The hip joints experience 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 the 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 individually selected effective drugs that affect the cause and mechanism of development of pain. Rehabilitation clinic specialists provide rehabilitation therapy using the latest physical therapy 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 many areas of medicine are involved: endocrinologists, rheumatologists, orthopedists, physiotherapists, chiropractors, acupuncturists. A multidisciplinary approach to the treatment of pain in the hip joint allows for rapid pain relief. Patients suffering from hip joint pathology often require external care.
Reasons
Pain in the hip joint is caused by the following pathological processes:
- Tendinitis (inflammation of tendons);
- Muscle burst;
- Iliotibial band syndrome;
- Other local changes in surrounding tissue;
- Systemic diseases (rheumatoid arthritis, polymyalgia).
Because the gluteus medius and minimus muscles play a large 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 as a result of excessive strain, the patient will be bothered 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:
- Osteoarthritis;
- 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 acute pain in the hip joint. Pain syndrome often develops with dysplasia (disturbance of the anatomical structure) of the hip joint. Acute pain in the hip joint radiating to the leg occurs in cases of pinched nerves due to diseases of the spine, malignant bone tumors and age-related changes.
Examination methods
During the first consultation, rheumatologists carry out a comprehensive examination of the patient:
- Collection of complaints, clarification of the nature of pain in the hip joint;
- Obtaining information about the course of the disease, the onset of pain, the course of pain, household 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 various movements of the lower limbs in the hip joint. The presence of pathology in the hip joint may be indicated by poor posture;
- Palpation (feeling). The doctor can find rheumatoid and rheumatic nodes, detect the exact location of pain during leg movements, determine the humidity and temperature of the skin in the hip joint.
Next, the doctor 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, which allows you to obtain accurate test results.
In case of 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 gout, 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 changes in patients with rheumatism, psoriatic polyarthritis, gout and ankylosing spondylitis. In severe forms of hip joint pathology, significant deviations from the norm are observed in urinalysis.
Doctors at the clinic carry out X-ray 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 occurrence of difficulties in movement of the lower extremities;
- The appearance of swelling and discoloration of the skin in the hip joint.
Using computed tomography, doctors at the clinic assess the bones that take part in the formation of the hip joint. On computed tomography, the radiologist finds changes in the structure of bone tissue, cartilage growth and osteophytes.
Using magnetic resonance imaging, doctors assess the condition of the soft tissue surrounding the hip joint.
Radionucleotide research methods make it possible to recognize pathology using radiopharmacological drugs.
Ultrasound examination of the hip joint is performed for injuries, inflammatory diseases, arthritis 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 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 substances 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 sounds when moving the joint bothers patients suffering from iliopectineal 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 limbs. Pain is also detected by deep palpation in the area of the femoral triangle (a formation bounded by the inguinal ligament, the outer edge of the long adductor 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 increases with movement.
Roth's myalgia is manifested by burning pain in the front outer part of the hip joint and thigh, which is intensified by walking and straightening the leg. Pain in the hip joints occurs with dysplasia. Over time, the patient develops a characteristic "duck" gait (he walks and waddles 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 older people. 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.
Growth appears on the bones. They limit the movement of the joint considerably. 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 treatment. If it is ineffective, endoprosthetics are 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. Serious cases of diseases where 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 from the 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 bones, cartilage and soft tissue in the joint area. For acute pain, hospital rheumatologists prescribe non-steroidal anti-inflammatory drugs. The well-being of patients is significantly improved by 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 in soft tissue (tendinitis, bursitis, epicondylitis), after injuries.
If such 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 in a specialized clinic 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 tissue.
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 are spasms in the muscles that participate in movements of the hip joint, muscle relaxants are prescribed to reduce the tone of the skeletal muscles.
Drug treatment is supplemented with physiotherapeutic procedures. They are of secondary importance for pain in the hip joint. The effectiveness of physiotherapeutic treatment methods is reduced due to deep location. Severity of pain in the hip joint decreases after medium-wave ultraviolet irradiation.
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, shock wave therapy stimulate tissue restoration. The intensity of pain that occurs due to circulatory disorders and nutrition 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 limbs. When the structures that participate in the formation of the hip joint are destroyed, the pain can be so severe 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 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, 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 for the treatment of the hip joint allows you to preserve its mobility, improve blood circulation in the joint and accelerate the recovery of cartilage tissue. Specialists in the rehabilitation department select a set of physiotherapeutic exercises taking into account the patient's joint disease. The 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 training.
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 predominantly in men and affects only one joint. The treatment consists in eliminating pain, restoring blood supply to the joint area, normal condition of the limb muscles and maintaining the functionality of the joint. The patient is prescribed pain-relieving and anti-inflammatory drugs, vitamins, physiotherapeutic procedures and therapeutic exercises. The patient is advised to wear orthopedic shoes and use extra support when moving.
The cause of pain in the hip joint may be a purulent process. Primary purulent arthritis develops when there is a wound or injury and infectious substances 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. To treat purulent arthritis, professional specialists perform antibacterial therapy. If pus accumulates in the joint cavity, the hip joint is punctured, 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 develops, the cavity of the periarticular bursa is cleaned. In severe cases, the joint capsule is removed using a surgical endoscopic technique, which has undergone irreversible changes.
Osteoporosis often causes a fracture of the femoral neck. The patients are bothered by sharp, severe pain when moving the hip joint, which radiates to the groin and inner thigh. The leg faces outwards. Bruising and swelling appear in the hip joint. 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 severe pain when spreading the legs and bending the knees. Treatment is carried out using special orthopedic structures.
If you or a relative has pain in the hip joint, you should not self-medicate. Seek professional medical attention immediately. Patients with acute pain are usually admitted to the clinic for at least a week. If the pain is not intense, patients can be offered examination by a professional doctor for hip joint diseases and treatment at home with strict adherence to all rules.