Human hip joints are subject to enormous stress. Walking, lifting and carrying heavy objects, jumping, running, bending, other physical exercises and even being overweight 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 several other specialists jointly 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 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 soft tissues and osteoarticular structures in the hip region 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 pertrochanteric fractures).
Of the traumatic causes, damage to the ligamentous apparatus (sprain, rupture, rupture) is less common. Most often, they are caused by serious injuries that the patient has suffered as a result of an accident, prolonged exposure to debris, or due to performing extreme stunts.
Infectious, inflammatory and degenerative diseases that can cause hip joint pain include:
- various forms of arthritis (infectious, aseptic, rheumatoid);
- panarthritis – total purulent inflammation of the hip joint;
- osteomyelitis;
- tuberculosis of the hip joint;
- hip arthrosis and other types of arthrosis;
- bursitis;
- aseptic necrosis of the femoral head, including Perthes disease;
- chondromatosis;
- trochanteritis.
Other pathological factors include:
- congenital anomalies in 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 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, porters, teachers, speakers, salespeople, delivery people, etc.
Other causes of severe pain in the hip joint when walking and at rest may be:
- excess weight, which greatly increases pressure on joints;
- postural disorders;
- irrational use of certain medications;
- 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 is unpleasant sensations in the joint area of various types: sharp, pulsating, painful, dull, cutting, etc. The location and intensity of the pain syndrome depend on the initial disease and the patient's health characteristics (presence of concomitant pathologies, excess weight, risk factors). Often, the pain syndrome spreads to the surrounding structures, radiating to the limbs, the sacrum and coccyx area, and the lower back.
Symptoms that may accompany hip pain include:
- swelling of tissues in the joint area;
- crunches, clicks and other sounds during movement;
- Limited mobility;
- numbness, decreased sensitivity in the leg;
- feeling of heat, pulsation in the damaged area;
- lameness, dragging of the leg;
- limb shortening;
- bruises;
- elevated body temperature.
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 of movement, discomfort in the knee and periodic "low back pain". 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 has limited 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 an auxiliary point or cannot walk at all.
Diagnosis
To establish the exact cause of pain, other symptoms of the primary disease/injury and select an effective treatment regimen, a comprehensive examination is performed.
First, a physical examination is performed. The doctor evaluates the external signs of the pathology, palpates the articulatory area, asks detailed questions about the nature of the complaints, the time and circumstances of their occurrence, etc. The specialist also needs to 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);
- pelvis x-ray in two projections;
- magnetic resonance imaging or computed tomography (as indicated);
- joint puncture;
- 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, the characteristics of the patient's current condition and the expected diagnosis.
Hip pain treatment
Medical care tactics depend on the cause of the pain. In case of sprains and bruises, the joint is immobilized, the patient is given painkillers and placed on complete rest. In case of dislocation, the joint is realigned, followed by fixing the limb in a stationary position. For fractures, skeletal traction, plaster immobilization or the use of special structures are indicated.
For hip pain caused by inflammatory or infectious causes, treatment may include:
- antibacterial medicines;
- anti-inflammatory medications;
- corticosteroid hormones;
- analgesics;
- chondroprotectors;
- cytostatics;
- ointments, creams and other topical agents that stimulate blood flow;
- vitamin complexes;
- synovial fluid substitutes.
The patient is obliged to receive a complex of physiotherapy, physical therapy and massages 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 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;
- endoprostheses;
- tumor removal;
- 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 course of rehabilitation.
Complications
Hip joint pain cannot be ignored. Even minor, 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 deformity;
- lameness;
- transition of pain to chronic form (in this case, they are present almost constantly);
- infringement 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 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 region of the hip joint, in the absence of treatment, infectious-toxic shock or sepsis may occur, which can be fatal.
Prevention
First of all, experts recommend leading a healthy lifestyle:
- move more, but don't overload your body with excessive training;
- monitor body weight to prevent obesity;
- follow a nutritious and varied diet (nutrition must 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 activity, are forced to stand for a long time, it is advisable to regularly rest their body and undergo preventive examinations with an orthopedist-traumatologist at least once a year.
Patients with diseases of the musculoskeletal system must be under dispensary observation, strictly follow medical instructions and monitor their condition.
To prevent 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 advised that seniors move with extreme caution in icy conditions and not leave the house unless absolutely necessary.
Hip pain treatment in a professional clinic
The doctors at the multidisciplinary center are high-level specialists, with the necessary practical skills and extensive knowledge in different areas of medicine. They consider the patient's problem individually, drawing up a diagnostic and treatment program taking into account all health characteristics. Specialists use an integrated approach to solving a variety of health problems. They not only eliminate a specific symptom, but also try to identify and eliminate its cause, obvious and non-obvious consequences. Only in this way is it possible to fully restore the patient's health, give him back the opportunity to live a normal life, to move without pain or restrictions.
When seeking medical care from the clinic's doctors, everyone has the right to count on the friendly attitude of specialists and junior staff, assistance in rehabilitation and objectivity.