Arthrosis of the hip joint, also known as coxarthrosis, is one of the most serious diseases of the modern person, usually leading to disability. Its first manifestations - mild groin pain - are often ignored. The patient seeks qualified medical care, as a rule, when drug treatment is ineffective and there is a need for an endoprosthesis.
Reasons
Arthrosis of the hip joint occurs due to a combination of various unfavorable circumstances. Microtraumas and bodily injuries are responsible for about a fifth of the total number of cases (on average 10-20%).
Other causes of hip arthrosis include:
- Excessive loads.
- Heart attack or aseptic necrosis of the hip joint.
- Prolonged stress, prolonged depression.
- Too much.
- Heredity.
- Congenital anomalies and underdevelopment.
- Inflammatory processes in the joints.
- Hormonal background failure.
Excessive loads
Until recently, it was believed that excessive physical effort, many hours of walking, hard work (as a porter) is the main cause of osteoarthritis. But it's not like that.
A healthy joint, which has never been injured, tolerates any stress perfectly, especially at a young age, and nothing happens to it.
But if before, even in childhood, microtrauma existed, then this joint is a candidate for the development of coxarthrosis. For this reason, the disease occurs 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 (intense stress).
- Excessive and unique loads at a time when the person is not ready for them.
Heart attack becomes one of the causes of coxarthrosis morbidity quite often - 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 route to joint problems, and not just in the hip. The incidence of arthrosis for this reason is very high - up to 50.
The mechanism of triggering the disease 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 stays in that state, the greater their 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 its composition is altered, the cartilage is poorly moistened, dry, covered with a mesh of tiny cracks.
The stress hormone reduces capillary permeability while impairing blood circulation in the joints.
Excess
It is an additional factor among other causes of arthrosis of the hip joint (coxarthrosis).
Overweight people put tremendous stress on their joints, especially their ankles, knees and hips.
As long as they are young, everything seems to work within normal limits. But with age, remaining at the same weight, joint problems will grow like a snowball.
Heredity
If one of your relatives has osteoarthritis, it is not necessary for you to be ill too. However, the occurrence of "wounds" is influenced by the peculiarities of the metabolism, the structure of the cartilage, and can be hereditary. This also includes muscle weakness. For this reason, coxarthrosis can only be acquired in 10% of cases. And it is far from true that this is going to happen. The main thing is to have regular examinations and monitor the condition of your joints.
Congenital anomaly
It is usually treated in early childhood, allowing the child to grow up and use the limb normally. However, the presence of an abnormality is always a risk of contracting coxarthrosis, especially if you do not monitor the condition of your joints. The incidence rate is small - only 5. It should not be disregarded that only a complex of several reasons leads to the occurrence of arthrosis of the hip joint.
Inflammation of the joints
This process is commonly known as arthritis. The disease causes secondary coxarthrosis to occur in 2-3% of cases. The inflammatory process alters the quality of the intra-articular fluid. It becomes more viscous and stops performing its direct functions. As a result, the cartilage rubs against the cartilage, gradually collapsing.
Among other reasons that directly or indirectly influence the occurrence of coxarthrosis, we can mention hormonal changes during menopause, metabolic diseases (diabetes), nervous diseases (in which the sensitivity of the lower limbs is lost), osteoporosis.
Symptoms
Arthrosis of the hip joint manifests itself in different ways. In the first phase of the development of the patient's pathology, almost nothing bothers, except for weak unpleasant sensations, sometimes painful, passing sensations independently.
The symptoms of arthrosis 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 you feel during the movement that something is wrong in that area, see a doctor as soon as possible. Groin pain usually reaches the front or side of the thigh and can radiate to the buttocks or knee. It is extremely rare that pain in arthrosis of the hip joint reaches the middle of the calf muscle. The patient feels discomfort when sinking in the chair or when getting up, or after a long walk.
- Mobility restricted. This symptom signals that arthrosis of the hip joint (coxarthrosis) is already progressing. If you ask that patient to sit on a chair, that is, on his back, he is unlikely to be able to do this.
- Crunching of the hip joint when walking. It does not appear immediately, but as the arthrosis progresses and the cartilage is destroyed. Its difference with the normal cracking of a healthy joint is a very 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.
- Limping, falling with pain in the leg due to partial or total destruction of the cartilage.
- Muscle atrophy of the affected leg. It looks visually dry and unhealthy.
- Pain in the knee joint due to muscle atrophy.
Diagnosis
This moment is not too long for the patient. After visual examination and interrogation of the patient, the doctor prescribes a referral for blood donation - general analysis, biochemistry and rheumatic examination. This is done to exclude the inflammatory process in the body. With arthrosis, all indicators are close to normal.
The next step is the instrumental exams:
- X-ray and / or CT.Computed tomography shows the joints a little better.
- MRI. Named first. This research is as informative as possible.
- Ultrasound of the joints.A sign of coxarthrosis in this study is a clear thinning of the cartilage. However, the accuracy of the result depends a lot on the qualification of the specialist who decipher the data obtained. Therefore, to establish the disease, it is prescribed in rare cases.
Consequences
If arthrosis of the hip joint is not treated, in the hope that "perhaps it will go away on its own", the disease will actively progress. The consequences of such indifference in itself are expressed in muscular atrophy and a clear shortening and dryness of the sick limb, at some point the person will not be able to move on his own. Pain syndrome will become a constant companion for such a patient, even strong painkillers cannot relieve it. The only way out of this situation will be joint replacement surgery - endoprosthesis.
If coxarthrosis is diagnosed in an elderly patient, treatment should be started immediately. A sedentary way of life, which invariably occurs in a patient due to constant severe pain, significantly shortens life.
Traditional treatment
It can be categorized as medical and surgical. The second is used in the case where the first does not bring significant improvement with prolonged use.
Coxarthrosis of the early stages is quite treatable:
- Medicines.
- Manual therapy.
- Draw on a special table.
- With PIR (post-measurement relaxation).
- Therapeutic massage.
- Hirudotherapy.
- Corrective gymnastics.
Medicines
The task of medicines is multifaceted. Not only are pills 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 (chondroprotective), relieve muscle spasm (muscle relaxants).
Ointments and creams have the weakest effect and are used to heat and irritate. Its effect is close to that of placebo. At the time of rubbing, the patient's body produces endorphins - pleasure hormones, which relieve pain quite effectively.
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 penetrate, even with the use of special auxiliary equipment. The procedure is done through the groin and is so complex that ninety-nine percent of doctors prefer to inject drugs into the periarticular sac through a puncture on the side of the thigh.
By injection:
- Relieves high-intensity pain syndrome (corticosteroids).
- They nourish cartilage (chondroprotectors).
- Improves lubricant quality (substitutes for hyaluronic acid - injected into the groin).
Nonsteroidal 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 place patients with moderate coxarthrosis in the feet. The doctor's task is to restore joint mobility, relieve pain. Manual therapy is subdivided 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 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 it loses significantly with manual therapy. The machine (device), unlike the doctor's hands, does not feel the patient and, if used incorrectly, can cause damage.
PIR
Post-isometric relaxation involves active interaction between the patient and the attending physician. The meaning of the method is that the patient relaxes / tensions certain muscle groups as directed by a specialist. At that point, the doctor stretches your ligaments and joints.
This treatment for coxarthrosis helps to relieve muscle spasms. The method is effective for coxarthrosis grades I and II.
Massage
If you decide to use this method, you need to find a highly qualified specialist. Otherwise, instead of relieving the condition, you can make it worse. The method is effective for coxarthrosis grades I and II as an aid.
The coxarthrosis massage should not cause pain. The sensations during the procedure are pleasant, relaxation and comfort must be felt.
Note that there are contraindications for massage. Don't self-medicate.
Hirudotherapy
Leech treatment helps in the early stages of arthrosis of the hip joints. This worm's saliva improves blood circulation, cartilage elasticity, and itself contains many useful substances. It acts as a chondroprotector, only smoother.
Leeches are placed not only on the painful thigh, but also on the sacrum, on the lower abdomen and on the lower back. You need to take 2 courses of 10 sessions per year.
Corrective Gymnastics
No disease can be cured or relieved without a dose of exercise. Arthrosis of the hip joint is no exception. If you don't strengthen your muscles, your atrophy will be inevitable, while the condition of the cartilage will deteriorate at a doubled rate.
It is preferable to study in special groups under the supervision of specialists. The medical complex is selected by a doctor based on the exams, the degree of coxarthrosis and the patient's physical capabilities.
Endoprosthesis
Surgical intervention is performed in degrees III and IV coxarthrosis, when conservative treatment gives minimal results or is not effective. The surgeon's task is to replace the articular head itself and the acetabulum with artificial implants through a small incision in the thigh.
These operations are now in progress. To imagine what awaits you if you ignore the first signs of coxarthrosis, imagine the course of the operation (in short):
- The patient is anesthetized.
- An incision is made in the thigh, the soft tissues are excised, the nerves are pushed back.
- The gasket is removed from its base. In simple words, the doctor makes an artificial shift to obtain the head.
- The head of the joint with part of the bone is removed.
- The acetabulum is cleaned.
- An endoprosthesis, an artificial articular head, is inserted into the bone, or rather "clogged".
- An artificial acetabulum is inserted.
- The joint is repositioned. The doctor checks his mobility by moving the limb in different directions.
- The wound is disinfected and sutured.
After the operation, a long period of rehabilitation and adherence to a certain regime is necessary.
Traditional methods
For lovers of self-medication, it should be noted that coxarthrosis is a disease that should only be treated by the doctor. All popular methods in the form of rashes, lotions and other "unusual things" will not do you any good.
However, some traditional medicine recipes can be used as an aid in the first degree of the disease:
- Cabbage leaves.Used to relieve pain without taking pain relievers and to relieve the "sprain" of a sore joint. In the evening, tie some cabbage leaves on the thigh, after rubbing pure honey on the skin. Wrap with plastic wrap and something hot. In the morning, remove, rinse the remaining honey with cold water and repeat the compress. Repeat until the pain is gone.
- Ointment of honey and turnip.Similar in action to cabbage leaves. You just need to stir it to cook it. The proportion of turnip and honey is 1/1. Twist the vegetable root in a meat grinder, add honey and stir. Pour in 50 ml of vodka or alcohol. Stir again. Rub on the affected joint until the pain is gone.
- Healing baths.To cook, you need pine branches (some large branches), turpentine (1 teaspoon), bath salt (1 kg) and Jerusalem artichoke tubers washed and cut into pieces (3-4 pieces)). Drizzle with hot water and let it ferment. When the water is nice for bathing, remove the branches and Jerusalem artichoke and start the procedure. Upon completion, apply an iodine net to the injured thigh or rub with honey, put on something warm and go to bed.
Arthrosis of the hip joint is a serious disease that occurs when several causes are combined.
In order not to be incapacitated, do not wait for the consequences, do annual exams, in the first sensation of discomfort in the groin area consult a doctor.