The hip joints experience the greatest stress in the body. They arise from the weight of walking, jumping, running, lifting and carrying heavy objects. Patients often experience pain in the hip joint. Orthopedists at a specialist hospital determine the cause using modern diagnostic equipment. Doctors determine the degree of joint damage and can therefore make an accurate diagnosis and develop optimal treatment tactics.
Professional doctors offer complex therapy for diseases that cause pain in the hip joint. Patients are individually selected effective medications that influence the cause and mechanism of pain development. The specialists at the rehabilitation clinics offer rehabilitation therapy using the most modern physiotherapeutic procedures, physiotherapy and acupuncture. The presence of special simulators allows you to reduce the load on the joint during exercise.
Doctors from many areas of medicine are involved in the treatment of pain in the hip joint: endocrinologists, rheumatologists, orthopedists, physiotherapists, chiropractors, acupuncturists. A multidisciplinary approach to treating hip joint pain provides rapid pain relief. Patients suffering from hip joint pathology often require external care.
causes
Pain in the hip joint is caused by the following pathological processes:
- tendonitis (tendonitis);
- muscle tear;
- iliotibial band syndrome;
- Other local changes in surrounding tissues;
- Systemic diseases (rheumatoid arthritis, polymyalgia).
Since the gluteus medius and minimus muscles play an important role in hip abduction, damage to these muscles leads to hip pain. The tendons of the gluteus medius and minimus muscles attach to the greater trochanter. If an inflammatory process develops in them due to microtrauma as a result of excessive stress, the patient is plagued by pain in the hip joint. Such disorders can be caused by an infectious process (tuberculosis), sports or stereotypical occupational stress, or the deposition of crystals.
Hip pain is a symptom of the following diseases:
- Arthrosis;
- 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 may occur after amputation of the lower limbs or hip replacement. With avascular necrosis of the head and fracture of the femoral neck, patients complain 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 with pinched nerves due to diseases of the spine, malignant bone tumors and age-related changes.
Investigation methods
At the first consultation, rheumatologists carry out a comprehensive examination of the patient:
- Collection of complaints, clarification of the type of pain in the hip joint;
- Obtaining information about the course of the disease, the onset of the pain, the progression of the pain, domestic and occupational factors that, in the patient's opinion, caused the pain;
- Through an external examination, the doctor can detect 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 extremity in the hip joint. The presence of pathology of the hip joint can be indicated by poor posture;
- Palpation (feeling). The doctor can detect rheumatic and rheumatic nodules, determine the exact location of pain when moving the legs, determine the humidity and temperature of the skin in the hip joint area.
Next, the doctor conducts goniometry - an examination using a goniometer. This allows you to determine the range of joint mobility. The rheumatologist then prescribes clinical and biological blood tests as well as a general urine test. The hospital's laboratory technicians conduct tests using high-quality reagents and modern equipment, so you can get accurate test results.
When the hip joint becomes inflamed, the number of leukocytes in the blood increases and the erythrocyte sedimentation rate increases. The inflammatory nature of the disease is indicated by an increase in the content of C-reactive protein in the blood serum.
An immunological blood test shows 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 sharply. The content of lysosomal enzymes (acid proteinase, acid phosphatase, cathepsins, 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.
Doctors at the clinic conduct X-ray examinations of patients with hip pain. It is indicated in the following cases:
- The presence of chronic or acute pain in the hip joint at rest and during movement;
- The occurrence of difficulties in moving the lower extremity;
- The appearance of swelling and discoloration of the skin in the hip joint area.
The clinic's doctors use computer tomography to examine the bones that are involved in the formation of the hip joint. On computer tomograms, the radiologist detects changes in the structure of bone tissue, cartilage growths and osteophytes.
Doctors use magnetic resonance imaging to assess the condition of the soft tissue surrounding the hip joint.
Radionucleotide research methods make it possible to detect pathologies using radiopharmacological drugs.
An ultrasound examination of the hip joint is performed for injuries, inflammatory diseases, rheumatism and rheumatoid arthritis. The treating doctor individually selects the necessary examination methods to determine the cause of pain in the hip joint.
Differential diagnosis
Pain in the hip joint when walking is the main complaint that patients see a doctor with. It can be localized in the joint area or extend to the thigh, buttock or knee joint. If pain occurs in the hip joint during movement, the patient is forced to use a stick. Due to pain, there is often a restriction of movement in the movement of the hip joint, especially in the external and internal rotation of the leg.
Pain in the hip joint, buttocks and groin area is a symptom of aseptic necrosis of the femoral head. The disease is often accompanied by long-term use of hormonal drugs and alcohol abuse. With the development of a deformity of the femoral head, the mobility of the hip joint is limited. At an early stage of the pathological process, the range of motion may be normal.
Pain in the front part of the hip joint and clicking noises when moving the joint cause problems for patients with bursitis. It radiates to the thigh and is accompanied by paresthesia (tingling, burning, tingling) due to compression of the femoral nerve. When bending and extending the lower extremity, the patient feels pain in the hip joint. Pain is also noted with deep palpation in the area of the femoral triangle (a formation limited by the inguinal ligament, the outer edge of the long adductor muscle and 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 in the outer part of the knee joint, which increases with movement.
Roth's myalgia is manifested by burning pain in the anterior outer part of the hip joint and thigh, which increases when walking and stretching the leg. Pain in the hip joints occurs with dysplasia. Over time, the patient develops a characteristic "duck gait" (walking and waddling from side to side).
Pain in coxarthrosis
Pain in the hip joint occurs with coxarthrosis, a disease characterized by degenerative processes in the bones that make up the joint. Older people are more likely to be affected by the disease. As we age, the cartilage tissue of the joint loses its elasticity, becomes thinner and begins to wear away. As the strain on the joint increases, the thin cartilage tissue is destroyed. The articular surfaces of the bones rub against each other, causing aseptic inflammation.
Growths appear on the bones. They significantly restrict movement in the joint. There is a deformation of the joint surfaces, which leads to severe pain. Treatment of the disease depends on the severity of the joint damage. Doctors offer drug therapy. If it is ineffective, endoprosthetics or palliative treatment is carried out.
After identifying the cause of pain in the hip joint, doctors begin treating the disease that caused the pain syndrome. Serious cases of the disease in which the patient suffers from pain in the hip joint are discussed at an expert council meeting 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 structural changes in bone, cartilage and soft tissue in the joint area. For acute pain, rheumatologists prescribe non-steroidal anti-inflammatory drugs in the hospital. The well-being of patients improves significantly with the use of local treatment methods - external application of gels and ointments, patches containing non-steroidal anti-inflammatory drugs. They relieve pain in the hip joints during inflammatory processes of soft tissues (tendinitis, bursitis, epicondylitis) after injuries.
If such therapy is not effective enough, doctors inject glucocorticoids into the cavity of the hip joint. The joint space in deforming coxarthrosis is narrowed, it is difficult to get into it. For this reason, rheumatologists in a specialist clinic carry out the procedure under X-ray control. For pain caused by muscle and tendon inflammation, glucocorticoid hormones are injected into the periarticular tissue.
To improve the condition of the cartilage and relieve pain in the hip joint, chondroprotectors are used. The therapy course lasts several months. In case of spasms of the muscles involved in movements in the hip joint, muscle relaxants are prescribed to reduce the tone of the skeletal muscles.
Drug therapy is supplemented by physiotherapeutic procedures. If you have pain in the hip joint, they are of minor importance. The effectiveness of physiotherapeutic treatment methods is reduced by the low position. The severity of pain in the hip joint decreases after UV irradiation with medium-length waves.
If an inflammatory process is present, high-intensity centimeter wave therapy, infrared laser treatment and low-intensity UHF therapy are carried out. High-intensity radiofrequency magnetic therapy, ozone therapy and shock wave therapy stimulate tissue recovery. The intensity of pain that occurs due to impaired blood circulation and nutrition of the hip joint is reduced under the influence of various types of electrotherapy (current impact) and ultrasound.
To reduce the stress on the hip joint, rheumatologists advise patients to use a walking stick when experiencing acute pain. After the severity of the pain syndrome is relieved, rehabilitators carry out therapeutic exercises. An individual set of exercises is developed for each patient to quickly restore lower extremity function. If the structures involved 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 joints. If cartilage tissue is damaged, the patient is prescribed chondroprotectors. An orthopedic doctor prescribes effective treatments, diets and exercises to improve blood circulation in the joint, restore cartilage tissue and maintain joint mobility. In severe cases, joint replacement with an endoprosthesis is necessary, 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 restoration of cartilage tissue. Specialists of the rehabilitation department select a set of physiotherapeutic exercises taking into account the patient's joint disease. Rehabilitation courses 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.
Which diseases cause joint pain?
Pain in the hip joint on the right or left side can be a manifestation of avascular necrosis. The disease occurs predominantly in men and only affects one joint. Treatment consists in eliminating pain, restoring blood supply to the joint area, normalizing the muscles of the limb and maintaining the functionality of the joint. The patient is prescribed painkillers and anti-inflammatory drugs, vitamins, physiotherapeutic procedures and therapeutic exercises. The patient is recommended to wear orthopedic shoes and use additional support when moving.
The cause of pain in the hip joint can be a purulent process. Primary purulent arthritis occurs when there is a wound or injury and infectious agents enter the joint cavity. A secondary purulent process occurs when sepsis or an infectious agent penetrates the joint from surrounding tissues 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 sucked out and antibacterial agents are 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 occurs, the cavity of the periarticular bursa is cleaned. In severe cases, the joint capsule, which has undergone irreversible changes, is removed using surgical endoscopy.
Osteoporosis often leads to a fracture of the femoral neck. Patients suffer from stabbing, severe pain when moving in the hip joint, which radiates to the groin and inner thigh. The leg rotates outwards. Bruising and swelling occur in the hip joint area. In this case, the treatment is carried out by professional orthopedists.
A traumatic hip dislocation is accompanied by pain in the hip joint. The hip reduction is carried out under general anesthesia. A congenital hip dislocation is diagnosed immediately after birth. It manifests itself as severe pain when spreading the legs and bending the knees. The treatment takes place with special orthopedic structures.
If you or a loved one have hip pain, you should not self-medicate. See a doctor immediately. Patients with acute pain usually remain hospitalized for at least a week. If the pain is not severe, patients can be offered an examination by a professional doctor for diseases of the hip joint and treatment at home with strict adherence to all the rules.