The human hip joints are subject to enormous stress. Walking, lifting and carrying heavy objects, jumping, running, bending, other physical exercises and even excess weight all 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 pain and at the first symptoms of discomfort, immediately seek help from qualified doctors. Orthopedists, traumatologists, surgeons, neurologists and a number of other specialists jointly assess symptoms, search for causes and treat 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 side can be caused by injuries, inflammatory and infectious pathologies, various degenerative processes, problems with the supply of useful minerals to bone tissue, etc.
Injuries to soft tissues and osteoarticular structures of the hip area are the most common cause of discomfort. These include:
- bruises;
- penetrating wounds;
- femoral neck fracture;
- hip dislocation;
- Fractures of the acetabulum and the upper part of the femur (so-called pertrochanteric fractures).
Of the traumatic causes, damage to the ligamentous 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 rubble, or due to performing extreme stunts.
Infectious, inflammatory and degenerative diseases that can cause pain in the hip joint include:
- various forms of arthritis (infectious, aseptic, rheumatoid);
- panarthritis – total 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 of the development of the hip joint (dysplasia, congenital dislocation of the hip, shortening of the limbs);
- various neoplasms of a malignant and benign nature;
- neuropathy of the sciatic nerve;
- osteochondrosis, scoliosis, intervertebral hernia and other diseases of the spine.
Pain in the hip joint when walking or lying down may indicate excessive stress on the musculoskeletal system. Discomfort may occur after strength training, carrying heavy objects, or prolonged walking or standing. The risk group includes athletes, fans of extreme sports, loaders, teachers, lecturers, salespeople, couriers, etc.
Other causes of severe pain in the hip joint when walking and at rest may be:
- excess weight, which greatly increases the pressure on the joints;
- posture disorders;
- irrational use of certain medications;
- diabetes;
- neuropsychiatric disorders.
The largest number of patients with pain of varying intensity in this area are people over 50 years of age. This is explained by age-related changes in the periarticular tissues and the joint itself. It has been observed 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, pulsating, aching, dull, cutting, etc. The localization and intensity of the pain syndrome depend on the initial disease and the patient’s health characteristics (the presence of concomitant pathologies, excess weight, risk factors). Often the pain syndrome spreads to surrounding structures, radiating to the limbs, the sacrum and coccyx area, and the lower back.
Symptoms that may accompany hip pain include:
- tissue swelling in the joint area;
- crunching, clicking and other sounds when moving;
- limited mobility;
- numbness, decreased sensitivity in the leg;
- feeling of heat, pulsation in the area of damage;
- lameness, dragging of the leg;
- shortening of the limb;
- bruising;
- elevated body temperature.
Aching pain in the hip joint, radiating to the lower back, leg, groin and sacral area, may indicate ankylosing spondylitis. This disease is also accompanied by stiffness of movement, discomfort in the knee, and periodic "lumbago". Symmetrical pain in the hip area, combined with conjunctivitis and damage to the genitourinary system, can be a sign of Reiter's syndrome.
The clinical picture is determined by the primary 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, support on the affected leg is impossible; the patient can only move with the help of an auxiliary point or cannot walk at all.
Diagnostics
To establish the exact cause of pain, other symptoms of the primary disease/injury and select 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 articulation area, asks detailed questions about the nature of the complaints, the time and circumstances of their occurrence, etc. The specialist also needs to know about previous surgical interventions and injuries, existing chronic pathologies (including those not directly related to the musculoskeletal system), lifestyle, etc.
A comprehensive objective examination includes:
- ultrasound examination of the hip joint (ultrasound);
- radiography of the pelvis in two projections;
- magnetic resonance or computed tomography (according to indications);
- joint puncture;
- diagnostic arthroscopy;
- laboratory tests (general clinical blood and urine tests, biochemistry, analysis for rheumatoid factor, tumor markers, etc. ).
The exact list of procedures is determined by the doctor based on medical history, characteristics of the patient’s current condition, and the expected diagnosis.
Treatment of hip pain
The tactics of medical care depend on the cause of pain. In case of sprains and bruises, the joint is immobilized, the patient is prescribed painkillers, and is placed on strict bed rest. In case of dislocation, 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 that is caused by inflammatory or infectious causes, treatment may include:
- antibacterial drugs;
- anti-inflammatory drugs;
- corticosteroid hormones;
- painkillers;
- chondroprotectors;
- cytostatics;
- ointments, creams and other topical agents that stimulate blood flow;
- vitamin complexes;
- synovial fluid substitutes.
The patient is required to receive a complex of physiotherapy, 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 corrected: prevention of obesity, normalization of physical activity, limitation of strength loads, etc.
If conservative treatment does not have the desired effect or the primary disease is treated only surgically, surgical intervention is prescribed. It is performed using an open approach or using arthroscopic technique. As part of the surgical treatment of diseases that cause pain in the hip joint, the following can be performed:
- reduction of dislocations;
- reconstruction of individual joint structures;
- endoprosthetics;
- removal of tumors;
- fixed fixation of the joint (arthrodesis);
- arthroplasty.
These and other surgical treatment methods are selected in accordance with the diagnosis and characteristics of the patient’s current condition. After surgical treatment, the patient undergoes a course of rehabilitation.
Complications
Pain in the hip joint cannot be ignored. Even minor and temporary discomfort can lead to the development of serious diseases in the future. In complex cases, the consequences may be irreversible.
Possible complications include:
- limb deformity;
- lameness;
- transition of pain into a chronic form (in this case, they are present almost constantly);
- infringement of intra-articular bodies;
- deep vein thrombosis;
- heterotopic ossification (formation of bone plates in soft tissues);
- arthrosis;
- contractures: impaired joint mobility;
- necrosis;
- pathological fractures.
Without treatment, pathologies can cause persistent impairment of mobility, the inability to live a full life and even take care of oneself, and disability. With extensive purulent processes in the area of 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 (nutrition should be balanced in terms of basic macro- and micronutrients, as well as total calorie content);
- Do not use systemic medications 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 advisable to regularly rest the body and undergo preventive examinations by an orthopedist-traumatologist at least once a year.
Patients with diseases of the musculoskeletal system must be under dispensary observation, strictly follow medical instructions and monitor their condition.
In order to prevent injuries to the hip joint, 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 advisable for older people to move extremely carefully in icy conditions and not to go outside unless absolutely necessary.
Treatment of hip pain in a professional clinic
The doctors of the multidisciplinary center are high-class specialists with the necessary practical skills and extensive knowledge in various fields of medicine. They consider the patient’s problem individually, drawing up a diagnostic and treatment program taking into account all health characteristics. Specialists use an integrated approach to solve a variety of health problems. They not only eliminate a specific symptom, but also try to identify and eliminate its cause, obvious and unobvious consequences. This is the only way to fully restore the patient’s health, to return him to the opportunity to live a normal life, to move without pain or restrictions.
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.