Treatment of coxarthrosis of the hip joint without surgery

How to cure arthrosis of the hip( coxarthrosis): advice to the patient

Coxarthrosis, or osteoarthrosis of the hip joint is a chronic disease in which the cartilage tissue of this joint is destroyed.

There are currently no medicines that would completely cure arthrosis, but there are different procedures and preparations, the regular use of which can significantly stop the development of this disease and reduce pain in the joints.

Non-drug treatments
drugs in
coxarthrosis Analgesics
Local treatment
Medicines that improve joint nutrition( hondroprotektory)
Surgical treatments
Arthroscopic debridment
Periarticular osteotomy
Video endoprosthesis
Treatment folk remedies

Coxarthrosis and methods of its treatment

Non-drug therapies

Because of the high load on the hipbecoming stronger the disease progresses, one of the most important methods of treatment of osteoarthritis 1 and 2 degrees, as well as the prevention of the disease - to minimize the burden on the affected joint. To do this, reduce the amount of time spent standing, and use any opportunity to sit. It is especially important to follow this rule during business hours, because it is at this time that most people have peak loads on their feet.

If necessary, use a walking stick for walking. If you know that during the trip somewhere you may have to stand a lot, do not be too lazy and take with you a folding highchair.

In addition, for the same purpose it is important to limit the wearing of weights. If you can not get rid of such a load, try to at least distribute the load on both hands equally, so that this load is symmetrical and not so large.

At the same time, a complete lack of loads on the joint is also not very useful. It is necessary to find the golden mean between the useful physical load and the load, when the joint is already beginning to be injured. For this purpose, it is recommended to undergo medical therapy exercises and physiotherapy exercises in parallel with medical treatment.


The effect of drugs on the course of the disease can be divided into several large groups: painkillers, chondroprotectors, muscle relaxants and others.

Medications for osteoarthritis are particularly effective in the first and second stages of the disease, when painful changes in cartilage have not gone too far.


Anesthetics should be prescribed by a physician

Painkillers should be prescribed by a doctor

Drugs of this group reduce pain in the joints. These include a group of drugs called non-steroidal anti-inflammatory drugs( NSAIDs), which include drugs such as indomethacin, paracetamol, diclofenac, etc.

Usually, drug treatment begins with the appointment of paracetamol in medium and high doses. Part of the patients, especially at the earliest stages of the disease, this is enough for the disappearance of pain.

If paracetamol does not help, indomethacin, diclofenac or aceclofenac( aeralt) is prescribed. These drugs have potent anti-pain activity, but it is important to remember that they can have an adverse effect on the gastric mucosa, causing the formation of gastritis and even ulcers of the mucosa. Therefore, these medicines can not be drunk for a long time, they should be taken at the doctor's prescription and under strict supervision, especially in people who have stomach problems in the form of a stomach ulcer or duodenal ulcer.

In addition, drugs from the NSAID group may differ in their effect on metabolic processes in the cartilage - some of them worsen, others do not, and others can improve, which increases the value of their use. To drugs that improve metabolic processes in cartilage, include indomethacin and aceclofenac.

Local treatment

Drugs from the group of non-steroidal anti-inflammatory drugs can be taken not only in the form of tablets: they can be applied topically, but without side effects for the whole organism. Such medicines include ointments and gels: voltaren-emulgel, diclofenac-ointment, DIP-Relief, butadione, fast-gel and others.

In cases where the use of NSAIDs and other analgesics does not help, a method of treatment such as intra-articular corticosteroids( intra-articular blockade of the joint) can be used when injections such as Kenalog, hydrocortisone, diprospan, etc. are injected into the joint area. This method allows not only to reduce pain, but also to slow the development of the disease and to facilitate the treatment of deforming arthrosis of the hip joint.

Drugs that improve joint nutrition( chondroprotectors)

In recent years, preparations have been synthesized that can improve cartilage nutrition in affected joints. With coxarthrosis, the destruction of cartilage is faster than their recovery, and the function of the chondroprotectors is that they bring to the joints building elements to strengthen the cartilage, thereby "helping" the cartilage cells in their work.

Chondroprotectors include such drugs as chondroitin sulfate, diacerein or artrodarin( this is a completely new drug for coxarthrosis therapy), hyaluronic acid, glucosamine sulfate, arthra, dona and others. The use of these chondroprotectors is one of the most important elements in the treatment of a disease without surgery. However, it is important to remember that these medications are slow-acting: for a distinct effect they need to be taken for several months, usually from 6 months to 1 year. In addition, chondroprotectors give good results of treatment only in the early stages of the disease.


In addition to medicines, a good effect in the treatment of arthrosis is given by various physiotherapeutic procedures. These include local laser therapy on the joint area, acupuncture, therapeutic baths, mud treatment and other methods. You can learn more about them in the article physiotherapeutic treatment of arthrosis.

Surgical treatment methods

In situations where the above methods do not help or do not help enough, surgery is shown - that is, surgical treatment of coxarthrosis.

Arthroscopic debridement

surgical methods of treatment are effective in advanced stages

Surgical treatment methods are effective in advanced stages of

This surgical procedure is performed only in the early stages of development of coxarthrosis. Its essence lies in the fact that the doctor with the help of an arthroscope - a special apparatus for joint operations - removes from the hip joint small fractured cartilage particles that, when floating in the synovial fluid in the joint, injure him and increase pain.

Thanks to this "cleaning" it is possible to reduce pain in the joint and reduce stiffness in it. However, this manipulation usually gives a temporary effect( which usually lasts 1-2 years) and is not carried out in the late stages of the disease.

Periarticular osteotomy

The essence of this more complex and time-consuming operation is that the femur is filed in several places, and then reconnected in such a way that the angle of bones in the joint with respect to each other varies by several degrees. This changes the points of the main loads on the joint, as a result of which it is partially "unloaded", which reduces pain and slows the progression of coxarthrosis.

Such an operation in the treatment of this disease can give a good effect( a significant reduction in pain for a period of 5 years), but preparation for such manipulation and rehabilitation after it is quite serious: recovery after osteotomy can take 4 to 6 months.


In those cases when the progression of the disease is so great that the joint has almost ceased to work and the pain in it is no longer removed by medication, the operation of hip replacement is indicated. Its essence lies in the fact that the affected joint is replaced by an artificial joint, made of special metal, special high-strength plastic or ceramic.

Thanks to this operation, it is possible to reduce pain in the joint completely or significantly. In addition, the patient is able to walk back and relatively freely perform movements in the joint, which due to arthrosis for many years was impossible.

Endoprosthetics of the hip joint - the main way to treat deforming arthrosis of the 3rd degree.

The lifespan of endoprostheses is quite large and amounts to 20 and more years of service.

We offer you to watch an interesting and informative video about endoprosthetics:

Treatment with folk remedies

Drug treatment of the disease and observation by a doctor can be combined with the use of various folk methods to reduce the symptoms of this ailment. There are many centuries of decoctions, ointments, lapping and means for applying compresses that can relieve joint pain. You can find out more about these methods of treating traditional arthrosis in this article.

Remember: the earlier treatment is started, the more the doctor has the ability to stop the progression of the disease and reduce pain. Therefore, when there are painful sensations in the hip joint and other symptoms of coxarthrosis, without delaying, seek qualified help from a doctor-arthrologist!

Coxarthrosis of 3rd degree

Coxarthrosis of 3rd degree

Coxarthrosis is a deforming arthrosis of the hip joint. Coxarthrosis of the third degree is the latest stage of the development of the disease, in which there is almost complete thinning of the articular cartilage, the absence of synovial fluid and damage to the entire structure of the joint, which is accompanied by severe pain and severe limitation of mobility.

Treatment of coxarthrosis of the 3rd degree without surgery

Conservative treatment of the disease( without surgery) includes a set of measures to reduce inflammation and repair of cartilage joint tissue:

  1. The administration of non-steroidal anti-inflammatory drugs in tablets or as injections.
  2. Given that pain with coxarthrosis 3 degrees is usually permanent and strong enough, at the initial stage of treatment of non-steroidal anti-inflammatory drugs for anesthesia may not be enough. In this case, additional painkillers are prescribed or complex treatment, including both injections and taking of tablets, as well as the use of special ointments with anti-inflammatory and analgesic effect.
  3. In the case of severe inflammation affecting the ligaments, intra-articular injections of corticosteroids are performed.
  4. Reception of chondroprotectors.
  5. Reception of muscle relaxants and vasodilators.
  6. Regular sessions of physiotherapy to improve joint mobility.

Surgical treatment of grade 3 coxarthrosis

At this stage of the disease, conservative treatment is often ineffective and in most cases surgery is required.

The operation, depending on the degree of damage to the joints, can be of three types:

  1. Artoplasty. The most sparing version of surgical treatment. Restoration of the joint function is carried out by restoring its surface, restoring interarticulate cartilage and linings, replacing them or Treatment of coxarthrosis of 3 degree with pads from the patient's tissue, or implants from a special artificial material.
  2. Endoprosthetics. Radical version of the artoplasty, which replaces the damaged joint or its part with a special prosthesis. The prosthesis is implanted in the bone and completely repeats the functions of a normal joint.
  3. Artrodes. An operation in which the joint is fixed and completely lost its mobility. It is used only in cases when other methods of treatment are ineffective, since a complete restoration of the motor function after such an operation is impossible.

Treatment of the pathology of the hip joint is designed to solve several problems:

  • relieve pain syndrome;
  • to restore the circulatory system in the joint itself and in adjacent tissues;
  • to provide restoration of cartilaginous tissue;
  • to relieve the joint at the time of recovery;
  • strengthen the adjacent muscular apparatus;
  • remove the restriction of mobility.

Treatment requires complex measures and a long time. In addition, a sufficiently high level of treating specialists is needed. Therapeutic treatment of painful manifestations in the hip joint is carried out in a complex, with the use of different groups of drugs.

Anti-inflammatory non-steroid preparations

This is a broad group of drugs that suppress inflammatory processes, which indirectly leads to a reduction in the pain syndrome. It includes Diclofenac, Piroxicam, Indomethacin, Otrofen and others. Preparations of this group effectively relieve pain, and their use is completely justified in the case of an acute process. They suppress inflammation, but articular arthritis itself and arthrosis do not cure. That is, the disease progresses, the patient is tied to non-hormonal anti-inflammatory drugs and can not stop taking them, as the pain returns with renewed vigor.

These drugs, intended for long-term use, have harmful effects on the mucous tissues, which leads to ulceration of the stomach and limits the possibility of their use. There is evidence that with prolonged use, anti-inflammatory non-steroid drugs suppress the synthesis of proteoglycans, which leads to dehydration of the cartilage tissue and its destruction.

A good alternative to non-steroids in the case when the treatment of hip joints requires the continued use of anti-inflammatory drugs are selective agents( Movalis).They do not have such negative side effects, do not affect cartilaginous tissues and without complications allow long-term courses.


The most useful drug group, because it nourishes and restores the cartilage tissue of the joint itself. Treatment of coxarthrosis using chondroprotectors allows not only to remove painful symptoms, but also to influence the cause of the disease. The restoration of the cartilaginous tissue begins and the development of joint fluid is normalized.

This effect on articular tissues is effective in the first stage of coxarthrosis and, to a lesser extent, in the second stage. For the third stage of the disease, when the cartilage tissue of the joint is practically destroyed, the use of chondroprotectors is ineffective. Getting rid of coxarthrosis without an operation is a long process and, if successful, will require 1-1.5 years. A long period is needed to restore the cartilage tissue of the joint, which can not happen quickly.

As an element of complex therapy, the use of

chondoprotectors is prescribed. Therefore, the advertising of chondroprotectors, promising rapid healing, does more harm than good. Applying an advertised drug and not having received the promised cure at unrealistic times, the patient loses faith both in favor of chondroprotectors, and in the possibility of cure without surgery. Chondroprotectors are a group of drugs that repair the cartilaginous tissue of the joints. Both praise and criticism of drugs from the TV screen cause bewilderment - doctors should treat diseases, and not commercial programs.

Prescribes the use of chondroprotectors in the complex treatment of coxarthrosis by the attending physician. It should be ready for a long process - from 90 to 150 days a year for 2-3 years. The most commonly used drugs are:

  1. "Artra"( USA);
  2. "Hondrolon", "Elbona" ​​(Russia).

Muscle relaxants

Arthritis and arthrosis of the hip joints are often accompanied by painful muscle spasms. This problem has been successfully removed by muscle relaxant drugs( "Sirdalud", "Midokalm").They help improve blood circulation in the area of ​​the affected joint.

At the same time, caution should be exercised towards muscular blockade. Perhaps this is the result of protecting the body's function, protecting the joint from destruction. Therefore, the treatment of coxarthrosis of the hip joint is complex, and muscle relaxants are used in conjunction with chondroprotectors and physioprocedures. As an independent treatment of joints, muscle relaxants are not used.

Injection of drugs directly into the joint

Treatment of coxarthrosis without surgery by the method of administering the drug directly into the cavity of the joint bag. Similarly, the introduction of hyaluronic acid preparations( Synvisc, Ostenil, Hyastat, Duralan) is advisable, which is an artificial analogue of the joint fluid.

Introduction of the drug directly into the joint bag is very effective in the treatment of coxarthrosis and is limited only by the complexity of the process itself. The doctor must inject the medication through the inguinal area into the joint through a narrow articular space. This can only be done by an experienced technician, the process is controlled by a tomograph or an X-ray machine.

Methods of manual therapy and massage

Treatment without surgery using manual therapy is performed either by mobilization or by manipulation. The first is a soft stretching of the hip joint, the process is multi-stage and long, the second - a sharp jerk, immediately bringing relief. Regardless of the method of manipulation, treatment of coxarthrosis should be carried out in conjunction with traditional therapy and under the supervision of the attending physician.

is used as an adjunct. As an auxiliary method, a therapeutic massage can be used in the complex treatment of coxarthrosis. Application of the method is limited to the first or second stages of coxarthrosis and is effective enough to improve blood supply, increase the elasticity of ligamentous and muscular apparatus.

In the process of massage there should be no pain, the patient should feel only the warmth and relaxed state. However, it should be remembered that therapeutic massage has its contraindications.and before use it is necessary to consult with your doctor.

Treatment and prophylactic gymnastics

It is difficult to overestimate the importance of gymnastics in coxorthoresis of the hip joint. Treatment will lose half of its effectiveness without using special exercises for joints. This is the most effective method used to strengthen the muscular system and the vascular system.

Special exercises for arthrosis joints are performed under the supervision of a doctor( at least initially).They need to be carried out in the same volume and method of implementation as prescribed by the physiotherapist. The result will appear only after a month, but it will be a tangible improvement in the condition.

Treatment of coxarthrosis of the hip joint - part two

In advanced stages, the treatment of coxarthrosis of the hip joint means surgery for joint endoprosthetics.


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.


Posttraumatic arthrosis of the knee joint is described here.

Symptoms of hip dysplasia http: // 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 exercise. 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 lesions are not yet very significant, then the following complex of exercises with coxarthrosis can be recommended.

Lying on your back, bend your knee 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 most 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 for 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.


Therapeutic gymnastics

Coxarthrosis is treated difficultly and multifaceted, with a whole complex of measures and measures. Therapeutic gymnastics is an important addition to traditional treatment.

Exercises with coxarthroses are specific:

  • 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 medical 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 rocking the pelvis - all this can worsen the patient's condition.
  • The complex of exercises of medical gymnastics with coxarthrosis and 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.

Starting 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 waist. 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 waist."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 your stomach

Exercise 8. Hands on the hips. 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 the 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, do a smooth flailing with a sick leg back and forth. 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 against 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 traumatizing 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-cartrose has not been scientifically proven, but it is assumed, as the joint loses moisture and becomes "dry" in the course of the disease. 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 the 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 can provide the body with 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 vasodilator 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.



For total endoprosthetics, 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, which is fixed with bone cement or screws.

With partial arthroplasty, 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.


Since all people are different, with different sizes and complexes, all the 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.

Thus, for an 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 is made of metal. This combination allows you to greatly increase the life of the endoprosthesis.

And if the operation is carried out 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( injections in the joint) with coxarthrosis are used rarely, because even a healthy hip joint has a narrow articular gap 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's 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, we must remember that such procedures are conducted no more than once in 2 weeks, and the total number of injections should not exceed five to seven per affected area, one joint.

Much more often, and most importantly, it is possible to carry out 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).


Medication treatment

Drug 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 with coxarthrosis, relieve swelling and inflammation of the joint, thereby relieving pain.

Muscle relaxants relieve muscle spasm, 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.



In the 1 st and 2 nd stages of coxarthrosis treatment can be carried out in polyclinic conditions with the use of physiotherapy: shock wave therapy, general magnetotherapy, pulsed 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 application 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.

Rotation of

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 tree sitting

Sit on the floor, stretch 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 the gait of patients with coxarthrosis is that practically all the elements of normal walking of adults 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 smallest durability of the implant is observed in young men 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. ...


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