PAIN IN THE HIP – CAUSES AND TREATMENTS

Hip osteoarthritis, also known as coxarthrosis, is one of the most common types of osteoarthritis. In simple terms, osteoarthritis refers to the wear and tear of a joint. This is because our joint surfaces are covered with cartilage. This cartilage has excellent sliding properties, so that friction during movement is minimised. Osteoarthritis leads to an increasing loss of joint cartilage.

There are many different causes for this. Injuries, inflammation or rheumatic diseases, but also chronic misuse and overloading as well as obesity and circulatory disorders can increase the risk of hip osteoarthritis. The consequences are pain in the hip, which can also become noticeable at rest in the advanced stages of osteoarthritis. Swelling and inflammation can also occur. Sometimes even secondary leg shortening results in the lower extremities. In the final stage, the joint can stiffen.

Fortunately, there are initially conservative treatment options. For example, doctors first recommend reducing weight and doing targeted sport as well as changing or optimising your diet. Physiotherapy measures can also be very helpful for hip osteoarthritis. They stabilise and relieve the joint by building up muscles. The movement and coordination exercises help to counteract the increasing stiffening of the joint and the degradation of the joint cartilage. There are also numerous other options such as manual therapy or cold, heat and electrical applications. Anti-inflammatory and pain-relieving medication and injections also alleviate hip pain caused by hip osteoarthritis. Hyaluronic acid therapy can temporarily improve the gliding behaviour in the early stages of hip osteoarthritis. ACP therapy also offers new possibilities. This involves the body’s own plasma, which stimulates the regeneration processes.

Necrosis of the femoral head is a painful disease of the hip joint that is associated with the death of the femoral head due to a circulatory disorder. The femoral head is inadequately supplied with oxygen, minerals and nutrients and bone cells increasingly die off.

Their primary function of controlling constant bone formation and resorption adapted to the changing load requirements can no longer be fulfilled biologically. The result: vital bone areas, in the worst case the entire femoral head, die off. The causes of femoral head necrosis vary and are often difficult to determine. However, it is known that femoral head necrosis goes through four stages. And the treatment also depends on the respective stage. The extent and localisation play an important role as well. However, the procedure must be considered in the context of the client: the patient’s age and general constitution are taken into account when choosing the therapeutic measures.

In early stage I, a conservative treatment approach may still be successful. Weight relief of the hip joint through the use of forearm crutches, mechanical relief in the context of physiotherapy, rest from sport and the use of hyperbaric oxygen therapy can be suitable measures in addition to treatment with medication as required. This is because incipient necrosis in the hip joint can still be reversible and therefore curable at this early stage. In stage II and, depending on the extent of the femoral head necrosis, occasionally also in stage III, femoral head necrosis can be treated by drilling or inserting vascularised bone grafts. This involves revitalising the femoral head by inserting a “living bone”. This form of therapy can prevent the need for a prosthesis.

In stage IV, the destruction process is already so far advanced that arthrotic deformation of the joint has set in. In these cases, an artificial hip joint, i.e. an endoprosthesis, is inserted. This procedure can be performed using the minimally invasive AMIS technique.