The hip joint experiences the greatest load in the body. They are created by weight while walking, jumping, running, lifting and carrying heavy objects. Patients often feel pain in the hip joint. Orthopedists at specialized hospitals determine the cause using modern diagnostic equipment. Doctors determine the extent of joint damage, which allows them to make an accurate diagnosis and develop optimal treatment tactics.
Professional doctors provide complex therapy for diseases that cause pain in the hip joint. Patients are individually selected effective drugs that affect the cause and mechanism of pain development. Rehabilitation clinicians provide rehabilitation therapy using the latest physiotherapeutic procedures, physical therapy and acupuncture. The presence of a special simulator allows you to reduce the load on the joints during training.
In the process of treating pain in the hip joint, doctors from many medical fields are involved: endocrinologists, rheumatologists, orthopedists, physiotherapists, chiropractors, acupuncturists. A multidisciplinary approach to the treatment of pain in the hip joint allows for rapid pain relief. Patients with hip joint pathology often require outpatient care.
Cause
Pain in the hip joint is caused by the following pathological processes:
- Tendinitis (inflammation of tendons);
- Muscle breakdown;
- Iliotibial band syndrome;
- Other local changes in the surrounding tissue;
- Systemic diseases (rheumatoid arthritis, polymyalgia).
Because the gluteus medius and minimus muscles play a major role in hip abduction, damage to them causes hip pain. The gluteus medius and minimus tendons attach to the greater trochanter. If the inflammatory process develops in it due to microtraumas due to excessive load, the patient will be disturbed by pain in the hip joint. Such disorders may be caused by an infectious process (tuberculosis), sports or stereotypical professional stress, or crystal deposition.
Hip pain is a symptom of the following diseases:
- Osteoarthrosis;
- Radicular Syndrome;
- Rheumatoid arthritis;
- Coxita.
Pain in the hip joint can bother people who are overweight, have different leg lengths, or have flat feet. Pain syndrome can occur after lower limb amputation or hip replacement. With avascular necrosis of the head and fracture of the femoral neck, the patient complained of acute pain in the hip joint. The pain syndrome often develops with dysplasia (disorder of the anatomical structure) of the hip joint. Acute pain in the hip joint, radiating to the leg, occurs in cases of pinched nerves due to spinal disease, malignant bone tumors, and age-related changes.
Examination method
During the first consultation, the rheumatologist conducts a comprehensive examination of the patient:
- Collection of complaints, clarification of the nature of pain in the hip joint;
- Get information about the course of the disease, the onset of pain, the development of pain, household and professional factors that, in the patient's opinion, cause pain;
- External examination allows the doctor to determine visible deviations from the norm. To understand the nature of the pain and the area of its spread, the doctor asks the patient to perform various movements of the lower limbs in the hip joint. The presence of hip joint pathology may be indicated by poor posture;
- Palpation (feeling). Doctors can find rheumatoid and rheumatic nodules, detect the exact location of pain during leg movement, determine the moisture and temperature of the skin in the hip joint area.
Next, the doctor performs goniometry - an examination using a goniometer. It allows you to determine the range of joint mobility. Then the rheumatologist prescribes clinical and biological blood tests and general urine tests. Hospital laboratory technicians perform research using high-quality reagents and modern equipment, which allows you to obtain accurate test results.
With inflammation of the hip joint, the number of leukocytes in the blood increases and the rate of erythrocyte sedimentation increases. The inflammatory nature of this disease is shown by an increase in the content of C-reactive protein in the blood serum.
Immunological blood tests show the presence of antinuclear antibodies in the blood in rheumatic inflammatory diseases. In patients with arthritis, the concentration of uric acid in the blood serum increases dramatically. Lysosomal enzyme content (acid protease, acid phosphatase, cathepsin, deoxyribonuclease) in blood serum and synovial fluid changes in patients with rheumatism, psoriatic polyarthritis, rheumatism, and ankylosing spondylitis. In severe forms of hip joint pathology, significant deviations from the norm are observed in urine analysis.
The doctor at the clinic is conducting an x-ray examination of a patient with hip pain. It is shown in the following cases:
- The presence of chronic or acute pain in the hip joint at rest and during movement;
- The occurrence of difficulty when moving the lower limbs;
- Swelling and discoloration of the skin in the hip joint area.
Using computed tomography, doctors at the clinic evaluate the bones that participate in the formation of the hip joint. On the computed tomogram, the radiologist found changes in the structure of bone tissue, cartilage growth, and osteophytes.
Using magnetic resonance imaging, doctors assess the condition of the soft tissues surrounding the hip joint.
Radionucleotide research methods make it possible to recognize pathologies using radiopharmacological drugs.
Ultrasound examination of the hip joint is performed for injuries, inflammatory diseases, rheumatism and rheumatoid arthritis. The attending physician individually selects in each case the necessary research methods to determine the cause of pain in the hip joint.
Differential diagnosis
Pain in the hip joint when walking is the main complaint for which patients see a doctor. It can be located in the joint area or extend to the thighs, buttocks, or knee joints. If pain occurs in the hip joint during movement, the patient has to use crutches. Often, due to pain, there is a limitation of mobility when moving the hip joint, especially when externally and internally rotating the leg.
Pain in the hip joint, back and groin area is a symptom of aseptic necrosis of the femoral head. This disease is often associated with long-term use of hormonal drugs and alcohol abuse. With the development of deformation of the femoral head, the mobility of the hip joint is limited. In the early stages of the pathological process, the range of motion may be normal.
Pain in the anterior part of the hip joint and a clicking sound when moving the joint bothers patients with iliopectineal bursitis. It radiates to the thigh and is accompanied by paresthesia (tingling, burning, crawling sensation) due to compression of the femoral nerve. The patient feels pain in the hip joint when flexing and extending the lower limb. Pain is also detected on deep palpation in the area of the femoral triangle (the formation is limited by the inguinal ligament, the outer edge of the long adductor muscle, the inner edge of the sartorius muscle).
Pain in the outer hip joint is a sign of iliotibial band syndrome. It is accompanied by a clicking sound when moving, pain on the outside of the knee joint, which increases with movement.
Roth's myalgia is manifested by a burning pain in the anterior outer part of the hip and thigh joints, which increases when walking and straightening the legs. Pain in the hip joint occurs with dysplasia. Over time, the patient develops a characteristic "duck" gait (he walks, walking from side to side).
Pain with coxarthrosis
Pain in the hip joint occurs with coxarthrosis, a disease characterized by degenerative processes in the bones that make up the joint. More often the disease affects older people. With age, joint cartilage tissue loses its elasticity, becomes thinner, and begins to wear out. When the load on the joint increases, thin cartilage tissue is destroyed. The articular surfaces of the bones rub against each other, resulting in aseptic inflammation.
Growths appear on the bones. They significantly limit movement in the joints. Deformation of the articular surface develops, resulting in severe pain. Treatment depends on the severity of the joint damage. Doctors provide drug therapy. If it is not effective, endoprosthetics are performed or palliative treatment is used.
After determining the cause of pain in the hip joint, the doctor begins to treat the disease that causes the pain syndrome. Cases of severe diseases in which patients are disturbed by pain in the hip joint are discussed at expert council meetings with the participation of professors, doctors and candidates of medical sciences, doctors of the highest category.
Treatment
An important condition for the successful treatment of diseases that cause pain in the hip joint is the elimination of factors that cause changes in the structure of bone, cartilage and soft tissue in the joint area. For acute pain, hospital rheumatologists prescribe non-steroidal anti-inflammatory drugs. The patient's well-being improves significantly with the use of local treatment methods - external application of gels and ointments, patches containing non-steroidal anti-inflammatory drugs. They reduce pain in the hip joint during soft tissue inflammation (tendinitis, bursitis, epicondylitis), after injury.
If such therapy is not effective enough, the doctor injects glucocorticoids into the hip joint cavity. The joint space with deformed coxarthrosis is narrowed, it is difficult to get into it. For this reason, rheumatologists in specialized clinics perform the procedure under X-ray control. In the presence of pain caused by inflammation of muscles and tendons, glucocorticoid hormones are injected into the periarticular tissue.
To improve the cartilage condition and reduce pain in the hip joint, chondroprotectors are used. The therapeutic course lasts several months. When there is muscle spasm that participates in movement in the hip joint, muscle relaxants are prescribed to reduce skeletal muscle tone.
Drug therapy is supplemented with physiotherapeutic procedures. They are of secondary importance for pain in the hip joint. The effectiveness of physiotherapeutic treatment methods is reduced due to the deep location. The severity of pain in the hip joint decreases after ultraviolet irradiation with medium long waves.
In the presence of an inflammatory process, high-intensity centimeter wave therapy, infrared laser treatment, and low-intensity UHF are performed. High-intensity high-frequency magnetic therapy, ozone therapy, shock wave therapy stimulate tissue recovery. The intensity of pain that occurs as a result of impaired blood circulation and nutrition of the hip joint is reduced under the influence of various types of electrotherapy (exposure to current) and ultrasound.
To reduce the load on the hip joint, rheumatologists advise patients to use crutches if there is acute pain. After reducing the severity of the pain syndrome, the rehabilitator conducts therapeutic exercises. An individual set of exercises is developed for each patient to quickly restore lower limb function. When the structures that participate in the formation of the hip joint are destroyed, the pain can be so severe that the only way to eliminate it is to replace the joint with an endoprosthesis.
Nonsteroidal anti-inflammatory drugs are prescribed to relieve pain. Treatment depends on the disease affecting the hip joint. Patients are prescribed chondroprotectors for cartilage tissue damage. Orthopedic doctors prescribe effective treatments, diets, and exercises to improve blood circulation in the joints, restore cartilage tissue, and maintain joint mobility. In severe cases, joint replacement with an endoprosthesis is required, which significantly improves the quality of life and eliminates pain.
Treatment with exercise therapy
The use of rehabilitation techniques in the treatment of the hip joint allows you to maintain its mobility, improve blood circulation in the joint, and accelerate the recovery of cartilage tissue. Specialists in the rehabilitation department select a set of physical therapy exercises taking into account the patient's joint disease. Remedial classes are conducted daily under the supervision of an instructor. For rehabilitation therapy, special simulators are used, and physiotherapeutic procedures are prescribed in combination with physical education.
What diseases cause joint pain?
Pain in the hip joint on the right or left side may be a manifestation of avascular necrosis. The disease develops mainly in men and affects only one joint. Treatment consists of eliminating pain, restoring blood supply to the joint area, normal condition of the limb muscles, and maintaining joint function. Patients are given painkillers and anti-inflammatory drugs, vitamins, physiotherapeutic procedures, and therapeutic exercises. Patients are recommended to wear orthopedic shoes and use additional support when moving.
The cause of pain in the hip joint may be a purulent process. Primary purulent arthritis develops when there is a wound or injury and an infectious agent enters the joint cavity. The secondary purulent process develops when sepsis or an infectious agent enters the joint from the surrounding tissue affected by the inflammatory process. To treat purulent arthritis, professional specialists carry out antibacterial therapy. If pus accumulates in the joint cavity, a puncture of the hip joint is performed, the contents are emptied, and an antibacterial agent is injected into the joint cavity.
Bursitis is an inflammation of the joint membrane. To relieve pain, doctors prescribe injections of anti-inflammatory drugs and glucocorticoids. If purulent inflammation develops, the periarticular bursa cavity is cleaned. In severe cases, using surgical endoscopic techniques, the joint capsule, which has undergone irreversible changes, is removed.
In osteoporosis, fractures of the femoral neck often occur. The patient is bothered by sharp and severe pain when moving in the hip joint, which radiates to the groin and inner thigh. Feet turned outwards. Bruising and swelling appear in the hip joint area. In this case, treatment is carried out by a professional orthopedic specialist.
Traumatic hip dislocation is accompanied by pain in the hip joint. The hip is reduced under general anesthesia. Congenital hip dislocation is diagnosed shortly after birth. It manifests itself as severe pain when spreading the legs and bending the knees. Treatment is carried out using a special orthopedic structure.
If you or a loved one has pain in the hip joint, you should not self-medicate. Seek professional medical attention immediately. Patients with acute pain are usually hospitalized in the clinic for at least a week. If the pain is not strong, the patient may be offered an examination by a professional doctor for hip joint disease and treatment at home with strict adherence to all the rules.