Human hip joints are subjected to enormous stress. Walking, lifting and carrying heavy objects, jumping, running, bending, other physical exercises and even being overweight put pressure on the musculoskeletal system. Pain in the hip joint reduces its functionality, interferes with free movement, and causes suffering to the patient not only during movement, but also at rest. It is very important not to ignore the pain, and at the first symptoms of discomfort, immediately consult a qualified doctor. Orthopedists, traumatologists, surgeons, neurologists and many other specialists jointly evaluate symptoms, search for causes and treat hip joint pain.
Causes of pain
There are many diseases and conditions that can be accompanied by pain. Pain in the left or right hip joint can be caused by injuries, inflammatory and infectious pathologies, various degenerative processes, problems with the supply of useful minerals to the bone tissue, etc. can cause
The most common cause of discomfort is injuries to the soft tissues and joint structures of the hip. These include:
- bruises;
- penetrating wounds;
- femoral neck fracture;
- hip dislocation;
- Fractures of the acetabulum and the upper part of the femur (so-called pertrochanteric fractures).
Damage to the ligament apparatus (sprain, rupture, tear) is less common among traumatic causes. It is most often caused by severe injuries that the patient received as a result of an accident, prolonged exposure to debris or performing extreme stunts.
Infectious, inflammatory and degenerative diseases that can cause pain in the hip joint include:
- various forms of arthritis (infectious, aseptic, rheumatic);
- panarthritis – complete purulent inflammation of the hip joint;
- osteomyelitis;
- tuberculosis of the hip joint;
- coxarthrosis and other types of arthrosis;
- bursitis;
- aseptic necrosis of the femoral head, including Perthes disease;
- chondromatosis;
- trochanteritis.
Other pathological factors include:
- congenital disorders of the development of the hip joint (dysplasia, congenital dislocation of the hip, shortening of the limbs);
- various malignant and benign tumors;
- neuropathy of the sciatic nerve;
- osteochondrosis, scoliosis, intervertebral hernia and other spinal diseases.
Pain in the hip joint while walking or lying down may indicate excessive use of the musculoskeletal system. Unpleasant feeling can occur after strength training, carrying heavy objects or prolonged walking or standing. The risk group includes athletes, fans of extreme sports, loaders, teachers, lecturers, sellers, couriers, etc.
Other causes of severe pain in the hip joint when walking and at rest can be:
- excess weight, which greatly increases the pressure on the joints;
- posture disorders;
- irrational use of certain drugs;
- diabetes;
- neuropsychiatric disorders.
Most people over the age of 50 suffer from pain of varying intensity in this area. This is explained by age-related changes in the periarticular tissues and the joint itself. Women have been observed to suffer from pain more often than men.
Types and symptoms of hip pain
Its main manifestation is discomfort in various types of joint area: sharp, throbbing, aching, dull, cutting, etc. The localization and intensity of the pain syndrome depends on the initial disease and the patient's health characteristics (presence of simultaneous pathologies, overweight, risk factors). The pain syndrome often spreads to the surrounding structures, the limbs, the area of the sacrum and coccyx, and radiating to the lower back.
Symptoms accompanying hip pain include:
- tissue swelling in the joint area;
- crunching, clicking and other sounds during movement;
- limited mobility;
- numbness, reduced sensitivity in the legs;
- feeling of heat, pulsation in the area of damage;
- lameness, dragging of the leg;
- shortening of the limb;
- bruises;
- increased body temperature.
Aching pain in the hip joint that radiates to the lower back, leg, groin, and sacrum area may indicate ankylosing spondylitis. This disease is accompanied by stiffness of movement, discomfort in the knees and periodic "lumbago". Symmetrical pain in the hips, combined with conjunctivitis and damage to the urogenital system can be a sign of Reiter's syndrome.
The clinical picture is determined by the primary disease or injury. In mild cases, the patient's movement is limited, but the ability to stand is preserved. In the case of severe bruises, fractures, dislocations, severe forms of infectious and inflammatory diseases, it is impossible to support the affected leg, the patient can only move with the help of an auxiliary point, or cannot walk at all.
Diagnostics
A comprehensive examination is performed to determine the exact cause of the pain, other symptoms of the primary disease/injury, and to choose an effective treatment regimen.
First of all, they perform a physical examination. The doctor evaluates the external signs of the pathology, palpates the articulation area, asks detailed questions about the nature of the complaints, the time of their occurrence, the circumstances, etc. The specialist must know about previous surgical interventions and injuries, existing chronic pathologies (including those not directly related to the musculoskeletal system), lifestyle, etc.
A comprehensive objective examination includes:
- ultrasound examination of the hip joint (ultrasound);
- X-ray of the pelvis in two views;
- magnetic resonance or computed tomography (as indicated);
- joint puncture;
- diagnostic arthroscopy;
- laboratory tests (general clinical blood and urine tests, biochemistry, rheumatoid factor analysis, tumor markers, etc. ).
The exact list of procedures is determined by the doctor based on the medical history, the characteristics of the patient's current condition and the expected diagnosis.
Treatment of hip pain
The tactics of medical care depend on the cause of the pain. In case of sprains and bruises, the joint is immobilized, the patient is prescribed painkillers and placed on strict bed rest. In case of dislocation, the joint is realigned and the limb is fixed in a standing position. In case of fractures, skeletal traction, plaster immobilization or wearing special structures are recommended.
For hip pain caused by inflammatory or infectious causes, treatment may include:
- antibacterial drugs;
- anti-inflammatory drugs;
- corticosteroid hormones;
- pain relievers;
- chondroprotectors;
- cytostatics;
- ointments, creams, and other topical agents that stimulate blood flow;
- vitamin complexes;
- synovial fluid substitutes.
The patient should receive a complex of physiotherapy, physical therapy and massage, which is necessary to restore motor activity, normalize joint nutrition and eliminate signs of inflammation. This may include:
- massage;
- UHF;
- laser therapy;
- electrophonophoresis;
- magnet therapy;
- shock wave therapy;
- hydrotherapy and swimming.
The patient's lifestyle is corrected: prevention of obesity, normalization of physical activity, limitation of physical exertion, etc.
If conservative treatment does not bring the desired effect, or the primary disease is only treated surgically, surgical intervention is prescribed. It is performed using an open approach or an arthroscopic technique. The following can be performed as part of the surgical treatment of diseases causing hip joint pain:
- reduction of dislocations;
- reconstruction of some joint structures;
- endoprostheses;
- removal of tumors;
- fixed fixation of the joint (arthrodesis);
- joint surgery.
These and other surgical treatment methods are selected according to the diagnosis and the characteristics of the patient's current condition. After the operation, the patient undergoes a rehabilitation course.
Complications
Pain in the hip joint cannot be ignored. Even minor and temporary discomfort can lead to the development of serious diseases in the future. In complicated cases, the consequences can be irreversible.
Possible complications include:
- limb deformity;
- lameness;
- the transition of pain into a chronic form (in this case, they are almost constantly present);
- violation of intra-articular bodies;
- deep vein thrombosis;
- heterotopic ossification (formation of bone plates in soft tissues);
- arthrosis;
- contractures: impaired joint mobility;
- necrosis;
- pathological fractures.
Without treatment, the symptoms can cause permanent mobility limitations, the inability to lead a full life and even self-care, and disability. In case of extensive purulent processes in the area of the hip joint, infectious-toxic shock or sepsis may develop, which can be fatal, in the absence of treatment.
Prevention
Above all, experts recommend a healthy lifestyle:
- move more, but do not overload the body with excessive training;
- monitors body weight to prevent obesity;
- eat a nutritious and varied diet (nutrition must be balanced in terms of essential macro- and micronutrients and total calories);
- Do not use systemic drugs without a doctor's prescription.
For those who are forced to spend a lot of time on their feet due to their professional activities, it is advisable to rest the body regularly and undergo preventive examinations by an orthopedic trauma specialist at least once a year.
Patients with musculoskeletal diseases should be under medical supervision, strictly follow medical instructions and monitor their condition.
In order to prevent injuries to the hip joint, it is recommended to avoid extreme sports, wear protective equipment during training, and not perform complex exercises without the necessary skills and physical preparation.
Elderly people are advised to exercise extreme caution in icy conditions and not go out unless absolutely necessary.
Treatment of hip pain in a professional clinic
The doctors of the multidisciplinary center are high-quality specialists who have the necessary practical knowledge and extensive knowledge in various fields of medicine. The patient's problem is assessed individually, and a diagnostic and treatment program is prepared taking into account all health characteristics. Specialists use an integrated approach to solving various health problems. They not only eliminate a particular symptom, but also try to identify and eliminate its cause, obvious and obvious consequences. This is the only way to fully restore the patient's health, give him the opportunity to lead a normal life, to move without pain and restrictions.
When seeking medical help from the clinic's doctors, everyone has the right to count on the friendly attitude of specialists and junior staff, assistance in rehabilitation and objectivity.