"What to do? "- men and women ask themselves when they have pain in the hip joints. One of the most common causes of this symptom is osteoarthritis. In the article we will tell you why the hip joints hurt in men or women when walking and at rest, where the pain goes, in what other pathologies it manifests itself and how to treat it.
Osteoarthritis of the hip joint (coxarthrosis)- degenerative-dystrophic disease. It often appears in people after age 40, often following an injury, but usually starts without an obvious cause.
The disease is characterized by a slow and gradually progressive course. In the initial stages, conservative treatment methods (medications, physiotherapy) are often used. However, in the later stages, to restore the normal function of the joint, in some cases it is necessary to undergo surgery to replace the joint.
Many people suffer from coxarthrosis: this is due to the fact that the load on the hip joint is usually high. In women, this condition occurs a little more often.
Factors that may increase the risk of developing this disease include prolonged and frequent heavy loads on the hip joint. Coxarthrosis often occurs in seemingly opposite categories of people: those who play sports professionally and those who are obese. Other risk factors include diseases that affect blood circulation, metabolism and hormonal balance, and pathologies of the musculoskeletal system (e. g. foot, spine). Coxarthrosis is also more common in older age.
The mechanism of development of arthrosis of the hip joint
Anatomically, the hip joint includes two bones:
- the ilium, which has the acetabulum;
- femoral, which has a head. Doctors call the femur bone for short: femur.
The two parts of these bones are connected to each other to form a joint. When a person moves his leg, the joint surfaces of the two mentioned parts rub against each other.
To prevent them from being damaged in the process, they are covered with elastic cartilage and joint fluid is secreted there, which plays the role of lubricant. This happens in a healthy person. The hip joint essentially works like a hinge.
When a person has coxarthrosis, the joint fluid becomes thicker and the cartilage becomes less elastic, cracks appear on it. As a result, the surfaces of the ilium and femur are less protected during friction and are more easily abraded and damaged. As a result, over time they begin to change shape.
Symptoms of osteoarthritis of the hip joint
Among the main signs of this condition is pain. They are localized in the area of \u200b\u200bthe joint itself, as well as in the groin, upper part of the thigh.
The following symptoms are also typical:
- limited movement;
- when a person tries to move the leg to the right (if it is right-sided coxarthrosis) or to the left (when the left joint is affected), he is unable to do so completely;
- the gait becomes different from the usual one of a healthy person, the patient limps;
- decrease in leg muscle mass;
- the affected leg becomes shorter.
Initial stage of arthrosis of the hip joint
At the initial stage of the development of the disease, pain occurs sometimes, periodically, mainly after physical exertion. For example, after a person has run or taken a long walk. The sensations are concentrated where the hip joint is located, sometimes in the upper leg or even in the knee. When a person rests, the pain usually goes away. Walking remains normal at this stage. The person can move the leg freely, the muscles are fine.
An x-ray examination reveals that the joint space is narrowed, but not yet that much. Bone spurs can be identified where the edges of the acetabulum are located. At this stage the head and neck of the femur remain unchanged.
Progression
In the next stage, the person suffers more from pain that occurs both during physical activity and at rest. They are strong, they reach the thigh, the groin. After trying to run, a person may limp, just like after a walk. Moving the leg laterally becomes more difficult and the range of motion is limited.
An x-ray examination shows that the joint space is narrowed and strongly. The images reveal displacement and distortion of the femoral head. In the area of the acetabulum, bony growths are visible.
Late stage of arthrosis of the hip joint
Here the person already suffers from severe constant pain. They can occur not only during the day during rest, but also at night. It becomes difficult for the patient to walk, so he buys a cane. Moving the leg becomes even more difficult than before. At this stage, atrophy of the leg and buttock muscles often occurs, leading the affected leg to shorten. To make walking easier, a person leans to the side, and this increases the load on the large joint even more.
An X-ray examination at this stage can see that the joint space is very narrow, the head of the femur is enlarged and there are many bony growths.
Diagnosis of arthrosis of the hip joint
It is carried out through a comprehensive examination, which includes:
- questioning of the patient by the doctor;
- examination by a doctor;
- auxiliary studies, the main one, of course, is X-rays.
On x-rays, it is sometimes possible to detect the cause of osteoarthritis, for example, you can see signs of previous injuries, dysplasia and other conditions.
Tomography (CT and MRI) also helps in diagnosis. With the first you can study changes in the bones and with the second you can study what happens to the soft tissues.
What can arthritis of the hip joint be confused with?
We wrote above that pain with coxarthrosis can occur not only in the hip joint, but also in the knee and the entire upper leg.
This means that if such symptoms occur, the doctor must first exclude the following pathologies:
- osteochondrosis (since it also causes pain in the upper part of the leg);
- osteoarthritis of the knee joint (manifests as knee pain).
The pain syndrome caused by osteochondrosis differs from that caused by arthrosis of the hip joint. With osteochondrosis, the pain appears sharp and most often is provoked by something: for example, a person turned sharply or lifted something heavy. In this case, the pain, as a rule, spreads from the buttock to the back of the leg.
With osteochondrosis, even if the pain is severe, a person can move his leg to the left or right. But with coxarthrosis, not always.
With arthrosis of the knee joint, pathological changes are detected on the x-ray of the knee joint.
It should be remembered that a person can have several diseases at once. For example, arthrosis of the knee and hip joints. Or osteochondrosis and osteoarthritis of various joints.
It is important to distinguish arthrosis of the hip joint from trochanteritis. The latter is an inflammatory disease of a part of the femur, called in Latin Trochanter major (greater trochanter) - the great trochanter. Trochanteritis occurs quickly, compared to arthrosis, the pain is stronger, and a person can move the leg freely.
In some cases, along with the pain that raises suspicion of osteoarthritis of the hip joint, some other condition is present (for example, ankylosing spondylitis, known as ankylosing spondylitis, etc. ). With them, as a rule, the pain occurs at night, disappears during the day and can even decrease with physical activity.
Treatment of coxarthrosis
If you suffer from joint pain, you should go to an orthopedic traumatologist.
Treatment includes conservative therapy (medications, physical therapy) and surgery.
Conservative therapy
Conservative treatment is prescribed in the initial stages.
This includes:
- ordinary painkillers that a person drinks in tablets or takes injections (injections), ointments;
- hormones injected into the joint;
- agents that restore the structure of cartilage (they are also taken orally and injected into the joint);
- other drugs prescribed by a doctor, depending on the patient's condition. These include drugs that relax muscles, dilate blood vessels, etc.
All medications should be taken strictly as prescribed by your doctor. This is especially true of conventional painkillers: with prolonged use they can have a negative effect on the stomach and cause serious complications, including bleeding. Therefore, the duration of courses should be determined only by a doctor.
Physiotherapy is also used in the treatment of osteoarthritis of the hip joint.
Many people benefit from laser treatment and ultrasound (called laser therapy and ultrasound therapy, respectively).
Magnetic therapy, inductothermy, light therapy and a number of other methods are used.
The therapy uses physiotherapy (physiotherapy) and massage.
It is worth saying a few words about diet. It does not directly treat hip arthritis. However, when a person weighs less, the load on the joint is reduced, which facilitates the disease.
Surgical treatment of arthrosis of the hip joint
When the disease has already reached advanced stages, the truly "working" method is surgery, in which the diseased joint is replaced with an artificial one. It's called an endoprosthesis.
Different parts of the joint may change. For example, just the head of the femur. This is a unipolar prosthesis. When both the femoral head and the acetabulum are replaced, such a prosthesis is called bipolar.
Endoprosthesis replacement is performed under general anesthesia. The person is first carefully examined. After surgery, antibiotic therapy and anticoagulants are prescribed. The stitches are removed on the tenth to twelfth day, then the person is transferred under the supervision of a doctor to a clinic or medical center, where treatment is provided on an outpatient basis.
After the operation, the person is prescribed a series of rehabilitation measures.
In ninety-five percent of cases, after surgery, a person is able to walk, work and some even play sports. An artificial joint "works" for fifteen to twenty years, then a new operation may be necessary.
Shock wave therapy is one of the effective methods of treating chronic diseases of the musculoskeletal system, which is based on the influence of acoustic waves. The procedure provides quick results and after a course of shock wave therapy it is possible to achieve a long-term therapeutic effect.