Hip pain

The human hip joints are exposed to enormous stress. Walking, lifting and carrying heavy objects, jumping, running, bending, other physical exercises and even being overweight put a strain on the musculoskeletal system. Pain in the hip joint impairs its functionality, impairs free movement and causes suffering in the patient not only during movement, but also at rest. It is very important not to ignore pain and to immediately seek qualified medical attention at the first sign of discomfort. Orthopedists, traumatologists, surgeons, neurologists and numerous other specialists work together to assess symptoms, look for causes and treat pain in the hip joint.

Causes of pain

There are a variety of diseases and pathological conditions that can be associated with pain. Pain in the hip joint on the left or right side can be caused by injuries, inflammatory and infectious diseases, various degenerative processes, problems in the supply of useful minerals to bone tissue, etc.

Injuries to the soft tissues and osteoarticular structures in the hip area are the most common cause of discomfort. These include:

• bruises;
• penetrating wounds;
• femoral neck fracture;
• hip dislocation;
• Fractures of the hip socket 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 serious injuries sustained by the patient as a result of an accident, prolonged exposure to debris, or extreme stunts.

Infectious, inflammatory and degenerative diseases that can cause hip joint pain 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 osteoarthritis;
• bursitis;
• aseptic necrosis of the femoral head, including Perthes disease;
• chondromatosis;
• Trochanteritis.

Other pathological factors are:

• congenital anomalies in the development of the hip joint (dysplasia, congenital hip dislocation, shortening of the limbs);
• various neoplasms of malignant and benign nature;
• sciatic nerve neuropathy;
• Osteochondrosis, scoliosis, intervertebral hernia and other diseases of the spine.

Pain in the hip joint when walking or lying down can indicate overloading of the musculoskeletal system. Discomfort may occur after strength training, carrying heavy objects, or walking or standing for long periods of time. The risk group includes athletes, extreme athletes, loaders, teachers, lecturers, salespeople, couriers, etc.

Other causes of severe pain in the hip joint when walking and at rest can include:

• Excess weight, which greatly increases pressure on the joints;
• posture disorders;
• irrational use of certain medications;
• diabetes mellitus;
• neuropsychiatric disorders.

Most patients with pain of varying intensity in this area are people over 50 years old. This is explained by age-related changes in the periarticular tissue 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. Localization and intensity of the pain syndrome depend on the initial disease and the patient's health characteristics (presence of concomitant diseases, excess weight, risk factors). Often the pain syndrome spreads to surrounding structures and radiates 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 noises 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;
• increased body temperature.

Aching pain in the hip joint that radiates to the lower back, leg, groin and sacrum 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, associated with conjunctivitis and damage to the genitourinary system, can be a sign of Reiter's syndrome.

The clinical picture is determined by the underlying disease or injury. In mild cases, the patient's movement is limited, but the ability to support the leg remains. In the case of severe bruises, fractures, dislocations and severe forms of infectious and inflammatory diseases, support on the affected leg is not possible; the patient can only move with the help of an auxiliary point or cannot walk at all.

diagnosis

To determine the exact cause of pain and other symptoms of the underlying disease/injury and to select an effective treatment regimen, a comprehensive examination is carried out.

First, a physical examination is carried out. The doctor assesses the external signs of pathology, palpates the joint area, asks detailed questions about the nature of the complaints, the time and circumstances of their occurrence, etc. The specialist must also know about previous surgical interventions and injuries, existing chronic pathologies (including those, that are not directly related to the musculoskeletal system), lifestyle, etc.

A comprehensive objective examination includes:

• Ultrasound examination of the hip joint (ultrasound);
• X-ray of the pelvis in two projections;
• Magnetic resonance imaging or computed tomography (depending on the indication);
• 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 the medical history, the 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 the pain. In the event of sprains and bruises, the joint is immobilized, the patient is prescribed painkillers and is advised to remain on strict bed rest. In the event of a dislocation, the joint is realigned and then the limb is fixed in a stationary position. In the case of fractures, skeletal traction, plaster immobilization, or supporting special structures are indicated.

For hip pain caused by inflammatory or infectious causes, treatment may include:

• antibacterial drugs;
• anti-inflammatory drugs;
• corticosteroid hormones;
• Painkiller;
• chondroprotectors;
• cytostatics;
• ointments, creams, and other topical agents that stimulate blood circulation;
• vitamin complexes;
• Joint fluid substitutes.

The patient must receive a complex of physiotherapy, physiotherapy and massage necessary to restore motor activity, normalize joint nutrition and eliminate signs of inflammation. This may include:

• Massage;
• UHF;
• laser therapy;
• electrophonophoresis;
• magnetic field therapy;
• shockwave therapy;
• Hydrotherapy and swimming.

The patient's lifestyle is corrected: prevention of obesity, normalization of physical activity, limitation of force load, etc.

If conservative treatment does not bring the desired effect or the underlying disease is only treated surgically, surgical intervention is prescribed. It is carried out openly or arthroscopically. As part of the surgical treatment of diseases that cause pain in the hip joint, the following measures can be carried out:

• reduction of dislocations;
• Reconstruction of individual joint structures;
• endoprosthetics;
• removal of tumors;
• firm fixation of the joint (arthrodesis);
• Arthroplasty.

These and other surgical treatment methods are selected according to the diagnosis and the characteristics of the patient's current condition. After surgical treatment, the patient undergoes rehabilitation.

Complications

Pain in the hip joint cannot be ignored. Even minor and temporary ailments can lead to the development of serious diseases in the future. In complex cases, the consequences can be irreversible.

Possible complications are:

• limb deformity;
• lameness;
• Transition of pain into a chronic form (in this case it is present almost constantly);
• injury to intra-articular organs;
• deep vein thrombosis;
• heterotopic ossification (formation of bone plates in soft tissues);
• Arthrosis;
• Contractures: limited mobility of the joints;
• Necrosis;
• pathological fractures.

Without treatment, pathologies can lead to permanent impairment of mobility, the inability to lead a full life and even care for oneself, and disability. If there are extensive purulent processes in the hip joint area, if left untreated, infectious-toxic shock or sepsis can occur, which can be fatal.

prevention

First of all, experts recommend a healthy lifestyle:

• Move more, but do not overload the body with excessive exercise.
• Monitor body weight to prevent obesity.
• eat a nutritious and varied diet (the diet should be balanced in terms of basic macro- and micronutrients as well as total calorie content);
• Do not take 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 take regular care of the body and undergo a preventive examination by an orthopedist-traumatologist at least once a year.

Patients with diseases of the musculoskeletal system must be under medical supervision, strictly follow doctor's instructions and monitor their condition.

To prevent injuries to the hip joint, it is recommended to avoid extreme sports, wear protective equipment when exercising, and do not perform complex exercises without the necessary skills and physical training.

Elderly people are advised to exercise extreme caution in icy conditions and only go outside if absolutely necessary.

Treatment of hip pain in a professional clinic

The doctors of the multidisciplinary center are first-class specialists with the necessary practical skills and extensive knowledge in various areas of medicine. They consider the patient's problem individually and create a diagnostic and treatment program that takes 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, as well as obvious and non-obvious consequences. Only in this way is it possible to completely restore the patient's health and give him back the opportunity to lead a normal life and move without pain and 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, support in rehabilitation and objectivity.