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 circulatory processes in the area of the patient's articulation;
- reduce the load 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 of coxarthrosis
In almost all cases coxarthrosis therapy is started with medical treatment, as it is a public method and does not require special efforts from the patient. Assign drugs from several groups.
Non-steroidal anti-inflammatory drugs
The main medicines( active substance):
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 for 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 administration 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 produced 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 is 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 controversy among researchers about the effectiveness of chondroprotectors, as there are not yet 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 application of
It should be noted immediately 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 to the hip should be performed under ultrasound guidance.
Intra-articular injections with coxarthrosis are rarely used, since the articular cleft in the 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 a pronounced 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 treatments for
In the early stages of coxarthrosis, conservative non-drug therapy is the main 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 joint traction).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 fragments of broken tissue that, when floating freely in the cavity, contribute to the further destruction of the cartilaginous coating;
- periarticular osteotomy is a labor-intensive 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 - replacement of a broken joint with an artificial endoprosthesis.
In case of endoprosthetics, the damaged joint structures are replaced with an artificial prosthesis.
. Non-traditional methods of therapy.
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, the bath with the 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.
Symptoms of coxarthrosis of the hip joint of the 2nd degree and its treatment
There is practically no cartilaginous tissue in the diseased joint and the bones are injured
Coxarthrosis is a disease that affects the joint and cartilage tissues in the human body. The disease has several degrees of development. It is advisable to begin rehabilitation at an early stage. Treatment of coxarthrosis of the third degree can be delayed for a long time and sometimes requires surgical intervention.
Symptoms of coxarthrosis may not appear for a long time. But sooner or later they will make themselves felt. The first sign of the disease is severe pain in the joints, swelling and swelling of the skin. The more coxarthrosis develops, the stronger its symptoms become. When the first signs of the disease appear, you should consult a doctor without delay.
Basic medicines for the treatment of arthrosis
How to treat coxarthrosis? If the disease is just beginning to develop, the methods of traditional medicine can help the patient. But most often patients seek medical help when the disease reaches 2 or 3 stages of development. In this case, prescribe drugs. Coxarthrosis of the hip joint of the 2nd degree is treated primarily with the help of non-steroidal anti-inflammatory drugs. Such medications ensure the speedy restoration of the damaged joint.
Drugs can be given in the form of injections or applied orally. First of all, such medicines are aimed at eliminating inflammation, which provokes a destructive process in the joint bag. The use of nonsteroidal drugs should be limited in time, as they can disrupt the natural function of cartilage regeneration. Such drugs do not have a negative effect on the entire body. They should not be used only in patients with an individual intolerance to certain components of the drug. A doctor can prescribe to a patient only one medication for one appointment.
X-ray image of healthy and aching joints
Treatment of coxarthrosis involves the use of vasodilator drugs. These drugs are aimed at restoring blood circulation in the affected area. They can also be injected into the joint itself. Vasodilator drugs relax the walls of blood vessels and contribute to the normalization of outflow and blood flow. They have practically no contraindications.
You can take such medications only in quantities that have been prescribed by your doctor. Vasodilator drugs relieve many symptoms of arthrosis. The effectiveness of the drug depends entirely on the tolerability of the components that make up its composition. The patient is not immediately prescribed a full course of such medications. First, a person takes the drug for several days in order to understand whether there will be some effect from it or not. In case of a positive result, the doctor writes a full course.
Treatment of coxarthrosis of stage 3 is impossible without the use of chondroprotectors. These drugs prevent the destruction of cartilage, restore its natural ability to regenerate, moisten dry tissues and remove muscle spasm. The result from the use of such medications is not immediately apparent, but today it is the most effective tool in the fight against arthrosis.
Coxarthrosis of the third degree provides for the use of such drugs as muscle relaxants. Treatment should be done very carefully and under strict medical supervision. These medications are aimed at relaxing the muscles. If the drug is injected, then the treatment should be limited to three injections.
Ignore these medications because they have a positive effect on the patient's body. If you do not start applying them on time, the disability of the patient may become a consequence. Muscle relaxants help to get rid of muscle spasm, which often becomes a cause of jamming of nerves near the inflamed joints. In this case, an overdose of the drug may lead to dizziness and partial numbness of the limbs.
Hormonal steroid medications are usually injected into the patient's body through injections. These drugs have a good effect on the body, affect not only the affected area, but also any other inflammation in the body. The result from the use of hormonal steroid medicines is not always long. Such medications are not suitable for everyone, because they have a long list of contraindications and various side effects. Between each injection should take at least 15 days. Frequent use of such drugs may have the opposite effect.
In the treatment of the knee joint, it is necessary not only to internalize the affected area, but also the external one. Therefore, the use of ointments and gels is an integral part of effective treatment. Also useful are lotions and compresses.
Exposure to the joint outside should occur daily. You can do special compresses and warming, which will help reduce swelling, eliminate inflammation and remove reddening of the skin. The use of ointments makes it possible to relieve the pain syndrome and improve blood circulation in the affected area.
Physiotherapeutic methods for the treatment of arthrosis
If treatment of coxarthrosis has not been started on time, it can lead to disability. In order to avoid such consequences, it is necessary to supplement the usual medical treatment regimen and make additional impact on the body. Physiotherapy can have a positive effect in the treatment of arthrosis.This is a whole range of procedures that doctors offer patients. This includes ultrasound treatment, laser application, magnetotherapy, UHF treatment. In some cases, the impact of these methods of rehabilitation on the body can be questioned. Let's say that physiotherapy can not repair a damaged joint or begin to stimulate cartilage to regenerate itself. However, similar methods of treatment contribute to the removal of pain syndrome and other symptoms of coxarthrosis of the hip joint of the 2nd degree. Physiotherapy helps improve blood circulation in the affected parts of the body. The duration and strength of the effect depends only on the patient's body.
For any degree of progression of coxarthrosis, the patient is given a massage course. This is an important element of therapy, and you should take it seriously. Correct medical massage helps to relax muscles and eliminate spasms in the injured part of the body. Massage restores the right inflow and outflow of blood, allows the joints and ligaments to be resilient.
Such an impact can not eliminate disability and help a seriously ill patient. But this is an excellent preventive method of combating arthrosis. You can combine different types of massage and work on muscles in various ways. The main thing is that such treatment would bring a visible result.
Additional methods of treatment and prevention
Prevention of arthrosis takes an important place in the rehabilitation course. It is important not only to cure the patient, but also to prevent the further appearance of the disease. Often as a preventive method, joint extension is used. Such a procedure will suit both patients who have coxarthrosis at the stage of development, and those who have a disability. Extension of the joints is carried out by traction apparatus or manually.
If the patient has joints and cartilage in addition to joint and cartilage damage, this treatment will bring a visible result. After the course of the procedures, the patient will be significantly bred, and the load that they receive is reduced. And the manual method of traction, and the hardware have their advantages. The effect of both methods of impact on the joint is almost the same. If you decide to choose a manual method of therapy, then choose a good doctor who will be able to carry out such a time-consuming procedure.
Diet in coxarthrosis does not always affect the patient's condition. In some cases, doctors advise nevertheless to refrain from consuming heavily salted, fatty and spicy food. Diet for arthrosis is most often prescribed for patients who suffer from excessive weight. Excess kilograms exert additional strain on damaged joints, and treatment may not be very effective in this case. The smaller the patient's weight, the easier it will be to overcome coxarthrosis.
If coxarthrosis occurs in a patient in chronic form, then it can be treated with physical exercises. It should be noted that the use of this method of treatment is prohibited when the disease is in acute form. The course of gymnastics must be performed regularly and under the supervision of a trainer, who will be able to evaluate the correctness of the performance of the elements.
Physiotherapy with coxarthrosis, as with any type of joint damage, gives an effective effect and helps the patient to get in shape faster. Such exercises will significantly strengthen the muscles, increase the elasticity of the binding tissue and improve blood circulation.
Drugs for coxarthrosis at different stages of the disease
With age, our entire body is undergoing changes. Fabrics change their structure, lose elasticity and can no longer perform their functions. Changing the cartilage tissue leads to disruption of the functions of the musculoskeletal system, after which a person can develop various diseases. Most often these are different varieties of arthrosis, osteochondrosis, spondylosis.
After 40 years, the cartilage gradually begins to lose water, which leads to a decrease in its strength. On the surface, microscopic cracks are found, which contributes to the appearance of scars on the joint surface. The formation of scars leads to the fact that when moving the joint surface rub against each other and pain occurs.
Osteoarthritis often affects large joints of the body, for example the hip, knee. Less often the disease concerns the ankle, the joints of the fingers.
Hysterectomy with arthrosis in medicine is called coxarthrosis. This disease contributes to the dystrophic changes in the hip joint, after which degeneration of the hyaline cartilage is observed, which leads to the defeat of the bony articular surfaces, the formation of various deformities and movement disorders. Coxarthrosis can affect both one and both hip joints.
Coxarthrosis is the leader among diseases of the musculoskeletal system.
Types and stages of the development of the disease
Because of the development of the disease, these types of coxarthrosis are distinguished:
- post traumatic( developed after a fracture or any other trauma to the head, neck of the femur);
- is involuted( due to age-related changes);
- congenital joint anomaly;
- idiopathic( the cause of which is unknown);
- after a history of rheumatoid arthritis.
Three stages are distinguished during the development of coxarthrosis.
The initial stage is characterized by periodic pain in the hip joint, which begins after any physical exertion. The pain disappears after a short rest. It can appear with prolonged walking and accompanied by lameness. At this stage the mobility of the joint does not change, but on the x-ray you can already see bone damage. If you start treatment immediately, you can avoid surgery, completely restore joint mobility and get rid of the pain.
In the second stage of the disease, the pain becomes more intense and pronounced. Pain gives into the groin area, reaches the hip and knee. When you walk in the joint, you hear a crunch. The mobility of the joint is reduced by 20 degrees. The aching leg is noticeably shortened, and the lameness becomes stronger. A man must walk with a cane, to reduce the load. But at the same time, the load on the lumbar spine increases and is accompanied by pain in the lower back. At the same stage, some muscles atrophy and dry up, so the sick leg looks thinner, compared to the healthy one. This increases pain in the knee joint. At this stage, the pain does not go away even after rest and can bother at night, which worsens the patient's sleep. On the x-ray, bone growths are seen.
The third stage of coxarthrosis is characterized by persistent and painful pains. It is impossible to move the joint. A person can only move with crutches and a short distance. The muscles of the thighs and buttocks atrophy, shortening becomes more noticeable. In this case, 10% of people may have atypical coxarthrosis, when the sick leg, on the contrary, becomes longer than healthy. Moreover, at this stage other joints are also affected, losing their mobility. Violated the usual mobility in the spine, there are frequent pain in the lumbar and sacral region.
Symptoms of coxarthrosis
The first symptom is low-noticeable pain in the thigh and groin area. Gradually, the pain becomes more intense. Lying on his stomach, a person can not bring his foot to the body or take her to the side. When walking, a pronounced crunch appears.
If you have such symptoms, you should immediately consult an orthopedist or rheumatologist.
Diagnosis of coxarthrosis is carried out by collecting data from the patient and radiology. On X-ray, depending on the stage of the disease, changes in the joint are visible. Usually the diagnosis is not difficult.
Treatment of hip osteoarthrosis
Treatment is symptomatic and depends on the stage of the disease. First of all, the treatment of coxarthrosis is aimed at improving the functioning of the musculoskeletal system and reducing pain.
Treatment can be based on the use of various drugs. The most commonly prescribed anti-inflammatory drugs that help relieve or reduce pain, muscle relaxants, vasodilator drugs that reduce muscle spasms, chondroprotectors to repair damaged cartilage tissue. Also of great importance are physiotherapy methods of treatment, joint extension, reduction of loads on the diseased joint.
In the first and second stages, treatment is aimed at reducing pain and preventing the development of other diseases of the musculoskeletal system. At this stage it is recommended to avoid all kinds of loads on the affected joint. When traveling, it is better to use a cane.
To reduce pain, use physician-prescribed analgesics and anti-inflammatory drugs. Best fit ketorol and diclofenac. It is also possible to use other medications. It is also recommended that the doctor's prescriptions are strictly followed, since the treatment is at home.
At this stage, vasodilators, hormonal drugs are used, the effect of which persists for a long time. If some pills do not help to relieve pain, painful injections are injected into the joint and slow the progression of the disease. With anesthesia, you can use a combination of NSAIDs with an analgesic. To relieve pain, it is recommended to perform a thigh massage, make compresses, rub warming ointments.
Should be enrolled in physiotherapy. Recommended methods of therapeutic therapy, such as electrotherapy and UHF therapy. All this helps to normalize blood circulation and strengthen muscles. You can perform various exercises, but remember that for each patient they are strictly individual.
Now many modern methods of treatment of coxarthrosis. One of them is treatment with the help of a plaster "Nanoplast forte." Since long-term use of different drugs can harm your health, less aggressive drugs should be used."Nanoplast forte" - this is a new painkillers, which has no side effects. The patch is advised to be applied in the morning for 12 hours to the place where the pain is localized. It will help get rid of the pain syndrome, normalize blood circulation in the affected area.
There are also non-traditional methods of treatment of coxarthrosis. As a medicine, you can use lemon, honey, various oils that are used to make compresses.
Treatment of coxarthrosis of the third degree is possible only with the help of surgical intervention. Anesthetizing injections are possible to reduce the patient's suffering. But further endoprosthetics of the hip is recommended.
Coxarthrosis is curable, if not run it to a late stage. As soon as you have the first suspicions, immediately consult a doctor. If you start treatment at an early stage and follow all the recommendations, you can forget about the pain in the hip joint and completely restore its function.
CoxarthrosisCoxarthrosis ( deforming arthrosis, osteoarthrosis of the hip joint) is a degenerative-dystrophic disease affecting mainly middle-aged and elderly people. Coxarthrosis develops gradually over several years. It is accompanied by pain and restriction of movements in the joint. In later stages, atrophy of the hip muscles and shortening of the limb are observed. Coxarthrosis can be provoked by various factors, including trauma, congenital pathology, pathological curvature of the spinal column( kyphosis, scoliosis), inflammatory and non-inflammatory joint diseases. Hereditary predisposition is noted. Sometimes coxarthrosis occurs for no apparent reason. It happens both one-way and two-way. The course is progressive. In the early stages of coxarthrosis, the treatment is conservative. With the destruction of the joint, especially - in patients of young and middle age, surgery( endoprosthetics) is indicated.
Coxarthrosis( osteoarthritis or deforming arthrosis of the hip joint) is a degenerative-dystrophic disease. Usually develops at the age of 40 years and older. It can be the result of various injuries and joint diseases. Sometimes there is no apparent reason. Perhaps both one-sided and two-sided defeat. For coxarthrosis is characterized by a gradual progressive course. In the early stages of coxarthrosis, conservative methods of treatment are used. In the later stages, the function of the joint can be restored only in an operative way.
In orthopedics and traumatology, coxarthrosis is one of the most common arthrosis. High frequency of its development is caused by a significant load on the hip joint and a wide spread of congenital pathology - joint dysplasia. Women suffer from coxarthrosis a little more often than men.
Anatomy of the hip joint
The hip joint is formed by two bones: the ileum and the femur. The head of the thigh is articulated with the acetabulum of the ilium, forming a kind of "hinge".At movements the acetabulum remains immovable, and the head of the femur moves in different directions, ensuring flexion, extension, withdrawal, reduction and rotational movements of the thigh.
During movements, the articular surfaces of the bones slide smoothly relative to each other, thanks to the smooth, resilient and durable hyaline cartilage covering the cavity of the acetabulum and the femoral head. In addition, hyaline cartilage performs a damping function and participates in the redistribution of the load during movements and walking.
In the joint cavity there is a small amount of joint fluid, which plays the role of lubrication and provides nutrition to the hyaline cartilage. The joint is surrounded by a dense and firm capsule. Above the capsule are large femoral and gluteal muscles, which provide movement in the joint and, along with the hyaline cartilage, are also shock absorbers, protecting the joint from injuries in case of unsuccessful movements.
Mechanism of development of coxarthrosis
With coxarthrosis, the joint fluid becomes thicker and more viscous. The surface of hyaline cartilage dries up, loses its smoothness, becomes covered with cracks. Because of the roughness that has arisen, the cartilages are constantly injured each other, which causes their thinning and aggravates the pathological changes in the joint.
As the coxarthrosis progresses, the bones begin to deform, "adapting" to the increased pressure. Metabolism in the joint area worsens. In the late stages of coxarthrosis, a marked atrophy of the muscles of the diseased limb is observed.
Causes of development of coxarthrosis
Primary coxarthrosis( arisen for unknown reasons) and secondary coxarthrosis( developed due to other diseases) are isolated.
Secondary coxarthrosis may result from the following diseases:
- Hip dysplasia.
- Congenital dislocation of the hip.
- Diseases of Perthes.
- Aseptic necrosis of the femoral head.
- Infectious lesions and inflammatory processes( eg, arthritis of the hip joint).
- Post-traumatic injuries( traumatic dislocations, hip fractures, pelvic fractures).
Coxarthrosis can be either unilateral or bilateral. With primary coxarthrosis, concomitant lesion of the spine( osteochondrosis) and knee joint( gonarthrosis) is often observed.
Among the factors that increase the likelihood of development of coxarthrosis include:
- Constant increased load on the joint. Most often observed in athletes and people with excessive body weight.
- Blood circulation disorders, hormonal changes, metabolic disorders.
- Pathology of the spine( kyphosis, scoliosis) or stop( flat feet).
- Elderly and old age.
- A sedentary lifestyle.
Coxarthrosis itself is not inherited by itself. However, certain features( metabolic disorders, structural features of the skeleton and weakness of the cartilaginous tissue) can be inherited by the child from the parents. Therefore, in the presence of blood relatives suffering from coxarthrosis, the probability of the onset of the disease increases somewhat.
Symptoms and degrees of coxarthrosis
Among the main symptoms of coxarthrosis are pain in the joint, groin, hip and knee joints. Also, with coxarthrosis, stiffness of movements and stiffness of the joint, abnormalities of gait, lameness, atrophy of the hip muscles and shortening of the limb on the side of the lesion are observed. A characteristic feature of coxarthrosis is the limitation of the lead( for example, the patient has difficulty in trying to sit "on" the chair).
The presence of certain signs and their severity depends on the stage of coxarthrosis. The first and most constant symptom of coxarthrosis is pain.
When coxarthrosis 1 degree , patients complain of periodic pain that occurs after physical exertion( running or long walking).The pain is localized in the joint area, less often in the thigh or knee area. After rest it usually disappears. Gait with coxarthrosis 1 degree is not broken, the movements are kept in full, there is no muscle atrophy.
On the radiograph of a patient suffering from coxarthrosis of the 1st degree, undeveloped changes are defined: a moderate uneven narrowing of the joint space, as well as bony overgrowth around the external or internal edge of the acetabulum, with no changes in the head and neck of the femur.
With coxarthrosis of 2nd degree , the pain becomes more intense, often appearing at rest, radiating to the thigh and groin area. After considerable physical exertion, the patient with coxarthrosis begins to limp. The volume of movements in the joint decreases: the retraction and internal rotation of the thigh are limited.
In x-ray images with co-xarthrosis of the 2nd degree, a significant uneven narrowing of the joint gap( more than half of the normal height) is determined. The head of the femur is somewhat shifted upward, deformed and increases in size, and its contours become uneven. Bony growths at this degree of coxarthrosis appear not only on the inner but also on the outer edge of the acetabulum and extend beyond the cartilaginous lip.
With coxarthrosis, the 3rd degree pains become permanent, patients worry not only during the day, but also at night. Walking is difficult, with the movement of patients with coxarthrosis is forced to use a cane. The volume of movements in the joint is severely limited, the muscles of the buttocks, thighs and lower legs are atrophied. The weakness of the hamstrings removes the pelvis in the frontal plane and shortens the limb on the affected side. In order to compensate for the shortening, a patient suffering from coxarthrosis, while walking, tilts the trunk to the sore side. Because of this, the center of gravity shifts, the load on the diseased joint sharply increases.
On X-rays with coxarthrosis of the third degree, a sharp narrowing of the joint gap, pronounced expansion of the femoral head and multiple bony proliferation are revealed.
Diagnosis of coxarthrosis
Coxarthrosis is diagnosed on the basis of clinical signs and additional research data, the main one of which is radiography. In many cases, X-rays provide an opportunity to establish not only the degree of coxarthrosis, but also the cause of its occurrence. For example, an increase in the neck-diaphyseal angle, slanting and flattening of the acetabulum indicate dysplasia, and changes in the shape of the proximal femur suggest that coxarthrosis is a consequence of Perthes disease or juvenile epiphysiolysis. On the X-ray patterns of patients with coxarthrosis, there may also be changes that indicate trauma.
As other methods of instrumental diagnosis of coxarthrosis, CT and MRI can be used. Computed tomography allows us to examine in detail the pathological changes from the side of the bone structures, and magnetic resonance imaging provides an opportunity to assess violations from soft tissues.
Differential diagnosis of coxarthrosis
First of all, coxarthrosis should be differentiated from gonarthrosis( osteoarthrosis of the knee joint) and osteochondrosis of the spine.
Muscle atrophy, occurring in stages 2 and 3 of coxarthrosis, can cause pain in the knee joint, which is often more pronounced than pain in the affected area. Therefore, when the patient complains of pain in the knee, a clinical examination( examination, palpation, determination of the volume of movements) of the hip joint should be performed, and if the coxarthrosis is suspected, refer the patient to a radiograph.
Pain with rootlet syndrome( nerve root compression) in osteochondrosis and some other diseases of the spine can mimic pain syndrome with coxarthrosis. Unlike coxarthrosis, when the roots are squeezed, the pain arises suddenly, after unsuccessful movement, sudden turn, weight lifting, etc., localizes in the buttock area and spreads over the hindface of the thigh. A positive symptom of tension is revealed - a pronounced soreness when the patient tries to lift a straightened limb, lying on his back. In this case, the patient freely withdraws his foot to the side, whereas in patients with coxarthrosis the withdrawal is limited. It should be taken into account that osteochondrosis and coxarthrosis can be observed simultaneously, therefore in all cases careful examination of the patient is necessary.
In addition, coxarthrosis is differentiated with trochanteritis( vertebral bursitis) - aseptic inflammation in the area of gluteus muscle attachment. Unlike coxarthrosis, the disease develops rapidly, within 1-2 weeks, usually after trauma or considerable physical exertion. The intensity of pain is higher than with coxarthrosis. Restrictions of movements and limb shortening are not observed.
In some cases, with an atypical course of Bechterew's disease or reactive arthritis, symptoms resembling coxarthrosis may occur. Unlike coxarthrosis, in these diseases peak pain occurs at night. Pain syndrome is very intense, it can decrease when walking. Typical morning stiffness, which occurs immediately after awakening and gradually disappears within a few hours.
Treatment of coxarthrosis
Orthopedics treat coxarthrosis. The choice of treatment methods depends on the symptoms and stage of the disease. Conservative therapy is performed at stages 1 and 2 of coxarthrosis.
During the exacerbation of coxarthrosis, non-steroidal anti-inflammatory drugs( piroxicam, indomethacin, diclofenac, brufen, etc.) are used. It should be taken into account that the drugs of this group are not recommended for a long time, since they can have a negative effect on the internal organs and inhibit the ability of the hyaline cartilage to recover.
For the restoration of damaged cartilage with coxarthrosis, agents from the group of chondroprotectors( arteparone, chondroitin sulfate, structum, rumalone, etc.) are used. To improve blood circulation and eliminate spasm of small vessels, vasodilator drugs are prescribed( cinnarizine, nikoshpan, trental, theonikol).According to the indications, muscle relaxants are used( medicines for muscle relaxation).
In case of persistent pain syndrome, patients suffering from coxarthrosis may be given intraarticular injections using hormonal drugs( hydrocortisone, Kenalog, Metipred).Treatment with steroids should be done with caution.
In addition, with coxarthrosis, local remedies are used - warming ointments that do not exert a pronounced therapeutic effect, but in some cases they relieve muscle spasm and reduce pain due to their "distracting" effect.
Also with coxarthrosis, physiotherapeutic procedures are prescribed( light therapy, ultrasound therapy, laser therapy, UHF, inductothermy, magnetotherapy, etc.), massage, manual therapy and therapeutic gymnastics.
Diet with coxarthrosis has no independent therapeutic effect and is used only as a means to reduce weight. Reducing the body weight can reduce the burden on the hip joints and, as a consequence, facilitate the course of coxarthrosis.
In order to reduce the strain on the joint, the doctor, depending on the degree of coxarthrosis, can recommend the patient to walk with a cane or with crutches.
In the advanced stages( with coxarthrosis 3 degrees), the only effective treatment is surgery - replacing the broken joint with an endoprosthesis. Depending on the nature of the lesion, either a single-pole( replacing only the head of the thigh) or a bipolar( replacing both the femur head and acetabulum) prosthesis can be used.
The operation of endoprosthetics in coxarthrosis is carried out in a planned manner, after a complete examination, under general anesthesia. In the postoperative period, antibiotic therapy is performed. Sutures are removed for 10-12 days, after which the patient is discharged for outpatient treatment. After endoprosthetics, rehabilitation measures are necessarily carried out.
In 95% of cases, joint replacement surgery with coxarthrosis ensures complete restoration of limb function. Patients can work, actively move and even play sports. The average life of the prosthesis, subject to all recommendations, is 15-20 years. After this, a repeated operation is necessary to replace the worn endoprosthesis.
Treatment of coxarthrosis - arthrosis of the hip joint
To date, there are many different methods for the treatment of arthrosis of the hip( coxarthrosis).We will try to talk about each method, taking into account its pros and cons. We do not induce you to self-medicate, but only give an opportunity to evaluate the effectiveness of different methods of treatment. Knowing exactly how each of these methods works, you will be able to more consciously approach the treatment of .Depending on the degree of coxarthrosis treatment is different.
With the third degree of arthrosis of the hip joint, the treatment is surgical only, with the help of endoprosthetics. Endoprosthetics of the hip joint is a replacement of the damaged joint with an artificial prosthesis. Technically, this is a rather complicated procedure. Part of the prosthesis is implanted in the femur, part in the pelvis, as shown in the figure. This prosthesis completely repeats the characteristics of a conventional joint.
When I and II degrees of arthrosis of the hip joint treatment is performed without surgery. The following methods are used:
Drugs( tablets, injections and ointments)
1. Nonsteroidal anti-inflammatory drugs ( indomethocin, piroxicam, ketoprofen, brufenic diclofenac, etc.). These are shown during the period of "reactive inflammation of the joints".
The advantages of .Very good pain in the joints due to a strong anti-inflammatory effect, relieve edema and inflammation.
Cons .With prolonged use, the drugs in this group suppress the natural ability of the articular cartilage to repair, and side effects often negatively affect the various internal organs.
The output was found. Especially for long-term use, the anti-inflammatory drug mohvalis was developed. Its effect is "softer", and it gives fewer side effects with prolonged use. Many doctors recommend using just movalis when it comes to prolonged exposure to an inflamed joint for pain relief.
Important .It is not recommended to use several different anti-inflammatory drugs at the same time. If the drug used does not relieve the pain, then either increase the dose or replace the drug with another.
2. Vasodilator preparations ( theonikol, trental, nikoshpan, tsinaresin, etc.) relax the smooth muscles of the vessels, expand their lumen. With coxarthrosis, treatment with these drugs produces tangible results.
The advantages of .Very useful drugs to treat coxarthrosis. When used correctly, they have very few contraindications. They promote the speedy restoration of the joint due to the improvement of the joint blood supply, improve the delivery of "building materials" to the joint, and relieve the spasm of small vessels. As well as vasodilator drugs eliminate night "vascular" pain.
Cons .The effectiveness depends on the individual tolerability of the drugs. Before use, consult a doctor.
Important .Before use, the individual tolerance of the drug should be checked. The first three days take this drug one tablet, and only with good efficiency and no side effects go to the recommended course of admission.
3. Muscle relaxation products - muscle relaxants ( midolgram, sirdalud).In coxarthrosis of the hip joint, treatment with myorelaxates should be done with caution.
Features .They help to relieve painful spasm of muscles with coxarthrosis, improve blood supply to the joint.
Cons .They can affect the nervous system - cause dizziness, intoxication and inhibition of consciousness.
4. Preparations for the restoration of cartilage - chondroprotectors ( glucosamine, rumalon, don, structum, chondraitin sulfate, arteparone)
Pros .The most useful drugs in the treatment of deforming arthrosis of the hip joint. Improve the restoration of the structure of the cartilage, feed it with the necessary elements. Regular use of chondroprotectors can stop the development of coxarthrosis. You will not notice a positive effect right away, but it will be more noticeable in the future. Restoration of cartilage will continue after the drug is discontinued.
Cons .Almost has no contraindications. Exceptions are: pregnancy, individual intolerance and inflammation of the joints.
5. Hormonal steroid preparations - intraarticular injections of ( motel, kenalog, hydrocotisone).
The advantages of .In some cases, such injections have a good result, especially when there are concomitant diseases like inflammation of the tendons of the femur.
Cons .Such injections rarely give lasting positive results. Have many side effects.
Important .It is not recommended to do more than three injections in one joint. The gap between each injection should be at least two weeks.
6. Medicinal preparations of topical application - ointments, lotions, compresses.
Many naively believe that all kinds of ointments, creams, lotions are the main drug in the treatment of joint diseases. This myth, moreover, is actively inflated by advertising. But this is just a myth. The problem is that the hip joint is deep beneath the skin, fatty tissue and muscles. The likelihood that some substances will overcome these barriers and in sufficient quantity reach the joint is extremely small. But nevertheless the positive effect from use of ointments is. And it does not consist in a "miraculous" composition, but in the very process of rubbing the ointment. For this use, conventional warming ointments are suitable.
Pros .The process of rubbing the ointment improves blood circulation, in some cases helps to relieve painful muscle spasm.
Cons .The composition of the ointment does not have a therapeutic effect.
Physiotherapy in the treatment of coxarthrosis of the hip joint
Physiotherapy includes: electrotherapy, magnetotherapy, inductothermy, UHF therapy, ultrasound therapy, the use of lasers, aeroionotherapy, ultrasound therapy, light therapy.
The situation with physioprocedures is about the same as with ointments. The hip joint is deep. Therefore, it is reasonable to use physiotherapy only to improve blood circulation and relieve spasm. As for specific procedures, everything is individual, some are helped by someone, others by others. Everything depends on the person and the particular case. According to some physiotherapists, good results with coxarthrosis are provided by laser therapy, cryotherapy and massage. The latter method deserves special attention.
Features .Improves blood circulation and reduces painful muscle spasm.
Cons .Has no serious effect on the course of the disease as a whole.
Massage in the treatment of coxarthrosis
With deforming arthrosis of the hip joint, treatment with a massage gives good results. Massage with coxarthrosis is a very effective and useful method. It is desirable that the massage was conducted by a good specialist and as often as possible. Its action is aimed at improving blood circulation, strengthening the muscles, relieving painful spasm, swelling and tension of the muscles, as well as increasing diastasis between the articulating elements of the joint. In the absence of a professional masseur, you can do the massage yourself. Massage with arthrosis can be performed both manually, and with the help of various massage aids and even a jet of water( hydrokinetic therapy).
Features .Very effective and harmless method. The beneficial effect of using massage is difficult to achieve using other methods.
Cons .With proper administration of complications does not cause.
This procedure is usually carried out using a traction device or manually. This is one of the few procedures that can dissolve articulating joint bones and reduce the burden on them.
Disadvantages of the traction device .The pull is only on the vertical axis. Although it would be more useful to perform traction a little in the side and in the outer side.
The advantages of the traction device .Ease of pulling.
Manual traction is free of this disadvantage. In addition to the angle of traction, it is more physiological. This stretching is performed directly by the manual therapist.
The advantages of manual traction .Allows you to calculate the load, taking into account the individual characteristics of the patient, its weight and ligament-muscle tone.
Cons of the manual traction .Firstly, this is a very time consuming procedure. It is physically difficult for both the patient and the doctor. Secondly, it is important not to be mistaken with the choice of the manual therapist. The consequences of poorly performed traction can be very serious.
Important .Addressing to the manual therapist, always ask him to present a diploma and a license for the provision of medical care. Because of the complexity of implementation and the possible consequences of such treatment can be equated to the operation.
Diet for coxarthrosis
To date, the relationship between eating any specific products and the development of coxarthrosis is not proven. No miracle diets to cure coxarthrosis. The only thing that can be useful diet is a decrease in body weight. Decreased body weight leads to a decrease in the load on the hip joints. The less a person weighs, the easier he tolerates coxarthrosis.
Features .All diets that lead to weight loss are useful.
Cons .On the disease itself, diets are not affected.
Gymnastics for the treatment of arthrosis of the hip
Caution should be taken to select gymnastic exercises for coxarthrosis. Movements should not be too sharp, energetic - they can injure a sick joint. In no case can you do those exercises that cause severe pain. It is recommended to give preference to exercises aimed at strengthening the muscles, not loading the joint itself. With coxarthrosis, it is useful to go swimming, especially in pools with salt water or at sea.
The advantages of .Gymnastics with coxarthrosis strengthens muscles, improves blood circulation.
Cons .Select exercises should be cautious. There is a risk of injuring the joint.
Auxiliaries for the treatment of osteoarthrosis of the hip joint
With coxarthrosis of I and II degrees it is recommended to walk with a cane, to reduce the load on the diseased joint. At the III stage it is recommended to walk with crutches.
In conclusion, it should be said that with coxarthrosis of the hip joint treatment, it is always a balanced set of methods - medicines and medical procedures. Choose and balance the treatment will help you your doctor.
Coxarthrosis of the hip joint - Treatment of coxarthrosis of the hip joint
Stages of coxarthrosis of the hip joint
The first stage of the
The first changes occur unnoticed for a person. The liquid that moistens the cartilage on the joints bones in the joint becomes more viscous. Cartilage, without proper moistening, lose elasticity, elasticity, damage.
A person can feel that the joint is not working harmoniously, only after a serious load - no aching pains that can pass after resting are possible. The mobility of the limb is still preserved. However, the muscles are already starting to work incorrectly and some of them are atrophied.
Often the pain is felt not so much in the hip, as in the knee. Therefore, often the first stage of coxarthrosis of the hip joint is missed by treating the knee joint.
X-ray photographs show slight damage to the cartilage, a slight narrowing of the joint gap, the bones have not yet been changed.
The second stage of
At the next stage, the destruction is already more significant. It affects not only the cartilage, but also the bones that make up the joint. The neck of the femur is flattened, this bone itself tends upwards, squeezing the articular fissure. The patient's leg becomes shorter, and the person begins to fall on it while walking.
It is not difficult to guess that this leads to an increase in the load on the joint and even more intensive destruction. Pains persecute a person not only during walking, but can also appear in a state of rest.
The amount of movement in the joint is already limited. Especially the ability to move one's foot to the side and rotate it in the hip joint area suffers.
The cartilage of the joint is broken, the heads of the bones touch each other, which causes severe pain. Bone tissue is strongly deformed and has significant growths.
Muscles atrophy, which further complicates movement. The aching leg is even shorter.
In this condition, the patient constantly suffers. Even the complete rest of the joint does not save you from pain.
Diagnosis of coxarthrosis of the hip joint
We have already touched on the fact that the initial stages of the disease often miss: the patients themselves, and even the doctors. The fact is that the changes in the joint can still be insignificant and poorly discernible on the x-ray or MRI.
The sooner coxarthrosis is revealed - the more effective its treatment will be. Therefore, it is worth paying attention to even the weak pain that occurs when moving. If your relatives have been diagnosed with this pathology - it should be understood that there is a risk of such a disease in you.
Treatment of coxarthrosis of the hip joint
The first two stages of this pathology are treated with conservative methods. They are aimed at preventing inflammation, relieving pain, normalizing metabolism, restoring muscle capacity.
It should be immediately said that these efforts can not reverse the process - the health of the joint will not be fully restored. But it is possible to slow down the destruction and delay the onset of the moment when endoprosthetics will be the only method.
In order to improve nutrition and breathing of joint tissues, patients are prescribed medications that enhance blood circulation. Pain removes drugs from the NVPS group( Movalis, Diclofenac and so on).Can be recommended chondroprotectors. Sometimes hormonal injections in the joint can dramatically improve his condition. Synovial fluid prostheses are also used, which replace their own joint lubrication( injections are injected directly into the joint bag).
Speaking about the medical methods of coxarthrosis therapy, it should be noted that the qualification of the doctor and his deep understanding of the ongoing processes are extremely important here. For example, most experts agree that chondroprotectors do not have a significant effect on the development of the disease. Although they are actively advertised and patients spend a lot of money on such funds.
To conservative methods of treatment of coxarthrosis can also be attributed:
Coxarthrosis of the hip joint: treatment, diet, drugs, prevention
Since the disease is fundamentally a metabolic disorder, a diet with coxarthrosis of the hip should be aimed at eliminatingfactors that cause this pathology. As a result of the studies, products containing compounds detrimental to the state of the cartilaginous tissue were identified.
Nutrition for coxarthrosis of the hip joint should exclude:
- meat and fish semi-finished products of long storage;
- meat and fish, grown on hormones and unnatural feeds, as well as stuffed with preservatives for presentation;
- more than 1 tsp.salt per day;
- refined vegetable oil;
- products with high salt content and preservatives: sausages, canned goods, chips, nuts, salted vegetables and fish, caviar, sauces, some cheeses;
- products with a high fat content: cottage cheese, cream, sour cream, red fish, mayonnaise, chocolate;
- jelly and steep meat broths.
In the presence of disease coxarthrosis of the hip joint, the diet should contain:
- a sufficient amount of liquid( 1-3 liters per day);
- all cereals of natural processing, macaroni, bread, potatoes;
- eggs( not more than 3 per day)
- low-fat dairy products;
- homemade meat or a properly cooked shop in small quantities;
- vegetables and fruits.
Drug treatment of coxarthrosis of the hip joint, most often, in the symptomatic elimination of problems arising from the destruction of cartilage and deformation of bones. The main actions that are expected from pharmacological agents: pain elimination, inflammation removal, improvement of blood circulation and nutrition of cartilaginous tissue, relaxation of spasmodic muscles.
Drugs for coxarthrosis of the hip joint, unfortunately, do not solve many other important issues. For example, pharmacology can temporarily improve the patient's condition, slow the destruction of cartilage, but it can not stop the process of joint degeneration. But systematic complex treatment, consisting of all known methods, can give very good results.
Drugs for the treatment of coxarthrosis of the hip joint:
- non-steroidal anti-inflammatory and analgesic agents( Indomethacin, Ibuprofen, Piroxicam, Diclofenac, Nimesulide, Movalis and analogues).Relieve pain, inflammation, fever, stiffness in the joints;
- hormonal steroid preparations, including intraarticular injections( Hydrocortisone, Methylpred, Kenalog).Neutralize reactive inflammation and pain;
- vasodilators( Nicospan, Cinnarizine, Trental).Improve blood circulation, relieve vasospasm, relieving pain in the joint;
- muscle relaxants( Sirdalud, Midokalm).Eliminate the painful muscle spasm;
- chondroprotectors - chondroitin sulfate and glucosamine( Arthra, Dona, Structum, Teraflex).Medicines designed to restore cartilage tissue at the initial stage. They work very slowly, the course is long( 3-5 months) and requires regularity. Qualified intraarticular administration significantly enhances the effect.
Surgical intervention is usually performed at the last stage of the disease, when the function of the joint is already broken completely and there is no longer a chance of another cure. It would seem that surgery for coxarthrosis of the hip joint is the simplest and right decision: after a while after rehabilitation, the joint becomes as new.
This is partly true, but there are also pitfalls: surgical interventions are not always successful and cheap, in addition, complications and loosening of the joint sometimes occur and a repeated operation is required. Even if everything goes well, the joint will still have to be changed after 15-20 years for natural reasons. Therefore, experienced specialists advise to resort to surgery at the later age of , delaying the time to the last.
- TDS endoprosthetics - the most difficult of all manipulations, when both bone surfaces are replaced: the affected elements are sawed out, implants are placed on them;
- arthroplasty - is a minimally invasive method of prosthetics, in which only a small part of the joint is replaced, for example, cartilage;
- arthrodesis - the affected bones are fastened with plates and screws to restore the supporting function. Disadvantage: the motor abilities of the joint are still limited;
- osteotomy - dissection of the wrong bone joints for subsequent fixation in anatomically correct position. The motor function is restored.
Alternative methods of
Than to treat coxarthrosis of the hip joint, if standard medical methods do not produce the expected result? Among the alternative types of arthrosis treatment the most well-proven:
- manual therapy( soft or jerky joint bones);
- applied kinesiology( motion treatment);
- traction therapy( hardware joint extension);
- post-isometric relaxation( non-hardware extension).
Treatment of coxarthrosis at different stages of
With initial cartilage and bone deformations, treatment usually reduces to reducing the load on the joint, restoring cartilage and training the periarticular muscles. Factors that will help alleviate coxarthrosis of the hip joint of the 2nd degree: treatment is more serious, with special attention paid to special exercises and massage, painkillers are added.
Treatment of coxarthrosis of the third degree hip joint is usually symptomatic or surgical. Some authors also distinguish coxarthrosis of the hip joint of the 4th degree: the treatment in this case does not differ from the methods of the previous level of the disease. Here we are talking, most likely, about the radiographic parameters of arthrosis.
Overcoming such a serious ailment as coxarthrosis TBS, almost completely depends on the mood and vigor of the patient .There are cases when a great desire to recover, multiplied by efforts, led to such obvious improvements in the 3 stages that the person no longer needed an operation. Conversely, mild cases of coxarthrosis were triggered because of the patient's reluctance to comply with the recommendations of a doctor or disbelief in their own strengths.
Treatment of coxarthrosis of the hip joint - part two
In advanced stages, treatment of coxarthrosis of the hip joint means surgery for joint replacement.
Nowadays, with coxarthrosis, endoprosthetics are usually performed, that is, a complete replacement of the deformed joint with an artificial one.
It looks something like this: the part of the femur is cut off, on which the joint head is located. In the cavity of the femur, a pin is inserted from titanium, zirconium( or other materials), and has an artificial joint on the end. The pin is fixed inside the cavity of the femur by the likeness of cement or glue( sometimes by the "dry" fixation method).
In parallel operate another articulating surface of the hip joint: a part of the acetabulum is removed on the hip bone, and a concave bed of high-density polyethylene is placed in its place. In this bed, the pressure will then rotate the titanium head of the joint.
If hip arthroplasty is successful, the patient quickly feels relieved: the pain disappears and the mobility of the joint is restored. Therefore, at first glance it seems that with coxarthrosis there is no sense to waste time and spend energy on therapy - you need to do the operation right away.
However, it is necessary to consider the following. First, with endoprosthetics, as with any serious surgery, there is a risk of complications and infection. In addition, with an imperfectly performed operation and a poor "fit" of the joint, there are violations of its fixation, and the prosthesis very quickly becomes blurred. In this case, after a year or two, a second operation may be required, and it is not known whether it will be more successful than the previous one.
But most importantly, in any case, even when the surgeon's work is impeccable, the artificial joint is thinned and requires a replacement usually within a maximum of 15-18 years.
The fact is that the leg( pin) of the artificial joint is subjected to constant overload and after some time its fixation inside the femur is broken. At some point, after an unsuccessful movement or load, the leg of the joint can finally loosen the niche inside the femur, and then it begins to "walk on the go."From this moment the dynamic work of the whole structure is disrupted, and the blotting proceeds at a particularly rapid rate - painful pains resume and the need for repeated endoprosthetics arises.
And now imagine: if the patient was first operated at 45, then at 60 years old, a second operation with all possible consequences and risk of complications may be required. And every operation is a serious stress and stress for the body.
Thus, operation on the hip joint does not solve all problems at once, and sometimes even generates new ones. And if there is a possibility, we must try to avoid the operation or delay it for as long as possible.
After all, every year there are new drugs for the treatment of arthrosis, the techniques of surgical treatment are being improved. New technologies are on the way. Apparently, not far off is the time when the idea of Italian and Israeli scientists will develop: to build on the head of the femur an artificial cartilaginous layer, instead of changing the entire joint.
In addition, endoprosthetics are quite expensive, and after this operation requires a fairly long period of rehabilitation. Therefore, I always tell those patients who have a chance to do without surgical intervention: direct those forces and means that are necessary for the operation, for therapeutic treatment - and, perhaps, you will be able to avoid the operating table altogether.
Post-traumatic arthrosis of the knee joint is described here.
Symptoms of hip dysplasia http: //sustavprof.ru/bolezni/dsp/ displaziya-tazobedrennyh-sustavov.html.
These exercises can not be performed too vigorously and abruptly. The goal of the exercises is to develop the affected joint, rather than complicate the situation, causing additional trauma to the already aching joint. That is why the exercises are rather static, not dynamic.
It is very desirable to perform muscle massage in the hip and hip joint area before and after performing exercise therapy. The same massage should be performed and with the appearance of unpleasant sensations during the performance of gymnastics.
A good assistant in the treatment of coxarthrosis is water. For example, swimming is very useful in this disease, regardless of whether you are swimming in the sea, the river or the pool. True, swimming can be practiced only if such an opportunity gives the physical condition of the patient. But a warm bath will make it possible to relieve unnecessary tension in the muscles and soothe the pain. Lying in it you can perform slow and smooth movements of low amplitude, so that the pain will decrease.
The most important rule that must be strictly observed during the performance of therapeutic exercises: do not perform those exercises that cause the appearance of sharp pain. The pain says that the joint can not yet perform such a task, and such an exercise, respectively, will cause harm.
Exercises in the initial stages of coxarthrosis
If the hip joint is not yet very significant, then the following set of exercises for coxarthrosis can be recommended.
Lying on the back, bend the leg as much as possible in the knee joint, then pull it out. Lying on your back, clasp your legs under your knee with both hands and pull as close to the belly as possible, press the second elongated leg to the floor. Lying on your back, bend your leg, with the opposite hand, hold your foot in this position. Lying on your back, bend your knees, the soles are firmly pressed to the floor. Tighten the buttocks and raise the pelvis as high as possible. Lying on your stomach, bend your leg in the knee at a right angle and lift it over the floor. Lying on your side, lean on the elbow and palm of the opposite hand. Pull up the elongated leg, the sole should be at a right angle to the shin. If the exercise is easy, you can use an elastic band, tied around the ankles, or a load of 1-2 kg. Sitting on a chair with feet firmly pressed to the floor, connect the knees and feet and unfold the heels as hard as possible outward. Sitting on a chair with feet firmly pressed to the floor, grip the ball or pillow between the knees and squeeze. Lie for a while on your stomach with your legs stretched out.
Start with each movement from 3 to 5 times, gradually bring the number of repetitions to 10. Pay special attention to the exercise that causes you the greatest difficulties. Fix the final pose for a couple of seconds. Between the exercises, relax. Exercise can be accompanied by mild soreness( but not strong).
Do not hold your breath during exercise, breathe freely.
Warning! If during the exercises there are noticeable painful sensations - this complex can not be used! In more severe cases of coxarthrosis, the following set of exercises is recommended.
Exercises for severe forms of coxarthrosis
This complex of exercises with coxarthrosis is based on the method of VD.Gitta. This complex can be recommended both at the initial stages of the disease, and in more severe cases.
Coxarthrosis is treated difficultly and multifaceted, with a whole complex of measures and measures. Therapeutic gymnastics is an important addition to traditional treatment.
Coxarthrosis exercises have special characteristics:
- Perform them smoothly, without sudden movements, not too vigorously. Sharp actions can only exacerbate the situation and injure the sick joint even more.
- Gymnastics is not dynamic, but static.
- Before and after therapeutic gymnastics, especially when there are unpleasant sensations, it is recommended to perform self-massage of the hip and in the region of the hip joint.
- A warm bath will help relieve pain and tension in the muscles. Taking a bath is useful to make smooth slow movements of small amplitude.
- Swimming helps improve the overall condition of a patient suffering from coxarthrosis. You can swim in open and closed water bodies - the main thing is that the water is not very cold.
- Avoiding too much physical activity and movement amplitudes, deep and sharp squats and pelvic swings - all this can worsen a patient's condition.
- The complex of exercises of therapeutic gymnastics with coxarthrosis absolutely excludes the axial load in the hip joints.
- Exclude from the complex exercises that cause severe pain.
Below is a common set of exercises for patients with coxarthrosis.
Initial position( IP): lie back
Exercise 1. Pull your legs forward, hands down along the trunk. Inhaling, raise your hands up, and on exhalation lower them. Repeat the exercise at a smooth pace 5-10 times.
Exercise 2. Accept the same starting position. Bend and straighten your arms at the elbows. Repeat 4-9 times.
Exercise 3. The IP is the same. Bend and unbend the legs slowly in the knees, while not tearing them off the floor. Repeat 9-11 times.
Exercise 4. PI is the same. Turn the straightened legs inwards, return to the FE.Repeat 8 times.
Exercise 5. Hands on the belt. Split your legs in different directions, without taking your heels off the floor, and then slowly return to the FE.
Exercise 6. Hands on the belt."A bike".Bend and unbend legs like when riding a bicycle at a calm pace of 10-15 seconds.
Exercise 7. Put your hands along the trunk. Exhaling, raise your arms outstretched, and on inhaling, lower them. Repeat the exercise 7 times. IP: lie on stomach
Exercise 8. Hands on hip. Raise head and shoulders, hold in this position a couple of seconds, and then return to the FE.Repeat 6 times with an interval of 2 seconds.
Exercise 9. Hands on the hips. Raise your legs straight and gently. Repeat 7 times.
Exercise 10. Hands in front of the chest. Raise the upper shoulder girdle and in this position make three movements, as if floating with a "breaststroke".Repeat the exercise 8 times.
Exercise 11. Hands in front of the chest. Cut your pelvic floor muscles, and then keep them in such a strained state for a few seconds, and then relax. Then keep the state of voltage up to 10-12 seconds.
IP: lie on the healthy side
Exercise 12. Put your head on your arm, pre-bending it at the elbow. Raise and remove the aching leg, gently lower and relax. Repeat 8 times.
PI: standing on a healthy leg
Exercise 13. Place your hand on the back of the chair from the side with which you have a healthy leg, make smooth flops sick leg forward and back. Repeat 11 times. Exercise 14. I.P.same. Do motion to the district with the foot that hurts. Repeat the exercise 9 times.
IP: standing on both legs
Exercise 15. Lean on the back of the chair. Half-way, go back to the IP.Repeat 11 times. Exercise 16. I.P.same. Rise on the socks, then return to the FE.Repeat 10 times.
Gymnastic exercises with coxarthrosis became the basis of the method of kinesitherapy, developed by SM.Bubnovsky. He created special simulators and a set of gymnastic exercises designed to combat the root cause of coxarthrosis - hypokinesia. It should be remembered that lack of mobility is the worst enemy of coxarthrosis, the patient should carefully listen to his body and do not limit himself in the movement of the disease.
Before and after the gym, you should perform a simple massage. If you feel a sharp pain during the exercise, it is advisable that you see the doctor.
Massage with coxarthrosis, of course, does not treat the disease of the hip joint. It is needed in order to improve blood supply in problem areas, improves cartilage nutrition, partially improves the development of joint lubrication, coxarthrosis is suspended. However, it is important to remember that illiterate and inept treatment of coxarthrosis of hip joints with massage can do more harm than good. Therefore, it is advisable to seek professional help.
Therapeutic massage should be performed smoothly, with gentle movements. Sensations in this case should be pleasant and painless. The actions of the masseur should cause a feeling of warmth and in no case provoke pain or discomfort. Any unpleasant symptom is a signal to stop the massage and, possibly, a change of the masseur. Massage for the treatment of coxarthrosis is recommended for courses of 10 sessions twice a year.
Exercises for coxarthrosis have their own characteristics, which should be noted:
Therapeutic gymnastics should not be performed abruptly or vigorously, otherwise the situation can only worsen as a result of injuring the painful joint. Exercises should be performed in a statistical rhythm, but not in a dynamic one. After performing exercise therapy with coxarthrosis, perform a gentle circular movement around the hips, massaging the hip joint. If after a physiotherapy exercise you feel fatigue and tension, take a warm bath that will relieve the pain and tension in the muscles. Lying in the water, you can make smooth movements in the region of the hip joint. If after examination the expert will allow you, with coxarthrosis it is useful to swim in the pool or river. Exercises with coxarthrosis should exclude the axial load on the hip joints. To the deterioration of the disease of the hip joints can lead any sudden movements or excessive physical activity.
Remember! Do not perform those exercises that cause severe pain.
The use of more water in co-cartroesis has not been scientifically proven, but it is expected, as the joint loses moisture and becomes "dry" when the disease occurs. Diet in coxarthrosis implies a restriction of food consumption provided with preservatives, hamburgers, sodas and "fast food".Priority in the diet should be vegetables, fruits, berries and natural meat and dairy products.
The cause of coxarthrosis in children lies in the problem of impaired blood supply to the head of the femur. Perthes' disease occurs for a number of different reasons, so it is very difficult to single out one thing. The disease is often found in boys( left-sided coxarthrosis) from 3 to 14 years, girls get sick less often.
Diet for coxarthrosis is extremely important. This is explained by the fact that only proper nutrition provides cartilage with the necessary "building blocks".It is worth remembering that the nutrition of the hip cartilage is due to the fluid produced in the joint itself( the composition and amount of this substance affects the quality of depreciation).A full set of elements, including vitamins( primarily ascorbic acid), minerals( magnesium, fluorine, phosphorus), organic acids and other important substances, allows us to launch a self-healing mechanism.
For people over 50 years, some types of diets will do more harm than good. So a lack of calcium in the diet will contribute to the development of osteoporosis, and its excess can cause an accelerated growth of osteophytes, a lack of potassium contributes to the development of heart diseases, provokes the appearance of seizures.
It should be noted that a balanced diet with coxarthrosis is only an additional component of complex treatment of the disease, which contributes to the improvement of the body as a whole and improves the condition of the joints. It is best that food is fractional, there is a need for small meals up to 6 times a day. The construction of new tissues, the restoration of cartilaginous tissue is promoted by proteins.
The most useful for joints is dairy products, because the body easily absorbs milk protein. Dairy products( cheeses, cottage cheese, sour-milk products and others) are also an indispensable supplier of calcium, necessary for strengthening bone tissue. Useful protein contained in lean meats and fish. The vegetable protein is included in the diet, it is contained in lentils, beans, buckwheat porridge. Preference should be given to stews, boiled and cooked for a couple of dishes.
For the construction of bone and cartilage tissue, ligaments and muscles, collagen, chondroprotectors for arthrosis, the so-called mucopolysaccharides, entering the body with products such as chilli, jellied fish, jelly are needed. As a dessert fruit jelly, containing many vitamins, gelatin, rich in mucopolysaccharides, is indispensable. The food intake necessarily includes products rich in phosphorus, phospholipids, also contributing to the restoration of cartilaginous tissue.
An important role in nutrition is played by carbohydrates, which provide the body with the energy necessary for all processes of vital activity( brain nutrition, cells, nucleic acids, enzymes, amino acids, immunoglobulins).But preference should be given to complex carbohydrates( polysaccharides, monosaccharides).So the excess of sugar leads to an excess of rapidly digestible carbohydrates, so sugar is better replaced with honey, which is a storehouse of vitamins, trace elements and other nutrients.
A sufficient number of complex forms of carbohydrates are able to provide the body cereals, fruits, vegetables, nuts, potatoes that provide optimal nutrition to the brain and reduce the risk of developing diabetes, stroke, atherosclerosis, and certain cancers. Instant and simple monosaccharides( fructose, glucose, galactose) immediately enter the blood. They are found in fruits, vegetables, honey.
Of fats, which are an energy substratum for the body, preference is given to vegetable fats.
The most optimal option for maintaining joint health is nutrition, aimed at reducing weight and normalizing metabolism. It will not cure coxarthrosis, but it will contribute to a speedy recovery.
Methods of treatment
Medication: Anti-inflammatory drugs( eg, diclofenac, movalis, etc.).They perfectly remove the swelling, inflammation, but with long-term use, side effects are possible, for example exacerbation of gastric ulcer. In the line of these preparations, mohvalis is allocated, as one of the safest. Drugs that have a vasodilating effect( trental, cinaresin) - improve blood supply around the joint, so that it is more quickly restored. There are practically no contraindications. Preparations, relaxing muscles( midocals).These drugs are good for relieving the pain caused by muscle spasms around the affected joint, but have side effects: they can cause delayed reactions, dizziness. Preparations that repair cartilage tissue( the so-called chondroprotectors - arteparone, glucosamine) are the most useful for the treatment of coxarthrosis. They contribute to the restoration of cartilage even after withdrawal of the drug. There are almost no contraindications. Steroid hormonal drugs( eg hydrocotisone) only sometimes give a good result, but they have many side effects.
Ointments, compresses, lotions - their effectiveness is low enough, because active substances can not get to the damaged joint. However, they bring unquestionable benefits, not so much due to the ingredients contained in them, but thanks to the massage that is performed when they are applied.
Physiotherapy. It includes many methods: massage, magnetotherapy, UHF therapy, laser therapy, ultrasound, light, electricity, etc. Physiotherapy works fairly superficially, but it helps improve blood circulation around the damaged joint.
Massage with coxarthrosis is very useful. The more often and better it is, the better.
Extension of joints by hand or with the help of a special device. It is much better to do stretching by hand, because it is possible to determine the direction of correction more precisely. The procedure is rather risky.
Exercises. They improve blood circulation. Only those exercises that are specially developed for patients with coxarthrosis that do not cause pain and are not traumatic are chosen. With coxarthrosis, swimming is very useful, especially in salt water.
With total arthroplasty, the femoral head is separated from the cervix. The head is replaced with a metal or ceramic implant and fixed in the femur with a long pin.
The acetabulum is treated in a special way and inserted into it a titanium cup corresponding to the form of the femur prosthesis, which is fixed with bone cement or screws.
With partial endoprosthetics, the head is not removed. A special cap is put on top of it. Similarly, prepare the articular surface of the acetabulum and attach a thin-walled metal cup over it.
As all people are different, with different sizes and complexes, all components of such an artificial endoprosthesis - pin, joint head, articular bed - are selected individually for each patient. There are about two hundred different components of this prosthesis. They are selected by the doctor in the process of examining the patient and preparing him for such an operation.
In addition, endoprostheses are made of different materials - metal, ceramics and high-quality plastic( polyethylene).Depending on the patient, the age and manner of life of the endoprosthesis operation, these materials can be combined with each other in various combinations.
So, for the elderly patient, who has little physical exertion on his leg, prostheses can be installed in which one part of the joint - for example, the articular bed - is made of plastic and the other one is made of metal. This combination allows you to greatly increase the life of the endoprosthesis.
And if the operation is performed by a young patient whose physical exertion on the joints was( and will be in the future) sufficiently large, then the selection strategy for the prosthesis will be completely different. Such a patient usually stops an endoprosthesis, in which both composite surfaces are made of ceramics, or both parts are made of metal. Such hip joint prostheses will be more rigid, but at the same time they can last for a long time even at high physical exertion on their feet.
Intra-articular injections( joint injections) with coxarthrosis are rarely used, since even a healthy hip joint has a narrow articular cleft and a small articular cavity. Accordingly, with coxarthrosis, when the gap narrows again by half, it is quite problematic to administer the medicine directly into the cavity of the affected joint. First, the risk of miss is very high. Secondly, there is a risk of damaging the vascular and nerve trunks located along the prospective introduction of the needle( since the needle is inserted through the groin).That is why most doctors inject medication through the thigh, but not into the joint itself, but into the periarticular region.
Such periarticular, or "periarticular" injections are most often performed in order to eliminate the aggravation of the pain syndrome. Then corticosteroid hormones( kenalog, diprospan, flosteron, hydrocortisone) are introduced into the periarticular zone. However, I would like to emphasize once again that this is not so much a medical procedure as a means to eliminate an exacerbation and reduce pain. Accordingly, it makes no sense to inject corticosteroid hormones in the case of a relatively quiet course of the disease.
If we still have periarticular injections of corticosteroid hormones, in order to suppress inflammation and eliminate the pain syndrome, it must be remembered: such procedures are performed no more often than once in 2 weeks, and the total number of injections should not exceed five to seven perone affected area, one joint.
Much more often, and most importantly, it is possible to conduct periarticular injections of chondroprotectors.
The advantage of these drugs is their ability to influence the cause of the disease. Penetrating into the joint, they improve the condition of the cartilaginous tissue and normalize the joint metabolism. That is, unlike corticosteroids, chondroprotectors not only eliminate the symptoms of the disease, but also treat coxarthrosis. However, the effect of these drugs develops very slowly, and the effect is not guaranteed. For this reason, periarticular chondroprotective injections can hardly be considered as a key treatment for coxarthrosis - unlike mechanical and biological treatments.
No injections directly into the hip joint. The fact that he is in the thickness of the muscles and get to the joint space is quite difficult. Therefore, they are treated with injections not in the joint itself, but in adjacent tissues( thigh, periarticular regions).
Medical treatment of coxarthrosis. This method is always aimed at eliminating or reducing the leading syndrome - pain. In the arsenal of drugs for drug treatment of coxarthrosis, parenteral agents are used - intramuscular, intra-articular injection of sterile solutions of hormones, blockade of nerve nodes with anesthetics, etc. It is justified to use drugs enterally in the form of tablets, capsules. The effect is achieved due to the suppression of pain, the removal of concomitant arthrosis of inflammatory phenomena. External means, prescribed for arthrosis, are divided into painkillers and distractions, which pain is not removed, but softened due to the cooling or warming effect of the components of the preparation. For example, a rather fashionable recently questionable use in the "horse" doses of a combination of camphor or menthol. Rubbing of external preparations on the thigh for analgesia has an inverse relationship due to the massiveness of the tissues around the joint.
Irritable nerve nodes are located in the depth of the soft tissues around the joint.
The above arsenal of funds from the use of curative physical education to pharmacological drugs is possible at all stages of the disease in the complex therapy of arthrosis.
NSAIDs are good pain relievers for coxarthrosis, relieve swelling and inflammation of the joint, thereby relieving pain.
Muscle relaxants relieve muscle spasms, stimulate blood circulation, and chondroprotectors contribute to the restoration of the affected cartilage tissue. These drugs are used both in tablets and in injections, depending on the degree of pain and the appointment of a doctor.
At the 1 st and 2 nd stages of coxarthrosis, treatment can be performed in outpatient settings using physiotherapy: shockwave therapy, general magnetotherapy, pulse currents, massage. It is aimed at reducing pain syndrome, aseptic inflammation in periarticular tissues, improving tissue trophism and blood circulation in the limb, improving joint stability and preventing other static disorders of the musculoskeletal system.
The use of physiotherapy will strengthen muscles and increase mobility of the joint. Local physiotherapy procedures are important components in alleviating pain, stimulating metabolism and reducing inflammation. Special training reduces the deformation of the hip joints and the consequences of incorrect loads( eg long standing, kneeling or sit-ups).This leads to a conscious and sparing treatment of patients with joints. In addition, often in this way, pain, joint fatigue and other symptoms decrease.
If you already have joint problems, such as coxarthrosis, perform this kit on a daily basis. For prevention will be enough two or three times a week. Most of the complex exercises are carried out in dynamics, each movement must be repeated 8-12 times. The amplitude of rotation should be comfortable, so that during practice you do not have any pain.
Each of us has a different anatomical structure of the head of the hip and acetabulum - the joint fossa of the hip joint. And so not everyone can sit in a vertical twine or lotus. Listen to yourself and do not chase after spectacular asanas, until the body is ready for them.
Stand on all fours, tighten the abdominal muscles and pull the spine in one line, lowering the head and pointing the vertex forward. Fix the position of the leg bent at right angles and lift it back. Perform a circular motion with your foot only due to the hip joint work. Start with the circles directed outwards, then inward.
Pose of a tree sitting
Sit on the floor, pull your legs forward, pull the socks on yourself. Straighten your back, pushing forward with your palms facing away from the floor behind your back, but without leaning on them, stretch your crown upwards. Work in dynamics: bend the leg and, directing the knee to the side and down, press the foot against the inside surface of the thigh of the other leg;then return the foot to its original position. Repeat with the other foot. It is possible to complicate this movement, throwing a foot on the thigh from above and continuing to pull the knee to the floor.
The peculiarity of gait in patients with coxarthrosis is that practically all the elements of normal adult walking suffer. In connection with developing hyperlordosis, pelvic incline, followed by scoliosis, the hip flexion is corrected, the amplitude of the trunk swing during walking increases. This, with unilateral coxarthrosis, creates a picture of the so-called bowing gait, and when two hip joints are affected, there is a "duck walk" with the pelvic and torso passing either one way or the other. According to NS Kosinskaya, in a third of patients coxarthrosis is bilateral. The disorder of posture arising on the background of coxarthrosis is accompanied by compression of the femoral, sciatic and blocking nerves. With complete loss of mobility in the hip joint, the pain subsides.
Can I resume playing sports?(Questions on endoprosthetics)
There are no special sports prostheses. After hip arthroplasty, you can walk freely, ride a bicycle, swim. Scandinavian walking is also possible. Team sports, ball games are limited. For example, tennis lessons are not recommended. The exception is a game of golf, where the athlete does not feel any obvious restrictions in the movement. Studies have shown that increasing sports loads leads to a decrease in the life of the prosthesis.
Statistically, the youngest men experience the smallest durability of the implant due to their physical activity. As a rule, they have a replacement in about 15 years.
Patients are assigned the following groups of medicines:
Anti-inflammatory and analgesic agents. Their use helps to relieve inflammation and pain, but is not able to completely cure the disease. Assign Diclofenac, Brufen, Naproxen. Means that increase blood circulation and relieve vascular spasm( Trental, Nikospan).Miorelaxants( Midokalm) help to reduce the increased muscle tone, but can cause dizziness and weakness. Hormonal preparations. They are prescribed as injections into the affected joint, give a quick analgesic effect. However, it is not recommended to use more than 3 injections in a row. Chondroprotectors. They help to repair the damaged cartilaginous tissue, but do not expect a rapid effect. The use of these drugs is a long time, the positive effect will be visible in the future. Local treatment( ointments, lotions).It is possible to use warming ointments, such as Finalgon, Gevkamen, Espol. Rubbing these funds helps improve blood circulation in the joint area, slightly reduce pain. However, no miracle cure is expected from these ointments, rather the effect arises from the massage of the affected area.
In the conservative treatment of coxarthrosis, the following drugs are usually used:
Medication therapy( NSAIDs, analgesics, hormones).In coxarthrosis, non-steroidal, that is non-hormonal, anti-inflammatory drugs are traditionally used to eliminate pain and inflammation of the joint, because against a background of severe pain it is impossible to begin normal treatment. However, it is undesirable to use drugs of this group for a long time. After all, when the pain decreases, a deceptive impression is created that a cure has begun. Coxarthrosis, meanwhile, continues to progress: NSAIDs only eliminate individual symptoms of the disease, but do not cure it. As a result, the cartilage already affected by coxarthrosis starts to break even faster. Thus, the tablets that the patient takes to reduce pain in the joint can accelerate the destruction of this joint. In addition, using non-steroidal anti-inflammatory drugs, it must be remembered that they all have serious contraindications and, with prolonged use, they can produce significant side effects. Chondroprotectors( preparations for the restoration of cartilaginous tissue not so much eliminate the symptoms of coxarthrosis, affect the "basis" of the disease, help restore cartilaginousjoint surfaces, improving the production of joint fluid and the normalization of its "lubricating" properties. This complex effect of chondroprotof the joints makes them indispensable in the treatment of the initial stage of coxarthrosis, but they are not very effective in the third stage, when the cartilage is almost completely destroyed, and even in the first and second stages of coxarthrosis, they improve the patient's condition far from immediately.minimum 2 to 3 courses of treatment with these drugs, which usually takes six months to a year. Myorelaxants - drugs used to eliminate muscle spasm are prescribed to eliminate painful muscle spasm, often accompanied bywaiting for coxarthrosis of the hip joint. However, it must be remembered that muscle spasm is a protective reaction of the body, protecting the joint from further destruction. If you simply remove the protective muscle tension, but do not reduce the excessive pressure on the hip joint( for example, use the walking stick when walking), the damaged joint will begin to break down at an accelerated rate. Vasodilator drugs help to restore the hip joint by improving the joint blood flow and reducing the spasm of small vessels. With their help, the delivery of "building material" to the painful joint is facilitated, and night vascular pain is also eliminated.
Therapeutic ointments and creams with coxarthrosis are ineffective. The main effect of ointments in the treatment of coxarthrosis is to improve blood circulation( especially with vigorous rubbing), massage when rubbing also reduces muscle spasm. But the hip joint is located quite deep beneath the muscle layer;In addition, our skin has good "barrier" properties;so expect that some substance will penetrate through it in sufficient quantity, pass deeply through the thickness of muscles and reach the hip joint, unfortunately, it is not necessary.
Preparations for cartilage restoration - chondroprotectors( glucosamine, rumalon, don, structum, chondraitin sulfate, arteparone)
Advantages: The most useful drugs in the treatment of deforming arthrosis of the hip joint. Improve the restoration of the structure of the cartilage, feed it with the necessary elements. Regular use of chondroprotectors can stop the development of coxarthrosis. You will not notice a positive effect right away, but it will be more noticeable in the future. Restoration of cartilage will continue after the drug is discontinued.
Cons: Almost has no contraindications. Exceptions are: pregnancy, individual intolerance and inflammation of the joints.
Therapeutic ointments and creams with coxarthrosis are ineffective. The main effect of ointments in the treatment of coxarthrosis is to improve blood circulation( especially with vigorous rubbing), massage when rubbing also reduces muscle spasm. But the hip joint is located quite deep beneath the muscle layer;In addition, our skin has good "barrier" properties;so expect that some substance will penetrate through it in sufficient quantity, pass deeply through the thickness of muscles and reach the hip joint, unfortunately, it is not necessary.
To relieve pain in coxarthrosis of the hip joint, you can use the folk recipes for the preparation of the following ointments:
Natural honey and finely chopped turnip must be mixed 1: 1 and add 50 grams of vodka. The resulting mixture should be applied morning, afternoon and evening to the affected hip joint.1: 1 mix the mint leaves, aloe juice and eucalyptus. The mixture is also applied to the damaged joint three times a day. Also, with coxarthrosis of the hip joint, an ointment prepared from nettle leaves, juniper berries and melted smelt can be used. All ingredients must be mixed until smooth and applied to the affected joint.
- rub in a sore spot bee venom, fir oil, clove or eucalyptus oil;
- a compress made from cabbage leaves, smeared with honey
- grind the leaves of eucalyptus and mint in equal parts, mix with aloe juice, apply as an ointment;
- mix honey with aloe juice, pour vodka in the proportion of 2: 1: 3.Apply as a compress. ...