The 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. In a special hospital, the orthopedist determines the cause with the help of 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. Effective drugs that affect the cause of pain and the mechanism of its development are individually selected by patients. The specialists of the rehabilitation clinic perform rehabilitation therapy using the latest physiotherapy procedures, physical therapy and acupuncture. The presence of special simulators makes it possible to reduce the load on the joint during training.
Doctors from many fields of medicine participate in the treatment of hip joint pain: endocrinologists, rheumatologists, orthopedists, physiotherapists, chiropractors, and acupuncture specialists. A multidisciplinary approach to the treatment of hip joint pain allows rapid pain relief. Patients with hip joint pathology often require outpatient care.
Cause
Pain in the hip joint is caused by the following pathological processes:
- Tendinitis (tendon inflammation);
- 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 large role in hip abduction, damage to these muscles 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 strain, the patient is disturbed by pain in the hip joint. Such disorders can be caused by an infectious process (tuberculosis), sports or stereotypical professional stress, or 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. Patients with avascular necrosis of the head and fracture of the femoral neck complain of acute pain in the hip joint. The pain syndrome often develops with dysplasia of the hip joint (abnormality of the anatomical structure). Acute pain in the hip joint radiating to the leg occurs in the case of spinal diseases, malignant bone tumors, and pinched nerves due to age-related changes.
Test methods
During the first consultation, rheumatologists perform a comprehensive examination of the patient:
- Collecting complaints, clarifying the nature of hip joint pain;
- Obtaining information about the course of the disease, the appearance of the pain, the course of the pain, the household and professional factors that, according to the patient, caused the pain;
- The external examination allows the doctor to determine visible deviations from the norm. In order to understand the nature of the pain and its distribution area, the doctor asks the patient to perform various movements of the lower limb in the hip joint. Bad posture can indicate the presence of hip joint pathology;
- Touch (feeling). The doctor finds rheumatic and rheumatic nodules, determines the exact location of pain during leg movements, determines the humidity and temperature of the skin in the area of the hip joint.
Then the doctor performs goniometry - an examination with a goniometer. It allows you to determine the range of joint mobility. Then the rheumatologist prescribes a clinical and biological blood test and a general urinalysis. The hospital's laboratory technicians carry out research with high-quality reagents and modern equipment that allow accurate test results.
In case of inflammation of the hip joint, the number of leukocytes in the blood increases and the sedimentation rate of red blood cells increases. The inflammatory nature of the disease is indicated by an increase in the content of C-reactive protein in the blood serum.
The immunological blood test shows the presence of antinuclear antibodies in the blood in rheumatic inflammatory diseases. In patients with arthritis, the concentration of uric acid in the blood serum rises sharply. The content of lysosomal enzymes (acid proteinase, acid phosphatase, cathepsins, deoxyribonuclease) changes in blood serum and synovial fluid in patients with rheumatic, psoriatic polyarthritis, rheumatism and ankylosing spondylitis. In severe forms of hip joint pathology, significant deviations from the norm can be observed during urine analysis.
Doctors at the clinic perform X-rays 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;
- Occurrence of difficulties when moving the lower limb;
- Swelling and discoloration of the skin in the area of the hip joint.
With the help of computerized tomography, the doctors of the clinic evaluate the bones that are involved in the formation of the hip joint. On computer tomograms, the radiologist finds changes in the structure of bone tissue, cartilaginous growths and osteophytes.
With the help of magnetic resonance imaging, doctors evaluate the condition of the soft tissues surrounding the hip joint.
Radionucleotide research methods make it possible to recognize pathology with the help of radiopharmacological drugs.
Ultrasound examination of the hip joint is performed in case of injuries, inflammatory diseases, rheumatism and rheumatic arthritis. In each case, the treating physician individually selects the research methods necessary to determine the cause of hip joint pain.
Differential diagnosis
Pain in the hip joint while walking is the main complaint with which patients consult a doctor. It can be located in the joint area or spread to the thigh, buttock 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 movement when moving the hip joint, especially when rotating the leg externally and internally.
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 deformation of the femoral head, the mobility of the hip joint is limited. In the early stages of the pathological process, the range of motion may be normal.
Pain in the front of the hip joint and clicking sounds when moving the joint bother patients with iliopectineal bursitis. It radiates to the thigh and is accompanied by paresthesia (tingling, burning, crawling sensation) 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 by deep palpation in the area of the femoral triangle (formation bounded by the inguinal ligament, the outer edge of the long adductor muscle, and 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 during movement, pain in the outer part of the knee joint, which intensifies with movement.
Roth's muscle pain manifests as a burning pain in the hip joint and anterior outer thigh that worsens when walking and straightening the leg. Pain in the hip joints is associated with dysplasia. Over time, the patient develops a characteristic "duck" gait (walks, ducks from one side to the other).
Pain with coxarthrosis
Pain in the hip joint occurs in coxarthrosis, a disease characterized by degenerative processes of the bones that make up the joint. The disease affects the elderly more often. As we age, the cartilage tissue of the joint loses its elasticity, thins and begins to wear. 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.
Growths appear on the bones. They significantly limit movement in the joint. Deformation of the joint surfaces develops, which causes severe pain. The treatment of the disease depends on the severity of the joint damage. Doctors provide medication. If ineffective, endoprosthesis or palliative treatment is performed.
After determining the cause of pain in the hip joint, doctors begin to treat the disease causing 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, as well as doctors of the highest category.
Treatment
An important condition for the successful treatment of diseases that cause hip joint pain is the elimination of factors that cause structural changes in the bone, cartilage and soft tissues of the joint area. In case of acute pain, hospital rheumatologists prescribe non-steroidal anti-inflammatory drugs. Patients' well-being improves significantly by using local treatment methods - external application 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 such therapy is not effective enough, doctors inject glucocorticoids into the cavity of the hip joint. The deforming coxarthrosis joint space is narrowed and difficult to enter. For this reason, rheumatologists perform the procedure in a specialized clinic under X-ray control. In the presence of pain caused by inflammation of muscles and tendons, glucocorticoid hormones are injected into the periarticular tissues.
Chondroprotectors are used to improve the condition of the cartilage and reduce pain in the hip joint. The therapeutic course lasts several months. If the muscles involved in the movement of the hip joint are spasmodic, muscle relaxants are prescribed to reduce the tone of the skeletal muscles.
Drug therapy is complemented by physiotherapy procedures. They are secondary to hip pain. The effectiveness of physiotherapy treatment methods decreases due to the deep location. The severity 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 laser treatment, and low-intensity UHF are performed. High-intensity, high-frequency magnetic therapy, ozone therapy, and shock wave therapy stimulate tissue recovery. The intensity of pain caused by circulatory disorders and nutrition of the hip joint is reduced under the influence of various electrotherapy (exposure to currents) and ultrasound.
In order to reduce the load on the hip joint, rheumatologists advise patients to use a stick in case of 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 severe that the only way 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 in case of cartilage tissue damage. The 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, joint replacement with an endoprosthesis is required, 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 makes it possible to maintain mobility, improves blood circulation in the joint, and accelerates the recovery of cartilage tissue. The specialists of the rehabilitation department select physical therapy exercises, taking into account the patient's joint disease. Rehabilitation classes are held daily under the supervision of instructors. For rehabilitation therapy, special simulators are used and physiotherapy procedures combined with physical education are prescribed.
What diseases cause joint pain
Pain in the hip joint on the right or left side can be a manifestation of vascular necrosis. The disease develops mainly in men and affects only one joint. Treatment consists of eliminating pain, restoring blood supply to the joint area, restoring the limb's musculature to normal, and maintaining the joint's functionality. The patient is prescribed painkillers and anti-inflammatory drugs, vitamins, physiotherapy procedures and therapeutic exercises. The patient is recommended to wear orthopedic shoes and use additional support during movement.
The cause of hip joint pain can be a purulent process. Primary suppurative 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 surrounding tissues affected by the inflammatory process. For the treatment of purulent arthritis, professional specialists perform antibacterial therapy. If pus accumulates in the joint cavity, the hip joint is punctured, the contents are drained, and antibacterial agents are injected into the joint cavity.
Bursitis is inflammation of the joint membrane. Doctors prescribe injections of anti-inflammatory drugs and glucocorticoids to relieve pain. If purulent inflammation develops, the cavity of the periarticular bursa is cleaned. In severe cases, the joint capsule that has undergone irreversible changes is removed using a surgical endoscopic technique.
Fractures of the femoral neck often occur in cases of osteoporosis. Patients are disturbed by sharp, severe pain during the movement of the hip joint, which radiates to the groin and the inner part of the thigh. The foot turns outwards. Bruises and swelling appear in the area of the hip joint. In this case, the treatment is carried out by professional orthopedists.
Traumatic dislocation of the hip joint causes 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. The treatment is carried out with special orthopedic structures.
If you or a loved one has pain in the hip joint, do not self-medicate. Consult a specialist immediately. Patients with acute pain are usually hospitalized at the clinic for at least a week. If the pain is not severe, patients can be offered an examination of hip joint diseases by a professional doctor and home treatment, with strict adherence to all rules.