Arthrosis of the hip joint (coksartrosis) is a chronic, gradually progressing disease, in the absence of timely and proper treatment, it can result in a complete loss of movement in it.The end suggests that not an inflammatory, but a degenerative process prevails.
Symptoms of this disease differ depending on the stage.At the very beginning, this is barely noticeable discomfort that occurs when walking and physical exercises.Perhaps the manifestation in the form of weak pain in the thigh, which at rest passes.In this case, pain can be felt not only in the thigh, but also in the groin or in the knee.
As a rule, coxarthrosis is a process that is leaking for many years, characterized by a gradual change in cartilage, followed by deformation of bones and the loss of joint functionality.Mostly affecting people after 40 years, but very young patients are also found.
Causes
Why does arthrosis of the hip joint occur, and what is it?The causes of coxarthrosis can be different, but the picture of the disease is always the same.Everything begins with changes in the articular cartilage, which is thinner and loses the property of amortizing the loads.The body compensates for the stratification of the cartilage tissue by the formation of bone growths along the edge of the articular surfaces, which leads to deformation of the joints and bones of varying degrees.
The main causes of this joint disease:
- Injuries.This cause may not be some major lesion, but in many cases, chronic microtraumas affect the development of the disease that contribute to cracking and thinning of cartilage.They also affect the anguish of the joint capsule, leading to the accumulation of many damage.Often repeated microtraumas are the forerunner of the appearance of such a disease.
- Excessive loadsleading to systematic microtrauma, as well as joint injuries.Most often, this is found in people engaged in heavy physical labor or professional athletes.In this case, treatment without changing lifestyle or load restrictions is also ineffective and is often accompanied by relapses.
- Hereditary predisposition.This includes abnormalities in the development of the femoral head itself, the underdevelopment of the joint elements, and so on.In this case, the so -called dysplastic arthrosis of the hip joint occurs.
- Diseases.For example, arthritis, in the absence of proper treatment, can degenerate into arthrosis over time.This is due to the fact that during arthritis the properties of cartilaginous tissue change, circulatory disturbance occurs.Gradually, this leads to the development of a degenerative process.
- Excess body weight.Excess body weight, even when walking, has a load on the joints exceeding their physiological limits of strength.
Depending on the cause of the development of the disease and its pathogenesis, 2 main types of arthrosis of the hip joint are distinguished.
- Primary coksartrosis.In this case, the disease develops very slowly and begins with impaired blood supply to tissues.The reasons for the development of this type of arthrosis are rooted in violation of metabolism, which is more characteristic of people over 50 years old.Primary arthrosis of the hip joint is the most commonly diagnosed.
- Secondary coksartrosis.In this case, the disease develops against the background of systemic inflammatory lesion of many joints in the body.Inflammation can be both infectious and autoimmune nature.
At the initial stage of coksartrosis of patients, only slight pain or a sense of discomfort in the area of joint is worried.Often such signs are ignored, as a result of which the disease progresses.
Symptoms of arthrosis of the hip joint
Coksartrosis of the hip joint, the symptoms of which cannot be ignored, can lead to serious consequences.There are several basic signs of the disease that depend on the stage of the disease:
- The pain in the joint is the most obvious symptom by which any disease of TBS can be assumed.The intensity and nature of sensations usually depends on the stage.
- Limiting the mobility of the limb is also a symptom of coxarthrosis.For the early stage, the sensation of the “constraint” of the joint, which passes after some load, is characteristic.
- Weakening of the hip muscles can be observed already at the second stage of the disease, reaching the third to complete atrophy.
- Changing the length of the leg due to the deformation of the pelvis is characteristic of “neglected” osteoarthritis.
- Lame or change of gait is a very likely sign of bone deformation.
- A distinct crunch in the joint is far from always a sign of arthrosis.Usually taken into account if there are other symptoms.
The main feature of coxarthrosis is the pain, the nature of which, its duration, localization and intensity depend on the stage of the disease.
Arthrosis of the hip joint of the 1st degree
This stage of the disease is characterized by pain in the joint and thigh, sometimes in the knee that occur after physical activity and subsides after rest.The mobility of the joint is not limited and there are no gait violations.
Coksartrosis of the 1st degree is the initial stage of the disease, by starting the treatment of which, you can still stop the process of destruction and deformation of the joint and preserve its functions in full.But, unfortunately, many do not consider it necessary to see a doctor because of the weak pain in the joint, and the disease, meanwhile, progresses.
Arthrosis of the hip joint 2 degrees
It manifests itself more clearly - the intensity of the pain grows, it occurs not only after the load, but also at rest, there is a limitation of motor functions.In particular, coksartrosis is characterized by difficulty in performing the pronation (rotation of the thigh inward) and abduction, contracture is formed.
In an X -ray examination, we see a narrowing of the articular space and the appearance on the surfaces of bone growths.The swivel cavity and the femoral head are deformed.The muscles of the thigh on the side of the lesion are beginning to atrophy, and the pain syndrome spreads below, capturing both the knee joint and the inguinal region (it is important to understand that this will not be accompanied by dystrophic changes in the knee joint).
Arthrosis of the hip joint 3 degrees
Signs of the disease are pronounced and are constant.Pain syndrome overtakes at night.When walking, the patient uses the support.The muscles of the lower leg and hips are gradually atrophy, and the sick leg of the sick person becomes very shorter.
Often, to the 3rd degree, the joint gap completely disappears, and the joints grow together into a single bone structure, this demonstrates a picture.As a result of this, complete immobility of the joint occurs.
The radiographs determine extensive bone growths from the side of the roof of the swivel and the head of the femur, a sharp narrowing of the joint gap.The femoral neck is significantly expanded and shortened.
Diagnostics
Before finding out how to treat arthrosis of the hip joint, it is necessary to correctly make a diagnosis.In case of suspicion of coksartrosis, a person will be aimed at conducting a biochemical blood test - in the presence of a disease, patients have a slight increase in ESR, globulins, immunoglobulins and serumucoid.
The next stage in the detection of arthrosis is an X -ray photo.It will identify:
- Handering cartilage,
- bone growths on the border of the cartilage,
- narrowing of the distance between the joints,
- Bone tissue compaction under the cartilage.
Unfortunately, an X -ray photo does not allow the joint capsule and the cartilage itself, if you need to get information about these soft tissues, then the patient will be directed to tomography.
Treatment of arthrosis of the hip joint
With diagnosed arthrosis of the hip joint, treatment will directly depend on the stage at which the disease is located.The general treatment scheme provides for the achievement of the following goals:
- eliminate pain and discomfort in the area of the sore joint;
- to establish the nutrition of intra -articular cartilage and start the process of its restoration;
- eliminate the deficiency of intraarticular fluid;
- activate microcirculation in joint tissues;
- eliminate increased load on the hip joint;
- strengthen the muscles that surround, protect and maintain joints;
- prevent deformation and increase mobility in the thigh joint.
All this can be achieved only with the help of an integrated approach, which should include not only drug therapy, but also a change in lifestyle in order to get rid of risk factors of coxarthrosis.
- At the third stage of the disease, treatment involves surgery, during which the joint is replaced by an endoprosthesis, while part of the prosthesis is imprisoned in the femur, and part into the pelvic.The operation is quite complicated, long in time and requires a long rehabilitation period.
- With I and II degree of arthrosis of the hip joint, treatment is carried out without surgical intervention.Used: non -steroidal anti -inflammatory drugs, muscle relaxants, chondroprotectors, vasodilating drugs, hormonal steroid drugs, local drugs - ointments, lotions, compresses.
All these drugs are prescribed exclusively by the attending physician.Some of them are effective in the form of injections directly to the affected articular region.Such injections can only be made by qualified medical personnel.Therefore, self -medication is strictly not recommended.
Non -drug methods
In addition to the use of drugs, doctors recommend non -drug methods to combat the disease.These include the following methods of treating this disease:
- physiotherapy;
- massage;
- joint breeding;
- diet.
Physiotherapy used for arthrosis includes the following types of treatment:
- magnetotherapy;
- UHF and ultrasonic therapy;
- aeroion and electrotherapy;
- inductothermia;
- phototherapy;
- The use of laser technology.
All these methods can only be used to improve the blood supply to the joints and relieve spasms.
Drug therapy
Combined treatment of hip arthrosis provides for the appointment of the following groups of medication:
- Nonsteroidal anti -inflammatory drugs, they all eliminate pain, relieve inflammatory processes, but do not restore cartilage tissues.
- Chondroprotectors.Preparations for nutrition of cartilage tissue.Accelerating its restoration.Important in 1.2 phase of treatment of arthrosis.With 3 degrees of disease, the cartilage is already destroyed, these drugs will be useless.You need to take drugs for a long time, take a few courses.
- MusorelaxantsEliminate muscle cramps in the area of sore joints, contribute to improving tissue blood supply.
- Ointments and creams.Therapeutic ointments are to alleviate the condition of a sick person, but do not contribute to a complete recovery.Warming ointments are well suited.They irritate the receptors of the skin, and due to this they reduce the pain syndrome.Warming ointments also work to restore increased blood circulation in tissues and muscles located around the sick joint.
- Injections of steroids into the joint cavity, the injections of these drugs are prescribed to relieve exacerbation of the disease and eliminate severe pain.
- Vasodilative drugs, expand the vessels inside the joint cavity and near it, thereby improving the delivery of nutrients needed to restore tissues.
It is not necessary to count on folk remedies of treatment.But some healers recommend tincture of lemon, garlic or celery root for the treatment of joints and bones.
Massage in the treatment of coxarthrosis
With deforming arthrosis of the hip joint, treatment with massage gives good results.Massage for coxarthrosis is a very effective and useful method.It is desirable that the massage is carried out by a good specialist and as often as possible.
Its effect is aimed at improving blood circulation, strengthening of muscles, removing a painful spasm, swelling and muscle tension, as well as an increase in diastasis between articulations of the joint.
In the absence of a professional massage therapist, massage can be done yourself.Massage with arthrosis can be performed both manually and using various massage devices and even water jets (hydrokinesotherapy).
Gymnastics
Treatment of arthrosis of the hip joint with physical education lies in achieving two tasks: to increase the mobility of the legs and prevent muscle atrophy.All standard LFK complexes for coksartrosis also have a general strengthening nature and a positive effect on the whole organism.
The complex of gymnastic exercises is prescribed by a specialist.The first pair of medical physical education should take place under the supervision of a doctor.He will show how to properly perform each movement, and also control the proper load on the hip joints.
Diet
Main recommendations:
- Give preference to porridge on the water.
- Use a sufficient amount of animal protein: fish (except salty), poultry meat, beef.
- Use at least 5 servings of vegetables per day (one portion - 100 grams, can be used as a side dish).
- Mandatory dairy products: cottage cheese, yogurt, fermented.
- Exclude alcohol, coffee, strong black tea.
- Exclude sweet, flour.
- Eat a little, but often.
The diet will reduce the load on the hip joints and provide them with everything necessary to restore tissues.