How is medical treatment of coxarthrosis of the hip performed?
How is medication treated with coxarthrosis of the hip joint? The musculoskeletal system of a person suffers from various ailments. Coxarthrosis of the hip joint is a kind of pathology that has developed for certain reasons.
To clarify what is coxarthrosis, it is important to understand what is meant by the word arthrosis. Under arthrosis is meant joint diseases, which can occur chronically. With this disease, the various joints of the human body are affected. The hip, ankle, elbow joints are subjected to stress throughout life. Therefore, wear can be at an early age.
Causes of hip joint disease
There are many reasons for the pathology of the hip joint. People of different ages are subject to this violation, but more often those who are over 40 years old have a greater risk. The disease affects both men and women, but in women the disease manifests itself in a more severe form. Sometimes changes can affect the knee joint.
Along with other diseases coxarthrosis in the early stages can successfully be treated without surgery. But not always patients with the first appearance of pains turn to the doctor for the definition of painful sensations and treatment. The disease progresses, which can subsequently lead even to disability.
The main causes of coxarthrosis of the hip are:
- disrupted blood circulation in the joints - violation of venous outflow and arterial inflow;
- mechanical damage leading to joint damage;
- disruption of the hormonal background, biochemical changes in the cartilage;
- trauma, fractures in the pelvis, dislocations;
- inflammatory-infectious processes;
- congenital dysplasia( pathology associated with joint development);
- sedentary lifestyle;
- age factor;
- predisposition and heredity.
Athletes lifting weights, as well as people who are overweight, are at risk. Because of obesity, metabolism and circulation are disturbed. Excess body weight exerts pressure on the musculoskeletal system, including joints.
Usually young people because of injuries are coxarthrosis of the hip joint.
It should be noted that coxarthrosis is not hereditary, but the structure of the skeleton, its weakness or cartilaginous tissue, the metabolism can be transmitted from parents to children. If one of the parents in the family was sick with such a disease, then such a person is also at risk.
Mechanism of development of coxarthrosis
When the hip joint is healthy, it functions as a hinge, while it is covered with cartilage. In normal condition, the joint rotates perfectly. This rotation is possible due to the lubrication - the fluid, which is filled with the joint cavity.
With the development of coxarthrosis in humans, the property of the fluid that is in the cartilage changes. It becomes viscous and thick. Because of this, the cartilage begins to dry out, and on its surface cracks and roughness are formed. As a result, the articular surfaces rub, the cartilage becomes thinner. As a result, the distance between the bones decreases, but the pressure increases and destruction occurs.
With such violations there is a violation of blood circulation in the joint, blood circulates less, so the metabolism slows down. At the same time, the muscles of the injured leg are atrophied. This process is rather slow. With a sluggish course of the disease, the joint can become inflamed, which leads to aggravation of pain in the joint.
With the progression of the hip joint pathology, the patient may develop a crunch sound when walking or otherwise moving. When the disease is at the most advanced stage, the aching leg is shortened. In this case, you can not avoid lameness. And this will lead to increased stress on the spine: especially the lumbar region will suffer. In addition to joint pain, lumbar pain is added.
Sometimes cartilage wears out because of age. Then the doctors can suggest different methods of treatment and means for maintaining the functions of the joint.
The main symptoms of the disease
The warning symptoms of the disease include:
- pain in the groin;
- pain manifested in the thigh;
- aching pain when walking;
- muscular atrophy;
- appearance of a crunch coming from the joint.
These symptoms may occur, but not always. Appear in later stages of the disease.
In the first stages of the disease, the pain may not be strong, so the patient is not in a hurry to receive. This worsens the situation, because the joint is gradually becoming unusable. Over time, the mobility of the leg will be limited. The patient will not be able to bend over himself or take his injured leg to the sides.
Painful manifestations of coxarthrosis can manifest as radiculitis. It happens that this disease is confused with arthrosis. Making an erroneous diagnosis will lead to incorrect treatment. To establish the diagnosis correctly, you need to undergo a test, appointed by a doctor. Then treatment of coxarthrosis will be effective.
Determination of the stage of the disease
The manifestation of coxarthrosis of the hip joint has several degrees. The first degree of the disease is manifested by periodic pain that occurs after walking or jogging. The pain comes from the hip joint, in rare cases is felt in the hip and knee joint. After rest, the pain disappears.
At this stage, the gait is smooth, the movements are not constrained and free. The strength of the muscles is normal. When X-ray examination, you can see minor violations in the bone.
The second stage of coxarthrosis of the hip joint is manifested with more intense pains. Pain more often radiates to the groin, thigh and can appear even in a calm state. With prolonged walking, walking causes difficulties, which leads to limping. Muscles of the hips lose elasticity and strength. The joint does not work normally. X-rays show significant growths occurring in the bones.
The third stage is characterized by persistent pain, disturbing even at night. The patient himself can not walk and resorts to the cane. Articular movements are limited. Muscles atrophy. The sick limb is shortened.
Treatment of coxarthrosis of the hip joint
Treatment of coxarthrosis of the hip joint has different methods. It is important to consider that it is impossible to treat such a disease. There are a number of contraindications. For example, it is forbidden to resort to cycling or running in case of damage to the hip joint. Rubbing the sore spot with ointment will not bring relief. The joint is placed under a layer of muscles.
Methods of treatment of coxarthrosis can be different depending on the degree of disease. This includes:
- drug therapy with the use of modern drugs;
- is a curative, gentle exercise;
- folk methods.
It is necessary to treat this disease in a complex way. One method is unlikely to be effective for getting rid of coxarthrosis of the hip joint. People's methods can be used at the initial stage of the disease or for prevention. At this time, the cartilage is not yet damaged. Treatment can be done with gels, compresses. However, you can do this after consulting a specialist.
Drug treatment is indicated with pronounced pain sensations and changes in the joint.
Drugs are selected based on the degree of destruction and pain. Usually, medicines that have an anti-inflammatory, non-steroidal effect are prescribed. In combination with them, drugs that improve blood circulation, hormones, muscle relaxants, chondroprotectors are prescribed.
Medications used to treat
If severe, severe symptoms of the hip joint, causing the patient suffering, it is necessary to immediately begin therapy with medications. Treatment with folk methods can be an auxiliary therapy.
Drugs that are commonly used to treat pain are:
- is orthophane.
All of them belong to the group of non-steroidal anti-inflammatory drugs. They help reduce edema in the joint and relieve pain.
Chondroprotectors are preparations:
- chondroitin sulfate;
The action of these medicines is directed to feeding cartilage, which contributes to the restoration of its structure. Sometimes in complex therapy, dietary supplements( biologically active substances) are used. Such drugs should be taken at least three months. You can buy them in a pharmacy without a prescription.
Also used to treat coxarthrosis of the hip joint are preparations that improve blood microcirculation. These can be:
These drugs are vasodilators that improve the flow of blood to the joint and lead to better nutrition of the joint and slowing down the destructive processes.
It is important to use muscle relaxants. These are the preparations called:
- of sirdaluda.
Thanks to them, a painful spasm is removed. Such a comprehensive selection of medications will improve health in the shortest possible time.
Hormonal drugs help to cope with inflammatory processes. But you can not buy drugs yourself and take them.
Self-medication can be harmed, which does not exclude disability or death. Competent treatment will be chosen by the attending physician.
Auxiliary therapies for
Doctors have resorted to physiotherapeutic methods for the treatment of coxarthrosis of the hip joint, along with drug therapy. The most commonly used cryotherapy, laser therapy and massage. Such procedures help improve blood circulation in the damaged joint and relieve painful muscle spasms.
Another method of alleviating a patient's condition is traction of the joint. The purpose of this procedure is to reduce the burden on the joint and cartilage. But the hood of the joint should be made exclusively by a specialist in this field, who is well acquainted with the anatomy of the body and knows how to treat coxarthrosis.
This method involves stretching the bone with a special traction device, and this allows you to increase the distance between the bones.
In cases of joint disease, a physician can recommend gymnastics treatment together with medication. In severe, neglected cases, surgical intervention is shown with the help of modern technologies. Using a comprehensive treatment and medications, you can achieve a significant improvement in the condition of patients.
Methods of treatment of coxarthrosis of the hip joint
Treatment of coxarthrosis of the hip joint is a serious not only medical but also a social problem, as this dystrophic and degenerative musculoskeletal disease often leads to the loss of working capacity of the middle and older population and, accordingly, to disability. Treatment for coxarthrosis of the hip joint depends on the stage of pathology. If at the initial stages the medicamentous and other conservative therapy is applied, in the late stages the positive effect can be observed only with the use of surgical methods.
The main goals in the treatment of coxarthrosis:
- relieve a person from pain;
- to adjust the normal supply of intraarticular cartilage and activate its recovery;
- to activate blood circulation in the area of the patient's articulation;
- reduce the burden on the affected joint and prevent further destruction of the cartilaginous tissue;
- strengthen the muscular framework of the hip joint to improve the supporting function;
- to increase the mobility of the diseased joint.
It's important to remember! To date, there are no medications and techniques that can cure osteoarthritis of the hip joint. The whole arsenal of conservative therapy allows only to stop the progression of pathological processes in the joint and relieve the patient of the pain for some time. If the function of the joint is lost, only the operation can return the possibility of active movements.
Drug treatment for coxarthrosis
In almost all cases, coxarthrosis therapy is initiated with medical treatment, as this is a generally available method and does not require special efforts from the patient. Assign drugs from several groups.
Non-steroidal anti-inflammatory drugs
The main medicines( active ingredient):
Doctors, and the patients themselves, are very fond of prescribing NSAIDs, since these medicines literally from the first pill or injections are able to relieve unbearable pain. But we must not forget that drugs from this group, although they relieve the patient of the main symptom of arthrosis - pain, do not affect the course of the pathology itself.
The use of non-steroidal anti-inflammatory drugs in coxarthrosis should be short-term to prevent the side effects of
. In addition, there are reports that long-term use of drugs from this group contributes to the destruction of proteoglycans. These are substances that are part of the cartilaginous tissue and retain water molecules, thus contributing to the high hydrophilicity of the cartilage and maintaining its normal structure and shape. If the content of proteoglycans decreases, the cartilage dries up and begins to crack. And this phenomenon aggravates its destruction with coxarthrosis.
The purpose of NSAIDs is justified during an exacerbation of the disease, when other methods of therapy are contraindicated because of the pain syndrome, for example, therapeutic gymnastics with coxarthrosis of the hip joint, massage, physiotherapy, joint traction, etc.
There are only two active substances of chondroprotective drugs: chondroitinand glucosamine. Medicines from this group can have one of these components or a combination thereof. Some manufacturers also add other active ingredients, for example, from the NSAID group, thereby enhancing their effectiveness.
The most popular representatives of chondroprotectors:
These drugs are released in a variety of dosage forms: tablets, capsules for oral administration, solution for intramuscular and intraarticular injections, ointments and gels for topical use. This feature allows for stepwise therapy, when the treatment begins with injections, and continues to use tablets and ointments.
Dona - a popular chondroprotective drug
The mechanism of action of these drugs is as follows. Active components, chondroitin and glucosamine, are the main structural components of the hyaline cartilage that covers the head of the femur. Thus, integrating into their composition, these components help inhibit the destruction of cartilage, and if the disease is in the first stage, the chondroprotectors can even restore the destroyed tissue.
It's important to know! Chondroprotectors do not have an analgesic effect, as NSAIDs, and the effect of their use will be noticeable only after 4-6 months of regular admission.
Today there is a lot of debate among researchers about the effectiveness of chondroprotectors, as there are no clinical large-scale studies in which their effectiveness has been proven. Given the need for long-term use of the drug( courses 4-6 months once a year), the lack of instantaneous effect and the high cost of such treatment, the acceptability of patients for therapy with chondroprotective agents is not very high.
Muscle relaxantsAlso you can read: Pain in the right hip joint
How to treat coxarthrosis of the hip joint without eliminating the pathological muscle spasm that accompanies almost all exacerbations of arthrosis and strengthens the pain sensations? No way. To this end, mainly used 2 drugs: midokalm and sirdalud.
These medicines well eliminate muscle spasm around the aching joint and reduce pain. But they need to be assigned adequately. The fact is that the tension of the muscular corset of the hip joint is a protective reaction of the body, therefore, by eliminating spasm and without taking any measures to unload the affected joint, for example, traction, one can only aggravate the situation. Therefore, muscle relaxants should be prescribed only in complex treatment.
Ointments, gels, creams for topical use
It should immediately be noted that with coxarthrosis, local remedies are practically ineffective. The fact is that the acting components simply can not physically reach the necessary point of application. Skin, muscles, fatty tissue and deep jointing do not allow the ointment to penetrate to the required depth.
Intra-articular injections of
Intra-articular injections into the hip should be performed under ultrasound guidance.
Intra-articular injections with coxarthrosis are rarely used, as the articular cleft in a healthy joint is small, and in the joint affected by arthrosis, it is practically absent. In addition, there are large blood vessels and nerves nearby, which can be damaged by a needle. Therefore, the injections are performed not in the cavity of the joint, but in the periarticular region( periarticular).
Enter, as a rule, corticosteroid hormones with severe pain syndrome. This is Diprospan, Kenalog, Hydrocortisone, Flosteron. Sometimes they resort to injections of chondroprotectors( Alflutop, Hondrolon, Traumeel T).
Hyaluronic acid drugs are injected directly into the joint under ultrasound control. They serve as substitutes for intra-articular fluid. Today the following drugs are popular:
Other conservative methods of treatment
In the initial stages of coxarthrosis, conservative non-drug therapy is the main method of treatment. It includes the following activities:
- Therapeutic gymnastics. This is the most important treatment for coxarthrosis. No patient can improve the condition and get rid of pain without regular physical therapy. But it is necessary to correctly choose the exercises and correctly execute them. Excellent, if the gym is picked up by a specialist and will teach all the nuances of doing exercises. There are different methods of curative gymnastics, for example, a therapeutic exercise for Bubnovsky is very effective.
- Massage and manual therapy. They can be used only outside of exacerbation of arthrosis, when the pain is absent. It is advisable to regularly take massage courses 2-3 times a year.
- Hardware traction( hip extension).This unloads the joint. The traction itself lasts 15 minutes, is carried out by a course of 10-12 procedures. In a year it is recommended to spend 2 courses.
- Physiotherapeutic methods of treatment. Unfortunately, all existing techniques have little effectiveness in coxarthrosis. This is due to the deep occurrence of the joint. But despite this, many doctors prescribe physiotherapy courses, which sometimes help reduce pain.
Kinesiotherapy and therapeutic gymnastics are the most effective methods of treatment of coxarthrosis
Surgical treatment of coxarthrosis
Surgical treatment of coxarthrosis is prescribed at the last stage of the disease, when a person has pain that is not removed in any way or the function of the joint is limited. Several surgical techniques may be used:
- arthroscopic debridement is the extraction from the hip joint of pieces of broken tissue that, when floating freely in the cavity, contribute to the further destruction of the cartilaginous coating;
- periarticular osteotomy is a time-consuming operation, during which the surgeon changes the angle of the hip bone, so that the joint is unloaded, and the degenerative processes are suspended;
- hip arthroplasty - replacing the broken joint with an artificial endoprosthesis.
In case of endoprosthetics, the damaged joint structures are replaced with an artificial prosthesis
Treatment of coxarthrosis at home usually starts with the use of various folk remedies. Consider the most effective.
Compress with cabbage leaf. It is necessary to take a large leaf of cabbage, grease it with honey and attach it to the affected joint. Top with polyethylene and a warm cloth. Keep the compress 2-3 hours. The course of treatment is 10-14 procedures.
For the next recipe, you need 250 grams of celery root, 2 lemons, 100 grams of garlic. All ingredients are twisted through a meat grinder, the mixture must be poured in 3 liters of boiling water. You need to insist 24 hours. After that, take 50 grams every morning on an empty stomach. The course of treatment is 1 month.
With coxarthrosis, a bath with topinambour infusion will help. To prepare a healing bath you will need a serving of water: topinambour infusion, pine, sea salt, 2 tablespoons of honey. Take 10-12 baths every other day.
When making conclusions, it is worth noting that, the earlier treatment is begun, the more likely it is to stop the pathological process and save the patient from pain. But, unfortunately, it often happens that only the replacement of the hip joint can restore the person the joy of movement and relieve the chronic pain.
Injections for coxarthrosis of the hip joint: mechanism of action
Locomotor system diseases occupy one of the leading places in the general structure of diseases of the elderly. With age, bone and cartilaginous tissue undergo changes that can affect human health. A special place in this group of pathologies is coxarthrosis of the hip joint. The second name is deforming osteoarthritis. You can treat coxarthrosis of the hip joint in various ways. A good effect can give injections with coxarthrosis of the hip joint. Arthrosis is characterized by the appearance of degenerative-dystrophic changes in the joint. At the same time, the cartilage itself and the periarticular formations are involved in the process. Coxarthrosis develops against the background of metabolic disturbances. This is an irreversible process.
This pathology continues for a long time. Coxarthrosis is the most common disease of the musculoskeletal system. Suffer from this ailment is more of a person over 40 years old. Coxarthrosis of the hip joint, developed at an able-bodied age, has great social significance. This is associated with a significant impairment of motor activity, which leads to a temporary or permanent loss of ability to work. All this causes great economic damage. Consider in more detail the main groups of drugs used as an injectable treatment of the disease.
Etiology of the disease
Of great interest are those reasons that can provoke coxarthrosis. They can be divided into 2 large groups: endogenous( internal) and exogenous( external).The first group includes:
- metabolic disorders( excess body weight);
- bone disease;
- endocrine pathology;
- congenital or acquired defects of the femurs or joints;
- age characteristics of the organism;
- hormonal imbalance.
The risk of developing pathology is increased if there is arthrosis in the parents or other relatives. Congenital defects include, in the first place, dysplasia. It is she who causes arthrosis. Dysplasia is caused by improper development of the head of the bone or cavity. Among endocrine factors, hypothyroidism and diabetes mellitus are most important. An etiological factor may be a previously suffered hip joint infarction. Of no little importance is arthritis.
Among the external predisposing factors, the most important are: hip joint injuries as a result of careless daily activities, stress, the effects of alcohol or other toxic substances, increased stress on the joint. As for stress, this condition contributes to the development of corticosteroids, which violate the synthesis of hyaluronic acid, which is part of the joint fluid.
Clinical manifestations of
Coxarthrosis of the hip joint has a rich symptomatology. It largely depends on the stage of the disease. There are 4 stages of this pathology. It is important that coxarthrosis of the hip joint for a very long time can go unnoticed for the patient. This is typical for the primary form of the disease. In the beginning, the pain syndrome may be absent. The patient is worried about muscle weakness, fatigue. This is observed both in walking and in standing position. For stage 1, the disease is characterized by moderate pain in the region of the hip joint. They occur with physical activity, fast or prolonged walking. It is important that the pain disappears with time if the person is at rest. X-ray reveals small structural changes in the hip joint.
In the second stage, the pain syndrome increases. Pain occurs even with minor motor acts. It can be observed at night. The sick person begins to limp, passing several hundred meters. The volume of movements decreases. If at the first stage it decreases by 10%, then at the second stage it decreases by 20%.Some patients require a cane to move better. The third stage is very difficult. Deforming osteoarthritis of the hip joint can be detected not only in the constant pain syndrome, but also in other symptoms.
Patients often develop hip dystrophy. An important sign of this stage is the change in the length of the affected leg. It can somewhat lengthen or shorten. In some cases, other joints of the affected leg may also suffer. With coxarthrosis of the hip joint of the third degree, pain can occur in the spine or sacrum. If the condition does not improve with any kind of drug treatment, then surgery is applied. During the operation, endoprosthetics are performed. There is also the fourth stage of arthrosis of the hip joint. With her develops ankylosis( destruction and complete immobility of the hip joint).In this situation, the operation is shown.
Injection in the treatment of arthrosis
Therapy of the disease is performed in various ways. It includes medications( NSAIDs, chondroprotectors, painkillers and glucocorticosteroids), massage, exercise therapy, proper nutrition, physical activity, physical therapy, local remedies( ointments, compresses, lotions).Spa treatment is also shown. With coxarthrosis of the hip joint, a good effect is given by injections with various active preparations. In some cases, this method of treatment can be the most effective. The advantages of the injection are that the drug quickly penetrates into the affected area.
If the effect of oral administration occurs after a few hours, then everything is much faster. Ointments, creams can not penetrate so deeply, so injections are the best option for topical treatment of arthrosis of the hip joint. Despite this, you need to be careful and follow certain rules. There should be a break between injections. In addition, more than 3 injections per joint are not recommended. The injections are mostly shown when the patient has concomitant pathology.
How do injections for arthrosis of the hip joint
? Whatever types of medicines are used to treat the disease, it is necessary to know that the doctor should do the injections. Do not self-medicate and inject the drug yourself. Injections to the joint are not often used. This is due to some difficulties with the administration of the drug. The thing is that the articular fissure of the hip joint is small. Coxarthrosis contributes to its even narrowing. The articular cavity itself is also small. All this complicates the administration of the medicine. In such a situation, even an experienced doctor may miss and touch blood vessels or nerves, which is fraught with complications.
With coxarthrosis of the hip joint, a safer method of pricking can be used. In this case, injections are not made to the joint itself, but to the periarticular region through the thigh. Most often, injections are used to relieve the pain syndrome. In this situation, you can enter corticosteroids. In the event that the patient's condition is satisfactory and there is no pain, they are not used. It is important that the injections are done no more often than after 2 weeks. Their total number should not exceed 5-7.More effective drugs that affect the very cause of arthrosis of the hip joint are chondroprotectors.
Injections of chondroprotectors
Despite all types of therapy of deforming osteoarthrosis of the hip joint, the best effect is provided by the introduction of chondroprotectors. They are used in the second and first stages of the disease. In all other cases, prosthetics is recommended. The composition of these drugs includes glucosamine or chondroitin. Similar substances are synthesized in the hip joint itself. Articular cartilage performs a number of important functions: it participates in depreciation, rationally distributes the load. All this is of great importance when walking. With coxarthrosis of the hip joint, the cartilage tissue is destroyed. Chondroprotectors help to restore it.
These drugs promote the synthesis of synovial fluid that lubricates the cartilage surface, significantly improve the elasticity of the cartilaginous tissue, suspend the processes of destruction of articular cartilage. Glucosamine possesses these properties. Chondroitin also increases the formation of collagen, normalizes the flow of blood to the joint. In addition, it has an anti-inflammatory effect. To date, the following chondroprotectors are used: Elbona, Dona. They are available in ampoules for injections. The active ingredient is glucosamine. Alternatively, injections of drugs based on chondroitin. These include "Mukosat", "Artradol" and some others. There are also complex preparations.
All medicines can not be used at the same time. First of all, to reduce the pain syndrome it is recommended to take drugs from the group of NSAIDs, other painkillers in the form of tablets or capsules for ingestion. If conservative methods do not give a positive result, then injections based on glucocorticosteroids are used. The most commonly used drug is Cortisone. It has a strong anti-inflammatory effect. Corticosteroids inhibit the process of destruction of cartilaginous tissue. The duration of the therapeutic effect is several days after the administration of the drug.
It should be remembered that such drugs have many side effects. These include increased pain, redness of the skin, impaired function of the gastrointestinal tract, muscle weakness, increased blood glucose levels and others. In addition to "Cortisone" can be used and other drugs, such as "Betamethasone", "Aristocort."The choice of medicine is carried out by the attending physician individually. When performing injections, you must adhere to certain rules: observe sterility, the frequency of injections, limit the load in the first hours after the injections.
Injections of other medications
With each type of drug help, the patient's condition can be improved. To this end, you can make injections based on hyaluronic acid. It is applied only when all of the above medicines do not have an effect. In most cases, injections are done once, the therapeutic effect can last a very long time. Hyaluronic acid normalizes the quality of synovial fluid, thereby improving the process of lubricating the surface of the articular cartilage. With coxarthrosis of the hip joint, injections of anesthetics can also be used.
The effect of their temporary. Currently they are not widely used in therapy. Thus, coxsatroz of the hip joint is treated with the help of injections. They are used when conservative therapy is ineffective. At the 3rd and 4th stages of the disease various types of operation are shown.
Coxarthrosis of the hip joint: treatment with folk remedies
There are three degrees of coxarthrosis.
In no case do not start treatment until the doctor determines the degree of the disease!
First degree. is characterized by pain in the hip joint. Pains, pulling, arise in response to physical exertion. There are small changes in the structure of cartilaginous tissues. Limitations in mobility - no more than 10%.
Second degree. Pains in the hip joint area increase, appear with any activity, begin to be given to the groin, knee and thigh. The muscles in the region of the hip joint strain, the tension becomes constant. There are night pains. When walking, there is lameness. The limitation of mobility reaches 20%.
Third degree. Pains become permanent. The functioning of the joint is completely broken. Because of the permanent tension of the muscles, their shortening occurs, leading to a shortening of the leg. About 10% of cases occur on the contrary - the leg is lengthened. Then they say about atypical coxarthrosis. Dystrophy of the muscles of the buttock and femoral regions is observed. Dystrophy of the femoral muscles can cause severe pain in the knee area at the attachment sites of the ligaments. The patient can no longer move without a cane or crutches.
- clinical examination, examination of the patient's symptoms and complaints;
- radiograph of the affected joint.
Treatment of coxarthrosis
Treatment of coxarthrosis of the hip joint is always complex and depends on the degree of the disease. The main tasks in the treatment are the removal of pain and inflammation, improvement of blood circulation and maximum recovery of joint mobility.
Medication. Non-steroidal anti-inflammatory drugs, analgesics, hormones. They relieve acute pain and inflammation, but do not eliminate the cause of the disease. Allow to begin therapy, which was not available because of the pain syndrome. It can not be used for a long time: analgesics cause side reactions, and the removal of pain promotes the appearance of a cure in the patient. Disease thus progresses and there is a risk of occurrence of coxarthrosis of the third degree.
Chondroprotectors. Especially effective for treating the first degree of the disease, when the joint is not yet very damaged. It is conducted by courses, usually several courses are required. Chondroprotective treatment takes a lot of time.
Muscle relaxants. Relieve muscle spasm. Apply with caution. Muscle tension is a protective reaction of the body. If you remove muscle spasm, but not reduce the strain on the joint, you can aggravate the situation and accelerate the development of the disease.
Vasodilator drugs. Promotes restoration of blood flow around the joint, removal of spasm of blood vessels, eliminates night pains, accelerates the regeneration of joint tissues.
Physiotherapy - electrophoresis, cryotherapy, laser therapy.
Hardware extension of the joint. Course treatment is performed by special equipment. Reduces the load on the surface of the joint.
Postisometric relaxation. The patient relaxes muscle groups, the doctor at this point performs their stretching. Course treatment.
Physiotherapy is an important addition to medical treatment!
Intraarticular injections. Injections of the drug are carried out directly into the articular cavity, through the groin. This method is rarely used. There is a risk of miss, touch blood vessels or nerve trunks. More often the medicine is injected into the periarticular region, and not through the groin, but into the thigh.
Therapeutic physical training. plays an important role in the treatment of any stage of coxarthrosis. The complex of exercises is selected individually. Exercises are performed three to five times a day, before meals, the duration gradually increases from 3-5 to 10 minutes. Surgical treatment of coxarthrosis. It is shown at the second-third degree of the disease. When the joint tissues are irreversibly destroyed, endoprosthetics is the only way to improve the patient's quality of life.
Folk remedies for coxarthrosis of the hip joint
Treatment of coxarthrosis with the help of folk remedies can be a good addition to drug therapy. In folk medicine coxarthrosis treat with cabbage leaf, lemon, garlic, honey.
Lemon-honey infusion. Three liters of boiling water are ground three lemons together with zest. In the cooled infusion add three tablespoons of honey. Eat half a cup three times a day for a month.
Home chondroprotector. Kilogram of beef front knees for 3-4 hours cook as a cold in 2 liters of water. Take daily 200 g before meals.
Honey lapping. Take one part of glycerin, honey, iodine and alcohol. To stir thoroughly. Insist 2-3 hours. Soak the fleece in the infusion and rub the joint with the movements from the bottom up. Lapping helps improve blood circulation.
Manual therapists use two types of joint effects for the treatment of coxarthrosis: mobilization and manipulation.
Manipulation of - one short sharp movement of the doctor. If carried out in a timely and qualitative way, the patient has a noticeable improvement in the condition. The pain is reduced, mobility is restored.
Mobilization - neat extension of the joint, helps reduce the load on the cartilage. This systematic treatment requires up to four courses per year, for three to four treatment sessions. That is, in a year the patient should undergo 12-15 sessions of exposure. Contraindications: arthritis, fresh injuries, oncological lesions of joints, fragility of bones.
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Treatment of coxarthrosis is impossible without the use of medicines, since tablets not only relieve symptoms, but also affect the causes of the disease. Modern medicine offers a lot of chemicals that help to relieve pain and inflammation and facilitate the patient's condition with coxarthrosis in the acute stage of .
For the expansion of blood vessels doctors prescribe vasodilators( "Nikoshpan", "Xanthonol nicotinate", "Pentoxifylin"), which relieve spasms from the blood vessels and provide a complete delivery of blood and nutrition of the cartilaginous tissue. Together with NSAIDs, vasodilators relieve severe pain.
Muscle relaxants are needed to relax muscle tissue with coxarthrosis. Kupirovanie muscle spasm gives the patient a breathing space. But this group of drugs has some influence on HC( state of intoxication, nausea, dizziness).
Chondroprotectors in coxarthrosis are popular and "convincing" drugs, they help to restore damaged cartilage and optimize metabolic processes in the body, "push" the disability of the patient. Effective drugs in the initial stages of coxarthrosis, at late - contribute to the delay of surgical intervention( endoprosthetics).
In no case should you choose medication yourself. All of them differ not only in value, but also in their effect and contraindications. Drug treatment should be prescribed only by qualified doctors after the patient is examined.
The most common drugs prescribed by doctors for coxarthrosis are:
- NSAIDs( non-steroidal anti-inflammatory drugs), "Pirovsikam", "Diclofenac", "Indomethocin", "Ketoprofen".They have a non-hormonal basis, effectively reduce pain.
- "Glucosamine" and "Chondroitin sulfate"( chondroprotectors) -restore the cartilaginous tissue and are the most useful group of drugs in coxarthrosis.
- "Midokalm", "Sirdalud"( muscle relaxants) - eliminate muscle spasm and improve blood circulation in the pathology zone, thereby reducing pain.
- Non-steroidal anti-inflammatory drugs "Nice", "Analgin" - analgesics.
- Healing creams and ointments. Despite widespread advertising and the widespread belief that local remedies can cure coxarthrosis, this has not been confirmed by practice. But this does not mean that ointments and creams are useless, they significantly alleviate the patient's condition( "Gevkamen", "Menovazin", "Finalgon", "Espol", "Nikofleks"), have a warming and analgesic effect.
- Intra-articular injections - their doctors use coxarthrosis relatively rarely because of a small joint joint and a small joint cavity in the hip joint. With coxarthrosis, when the joint gap is further reduced, there is a risk of damaging the vascular and nerve trunks. That is why the injection is often carried out not through the groin, but into the periarticular region( through the thigh).
The most common areas are:
- Manual therapy( mobilization or gentle stretching and manipulation or a significant sharp and short movement).Manual therapy is not a panacea for coxarthrosis, it only helps in combination with other methods of treatment.
- Hardware traction( traction).Used in the pathology of the hip joint to reduce the load on the cartilage and for the articulation of the joint ends.
- PIR( post-isometric relaxation).It is an extension of the ligaments and muscles of the hip joint.
- Therapeutic massage. Effective in the first two stages of the disease, improves blood circulation, speeds up cartilage nutrition, increases the elasticity of the joint capsule, restores the function of the synovial membrane.
- Hirudotherapy( leeches).Assign in the initial stage of the disease. The action of the enzymes that secrete a leech is similar to that of chondroprotectors. Relieves inflammation and pain.
Swimming has a beneficial effect on the mobility of joints.
Most physiotherapy methods are little suitable for the treatment of coxarthrosis and have less effect than, for example, gymnastics with coxarthrosis or massage. The patient with the hip joint is "hidden" and "get it" with his physiotherapy procedures becomes difficult.
But in the initial stages, physiotherapy can help remove primary symptoms. In general, laser, shock wave, magnetic therapy and electrophoresis are used. For 10-12 sessions of such therapy, you can remove swelling or reduce pain.
Therapy with unconventional means
Traditional medicine has in its arsenal a wide range of methods and approaches to the treatment of the disease. Apply lotions, compresses, tinctures, decoctions. These drugs can be divided according to the principle of application:
- taken inwards( restoring cartilage tissue and those that can remove inflammation);
- applied externally( warming, anti-inflammatory, distracting);
- is an independent physical exercise that includes stretch marks, dynamic and static exercises.
On the recommendation of one of the best doctors in the field of joint treatment( Dr. Bubnovsky SM), you can cure the disease if you combine gymnastics and a cold font. All exercises are good to perform in the evening after work, in order to properly stretch tired muscles of the day and ensure the flow of blood to the joint, respectively, improve the nutrition of the hip joint with coxarthrosis.
In advanced cases, arthroplasty is recommended( replacing a worn joint with an artificial analog).Most often, surgery is recommended for coxarthrosis of grade 3, when the patient receives a disability and can not move independently. But this operation is not easy, inaccessible and its cost is rather big, therefore, endoprosthetics is not prescribed to everyone and taking into account age, since repeated surgery is undesirable.
Even with a successful operation, the patient has a disability and must comply with strict rules of life with an artificial hip joint. A doctor who treats coxarthrosis will give recommendations for improving the quality of life.
Coxarthrosis - a serious ailment, which in neglected cases is incurable. But even in such a situation, there are many methods and means that can facilitate the patient's existence and allow living with a hip joint pathology quite interesting and rich life. The main thing is to notice symptoms in time and get help from a doctor.