Causes and treatment of osteoarthritis of the hip joint

Osteoarthritis of the hip joint, otherwise referred to as coxarthrosis, is one of the most serious diseases of a modern person, often leading to disability. Its first manifestations - mild pain in the groin - are usually ignored. The patient seeks qualified medical help, as a rule, when drug treatment is ineffective and endoprosthesis is required.

Reasons

Osteoarthritis of the hip joint occurs due to a combination of various unfavorable circumstances. Microtraumas and full-fledged injuries account for about one fifth of the total number of cases (on average 10-20%).

Other causes of hip osteoarthritis include:

• Excessive loads.
• Heart attack or aseptic necrosis of the hip joint.
• Prolonged stress, prolonged depression.
• Overweight.
• Inheritance.
• Congenital anomalies and underdevelopment.
• Inflammatory processes in the joints.
• Hormonal background error.

Excessive loads

Until recently it was believed that excessive physical exertion, many hours of walking, hard work (as a loader) was the main cause of osteoarthritis. But is not so.

A healthy joint, which has never injured itself, perfectly tolerates any stress, especially at a young age, and nothing happens to it.

But if once, even in childhood, there were microtraumas, then such a joint is a candidate for the development of coxarthrosis. For this reason, the disease manifests itself in 20-30% of cases.

Heart attack

This is a violation of 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 (high stress).
• Excessive one-off uploads at a time when a person is not ready for them.

Heart attack quite often becomes one of the causes of the morbidity of coxarthrosis - in 10-30% of cases.

Persistent stress

Few people believe in psychosomatics. However, prolonged experiences, depression, lack of understanding in the family and various phobias that arise in this context are a direct path to problems with the joints and not just the hip. The incidence of osteoarthritis for this reason is very high, up to 50.

The mechanism of disease activation in this situation is simple. During prolonged depression, the patient's body produces stress hormones that belong to the group of corticosteroids. The longer a person is in this state, the higher his concentration in the blood. Corticosteroids inhibit the production of hyaluronic acid, which is the main component of joint fluid. If not enough is produced or if its composition is changed, the cartilage is poorly wet, dry, covered with a network of tiny cracks.

The stress hormone reduces capillary permeability while altering blood circulation in the joints.

Overweight

It is an additional factor among other causes of osteoarthritis of the hip joint (coxarthrosis).

Overweight people place enormous stress 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, staying at the same weight, joint problems will grow like a snowball.

Inheritance

If one of your relatives has had osteoarthritis, you don't need to get sick too. However, the appearance of "sores" is influenced by the peculiarities of metabolism, the structure of the cartilage and can be inherited. This also includes weakness of the muscular system. For this reason, coxarthrosis can only be obtained in 10% of cases. And it is far from the fact that this will happen. The main thing is to undergo regular examinations and monitor the condition of the joints.

Congenital anomaly

This is usually treated in early childhood, allowing the child to grow and use the limb normally. However, the presence of an abnormality is always a risk of contracting coxarthrosis, especially if the condition of the joints is not monitored. The incidence rate is small - only 5. It should not be overlooked that only a combination of several causes leads to the onset of osteoarthritis of the hip joint.

Joint inflammation

This process is commonly referred to as arthritis. The disease causes the occurrence of secondary coxarthrosis in 2-3% of cases. The inflammatory process changes the quality of the intra-articular fluid. It becomes more viscous and ceases to perform its direct functions. As a result, the cartilage rubs against the cartilage, gradually collapsing.

Among other reasons, which directly or indirectly influence the onset of coxarthrosis, we can mention hormonal changes in menopause, metabolic diseases (diabetes), nervous diseases (in which the sensitivity of the lower limbs is lost), osteoporosis.

Symptoms

Osteoarthritis of the hip joint manifests itself in different ways. At the first stage of the development of the patient's pathology, almost nothing disturbs, except for weak, unpleasant, sometimes painful sensations, which pass independently.

The symptoms of osteoarthritis of the hip joint are specific and allow a preliminary conclusion (to make a diagnosis) already in the examination phase:

• Pain in the groin. This is the main symptom of the disease. If during the movement you feel that something is wrong with this area, try to visit a doctor as soon as possible. Groin pain usually travels down the front or side of the thigh and can radiate to the buttock or knee. It is extremely rare for pain in osteoarthritis of the hip joint to reach the middle of the calf muscle. The patient feels discomfort when lowering into a chair or standing up or after a long walk.
• Limited mobility. This symptom indicates that osteoarthritis of the hip joint (coxarthrosis) is already progressing. If you ask such a patient to sit "astride a chair", ie backwards, he is unlikely to be able to do so.
• Crunch of the hip joint when walking. It does not appear immediately, but as osteoarthritis progresses and cartilage destruction. Its difference from the usual crunch of a healthy joint is a rather dry sound and a pain syndrome of weak or moderate intensity.
• Shortening of the diseased limb. It occurs when the disease is already sufficiently advanced.
• Limp, fall on a sore leg due to partial or complete destruction of cartilage.
• Muscular atrophy of the affected leg. It looks visually dry and unhealthy.
• Pain in the knee joint due to muscle atrophy.

Diagnostics

This moment is not too long for the patient. After a visual examination and questioning of the patient, the doctor prescribes a referral for blood donation: a general analysis, biochemistry and rheumatic test. This is done to rule out the inflammatory process in the body. With osteoarthritis, all indicators are close to normal.

The next step is the instrumental exams:

1. Radiography and / or CT.Computed tomography shows the joints a little better.
2. MRI. Named first. Such a survey is as informative as possible.
3. Ultrasound of the joints.A sign of coxarthrosis in this study is a clear thinning of the cartilage. However, the accuracy of the result largely depends on the qualifications of the specialist who decrypts the data obtained. Therefore, to establish the disease, it is prescribed in rare cases.

Consequences

If osteoarthritis of the hip joint is not treated, hoping that "maybe it will go away on its own", the disease will actively progress. The consequences of such indifference to oneself are expressed in muscle atrophy and a clear shortening and dryness of the diseased limb, at some point a person will not be able to move independently. Pain syndrome will become a constant companion of such a patient; even strong pain relievers cannot relieve it. The only way out of this situation will be a joint replacement surgery - endoprosthesis.

If coxarthrosis is diagnosed in an elderly patient, treatment should be started immediately. A sedentary way of life, which invariably arises in a patient due to constant severe pain, significantly shortens life.

Traditional treatment

It can be divided into medical and surgical. The second is used in the event that the first does not bring significant improvements with prolonged use.

Coxarthrosis of the early stages is quite treatable:

1. Medicines.
2. Manual therapy.
3. Traction on a special table.
4. With PIR (post-measurement relaxation).
5. Therapeutic massage.
6. Hirudotherapy.
7. Corrective gymnastics.

Drugs

The task of drugs is multifaceted. Not only tablets are used, but also ointments, intra-articular injections. Tablets (capsules, sachets) are prescribed to relieve pain (non-steroidal anti-inflammatory drugs), improve cartilage nutrition and improve the quality of intra-articular lubrication (chondroprotectors), relieve muscle spasms (muscle relaxants).

Ointments and creams have the weakest effect and are used to warm and irritate. Their effect is close to placebo. At the time of rubbing, the patient's body produces endorphins - pleasure hormones, and they are quite effective in relieving pain.

Intra-articular injections for osteoarthritis of the hip joint are very rare. This is due to the narrow joint space, which is quite difficult to enter, even with the use of special auxiliary equipment. The procedure is performed through the groin and is so complex that ninety-nine percent of doctors prefer to inject drugs into the periarticular sac by puncturing the side of the thigh.

For injection:

• Relieve high intensity pain syndrome (corticosteroids).
• They nourish the cartilage (chondroprotectors).
• Improves the quality of the lubricant (substitutes for hyaluronic acid - injected through the groin).

Non-steroidal anti-inflammatory drugs are administered orally for mild to moderate pain. They also effectively extinguish inflammatory processes.

Manual therapy

Treatment by an experienced specialist can set up patients with moderate coxarthrosis. The doctor's task is to restore the mobility of the joint, to relieve pain. Manual therapy is divided into manipulation (a single effect on the joint) and mobilization (4 cycles per year, 3 - 4 sessions each).

Mobilization allows you to stretch the affected limb with minimal pain. Enlarge the joint space, relax tense muscles. Manipulation is allowed only in the early stages of the disease.

Traction on a special table also gives certain results, but significantly loses manual therapy. The machine (device), unlike the hands of a doctor, does not hear the patient and, if not used correctly, can cause damage.

PIR

Post-isometric relaxation involves active interaction between the patient and the treating physician. The significance of the method is that the patient relaxes / strains certain muscle groups as directed by a specialist. At this point, the doctor stretches the ligaments and joints.

This treatment for coxarthrosis helps relieve muscle spasms. The method is effective for coxarthrosis of I and II degree.

Massage

If you decide to use this method, you need to find a highly qualified specialist. Otherwise, instead of alleviating the condition, you can make it worse. The method is effective for I and II degrees of coxarthrosis as an auxiliary.

Coxarthrosis massage should not cause pain. The sensations during the procedure are pleasant, relaxation and comfort should be felt.

Please note that there are contraindications for massage. Do not 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 cartilage, and it itself contains many useful substances. It acts as 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 of 10 sessions per year.

Corrective gymnastics

No disease can be cured or alleviated without a dose of exercise. Osteoarthritis of the hip joint is no exception. If you don't strengthen your muscles, their atrophy is inevitable, while the condition of the cartilage deteriorates at twice the rate.

It is preferable to study in special groups under the supervision of specialists. The medical complex is selected by a doctor based on examinations, the degree of coxarthrosis and the physical capabilities of the patient.

Endoprosthesis

Surgery is performed at III and IV degree of coxarthrosis, when conservative treatment gives minimal results or is not at all effective. The surgeon's job is to replace both the joint head itself and the acetabulum with artificial implants through a small incision in the thigh.

Now these operations are in progress. To imagine what awaits you if you ignore the first signs of coxarthrosis, imagine the progress of the operation (in short):

1. The patient is anesthetized.
2. An incision is made in the thigh, the soft tissues are removed, the nerves are pulled back.
3. The joint is removed from its bed. Put simply, the doctor does an artificial dislocation to get his head.
4. The joint head with part of the bone is removed.
5. The acetabulum is cleaned.
6. An endoprosthesis, an artificial joint head, is inserted into the bone, or rather, "clogged".
7. An artificial acetabulum is inserted.
8. The joint is repositioned. The doctor checks his mobility by moving the limb in different directions.
9. The wound is disinfected and stitched up.

After the operation, a rather long period of rehabilitation and adherence to a certain regimen is required.

Traditional methods

For those who like 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 things" will not lead to anything good.

However, some recipes of traditional medicine can be used as ancillary to the first degree of the disease:

1. Cabbage leaves.Used to relieve pain without taking analgesics and to relieve "twisting" from a sore joint. At night, tie a few cabbage leaves to the thigh, after rubbing pure honey into the skin. Wrap it over with cling film and something warm. In the morning, remove, rinse the remaining honey with cold water and repeat the compress. Repeat until the pain subsides.

2. Honey and turnip ointment.Similar in action to cabbage leaves. You just have to tinker to cook it. The ratio of turnip to honey is 1/1. Twist the vegetable root in a meat grinder, add honey, mix. Pour in 50 ml of vodka or alcohol. Stir again. Rub on the affected joint until the pain goes away.
3. Healing baths.For cooking you need pine branches (a couple of large branches), turpentine (1 tsp), 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 pleasant for bathing, remove the branches and Jerusalem artichoke and start the procedure. When finished, apply iodine mesh to your 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 multiple causes are combined.

In order not to become disabled, do not wait for the consequences, undergo annual examinations, at the first feeling of discomfort in the groin area, consult a doctor.