"What should be done? " - men and women ask themselves when their hip joints hurt. 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 while 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 usually occurs over the age of 40, often as a result of injury, but usually begins for no apparent reason.
The disease is characterized by a slow and gradually progressive course. In the initial stage, conservative treatment methods (medicines, physiotherapy) are often used. However, in the later stages, in order to restore the normal function of the joint, joint surgery is necessary in some cases.
Many people suffer from coxarthrosis: this fact is due to the fact that the load on the hip joint is usually high. In women, this condition occurs slightly more often.
Factors that increase the risk of developing the disease include prolonged and frequent heavy loading of the hip joint. Coxarthrosis often occurs in seemingly opposite categories: professional athletes and obese people. Other risk factors include diseases affecting blood circulation, metabolism and hormonal balance, as well as pathologies of the locomotor system (e. g. feet, spine). Coxarthrosis is also more common in old age.
The mechanism of the development of osteoarthritis of the hip joint
Anatomically, the hip joint contains two bones:
- the hip bone, which contains the acetabulum;
- femur, which has a head. Doctors call the femur a femur for short.
The two parts of these bones connect together to form a joint. When a person moves his leg, the joint surfaces of the two mentioned parts rub against each other.
So that they are not injured during the process, they are covered by flexible cartilage, and synovial fluid is secreted there, which acts as a lubricant. This happens in a healthy person. The hip joint essentially acts as a hinge.
When a person suffers from coxarthrosis, the synovial fluid becomes thicker and the cartilage becomes less elastic, cracks appear on it. For this reason, the surfaces of the hip bone and femur are less protected during friction, and are more easily worn and damaged. As a result, they begin to change shape over time.
Symptoms of osteoarthritis of the hip joint
The main symptoms of this condition include pain. They are located in 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 (if the left joint is affected), he does not succeed completely;
- the gait is different from the usual for a healthy person, the patient limps;
- decreased leg muscle mass;
- the affected leg becomes shorter.
Early stage of osteoarthritis of the hip joint
In the early stages of the disease, the pain sometimes occurs intermittently, especially 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 legs freely, the muscles are fine.
An X-ray shows that the joint space has narrowed, but not so much yet. Where the edges of the acetabulum are, bone spurs can be identified. At this stage, the head and neck of the femur remain unchanged.
Progress
In the next stage, the person suffers more from pain, which occurs both during physical activity and at rest. They are strong, go up to the thighs and groins. After an attempt to run, a person can limp, just like after a walk. Lateral movement of the leg becomes more difficult and its range of motion is limited.
X-rays show that the joint space has narrowed, and severely. The images show displacement and distortion of the femoral head. Bone growths are visible in the area of the acetabulum.
Late stage of arthrosis of the hip joint
Here, the person already suffers from severe pain all the time. They can occur not only during daytime rest, but also at night. It will be difficult for the patient to walk, so he buys a stick. Moving the leg becomes even more difficult than before. Atrophy of the leg and buttock muscles often occurs at this stage, leading to a shortening of the affected leg. In order to walk more easily, the person leans to the side, and this increases the load on the large joint even more.
X-ray examination at this stage shows that the joint space is very narrowed, the head of the femur is enlarged, and there is a lot of bone growth.
Diagnosis of osteoarthritis of the hip joint
This is done through a comprehensive examination that includes:
- questioning of the patient by the doctor;
- examination by a doctor;
- ancillary studies, the main one of course being x-rays.
X-rays can sometimes show the cause of osteoarthritis—for example, they can show signs of previous injuries, dysplasia, and other conditions.
Tomography (CT and MRI) also helps in the diagnosis. With the help of the first, the changes in the bones, and with the help of the second, what happens to the soft tissues.
What can be mistaken for arthrosis of the hip joint?
We wrote above that the pain caused by 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 appear, the doctor must first rule out the following pathologies:
- osteochondrosis (as it also causes pain in the upper part of the leg);
- arthrosis of the knee joint (manifests as knee pain).
The pain syndrome caused by osteochondrosis differs from arthrosis of the hip joint. In case of 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 usually spreads from the buttocks 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 in case of coxarthrosis - not always.
With arthrosis of the knee joint, pathological changes are detected on 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 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 a part of the femur, in Latin Trochanter major (trochanter major) - the greater trochanter. Trochanteritis occurs quickly, compared to osteoarthritis, the pain is stronger and the person can move the leg freely.
In some cases, when the pain leads to the suspicion of osteoarthritis of the hip joint, another condition is also present (for example, ankylosing spondylitis, ankylosing spondylitis, etc. ). For them, the pain usually 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 see an orthopedic traumatologist.
Treatment includes conservative therapy (medications, physical therapy) and surgery.
Conservative therapy
In the early stages, conservative treatment is prescribed.
This includes:
- usual painkillers that a person takes in tablets or injection(s), ointments;
- hormones injected into the joint;
- agents that restore the cartilage structure (also taken orally and injected into the joint);
- other medicines 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 for traditional painkillers: with long-term use, they can have a bad effect on the stomach and cause serious complications, including bleeding. Therefore, the duration of the courses is determined only by a doctor.
Physiotherapy is also used to treat osteoarthritis 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 many other methods are used.
Therapy uses physical therapy (physiotherapy) and massage.
It is worth saying a few words about the diet. It does not directly treat hip arthritis. However, if a person weighs less, the load on the joint is reduced, which makes the disease easier.
Surgical treatment of arthrosis of the hip joint
When the disease is already in an advanced stage, the really "working" method is surgery, when the diseased joint is replaced with an artificial one. This 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 both the femoral head and the acetabulum are replaced, such a prosthesis is called bipolar.
The endoprosthesis is replaced under general anesthesia. The person is first thoroughly examined. Antibiotic therapy and anticoagulants are prescribed after surgery. The sutures are removed from the tenth to twelfth day, and then the affected person is transported to a clinic or health center under medical supervision, where care is provided on an outpatient basis.
After the operation, the person is prescribed for rehabilitation measures.
In ninety-five percent of cases, the person can walk, work, and some can even play sports after the operation. An artificial joint "works" for fifteen to twenty years, after which a new operation may be necessary.
Shock wave therapy is one of the effective methods of treating chronic diseases of the locomotor system, which is based on the effect of acoustic waves, gives quick results, and after shock wave therapy, a long-term therapeutic effect can be achieved. effect.