"What to do? " – men and women ask themselves when they have pain in their 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, in what other pathologies it occurs and how to treat it.
Osteoarthritis of the hip joint (coxarthrosis)- degenerative-dystrophic disease. It often occurs in people after the age of 40, often as a result of an injury, but usually begins with no apparent cause.
The disease is characterized by a slow and gradually progressive course. In the early stages, conservative treatment methods (medications, physiotherapy) are often used. However, in order to restore the normal function of the joint, surgical replacement of the joint is required in certain cases in later stages.
Many people suffer from coxarthrosis: This is because the load on the hip joint is usually large. This condition is slightly more common in women.
Factors that can increase the risk of developing this disease include prolonged and frequent heavy strain on the hip joint. Coxarthrosis often occurs in seemingly opposite groups of people: working people who play sports and those who are overweight. Other risk factors include diseases that affect blood circulation, metabolism and hormonal balance, as well as pathologies of the musculoskeletal system (e. g. foot, spine). Coxarthrosis also occurs more frequently in old age.
The mechanism of development of arthrosis of the hip joint
Anatomically speaking, the hip joint consists of two bones:
- the ilium, which has the hip socket;
- Femur that has a head. Doctors call the thigh bone the femur for short.
The two parts of these bones are connected to each other and form a joint. When a person moves his leg, the joint surfaces of the two parts mentioned rub against each other.
So that they are not damaged, they are covered with elastic cartilage and synovial fluid is secreted there, which acts as a lubricant. This happens in a healthy person. The hip joint essentially functions like a hinge.
When a person suffers from coxarthrosis, the synovial fluid becomes thicker and the cartilage becomes less elastic, cracks appear. As a result, the surfaces of the ilium and femur are less protected from 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 disease include pain. They are localized in the area of the joint itself and in the groin at the top of the thigh.
The following symptoms are also typical:
- limited movement;
- If a person tries to move his leg to the right (if it is a right-sided coxarthrosis) or to the left (if the joint on the left side is affected), he does not succeed completely;
- the gait differs from what it normally has 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 sometimes occurs periodically, mainly after physical exertion. For example, after a person runs or takes a long walk. The sensations are concentrated where the hip joint itself is located, 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 their leg freely and the muscles are fine.
An x-ray shows that the joint space has narrowed, but not yet to such an extent. Bone spurs can be seen on the edges of the hip socket. At this stage, the head and neck of the femur are unchanged.
Progression
In the next stage, the person suffers more pain, which occurs both during physical activity and at rest. They are strong, they reach to the thigh, to the groin. After attempting to run, a person may experience a limp, just as they would after a walk. Moving the leg sideways becomes more difficult and freedom of movement is restricted.
An X-ray examination shows that the joint space is severely narrowed. The images show displacement and deformation of the femoral head. Bone growths are visible in the hip socket area.
Late stage of osteoarthritis of the hip joint
Here the person is already suffering from constant severe pain. They can occur not only during the day when at rest, but also at night. Since walking becomes difficult for the patient, he buys a walking stick. Moving your leg becomes even more difficult than before. At this stage, atrophy of the leg and buttock muscles often occurs, causing the affected leg to become shorter. To make walking easier, a person bends to the side, which further increases the load on the large joint.
An X-ray examination at this stage may show that the joint space is severely narrowed, the femoral head is enlarged, and there are many bone growths.
Diagnosis of osteoarthritis of the hip joint
It is carried out through a comprehensive investigation that includes:
- Questioning the patient by the doctor;
- examination by a doctor;
- Auxiliary studies, the most important of which are, of course, x-rays.
X-rays can sometimes reveal the cause of osteoarthritis - for example, signs of previous injuries, dysplasia and other diseases can be seen.
Tomography (CT and MRI) also helps with the diagnosis. The first allows you to examine changes in the bones, and the second allows you to examine what happens to soft tissue.
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.
That is, when such symptoms appear, the doctor must first exclude the following pathologies:
- osteochondrosis (since it also causes pain in the upper part of the leg);
- Osteoarthritis of the knee joint (manifested by pain in the knee).
The pain syndrome caused by osteochondrosis is different from that caused by arthrosis of the hip joint. With osteochondrosis, pain occurs sharply and is usually provoked by something: for example, a person turns around abruptly or lifts something heavy. In this case, the pain usually spreads from the buttocks to the back of the leg.
With osteochondrosis, a person can move his leg to the left or right even with severe pain. 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 borne in mind that a person can have several diseases at the same time. For example, osteoarthritis of both the knee and hip joints. Or osteochondrosis and arthrosis 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 femur, which in Latin is called trochanter major (trochanter major) - the greater trochanter. Trochanteritis occurs quickly, compared to osteoarthritis, the pain is more severe and the person can move his leg freely.
In some cases, pain that leads to the suspicion of osteoarthritis of the hip joint may also be due to another disease (e. g. Bechterew's disease, so-called ankylosing spondylitis, etc. ). For them, the pain usually occurs at night, disappears during the day and can even subside with physical activity.
Treatment of coxarthrosis
If you have joint pain, you should consult an orthopedic traumatologist.
Treatment includes conservative therapy (medications, physiotherapy) and surgery.
Conservative therapy
In the early stages, conservative treatment is prescribed.
This contains:
- ordinary painkillers that a person drinks in tablet form or takes in the form of injections (injections), ointments;
- hormones injected into the joint;
- Means 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 must be taken strictly as prescribed by a doctor. This is especially true of conventional painkillers: if used for a long time, they can damage the stomach and cause serious complications, including bleeding. Therefore, the duration of the courses should only be determined 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 field therapy, inductothermy, light therapy and a number of other methods are used.
Therapy takes place using physical therapy (physiotherapy) and massage.
It is worth saying a few words about nutrition. This does not directly treat osteoarthritis of the hip. However, when a person weighs less, the load on the joint decreases, which facilitates the course of the disease.
Surgical treatment of arthrosis of the hip joint
If the disease has already reached an advanced stage, the truly "working" method is surgery to replace the diseased joint with an artificial one. It is called endoprosthetics.
Different parts of the joint can change. For example, just the femoral head. It is a unipolar prosthesis. When both the femoral head and the hip socket are replaced, it is called a bipolar prosthesis.
The endoprosthesis is replaced under general anesthesia. The person is first examined thoroughly. After the operation, antibiotic therapy and anticoagulants are prescribed. From the tenth to the twelfth day, the stitches are removed and then the person is transferred to a clinic or medical center under medical supervision, where care is provided on an outpatient basis.
After the operation, the person is prescribed a number of rehabilitation measures.
In 95 percent of cases, a person is able to walk, work, and in some cases even exercise after surgery. An artificial joint "works" for fifteen to twenty years, after which another operation may be necessary.
Shock wave therapy is one of the most effective methods of treating chronic diseases of the musculoskeletal system, which is based on the influence of sound waves. The procedure gives quick results, and after shockwave therapy you can get a long-term effect.