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. Orthopedists in 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 offer complex therapy for diseases that cause pain in the hip joint. Patients are individually selected effective medications that affect the cause and mechanism of pain development. The specialists of the rehabilitation clinic provide rehabilitation therapy using the latest physiotherapy procedures, physical therapy and acupuncture. The presence of special simulators allows you to reduce the load on the joints 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 hip pain treatment allows for 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 tendons);
- Muscle breakdown;
- Iliotibial band syndrome;
- Other local changes in the surrounding tissues;
- Systemic diseases (rheumatoid arthritis, polymyalgia).
Because the gluteus medius and minimus muscles play a major 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 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), sports stress or professional stereotype, or the deposition of crystals.
Hip pain is a symptom of the following diseases:
- Osteoarthrosis;
- radicular syndrome;
- Rheumatoid arthritis;
- Coxita.
Hip joint pain 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. The pain syndrome often develops with dysplasia (disorder of the anatomical structure) of the hip joint. Acute pain in the hip joint, radiating to the leg, occurs in the case of pinched nerves due to diseases of the spine, malignant bone tumors and age-related changes.
Examination methods
During the first consultation, rheumatologists perform 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, the onset of pain, the progression of pain, household and professional factors that, according to the patient, caused the pain;
- An external examination allows the doctor to determine obvious 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 in the hip joint. The presence of hip joint pathology can be indicated by poor posture;
- Palpation (sensation). The doctor can find rheumatoid and rheumatic joints, find out the exact location of pain during leg movements, determine the moisture and temperature of the skin in the hip joint area.
Next, the doctor performs goniometry - an examination using a goniometer device. This allows you to determine the range of joint mobility. Then the rheumatologist prescribes clinical and biological blood tests and general urine analysis. Hospital laboratory technicians conduct research using high-quality reagents and modern equipment, which allow you to get accurate test results.
With inflammation of the hip joint, the number of leukocytes in the blood increases and the sedimentation rate of erythrocytes 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 analysis 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 significantly. The content of lysosomal enzymes (acid proteinase, acid phosphatase, cathepsin, deoxyribonuclease) in blood serum and synovial fluid varies in patients with rheumatism, psoriatic polyarthritis, rheumatism and ankylosing spondylitis. In severe forms of hip joint pathology, significant deviations from the norm are observed in the urine analysis.
Doctors at the clinic perform 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 appearance of difficulties during the movement of the lower limbs;
- The appearance of swelling and discoloration of the skin in the area of the hip joint.
Using computerized tomography, doctors at the clinic evaluate the bones that participate in the formation of the hip joint. In computerized tomograms, 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 tissues 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, rheumatism 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 while walking is the main complaint with which patients consult a doctor. It can be placed in the ankle 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 it rotates externally and internally of the leg.
Pain in the hip joint, buttocks and hip area 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. At an early stage of the pathological process, the range of motion may be normal.
Pain in the front 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 paresthesia (pins and needles, burning, crawling) due to compression of the femoral nerve. The patient feels pain in the hip joint when bending and extending the lower limb. Pain is also detected on 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 click during movement, pain in the outer part of the knee joint, which intensifies with movement.
Roth's myalgia is manifested by burning pain in the anterior outer part of the hip joint and thigh, which intensifies during walking and walking. Pain in the hip joints occurs with dysplasia. Over time, the patient develops a characteristic "duck" gait (he walks, walking 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, joint cartilage 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.
Growths appear in the bones. They significantly limit movement in the joint. Deformation of the articular surfaces develops, resulting in severe pain. Treatment of the disease depends on the severity of the joint damage. Doctors offer drug therapy. 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. At the meeting of the expert council with the participation of professors, doctors and candidates of medical sciences, doctors of the highest category, serious cases of diseases in which the patient is bothered by pain in the hip joint are discussed.
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 the bone, cartilage and soft tissues in the joint area. For acute pain, hospital rheumatologists prescribe non-steroidal anti-inflammatory drugs. The well-being of patients improves significantly 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 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 joint space with deforming coxarthrosis is narrowed, it is difficult to get into 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 tissues.
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 is spasm of the muscles involved in the movements of the hip joint, muscle relaxants are prescribed to reduce the tone of the skeletal muscles.
Drug therapy is complemented by physiotherapeutic procedures. They are of secondary importance for pain in the hip joint. The effectiveness of physiotherapeutic treatment methods decreases due to the deep location. The severity of pain in the hip joint decreases after medium-wave ultraviolet radiation.
In the presence of an inflammatory process, high-intensity centimeter wave therapy, low-intensity infrared and UHF laser treatment are performed. High intensity high frequency magnetic therapy, ozone therapy, shock wave therapy stimulate tissue restoration. The intensity of pain that occurs due to disorders of blood circulation 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. For each patient, a set of individual exercises is developed 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 strong that the only way to eliminate it is to replace the joint with an endoprosthesis.
Non-steroidal 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 joints, restore cartilage tissue and maintain joint mobility. In severe cases, joint replacement with 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 allows you to maintain its mobility, improve blood circulation in the joint and accelerate the restoration of cartilage tissue. Specialists in the rehabilitation department select a set of physical therapy 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 in combination 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 develops mainly in men and affects only one joint. Treatment consists of eliminating pain, restoring blood supply to the joint area, normal condition of the muscles of the limbs and maintaining the functionality of the joint. Painkillers and anti-inflammatory drugs, vitamins, physiotherapeutic procedures and therapeutic exercises are prescribed to the patient. The patient is recommended to wear orthopedic shoes and use additional support during movement.
The cause of pain in the hip joint can 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 the 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, a puncture of the hip joint is performed, 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, using an endoscopic surgical technique, the joint capsule is removed, which has undergone irreversible changes.
In osteoporosis, a fracture of the femoral neck often occurs. Patients are bothered by sharp and severe pain when moving in the hip joint, which radiates to the groin and inner thigh. The leg turns outward. Bruises and swelling appear in the hip joint area. In this case, the treatment is carried out by professional orthopedists.
Traumatic dislocation of the hip is accompanied by pain in the hip joint. Hips are reduced under general anesthesia. Congenital hip dislocation is diagnosed immediately after birth. It appears as severe pain when you spread your legs and bend your 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 for at least a week. If the pain is not intense, patients can be offered examination by a professional doctor for diseases of the hip joints and treatment at home with strict observance of all the rules.