"What should I 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 at rest, where the pain goes, what other pathologies it occurs in, 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 for no apparent reason.
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, in order to restore the normal function of the joint, in some 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 slightly 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 seemingly opposite categories of people: professionally involved in sports and suffering from obesity. Other risk factors include diseases that affect circulation, metabolism, and hormonal balance, as well as pathology of the musculoskeletal system (eg, foot, spine). Coxarthrosis also occurs more often in old age.
The mechanism of development of osteoarthritis of the hip joint
Anatomically, the hip joint includes two bones:
- the ilium, which has the acetabulum;
- femur that has a head. Doctors call the femur a 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 joint surfaces of the two mentioned parts rub against each other.
In order not to be damaged in the process, they are covered with elastic cartilage, and joint fluid is released there, which plays the role of a 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, over time they begin to change their shape.
Symptoms of osteoarthritis of the hip joint
Among the main signs of this condition are pain. They are located in the area of 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 left joint is affected), then he does not succeed 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.
Initial 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 taken a long walk. Sensations are concentrated where the hip itself is, sometimes in the upper 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 leg freely, the muscles are fine.
An x-ray shows that the joint space is narrowed, but still not that much. Where the edges of the acetabulum are, bone spurs can be identified. At this stage, the head and neck of the femur are unchanged.
Progression
At the next stage, the person suffers more from pain that occurs both during physical activity and at rest. They are strong, reach to the thigh, to the groin. After attempting to run, a person may limp as well as after a walk. Lateral movement of your leg becomes more difficult and your range of motion is limited.
An X-ray examination shows that the joint space is narrowed, and severely so. Images reveal displacement and distortion of the femoral head. Bony outgrowths are visible in the acetabulum area.
Late stage osteoarthritis of the hip joint
Here the person already suffers 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 your leg becomes even more difficult than before. At this stage, atrophy of the muscles of the legs and buttocks often occurs, leading to a shortening of the affected leg. For easier walking, a person leans to the side, and this further increases the load on the large joint.
An X-ray examination at this stage shows that the joint space is strongly narrowed, the head of the femur is enlarged, and there are numerous bony outgrowths.
Diagnosis of arthrosis of the hip joint
It is carried out through a comprehensive examination, which includes:
- examination of the patient by the doctor;
- examined by a doctor;
- auxiliary studies, the main one, of course, is X-ray examination.
On X-rays, you can sometimes find 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. With the help of 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 mistaken for osteoarthritis of the hip joint?
We wrote above that pain in coxarthrosis can appear not only in the hip joint, but also in the knee, as well as 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 (as it also causes pain in the upper part of the leg);
- osteoarthritis of the knee joint (appears as pain in the knee).
The pain syndrome caused by osteochondrosis differs from that caused by osteoarthritis of the hip joint. With osteochondrosis, the pain appears suddenly 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 buttock 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 with coxarthrosis - not always.
In osteoarthritis of the knee joint, pathological changes are detected on the X-ray of the knee joint.
It should be remembered that one person can have several diseases at once. For example, osteoarthritis of both the knee and hip joints. Or osteochondrosis and osteoarthritis of several joints.
It is important to distinguish arthrosis of the hip joint from trochanteritis. The latter is an inflammatory disease of part of the femur, called in Latin Trochanter major (trochanter major) - the big trochanter. Trochanteritis progresses quickly, compared to osteoarthritis, the pain is stronger and a person can move his leg freely.
In some cases, pain that makes one suspect osteoarthritis of the hip joint is accompanied by some other condition (for example, ankylosing spondylitis, known as ankylosing spondylitis, etc. ). With them, as a rule, the pain appears at night, disappears during the day, and may even decrease with physical activity.
Treatment of coxarthrosis
If you have joint pain, you should go to an orthopedic traumatologist.
Treatment includes conservative therapy (medications, physical therapy) and surgery.
Conservative therapy
In the early stages, conservative treatment is prescribed.
This includes:
- ordinary painkillers that a person drinks in tablets or takes in 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 drugs prescribed by a doctor, depending on the patient's condition. These include drugs that relax muscles, dilate blood vessels, and more.
All medications should be taken strictly as prescribed by the doctor. This is especially true for 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 treatments (this is called laser therapy and ultrasound therapy, respectively).
Magnetotherapy, inductothermy, light therapy and a number of other methods are used.
Therapy uses physiotherapy (physical therapy) and massage.
It is worth saying a few words about the diet. It does not directly treat osteoarthritis of the hip. But when a person weighs less, the load on the joint decreases, making the disease easier.
Surgical treatment of arthrosis of the hip joint
When the disease is already in an advanced stage, the truly "working" method is surgery, in which the diseased joint is replaced with an artificial one. It 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. First, the person is thoroughly examined. After the operation, antibiotic therapy and anticoagulants are prescribed. Sutures are removed from the tenth to the twelfth day, after which 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 set of rehabilitation measures.
In ninety-five percent of cases, after the operation, a person can walk, work, and some even play sports. The artificial joint "works" for fifteen to twenty years, after which another operation may be necessary.
Shock wave therapy is one of the effective methods of treating chronic diseases of the musculoskeletal system, which is based on the impact of acoustic waves. The procedure provides quick results, and after a course of shock wave therapy, you can get a long-lasting therapeutic effect.