drugs of choice to treat grade 3 hip osteoarthritis are: Hydrocortisone, Prednisolone, Methylprednisolone.
Chondroprotectors treat hip osteoarthritis
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 hip osteoarthritis is unthinkable without the drugs chondroitin and glucosamine sulfate, which provide the body with building materials for the formation of new cartilage cells.
Because the metabolic process in cartilage tissue is very slow, it is necessary to take cartilage-protecting drugs for a long time - 3-6 months per year.However, with lifelong preventative use, they will result in remission without the need for medication.
Chondroprotectors include: Glucosamine, Chondroitin.
Vasoprotective drugs and microcirculatory modifiers
Inflammation and microtrauma that accompany joint disease disrupt the blood supply around the affected joint.But it is the capillaries that carry nutrients to the boundaries of the joint capsule.
The following drugs help reduce swelling and improve the nutritional status of tissues: Troxerutin, horse chestnut extract, Diosmin in combination with other drugs, Pentoxifylline.
Muscle relaxants
When the support function of a joint is impaired, the body tries to compensate by using muscles and ligaments that are not designed to withstand such near-constant loads.Due to chronic stress, muscle pain and spasm appear.These cramps can interfere with sleep or movement.
To eliminate them, in the treatment of osteoarthritis of the hip joint, the following drugs are prescribed: Baclofen, Tizanidine, Tolperisone.
External and warming agents
Drugs in this group have a vasodilating effect.They help reduce swelling, relieve pain and distract from joint discomfort.
Most often, to treat hip arthritis, products made from animal poisons or pungent plant extracts are used.
Pharmaceutical dosage form for treating hip osteoarthritis
Depending on the clinical manifestations of joint disease and the patient's lifestyle, rheumatologists will prescribe medications to treat hip osteoarthritis in many different forms.
Tablets, capsules, powder
These hip arthritis treatment products are easy to dose and carry with you.All you need to get is a glass of water.In addition, the blister or packaging allows you to keep track of how many days the course has lasted.Such drugs have good bioavailability.But anti-inflammatory drugs can have a negative effect on the mucous membrane of the stomach and intestines - for gastritis, ulcers, colitis, it is better to take injections for the treatment of osteoarthritis of the hip joint.
Intramuscular and intra-articular injections
Anti-inflammatory drugs, muscle relaxants, and cartilage protectants are often given by injection.This ensures maximum bioavailability and is gentle on the stomach lining, but usually requires the presence of a medical professional.Intra-articular injections without special qualifications are strictly prohibited!
Ointments, gels and creams
External agents for the treatment of hip arthropathy have low bioavailability (about 5%), which limits their use in therapy to an auxiliary role.But there are fewer contraindications to their use.
Less common are liquid preparations for the treatment of hip arthritis - in the form of balms, compresses.