Human hip joints are subject to great stress. Walking, lifting and carrying heavy objects, jumping, running, bending, other physical exercises and even being overweight all 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 seek help from qualified doctors. Orthopedists, traumatologists, surgeons, neurologists and a number of other specialists together evaluate symptoms, look for causes and treat pain in the hip joint.
Causes of pain
There are a large number of diseases and pathological conditions that can be accompanied by pain. Pain in the hip joint on the left or right side can be caused by injuries, inflammatory and infectious pathologies, various degenerative processes, problems with the supply of useful minerals to bone tissue, etc.
Injuries to the soft tissues and osteoarticular structures of the hip area are the most common cause of discomfort. This includes:
- bruises;
- penetrating wounds;
- femoral neck fracture;
- hip dislocation;
- Fractures of the acetabulum and the upper part of the femur (so-called pertrochanteric fractures).
From traumatic causes, damage to the ligamentous apparatus (sprain, tear, rupture) is less common. Most often, they are caused by severe injuries that the patient received as a result of an accident, prolonged exposure to debris or due to performing extreme stunts.
Infectious, inflammatory and degenerative diseases that can cause pain in the hip joint include:
- various forms of arthritis (infectious, aseptic, rheumatoid);
- panarthritis - total purulent inflammation of the hip joint;
- osteomyelitis;
- hip joint tuberculosis;
- coxarthrosis and other types of arthrosis;
- scholarships;
- aseptic necrosis of the femoral head, including Perthes disease;
- chondromatosis;
- trochanteritis.
Other pathological factors include:
- congenital anomalies of the development of the hip joint (dysplasia, congenital hip dislocation, limb shortening);
- various neoplasms of malignant and benign nature;
- sciatic nerve neuropathy;
- osteochondrosis, scoliosis, intervertebral hernia and other diseases of the spine.
Pain in the hip joint when walking or lying down can indicate excessive stress on the musculoskeletal system. Discomfort 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 while 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.
The largest number of patients with pain of varying intensity in this area are people over 50 years old. This is explained by age-related changes in the periarticular tissues and the joint itself. It has been observed that women suffer from pain more often than men.
Types and symptoms of hip pain
The main manifestation are unpleasant sensations in the joint area of various types: sharp, throbbing, painful, dull, cutting, etc. The localization and intensity of the pain syndrome depend on the initial disease and the health characteristics of the patient (presence of accompanying pathologies, excess weight, risk factors). Often the pain syndrome spreads to the surrounding structures, radiating to the limbs, the area of the sacrum and coccyx and the lower back.
Symptoms that may accompany hip pain include:
- tissue swelling in the joint area;
- crackling, clicking and other sounds during movement;
- limited mobility;
- numbness, decreased sensation in the legs;
- feeling of heat, throbbing in the area of damage;
- lameness, dragging of the leg;
- limb shortening;
- bruises;
- elevated body temperature.
Painful pain in the hip joint, radiating to the lower back, leg, hip and sacral area, may indicate ankylosing spondylitis. This disease is also associated with stiffness in movement, discomfort in the knee and periodic "lumbago". Symmetrical pain in the groin area, combined with conjunctivitis and damage to the genitourinary system, can be a sign of Reiter's syndrome.
The clinical setting is determined by the primary disease or injury. In mild cases, the patient is limited in movement, but the ability to support the leg remains. With severe bruises, fractures, dislocations and severe forms of infectious and inflammatory diseases, support on the affected leg is impossible; the patient can only move with the help of a crutch or cannot walk at all.
Diagnosing
In order to determine the exact cause of the pain, other symptoms of the primary disease/injury and to choose an effective treatment regimen, a comprehensive examination is performed.
First of all, a physical examination is done. The doctor assesses the external signs of pathology, palpates the joint area, asks detailed questions about the nature of the complaints, the time and circumstances of their appearance, etc. The specialist should also 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 projections;
- magnetic resonance or computed tomography (according to indications);
- joint puncture;
- diagnostic arthroscopy;
- laboratory tests (general clinical tests of blood and urine, biochemistry, analysis for rheumatoid factor, 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.
Hip pain treatment
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, followed by fixation of the limb in a stationary position. For fractures, skeletal traction, plaster immobilization or dressing of special structures is indicated.
For hip pain that is 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 is required to receive a complex of physiotherapy, physical therapy and massage necessary to restore motor activity, normalize joint nutrition and eliminate signs of inflammation. This may include:
- massage;
- UHF;
- laser therapy;
- electrophonophoresis;
- magnetic therapy;
- shock wave therapy;
- hydrotherapy and swimming.
The patient's lifestyle is corrected: prevention of obesity, normalization of physical activity, limitation of strength loads, etc.
If conservative treatment does not have the desired effect or the primary disease is treated only surgically, surgical intervention is prescribed. It is performed using an open approach or using the arthroscopic technique. As part of the surgical treatment of diseases that cause pain in the hip joint, the following can be performed:
- reduction of dislocations;
- reconstruction of individual joint structures;
- endoprosthetics;
- tumor removal;
- fixed fixation of the joint (arthrodesis);
- arthroplasty.
These and other methods of surgical treatment are selected in accordance with the diagnosis and the characteristics of the patient's current condition. After surgical treatment, the patient undergoes a rehabilitation course.
Complications
Pain in the hip joint cannot be ignored. Even small and temporary discomfort can lead to the development of serious diseases in the future. In complex cases, the consequences can be irreversible.
Possible complications include:
- deformation of limbs;
- lameness;
- the transition of pain to a chronic form (in this case, they are present almost constantly);
- 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, pathologies can cause permanent impairment of mobility, inability to live a full life and even to take care of oneself and disability. With extensive purulent processes in the hip joint area, in the absence of treatment, infectious-toxic shock or sepsis can develop, which can be fatal.
Preventing
First of all, experts recommend a healthy lifestyle:
- move more, but do not overload the body with excessive training;
- monitor body weight to prevent obesity;
- eat a nutritious and varied diet (food should be balanced in terms of basic macro- and micronutrients, as well as total calorie content);
- Do not use systemic medications without a doctor's prescription.
For people who, due to their professional activities, are forced to spend a lot of time on their feet, it is recommended that at least once a year they regularly rest their bodies and undergo preventive examinations by an orthopedist-traumatologist.
Patients with diseases of the musculoskeletal system should be under the supervision of the dispensary, strictly follow medical instructions and monitor their condition.
To prevent injuries to the hip joint, it is recommended to avoid extreme sports, wear protective equipment during exercise and not perform complex exercises without the necessary skills and physical training.
It is advised that the elderly move very carefully in icy conditions and do not go outside unless absolutely necessary.
Treatment of hip pain in a professional clinic
The doctors of the multidisciplinary center are high-class specialists with the necessary practical skills and extensive knowledge in various fields of medicine. They consider the patient's problem individually, designing a diagnostic and treatment program taking into account all health characteristics. Specialists use an integrated approach to solve a variety of health problems. They not only eliminate a specific symptom, but also try to identify and eliminate its cause, visible and invisible consequences. This is the only way to fully restore the patient's health, to give him the opportunity to live a normal life, to move without pain and limitations.
When seeking medical help from the clinic's doctors, everyone has the right to count on the friendly attitude of specialists and young staff, assistance in rehabilitation and objectivity.