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