Human hip joints are under enormous stress. Walking, lifting and carrying heavy objects, jumping, running, bending, other physical exercises and even excess weight put strain on the musculoskeletal system. Pain in the hip joint reduces its functionality, interferes with freedom of movement and causes the patient to suffer not only during movement, but also at rest. It is very important not to ignore the pain and, at the first symptoms of discomfort, to immediately seek help from a qualified doctor. Orthopedists, traumatologists, surgeons, neurologists and many other specialists together evaluate the symptoms, look for the causes and treat pain in the hip joint.
Causes of pain
There are a large number of diseases and 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 are the most common cause of discomfort. These include:
- bruises;
- penetrating injuries;
- femoral neck fracture;
- hip dislocation;
- Fractures of the acetabulum and the upper part of the femur (so-called pertrochanteric fractures).
Among traumatic causes, damage to the ligamentous system (sprain, tear, rupture) is less common. Most often, they are caused by serious injuries that the patient suffered from an accident, prolonged exposure to rubble, or 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;
- tuberculosis of the hip joint;
- coxarthrosis and other types of osteoarthritis;
- bursitis;
- 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 dislocation of the hip, shortening of the limbs);
- 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 may indicate excessive stress on the musculoskeletal system. Discomfort may occur after strength training, carrying heavy objects, or prolonged walking or standing. The risk group includes athletes, extreme sports enthusiasts, chargers, teachers, lecturers, sellers, couriers, etc.
Other causes of severe pain in the hip joint when walking and at rest can be:
- excess weight, which considerably increases the pressure on the joints;
- posture disorders;
- irrational use of certain medications;
- diabetes;
- neuropsychiatric disorders.
The largest number of patients suffering from 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 in 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 is unpleasant sensations in the joint area of different types: sharp, throbbing, painful, dull, cutting, etc. The location and intensity of the pain syndrome depend on the initial illness and the health characteristics of the patient (presence of concomitant pathologies, excess weight, risk factors). Often, the pain syndrome spreads to surrounding structures, radiating to the limbs, the sacrum and coccyx region, as well as the lower back.
Symptoms that may accompany hip pain include:
- swelling of tissues in the joint area;
- crackles, clicks and other sounds when moving;
- reduced mobility;
- numbness, decreased sensitivity in the leg;
- sensation of heat, pulsation in the damaged area;
- lameness, leg dragging;
- shortening of the limb;
- bruises;
- high body temperature.
Aching pain in the hip joint, radiating to the lower back, leg, groin and sacral region, may indicate ankylosing spondylitis. This disease is also accompanied by stiffness in movements, knee discomfort and periodic "lumbago". Symmetrical pain in the hip area, combined with conjunctivitis and damage to the genitourinary system, may be a sign of Reiter's syndrome.
The clinical picture is determined by the primary disease or injury. In mild cases, the patient's movements are limited, but the ability to support the leg remains. In case of severe bruises, fractures, dislocations and severe forms of infectious and inflammatory diseases, weight bearing on the affected leg is impossible; the patient can only move with the help of an auxiliary point or cannot walk at all.
Diagnostic
To establish the exact cause of pain, other symptoms of the primary disease / injury and select an effective treatment regimen, a comprehensive examination is carried out.
First, a physical exam is performed. The doctor assesses external signs of pathology, palpates the joint area, asks detailed questions about the nature of 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 (as indicated);
- joint pricking;
- 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, characteristics of the patient's current condition and the expected diagnosis.
Treatment of hip pain
Medical care tactics depend on the cause of the pain. In case of sprains and bruises, the joint is immobilized, the patient is prescribed painkillers and put to bed strictly. In the event of a dislocation, the joint is realigned, followed by fixation of the limb in a stationary position. In case of fractures, skeletal traction, cast immobilization or the wearing of special structures are indicated.
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 circulation;
- vitamin complexes;
- synovial fluid substitutes.
The patient should receive a complex of physiotherapy, physiotherapy and massages necessary to restore motor activity, normalize joint nutrition and eliminate signs of inflammation. This may include:
- massage;
- Ultra-high frequency;
- 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 efforts, etc.
If conservative treatment does not have the desired effect or the primary disease is treated only surgically, surgical intervention is prescribed. It is carried out by an open approach or by an arthroscopic technique. As part of the surgical treatment of diseases causing pain in the hip joint, the following operations can be performed:
- reduction of dislocations;
- reconstruction of individual joint structures;
- endoprostheses;
- removal of tumors;
- fixed fixation of the joint (arthrodesis);
- arthroplasty.
These and other methods of surgical treatment are selected depending on the diagnosis and 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 minor and temporary discomfort can lead to the development of serious illnesses in the future. In complex cases, the consequences may be irreversible.
Possible complications include:
- limb deformation;
- lameness;
- 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 bony plates in soft tissues);
- osteoarthritis;
- contractures: impaired joint mobility;
- necrosis;
- pathological fractures.
If left untreated, the conditions can lead to persistent mobility impairment, an inability to live fully or even take care of oneself, and disability. In case of extensive purulent processes in the hip joint area, in the absence of treatment, infectious-toxic shock or sepsis may develop, which can be fatal.
Prevention
First of all, experts recommend leading 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 (nutrition 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 advisable to regularly rest the body and undergo preventive examinations by an orthopedist-traumatologist at least once a year.
Patients with diseases of the musculoskeletal system should be under dispensary observation, strictly follow medical instructions and monitor their condition.
In order to prevent hip joint injuries, it is recommended to avoid extreme sports, wear protective equipment when exercising, and not perform complex exercises without the skills and trainingphysical requirements.
Elderly people are advised to travel with extreme caution in freezing conditions and not to go out unless absolutely necessary.
Treatment of hip pain in a professional clinic
Doctors of the multidisciplinary center are high-level specialists with the necessary practical skills and in-depth knowledge in various fields of medicine. They consider the patient's problem individually and develop a diagnostic and treatment program taking into account all health characteristics. Specialists use an integrated approach to solving various health problems. They not only eliminate a specific symptom, but also try to identify and eliminate its cause, obvious and non-obvious 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 or restrictions.
When seeking medical help from doctors of the clinic, everyone has the right to count on the friendly attitude of specialists and junior staff, assistance in rehabilitation and objectivity.