Human hip joints are under enormous stress. Walking, lifting and carrying heavy objects, jumping, running, bending, other physical exercises, and even being overweight all put stress on the musculoskeletal system. Pain in the hip joint reduces its functionality, hinders free movement and causes discomfort to the patient not only during movement, but also during 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 several other specialists work together to evaluate symptoms, look for causes, and treat hip joint pain.
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. These include:
- bruises;
- penetrating wounds;
- femoral neck fracture;
- hip dislocation;
- Fractures of the acetabulum and the upper part of the femur (so-called supratrochanteric fractures).
Of the traumatic causes, damage to the ligamentous apparatus (sprain, rupture, rupture) is less common. Most often, they are caused by serious injuries received by the patient 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;
- tuberculosis of the hip joint;
- Hip joint and other joint types.
- folliculitis;
- 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.
- neuropathy of the sciatic nerve.
- 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 may occur after strength training, carrying heavy objects, or prolonged walking or standing. The risk group includes athletes, extreme sports enthusiasts, loaders, teachers, professors, sellers, couriers, etc.
Other causes of severe pain in the hip joint when walking and at rest can be:
- excess weight, which significantly increases the pressure on the joints.
- posture disorders;
- reckless 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 peri-articular 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 is unpleasant sensations in the joint area of various types: sharp, throbbing, aching, dull, cutting, etc. The localization and intensity of the pain syndrome depend on the initial disease and the patient's health characteristics (presence of accompanying pathologies, overweight, risk factors). Often the pain syndrome spreads to the surrounding structures, radiating to the extremities, the sacrum and coccyx, and the lower back.
Symptoms that may accompany hip pain include:
- tissue swelling in the joint area.
- creaking, clicking and other sounds when moving.
- limited mobility;
- numbness, reduced sensitivity in the leg.
- feeling of heat, pulse in the area of damage.
- lameness, dragging of the leg.
- limb shortening;
- bruises;
- increased body temperature.
Pain in the hip joint, radiating to the lower back, leg, groin and sacrum, may indicate ankylosing spondylitis. This disease is also accompanied by stiffness of movement, knee discomfort and periodic "back pain". Symmetrical pain in the hip area, combined with conjunctivitis and damage to the genitourinary 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 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 move only with the help of an auxiliary point or cannot walk at all.
Diagnostics
In order to establish the exact cause of the pain, other symptoms of the primary disease/injury and to choose an effective treatment regimen, a comprehensive examination is carried out.
First of all, a physical examination is performed. The doctor evaluates the external signs of the 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 surgeries 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 (according to indications).
- joint puncture;
- diagnostic arthroscopy;
- laboratory tests (general clinical blood and urine tests, biochemistry, analysis for rheumatoid factor, cancer 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
The tactic of medical care depends on the cause of the pain. For 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 the use of special structures is indicated.
For hip pain caused by inflammatory or infectious causes, treatment may include:
- antibacterial drugs;
- anti-inflammatory drugs?
- corticosteroid hormones;
- painkillers;
- chondroprotectors;
- cytostatics?
- ointments, creams and other topical agents that stimulate blood flow.
- vitamin complexes;
- synovial fluid substitutes.
The patient must 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, surgery is prescribed. It is performed with an open approach or with an 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.
- endoprosthetic;
- tumor removal;
- permanent fixation of the joint (arthrodesis).
- arthroplasty.
These and other methods of surgical treatment are selected according to the diagnosis and the characteristics of the patient's current condition. After the 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 complicated cases, the consequences can be irreversible.
Possible complications include:
- limb deformity;
- 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 bone plates in soft tissues);
- arthropathy;
- contractions: reduced joint mobility.
- necrosis;
- pathological fractures.
Without treatment, pathologies can cause persistent impairment of mobility, inability to live a full life and even take care of oneself, and disability. With extensive purulent processes in the area of the hip joint, in the absence of treatment, infectious-toxic shock or septicemia can develop, which can be fatal.
Prevention
First of all, experts recommend a healthy lifestyle:
- move more, but do not overload the body with excessive training.
- monitoring body weight to prevent obesity.
- eat a nutritious and varied diet (the diet should be balanced in terms of essential macronutrients and micronutrients, as well as total calorie content);
- Do not use systemic drugs 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 to rest the body regularly and undergo preventive examinations by an orthopedic-traumatologist at least once a year.
Patients with diseases of the musculoskeletal system must be under medical supervision, strictly follow medical instructions and monitor their condition.
In order to avoid injuries to the hip joint, it is recommended to avoid extreme sports, use protective equipment during exercise and not perform complex exercises without the necessary skills and physical training.
It is good for the elderly to move extremely carefully in frosty conditions and 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 examine the patient's problem individually, drawing up a diagnostic and treatment plan 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, obvious and invisible consequences. This is the only way to fully restore the patient's health, to give him back the opportunity to live a normal life, to move without pain or limitations.
When seeking medical help from the clinic's doctors, everyone has the right to count on the friendly attitude of specialists and junior staff, help in rehabilitation and objectivity.