Causes and treatment of arthrosis of the hip joint

Arthrosis 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 groin pain - are usually ignored. The patient seeks qualified medical help, as a rule, when drug treatment is ineffective and endoprosthetics is required.

Reasons

Arthrosis of the hip joint occurs due to a combination of various, unfavorable circumstances. Microtraumas and full-fledged injuries account for about a fifth of the total number of patients (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.
• Overweight.
• Heredity.
• Congenital anomalies and underdevelopment.
• Inflammatory processes in the joints.
• Hormonal background failure.

Excessive loads

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

A healthy joint, which has never been injured, 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 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 injury.

In addition to injury, the cause of a heart attack can be:

• Excessive alcohol consumption.
• Frequent injections of corticosteroids.
• An unexpected shock (severe stress).
• Excessive, one-time loads at a time when a person is not ready for them.

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

Lingering Stress

Few people believe in psychosomatics. However, protracted experiences, depression, lack of understanding in the family and various phobias arising against this background are a direct path to problems with the joints, and not only with 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 is in this state, the higher their concentration in the blood. Corticosteroids inhibit the production of hyaluronic acid, which is the main component of joint fluid. If it is not produced enough or its composition is changed, the cartilage is poorly wetted, dries up, covered with a mesh of tiny cracks.

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

Overweight

Is an additional factor among other causes of arthrosis of the hip (coxarthrosis) joint.

Overweight people place tremendous stress on their joints, especially the ankles, knees and hips.

As long as they are young, everything seems to be functioning 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 had arthrosis, it is not at all necessary that you will also get sick. However, the occurrence of "sores" is influenced by the peculiarities of metabolism, the structure of cartilage, and they can be inherited. This also includes the weakness of the muscular apparatus. For this reason, coxarthrosis can only be earned 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 your joints.

Congenital anomaly

This is usually treated in early childhood, allowing the child to grow up and use the limb normally. However, the presence of an anomaly is always a risk of getting 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.

Joint inflammation

This process is commonly referred to as arthritis. The disease provokes 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, directly or indirectly affecting the occurrence of coxarthrosis, one can name hormonal changes in menopause, metabolic diseases (diabetes), nervous diseases (in which the sensitivity of the lower extremities is lost), osteoporosis.

Symptoms

Arthrosis of the hip joint manifests itself in different ways. At the first stage of the development of the pathology of the patient, almost nothing bothers, except for weak unpleasant, sometimes painful, passing independently, sensations.

The symptoms of arthrosis of the hip joint are specific and allow a preliminary conclusion (to make a diagnosis) already at the stage of examination:

• Groin pain. This is the main symptom of the disease. If you feel during movement that something is wrong in this area, try to visit a doctor as soon as possible. Pain from the groin usually travels along the front or side of the thigh, and may radiate to the buttock or knee. It is extremely rare for pain in arthrosis of the hip joint to reach the middle of the calf muscle. The patient feels discomfort at the time of sinking into a chair or getting up, or after a long walk.
• Restricted mobility. This symptom signals that arthrosis of the hip (coxarthrosis) joint is already progressing. If you ask such a patient to sit “astride a chair, ” that is, backwards, 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 destruction of cartilage. Its difference from the usual crunch of a healthy joint is a rather dry sound and pain syndrome of weak or moderate intensity.
• Shortening of the diseased limb. Occurs when the disease is already sufficiently advanced.
• Limping, falling on a sore leg due to the fact that there is a partial or complete destruction of the cartilage.
• Muscle atrophy of the affected leg. It visually looks 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 donating blood - general analysis, biochemistry and rheumatic test. This is done in order to exclude the inflammatory process in the body. With arthrosis, all indicators are close to normal.

The next step is instrumental examinations:

1. X-ray and / or CT.Computed tomography shows the joints a little better.
2. MRI. Appointed 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 deciphers the data obtained. Therefore, to establish the disease, it is prescribed in rare cases.

Consequences

If arthrosis of the hip joint is left untreated, hoping that "maybe it will go away by itself", the disease will actively progress. The consequences of such indifference to oneself are expressed in muscle atrophy and an obvious shortening and drying out of the diseased limb, at some point a person will not be able to move independently. The pain syndrome will become a constant companion of such a patient; even strong painkillers cannot relieve it. The only way out of this situation will be joint replacement surgery - endoprosthetics.

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

Traditional Treatment

It can be categorized as medicinal and surgical. The second is used in the case when the first does not bring significant improvement with prolonged use.

Coxarthrosis of the initial 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. Remedial gymnastics.

Medicines

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 spasm (muscle relaxants).

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

Intra-articular injections for arthrosis of the hip joint are very rare. This is due to the narrow joint space, which is quite difficult to get into, 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 the medication into the periarticular sac by making a puncture at the side of the thigh.

By injection:

• Relieve 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 administered orally for mild to moderate pain. They also effectively extinguish inflammatory processes.

Manual therapy

Treatment by an experienced specialist can put patients with moderate coxarthrosis on their feet. The doctor's task is to restore mobility to the joint, relieve pain. Manual therapy is subdivided into manipulation (a single effect on the joint) and mobilization (4 courses a 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 tight muscles. Manipulation is permissible only in the early stages of the disease.

Traction on a special table also gives certain results, but significantly loses to manual therapy. The machine (device), in contrast to the doctor's hands, does not feel the patient and, if used incorrectly, can cause harm.

PIR

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

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

Massage

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

Massage for coxarthrosis 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 arthrosis of the hip joints. The saliva of this worm improves blood circulation, the elasticity of the cartilage, and itself contains many useful substances. It acts like a chondroprotector, only softer.

Leeches are placed not only on the sore thigh, but also on the sacrum, lower abdomen, lower back. You need to complete 2 courses of 10 sessions per year.

Remedial gymnastics

No disease can be cured or relieved of the patient's condition without dosed physical exercises. Arthrosis of the hip joint is no exception. If you do not strengthen the muscles, their atrophy is inevitable, while the condition of the cartilage will deteriorate at a double 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 patient's physical capabilities.

Endoprosthetics

Surgical intervention is performed at III and IV degrees of coxarthrosis, when conservative treatment gives minimal results or is not effective at all. The task of the surgeon is to replace both the articular head itself and the acetabulum with artificial implants through a small incision in the thigh.

Now such operations are on stream. To imagine what awaits you if you ignore the first signs of coxarthrosis, imagine the course of the operation (in short):

1. The patient is anesthetized.
2. An incision is made on the thigh, soft tissues are excised, nerves are pulled back.
3. The joint is removed from its bed. In simple words, the doctor makes an artificial dislocation to get his head.
4. The head of the joint with part of the bone is removed.
5. The acetabulum is cleaned out.
6. An endoprosthesis, an artificial articular 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.

After the operation, a rather long period of rehabilitation and adherence to a certain regimen are 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 rashes, 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 relieve "torsion" from a sore joint. At night, tie a few cabbage leaves to your thigh, after rubbing pure honey into the skin. Wrap it on top with plastic wrap and something warm. In the morning, remove, rinse off 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 and honey is 1/1. Twist the root vegetable in a meat grinder, add honey, stir. Pour in 50 ml of vodka or alcohol. Stir again. Rub into the affected joint until the pain disappears.
3. Healing baths.For cooking, you need pine branches (a couple of large branches), turpentine turpentine (1 teaspoon), bath salt (1 kg), and washed Jerusalem artichoke tubers chopped into pieces (3-4 pieces). Fill with hot water and let it brew. When the water is pleasant for taking a bath, remove the branches and Jerusalem artichoke and start the procedure. Upon completion, apply an iodine net to the sore thigh or rub honey, put on something warm and go to bed.

Arthrosis of the hip joint is a serious disease that occurs when a number of 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, see a doctor.