The hip joints experience the greatest load in the body. They are created by weight while walking, jumping, running, lifting and carrying 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 extent 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. The specialists of the rehabilitation clinic provide rehabilitation therapy using the latest physiotherapeutic procedures, physical therapy 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 treating hip joint pain allows for rapid pain relief. Patients suffering from hip joint diseases often require external treatment.
Causes
Pain in the hip joint is caused by the following pathological processes:
- Tendonitis (inflammation of the tendons);
- Muscle breakdown;
- Iliotibial band syndrome;
- Other local changes in surrounding tissues;
- Systemic diseases (rheumatoid arthritis, polymyalgia).
Because the gluteus medius and minimus muscles play an important 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 in them due to microtraumas resulting from excessive load, the patient will be disturbed by pain in the hip joint. Such disorders can be caused by an infectious process (tuberculosis), sports or stereotyped professional stress, or crystal deposition.
Hip pain is a symptom of the following diseases:
- Osteoarthritis;
- Radicular syndrome;
- Rheumatoid arthritis;
- Coxita.
Hip joint pain 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. 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 (disorder of the anatomical structure) of the hip joint. Acute pain in the hip joint, radiating to the leg, occurs in case 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;
- Obtain information on the course of the disease, the onset of pain, the progression of pain, the home and professional factors that, according to the patient, 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 in the hip joint. The presence of hip joint pathology may be indicated by poor posture;
- Palpation (sensation). The doctor can find rheumatoid and rheumatic nodules, detect 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. It allows you to determine the range of joint mobility. Then the rheumatologist prescribes clinical and biological blood tests and a general urine test. The hospital's laboratory technicians perform research using high-quality reagents and modern equipment, which allows for 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 the blood serum.
An immunological blood test shows the presence of antinuclear antibodies in the blood in rheumatic inflammatory diseases. In arthritis patients, the concentration of uric acid in the blood serum increases markedly. The content of lysosomal enzymes (acid proteinase, acid phosphatase, cathepsins, deoxyribonuclease) in blood serum and synovial fluid changes in patients with rheumatism, psoriatic polyarthritis, rheumatism and ankylosing spondylitis. In severe forms of pathology of the hip joint, significant deviations from the norm are observed in the urinalysis.
Doctors at the clinic perform x-ray examinations on 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 limb;
- The appearance of swelling and discoloration of the skin in the area of the hip joint.
Using computed tomography, doctors at the clinic evaluate the bones that participate in the formation of the hip joint. In computed tomography scans, the radiologist detects changes in the structure of bone tissue, cartilaginous growths and osteophytes.
Using MRI, doctors evaluate the condition of the soft tissues surrounding the hip joint.
Radionucleotide research methods allow you 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 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 with which patients consult a doctor. It may be localized in the joint area or extend to the thigh, buttock or knee joint. If pain in the hip joint occurs during movement, the patient is forced to use a cane. Often, due to pain, there is a limitation of mobility during the movement of the hip joint, especially during external and internal rotation of the leg.
Pain in the hip joint, buttocks 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, 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 disturb patients suffering from iliopectineal bursitis. It radiates to the thigh and is accompanied by paresthesias (sensations of tingling, burning, tingling) due to compression of the femoral nerve. The patient feels pain in the hip joint during flexion and extension of the lower limb. Pain is also detected on deep palpation in the area of the femoral triangle (formation limited by the inguinal ligament, external edge of the long adductor muscle, internal edge of the sartorius muscle).
Pain in the external hip joint is a sign of iliotibial band syndrome. It is accompanied by clicking during movement, pain in the outer part of the knee joint, which intensifies with movement.
Roth myalgia manifests itself as a burning pain in the front outer part of the hip joint and thigh, which intensifies when walking and straightening the leg. Hip joint pain occurs with dysplasia. Over time, the patient develops a characteristic "duck" gait (walks, rocking 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 cartilaginous tissue of the joint loses its elasticity, becomes thin and begins to wear out. When the load on the joint increases, the thin cartilaginous tissue is destroyed. The articular surfaces of the bones rub against each other, causing aseptic inflammation.
Growths appear on the bones. They significantly limit the movement of the joint. A deformation of the joint surfaces develops, which causes severe pain. Treatment of the disease depends on the severity of the joint damage. Doctors provide drug therapy. If it is ineffective, endoprosthesis is 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 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 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 the bones, cartilage and soft tissues in the joint area. For acute pain, hospital rheumatologists prescribe nonsteroidal anti-inflammatory drugs. The well-being of patients improves significantly with the use of local treatment methods: external applications of gels and ointments, plasters 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 enter it. For this reason, rheumatologists of a specialized clinic perform the procedure under radiographic control. If there is pain caused by inflammation of the 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 a spasm of the muscles that take part in the movements of the hip joint occurs, muscle relaxants are prescribed to reduce the tone of the skeletal muscles.
Drug therapy is integrated with physiotherapeutic procedures. They are of secondary importance for hip joint pain. The effectiveness of physiotherapeutic treatment methods is reduced due to deep localization. The severity of pain in the hip joint decreases after ultraviolet irradiation with medium-length waves.
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 in case of acute pain. After reducing the severity of the pain syndrome, rehabilitators conduct therapeutic exercises. For each patient, an individual set of exercises is developed to quickly restore the function of the lower limb. When the structures that participate in the formation of the hip joint are destroyed, the pain can be so severe that the only way 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 damage to the cartilaginous tissue. An orthopedic doctor prescribes effective treatments, diet and exercises to improve blood circulation in the joint, restore cartilage tissue and maintain joint mobility. In more severe cases, joint replacement with an endoprosthesis is necessary, which significantly improves the quality of life and eliminates pain.
Treatment with physical 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 of the rehabilitation department select a set of physiotherapy exercises taking into account the patient's joint disease. Rehabilitation lessons take place 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 predominantly in men and affects only one joint. Treatment consists of eliminating pain, restoring blood supply to the joint area, the normal condition of the muscles of the limb and maintaining the functionality of the joint. The patient is prescribed painkillers and anti-inflammatory drugs, vitamins, physiotherapeutic procedures and therapeutic exercises. The patient is advised to wear orthopedic shoes and use additional support when moving.
The cause of pain in the hip joint can be a purulent process. Primary purulent arthritis develops when there is a wound or lesion 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. To treat purulent arthritis, professional specialists carry out 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 bag is cleaned. In more serious 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 disturbed by sharp, intense pain during movement of the hip joint, which radiates to the groin and inner thigh. The leg turns outward. Bruising and swelling appear in the hip joint area. 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 a sharp pain when you spread your legs and bend your knees. The treatment is carried out using special orthopedic structures.
If you or a loved one has hip joint pain, 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 severe, patients can be offered an examination by a professional doctor for diseases of the hip joint and home treatment in strict compliance with all the rules.