Osteoarthritis of the hip joint, also known as coxarthrosis, is one of the most serious diseases of a modern person and often leads to disabilities. Its first manifestations - slight pain in the groin area - are usually ignored. A patient usually seeks qualified medical help when drug treatment is already ineffective and endoprosthetics are required.
reasons
Osteoarthritis of the hip joint occurs due to a combination of various unfavorable circumstances. Microtrauma and full-fledged injuries account for about a fifth of the total number of cases (an average of 10–20%).
Other causes of hip osteoarthritis are:
- Excessive loads.
- Heart attack or aseptic necrosis of the hip joint.
- Prolonged stress, persistent depression.
- overweight.
- inheritance.
- Congenital anomalies and underdevelopment.
- inflammatory processes in the joints.
- Background hormonal failure.
Excessive loads
Until recently, it was believed that excessive physical exertion, long hours of walking, and hard work (as a loader) were the main causes of osteoarthritis. But that's not the case.
A healthy joint that has never been injured can handle stress perfectly, especially at a young age, and nothing happens to it.
But if there was microtrauma in childhood, then such a joint is a candidate for the development of coxarthrosis. Because of this, the disease occurs in 20-30% of cases.
Heart attack
This is a violation of the blood flow in the joint. In other words, the disease is called aseptic necrosis of the hip joint, which usually occurs after an injury.
In addition to injuries, the cause of a heart attack can be:
- Excessive alcohol consumption.
- Frequent injections of corticosteroids.
- An unexpected shock (severe stress).
- Excessive, one-time charging at a time when a person is not ready for them.
Myocardial infarction is often one of the causes of coxarthrosis morbidity - in 10-30% of cases.
Persistent stress
Few people believe in psychosomatics. However, protracted experiences, depression, misunderstanding in the family and various phobias against this background are a direct route to problems with the joints, and not just the hip. The incidence of osteoarthritis is very high for this reason - up to 50.
The mechanism of triggering the disease in this situation is simple. With prolonged depression, the patient's body produces stress hormones, which belong to the group of corticosteroids. The longer a person is in this state, the higher their concentration in the blood. Corticosteroids inhibit the production of hyaluronic acid, which is the main component of synovial fluid. If it is not produced enough or if its composition is changed, the cartilage is poorly wetted, dries out and is covered with a network of tiny cracks.
The stress hormone reduces capillary permeability and at the same time impairs the blood circulation in the joints.
Overweight
Is another factor among other causes for osteoarthritis of the hip joint (coxarthrosis).
Obese people put enormous strain on their joints, especially the ankles, knees and hips.
As long as they are young, everything seems to work within normal limits. But with age, joint problems grow like a snowball.
Inheritance
If one of your relatives had osteoarthritis, you don't need to get sick too. However, the appearance of "wounds" is influenced by the peculiarities of metabolism, the structure of the cartilage, and they can be inherited. This also includes the weakness of the muscular system. For this reason, coxarthrosis can only be acquired in 10% of cases. And it is far from going to happen. The main thing is to undergo regular examinations and monitor the condition of your joints.
Congenital anomaly
This is usually treated in early childhood so the child can grow up and use the limb normally. However, the presence of an abnormality always carries a risk of coxarthrosis, especially if you don't monitor the condition of your joints. The incidence rate is low - only 5. It should not be ignored that only one complex leads to the appearance of osteoarthritis of the hip joint for several reasons.
Joint inflammation
This process is commonly known as arthritis. The disease leads to secondary coxarthrosis in 2-3% of cases. The inflammatory process changes the quality of the intra-articular fluid. It becomes more viscous and no longer fulfills its direct functions. As a result, the cartilage rubs against the cartilage and gradually collapses.
Among other things, hormonal changes in menopause, metabolic diseases (diabetes), nervous diseases (in which the sensitivity of the lower extremities is lost) and osteoporosis can be mentioned, which directly or indirectly influence the occurrence of coxarthrosis.
Symptoms
Arthrosis of the hip joint manifests itself in different ways. At the first stage of the development of the patient's pathology, almost nothing bothers, except for weak unpleasant, sometimes painful, independently passing sensations.
The symptoms of osteoarthritis of the hip joint are specific and allow a preliminary conclusion (to make a diagnosis) at the examination stage:
- Groin pain. This is the main symptom of the disease. If, while moving, you feel that something is wrong with this area, try to see a doctor as soon as possible. Groin pain usually travels down the front or side of the thigh and can spread to the buttocks or knee. It is extremely rare for hip joint pain to reach the center of the calf muscle. The patient feels uncomfortable when sinking into a chair, standing up or after a long walk.
- Limited mobility. This symptom signals that osteoarthritis of the hip joint (coxarthrosis) is already progressing. If you ask such a patient to sit "astride a chair, " that is, backwards, it is unlikely that they will be able to do so.
- Grinding of the hip joint when walking. It does not appear immediately, but in the course of osteoarthritis and the destruction of the cartilage. The difference to the usual crunch of a healthy joint is a rather dry sound and pain syndrome of weak or moderate intensity.
- Shortening of the diseased extremity. Occurs when the disease has progressed sufficiently.
- Limping, falling on a sore leg as the cartilage is partially or completely destroyed.
- Muscular atrophy of the affected leg. It looks dry and unhealthy.
- Pain in the knee joint due to muscle atrophy.
Diagnosis
This moment is not too long for the patient. After a visual examination and questioning of the patient, the doctor will prescribe a referral for blood donation - a general analysis, biochemistry and a rheumatic test. This is done in order to exclude the inflammatory process in the body. With osteoarthritis, all indicators are almost normal.
The next step is instrumental investigations:
- X-ray and / or CT.The computed tomography shows the joints a little better.
- MRT. First appointed. Such a survey is as informative as possible.
- Ultrasound of the joints.One sign of coxarthrosis in this study is a significant thinning of the cartilage. But the accuracy of the result largely depends on the qualifications of the specialist who will decipher the data received. Therefore, to determine the disease, it is prescribed in rare cases.
Consequences
If osteoarthritis of the hip is left untreated, in the hope that "it may go away on its own, " the disease will actively progress. The consequences of such indifference to oneself are manifested in muscular atrophy and an apparent shortening and drying of the diseased limb. At some point a person can no longer move independently. Pain syndrome becomes a constant companion of such a patient, even strong pain relievers cannot relieve it. The only way out of this situation is joint replacement surgery - endoprosthetics.
If an elderly patient is diagnosed with coxarthrosis, treatment should be started immediately. A sedentary way of life, which always occurs in a patient due to severe constant pain, significantly shortens life.
Traditional treatment
It can be classified as medical and surgical. The second is used in the case when the first does not bring any significant improvement with prolonged use.
Coxarthrosis in the early stages can be treated:
- Medicines.
- Manual therapy.
- traction on a special table.
- With PIR (relaxation after the measurement).
- Therapeutic massage.
- Hirudotherapy.
- Remedial gymnastics.
Medicines
The task of drugs is diverse. Not only tablets are used, but also ointments, intra-articular injections. Tablets (capsules, sachets) are prescribed for pain relief (nonsteroidal anti-inflammatory drugs), to improve cartilage nutrition and to improve the quality of intra-articular lubrication (chondroprotectors), as well as to relieve muscle spasms (muscle relaxants).
Ointments and creams have the weakest effect and are used for warming up and irritation. Its effect is close to that of a placebo. At the moment of rubbing, the patient's body produces endorphins - hormones of pleasure, and they are very effective in relieving pain.
Intra-articular injections for osteoarthritis of the hip joint are very rare. This is due to the narrow connection space, which is difficult to reach even with the use of special aids. The procedure is performed through the groin and is so complex that ninety-nine percent of doctors prefer to inject medication into the periarticular sac by making a puncture on the side of the thigh.
By injection:
- Relieves high-intensity pain syndrome (corticosteroids).
- They nourish the cartilage (chondroprotectors).
- Improves the quality of the lubricant (hyaluronic acid substitutes - injected through the groin).
Nonsteroidal anti-inflammatory drugs are given orally for mild to moderate pain. They also effectively clear inflammatory processes.
Manual therapy
Treatment by an experienced specialist can put patients with moderate coxarthrosis on their feet. The doctor's job is to restore mobility to the joint and relieve pain. Manual therapy is divided into manipulation (a single effect on the joint) and mobilization (4 courses per year, 3 to 4 sessions each).
Mobilization allows you to stretch the affected limb with a minimum of pain. Enlarge the joint space, relax the tense muscles. Tampering is allowed only in the early stages of the disease.
Traction on a special table also gives certain results, but it loses a lot of manual therapy. In contrast to the doctor's hands, the device does not feel the patient and can cause damage if used improperly.
PIR
Post-isometric relaxation involves an active interaction between the patient and the attending physician. The importance of the method is that the patient relaxes / strains certain muscle groups as instructed by a specialist. At this point, the doctor stretches his ligaments and joints.
This treatment for coxarthrosis relieves muscle cramps. The method is effective for coxarthrosis of I and II degrees.
Massage
If you choose this method, you need to find a highly qualified specialist. Otherwise, instead of alleviating the condition, the condition may worsen. The method is effective as an aid for I and II degrees of coxarthrosis.
A massage against coxarthrosis shouldn't cause pain. The sensations during the procedure are pleasant, relaxation and comfort should be felt.
Please note that there are contraindications for a massage. Don't self-medicate.
Hirudotherapy
Treatment with leeches helps in the early stages of osteoarthritis of the hip joints. The saliva of this worm improves blood circulation, the elasticity of the cartilage and itself contains many useful substances. It works like a chondroprotector, only softer.
Leeches are placed not only on the sore thigh, but also on the sacrum, lower abdomen and lower back. You have to take 2 courses with 10 sessions per year.
Remedial gymnastics
No disease can be cured or alleviated without a dose of exercise. Arthrosis of the hip joint is no exception. If you do not strengthen the muscles, then their atrophy is inevitable, while the condition of the cartilage doubly worsens.
It is preferable to study in special groups under the supervision of specialists. The medical complex is selected by a doctor based on the examinations, the degree of coxarthrosis and the patient's physical abilities.
Endoprosthetics
Surgical interventions are carried out in grade III and IV coxarthrosis when conservative treatment provides minimal results or is not effective at all. The surgeon's job is to replace both the joint head itself and the acetabulum through a small incision in the thigh with artificial implants.
Now such operations are in operation. To imagine what to expect if you ignore the first signs of coxarthrosis, imagine the course of the operation (briefly):
- The patient is anesthetized.
- An incision is made in the thigh, soft tissues cut out, nerves pushed back.
- The joint is removed from the bed. In simple terms, the doctor makes an artificial dislocation to get his head.
- The head of the joint with part of the bone is removed.
- The acetabulum is cleaned.
- An endoprosthesis, an artificial joint head, is inserted into the bone or rather "blocked".
- An artificial acetabulum is inserted.
- The joint is repositioned. The doctor checks its mobility by moving the limb in different directions.
- The wound is disinfected and sewn.
After the operation, a fairly long period of rehabilitation and compliance with a certain regime is required.
Traditional methods
For lovers of self-medication, it should be noted that coxarthrosis is a disease that should only be treated by a doctor. All folk methods in the form of rubbing, lotions and other "unusual" methods do not lead to anything good.
However, some traditional medicine recipes can be used as a supplement to the first degree of the disease:
- Cabbage leaves.Used to relieve pain without taking analgesics and to relieve the "torsion" of the painful joint. Tie a few cabbage leaves to your thigh at night after rubbing pure honey into the skin. Wrap it on top with plastic wrap and something warm. Remove in the morning, rinse off the remaining honey with cold water and repeat the compress. Repeat until the pain subsides.
- Honey and beet ointment.Similar to cabbage leaves. You just have to tinker to cook it. The ratio of beet and honey is 1/1. Rotate the root vegetables in a meat grinder, add honey, stir. Pour 50 ml of vodka or alcohol. Stir again. Rub into the affected joint until the pain goes away.
- therapeutic baths.For cooking you will need fir branches (a couple of large twigs), turpentine turpentine (1 teaspoon), bath salt (1 kg) and washed Jerusalem artichoke tubers cut into pieces (3-4 pieces). Fill with hot water and let it brew. When the water is comfortable for bathing, remove the twigs and Jerusalem artichoke and begin the procedure. When finished, apply an iodine net to the sore thigh or rub honey, put on something warm and go to bed.
Osteoarthritis of the hip joint is a serious disease that occurs when several causes are combined.
In order not to become disabled, do not wait for the consequences, have yourself checked annually and see a doctor at the first discomfort in the groin area.