The hip joints experience the greatest load on the body. They are created by the weight of 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.
Medical professionals provide complex treatment for diseases that cause pain in the hip joint. Patients are individually selected effective drugs that affect the cause and mechanism of pain development. Clinical rehabilitation specialists provide rehabilitation treatment using the latest physiotherapy procedures, physical therapy and acupuncture. The presence of special simulators allows you to reduce the load on the joint during training.
In the process of dealing with pain in the hip joint, doctors from many fields of medicine are involved: endocrinologists, rheumatologists, orthopedists, physiotherapists, chiropractors, acupuncturists. A multidisciplinary approach to the treatment of hip joint pain allows rapid 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:
- Tendonitis (inflammation of the 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 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), sports or stereotyped occupational stress, or crystal deposition.
Hip pain is a symptom of the following diseases:
- Osteoarthritis?
- Radical syndrome?
- Rheumatoid arthritis;
- Coxita.
Hip joint pain can bother people who are overweight, have different leg lengths, or have flat feet. Pain syndrome may occur after a lower limb amputation or hip replacement. With avascular necrosis of the head and fracture of the femoral neck, 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. Sharp 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 conduct a comprehensive examination of the patient:
- Collection of complaints, clarification of the nature of pain in the hip joint.
- Obtain information about the course of the disease, the onset of pain, the progression of pain, household and occupational factors that, in the patient's opinion, caused the pain.
- An external examination allows the doctor to identify 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 various movements of the lower limb in the hip joint. The presence of hip joint pathology can be indicated by poor posture.
- Palpation (feeling). The doctor can find rheumatoid and rheumatic nodules, locate the exact location of pain during leg movements, determine the moisture and temperature of the skin in the area of the hip joint.
The doctor then performs goniometry - an examination using a goniometer device. It allows you to determine the range of joint mobility. The rheumatologist then prescribes clinical and biological blood tests and a general urine test. The hospital's laboratory technicians conduct research using high-quality reagents and modern equipment, allowing you to receive accurate test results.
With inflammation of the hip joint, the number of leukocytes in the blood increases and the sedimentation rate of erythrocytes 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 is altered in patients with rheumatism, psoriatic arthritis, rheumatism and ankylosing spondylitis. In severe forms of hip joint pathology, significant deviations from the norm are observed in urine analysis.
Doctors at the clinic perform radiological 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 during the movement of the lower limb.
- The appearance of swelling and discoloration of the skin in the area of the hip joint.
Using computed tomography, doctors at the clinic evaluate the bones involved in the formation of the hip joint. In computed tomography, the radiologist detects changes in the structure of bone tissue, cartilage growths and osteophytes.
Using MRI, doctors assess the condition of the soft tissues surrounding the hip joint.
Radionucleotide research methods make it possible to identify pathology using radiopharmacological drugs.
Ultrasound examination of the hip joint is performed for injuries, inflammatory conditions, rheumatism and rheumatoid arthritis. The attending physician selects individually in each case 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 with which patients consult a doctor. It can 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 a limitation of mobility when moving the hip joint, especially when the leg is externally and internally rotated.
Pain in the hip joint, buttocks 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 deformity of the femoral head, the mobility of the hip joint is limited. At an early stage of the pathological process, the range of motion may be normal.
Pain in the anterior part of the hip joint and clicking noises when moving the joint bothers patients suffering from ileoplenic 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 area of the femoral triangle (a formation bounded by the inguinal ligament, the outer end of the adductor longus muscle, the inner end of the sartorius muscle).
Pain in the outer hip joint is a sign of iliotibial band syndrome. Accompanied by a clicking sound on movement, pain in the outer part of the knee joint, which intensifies with movement.
Roth's myalgia manifests as burning pain in the anterior outer part of the hip and thigh joint, which is aggravated by walking and straightening the leg. Hip joint pain occurs with dysplasia. Over time, the patient develops a characteristic "duck" gait (walks, sways from side to side).
Pain with coxarthrosis
Pain in the hip joint occurs with coxarthrosis, a disease characterized by degenerative processes in the bones that form the joint. More often the disease affects the elderly. 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.
The growths appear in 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 ineffective, endoprosthetics are performed or palliative therapy is used.
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 the factors that cause structural changes in the bones, 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. They reduce pain in the hip joints during inflammatory processes of soft tissues (tendonitis, bursitis, epicondylitis), after injuries.
If such treatment is not effective enough, doctors inject glucocorticoids into the hip joint cavity. The joint space with deforming coxarthrosis narrows, it is difficult to enter it. For this reason, rheumatologists in a specialized clinic perform the procedure under radiological control. In the presence of pain caused by inflammation of muscles and tendons, glucocorticoid hormones are injected into the periarticular tissues.
In order 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 a spasm of the muscles involved in movements in the hip joint, muscle relaxants are prescribed to reduce skeletal muscle tone.
The pharmaceutical treatment is complemented by physical therapy procedures. They are of secondary importance for hip joint pain. The effectiveness of physiotherapy treatment methods is reduced due to deep localization. Severity of hip joint pain is reduced after medium-wave ultraviolet radiation.
In the presence of an inflammatory process, high intensity wave therapy, infrared laser therapy and low intensity UHF are performed. High intensity high frequency magnetic therapy, ozone therapy, shock wave therapy stimulate tissue repair. 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 the function of the lower limb. When the structures involved in the formation of the hip joint are destroyed, the pain can be so intense that the only method of elimination 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 chondroprotectants for cartilage tissue damage. An orthopedic doctor prescribes effective treatment, diet and exercises to improve blood circulation in the joint, restore cartilage tissue and maintain joint mobility. In 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 therapy
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 cartilage tissue. Specialists in 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 an instructor. For rehabilitation treatment, special simulators are used and physiotherapy procedures are prescribed in combination with physical therapy.
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 mainly in men and affects only one joint. Treatment consists of eliminating pain, restoring blood supply to the joint area, normalizing the muscles of the limb, and maintaining the functionality of the joint. The patient is prescribed painkillers and anti-inflammatory drugs, vitamins, physical therapy procedures and therapeutic exercises. It is recommended that the patient wear orthopedic shoes and use additional support when moving.
The cause of pain in the hip joint may be a purulent process. Primary suppurative arthritis develops when there is trauma 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. 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 drained, and antibacterials 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 capsule is cleaned. In severe cases, using an endoscopic surgical technique, the capsule of the joint, which has undergone irreversible changes, is removed.
In osteoporosis, a fracture of the femoral neck often occurs. Patients are bothered by sharp, intense pain when moving the hip joint, which radiates to the groin and inner thigh. The foot turns outward. Bruising and swelling occur in the hip joint area. In this case, treatment is carried out by orthopedic professionals.
Traumatic hip dislocation is accompanied by pain in the hip joint. The hip is reduced under general anesthesia. Congenital hip dislocation is diagnosed soon after birth. It manifests as severe pain when you stretch your legs and bend your knees. The treatment is carried out using special orthopedic structures.
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 for at least one week. If the pain is not severe, patients can be offered examination by a professional doctor for diseases of the hip joint and treatment at home with strict adherence to all the rules.