The main symptoms and methods of treatment of coxarthrosis of the hip joint
Bone tissue is destroyed due to depletion of the cartilaginous connective tissue
Coxarthrosis is the most common disease of the musculoskeletal system. This pathology causes degenerative-dystrophic changes in the hip joint. The etiology of the disease is the topic of scientific disputes. It is accepted to isolate primary and secondary coxarthrosis.
The first arises as an independent pathology, and the second - as a consequence of congenital structural changes in the hip joint, various injuries or other concomitant diseases. It is generally believed that the primary coxarthrosis of the hip arises as a result of a violation of blood circulation in the joint and metabolism in the patient's body. Do not discount the mechanical damage, unnecessary load. Often, the disease affects people with excessive body weight, as well as patients after the age of 40 years.
It should be noted that coxarthrosis has a progressive course. At the beginning of the disease, the symptoms are mild and do not cause the patient any special discomfort.
The main signs of coxarthrosis
There are characteristic signs of arthrosis of the hip joint. It is their presence, intensity and nature of the disease that indicate the degree of damage to the joints. It is accepted to allocate 3 degrees of coxarthrosis.
The first degree is characterized by periodic pain in the affected joint, which occur only after a certain physical exertion. Such a load can be a long walk, climbing stairs, and ordinary homework. After the person has had a rest, pains pass or take place, but in due course come back again. Sometimes pain gives to the knee. The movements of the joint are not limited, the gait does not have features characteristic for later stages of coxarthrosis of the hip joint. Patients often ignore the first symptoms of the disease. And completely in vain! It is timely diagnosis and timely treatment begun to help stop the destructive processes and save the joint.
The second degree of coxarthrosis is characterized by intense degenerative-destructive processes. The tissues of the joint are rapidly deformed, the pain becomes more intense, gives up in the knee or in the groin, and worries the patient even at rest. After any physical activity, the patient has limp and stiffness, which does not go away even after rest. The functional state of the affected joint is impaired. At this stage, the situation can be assessed as complex, but not critical.
The third degree of the disease is characterized by continuous pain in the joint, which disturbs the patient even at night, which causes the patient to have a sleep disorder, fatigue and other psychosomatic changes. At this stage of coxarthrosis, not only articular and periarticular tissues are affected, but also muscle atrophy, marked shortening of the affected limb. A patient can walk only with the help of a cane. Often the disease is accompanied by the pathology of the internal organs, which arise from the displacement of the pelvic bones.
In coxarthrosis, symptoms and treatment directly depend on the degree of joint damage. The earlier a patient seeks help from specialists, the more chances he has to recover.
Diagnosis and treatment of
Differential diagnosis is not difficult for an experienced specialist. Even after the initial examination, the doctor can draw conclusions about the nature and course of the disease. To clarify the condition of the affected joint, an x-ray examination is prescribed to the patient, the results of which determine the degree of coxarthrosis and the intensity of destructive processes.
In the 1st and 2nd stages of the disease, the treatment of coxarthrosis of the hip joint is conservative and is performed in an ambulatory or day hospital. Only in especially severe cases the patient is shown hospitalization. Treatment of coxarthrosis should be comprehensive, aimed at preserving the functions of the joint.
All forms of arthrosis are accompanied by the presence of an inflammatory process. The main direction in the treatment is the removal of inflammation and the elimination of pain syndrome. To this end, it is customary to prescribe non-steroidal anti-inflammatory drugs. Medicines and the duration of the course of treatment are selected by the doctor individually. Nonsteroidal anti-inflammatory drugs effectively eliminate swelling and pain.
Medication administration requires constant medical supervision. Long-term use can cause adverse reactions and slow down the regeneration of joint tissues. Most often, side effects are observed from the gastrointestinal tract, since non-steroidal anti-inflammatory drugs can cause permanent lesions of its mucous membranes.
With severe pain, intraarticular administration of hormonal anti-inflammatory drugs is possible. Such procedures are carried out only by medical personnel as directed by the attending physician. Intraarticular injections relieve inflammation in the joint itself, in the muscles and in the tendons, which greatly enhances the therapeutic effect.
Therapy aimed at improving the blood circulation in the joint is important. With disturbed blood circulation, tissue repair processes are difficult or even impossible. It is for this reason that it is customary to prescribe vasodilator drugs with coxarthrosis of the hip joint.
It is advisable to use muscle relaxants, which not only relieve spasm and pain in muscles and tendons, but also have pronounced anti-inflammatory properties. Widely used and chondroprotectors - drugs that can slow down or completely stop the destructive processes in the joint and slow the progression of coxarthrosis. They take chondroprotectors for quite a long time. It should be borne in mind that even after discontinuation of medication for some time in the patient's body there are intensive regeneration processes.
The use of topical therapy is not a highly effective treatment because of its low bioavailability. However, the use of various warming ointments can be effective by improving blood circulation and vasodilatation when massaging the affected area.
Non-pharmacological treatment methods
Physiotherapy and exercise therapy are auxiliary therapies. Such procedures effectively improve blood circulation and muscle tone, prevent the occurrence of spasms and edema, and help strengthen the muscles.
Effective therapeutic massage, UHF, cryotherapy, laser and electrotherapy are used. Useful for coxarthrosis of the hip joint and moderate physical activity. A good help is swimming in salt water or special therapeutic baths. The combined use of these methods provides an excellent therapeutic effect. All procedures are conducted in accordance with the appointments of the attending physician, within the walls of specialized medical institutions and under the constant supervision of medical personnel.
It's no secret that the treatment of joint diseases has become a source of income for countless manual therapists. This method should be treated with extreme caution. Do not use the services of little-known healers. In this case, treatment can not only not bring the desired results, but also cause irreparable harm to your health.
Coxarthrosis of the hip joint is a very serious disease, therefore it is necessary to approach the treatment with responsibility. Symptoms and methods of therapy are very individual. You can not categorically approach the drugs that your neighbor, friend, grandmother, etc. effectively use. Coxarthrosis of the third degree is treated only surgically, with full or partial replacement of the joint. In your power to avoid such complications.
All diseases must be treated on time. Take care of yourself and be well!
Coxarthrosis of the hip joint - symptoms
Coxarthrosis is a chronic disease accompanied by a malnutrition and a gradual disruption of the cartilage tissues. This disease affects older people, while among men it occurs much more often. Coxarthrosis of the hip joint, the symptoms of which are given in the article, is characterized by a slow course and gradual progression. Therefore often at the first stages the pathology remains unnoticed.
Coxarthrosis - symptoms of
Symptoms of the disease manifest themselves gradually. Many patients prefer to struggle with pain on their own. However, taking analgesics allows you to forget about the painful sensations just for a while. The most common manifestations of the disease are as follows:
- Pain in the groin, knee, damaged joint.
- The symptom of coxarthrosis is lameness, which occurs because the patient tries to reduce the load on the limb.
- To ease the pain syndrome, many limit mobility, which leads to muscle wasting and deformation of the affected joint. Therefore, the observed shortening of the diseased leg also indicates coxarthrosis.
- As the pathology gains momentum, the patient enters a vicious circle, in which some processes influence the formation of new ones, thereby increasing the manifestation of the symptoms of coxarthrosis. Due to the fact that the patient limits the mobility of the limb, muscle is hypotrophic.
Symptoms of coxarthrosis 1 degree
At this degree of pathology, there are:
- pain in the hip joint, which can give to the knee and thigh;
- stihanie painful syndrome after rest;
- gait does not change.
Since the patient does not experience stiffness of movements, the remaining signs of coxarthrosis of the 1st degree are ignored. At the same time, the disease continues to develop.
Bony growths begin to form around the edge of the joint. There is a decrease in the joint gap, the head of the bone remains unchanged. These manifestations do not limit the mobility of a person.
Symptoms of coxarthrosis of the 2nd degree
At this stage, the symptoms intensify. Characteristic for the second degree of the disease manifestations:
- occurrence of pain at rest;
- movement is difficult, there is lameness when walking;
- weakened muscles responsible for the removal and flexion of the hip.
In fluoroscopy, the following changes are observed:
- , bone growths increase, become more prominent;
- rapid reduction of the joint space;
- increases and deforms the head of the hip bone;
- presence of cysts in the areas of the greatest joint load.
Symptoms of the 3rd degree of coxarthrosis
The third stage is characterized by such pathological processes:
- permanent pain that occurs even at night;
- restriction of mobility, as a result of which the buttock and calf muscles begin to atrophy;
- shortening of the affected limb.
X-ray shows excessive bony growth, the disappearance of the joint gap, resulting in mobility is impaired.Coxarthrosis - complications
Due to increased physical exertion, the blood supply to the cartilaginous tissue covering the surface of the joints is impaired. There is coxarthrosis of the knee joint, the symptoms of which are similar in many respects to the symptoms of coxarthrosis of the hip joint. The most obvious ones are:
- edema in the place of the affected joint;
- crunching in the lap while driving;
- acute knee pain when flexing;
- at rest, pain relief is observed;
- an increase in the knee in the volume due to inflammation occurring in the joint;
- mobility impairment.
Coxarthrosis of the hip joint: degrees, causes, signs, treatment and prevention
Coxarthrosis of the hip joint is one of the most common diseases of the musculoskeletal system. In this pathology degenerative processes occur in the hip joint. Primary and secondary coxarthrosis is isolated. During this disease, bone tissue is destroyed due to depletion of the cartilaginous connective tissue.
In this disease there are changes in the integrity of the surfaces of the joints. At the heart of these changes is a metabolic disorder. This disease proceeds slowly, gradually afflicting the cartilaginous tissues and subsequently passes into deforming coxarthrosis, which is characterized by bone reshaping and impairment in the functional capabilities of the joints. This disease is most often affected by people after 40 years.
Symptoms of the disease
Symptoms at different stages of the disease are not much different. There are common manifestations on which it is possible to learn about the onset of the development of the disease and to provide timely treatment. But often it happens that with this disease a person applies for medical care already at the advanced stages, and this significantly reduces the chances of a complete cure.
Signs of coxarthrosis:
- Severe pain in the area of the affected joint is the main sign of joint damage. In the initial stages of pain appear during motor activity, at subsequent stages the pain becomes permanent.
- Stiffness in movements appears at the initial stage, after awakening or after physical exertion.
- The length of the lower limbs changes - this symptom of the disease is the heaviest and occurs on the neglected stages( when the pelvic bones are deformed).
- At the initial stages there is a weakening of the muscles, and at the neglected stages there is an atrophy of the muscular apparatus.
- An indication of deformation of the bone system is lameness or a change in gait.
- Strong crunch in the joint area may indicate the presence of pathological changes.
If you have any symptoms, you need to contact the doctor and, after the diagnosis has passed, begin timely treatment. The diagnosis of coxarthrosis of the hip joint is made after the passed diagnosis and the delivery of all necessary tests.
What are the causes of the disease
The causes of such a pathology can be the violation of blood circulation in the area of the patient's joint. For various reasons, the human body has malfunctioning of the circulatory system, venous outflow and arterial inflow may worsen. As a result of such negative processes in the periarticular tissues, there is an accumulation of metabolic products that promote the appearance of destructive enzymes. The cause of abnormal processes in the joints can be a microtrauma, as a result of which the cartilage is thinned and damaged.
The disease can occur because of excessive stress on the joint due to physical stress or large body weight. Such factors overload the joint, causing inflammation and deformation of the joint itself. To reduce body weight in this pathology and in complex treatment, it is recommended to use an exercise bike with coxarthrosis of the hip joint.
Heredity is one of the factors in the appearance of such abnormal processes in the body. Genetically laid not the disease itself, but the structure of the cartilaginous and bony tissues in the joints. Under certain circumstances, the influence of the hereditary factor is fraught with hip joint disease.
Changes in the hormonal background can cause metabolic disorders in the human body. Hormonal imbalance can contribute to inflammation of the joints and expose tissues to disease.
Pathological processes can arise due to a sedentary lifestyle, concomitant diseases, congenital pathologies. Untimely or incorrect treatment of dysplasia, hip dislocation or other pathologies is fraught with joint disease.
In patients with coxarthrosis of the hip joint of the 1st degree, the symptoms may not be manifested for a long time. Sometimes pain can occur in the area of the affected joint after prolonged physical exertion, but they pass by themselves. At this degree, there is no lameness or weakness in the muscles. Pain passes in a state of rest. X-rays can show a slight narrowing of the articular lumen.
Coxarthrosis of the hip joint of the 2nd degree signifies more serious manifestations: the destruction of cartilaginous tissues begins. The pain increases and gives out in the groin and thigh, can occur not only after prolonged physical exertion, but also at the usual time. If you do not start therapy at this stage, the normal motor mechanism may be disrupted. The patient limps, changes gait, muscle tone decreases, morning stiffness appears.
When coxarthrosis of grade 3 appears, there is almost complete destruction of the cartilaginous tissue in the joint, a strong deformation of the joint. The pain is constantly felt, it can only be cured with the help of certain medications and for a short time. A sick person can not move without a cane or other attachments because of the joint's stiffness and limited movement. Around the joint formed edema, tissue atrophy occurs.
With the 4th degree of coxarthrosis, complete coalescence of the bones of the hip joints occurs between each other. This is the most severe form of disease. Permanent pain syndrome, severe swelling of the periarticular tissues, complete immobility of the hip joints - these are the symptoms of the last stage. In this case, a person is assigned a disability group.
Diagnosis of pathology
At the very beginning of the diagnosis, a patient is questioned, anamnesis is collected, his complaints are examined, joints are examined and palpated, and functional tests are performed.
Diagnosis is a clinical and biochemical blood test. The first analysis of the disease provokes an increase in the rate of erythrocyte sedimentation, while in the second, markers of the inflammatory process are raised: proteins, globulins, immunoglobulins, seromucoids. Such studies are indispensable diagnostics for joint damage and disorders in the locomotor apparatus.
The basis of diagnostics are instrumental methods. The method of detection of lesions of the joints remains fluoroscopy, which shows bone growth along the edges of the cartilage, a decrease in the lumen between the joints, a thinning of bone tissues( osteoporosis), a change in the structure of bone tissues. The main disadvantage of this method is that the picture shows only bones, and cartilages and articular capsules are not visible on it.
More informative diagnosis is carried out using magnetic resonance imaging or computed tomography. This technique helps to detect the manifestations of the disease in the first stages.
The main methods of treatment
With this disease, long-term, complex, multi-stage treatment is provided. The main condition for successful therapy is the timely initiation of treatment. At the initial stage, lifestyle, nutrition, and problems with blood circulation and metabolism in the joint tissues are subject to adjustment. The late and neglected stages of destructive change require a lot of effort to recover.
Therapy with the help of medications is based on symptomatic treatment: removal of pain, swelling and inflammation, normalization of blood circulation, nutrition of cartilaginous tissues, removal of muscle load.
Non-steroidal anti-inflammatory drugs( Diclofenac, Ketopofen, Indomethacin) are designed to fight the disease in the acute form of the inflammatory process. The disadvantage of such drugs is the rapid adaptation of the body to them, the independent restoration of the cartilaginous tissue may stop, side effects have a negative effect on internal organs. The most sparing drug for today is Movalis, it has the least amount of side effects and does not cause fast addiction. It is not recommended to take several anti-inflammatory drugs. If the prescribed drug is not effective, you need to change the dosage or take another remedy.
Therapy with vasoconstrictive medications( Trental, Cinnarizine, Theonikol) will help to relax the smooth muscles of the vessels and widen the lumen between them, this will ensure a normal circulation of blood. Such drugs relieve vasospasm.
Miorelaxant medications( Midokalm) are used to relieve painful muscle spasms, normalize outflow and blood flow. But they need to be taken cautiously and shortly to avoid side effects.
Chondroprotectors( chondroitin, arthra, dona) are the most useful and effective. Their task is to regenerate the structure of the cartilaginous tissue. The systematic use of such drugs is an excellent prevention of coxarthrosis and its treatment in the early stages. Regular use stops the disease in the early stages.
Hormonal intramuscular or intraarticular drugs( hydrocortisone) are used if there is no inflammation. They can be used once every two weeks.
Treatment with local remedies is not effective, as the probability of penetration through the skin, layers of muscles and fat of the necessary substances is low. If the motor activity is completely disturbed, it is possible to solve the problem operatively by using prosthetics or modeling the destroyed surfaces.
To treat the disease, therapeutic gymnastics, massage, physiotherapy( cryotherapy, mud baths, magnetotherapy, laser therapy, electrophoresis, ultrasound) are used.
A good complement to the main treatment can be traditional medicine.
You can make tinctures, ointments, compresses, decoctions. Remember, do not do self-diagnosis and self-medication. Coxarthrosis of the hip joint is a complex disease that requires timely and prolonged treatment.
Coxarthrosis - arthrosis of the hip joint. Degrees and symptoms of coxarthrosis.
There is both a lesion of one and both hip joints at once. So bilateral bilateral coxarthrosis of the hip joints is not uncommon. When the primary is very often affected knee joint and spine.
The structure of the hip joint
To gain a deeper understanding of the meaning of all measures for the treatment of coxarthrosis, you need to know a little about the structure of the joint and about the changes that occur with it when arthrosis of the hip joints .
Two joints are involved in the formation of the hip joint: the femoral and iliac bones. It is the acetabulum of the iliac bone that serves as a "pocket", into which the joint ball-shaped head of the femur is inserted. Together, the joint and the acetabulum form a hinge, thanks to which the hip joint is able to produce various rotational movements in a healthy state.
In normal state, the femoral head and the cavity of the acetabulum are covered with a layer of hyaline cartilage. The articular cartilage is a very smooth, firm and resilient "padding" that provides an ideal glide of the connecting bones relative to each other. Also, the cartilage is involved in depreciation and load distribution during walking and movement.
Ideal gliding of articulated bones is possible due to the special physiology of the cartilage. It works on the principle of a wet sponge, which during the squeezing releases water, and after compression again fills its pores with water. Only in contrast to the ordinary sponge, from the cartilage is not allocated water, and articular fluid, which has a special lubricating properties. It is the articular fluid that forms the protective film on the surface of the cartilage. The thickness of the protective film depends on the degree of stress on the joint. That is, the greater the pressure force, the larger the layer.
Filling all the free space in the joint cavity, articular synovial fluid provides nutrition and lubrication of the cartilage. The joint cavity is surrounded by a capsule, which consists of very strong and dense fibrous fibers.
A very important role for the normal functioning of the hip joint is played by the surrounding massive muscles - gluteal and femoral. If the muscles are poorly developed - the correct movement of the joints is impossible. In addition, the femoral and gluteal muscles take on a part of the load when running and walking, thus playing the role of active shock absorbers. It is thanks to very well developed muscles, the joint trauma decreases with unsuccessful movements, running, jumping or long walking.
And do not forget about another very important function of the muscles: during their intense motor work they perform the role of a kind of pump and pump through their blood vessels very large volumes of blood. It is because of this that the blood circulates better around the joint and delivers the necessary nutrients to it. Accordingly, the more perfect the work of the muscles, the more circulating blood circulates through them and the more nutrients the joint gets from the body.
Mechanism of arthrosis development
So what happens with the joint during the development of deforming coxarthrosis? At the beginning of the disease, the properties of the joint fluid change - for various reasons it becomes viscous and dense. And without proper "lubrication" articular cartilage begins to dry up, and its surface becomes rough and covered with cracks. As a result, the cartilage begins to thin, as it does not withstand increased friction during movement. And the distance between the articulating bones of the joint gradually decreases. Bones seem to be exposed from under the cartilage, the pressure on them increases and they begin to deform. That is why the disease of coxarthrosis is called deforming arthrosis of the hip joint.
In addition to changing the properties of the joint fluid, there is a violation of blood circulation and thus slows the metabolism in the joint, by reducing the circulation of blood through its vessels. Over time, the muscles of the sore leg atrophy. The whole process takes place in the body gradually. But sometimes the chronic course of the disease is accompanied by periods of severe exacerbation of joint pain, this is the so-called period of "reactive" inflammation of the joints. It is during this period that sick patients often seek medical help from a doctor.
Causes of coxarthrosis
The reasons for the appearance of this disease are in fact very many:
- a violation of blood circulation in the joint - worsening of venous outflow and arterial inflow. As a result of insufficient supply of tissues, accumulation of under-oxidized metabolic products takes place, activating enzymes that destroy cartilage;
- mechanical factors causing overload of the joint. Most often overloads are subject to professional athletes. But you can also include people with excess body weight. And since complete people are also characterized by metabolic and circulatory disorders, then in combination with overload on the joint, it is they who very often joints are affected by arthrosis;
- biochemical changes in cartilage, metabolic disorders in the human body, hormonal changes;
- trauma( pelvic fractures, cervical fractures and traumatic dislocations).It is the trauma that leads to the development of coxarthrosis of the hip joints in young people;
- aseptic necrosis of the head of the hip;
- infectious processes and inflammation of the joints;
- pathology of the spinal column( scoliosis, kyphosis) and feet( flat feet);
- congenital hip dislocation - takes about 20% of all arthroses of the hip joints;
- congenital dysplasia( joint development disorder);
- "lack of training" as a result of a sedentary lifestyle;
- predisposition and heredity of the body. Undoubtedly coxarthrosis itself is not inherited, but here the weakness of the skeleton, the features of the structure of the cartilaginous tissue and metabolism are transmitted genetically from the parents to the child. Therefore, if your parents or close relatives are ill with arthrosis, then the risk of getting a diagnosis of coxarthrosis rises.
Symptoms of coxarthrosis
General symptoms of coxarthrosis of the hip joint can be identified, but it must be understood that the symptoms depend on the stage of the disease:
- pains in the joint, thigh, inguinal region, at the knee, both under load and at rest;
- stiffness and stiffness of movements;
- the aching leg becomes shorter;
- there is an atrophy of muscles of a femur;
The main symptom of coxarthrosis and the main complaint with which patients refer to a doctor is pain. The nature, duration, intensity and localization of which depends on the stage of the disease. At the initial stage, when it is best to start treatment, joint pain is still quite weak. That's why patients do not immediately rush to see a doctor, hoping that the pain will go somehow miraculously by themselves. And this is the most important mistake, which leads to loss of time and destruction of the joint. Painful sensations begin to increase, and the mobility of the aching leg is limited. Pain appears already at the first steps and subsides only in a state of rest. The patient begins to limp, crouching when walking on a sore leg. The muscles of the thigh atrophy - shrink and decrease in volume.
The most interesting thing is that the atrophy of the hip muscles causes the pain in the knee region and in the attachment of tendons. And the intensity of pain in the knee can be much more pronounced than the femoral or inguinal. That is why very often the wrong diagnosis is made - arthrosis of the knee joint and the doctor prescribes a completely inappropriate treatment, and the present disease only progresses.
By the way, pain in the thigh and groin, can be caused in the patient not only by arthrosis. Very often pain in these areas is given from the inflamed femoral tendon or damaged spine. Moreover, the complaints of such patients almost coincide with the complaints of those people who suffer from coxarthrosis of the hip joint. Therefore, the correct diagnosis should be entrusted only to experienced doctors. Diagnosis of the degree of disease and choice of treatment is determined only by a doctor!
Degrees of coxarthrosis
There are three degrees of arthrosis of the hip joint:
For coxarthrosis of 1 degree, periodic pain that occurs after physical exertion( prolonged walking or running) is characteristic. Basically, pain concentrates in the hip joint area, rarely occurs in the thigh and knee area. Usually after rest the pain passes. The amplitude of the movements is not limited, the gait is not violated, muscle strength is not changed. If you make an x-ray at this stage, you will see slight bony growths, but they do not go beyond the joint lip. Bony growths are located around the inner or outer edge of the articular surface of the acetabulum. The cervix and the head of the femur are practically unchanged. The joint gap is unevenly narrowed.
In coxarthrosis of the 2nd degree, the pain intensifies and is more intense. In addition to pain in the joint itself, they are given to the inguinal region, thigh and arise even in a state of rest. Long walking causes lameness. Normally, the joint can no longer function. The internal rotation and hip removal are significantly limited. The muscles that remove and unbend the hip loosen their former strength. On the roentgenogram of the patient, significant bone growths are seen both on the inner and outer edges of the acetabulum, which extend beyond the boundaries of the cartilaginous lip. The head of the femur is deformed, enlarged in volume and has an uneven contour. In the most loaded parts of the head and swivel cavities, cysts are possible. The neck of the femur extends and thickens. The slit of the hip joint is unevenly narrowed( up to 1/3 - 1/4 of the initial height).The patient tends to shift the head of the hip to the top.
Pain in coxarthrosis of 3 degrees is already permanent, arising even at night. When walking, the patient must use a cane. Movement in the joint is severely limited, the muscles of the thigh, lower legs and buttocks - atrophy. Because of the weakness of the hip muscles, the pelvis tilts in the frontal plane, which leads to a shortening of the limb on the affected side. To get to the floor when walking, the patient has to step on the toes and tilt his torso on the sore side. This is how you have to compensate for the shortening of the limb and the slope of the pelvis. But the method of compensation leads to the movement of the center of gravity and to overloads on the joint. On the radiographs, extensive bony enlargements are seen from the side of the femoral head and the roof of the swivel cavity. The joint gap narrows sharply. The neck of the thigh is greatly expanded.
Deforming osteoarthrosis of the hip joint and its diagnosis
Diagnostics is based on clinical radiology data. Radiographic examination helps to establish the stage of the disease and its etiology. For example, with dysplastic coxarthrosis, flattening and slanting of the acetabulum and an increase in the neck-diaphyseal angle are clearly visible. If the disease was a consequence of juvenile epiphysiolysis or Perthes disease, then changes in the shape of the proximal end of the femur are noticeable. There is deformation of the head and the neck-diaphyseal angle decreases with the formation of coxa vara. Features of the x-ray picture of posttraumatic coxarthrosis depend on the nature of the resulting injury and the shape of the articular surfaces after the fusion of the bones forming the hip joint.
Recall once again that the complexity of the primary diagnosis is that the symptoms of arthrosis of the hip joint resemble the symptoms of the knee. But X-ray studies help to make an accurate diagnosis. It is from the correct diagnosis of the disease depends on the choice of treatment methods. More details about all possible methods of treatment of this disease, we will tell in the article - "Treatment of coxarthrosis."
And most importantly - do not make a diagnosis yourself. Only an experienced doctor can correctly diagnose and select the optimal method of treatment.
Coxarthrosis - deforming arthrosis of the hip joint. The most common disease in the field of degenerative-dystrophic diseases of the musculoskeletal system. The hip joint, one of the largest joints of the human body, carries a tremendous strain throughout the life of a person: body weight, slopes, lifts, increased exercise and weight, all this falls on the hip joint. Despite the fact that in this area there are some of the most powerful tendons and muscles, the head of the hip joint itself is poorly supplied with blood, and with age it undergoes destruction of bone tissue - osteoporosis.
Diseases are susceptible to all categories of people, except children. But most often the disease occurs in men and women after 35-40 years, and women suffer the disease is much harder, in view of their greater propensity to osteoporosis. The disease can be localized, both on one side, and symmetrically on both sides.
Types and causes of the disease
Different types of coxarthrosis are determined by the causes that cause the disease. There are 7 types of the disease:
- Involute coxarthrosis occurs as a result of age-related changes in cartilage and joint.
- Coxarthrosis developing as a complication of Perthes' disease .As a result, there is osteochondropathy( necrosis of spongy tissue) of the head of the femur.
- Dysplastic coxarthrosis , that is, congenital malformation of the joint. It occurs in 75% of cases, and 6 times more often in women. In every tenth case, the blame for the disease is a congenital subluxation of the femoral head( dysplasia).
- Post-infectious coxarthrosis , arises as a complication after arthritis. This changes the composition of the cartilaginous tissue and joint fluid, which leads to a decrease in the strength of the articular cartilage.
- Post-traumatic coxarthrosis .Direct injuries are caused to him - fractures of the head and neck of the thigh and microtrauma, appearing with a constant incorrect load on the hip joint. Microtraumas are especially dangerous because, accumulating, they lead to destruction of articular cartilage and adjacent bone.
- Dyshormonal coxarthrosis .The risk group includes people taking corticosteroids and antidepressants, as well as people with diabetes mellitus, osteoporosis and other hormonal disorders that lead to a decrease in the mechanical properties of the bone tissue of the joint.
- Idiopathic coxarthrosis of .The diagnosis is made if the cause of the disease is not known.
This classification gives us to understand that the main causes of the disease are excessive loads on the hip joint, especially for professional athletes, arthritis, various hormonal disorders. In addition, a certain role is played by the hereditary factor, since from parents we get features of the structure of bone and cartilaginous tissues, as well as metabolism, which under certain circumstances can serve as a catalyst for the development of the disease.
Another possible cause of coxarthrosis is chronic stress. The fact is that with constant nervous tension, the adrenal glands begin to release an excessive amount of corticosteroid hormones, which leads to a decrease in the production of hyaluronic acid, which is an important component of the joint lubricant. Due to lack of fluid in the joints, drying begins, excessive friction of the joints, which leads to various joint injuries. Moreover, "stress hormones" reduce the permeability of capillaries thereby worsening the blood supply of the joint.
disease development The main signs of coxarthrosis are pain, gait disturbance and the inability to perform some familiar movements: slopes, sit-ups, getting up from the chair, actually those movements where there is a load on the hip joint. At the onset of the disease, pain may not disturb and appear at later stages. The pain inherent in this disease is felt in the surface of the thigh and reaches the knee, in rare cases to the middle of the shin. The first sign of the appearance of problems in the hip joint is the restriction of the rotational movements of the joint.
There are three stages of the disease:
- It is difficult to feel the disease at an early stage. The gait is not broken yet, the muscle tone is in order, the movements of the joint are not constrained. Pain in the thigh may appear after physical exertion, but it passes after rest. You can detect coxarthrosis on X-rays. The joint gap will be slightly unevenly narrowed, and on the outer and inner edges of the articular surface of the acetabulum, mild bony growths are usually seen.
- In the second stage, the function of the joint is impaired. After walking or running, there is lameness, pain in the thigh and groin area, can arise at rest. In the joint, the amplitude of movements is disturbed, the patient feels stiffness. In the femoral muscles, hypotension and hypotrophy occur. X-rays show strong stagnant growths that extend beyond the cartilaginous lip. The head of the femur is deformed, cysts can form in the places of greatest stress. The joint gap is unevenly narrowed, and the neck of the femur, on the contrary, widens.
- The third stage is characterized by a sharp restriction of movement in the entire joint. Pain becomes permanent, rest does not bring relief. Moving becomes possible only with auxiliary means. There is atrophy of the femoral and gluteal muscles. In connection with the weakness of the femoral muscles, there is a constant frontal incline of the pelvis, which leads to a functional shortening of the limb. The patient has to tilt the pelvis in the direction of the affected hip, which leads to a shift in the center of gravity and an additional uneven load on the affected joint. X-ray photographs show extensive stagnant growths and a sharp narrowing of the joint space. The neck of the femur is greatly shortened and enlarged.
Treatment of coxarthrosis with conservative methods
Because osteoarthritis is not completely cured, treatment is symptomatic. The purposes of such treatment are: to stop the development of the disease, to prevent complications, to restore the mobility of the joint and to relieve the patient physical discomfort.
The main directions in the treatment of the disease: the removal of the pain syndrome, strengthening the muscles in the hip area and reducing the load on the joint, as well as the treatment of articular cartilage defects. Treatment is complex, depending on the stage of the disease.
First of all, medications are prescribed that relieve pain and inflammation in the joint. Most often non-steroid drugs are prescribed. It is important to remember that you can not drink such drugs for a long time, because they have serious contraindications, and they can give additional complications. Analgetics have a different problem, they create a deceptive impression that the disease recedes, whereas the destruction of the joint is still happening.
preparations for the restoration of cartilaginous tissue are most often prescribed. They contribute to the improvement of the quality of cartilaginous tissue and interarticulate fluid, which greatly facilitates the work of the joint. It is important to remember that such drugs work on a funded basis and, possibly, several courses of admission that will take more than a year. Such drugs can help only in the first two stages of the disease.
The next group of drugs prescribed for coxarthrosis, muscle relaxants .These are medicines designed to relieve muscle spasm. They can only be applied by removing the load from the joint with crutches or walking stick, as the muscle spasm protects the joint. Having removed a spasm and, having left a load, you will strengthen the progression of the disease at times. If you have chosen a cane as support, keep it in your hand on the healthy side.
Restoration of blood circulation in the affected joint will help vasodilator preparations .They also relieve spasm of small capillaries in the inflamed area.
Various types of physiotherapy are used to improve blood circulation and relieve muscle spasm: electrophoresis, cryotherapy, laser therapy. With the help of manual therapy, the joint is stretched, which for some time reduces the load on the articular cartilage.
physiotherapy and gymnastics are well established. They can be done, both in polyclinics, and at home. Physical training increases the endurance of the muscles that support the joint and relieve the load. Exercises should be with the movement of the joint in a painless amplitude, and also to strengthen the muscles of the back and abdominal press. They are lying on their back and stomach with their feet raised with a sick joint in different directions. It is very useful for patients with coxarthrosis swimming in the pool. A strong muscular corset, in the borderline inflammation zones, can help develop compensatory mechanisms even at the last stage of the disease. It is very important to constantly monitor the correct unloading of the joint.
If the treatment does not help and the disease progresses, operative joint replacement surgery - hip joint replacement .In this case, the joint end of the femur and the acetabulum are replaced with a metal implant, and the femoral head is made of another material. Slip in the joint is provided with a polyethylene gasket. More specific methods and materials are chosen by the doctor, depending on the extent of the lesion, age and concomitant diseases. After the operation, pain, as a rule, goes away, and motor abilities are restored. But such movements as squats, cross legs, strong slopes are not recommended. Some time after the operation should continue to use a cane and not wear shoes with heels.
Surgical intervention can be avoided by contacting a doctor on time.
Auxiliary treatment with traditional medicine
It should be remembered that coxarthrosis is a serious disease, and only with the help of traditional medicine it can not be cured. But with its help, you can reduce the number of medications taken, and strengthen the body and help him overcome the disease. The proposed remedies carry symptomatic treatment and pain relief. They can be used together with drug treatment, after consulting with the doctor in charge. Consultation with a doctor is necessary because the substances contained in the plants may be incompatible with the medicines that you are taking for one reason or another.
Coxarthrosis, a disease that is accompanied by constant pain. To reduce the pain, phytotherapy will help you. But remember that by getting rid of the pain, you do not get rid of the disease.
- An analgesic ointment is prepared from 100 ml of fresh honey, 100 g, grated, turnips and 50 ml of vodka. Ready to apply ointment massaging movements on the affected thigh thrice a day. After massage with ointment the thigh should be warm. Ointment can be stored in the refrigerator.
- Infusion of young leaves of lilac. To do this, you need 50 grams of crushed lilac leaves and 500 ml of vodka. The infusion is prepared for 10 days in a dark place. Then it is filtered. Take 50 drops before eating.
- Compress from cabbage leaves with honey has not only an analgesic, but also anti-inflammatory effect. Leaves smeared with honey are applied in the area of the affected joint. It is necessary to put polyethylene and woolen scarf on top. The compress is left overnight.
- The bay oil, rubbed into the thigh, will also ease the pain and improve blood circulation.
To improve blood circulation in the area of the affected joint, massage with fir oil or tea tree oil, as well as bee venom, is used.
There are special collections of herbs that prevent the destruction of cartilaginous tissue and relieve inflammation in the joint area. Take them for about a year, and possibly more.
- Calendula, buckthorn bark, elderberry flowers, juniper fruit, field horsetail, birch leaves and willow bark are taken in equal parts. A liter of boiling water is taken two tablespoons of collection. The night is nurtured. Are accepted on a half-glass 5 times a day.
- Take 2 parts of the root of the Kalgan, 3 parts of the root of elecampane, 2 parts of the yarrow and flax seeds and 5 parts of the string. Two tablespoons of the collection are poured with a liter of boiling water, insisted and taken half a cup 5 times a day.
- To collect are taken on 3 parts of chamomile flowers and birch buds, 2 parts of nettle, poplar bud and root of elecampane, one part of lime flowers, mint and dill seeds. Pour two tablespoons of the collection with a liter of boiling water. Take half a glass 5 times a day.
Co-quartz and turpentine baths help. They contribute to increased blood circulation, the opening of capillaries and the reduction of smooth muscles.
Coxarthrosis is a serious disease of the hip joints. Like any complex disease, it needs timely, comprehensive treatment. Perhaps the treatment will take a long time, it is important not to give up and throw it halfway. And then health will definitely return to you
Material from the site: http: //nmedik.org/ - Coxarthrosis