Hip arthritis is the most common type of joint disease.Because the hip joint (HJ) is larger than other joints and has a multivector axis of rotation, it is subject to significant loads throughout a person's life (walking, running, jumping, stair climbing, sports, and daily activities).
Typically, patients between the ages of 25 and 35 have to worry about the symptoms and treatment of hip arthritis.The disease can progress rapidly under the influence of injuries, compensatory physical activity (non-compliance with exercise training techniques, "standing" work, overweight), genetic factors, infectious diseases and chronic diseases.
However, effective treatment for hip osteoarthritis can preserve mobility and prevent bone destruction.In old age, it helps avoid more dangerous pathologies such as osteonecrosis or fractures of the femoral head.
symptoms of hip arthritis
Hip symptoms and treatment depend on the stage of the disease.
- Stage 1: The patient feels mild pain in the groin. This pain occurs after physical activity, standing for a long time, or sudden joint movement, and disappears completely when resting.
- The second stage.Pain syndrome can intensify and bother patients even when performing normal household activities.The pain may radiate to the lower back or inner thighs.Stiffness and crunching sounds occur, and the range of motion of the joints is reduced.The musculoligamentous system begins to weaken, leading to increased fatigue.
- Stage 3: Pain persists and makes it difficult for the patient to move without crutches or a walker.The movement of the joints is severely restricted.Climbing stairs is a serious challenge.Gait impairment (limping, falling on one or both legs) is present.In unilateral hip arthritis, pelvic distortion and spinal curvature may be visible to the naked eye.
- The fourth stage.Due to the proliferation of osteophytes, the joint space closes and any movement of the joint becomes almost impossible.Due to bone destruction, it loses its function and becomes severely deformed.
Prognosis of hip arthritis
With successful lifelong treatment, pain caused by hip joints may completely disappear or rarely bother the patient.The prospects for this treatment depend on the patient's compliance with the rheumatologist's rules and personal self-discipline.Please note that only the treating physician can make the most accurate prediction of the disease.
Timely and regular treatment
Hip replacement may be avoided if chronic disease does not lead to disease progression and hip treatment is initiated in stage one or two.If doctors' recommendations are followed, disability and incapacity can extend for up to 20 years, sometimes leaving patients with virtually unrestricted joint range of motion into old age.The so-called best prognosis is possible.Benign arthropathy - wear and tear of cartilage depends on external factors (occupational activities, hygiene violations).In this case, it is worth ruling them out and undergoing a course of recovery treatment to slow down further degeneration of the joint.
Prompt surgical treatment of grade 3 osteoarthritis of the hip will help avoid joint immobility, consequences for the entire musculoskeletal system, and years of pain.In the absence of contraindications, a prosthesis will help you return to your previous activities.
When self-medicating
When choosing a treatment for hip arthritis, doctors consider the patient's age, constitution, physical fitness, health, specific symptoms of the disease, and its stage.In this case, the joint space is examined for luminal narrowing, the presence of osteophytes, the rate of progression of the arthropathy, the quality of the synovial fluid and other indicators.
Self-treatment of hip osteoarthritis using traditional methods does not take these individual indicators into account and may lead to severe exacerbation, metabolic derangement, and exacerbation of the condition rather than achieving the desired results.But the worst part is that people spend their time under the illusion that serious, chronic conditions like the hip can only be cured through traditional methods.Avoid taking anti-inflammatory medications without a doctor's prescription - this can cause serious problems with your digestive and endocrine systems!
No treatment
If left untreated, arthritis in the hip progresses an average of 2-4 times faster.In this case, deterioration in quality of life and disability may appear at a relatively young age (approximately 45-50 years).The patient's sleep quality deteriorates, physical activity decreases, and psychoemotional disturbances occur.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 arthropathy is conservative outpatient management.It includes medication, physical therapy, dietary therapy, wearing bandages and adjustable orthotics for hip arthrosis.This approach can reduce pain, maintain muscle function, and increase joint mobility.Treatment for grade 2 hip arthritis is similar.
If conservative treatment of the hip joint is delayed or ineffective, cartilage degeneration can progress rapidly, requiring surgery.Sometimes, the doctor may decide to perform an osteotomy or arthrodesis, but in most cases, when treating grade 3 hip arthropathy, an endoprosthesis—a partial or complete replacement of the diseased joint—is prescribed.Prostheses made of metal and ceramic or polymer liners last 15 to 25 years before needing to be replaced.Total joint replacement (total joint replacement) is the most effective way to treat your hip joint.It allows you to fully regain its function through a minimal incision of up to 8cm and be able to walk with support within a day.Full recovery takes 1-3 months.
Physical therapy for hip arthritis
Physical therapy for the hip joint is performed in separate sessions according to the doctor's instructions.With the exception of magnet therapy and cryotherapy, almost all techniques can only be used in remission, with no symptoms of inflammation at all.The following measures are used to treat hip osteoarthritis:
- UHF therapy;
- Ultrasound therapy;
- laser treatment;
- magnet therapy;
- therapeutic exercises (therapeutic gymnastics);
- Therapeutic massage and manual therapy;
- ozone therapy;
- cryotherapy;
- acupuncture;
- Traction therapy (traction);
- Paraffin application and wrapping;
- balneotherapy and mud therapy;
- Hydromassage.
Exercise therapy for hip arthritis
Physical therapy for the hip joint aims to strengthen the muscles and ligaments - they act as natural orthotics, taking the load off the joint and keeping it in a physiologically correct position.Therefore, treating hip osteoarthritis through exercise can help relieve pain and inflammation, improve mobility, slow down cartilage wear, and ensure the nutritional supply of synovial fluid.The following exercises will help strengthen your legs:
- Starting position - Sit on the floor and focus on your arms extended behind you.Stretch your legs straight in front of you.We flex and straighten our toes.
- The starting position is the same.Alternately bend and straighten your feet (toes toward you, toes away from you).
- The starting position is the same.Bend your legs at the knees and pull them toward you along the mat or with weights.It is recommended to only touch the floor with your toes after completing the movement.
- Starting position - Lie on your back with your legs bent at the knees and feet on the floor.We do the "frog" exercise - open your bent knees and hold for 20 seconds.Then we put it together again.
- Starting position - Lie on your back with one leg straight and the other bent and aside.We lay like that for a minute, then switch legs.
- Starting position - Lie on your back with your legs straight and free.We pull the socks inward, touching them, and then separate them.Repeat 10 times at a certain speed.
- Starting position - Lie on your back with one leg (from the side of the affected joint) crossed over the other.We move the lower leg foot like in the exercise above.
- Starting position - lying on your back.We draw the knees toward the abdomen and clasp the back of the thighs with the fingers.Perform each leg for 30 seconds.
- The starting position is the same.We draw the legs with bent knees toward the abdomen and secure them under the knees with a clasping finger.Do this for at least 30 seconds.
- The starting position is the same.We move the straight leg to one side above the floor.20-30 reps per leg.
- Starting position - standing.Set a chair aside with its back facing you.Holding the back of a chair, stand on one leg and swing the other leg back and forth like a pendulum.20-30 times.
Massage Treatment for Hip Osteoarthritis
Massage is an effective relaxation and restorative technique for treating early-stage hip arthritis.As a treatment for 1st degree hip joints (and 2nd degree - without pain and swelling), it can extend the period of remission, relieve discomfort and pain without medication, improve tissue nutrition and slow cartilage degradation.It also eliminates cramps that interfere with sleep and movement, strengthens ligaments, normalizes gait, and allows you to quickly warm up when going from rest to active activity and vice versa.
For hip arthritis, professional therapeutic massage (at least 10-12 sessions) is required.But gentle self-massage at home can also help improve the condition.It is important to avoid pain and severe discomfort.As soon as the slightest signs of inflammation appear in the joint, the operation is temporarily stopped - after a course of anti-inflammatory treatment, it can be resumed with the permission of the attending physician.
Even if the patient has unilateral hip arthropathy, both sides should be massaged.How to do it correctly?
- First, get into a comfortable position that takes pressure off your hips and lower back.For example, lie on your back, side, or stomach.
- Start gently massaging the area around the affected joint.If you have an assistant, ask him or her to rub your back from shoulder blades to sacrum for 7 to 10 minutes to improve circulation.
- Continue stroking the lower back slowly, then use two fingers to warm up in circular motions in the sacrolumbar area.
- Massage your spine with your thumbs, gradually moving down into your lower back as your posture allows.
- Press your palms into the sacrogluteal area and begin rubbing and stretching the muscles.This completes the preparation work.
- Rub your thighs with your palms and massage in circular motions with your thumbs.
- Knead your inner thighs without applying pressure (so as not to squeeze the blood vessels).It's best to grab the fat folds with your thumb and fingers and knead them thoroughly.
- Important!Complete the process with relaxing strokes and gentle pats.
Use horizontal, vertical, grasping, squeezing and other movements during thigh massage.Use different parts of your palm or flexed fingers to rub toward the groin area.
After surgical treatment of grade 3 osteoarthritis of the hip joint and removal of stitches, massage is used for rehabilitation and motor function recovery.
Treating Hip Arthritis with Diet
The main principle of nutrition in the treatment of hip joint disease 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 B (anti-inflammatory), C, D, E are the most important.A low-protein diet is contraindicated in the treatment of hip osteoarthritis.Therefore, be sure to include in your menu:
- Diet meat, poultry, fish.
- egg.
- Milk and dairy products.
- Fruit, vegetables and fresh herbs.
- Whole grains and oilseeds (such as flax) and nuts.
- Dishes and products containing natural cartilage protectants (jelly, jelly, cartilage, pork legs, ears, etc.).
But it's better to cut back on carbs - after all, being even slightly overweight can put a huge strain on painful joints.Rehabilitation experts joke that losing a few kilograms is the most effective way to treat hip arthritis, and it's not without reason.You also need to eliminate salty, spicy, sweet and fried foods, which can cause your body to retain water.Minimize intake of:
- Fast food and semi-finished products;
- baked goods, sweets and pastries;
- Sausage and marinade.
Don’t forget to drink at least 2.5 liters of water every day!
Medication Treatment for Hip Arthritis
Medical treatment for hip osteoarthritis should be carried out strictly as prescribed by your doctor.If the pain becomes intensified and severe, regular analgesics or a mild anti-inflammatory drug (ibuprofen) can be taken, but not more than 10 days before contacting a specialist.Otherwise, the picture of the disease will become unclear and it will be difficult for doctors to choose the appropriate treatment for the hip joint.
There are a variety of medications available to treat hip arthritis.In the comprehensive treatment of hip arthritis with medications, 5 main drug groups are used.
Anti-Inflammatory Drugs for Hip Osteoarthritis
Swelling, stagnation of blood and other body fluids, localized heat and pain - these common symptoms of joint inflammation not only poison the patient's life, but also worsen the course of the disease.Over time, they lead to tissue starvation, depletion of the synovial fluid that "feeds" the cartilage and destroys its viscosity (due to friction destroying the surface of the joint membrane!), muscle dystrophy and continued deterioration of mobility.
But the main danger of inflammation is the death of chondrocytes – cartilage cells.When they break down in large amounts, they produce a buildup of enzymes that "erode" the surface of joint cartilage.
Therefore, in order to relieve inflammatory symptoms and restore tissue metabolism, 2 groups of anti-inflammatory drugs are used: nonsteroidal (NSAIDs, NSAIDs) and glucocorticoids.
NSAIDs are considered mild, although they can also affect the digestive system.That's why they were appointed in the first place.Treat grade 2 hip arthritis - during treatment or as needed.
These include: nimesulide, ibuprofen, meloxicam, ketoprofen, indomethacin, diclofenac.
If NSAIDs don't work, rheumatologists may prescribe corticosteroids.They can provide immediate relief from severe pain and inflammation, but should not be taken in high doses over long periods of time.As with any hormonal drugs, they affect the weight and condition of internal organs, and if the therapeutic dose is exceeded, they can aggravate the course of arthropathy.
The drugs of choice for treating grade 3 hip arthropathy are: hydrocortisone, prednisolone, and methylprednisolone.
Chondroprotective Agents for Hip Osteoarthritis
Although anti-inflammatory drugs can relieve symptoms, they don't solve the problem—they don't restore the damaged cartilage surface or enrich the synovial fluid with glycosaminoglycans.Therefore, effective treatment of hip arthritis is unthinkable without the drugs chondroitin and glucosamine sulfate, which provide the body with the building materials to form new cartilage cells.
Since cartilage tissue metabolizes very slowly, chondroprotective agents need to be taken long-term - 3-6 months per year.However, with lifelong preventive use, they can help achieve drug-free remission.
Chondroprotective agents include: glucosamine and chondroitin.
Vascular protectants and microcirculatory correctors
The inflammation and microtrauma that accompany arthrosis can disrupt the blood supply around the affected joints.But capillaries carry nutrients to the borders of the joint capsule.
The following medications help reduce swelling and improve tissue nutrition: troxerutin, horse chestnut extract, diosmin in combination with other medications, pentoxifylline.
muscle relaxants
When the supporting function of a joint is compromised, the body attempts to compensate using muscles and ligaments that were not designed for this near-constant load.Muscles can experience pain and spasm due to chronic overstrain.These cramps may interfere with sleeping or walking.
To eliminate them, in the treatment of osteoarthritis of the hip joint, the following drugs are prescribed: baclofen, tizanidine, tolperisone.
Topicals and warming agents
This group of drugs has a vasodilatory effect.They help relieve swelling, reduce pain, and psychologically distract from joint discomfort.
Often, for the treatment of hip arthrosis, products based on animal poisons or irritating plant extracts are used.
Drug-release form used to treat hip arthritis
Depending on the clinical manifestations of the arthropathy and the patient's lifestyle, rheumatologists will prescribe various forms of medications to treat hip osteoarthritis.
Tablets, capsules, powders
These products for treating hip arthritis are easy to dose and take with you.All you need is a glass of water.Additionally, via the blister or packaging, you can keep track of how many days the course has lasted.These drugs have good bioavailability.But anti-inflammatory tablets can have a negative effect on the mucosa of the stomach and intestines - for gastritis, ulcers, colitis, it is better to choose injections for osteoarthritis of the hip joint.
Injections for intramuscular and intraarticular administration
Anti-inflammatory drugs, muscle relaxants, and chondroprotectants are usually given by injection.This ensures maximum bioavailability and is gentle on the gastric mucosa, but usually requires the presence of a medical professional.It is strictly prohibited to perform intra-articular injections without special qualifications!
Ointments, gels and creams
Topical drugs used to treat hip arthritis have low bioavailability (approximately 5%), which limits their use in treatment to an adjunctive role.But their use has far fewer contraindications.
Less common are liquid preparations for the treatment of hip arthrosis - in the form of balms, compress solutions.