"What to do? " - ask men and women 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 resting, where the pain goes, in which other pathologies it occurs and how to treat it.
Osteoarthrosis of the hip joint (coxarthrosis)- degenerative-dystrophic disease. It often occurs in people after the age of 40, 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 later stages, in order to restore the normal function of the joint, in certain cases it is necessary to undergo joint replacement surgery.
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 somewhat more often.
Factors that can increase the risk of developing this disease include long-term and frequent heavy loads on the hip joint. Coxarthrosis often occurs in seemingly opposite categories of people: those who are professionally involved 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 (for example, feet, 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 thigh bone femur for short.
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 mentioned parts rub against each other.
In order to prevent their damage in the process, they are covered with elastic cartilage, and joint fluid is secreted there, which plays the role of lubricant. This happens in a healthy person. The hip joint essentially 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 are more easily abraded and damaged. As a result, they begin to change their shape over time.
Symptoms of osteoarthritis of the hip joint
Among the main signs of this condition are pain. They are localized 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:
- restricted movement;
- when a person tries to move his leg to the right (if we are talking about right coxarthrosis) or to the left (when the joint on the left side is affected), then he fails completely;
- the gait becomes different from the usual one in a healthy person, the patient limps;
- reduced leg muscle mass;
- the affected leg becomes shorter.
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 has run or walked for a long time. The sensations are concentrated in the hip joint itself, sometimes in the upper part of the leg or even in the knee. When a person rests, the pain usually goes away. Walking 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 is narrowed, but not so much yet. Where the edges of the acetabulum are located, bony spurs can be identified. At this stage, the head and neck of the femur are unchanged.
Progression
In the next phase, the person suffers more from pain that occurs both during physical activity and at rest. They are strong, they go to the thighs, to the groin. After trying to run, a person may limp, as well as after walking. Lateral movement of the leg becomes more difficult, and the range of motion is limited.
X-ray examination shows that the joint space is narrowed, and very much so. Images reveal displacement and distortion of the femoral head. Bone growths are visible in the acetabulum area.
Late stage osteoarthritis of the hip joint
Here the person is already suffering from constant severe pain. They can appear not only during the day when they are resting, but also at night. It becomes difficult for the patient to walk, so he buys a cane. Moving the leg becomes even more difficult than before. In this phase, atrophy of the muscles of the legs and buttocks often occurs, which leads to the shortening of the affected leg. In order to walk more easily, the person leans to the side, and this increases the load on the big 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 are many bony growths.
Diagnosis of osteoarthritis of the hip joint
It is conducted through a comprehensive review that includes:
- examination of the patient by the doctor;
- doctor's examination;
- auxiliary studies, the main ones are, of course, 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 osteoarthritis of the hip joint be confused with?
We wrote above that pain in coxarthrosis can occur not only in the hip joint, but also in the knee and in the entire upper part of the leg.
This means that if such symptoms appear, 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 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 caused by something: for example, a person suddenly turned 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 the leg to the left or right. But with coxarthrosis - not always.
In osteoarthritis of the knee joint, pathological changes are detected on an X-ray of the knee joint.
It should be remembered that one person can have several diseases at once. For example, osteoarthritis of the knee and hip joints. Or osteochondrosis and osteoarthrosis of several joints.
It is important to distinguish hip osteoarthritis from trochanteritis. The latter is an inflammatory disease of the part of the femur, in Latin it is called Trochanter major (trochanter major) - big trochanter. Trochanteritis occurs quickly, compared to osteoarthritis, the pain is stronger, and the person can move the leg freely.
In some cases, in addition to the pain that makes osteoarthritis of the hip joint suspected, another condition is present (for example, ankylosing spondylitis, known as ankylosing spondylitis, etc. ). In 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, physical therapy) and surgery.
Conservative therapy
Conservative treatment is prescribed in the early stages.
This includes:
- ordinary painkillers that a person drinks in tablets or takes in injections (injections), ointments;
- hormones injected into the joint;
- agents that restore the cartilage structure (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 must be taken strictly according to the doctor's prescription. This is especially true for conventional 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 (called laser therapy and ultrasound therapy, respectively).
Magnetic therapy, inductothermy, light therapy and a number of other methods are used.
The therapy uses physical therapy (physical therapy) and massage.
It is worth saying a few words about nutrition. It does not directly treat osteoarthritis of the hip. However, when a person has less weight, 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 an advanced stage, the really "working" method is surgery, when the diseased joint is replaced with an artificial one. This is called endoprosthetics.
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.
Endoprosthesis replacement is performed under general anesthesia. The person is first examined thoroughly. After surgery, antibiotic therapy and anticoagulants are prescribed. The sutures are removed from 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 he is treated on an outpatient basis.
After the operation, the person is prescribed a set of rehabilitation measures.
In ninety-five percent of cases, after surgery, a person can walk, work, and some can even play sports. The 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 of 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-lasting therapeutic effect.