The influence of kinesiotherapy in pain relief and reduction of medication prescribed for patients with coxofemoral degenerative joint disease

Abstract

The entire joint gradually wears down incoxofemoral degenerative joint disease, albeit the articular cartilage of the femoral head and acetabulum is affected the most. Coxofemoral degenerative joint disease’s prevalence is increasing due to the elderly population’s life expectancy increase, thus making these patients compelled to resort to pain relief medication. This medication includes nonsteroidalanti-inflammatory drugs, taken orally or topically, whose efficacy has been shown by various studies as high, but only during the first weeks, thereafter becoming futile. Chronic pain experienced by the elderly population due to coxofemoral degenerative joint disease has a negative impact on their quality of life. Given the high risk of comorbidities and toxicity to medication, we have hypothesized that kinetic treatment of the coxofemoral degenerative joint disease is, if not an alternative to pharmacological therapy, at least a way to reduce the nonsteroidal anti-inflammatory and anti-rheumatic drugs taken, which would then lead to high pain relief/ prevention and maintaining independence in carrying out the physical activities of daily living in the old age patients affected by this joint disease. We conducted a comparative study on patients with stage one and stage two coxofemoral degenerative joint disease, evaluating the results of two batches of female patients: an experimental one (who followed a kinetic programme we proposed) and a control group (who did not follow a kinetic program, but agreed to participate in assessments). Due to the high risk of toxic reactions: gastro-intestinal, hepatic, renal, cardio-circulatory, cerebrovascular etc. the elderly patients are prone to have to the drugs in the nonsteroidal anti-inflammatory and anti-rheumatic drugs pharmacological group, as well as low effectiveness in the disease’s late stages, the optimal pain management for joint pain in the coxofemoral degenerative joint disease is non-pharmacological, using kinesiotherapy or hip replacement. In designing the kinetic programme, we inserted predominantly proprioceptive neuromuscular facilitation techniques and stretching, as their therapeutic value is recognized. The operational strategy proposed, carried out based on the patient’s functional capacities and permanently adapted to the progress made by them, both in terms of content, and dosage, at the same time considering the continuous evolution of degenerative processes led to a favourable outcome, demonstrating a significant decrease of joint pain, an enhancement of the possibilities to perform most of the domestic activities, but also a significant reduction of medication use; this verified our hypothesis.