Human hip joints are subject to tremendous stress. Walking, lifting and carrying heavy objects, jumping, running, bending, other physical exercises and even being overweight all put pressure on the musculoskeletal system. Pain in the hip joint reduces its functionality, hinders 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 to immediately seek the help of a qualified doctor at the first symptoms of discomfort. Orthopedists, traumatologists, surgeons, neurologists and numerous other specialists jointly assess symptoms, search for 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 bone tissue with useful minerals, etc.
Injuries of soft tissues and osteoarticular structures in the hip area are the most common cause of complaints. This includes:
- 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 ligament apparatus (sprain, tear, rupture) is less common. Most often, they are caused by severe injuries that the patient received as a result of an accident, prolonged exposure to rubble or due to performing extreme stunts.
Infectious, inflammatory and degenerative diseases that can cause hip pain include:
- different forms of arthritis (infectious, aseptic, rheumatoid);
- panarthritis – total purulent inflammation of the hip joint;
- osteomyelitis;
- tuberculosis of the hip joint;
- coxarthrosis and other types of arthrosis;
- bursitis;
- aseptic necrosis of the femoral head, including Perthes disease;
- chondromatosis;
- trochanteritis.
Other pathological factors include:
- congenital anomalies of the development of the hip joint (dysplasia, congenital hip dislocation, limb shortening);
- 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 down can indicate an excessive load on the musculoskeletal system. Discomfort can occur after strength training, carrying heavy objects, or prolonged walking or standing. The risk group consists of athletes, fans of extreme sports, loaders, teachers, lecturers, sellers, couriers, etc.
Other causes of severe pain in the hip joint when walking and resting can be:
- excess weight, which greatly increases the pressure on the joints;
- posture disorders;
- irrational use of certain drugs;
- 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, throbbing, painful, dull, cutting, etc. The localization and intensity of the pain syndrome depend on the initial disease and the health characteristics of the patient (presence of accompanying pathologies, overweight, risk factors). Often, the pain syndrome spreads to the surrounding structures, radiating to the limbs, sacrum and coccyx, and the lower back.
Symptoms that may accompany hip pain include:
- tissue swelling in the joint area;
- creaking, clicking and other noises when moving;
- limited mobility;
- numbness, reduced sensitivity in the leg;
- feeling of heat, pulsation in the area of damage;
- lameness, leg dragging;
- shortening of limbs;
- bruises;
- elevated body temperature.
Painful pain in the hip joint, which spreads to the lower back, legs, groin and sacrum, may indicate ankylosing spondylitis. This disease is also accompanied by stiffness of movements, discomfort in the knee and periodic "lumbago". Symmetrical pain in the hip area, combined with conjunctivitis and damage to the genitourinary system, can be a sign of Reiter's syndrome.
The clinical picture is determined by the primary disease or injury. In mild cases, the patient is limited in movement, but the ability to support the leg remains. With severe bruises, fractures, dislocations and severe forms of infectious and inflammatory diseases, it is impossible to support the affected leg, the patient can move only with the help of an auxiliary point or cannot walk at all.
Diagnostics
In order to determine the exact cause of the pain, other symptoms of the primary disease/injury and choose an effective treatment regimen, a comprehensive examination is conducted.
First of all, a physical examination is done. The doctor assesses external signs of pathology, palpates the area of articulation, asks detailed questions about the nature of complaints, the time and circumstances of their occurrence, etc. The specialist must also know about previous surgical interventions and injuries, existing chronic pathologies (including those not directly related to the musculoskeletal system), lifestyle, etc.
A comprehensive objective review includes:
- ultrasound examination of the hip joint (ultrasound);
- radiography of the pelvis in two projections;
- magnetic resonance imaging or computer tomography (according to indications);
- wrist 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 anamnesis, the characteristics of the patient's current condition and the expected diagnosis.
Treatment of hip pain
Tactics of medical care depends on the cause of the pain. In case of sprains and bruises, the joint is immobilized, the patient is prescribed painkillers, and is strictly confined to bed. In case of dislocation, the joint is realigned, followed by fixation of the extremity in a stationary position. For fractures, skeletal traction, plaster immobilization or wearing special structures are indicated.
For hip pain that is caused by inflammatory or infectious causes, treatment may include:
- antibacterial drugs;
- anti-inflammatory drugs;
- corticosteroid hormones;
- pain relievers;
- chondroprotectors;
- cytostatics;
- ointments, creams and other local agents that stimulate blood flow;
- vitamin complexes;
- substitutes for synovial fluid.
The patient must receive a complex of physiotherapy, physical therapy and massage necessary to restore motor activity, normalize joint nutrition and remove 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 load, 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 an 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;
- endoprosthetics;
- tumor removal;
- fixed fixation of the joint (arthrodesis);
- arthroplasty.
These and other methods of surgical treatment are selected in accordance with the diagnosis and characteristics of the patient's current condition. After the surgical treatment, the patient goes through rehabilitation.
Complications
Hip pain cannot be ignored. Even a small and temporary discomfort can lead to the development of serious diseases in the future. In complex cases, the consequences can be irreversible.
Possible complications include:
- limb deformity;
- lameness;
- the transition of pain into a chronic form (in this case they are present almost constantly);
- injury of intra-articular bodies;
- deep vein thrombosis;
- heterotopic ossification (formation of bone plates in soft tissues);
- arthrosis;
- contractures: reduced joint mobility;
- necrosis;
- pathological fractures.
Without treatment, pathologies can cause permanent impairment of mobility, inability to live a full life and even take care of oneself, and disability. With extensive purulent processes in the area of the hip joint, in the absence of treatment, infectious-toxic shock or sepsis can develop, which can be fatal.
Prevention
First of all, experts recommend leading a healthy lifestyle:
- move more, but do not overload the body with excessive training;
- monitor body weight to prevent obesity;
- eat a nutritious and varied diet (the diet should be balanced in terms of basic macro- and micronutrients, as well as total caloric content);
- Do not use systemic drugs without a doctor's prescription.
For people who, due to their professional activities, are forced to spend a lot of time on their feet, regular body rest and preventive examinations by an orthopedist-traumatologist are advised at least once a year.
Patients with diseases of the musculoskeletal system must be under dispensary supervision, strictly follow medical instructions and monitor their condition.
In order to prevent injuries to the hip joint, it is recommended to avoid extreme sports, wear protective equipment during exercise and not perform complex exercises without the necessary skills and physical training.
It is recommended for the elderly to move with extreme caution in icy conditions and not to go outside unless absolutely necessary.
Treatment of hip pain in a professional clinic
The doctors of the multidisciplinary center are high-class specialists with the necessary practical skills and broad knowledge in various fields of medicine. They consider the patient's problem individually, compiling a diagnostic and treatment program taking into account all health characteristics. Specialists use an integrated approach to solve various health problems. They not only remove a certain symptom, but try to identify and eliminate its cause, obvious and non-obvious consequences. It is the only way to fully restore the patient's health, to return to the possibility of living a normal life, to move without pain and limitations.
When seeking medical help from the clinic's doctors, everyone has the right to count on the friendly relationship of specialists and junior staff, assistance in rehabilitation and objectivity.