Diseases of the musculoskeletal system are observed not only in the elderly - they are characteristic even of children. Coxarthrosis of the hip joint, the key symptom of which is severe pain in the affected area, can affect anyone, so you need to understand what causes it and how to deal with it. Is it possible to do without conservative treatment and when is an operation necessary?
What is coxarthrosis of the hip joint
The whole group of osteoarthritis is a disease characterized by degenerative changes and deformities of the tissues. Coxarthrosis among them is distinguished by the frequency of diagnosis, especially in women, and the defeat of the hip area occurs more often than others due to the increased load, even in a person who does not practicegreat sports. The rate of progression of coxarthrosis is slow, therefore, at an early stage doctors' predictions are positive. The mechanism of development of the disease is as follows:
- Joint fluid thickens, its viscosity increases. The cartilage surface dries up, cracks form on it.
- Friction of articular cartilage leads to their thinning, pathological processes begin in the tissues.
- The process of bone deformation is triggered, the mobility of the hip area is disturbed. The local metabolism suffers, the muscles of the affected leg atrophy.
The main symptom of dystrophic changes is pain: which can be localized in the groin, hip and even knee area. In this case, the nature of the pain depends on the stage of the disease - at the initial stage it appears only when the patient engages in physical activity. Later, the pain becomes constant, torments even at rest, the painful area widens. Osteoarthritis of the hip joints is characterized mainly by the following symptoms:
- stiffness of movements;
- walking disorders (up to lameness);
- decreased range of motion in the hip area;
- shortening of the limb with the affected joint.
Modern medicine divides all arthritis into 2 categories: the primary is characterized by the absence of obvious reasons for the onset of the disease, excluding risk factors and certain congenital moments. So, an indirect prerequisite may be a violation of metabolic processes or weakness of cartilage tissue, but primary coxarthrosis develops mainly against the background of:
- prolonged stress on the joint;
- pathologies of the spine;
- problems with blood circulation and hormonal background;
- old age;
- sedentary work.
Secondary osteoarthritis is a disease which is further supported by a whole "group" of diseases associated with the musculoskeletal system, cartilage and bone tissue, or which presents as a post-traumatic complication. Unilateral lesion of the hip area occurs mainly against the background of osteochondrosis and bilateral lesions of the knee joint. The main causes of the disease:
- aseptic necrosis affecting the femoral head;
- Perthes disease;
- Congenital dislocation of the hip;
- inflammatory process (often complicated by infection) in the hip area.
Official medicine reports that deforming osteoarthritis of the hip joint has 3 stages of development, in which the only common symptom is pain, which gradually increases in intensity. The other signs change as the osteoarthritis progresses, so it is easy to determine from them the progress of the disease. The classification is simple:
- 1st degree - narrowing of the joint space, the head and neck of the femoral bone are normal, but there are growths in the acetabulum.
- 2nd degree - The x-ray will show a large and uneven narrowing of the space, there is a deformation of the femoral head, which is displaced upward and enlarged. Bone growths on both edges of the acetabulum.
- 3rd degree - characterized by significant narrowing of the space and expansion of the femoral head. Symptoms of this stage include persistent pain, muscle atrophy (due to impaired blood flow to the joint) and limb shortening.
The main method of checking the condition of the hip area when there is a suspicion of hip osteoarthritis is an x-ray: the informative content of the picture is almost absolute - you can even find out the exact cause of the disease. In addition to the x-ray, your doctor may prescribe:
- MRI (check for soft tissue problems);
- CT (for a detailed examination of bone structures).
Until the cause of the dystrophic changes in the tissues is clarified, the main task of the patient is to eliminate the symptoms - mainly to combat pain and try to restore joint mobility. At the same time, doctors imposed a requirement to limit the loads on the muscles of the thigh so that the disease does not take an acute form. At the initial stages, specialists choose conservative therapy; in a neglected situation, they will have to resort to surgery.
How to cure coxarthrosis of the hip joint without surgery
If dystrophic osteoarthritis has been facilitated by congenital pathologies of the connective or cartilage tissue, or of the spine, treatment will only be aimed at preventing the exacerbation and alleviating the main symptoms. In other cases, the doctor acts on the cause of the disease, for which the patient is prescribed:
- pharmacotherapy (topical, injectable, oral);
- physiotherapy for a painful joint;
- physiotherapy exercises (maintains mobility of the hip area);
All pills and topical drugs (ointments, injections) are prescribed to the patient depending on the cause of coxarthrosis and the stage of its development. NSAIDs help relieve pain, but they don't cure - they just stop symptoms. To improve the blood supply to the joint and eliminate spasms, muscle relaxants and vasodilators are used, and chondroprotectors are used to restore cartilage.
When coxarthrosis becomes acute, the patient needs not only to be treated, but also to alleviate his health by relieving an attack of pain in the joint. To this end, doctors inject novocaine, followed by a glucocorticoid drug with strong anti-inflammatory properties. The blockage can last for several weeks, but the injection is chosen exclusively by the doctor.
Injections for coxarthrosis of the hip joint
Injections for this disease can be intramuscular, intravenous and into the joint cavity. The latter - with drugs that replace joint fluid, based on hyaluronic acid, which protect and restore cartilage tissue. Intramuscular injections can be done with chondroprotectors and anti-inflammatory drugs.
Correcting nutrition to treat coxarthrosis will not help - it is only necessary to reduce the load on the joint if the patient is overweight. It is recommended to completely abandon simple carbohydrates, consume more water and make sure to include in the diet dairy products, fish, buckwheat, beans and gelatin (collagen) - meat dishes. jelly, jelly.
Heavy loads for a patient with coxarthrosis are prohibited in order to prevent the progression of the disease, but the activity cannot be abandoned - it helps to maintain the mobility of the joints. A set of exercises in exercise therapy should be compiled by a doctor and exclude axial loading. The following options are possible:
- Lying on your back, slowly "pedal" with your legs raised for 15 seconds. Take a break, repeat the exercise.
- Lying on your stomach and placing your hands on your hips, raise your straight legs alternately.
- Lie on your side with your lower arm under your head. Slowly raise your upper leg and lower it.
Manual techniques are shown not only for the hip area, but also for the entire spine (traction procedure), especially in the 2nd stage of the disease. Massage helps increase blood circulation, strengthen muscles and reduce the load on areas of their joints. Home massage involves rubbing and stroking the affected hip area circularly for 10 minutes, but it is important to remember:
- Abrasions and bruises should not be allowed - do not press too hard.
- You should feel how the painful joint and the surrounding tissues relax, not the spasms more strongly.
Improving blood circulation and relieving vascular spasms are the main tasks of all procedures (from electrophoresis to UHF), but without drug treatment they will be almost useless, especially in the 2nd stage of the disease and beyond. Often, treatment for coxarthrosis of the hip joint involves:
- Magnetotherapy - exposure of the joint to a magnetic field (constant / pulsed), which dilates the blood vessels.
- Shock wave therapy - the effect of waves on bone growths to improve joint mobility.
- Laser exposure - at a depth of 15 cm to improve metabolic and regenerative processes in the cartilage of the hip region.
Surgery is not recommended until the last stage of hip osteoarthritis, as many complications and negative results are possible with any operation. It is prescribed if the pain attacks can no longer be stopped and the joint stops working normally. According to doctors, in 95% of cases a person returns to his usual rhythm of life and does not even lose the opportunity to play sports, and the remaining 5% fall on arthrodesis - fixation of the bones, as a result of which themember only retains support function.
At an early stage of cartilage or bone destruction (often when hip osteoarthritis has occurred against the background of trauma), doctors prescribe restoration of the missing surfaces. Arthroplasty is performed under general anesthesia: the surgeon pushes back the tissues or cuts the muscles to access the affected area, fixes the prosthesis on the bone cement and, if necessary, sutures the muscles or other tissues that have been dissected.
Replacement of the hip joint with an artificial joint (metal / ceramic) is carried out only with the complete destruction of its own, according to a scheme similar to arthroplasty. Before the operation, an examination is carried out, during the procedure, general anesthesia is performed. The prosthesis, which is placed on the patient, can only replace the head of the femur or the latter, but with the acetabulum. During rehabilitation, antibiotics are prescribed, the patient is hospitalized for 10-12 days, then the stitches are removed and sent home.
Consequences of the disease
The main danger of coxarthrosis is disability, which develops if the disease is not treated, even at the last stage, or if the treatment is poorly chosen. Gradual irreversible changes will lead to the need to move infrequently, little and only with a cane. If you ignore the initial form of coxarthrosis, a person will experience less serious complications:
- postural disturbances;
- shortening of the leg.
If a person belongs to the risk group for coxarthrosis (both due to the presence of congenital prerequisites and due to the influence of external factors), his main task is to protect the cartilage tissue and the joint as much as possible. -same. It is important to monitor nutrition (the above diet for coxarthrosis of the hip joints), as well as:
- daily practice of long walks or sports (swimming, gymnastics);
- avoid overloading the joint;
- avoid hypothermia.