"What to do? "- men and women ask themselves when they have 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, what other pathologies it occurs in, and how to treat it.
Osteoarthrosis of the hip joint (coxarthrosis)- degenerative-dystrophic disease. It often appears in people after 40 years of age, often as a result of injury, but usually begins 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, in order to restore normal function of the joint, in certain cases it is necessary to undergo surgery to replace the joint.
Many people suffer from coxarthrosis: this fact is due to the fact that the load on the hip joint is usually large. In women, this condition occurs somewhat more often.
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 that affect blood circulation, metabolism and hormonal balance, and pathology of the musculoskeletal system (for example, 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 parts mentioned rub against each other.
To prevent them from being damaged in the process, they are covered with elastic cartilage, and joint fluid is secreted there, which plays the role of a lubricant. This happens in a healthy person. The hip joint essentially works like a hinge.
When a person has coxarthrosis, the joint fluid becomes thicker, and the cartilage becomes less elastic, cracks appear on it. As a result, the surfaces of the ilium and femur are less protected during friction and are more easily abraded and damaged. As a result, over time they begin to change their shape.
Symptoms of osteoarthritis of the hip joint
Among the main signs of this condition are pain. They are localized in the area of the joint itself, as well as in the groin, at the top 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), then he does not succeed fully;
- the gait becomes different from what it usually is in a healthy person, the patient limps;
- decreased leg muscle mass;
- the affected leg becomes shorter.
Early stage of osteoarthritis of the hip joint
At an early stage of the development of the disease, pain occurs sometimes, periodically, mainly after physical exertion. For example, after a person has run or taken a long walk. The sensations are concentrated where the hip joint itself is, sometimes in the upper part of the leg or even in the knee. When a person rests, the pain usually subsides. Walking remains normal at this stage. The person can move his leg freely, the muscles are fine.
An X-ray examination reveals that the joint space is narrowed, but not yet so much. Where the edges of the acetabulum are, bone spurs can be identified. At this stage, the head and neck of the femur are unchanged.
Progression
At the next stage, the person suffers more from pain that occurs both during physical activity and at rest. They are strong, they go to the thigh, to the groin. After trying to run, a person may limp, just like after a walk. Moving your leg laterally becomes more difficult and your 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 of osteoarthritis of the hip joint
Here the person already suffers from constant severe pain. They can occur not only during the day when resting, but also at night. It becomes difficult for the patient to walk, so he purchases a cane. Moving your leg becomes even more difficult than before. At this stage, atrophy of the muscles of the legs and buttocks often occurs, which leads to the affected leg becoming shorter. To make it easier to walk, a person leans to the side, and this increases the load on the large joint even more.
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, is x-rays.
On radiographs, 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 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 throughout the entire upper part of the leg.
This means that if such symptoms occur, the doctor must first rule out the following pathologies:
- osteochondrosis (since it also causes pain in the upper part of the leg);
- osteoarthritis of the knee joint (it manifests itself as pain in the knee).
The pain syndrome caused by osteochondrosis differs from that caused by osteoarthritis of the hip joint. With osteochondrosis, 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.
With osteochondrosis, even if the pain is severe, a person can move his leg to the left or right. But with coxarthrosis - not always.
With osteoarthritis of the knee joint, pathological changes are detected on the x-ray of the knee joint.
It should be remembered that one person can have several diseases at once. For example, osteoarthritis of both the knee and hip joints. Or osteochondrosis and osteoarthrosis of several 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 Trochanter major (trochanter major) - the greater trochanter. Trochanteritis occurs rapidly, compared to osteoarthritis, the pain is stronger, and a person can move his leg freely.
In some cases, with pain that makes one suspect osteoarthritis of the hip joint, some other condition is present (for example, ankylosing spondylitis, known as ankylosing spondylitis, etc. ). With them, as a rule, pain occurs at night, goes away during the day, and can even decrease with physical activity.
Treatment of coxarthrosis
If you have joint pain, you should go to an orthopedic traumatologist.
Treatment includes conservative therapy (medicines, physical therapy) and surgery.
Conservative therapy
Conservative treatment is prescribed in the early stages.
This includes:
- ordinary painkillers that a person drinks in tablets or takes in injections (injections), ointments;
- hormones injected into the joint;
- agents that restore the structure of cartilage (they are also taken orally and injected into the joint);
- other medications prescribed by a doctor, depending on the patient’s condition. These include drugs that relax muscles, dilate blood vessels, etc.
All medications must be taken strictly as prescribed by the doctor. This is especially true for conventional painkillers: with prolonged use, they can have a bad 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 in the treatment of 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, light therapy, and a number of other methods are used.
The therapy uses physical therapy (physical therapy) and massage.
It’s worth saying a few words about diet. It does not directly treat osteoarthritis of the hip. However, when a person weighs less, the load on the joint is reduced, which makes the disease easier.
Surgical treatment of osteoarthritis of the hip joint
When the disease has already reached the advanced stages, the really "working" method is surgery, when the diseased joint is replaced with an artificial one. It's called endoprosthetics.
Different parts of the joint can change. For example, only the head of the femur. This is a unipolar prosthesis. When both the femoral head and the acetabulum are replaced, such a prosthesis is called bipolar.
Endoprosthesis replacement is done under general anesthesia. The person is first thoroughly examined. After surgery, antibiotic therapy and anticoagulants are prescribed. The sutures are removed from the tenth to the twelfth day, and then the person is transferred under the supervision of a doctor at a clinic or medical center, where care is provided on an outpatient basis.
After the operation, the person is prescribed a set of rehabilitation measures.
In ninety-five percent of cases, after surgery, a 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 get a long-term therapeutic effect.