The hip joints experience the greatest load in the body. They are caused by weight during walking, jumping, running, lifting and carrying heavy objects. Patients often feel pain in the hip joint. Orthopedists in a specialized hospital determine the cause with the help of modern diagnostic equipment. Doctors determine the degree 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 clinic specialists provide rehabilitation therapy using the latest physiotherapeutic procedures, physical therapy and acupuncture. The presence of special simulators allows you to reduce the load on the joint during training.
Doctors from many fields of medicine are involved in the process of treating pain in the hip joint: endocrinologists, rheumatologists, orthopedists, physiotherapists, chiropractors, and acupuncturists. A multidisciplinary approach to the treatment of hip pain provides rapid pain relief. Patients suffering from hip joint pathology often require outpatient care.
Causes
Pain in the hip joint is caused by the following pathological processes:
- Tendinitis (tendon inflammation);
- Muscle rupture;
- Iliotibial band syndrome;
- Other local changes in surrounding tissues;
- Systemic diseases (rheumatoid arthritis, polymyalgia).
Since the gluteus medius and minimus muscles play a major role in hip abduction, their damage causes hip pain. The tendons of the gluteus medius and minimus attach to the greater trochanter. If an inflammatory process develops in them due to microtraumas caused by excessive load, the patient will suffer from pain in the hip joint. Such disorders can be caused by an infectious process (tuberculosis), sports or stereotyped professional stress or crystal deposition.
Hip pain is a symptom of the following diseases:
- Osteoarthrosis;
- Radicular syndrome;
- Rheumatoid arthritis;
- Coxita.
Hip pain can be a problem for 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 neck of the femur, 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 spinal disease, malignant bone tumors and age-related changes.
Test methods
During the first consultation, rheumatologists conduct a comprehensive examination of the patient:
- Collecting complaints, clarifying the nature of pain in the hip joint;
- Obtaining information about the course of the disease, onset of pain, progression of pain, household and professional factors that, according to the patient, caused the pain;
- An external examination allows the doctor to determine visible deviations from the norm. In order 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 limb in the hip joint. The presence of hip joint pathology may be indicated by poor posture;
- Palpation (feeling). The doctor can find rheumatoid and rheumatic nodes, discover the exact location of pain when moving the legs, determine the humidity and temperature of the skin in the area of the hip joint.
Next, the doctor performs goniometry - an examination using a goniometer device. It allows you to determine the range of motion of the joints. Then the rheumatologist prescribes clinical and biological blood tests and a general urine test. Hospital laboratory technicians perform research using high-quality reagents and modern equipment, which allows you to get accurate test results.
In case of inflammation of the hip joint, the number of leukocytes in the blood increases and the rate of erythrocyte sedimentation 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 suffering from arthritis, the concentration of uric acid in the blood serum rises 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 the 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 appearance of difficulties in the movement of the lower limb;
- Swelling and discoloration of the skin in the hip joint area.
Using computerized tomography, doctors at the clinic evaluate the bones that participate in the formation of the hip joint. On computerized tomograms, the radiologist finds changes in the structure of bone tissue, cartilaginous growths and osteophytes.
Using magnetic resonance imaging, doctors assess the condition of the soft tissues surrounding the hip joint.
Radionucleotide research methods enable recognition of pathology using radiopharmacological drugs.
Ultrasound examination of the hip joint is performed for injuries, inflammatory diseases, rheumatism and rheumatoid arthritis. In each case, the doctor individually selects the research methods necessary 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 turn to the doctor. It can be located in the joint area or spread to the thigh, buttock or knee joint. If pain occurs in the hip joint during movement, the patient is forced to use a cane. Often due to pain, there is limitation of mobility when moving the hip joint, especially during 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 associated with long-term use of hormonal drugs and alcohol abuse. With the development of femoral head deformity, the mobility of the hip joint is limited. In the early stage of the pathological process, the range of motion may be normal.
Pain in the front of the hip joint and clicking when moving the joint bothers patients suffering from iliopectineal bursitis. It radiates to the thigh and is accompanied by paresthesia (tingling, burning, crawling) due to compression of the femoral nerve. The patient feels pain in the hip joint when bending and extending the lower limb. Pain is also detected by deep palpation in the area of the femoral triangle (formation 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 in the outer part of the knee joint that increases with movement.
Roth's myalgia is manifested by a burning pain in the front outer part of the hip joint and thigh, which increases when walking and straightening the leg. Hip joint pain occurs with dysplasia. Over time, the patient develops a characteristic "duck" gait (he walks, 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 form the joint. The disease affects older people more often. With age, the cartilage tissue of the joint loses its elasticity, becomes thin and begins to wear out. When the load on the joint increases, the 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 joint. Deformation of joint surfaces develops, resulting in severe pain. The treatment of the disease depends on the severity of the joint damage. Doctors provide drug therapy. If it is ineffective, endoprosthetics or palliative treatment are performed.
After determining the cause of pain in the hip joint, doctors begin to treat the disease that caused the pain syndrome. Serious cases of diseases in which the patient suffers from pain in the hip joint are considered at the session of the expert council 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 bones, cartilage and soft tissue in the joint area. For acute pain, hospital rheumatologists prescribe nonsteroidal anti-inflammatory drugs. The well-being of patients is significantly improved by 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 joints during inflammatory processes of soft tissues (tendinitis, bursitis, epicondylitis), after injuries.
If such therapy is not effective enough, doctors inject glucocorticoids into the hip joint cavity. The joint space with deforming coxarthrosis is narrowed, it is difficult to enter it. For this reason, rheumatologists in a specialized clinic 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 tissues.
Chondroprotectors are used to improve the condition of the cartilage and reduce pain in the hip joint. The therapeutic course lasts several months. When there is a spasm of the muscles involved in the movements of the hip joint, muscle relaxants are prescribed to reduce the tone of the skeletal muscles.
Drug therapy is complemented by physiotherapeutic procedures. They are secondary to hip pain. The effectiveness of physiotherapeutic treatment methods is reduced due to the deep location. The intensity of pain in the hip joint decreases after ultraviolet radiation with medium wavelengths.
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 renewal. The intensity of pain caused by disturbances in circulation and nutrition of the hip joint is reduced under the influence of various types of electrotherapy (exposure to currents) and ultrasound.
In order to reduce the load on the hip joint, rheumatologists advise patients to use a cane if there is acute pain. After reducing the severity of the pain syndrome, rehabilitators carry out therapeutic exercises. An individual set of exercises is developed for each patient in order to quickly restore the function of the lower limb. When the structures involved in the formation of the hip joint are destroyed, the pain can be so severe that the only way to get rid of it is to replace the joint with an endoprosthesis.
Nonsteroidal anti-inflammatory drugs are prescribed for pain relief. Treatment depends on the disease affecting the hip joints. The patient is prescribed chondroprotectors for cartilage tissue damage. The orthopedic doctor prescribes effective treatment, diet and exercises to improve blood circulation in the joint, restore cartilage tissue and maintain joint mobility. In more severe cases, it is necessary to replace the joint with an endoprosthesis, which significantly improves the quality of life and eliminates pain.
Treatment with exercise
Using 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 physical therapy exercises taking into account the patient's joint disease. Rehabilitation classes are held daily under the supervision of instructors. Special simulators are used for rehabilitation therapy, 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 can be a manifestation of avascular necrosis. The disease develops predominantly in men and affects only one joint. Treatment consists of pain relief, restoration of blood supply to the joint area, normal condition of the limb muscles and maintenance of joint functionality. The patient is prescribed painkillers and anti-inflammatory drugs, vitamins, physiotherapeutic procedures, 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 suppurative arthritis occurs when there is a wound or injury and infectious agents enter the joint cavity. The secondary purulent process occurs when sepsis or an infectious agent enters the joint from the surrounding tissues affected by the inflammatory process. For the treatment of purulent arthritis, professional specialists carry out antibacterial therapy. If pus accumulates in the joint cavity, the hip joint is punctured, the contents are evacuated, 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 develops, the cavity of the periarticular bursa is cleaned. In severe cases, the joint capsule that has undergone irreversible changes is removed using a surgical endoscopic technique.
Fractures of the femoral neck often occur with osteoporosis. Patients suffer from sharp, severe pain during movement in the hip joint, which radiates to the groin and inner thighs. The leg turns outward. Bruises and swelling appear in the hip joint area. In this case, the treatment is carried out by professional orthopedists.
Traumatic hip dislocation is accompanied by pain in the hip joint. The hip is reduced under general anesthesia. Congenital hip dislocation is diagnosed immediately after birth. It manifests as severe pain when spreading the legs and bending the knees. Treatment is carried out using special orthopedic constructions.
If you or a loved one has hip pain, 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 intense, patients can be offered an examination by a specialist doctor for diseases of the hip joints and treatment at home with strict adherence to all rules.