"What should be done? " - 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 hip joints hurt in men or women when walking and at rest, where the pain goes, in which other pathologies it appears and how to treat it.
Osteoarthritis of the hip joint (coxarthrosis)- degenerative-dystrophic disease. It often appears in people after 40 years, 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 the later stages, to restore the normal function of the joint, in certain cases it is necessary to undergo an 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 great. In women, this condition occurs somewhat more 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 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, as well as pathology of the musculoskeletal system (for example, 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 the acetabulum;
- femoral, which has a head. Doctors call the femur bone 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 their damage during 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 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 surfaces of the ilium and femur are less protected during friction and wear and tear more easily. 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 pains. They are located 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 coxarthrosis of the right side) or to the left (when the joint on the left is affected), then he does not succeed completely;
- walking becomes different from what is usual in a healthy person, the patient limps;
- decrease in leg muscle mass;
- the affected leg becomes shorter.
Early stage osteoarthritis of the hip joint
In an early stage of the development of the disease, pain occurs sometimes, periodically, mainly after physical exercises. 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. Gait 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 has narrowed, but still not that much. Where the edges of the acetabulum are, bony spurs can be identified. At this stage, the head and neck of the femur are unchanged.
Progress
In the next stage, the person suffers more from pain that appears both during physical activity and at rest. They are strong, they go up to the thigh, to the hip. 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 hard. Images reveal displacement and distortion of the femoral head. Bony growths are visible in the area of the acetabulum.
Late stage osteoarthritis of the hip joint
Here the person already suffers from constant severe pain. They can happen not only during the day when you are resting, but also at night. The patient finds it difficult to walk, so he buys a cane. Leg movement becomes even more difficult than before. At this stage, atrophy of the muscles of the legs and buttocks often occurs, which leads to the shortening of the affected leg. To make walking easier, a person bends to the side, and this increases the load on the large joint even more.
An X-ray examination at this stage may show that the joint space is very narrowed, the femoral head is enlarged and there is a lot of bone growth.
Diagnosis of osteoarthritis of the hip joint
It is carried out through a comprehensive examination, which includes:
- interrogation of the patient by the doctor;
- examination by a doctor;
- auxiliary studies, the main, of course, are x-rays.
On X-rays, you can sometimes find out 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 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 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);
- knee osteoarthritis (appears 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 buttocks to the back of the leg.
With osteochondrosis, even if the pain is strong, a person can move the leg to the left or right. But with coxarthrosis - not always.
With osteoarthritis 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 once. For example, osteoarthritis of the 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 a part of the femur, called in Latin Trochanter major (trochanter major) - big trochanter. Trochanteritis appears quickly, compared to osteoarthritis, the pain is stronger and a person can move the leg freely.
In some cases, with pain that suspects osteoarthritis of the hip joint, another condition is present (for example, ankylosing spondylitis, known as ankylosing spondylitis, etc. ). With them, as a rule, the pain appears 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 (drugs, physical therapy) and surgery.
Conservative therapy
Conservative treatment is prescribed in the early stages.
This includes:
- common sedatives 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 the doctor, depending on the patient's condition. These include drugs that relax muscles, dilate blood vessels, etc.
All medications should be taken strictly as prescribed by the doctor. This is especially true for common 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.
Therapy uses physical therapy (physiotherapy) and massage.
It is worth saying a few words about the 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 already reached advanced stages, the truly "functional" method is surgery, when the diseased joint is replaced with an artificial one. It is called endoprosthetics.
Different parts of the joint may vary. 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 and anticoagulant therapy is prescribed. The stitches are removed on the tenth to the twelfth day, and then the person is transferred under the supervision of a doctor to a clinic or medical center, where care is provided on an outpatient basis.
After the operation, the person is prescribed a series 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 for treating chronic diseases of the musculoskeletal system, which is based on the impact of acoustic waves. The procedure gives quick results, and after a course of shock wave therapy you can get a long-term therapy. effect.