Osteoarthritis of the hip (hofte artrose)
Rehab methods
Mobilitets program – Rehab strength workout
Description of osteoarthritis of the hip
Osteoarthritis of the hip occurs when the surface cartilage of the bones (also called hyaline cartilage or articular cartilage) becomes worn away, leaving the raw bone free. The articular cartilage normally acts as a protective layer between the bones and is both very thin and extremely strong. You could compare it with asphalt on a road that protects the underlying layers of sand, stable gravel, pipes, wires and whatever else may be under the asphalt. The articular cartilage is also incredibly smooth. With two smooth joint surfaces with articular cartilage and a bit of synovial fluid, it means that the frictional resistance is very low, while the movement can take place very easily. When the cartilage breaks down for various reasons, age, improper wear or lack of nutrition, the bone is exposed and the surface becomes rough and uneven, in the same way as an old road with many holes in the asphalt. This of course means that mobility is reduced and you get the pain from trying to move in extreme positions that people associate with osteoarthritis.
There are over 200 types of arthritis, and osteoarthritis is by far the most common. The hip joint is the second most affected among the large joints of the body. Osteoarthritis is a chronic disease that can develop from asymptomatic to major symptoms over months to years. The condition itself cannot be cured, but the symptoms of reduced mobility that most people experience, can be treated. There are also varying degrees of osteoarthritis, and most patients have the mild degree where with proper therapy, can become virtually asymptomatic. Conversely, some cases of osteoarthritis of the hip can cause severe pain when using the hip and greatly reduced mobility, affecting one’s ability to walk, work or stay active. In such cases, a new artificial hip (hip alloplasty) may be the only way to have a reasonably active and pain-free life.
Osteoarthritis of the hip often starts with having pain around the hip where the muscles attach, followed by reduced mobility, sometimes only related to certain activities or continuous activity. The pain increases if you put weight on the leg that is a problem (if it is not both of them), and if you have been at rest for a long time. Later, a strong unevenness can appear on the joint’s surface, due to cartilage wear, and limescale deposits on the bones. These in turn can give rise to other symptoms in the legs and back. When osteoarthritis becomes severe, you have constant pain, both during activity and when you are at rest. Precisely because osteoarthritis is a constant condition that gradually changes all the time, pills and injections also become less and less effective.
Many people with osteoarthritis of the hip also gain weight, not because it affects the metabolism, but because one’s activity level changes markedly, which exacerbates the condition.
However, there are some other conditions that can cause the same pain in the beginning as hip osteoarthritis, and therefore it is necessary to rule out other conditions / diseases before putting together a therapy proposal. Spinal stenosis (narrowing of the spinal cord), bursitis (inflammation of the mucous membranes of the hip) and other types of arthritis in the hip should be ruled out. So-called post traumatic arthritis, which is the second most common type of arthritis and avascular necrosis (a condition in which the tissue dies because it does not receive blood and oxygen) are very difficult to distinguish from common hip arthritis.
It is not possible to predict who will get hip osteoarthritis, but there are risk factors that for determining whether you are in a higher risk group for contracting the condition.
These are:
- Genetics as there is a hereditary tendency.
- Pediatric diseases such as hip dysplasia, Legg-Calve-Perthes, Epiphysiolysis capitis femoris (SCFE)
- Avascular hip necrosis, which can be caused by consuming too much alcohol, medication, and especially Prednisone which is also called adrenocortical hormone.
- Femoro-acetabular impingement.
- Misalignment in the pelvis; here it is the posterior rotation of the os ilium which can squeeze the vein which carries the blood back from the acetabulum (hip socket).
- Severe hip trauma, such as fractures of the hip socket or femur.
- Through the years, obesity adds extra extra pressure on the cartilage ends, which is exacerbated by the fact obese people are generally inactive.
Symptoms of osteoarthritis of the hip
- Pain around the hip joint during activity.
- Pain and discomfort when leaving rest.
- Later on pain and discomfort in all situations, including rest.
- Pain and discomfort in legs and back.
Diagnosis of osteoarthritis of the hip
A number of clinical tests as well as the patient’s medical history can help diagnose osteoarthritis of the hip. The safest examination, is X-ray, which should be taken standing up. MRI scans are not very useful to confirm whether it is osteoarthritis, unless it is a mild osteoarthritis where inflammation can also be seen.
Treatment of osteoarthritis of the hip
Der er næsten lige så mange forslag til terapi, som er der terapeuter, og noget virker på nogen, mens andre slet ikke har effekt af samme behandling. Så det kan være lidt af en jungle at finde den terapiform der hjælper dig. Der er dog nogle generelle ting som burde hjælpe på de fleste.
- Exercise therapy is the most effective form of therapy if one has hip osteoarthritis. It can quickly reduce the pain and increase mobility. This also fights obesity, compounding the help.
- Dietary supplements containing glucosamine and chondroitin but in humans this only works when taking a lot of Vitamin C, at least 1000 mg*
- Diet change. It has been shown that people who eat more acidic foods have more symptoms. We will write about dietary acid-base balance later.
- Re5 electromagnetic pulse generator transmits pulses to the selected part of the body. See more at: re.com.
- K-laser or class4 lasers. It must be a class 4 laser, as otherwise the light will not be able to penetrate into the problem area of the hip. See more at k-laser.dk
- Many also have a really good response to acupuncture.
- Anti-inflammatory agents such as Ibuprofen or Naproxen. Talk to your own doctor about what is best for you.
- Many people respond to Curmin-black, which is a substance found in turmeric and peperin, which is a substance in pepper. Some who have a more liberal view of natural medicine claim that this combination is many times stronger than any NSAID, and has no side effects.
- Surgery as an absolutely last resort if one’s pain is constant, therapy is not helping and one feels one’s quality of life diminished.
* For years, veterinarians used glucosamine and chondroitin to treat dogs especially for osteoarthritis of the hip. When it helped the animals, there was a lot of pressure on the politicians in Denmark to get the trump card through that it also became a medicine. Many acquired it from abroad or in the German border trade. Since then, after it was declared a drug that one could get a prescription from the doctor, a study was done that showed it did not have a great effect on osteoarthritis patients. No one could understand why it did not work on humans while it did on animals. Some people think the cause must be found in vitamin C, of which humans do not produce themselves and have to include in their diet. Vitamin C is very important for the liver to make the right building blocks that form the connective tissue collagen. Therefore, remember to take a strong supplement of vitamin C if you decide to try glucosamine and chondroitin. We recommend Mega-C which is a 1500 mg. tablet, but otherwise you need over 1000 mg, preferably slow-absorbing tablets, as the body can only absorb a certain amount at a time.
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