"What to do? " - men and women ask themselves when they have pain in the hip joint. One of the most common causes of these symptoms is osteoarthritis. In the article we will tell you why the hip joint hurts in men or women when walking and resting, where the pain goes, what other pathologies occur, 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 usually begins for no apparent reason.
The disease is characterized by a slow and gradually progressive course. In the early stages, conservative treatment methods (drugs, physiotherapy) are often used. However, at the next stage, to restore the 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 quite often.
Factors that can 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 engaged in sports and those who are obese. Other risk factors include diseases that affect blood circulation, metabolism and hormonal balance, and pathologies of the musculoskeletal system (eg, legs, 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:
- ilium, which has an acetabulum;
- femoral, which has a head. Doctors call the femur bone short.
These two parts of the bone 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, and joint fluid is secreted there, which plays the role of a lubricant. This happens in healthy people. The hip joint basically 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 surface of the ilium and femur is less protected during friction and is more easily abraded and damaged. As a result, over time they begin to change shape.
Symptoms of osteoarthritis of the hip joint
One of the main symptoms of this condition is pain. They are localized in the area 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 coxarthrosis of the right side) or to the left (when the joint on the left side is affected), then he does not succeed completely;
- gait becomes different from what normally occurs in healthy people, lame patients;
- reduce leg muscle mass;
- the affected leg becomes shorter.
Early stages of osteoarthritis of the hip joint
In the early stages of the development of the disease, pain sometimes occurs, periodically, especially after doing physical exercise. For example, after a person runs or walks a long distance. The sensation is concentrated where the hip joint itself is, sometimes at the top of the leg or even at the knee. When a person rests, the pain usually decreases. Walking remains normal at this stage. The person can move his legs freely, his muscles are fine.
An X-ray examination revealed that the joint space was narrowing, but not by much. Where the edge of the acetabulum is, a bone spur can be identified. At this stage, the head and neck of the femur do not change.
Progress
In the next stage, the person suffers more from pain that occurs during physical activity and during rest. They are strong, they go to the thigh, to the groin. After trying to run, a person may faint, just like after walking. Moving your legs laterally becomes more difficult and your range of motion is limited.
X-ray examination shows that the joint space is narrowed, and strong. Images reveal displacement and distortion of the femoral head. Bone growth is visible in the acetabulum area.
End stage osteoarthritis of the hip joint
Here the person is already in constant severe pain. They can occur not only during the day when resting, but also at night. It became difficult for the patient to walk, so he bought a cane. Moving your legs becomes more difficult than before. At this stage, leg and buttock muscle atrophy often occurs, leading to the affected leg becoming shorter. To facilitate walking, a person leans to the side, and this increases the load on the large joints even more.
X-ray examination at this stage can see that the joint space is very narrow, the head of the femur is enlarged, and there is a lot of bone growth.
Diagnosis of osteoarthritis of the hip joint
It is conducted through a comprehensive exam, which includes:
- interrogation of the patient by the doctor;
- examination by a doctor;
- additional study, the main one, of course, is x-ray.
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 the changes in the bones, and with the second, you can study what happens to the soft tissues.
Can osteoarthritis of the hip joint be confused?
We wrote above that pain with coxarthrosis can occur not only in the hip joint, but also in the knee, and throughout the upper part of the leg.
This means that if such symptoms occur, the doctor must first rule out the following pathologies:
- osteochondrosis (because 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 is different from that caused by osteoarthritis of the hip joint. With osteochondrosis, pain appears suddenly and is most often provoked by something: for example, a person suddenly turns or lifts something heavy. In this case, the pain, as a rule, spreads from the back 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.
Keep in mind that a person can have several diseases at once. For example, osteoarthritis of both knee and hip joints. Or osteochondrosis and osteoarthrosis of some 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) - greater trochanter. Trochanteritis occurs quickly, 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, there are several other conditions (for example, ankylosing spondylitis, known as ankylosing spondylitis, etc. ). With them, as a rule, the pain occurs at night, disappears during the day, and can also decrease with physical activity.
Treatment of coxarthrosis
If you have joint pain, you should go to an orthopedic traumatologist.
Treatment includes conservative therapy (drugs, physical therapy) and surgery.
Conservative therapy
Conservative treatment is prescribed at the initial stage.
This includes:
- common painkillers that a person takes in tablets or takes injections (injections), ointments;
- hormones are injected into the joint;
- agents that restore the cartilage structure (they are also taken orally and injected into the joint);
- other drugs prescribed by the 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 an adverse effect on the stomach and cause serious complications, including bleeding. Therefore, the duration of the course should be determined only by the doctor.
Physiotherapy is also used in the treatment of osteoarthritis of the hip joint.
Many people benefit from laser and ultrasound treatments (called laser therapy and ultrasound therapy, respectively).
Magnetic therapy, inductothermy, light therapy, and several other methods are used.
The therapy uses physical therapy and massage.
It is worth saying a few words about diet. It does not directly treat hip osteoarthritis. However, when a person weighs less, the load on the joints is reduced, which makes the disease easier.
Surgical treatment of osteoarthritis of the hip joint
When the disease has reached an advanced stage, the method that really "works" is surgery, when the diseased joint is replaced with an artificial one. It is called an endoprosthetic.
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 performed under general anesthesia. The person is first thoroughly examined. After surgery, antibiotic and anticoagulant therapy is prescribed. The sutures are removed from the tenth to the twelfth day, and then the person is transferred under the supervision of a doctor in a clinic or medical center, where care is provided on an outpatient basis.
After the operation, the person is prescribed a set of recovery measures.
In ninety-five percent of cases, after surgery, a person can walk, work, and some even play sports. Artificial joints "work" for fifteen to twenty years, and then a new operation may be necessary.
Shock wave therapy is one of the effective methods for treating chronic diseases of the musculoskeletal system, which is based on the influence of acoustic waves. The procedure gives quick results, and after a course of shock wave therapy you can get a long-term therapeutic effect.