Human hip joints are subjected to great stress. Walking, lifting and carrying heavy objects, jumping, running, bending over, other physical exercises and even being overweight put pressure on the musculoskeletal system. Pain in the hip joint reduces its functionality, prevents free movement and causes pain to the patient not only during movement, but also during rest. It is very important not to ignore the pain and immediately seek help from qualified doctors at the first signs of discomfort. Orthopedists, traumatologists, surgeons, neurologists and a number of other specialists together evaluate symptoms, search for causes and treat pain in the hip joint.
Causes of pain
There are many diseases and pathological conditions that can be accompanied by pain. Pain in the hip joint on the left or right side is caused by injuries, inflammatory and infectious pathologies, various degenerative processes, problems with the supply of useful minerals to the bone tissue, etc.
Damage to the soft tissues and osteoarticular structures of the hip is 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 (the so-called pertrochanteric fractures).
Damage to the ligament apparatus due to traumatic reasons (sprain, tear, fracture) is less common. Often, these are caused by severe injuries the patient has sustained in an accident, prolonged exposure to debris, or performing extreme stunts.
Infectious, inflammatory, and degenerative diseases that can cause hip pain include:
- various forms of arthritis (infectious, aseptic, rheumatoid);
- panarthritis - general 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 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 while walking or lying down can indicate excessive tension in the musculoskeletal system. Discomfort can occur after strength training, carrying heavy objects, or walking or standing for long periods of time. The risk group includes athletes, extreme sports enthusiasts, loaders, teachers, lecturers, sellers, couriers, etc.
Other causes of severe pain in the hip joint while walking and resting may be:
- excess weight, which greatly increases the pressure on the joints;
- posture disorders;
- ineffective use of certain drugs;
- diabetes;
- neuropsychiatric disorders.
Most of the patients with pain of varying intensity in this area are people over 50 years old. This is explained by age-related changes in periarticular tissues and the joint itself. It has been observed that women suffer from pain more than men.
Types and symptoms of hip pain
The main manifestation is various types of unpleasant sensations in the joint area: sharp, pulsating, aching, dull, cutting, etc. The localization and intensity of the pain syndrome depends on the primary disease and the patient's health characteristics (presence of combined pathologies, excess weight, risk factors). Often, the pain syndrome spreads to the surrounding structures, spreads to the limbs, the sacrum and coccyx region, 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, decreased sensitivity in the leg;
- feeling of warmth, pulsation in the damaged area;
- lameness, dragging of the leg;
- shortening of the limb;
- bruising;
- high body temperature.
Painful pain in the hip joint that spreads to the back, leg, groin, and sacral region may indicate ankylosing spondylitis. This disease is also accompanied by stiffness of movement, discomfort in the knee and periodic "lumbago". Symmetrical pain in the buttock along with conjunctivitis and damage to the genitourinary system can be a symptom of Reiter's syndrome.
The clinical picture is determined by the underlying disease or injury. In mild cases, the patient's movement is limited, but the ability to support the leg remains. With severe bruises, fractures, dislocations and severe forms of infectious and inflammatory diseases, the support of the affected leg is impossible, 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 main disease / injury and to choose an effective treatment regimen.
First, a physical examination is performed. The doctor evaluates the external signs of pathology, palpates the articulation area, asks detailed questions about the nature of the complaints, the time and conditions of their occurrence, etc. The specialist also examines 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 blood and urine tests, 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
The tactics of medical help depends 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 withdrawal, the joint is realigned, followed by fixation of the limb in a stationary position. For bone fractures, drawing of the skeleton, immobilization of plaster or wearing of special structures is indicated.
Treatment for hip pain due to inflammatory or infectious causes may include:
- antibacterial drugs;
- anti-inflammatory drugs;
- corticosteroid hormones;
- pain relievers;
- chondroprotectors;
- cytostatics;
- ointments, creams and other local 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 inflammatory symptoms. 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 power loads, etc.
If conservative treatment does not give the desired effect, or if the main disease can be treated only surgically, surgical intervention is prescribed. It is performed using an open approach or arthroscopic technique. As part of the surgical treatment of diseases that cause pain in the hip joint, the following can be done:
- reduction of dislocations;
- reconstruction of individual joint structures;
- endoprosthetics;
- tumor removal;
- stable fixation of the joint (arthrodesis);
- arthroplasty.
These and other surgical treatment methods are selected according to 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 results may be irreversible.
Possible complications include:
- deformation of limbs;
- lameness;
- the transition of pain into a chronic form (in this case, they are almost always present);
- disruption of intra-articular organs;
- deep vein thrombosis;
- heterotopic ossification (formation of bone plates in soft tissues);
- arthrosis;
- contractures: impaired joint mobility;
- necrosis;
- pathological fractures.
Without treatment, pathologies can lead to permanent impairment of mobility, inability to live a full life and even inability to care for oneself and disability. With extensive purulent processes in the hip joint, in the absence of treatment, infectious-toxic shock or sepsis can develop, which can be fatal.
Prevention
Experts recommend leading a healthy lifestyle first:
- move more, but do not overload the body with excessive exercise;
- 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 caloric content);
- Do not use systemic drugs without a doctor's prescription.
For people who have to spend a lot of time on their feet due to their professional activities, it is recommended to regularly rest the body and undergo preventive examinations by an orthopedic traumatologist at least once a year.
Patients with diseases of the musculoskeletal system should be under the supervision of a dispensary, strictly follow medical instructions and monitor their condition.
To prevent damage to the hip joint, it is recommended to avoid extreme sports, use protective equipment while exercising, and not to perform complex exercises without the necessary skills and physical preparation.
Elderly people are advised to exercise extreme caution in icy conditions and not go outside unless absolutely necessary.
Treatment of hip pain in a professional clinic
The doctors of the multidisciplinary center are high-level specialists with the necessary practical skills and extensive knowledge in various fields of medicine. They consider the patient's problem individually, draw up a diagnostic and treatment program taking into account all health characteristics. Specialists use an integrated approach to solve various health problems. They not only eliminate a certain 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 return him to the possibility of leading a normal life, pain-free and unrestricted movement.
When seeking medical help from the clinic's doctors, everyone has the right to hope for the friendly attitude of specialists and small staff, help in rehabilitation and objectivity.