Human hip joints are under enormous stress. Walking, lifting and carrying heavy objects, jumping, running, bending over, 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 to immediately seek help from qualified doctors. Orthopedists, traumatologists, surgeons, neurologists and a number of other specialists jointly assess the symptoms, search for the causes and treat the 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 can be caused by injuries, inflammatory and infectious pathologies, various degenerative processes, problems with the supply of useful minerals in the bone tissue, etc.
Injuries to the soft tissues and bone-joint structures of the hip area are the most common cause of discomfort. They include:
- bruises;
- penetrating wounds;
- fracture of the neck of the femur;
- hip luxation;
- Fractures of the acetabulum and upper 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 debris or due to the performance of extreme stunts.
Infectious, inflammatory, and degenerative diseases that can cause hip pain include:
- various forms of arthritis (infectious, aseptic, rheumatoid);
- panarthritis - complete 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 in the development of the hip joint (dysplasia, congenital dislocation of the hip joint, shortening of the limbs);
- various neoplasms of malignant and benign nature;
- sciatic neuropathy;
- osteochondrosis, scoliosis, intervertebral hernia and other diseases of the spine.
Hip pain when walking or lying down can mean excessive strain on the musculoskeletal system. Discomfort can occur after strength training, carrying heavy objects, or prolonged walking or standing. The risk group includes athletes, extreme sports enthusiasts, loaders, teachers, lecturers, sellers, couriers, etc.
Other causes of severe hip pain when walking and at rest can be:
- overweight, which significantly 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 found 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, aching, dull, cutting, etc. The localization and intensity of the pain syndrome depend on the initial disease and the patient's health characteristics (presence of concomitant pathologies, overweight, risk factors). Often, the pain syndrome spreads to the surrounding structures, radiating to the limbs, the area of the sacrum and coccyx, and the lower back.
Symptoms that may accompany hip pain include:
- swelling of tissues in the joint area;
- crunching, clicking and other sounds when moving;
- limited mobility;
- numbness, reduced sensation in the leg;
- feeling of heat, pulsation in the area of damage;
- lameness, dragging of the feet;
- limb shortening;
- bruises;
- increased body temperature.
Hip pain radiating to the lower back, leg, groin, and sacral area 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 joint, combined with conjunctivitis and damage to the genitourinary system, can be a sign of Reiter's syndrome.
The clinical picture is determined by the underlying 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, the support of the affected leg is impossible, the patient can move only with the help of an auxiliary point or cannot walk at all.
Diagnosis
In order to find out the exact cause of the pain, other symptoms of the main disease / injury and to choose an effective treatment regimen, a comprehensive examination is carried out.
First of all, a physical examination is performed. The doctor evaluates the external signs of pathology, palpates the area of articulation, asks detailed questions about the nature of the complaints, the time and circumstances of their occurrence, etc. The specialist should also know about previous surgical interventions and injuries, existing chronic pathologies (including those not directly related to the musculoskeletal system), lifestyle, etc.
A complete objective examination includes:
- ultrasound examination of the hip joint (ultrasound);
- X-ray of the pelvis in two projections;
- magnetic resonance or computed tomography (as indicated);
- joint puncture;
- diagnostic arthroscopy;
- laboratory tests (general clinical tests of blood and urine, 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.
Treatment of hip pain
The tactics of medical assistance depends on the cause of the pain. In case of sprains and bruises, the joint is immobilized, painkillers are prescribed, and the patient is placed on strict bed rest. In case of luxation, the joint is realigned, followed by fixation of the limb in a stationary position. For fractures, skeletal traction, plaster immobilization or wearing special structures are indicated.
For hip pain caused by inflammatory or infectious causes, treatment may include:
- antibacterial drugs;
- anti-inflammatory drugs;
- corticosteroid hormones;
- pain relievers;
- chondroprotectors;
- cytostatics;
- ointments, creams and other topical agents that stimulate blood flow;
- vitamin complexes;
- synovial fluid substitutes.
The patient should receive a complex of physical therapy, physical therapy and massage, 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 adjusted: prevention of obesity, normalization of physical activity, limitation of power loads, etc.
If conservative treatment does not have the desired effect or the main disease is treated only surgically, surgical intervention is prescribed. It is performed through open access or through an arthroscopic technique. As part of the surgical treatment of diseases that cause pain in the hip joint, the following may be performed:
- reduction of dislocations;
- reconstruction of individual joint structures;
- endoprosthetics;
- tumor removal;
- fixed fixation of the joint (arthrodesis);
- arthroplasty.
These and other surgical methods of treatment are selected in accordance with the diagnosis and the characteristics of the patient's current condition. After surgical treatment, the patient undergoes a course of rehabilitation.
Complications
Hip pain cannot be ignored. Even minor 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;
- transition of pain in a chronic form (in this case they are present almost constantly);
- disorder of the intra-articular bodies;
- deep vein thrombosis;
- heterotopic ossification (formation of bone plates in soft tissues);
- arthrosis;
- contractures: impaired mobility of the joint;
- 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 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 the main macro- and micronutrients, as well as the total calorie 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, it is recommended to regularly rest the body and undergo preventive examinations by an orthopedic traumatologist at least once a year.
Patients with diseases of the musculoskeletal system must be under medical supervision, strictly follow medical instructions and monitor their condition.
To prevent hip injuries, it is recommended to avoid extreme sports, wear protective equipment when exercising and not perform complex exercises without the necessary skills and physical training.
It is recommended that elderly people move with extreme caution in icy conditions and not go outside unless absolutely necessary.
Treatment of hip pain in a professional clinic
The doctors of the multidisciplinary center are highly qualified specialists with the necessary practical skills and in-depth knowledge in various fields of medicine. They consider the patient's problem individually, draw up a diagnostic and treatment program, taking into account all health characteristics. Specialists use an integrated approach to solve various health problems. They not only eliminate a specific symptom, but also try to identify and eliminate its cause, obvious and non-obvious consequences. This is the only way to fully restore the patient's health, to give him back the opportunity to live 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 attitude of specialists and junior staff, assistance in rehabilitation and objectivity.