Hip joints experience the greatest load in the body. They are formed when 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 individually choose effective medications that affect the cause and mechanism of pain development. Rehabilitation clinic specialists provide rehabilitation therapy using the latest physiotherapy procedures, physiotherapy and acupuncture. The presence of special simulators allows you to reduce the load on the joint during training.
Doctors from many fields of medicine are involved in the treatment of hip joint pain: endocrinologists, rheumatologists, orthopedists, physiotherapists, chiropractors, acupuncturists. A multidisciplinary approach to the treatment of hip pain provides rapid pain relief. Patients with hip joint pathology often require outpatient care.
Reasons
Hip joint pain is caused by the following pathological processes:
- tendinitis (inflammation of tendons);
- muscle breakdown;
- iliotibial band syndrome;
- other local changes in surrounding tissues;
- Systemic diseases (rheumatoid arthritis, polymyalgia).
Because the gluteus medius and minimus muscles play a major role in hip abduction, damage to them can lead to hip pain. The gluteus medius and minimus tendons attach to the greater trochanter. If an inflammatory process develops in them due to microtraumas caused by excessive load, the patient will suffer from pain in the hip joint. Such disorders can 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;
- radicular syndrome;
- rheumatoid arthritis;
- Coxita.
Pain in the hip joint can affect people who are overweight, have different leg lengths or have flat feet. Pain syndrome may occur after lower extremity 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. Pain syndrome often develops with dysplasia of the hip joint (disorder of the anatomical structure). Acute pain in the hip joint, which radiates to the leg, occurs when nerves are stretched due to spinal diseases, malignant bone tumors, and age-related changes.
Research methods
During the first consultation, rheumatologists conduct a comprehensive examination of the patient:
- collecting complaints, clarifying the nature of pain in the hip joint;
- obtaining information about the course of the disease, occurrence of pain, progression of pain, household and professional factors, which, according to the patient, caused pain;
- External examination allows the doctor to identify visible deviations from the norm. To understand the nature of the pain and the area of its distribution, 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;
- palpation (feeling). The doctor can detect rheumatoid and rheumatic nodes, find the exact location of pain during leg movement, determine the moisture and temperature of the skin in the area of the hip joint.
Next, the doctor conducts goniometry - an examination using a goniometer device. This allows you to determine the range of motion of the joints. Then the rheumatologist will prescribe a clinical and biological blood analysis and a general analysis of urine. Hospital laboratories conduct research using high-quality reagents and modern equipment, which allows you to get accurate test results.
During inflammation of the hip joint, the number of leukocytes in the blood increases and the rate of erythrocyte sedimentation 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 sharply. In patients with rheumatism, psoriatic polyarthritis, rheumatism and ankylosing spondylitis, the content of lysosomal enzymes (acid proteinase, acid phosphatase, cathepsins, deoxyribonuclease) in blood serum and synovial fluid changes. In severe forms of hip joint pathology, urine analysis shows significant deviations from the norm.
Doctors of the clinic conduct X-ray examinations of patients with hip pain. It is indicated in the following cases:
- presence of chronic or acute pain in the hip joint at rest and during movement;
- difficulty in moving the lower limb;
- Swelling and discoloration of the skin in the hip joint area.
Using computed tomography, the clinic's doctors evaluate the bones involved in the formation of the hip joint. A radiologist detects changes in the structure of bone tissue, cartilage formations and osteophytes on a computer tomography.
Using magnetic resonance imaging, doctors assess the condition of the soft tissues that surround the hip joint.
Radionucleotide research methods make it possible to identify pathology using radiopharmacological drugs.
Ultrasound examination of the hip joint is performed during injuries, inflammatory diseases, rheumatism and rheumatoid arthritis. The attending physician individually selects research methods in each case, which are necessary to determine the cause of pain in the hip joint.
differential diagnosis
Pain in the hip joint while walking is the main complaint with which patients turn to the doctor. It can be located in the joint area or spread to the hip, buttock or knee joint. If pain occurs in the hip joint during movement, the patient is forced to use a crutch. Often, because of the pain, there is a limitation of mobility in the movement of the hip joint, especially in the external and internal rotation of the leg.
Pain in the hip joint, buttock 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 a clicking sound when moving the joint is a concern for patients with iliopectinal bursitis. It radiates to the thigh and is accompanied by paresthesia (tingling, burning, crawling sensations) due to compression of the femoral nerve. The patient feels pain in the hip joint when bending and extending the lower limb. Pain was also detected by deep palpation in the area of the femoral triangle (the formation is limited by the inguinal ligament, the outer edge of the long connecting 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 during movement, pain in the outer part of the knee joint, which increases with movement.
Rott's myalgia is characterized by burning pain in the hip joint and anterior outer part of the thigh that worsens with walking and straightening the leg. Pain in the hip joints occurs during dysplasia. Over time, the patient develops a characteristic "duck" gait (he walks, turns from side to side).
Pain with coxarthrosis
Pain in the hip joint occurs during coxarthrosis, a disease characterized by degenerative processes in the bones that make up the joint. More often the disease affects the elderly. With age, joint cartilage loses its elasticity, thins 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, which causes aseptic inflammation.
Growths appear on the bones. They significantly limit movement in the joint. Deformation of the articular surfaces develops, which causes severe pain. Treatment of the disease depends on the severity of the joint damage. Doctors conduct drug therapy. If it is ineffective, endoprosthesis is performed or palliative treatment is used.
After determining the cause of pain in the hip joint, doctors begin to treat the disease that caused the pain syndrome. Severe cases of the disease, in which the patient suffers from 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 causing pain in the hip joint is the elimination of the factors causing structural changes in the bone, cartilage and soft tissue in the joint area. In acute pain, hospital rheumatologists prescribe non-steroidal anti-inflammatory drugs. The well-being of patients is significantly improved by using local treatment methods - external use of gels and ointments, patches containing non-steroidal anti-inflammatory drugs. They reduce pain in the hip joints during soft tissue inflammatory processes (tendinitis, bursitis, epicondylitis), after injuries.
If such therapy is not effective enough, doctors inject glucocorticoids into the hip joint cavity. With deformed coxarthrosis, the joint space narrows, it is difficult to get into it. For this reason, in a specialized clinic, rheumatologists perform the procedure 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. When there is a spasm of the muscles involved in the movements of the hip joint, myorelaxants are prescribed to reduce the tone of the skeletal muscles.
Physiotherapy procedures are added to drug therapy. They are secondary to hip pain. The effectiveness of physiotherapeutic treatment methods decreases due to deep location. Severity of pain in the hip joint decreases after UV irradiation with medium wavelengths.
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 magnetotherapy, ozone therapy, shock wave therapy stimulate tissue recovery. The intensity of pain, which occurs due to blood circulation disorders and feeding of the hip joint, is reduced under the influence of various types of electrotherapy (current exposure) and ultrasound.
In order to reduce the load on the hip joint, rheumatologists advise patients to use crutches 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 damaged, 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 for cartilage tissue damage. An orthopedic doctor will prescribe 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 recovery of cartilage tissue. Specialists of the rehabilitation department choose a set of physiotherapy 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 together with physical education.
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 mainly develops in men and affects only one joint. Treatment includes pain relief, restoration of blood supply to the joint, normalization of limb muscles, and maintenance of joint function. 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 when moving.
The cause of pain in the hip joint can be a purulent process. Primary purulent arthritis develops during a wound or injury and when infectious agents enter the joint cavity. The secondary purulent process develops when sepsis or an infectious agent enters the joint from the adjacent tissues affected by the inflammatory process. For the treatment of purulent arthritis, professional specialists carry out antibacterial therapy. In case of accumulation of pus in the joint cavity, a puncture of the hip joint is performed, the contents are evacuated, and antibacterial agents are injected into the joint cavity.
Bursitis is inflammation of the joint lining. To relieve pain, doctors prescribe injections of anti-inflammatory drugs and glucocorticoids. If purulent inflammation has developed, the cavity of the periarticular bursa is cleaned. In severe cases, a joint capsule that has undergone irreversible changes is removed using surgical endoscopic techniques.
Fractures of the femoral neck often occur during osteoporosis. Patients experience sharp, severe pain in the hip joint with movement that radiates into the groin and inner thigh. The leg turns outward. Bruises and swelling appear in the hip joint area. In this case, 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 at birth. It is manifested by severe pain when extending 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 are usually hospitalized in the clinic for at least a week. If the pain is not intense, patients can be offered an examination by a professional doctor for diseases of the hip joint and home treatment with strict adherence to all rules.