Hip joints experience the greatest load in the body. They are created by weight when walking, jumping, running, lifting and carrying heavy objects. Patients often feel pain in the hip joint. Orthopedists of a specialized hospital determine its cause using 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 carry out complex therapy for diseases that cause pain in the hip joint. Patients are selected individually, effective drugs affect the cause of pain and the mechanism of development. Rehabilitation clinic specialists perform rehabilitation therapy using the latest physiotherapeutic procedures, physical therapy and acupuncture. The presence of special simulators allows reducing joint load during training.
Doctors from many fields of medicine participate in the process of treating pain in the hip joint: endocrinologists, rheumatologists, orthopedists, physiotherapists, chiropractors, acupuncturists. A multidisciplinary approach to the treatment of pain in the hip joint allows for quick pain relief. Patients suffering from hip joint pathology often require outpatient care.
Reasons
Pain in the hip joint is caused by the following pathological processes:
- Tendinitis (inflammation of tendons);
- Muscle tear;
- Iliotibial band syndrome;
- Other local changes in the surrounding tissues;
- Systemic diseases (rheumatoid arthritis, polymyalgia).
Because the gluteus medius and minimus muscles play a major role in hip abduction, damage to them can lead to hip pain. The gluteus medius and minimus tendons attach to the greater trochanter. If an inflammatory process develops in them due to microtraumas caused by overloading, the patient will suffer from pain in the hip joint. Such disorders can be caused by an infectious process (tuberculosis), sports or stereotypical professional stress, or crystal precipitation.
Hip pain is a symptom of the following diseases:
- Osteoarthritis;
- Radicular syndrome;
- rheumatoid arthritis;
- Quite a lot.
Pain in the hip joint can bother people who are overweight, have different leg lengths, or have flat feet. Pain syndrome may occur after lower limb amputation or hip replacement. Patients with avascular necrosis of the head and fracture of the femoral neck complain of acute pain in the hip joint. 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 when nerves are compressed as a result of diseases of the spine, malignant bone tumors and age-related changes.
Examination methods
During the first consultation, rheumatologists conduct a comprehensive examination of the patient:
- Collection of complaints, clarification of the nature of pain in the hip joint;
- To obtain information about the course of the disease, the onset of pain, the course of pain, household and professional factors that cause pain in the patient's opinion;
- External examination allows the doctor to identify visible deviations from the norm. To understand the nature of the pain and its area of distribution, the doctor asks the patient to perform various movements of the lower limb in the hip joint. The presence of pathology of the hip joint can be indicated by bad posture;
- Palpation (feeling). The doctor can find rheumatoid and rheumatic nodes, determine the exact location of pain during leg movements, determine the moisture and temperature of the skin in the area of the hip joint.
Then the doctor performs goniometry - an examination using a goniometer device. This allows you to determine the range of joint mobility. Then the rheumatologist prescribes clinical and biological blood tests and a general urine test. Laboratory technicians of the hospital conduct research using high-quality reagents and modern equipment, which allows obtaining 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 the disease is indicated by an increase in the amount 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 increases sharply. In patients with rheumatism, psoriatic polyarthritis, rheumatism and ankylosing spondylitis, the content of lysosomal enzymes (acid proteinase, acid phosphatase, cathepsins, deoxyribonuclease) in blood serum and synovial fluid changes. In severe forms of the pathology of the hip joint, significant deviations from the norm are observed in the urine analysis.
In the clinic, doctors perform X-ray examination of patients with hip pain. It is indicated in the following cases:
- Presence of chronic or acute pain in the hip joint during rest and movement;
- Difficulty in moving the lower limb;
- The appearance of swelling and discoloration of the skin in the area of the hip joint.
Using computed tomography, doctors in the clinic evaluate the bones involved in the formation of the hip joint. In computer 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 allow to recognize pathology using radiopharmacological drugs.
Ultrasound examination of the hip joint is performed for injuries, inflammatory diseases, rheumatism and rheumatoid arthritis. The attending physician, in each case, individually selects the research methods necessary to determine the cause of pain in the hip joint.
Differential diagnosis
Pain in the hip joint while walking is the main complaint that patients turn to the doctor for. It can be located in the joint area or extend to the thigh, hip 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 a restriction of mobility when moving the hip joint, especially during external and internal rotation of the leg.
Pain in the hip joint, hip, and groin 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 deformation of the femoral head, 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 noises when the joint moves disturb 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 during deep palpation in the region of the femoral triangle (a formation limited to the inguinal ligament, the outer edge of the long adductor muscle, the inner edge of the sartorius muscle).
Pain in the outer thigh joint is a symptom of iliotibial band syndrome. A clicking sound when moving is accompanied by pain on the outside of the knee joint, which is aggravated by movement.
Roth's myalgia is characterized by burning pain in the front outer part of the hip joint and thigh, which is aggravated by walking and straightening the leg. Pain in hip joints occurs with dysplasia. Over time, the patient develops a characteristic "duck" gait (he walks side to side, walks).
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, the cartilage tissue of the joint loses its elasticity, becomes thinner and begins to wear out. When the joint load increases, thin cartilage tissue is destroyed. The articular surfaces of the bones rub against each other, resulting in aseptic inflammation.
Bone growths appear. They significantly limit joint movement. Deformation of the articular surfaces develops, resulting in severe pain. Treatment of the disease depends on the severity of joint damage. Doctors administer medication. If ineffective, endoprosthetics are performed or palliative treatment is applied.
After determining the cause of pain in the hip joint, doctors begin to treat the disease that causes the pain syndrome. In the meeting of the expert council with the participation of professors, doctors of medical sciences and candidates, doctors of the highest category, serious cases of serious diseases where the patient is suffering from pain in the hip joint are discussed.
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 tissues in the joint area. For acute pain, hospital rheumatologists prescribe non-steroidal anti-inflammatory drugs. The well-being of patients improves significantly with the use of local treatment methods - external applications of gels and ointments, patches containing non-steroidal anti-inflammatory drugs. Inflammatory processes of soft tissues (tendinitis, bursitis, epicondylitis), reduce pain in the hip joints after injuries.
If such therapy is not effective enough, doctors inject glucocorticoids into the hip joint cavity. With deforming coxarthrosis, the joint space narrows, it is difficult to enter it. For this reason, rheumatologists perform the procedure under X-ray control in a specialized clinic. In case of pain caused by inflammation of muscles and tendons, glucocorticoid hormones are injected into periarticular tissues.
Chondroprotectors are used to improve cartilage condition and reduce pain in the hip joint. The therapeutic course lasts several months. When there is a spasm 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 complemented by physiotherapeutic procedures. They are of secondary importance for pain in the hip joint. Due to the deep location, the effectiveness of physiotherapeutic treatment methods decreases. After ultraviolet radiation with medium-long waves, the intensity of pain in the hip joint decreases.
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, and shock wave therapy stimulate tissue regeneration. The intensity of pain caused by blood circulation disorders and nutrition of the hip joint is reduced under the influence of various types of electrotherapy (exposure to currents) and ultrasound.
To reduce the load on the hip joint, rheumatologists advise patients to use a cane in case of acute pain. After reducing the severity of the pain syndrome, rehabilitators perform therapeutic exercises. In order to quickly restore the function of the lower limb, an individual set of exercises is prepared for each patient. When the structures involved in the formation of the hip joint are destroyed, the pain can be so severe that the only way to relieve it is to replace the joint with an endoprosthesis.
Non-steroidal anti-inflammatory drugs are prescribed to relieve pain. Treatment depends on the disease affecting the hip joints. The patient is prescribed chondroprotectors for cartilage tissue damage. An orthopedic doctor prescribes effective treatment, diet and exercises to improve joint blood circulation, 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 relieves pain.
Treatment with exercise therapy
The use of rehabilitation methods in the treatment of the hip joint allows to maintain its mobility, improve blood circulation in the joint and accelerate the recovery of cartilage tissue. Specialists of the rehabilitation department select a number of physical therapy exercises, taking into account the patient's joint disease. Rehabilitation classes are held every day under the supervision of an instructor. Special simulators are used for rehabilitation therapy and physiotherapeutic procedures are prescribed along with physical training.
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 mainly develops in men and affects only one joint. Treatment consists of pain relief, restoration of blood supply to the joint area, normal condition of limb muscles and maintenance of joint functionality. The patient is prescribed pain relievers and anti-inflammatory drugs, vitamins, physiotherapeutic procedures, therapeutic exercises. The patient is advised 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 develops when there is a wound or injury and infectious agents enter the joint space. A secondary purulent process develops when sepsis or an infectious agent enters the joint from 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, a puncture of the thigh joint is performed, the contents are drained, 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, using the surgical endoscopic technique, the joint capsule, which has undergone irreversible changes, is removed.
Fracture of the neck of the femur is common in osteoporosis. Patients complain of sharp, severe pain when moving in the hip joint that radiates to the groin and inner thigh. The leg turns outward. Bruising and swelling appear in the area of the hip joint. In this case, 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 itself as severe pain when spreading the legs and bending the knees. Treatment is carried out using special orthopedic structures.
If you or someone close to you has pain in the hip joint, you should not self-medicate. Consult a medical professional immediately. Patients with acute pain are usually hospitalized in the clinic for at least one week. If the pain is not severe, patients can be offered a professional doctor's examination of hip joint diseases and home treatment, strictly following all the rules.