The hip joints bear the greatest load in the body. They are created by weight during walking, jumping, running, lifting and carrying heavy objects. Patients often feel pain in the hip joint. Orthopedists at 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 provide complex therapy for diseases that cause pain in the hip joint. Patients are prescribed individually selected effective medications that affect the cause and mechanism of pain development. Rehab clinic specialists provide rehabilitation therapy using the latest physiotherapeutic procedures, physiotherapy and acupuncture. The presence of special simulators allows you to reduce the load on the joint during training.
In the process of treating pain in the hip joint, doctors from different areas of medicine are involved: endocrinologists, rheumatologists, orthopedists, physiotherapists, chiropractors, acupuncturists. A multidisciplinary approach to treating hip joint pain allows for 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:
- Tendinitis (inflammation of the tendons);
- Muscle rupture;
- Iliotibial band syndrome;
- Other local changes in surrounding tissues;
- Systemic diseases (rheumatoid arthritis, polymyalgia).
Because the gluteus medius and minimus muscles play an important role in hip abduction, damage to them causes hip pain. The gluteus medius and minimus tendons attach to the greater trochanter. If an inflammatory process develops in them due to microtraumas resulting from excessive load, the patient will be bothered by pain in the hip joint. Such disorders may be caused by an infectious process (tuberculosis), stereotypical sports or professional stress or by the deposition of crystals.
Hip pain is a symptom of the following diseases:
- Osteoarthrosis;
- 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 can occur after lower limb amputation or hip replacement. With avascular necrosis of the head and fracture of the femoral neck, patients complain of sharp 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 in the case of pinched nerves due to diseases of the spine, malignant bone tumors and age-related changes.
Examination methods
During the first consultation, rheumatologists perform a comprehensive examination of the patient:
- Collection of complaints, clarification of the nature of pain in the hip joint;
- Obtain information about the evolution of the disease, the onset of pain, the progression of pain, domestic and professional factors that, in the patient's opinion, caused the pain;
- An external examination allows the doctor to determine 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 several movements of the lower limb in the hip joint. The presence of hip joint pathology may be indicated by poor posture;
- Palpation (sensation). The doctor can find rheumatoid and rheumatic nodules, detect the exact location of pain during leg movements, determine the moisture and temperature of the skin in the hip joint area.
Next, the doctor performs goniometry - an examination using a goniometer device. It allows you to determine the range of joint mobility. Then the rheumatologist prescribes clinical and biological blood tests and a general urine test. The hospital's laboratory technicians carry out research using high-quality reagents and modern equipment, which allows accurate test results to be obtained.
With inflammation of the hip joint, 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 suffering from arthritis, the concentration of uric acid in the blood serum increases markedly. 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 in urine analysis are observed.
Doctors at the clinic perform X-ray examinations on 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 limb;
- The appearance of swelling and discoloration of the skin in the region of the hip joint.
Using computed tomography, doctors at the clinic evaluate the bones that participate in the formation of the hip joint. On computed tomography scans, the radiologist finds changes in the structure of bone tissue, cartilaginous growths and osteophytes.
Using magnetic resonance imaging, doctors evaluate the condition of the soft tissues surrounding the hip joint.
Radionucleotide research methods make it possible to recognize pathologies using radiopharmacological drugs.
Ultrasound examination of the hip joint is carried out for injuries, inflammatory diseases, rheumatism and rheumatoid arthritis. The attending physician individually selects in each case the necessary research 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 brings patients to the doctor. It may be located in the joint area or extend to the thigh, buttocks 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 limited mobility when moving the hip joint, especially when externally and internally rotating 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 prolonged use of hormonal drugs and alcohol abuse. With the development of femoral head deformity, the mobility of the hip joint is limited. At an early stage of the pathological process, range of motion may be normal.
Pain in the anterior part of the hip joint and clicking noises when moving the joint bother patients suffering from iliopectineal bursitis. It radiates to the thigh and is accompanied by paresthesia (tingling, burning and chills) due to compression of the femoral nerve. The patient feels pain in the hip joint when flexing and extending the lower limb. Pain is also detected on deep palpation in the area of the femoral triangle (a formation limited by the inguinal ligament, the outer edge of the adductor longus 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, which intensifies with movement.
Roth's myalgia is manifested by burning pain in the anterior outer part of the hip and thigh joint, which intensifies when walking and stretching the leg. Pain in the hip joints occurs with dysplasia. Over time, the patient develops a characteristic "duck" gait (he waddles from side to side).
Pain with coxarthrosis
Pain in the hip joint occurs in coxarthrosis, a disease characterized by degenerative processes in the bones that form the joint. More often, the disease affects elderly people. With age, the cartilage tissue of the joint loses elasticity, becomes thin and begins to wear away. When the load on the joint increases, the thin cartilaginous tissue is destroyed. The articular surfaces of bones rub against each other, resulting in aseptic inflammation.
Growths appear on the bones. They significantly limit movement in the joint. Deformation of the articular surfaces develops, resulting in severe pain. Treatment of the disease depends on the severity of the joint damage. Doctors provide drug therapy. If it is ineffective, endoprosthetics or palliative treatment is 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 is bothered by pain in the hip joint are discussed at a meeting 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 the bones, cartilage and soft tissues of the joint region. For acute pain, hospital rheumatologists prescribe nonsteroidal anti-inflammatory drugs. The well-being of patients significantly improves with the use of local treatment methods - external applications 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 this 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 at a specialized clinic perform the procedure under radiographic control. In the presence of pain caused by inflammation of muscles and tendons, glucocorticoid hormones are injected into the periarticular tissues.
To improve the condition of the cartilage and reduce pain in the hip joint, chondroprotectors are used. The therapeutic course lasts several months. When there is spasm of the muscles that participate 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 of secondary importance for hip joint 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 irradiation with medium-length waves.
In the presence of an inflammatory process, high-intensity centimeter wave therapy, infrared and low-intensity UHF laser treatment are performed. High-intensity, high-frequency magnetic therapy, ozone therapy, and shockwave therapy stimulate tissue restoration. The intensity of pain that occurs due to circulatory and nutritional disorders 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 if there is acute pain. After reducing the severity of the pain syndrome, rehabilitators perform therapeutic exercises. An individual set of exercises is developed for each patient to quickly restore lower limb function. When the structures that participate in the formation of the hip joint are destroyed, the pain can be so intense that the only method 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. The patient is prescribed chondroprotectors for damage to cartilaginous tissue. An orthopedic doctor prescribes effective treatment, diet and exercise 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 quality of life and eliminates pain.
Exercise therapy treatment
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 cartilaginous tissue. Specialists of the rehabilitation department select a set of physiotherapeutic exercises taking into account the patient's joint disease. Rehabilitation classes are held daily under the supervision of an instructor. For rehabilitation therapy, special simulators are used 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 may be a manifestation of avascular necrosis. The disease develops predominantly in men and affects only one joint. Treatment consists of eliminating pain, restoring blood supply to the joint area, the normal state of the limb muscles and maintaining the functionality of the joint. The patient is prescribed analgesics and anti-inflammatory drugs, vitamins, physiotherapeutic procedures and therapeutic exercises. It is recommended that the patient wear orthopedic shoes and 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 cavity. A secondary purulent process develops when sepsis or an infectious agent enters the joint from the 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 is performed in the hip joint, 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 occurs, the periarticular bursa cavity is cleaned. In severe cases, using an endoscopic surgical technique, the joint capsule, which has undergone irreversible changes, is removed.
In osteoporosis, a fracture of the femoral neck often occurs. Patients are bothered by sharp and intense pain when moving the hip joint, which radiates to the groin and inner thigh. 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 intense pain when opening the legs and bending the knees. Treatment is carried out using special orthopedic structures.
If you or a loved one has pain in the hip joint, you should not self-medicate. Seek professional medical attention immediately. Patients with acute pain usually stay in the clinic for at least a week. If the pain is not severe, patients can be examined by a professional doctor for diseases of the hip joint and treated at home with strict adherence to all rules.