The hip joints experience the greatest load in the body. They are created by weight when you walk, jump, run, lift and carry heavy objects. Patients often experience pain in the hip joint. Orthopedists of 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 offer complex therapy for diseases that cause pain in the hip joint. Patients receive individually selected effective drugs that affect the cause and mechanism of development of pain. Rehabilitation clinic specialists offer rehabilitation therapies using the latest physiotherapeutic 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 fields of medicine are involved: endocrinologists, rheumatologists, orthopedists, physiotherapists, chiropractors, acupuncturists. A multidisciplinary approach to treating pain in the hip joint provides rapid pain relief. Patients suffering from hip joint pathology often require outside care.
Causes
Pain in the hip joint is caused by the following pathological processes:
- Tendinitis (inflammation of the tendons);
- Muscle rupture;
- Iliotibial band syndrome;
- Other local changes in surrounding tissues;
- Systemic diseases (rheumatoid arthritis, polymyalgia).
Since the gluteus medius and gluteus minimus muscles play a major role in hip abduction, their damage causes hip pain. The tendons of the gluteus medius and minimus attach to the greater trochanter. If an inflammatory process develops there due to microtrauma resulting from excessive load, the patient will be bothered by pain in the hip joint. Such disorders can be caused by an infectious process (tuberculosis), stereotypical sports or professional stress, or even 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 legs of different lengths or have flat feet. Pain syndrome can occur after lower limb amputation or hip replacement. In case of avascular necrosis of the head and fracture of the femoral neck, patients complain of sharp pain in the hip joint. 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 when nerves are pinched due to spinal diseases, malignant bone tumors and age-related changes.
Examination methods
During the first consultation, the rheumatologists carry out a complete 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 course of pain, the domestic and occupational 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 limb at the hip joint. The presence of hip joint pathology can be indicated by poor posture;
- Palpation (feeling). The doctor can detect rheumatoid and rheumatic nodules, detect the exact location of pain during leg movements, determine the moisture and temperature of the skin at the hip joint.
Next, the doctor performs goniometry - an examination using a goniometer. It helps determine the extent of joint mobility. The rheumatologist then prescribes clinical and biological blood tests as well as a general urine analysis. The hospital's laboratory technicians carry out research using high-quality reagents and modern equipment, which allows you to obtain accurate test results.
With 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 blood serum.
An immunological blood test shows the presence of antinuclear antibodies in the blood in inflammatory rheumatic diseases. In patients suffering from arthritis, the concentration of uric acid in blood serum increases sharply. The content of lysosomal enzymes (acid proteinase, acid phosphatase, cathepsins, deoxyribonuclease) in blood serum and synovial fluid changes 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 X-ray examinations of patients suffering from 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 when moving the lower limb;
- The appearance of swelling and discoloration of the skin over the hip joint.
Using CT scans, doctors at the clinic evaluate the bones that participate in the formation of the hip joint. On CT scans, the radiologist notices changes in the structure of bone tissue, cartilaginous growths and osteophytes.
Using magnetic resonance imaging, doctors assess the condition of the soft tissues surrounding the hip joint.
Radionucleotide research methods make it possible to recognize pathology using radiopharmacological drugs.
An ultrasound examination of the hip joint is carried out to detect injuries, inflammatory diseases, rheumatism and rheumatoid arthritis. The attending physician individually selects in each case the necessary research methods to determine the cause of pain in the hip joint.
Differential diagnosis
Pain in the hip joint when walking is the main complaint for which patients consult a doctor. It can be localized at the joints or extend to the thigh, buttocks or knee joint. If pain appears 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 externally and internally rotating 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 femoral head deformity, mobility of the hip joint is limited. At an early stage of the disease process, the range of motion may be normal.
Pain in the anterior part of the hip joint and clicking noises when moving the joint bother patients suffering from iliopectineal bursitis. It radiates to the thigh and is accompanied by paresthesias (tingling, burning, crawling sensations) due to compression of the femoral nerve. The patient feels pain in the hip joint when flexion and extension of the lower limb. Pain is also detected on deep palpation at the level of the femoral triangle (formation limited by the inguinal ligament, the external edge of the adductor longus muscle, the internal 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 intensifies with movement.
Roth myalgia is manifested by burning pain in the outer anterior part of the hip joint and thigh, which intensifies when walking and straightening the leg. Pain in the hip joints occurs in cases of dysplasia. Over time, the patient develops a characteristic "duck" gait (walking waddling 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. The disease affects older people more often. With age, the cartilage tissue of the joint loses its elasticity, becomes thinner 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, leading to aseptic inflammation.
Growths appear on the bones. They considerably limit joint movements. Deformation of the joint surfaces develops, leading to severe pain. Treatment of the disease depends on the severity of the joint damage. Doctors offer drug treatment. If it is ineffective, stents are made or palliative treatment is used.
Having determined the cause of pain in the hip joint, doctors begin to treat the disease that caused the pain syndrome. Severe 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 mosthigh category.
Treatment
An important condition for the successful treatment of diseases causing pain in the hip joint is the elimination of factors provoking structural changes in the bones, cartilage and soft tissues of the joint area. For acute pain, hospital rheumatologists prescribe nonsteroidal anti-inflammatory drugs. The well-being of patients significantly improves 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 in soft tissues (tendinitis, bursitis, epicondylitis), after injuries.
If this treatment is not effective enough, doctors inject glucocorticoids into the hip joint socket. The joint space with deforming coxarthrosis is narrowed, it is difficult to enter it. For this reason, rheumatologists from a specialized clinic carry out the procedure under radiological control. In the presence of pain caused by inflammation of the 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. In case of spasms of the muscles participating in the movements of the hip joint, muscle relaxants are prescribed to reduce the tone of the skeletal muscles.
Drug therapy is supplemented by physiotherapeutic procedures. They are of secondary importance in case of pain in the hip joint. The effectiveness of physiotherapeutic treatment methods is reduced due to their deep localization. The intensity of pain in the hip joint decreases after ultraviolet irradiation with waves of medium length.
In the presence of an inflammatory process, high-intensity centimeter wave therapy, infrared laser treatment and low-intensity UHF treatment are carried out. High-intensity high-frequency magnetic therapy, ozone therapy and shock wave therapy stimulate tissue restoration. The intensity of pain 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 in case of acute pain. After reducing the severity of the pain syndrome, rehabilitators perform therapeutic exercises. A set of individual exercises is developed for each patient in order to quickly restore the function of the lower limb. When the structures that help form 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, endoprosthesis arthroplasty is necessary, 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 cartilaginous tissue. Specialists of the rehabilitation department select a set of physiotherapy exercises taking into account the patient's joint disease. Rehabilitation classes are provided daily under the supervision of an instructor. For rehabilitation therapy, special simulators are used and physiotherapeutic procedures are prescribed in combination with physical education.
What diseases cause joint pain
Pain in the hip joint on the right or left side may be a manifestation of avascular necrosis. The disease mainly develops in men and affects only one joint. Treatment consists of eliminating pain, restoring blood supply to the joint area, the normal state of the muscles of the limb and maintaining the functionality of the joint. The patient is prescribed pain relievers and anti-inflammatory drugs, vitamins, physiotherapeutic 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 may be a purulent process. Primary purulent 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. To treat purulent arthritis, professional specialists carry out antibacterial treatment. If pus accumulates in the joint cavity, a puncture of the hip joint is performed, the contents are drained 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 periarticular bursa cavity is cleaned. In severe cases, using an endoscopic surgical technique, the joint capsule, which has undergone irreversible changes, is removed.
In osteoporosis, a fracture of the femoral neck often occurs. Patients are bothered by sharp, intense pain during movements in the hip joint, which radiates to the groin and inner thigh. The leg turns 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 itself as intense pain when spreading the legs and bending the knees. Treatment is carried out using special orthopedic structures.
If you or a loved one experience pain in the hip joint, you should not self-medicate. Seek professional medical attention 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 by a professional doctor for diseases of the hip joint and treatment at home in strict compliance with all the rules.