"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 when walking and resting in men or women, 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 usually appears in people after the age of 40, often as a result of an injury, but usually begins without an obvious cause.
The disease is characterized by a slow and gradually progressive course. At the initial stage, conservative treatment methods (drugs, physiotherapy) are often used. But in the later stages, in order to restore the normal function of the joint, in certain cases, it is necessary to undergo a surgical operation 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. This condition occurs somewhat more often in women.
Factors that can increase the risk of developing this disease include long-term and often heavy loads on the hip joint. Coxarthrosis often occurs in seemingly opposite categories of people: those who engage in professional sports and those who are obese. Other risk factors include diseases that affect blood circulation, metabolism and hormonal balance, pathology of the musculoskeletal system (for example, foot, spine). Coxarthrosis is more common in old age.
The mechanism of development of osteoarthritis of the hip joint
Anatomically, the hip joint consists of two bones:
- ilium with acetabulum;
- femur with head. Doctors call the femur abbreviated as femur.
Two parts of these bones connect 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, which secretes synovial fluid, which acts as a lubricant. This happens in a healthy person. The hip joint essentially works like a hinge.
When a person has coxarthrosis, the joint fluid thickens 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 worn and damaged. As a result, they begin to change their shape over time.
Symptoms of osteoarthritis of the hip joint
Among the main symptoms of this condition is pain. They are localized in the joint itself, as well as in the groin, in the upper part of the thigh.
The following symptoms are also characteristic:
- 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 does not fully succeed;
- gait is different from that of a healthy person, the patient becomes lame;
- decrease in leg muscle mass;
- the affected leg is shortened.
Early stage of osteoarthritis of the hip joint
In the early stage of the disease, pain occurs sometimes, periodically, mainly after physical exertion. For example, after a person runs or goes for a long walk. Sensations are concentrated in the hip joint itself, sometimes in the upper leg or even in the knee. When a person rests, the pain usually subsides. Walking remains normal at this stage. A person can move his leg freely, his muscles are good.
X-rays show that the joint space has narrowed, but not yet. Bone spurs can be identified where the edges of the acetabulum are. At this stage, the head and neck of the femur remain unchanged.
Progress
In the next stage, a person suffers more from pain during physical activity and at rest. They are strong, they go to the thighs and groins. After attempting to run, a person may limp as they do after walking. It becomes difficult to move your leg laterally and your range of motion is limited.
X-ray examination shows that the joint space is narrowed and strong. The images show displacement and curvature of the femoral head. Bone growths appear in the acetabulum area.
Late stage osteoarthritis of the hip joint
Here, a person already suffers from constant severe pain. They can occur not only during daytime rest, but also at night. It becomes difficult for the patient to walk, so he gets a cane. Moving your leg becomes more difficult than before. At this stage, muscle atrophy of the legs and hips often occurs, causing the affected leg to become shorter. To facilitate walking, a person bends to the side, which further increases the load on the large joint.
At this stage, an X-ray examination can show that the joint space is very narrow, the head of the femur is widened and there are many bony protrusions.
Diagnosis of osteoarthritis of the hip joint
It is carried out through a comprehensive examination that includes:
- questioning of the patient by the doctor;
- examination by a doctor;
- auxiliary studies, the most important of which, of course, are X-rays.
X-rays can sometimes reveal 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.
What can be confused with osteoarthritis of the hip joint?
We wrote above that pain with coxarthrosis can occur not only in the hip joint, but also in the knee and the entire 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 (manifests as pain in the knee).
The pain syndrome caused by osteochondrosis differs from osteoarthritis of the hip joint. Pain with osteochondrosis appears sharply and is most often provoked by something: for example, a person turned sharply or lifted something heavy. In this case, the pain usually spreads from the hip to the back of the leg.
With osteochondrosis, a person can move his leg to the left or right, even if the pain is severe. But with coxarthrosis - not always.
With arthrosis of the knee joint, pathological changes are detected in the X-ray of the knee joint.
It should be remembered that a person can have several diseases at the same time. For example, osteoarthritis of both knee and hip joints. Or osteochondrosis and osteoarthrosis of several joints.
It is important to distinguish arthrosis of the hip joint from trochanteritis. The latter is an inflammatory disease of a part of the thigh bone, in Latin it is called Trochanter major (trochanter major) - big trochanter. Trochanteritis occurs quickly, compared to arthrosis, the pain is stronger and a person can move the leg freely.
In some cases, there is another condition with pain suspected of osteoarthritis of the hip joint (for example, ankylosing spondylitis, also known as ankylosing spondylitis, etc. ). With them, as a rule, the pain occurs at night, disappears during the day and can even be reduced by physical activity.
Treatment of coxarthrosis
If you have joint pain, you should see an orthopedic traumatologist.
Treatment includes conservative therapy (drugs, physiotherapy) and surgery.
Conservative therapy
In the early stages, conservative treatment is prescribed.
This includes:
- ordinary painkillers that a person drinks in tablets or takes an injection (needle), ointment;
- co-injected hormones;
- agents that restore the structure of cartilage (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 medicines should be taken strictly as prescribed by the doctor. This is especially true of conventional painkillers: with long-term 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 arthrosis of the hip joint.
Many people benefit from laser and ultrasound treatment (called laser therapy and ultrasound therapy, respectively).
Magnetic therapy, inductothermy, light therapy and a number of other methods are used.
Therapy uses physical therapy (physical therapy) and massage.
It is worth saying a few words about diet. It does not directly treat osteoarthritis of the hip. But when a person is underweight, 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 advanced stages, the method that really "works" is an operation in which the diseased joint is replaced with an artificial one. This is called endoprosthetics.
Different parts of the joint may 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 a bipolar prosthesis.
Replacement of the endoprosthesis is performed under general anesthesia. The person is first thoroughly checked. After surgery, antibiotic therapy and anticoagulants are prescribed. The sutures are removed from the tenth to the twelfth day, after which the person is transferred to an outpatient clinic or medical center under the supervision of a doctor.
After the operation, the person is assigned a number of rehabilitation measures.
In ninety-five percent of cases, after the operation, a person can walk, work, and some even do 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 based on the effect of acoustic waves in the treatment of chronic diseases of the musculoskeletal system. The procedure gives quick results, and after a course of shock wave therapy, you can get a long-term therapeutic effect. effect.