Treatment of arthrosis of the hip joint (coxarthrosis)

Coxarthrosis is deforming arthrosis of the hip joint. This is a chronic disease, which is characterized by degenerative changes in tissue and damage to cartilage. Symptomatically, coxarthrosis is determined by regular pain and deformation in the hip joint, and impaired mobility. The pathological changes are based on cartilage damage and the subsequent inflammatory reaction. With arthrosis, bone tissue changes. The lesion occurs locally, but may also involve other articular joints. The main group of patients are elderly people. Risk factors may include hereditary predisposition, large body weight, and previous trauma. People with this problem exhibit endocrine disorders and metabolic imbalances. But the main emphasis in treatment is on restoring the structure and functions of cartilage. Treatment of coxarthrosis is a long process, including anti-inflammatory therapy, the use of chondroitin and glucosamine preparations to replenish joint nutrition, exercise therapy and physiotherapy. To maintain joints at home, herbal treatment is recommended. A proper diet and moderate physical activity are extremely important.

Symptoms of coxarthrosis

In coxarthrosis, articular cartilage is the first to undergo deforming changes. There are 3 stages of disease development. At the initial stage, there are no morphological changes in the tissues of the joint. Only his functional viability suffers. A person feels periodic pain in the joint area after physical activity, running, or long-distance walking. After rest, the pain disappears. In the second stage, the bone begins to deform. The naturalness of movements decreases sharply. The pain varies in intensity and often appears at rest. The third stage is characterized by chronic pain syndrome. Pain bothers patients day and night. Walking without a cane is difficult; a person is forced to bend his torso forward. Multiple growths appear on the articular bones.

The main symptoms of arthrosis include:

• morning stiffness;
• joint pain;
• difficulties in moving at a distance of more than 1 km;
• increased pain with prolonged sitting or standing.

Orthopedists call coxarthrosis one of the most common types of arthrosis. The risk group includes obese people, those engaged in heavy physical work, and the elderly. Lack of treatment leads to complete destruction of the hip joint, accompanied by unnatural mobility or complete immobility, as well as severe dysfunction of the lower extremities.

Causes of degenerative pathogenesis

The disease is of primary and secondary types. In the primary type, the circumstances of its occurrence are still unclear to medicine, that is, the lesion develops spontaneously and for no apparent reason. The secondary type of pathology becomes a consequence of injuries, poor lifestyle, and certain ailments. Various factors can influence the development of this disease and trigger a destructive mechanism, most often these are:

• consequences of injuries - local fractures, dislocations, bruises, ligament damage, chronic microdamages, etc.;
• excessive physical activity;
• sedentary and sedentary lifestyle;
• excess body weight;
• long-term infections in the body;
• rheumatoid arthritis;
• smoking abuse;
• age-related aging of the body;
• hormonal imbalance and endocrine pathologies, especially diabetes;
• metabolic diseases;
• congenital anomalies of hip joint development (dysplasia, congenital dislocation);
• any problems with the spine;
• genetic predisposition.

There is a direct relationship between excess weight and the likelihood of joint problems.

Drug therapy

Treatment of coxarthrosis begins with limiting exercise. This is a long process that combines a variety of therapy methods: taking anti-inflammatory and painkillers, intra-articular injections, physiotherapeutic treatment and exercise therapy.

Features of treatment of coxarthrosis of 1, 2, 3 degrees:

• at the first stage, NSAIDs are prescribed to stop the inflammatory process; medications that normalize metabolic processes and analgesics are also needed; folk remedies are used in complex therapy;
• at the second stage of coxarthrosis, intra-articular injections based on hyaluronic acid are added to drug therapy, laser treatment, and electrical stimulation are performed;
• the third stage is treated conservatively and surgically, when it is impossible to cope without surgery, joint replacement is performed.

Drug treatment plays the biggest role. Without anti-inflammatory and supportive drugs, degenerative changes cannot be avoided and constant pain cannot be eliminated. Doctors prescribe pharmacological agents of various actions to alleviate the condition of patients during exacerbations.

1. Drug treatment plays the biggest role. Without anti-inflammatory and supportive drugs, degenerative changes cannot be avoided and constant pain cannot be eliminated. Doctors prescribe pharmacological agents of various actions to alleviate the condition of patients during exacerbations.
2. Muscle relaxants. Reduce the tone of skeletal muscles. The muscles relax, which reduces pain, and the person gets relief from pain. These drugs are contraindicated in patients with cardiac arrhythmias.
3. Chondroprotectors. Symptomatic preparations containing collagen. Nourishes damaged cartilage and restores it. They supply the joint with collagen from the outside and stimulate its production by the body. Chondroprotective drugs are taken for a long time. Under the influence of these agents, tissue metabolism improves, and damaged cartilage gradually increases. In complex therapy, these drugs have undoubted benefits, especially at the initial stage of the disease. In case of chronic arthrosis, they postpone disability.

To stop the destruction of cartilage tissue and provide the joint with “lubrication,” injections are given with drugs based on hyaluronic acid and synthetic substances, the composition of which is similar to synovial fluid. They are highly compatible with human body tissues. They effectively stop the process of cartilage destruction and have an analgesic and chondroprotective effect. Synthetic substances contain silver ions, which provide an additional bacteriostatic effect.

Recommendations by Product Category

When compiling a diet for coxarthrosis, it is necessary to note the ambiguity of the influence of products, even those belonging to the same category. Meat and fish products require particularly careful filtration. In particular, fatty varieties are prohibited foods, but low-fat meat and fish are simply necessary for the body. Especially useful for the regeneration of cartilage tissue is the use of jellies and aspic, which contain gelatin, and it is considered a source of collagen, which stimulates the restoration of cartilage.

From this category of products, the following should be considered prohibited for arthrosis:

• sausages;
• ham;
• bacon;
• smoking;
• canned food;
• meat dishes from fast food establishments.

In order for permitted meat and fish dishes to really bring benefits, they should be steamed, baked or stewed. Fat from meat must be trimmed, and it is recommended to remove the skin from poultry.

Dairy products in most varieties are useful for arthrosis, because... contain significant amounts of proteins and calcium necessary to strengthen bones. It is better to avoid whole milk, as well as high-fat products. It is advisable to replace it with goat milk, which contains proteins with vitamins PP and B1. The menu suggests increasing the number of such products:

• cottage cheese and low-fat cheeses;
• fermented milk products;
• skimmed milk.

The flour category of products is necessary given the high carbohydrate content. Bread products made from premium white flour and sweet baked goods should be limited. When ensuring the supply of carbohydrates, preference is given to complex varieties: poly- or monosaccharides. In this regard, useful:

The required composition of carbohydrates is found in oatmeal, buckwheat porridge, as well as brown rice. When preparing them, you should not overcook the cereal so as not to lose its beneficial properties.

Fats are also needed for a balanced diet. Vegetable fats help normalize metabolic processes and stimulate tissue regeneration. The most useful are seeds and nuts, as well as the oil produced from them. Animal fats include those found in marine fish. You can consume butter.

Prosthetics

Endoprosthetics is a surgical method of treating the hip joint. When, as a result of coxarthrosis and dysplasia, irreversible consequences occur in the cartilage tissues, joint replacement is resorted to. As a result of the operation, it is possible not only to reduce constant pain, but also to restore function and mobility of the joint. Artificial joints are made of metal-polyethylene and ceramics. Fixation to living bone occurs in a cemented or cementless manner. Endoprostheses take root well and can last for decades. But in some cases, the prosthesis wears out quickly, and then repeated surgery is required.

Physiotherapeutic treatment

Treatment of arthrosis of the hip joint is carried out using complex measures, including physiotherapy. This area is associated with physical rehabilitation, supporting the body during the period of recovery and remission, and preventing exacerbations. Physiotherapy is provided by orthopedists, traumatologists, rheumatologists, massage therapists, and exercise therapy instructors.

The following methods are recognized as effective for the treatment of coxarthrosis:

• ultrasound therapy;
• laser therapy;
• inductothermy;
• massage;
• manual therapy.

With ultrasound therapy, high-frequency waves penetrate tissue and act like a vibration massage. They improve biochemical processes, prevent stagnation, and promote better absorption of medicinal substances. Ultrasound reduces the inflammatory process.

Laser exposure dilates blood vessels, stimulates lymph flow, inhibits inflammation, and heals tissue. The technique improves tissue trophism and helps preserve the structure and function of organs.

During inductothermy, the body is exposed to high frequency waves. The method is effective in the presence of any inflammation and pathologies of the musculoskeletal system. Stimulates the immune system, relieves pain, and has a regenerating effect.

Massage can be hardware or mechanical. Contrary to popular belief, during a massage not only the superficial layer of skin and muscles is exposed. During the work of a massage therapist, reflex and humoral mechanisms of regulation of internal organs are activated. By combining a wide variety of massage techniques, the patient receives antispasmodic, tonic, lymphatic drainage and analgesic effects.

A chiropractor works on human bones and joints. It relieves tension from some areas, tones others, eliminates pain, and restores the functional viability of joints. First, the doctor uses diagnostic techniques, during which he determines the condition and capabilities of the muscles, ligaments, and joints. Then he moves on to treatment. Manual techniques are not used during exacerbations and complications.

The role of sanatorium treatment

For coxarthrosis, great importance is given to sanatorium treatment. Treatment and prevention institutions primarily use natural factors to support people with musculoskeletal diseases.

1. Climatotherapy. These are terrain features, a combination of weather factors, sea water, sun, air. Climatic therapy helps recovery, prevents the development of exacerbations, improves the course of biological and physiological processes in the body. Ideal conditions for the treatment of arthrosis are created in areas with high air temperatures and large amounts of solar radiation.
2. Healing mud. They vary in origin. There are peat, sulfide-silt, sapropel, hydrothermal. They are distinguished by high heat capacity. They contain mineral, organic, biologically active components that penetrate the skin and have a beneficial effect on the joints. Improve metabolic processes, reduce inflammation, normalize blood circulation.
3. Mineral water. Contains microelements, dissolved salts, and biologically active substances. For diseases of the musculoskeletal system, mineral baths are indicated. The procedures increase mobility, tone, activate blood circulation, and improve metabolism.
4. Phytotherapy. A method based on the use of medicinal herbs. Infusions and decoctions contain a large number of active substances that not only effectively support the sick body, but also have a pronounced therapeutic effect.

Treatment with natural factors in sanatoriums is combined with physiotherapeutic methods, physical therapy, dietary nutrition, and adherence to a daily routine. Sanatorium-resort programs are developed for all stages of joint diseases.

Advantages and disadvantages

Physical activity

In recommendations for people with arthrosis, doctors advise limiting the load on their legs. It is worth stopping squatting, squatting, and being more careful when doing physical work in the house and in the garden. Do not strain the joint if pain is already felt (reduce the drastic load). It is especially worth excluding running and jumping. However, you won’t be able to do without gymnastics.

To make the joint function, you should do special exercises. A person with arthrosis is categorically not suitable for “young” gymnastics - at a fast pace, with increasing loads, with a high intensity of the entire session. For a sore joint, gymnastics should be done extremely slowly, smoothly, measuredly, until discomfort or pain appears. If there is pain, you should take a break.

Therapeutic gymnastics allows you to normalize the condition of the muscles, improve blood circulation in the joint, provide it with adequate nutrition, and remove decay and inflammation products. Gymnastics helps medicinal substances get into the diseased joint faster and begin their therapeutic effect. The most difficult task of physical therapy is to dose the load correctly. Too short a workout will not allow you to achieve a therapeutic effect. And excessive load will cause additional harm to the joint. Only the attending physician can give competent recommendations. They will depend on the patient’s condition and the characteristics of the disease in each specific case.

Nutrition for coxarthrosis

There are many reasons for the destruction of cartilage. Great importance in the treatment of arthrosis of the hip joint of 1, 2, 3 degrees is given to nutrition. Today the market is filled with products rich in preservatives. Attractive hams, smoked meats, and sausages that flaunt on the shelves contain a large number of specific components. The meat is treated with enzymes, active substances that speed up the production process and allow you to quickly obtain an attractive product. Preservatives increase the shelf life of any product: finished or raw, which cannot but be widely used among manufacturers.

When consuming food loaded with preservatives, a person receives excess salt, which retains moisture. Salt is retained and accumulates in the cartilage tissue, causing the normal functioning of the joint to fail. Such arthrosis is essentially a simple inflammation, which is perfectly treatable. And coxarthrosis, which arose against the background of metabolic disorders, metabolic failure, and intake of junk food, requires adherence to a diet. It is not necessary to strictly limit your food intake or give up a whole list of healthy foods. It is enough to follow simple rules:

• refuse any ready-made smoked meats from the store;
• eliminate the consumption of concentrated broths;
• According to the method of preparing dishes, give preference to boiling and stewing;
• completely eliminate salt consumption, do not buy salted fish, sausages, canned foods;
• consume no more than 10-15 g of animal fats per day, prepare meals with the addition of a variety of vegetable oils;
• monitor the calorie content of foods, give up so-called “fast” carbohydrates, sugar, and confectionery;
• exclude mayonnaise from the diet, season salads and sauces with low-fat sour cream;
• eliminate the consumption of alcoholic beverages;
• limit consumption of fatty fish and caviar.

Instead of smoked meats, buy natural meat and chickens raised on farms by domestic producers. It is better to cook first courses in vegetable broths, without boiling vitamin-rich foods for several hours. The bouillon cubes popular today are almost 100% chemical. This is harm in its purest form.

You should not completely give up boiled meat. But it’s better to take pre-boiled lean pieces and put them in portions on a plate, and only then pour in the vegetable soup. Complete abstinence from meat is extreme.

An ancient recipe for maintaining strong bones and joints is jellied meat. Several decades ago, when little was known about artificial preservatives, this was justified. Now such a product can only increase cholesterol.

Fresh fish has not previously been treated with preservatives. But modern manufacturers have learned this too. Today, we can talk about the benefits of fish only if it came to the counter directly from a fishing trawler or was bought alive.

Only by changing the principles of nutrition can a person reduce suffering from deforming arthrosis. The diet should include a large amount of fresh vegetables, berries, herbs, and fruits. Low-fat dairy products, lean meats, and chicken are healthy. Rice, beets, potatoes, and watermelon help remove salt from the body. Once a week, it is recommended to arrange fasting days on kefir, cottage cheese, fruits, and herbal decoctions.

Approximate daily diet

Meals for coxarthrosis must be planned in advance; meals for every day should be varied and rich in various elements necessary for health.

There should be at least 6 meals, between them you need to drink 1.5 glasses of plain or mineral water, before going to bed it is recommended to drink a glass of low-fat kefir.

Diet for coxarthrosis per day

Approximate diet for coxarthrosis for one day:

If you feel hungry between meals while on a diet, you can have a light snack of fruit, yogurt, or just drink a glass of water.

Based on this example, you can create the correct diet for a week for coxarthrosis.

Proper nutrition helps to get rid of excess weight, promotes a speedy recovery and strengthens the body. When creating a diet, you can take help from a doctor who will give useful recommendations.

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Treatment of arthrosis of the hip joint in the Solnechny sanatorium in Belarus

Treatment of coxarthrosis is one of the main profiles of the Solnechny sanatorium. Over many years of work at the institution, an impressive practical base has been developed for the management of patients with this type of illness. Within the framework of the sanatorium, a wide range of therapeutic and preventive measures are carried out in the direction of diseases of the musculoskeletal system. The medical base is equipped with all the necessary instruments and equipment for the treatment of pathologies of the hip and other large and small joints. Specifically in this area, the following types of procedures are used: physiotherapy, massage, acupuncture, mud therapy, exercise therapy (including pool and swimming exercises).

Sanatorium Solnechny is the only one in the country that practices treatment of arthrosis of the hip joint through intra-articular injections of hyaluronic acid. A rehabilitation treatment program for hip arthrosis has been successfully applied. See here .