The 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 experience pain in the hip joint. Orthopedists in a specialized hospital establish its cause with the help of 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. Individually effective drugs are selected for patients, which 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 joint during training.
In the process of treating pain in the hip joint, doctors from many fields of medicine participate: endocrinologists, rheumatologists, orthopedists, physiotherapists, chiropractors, acupuncturists. A multidisciplinary approach to the treatment of hip pain allows rapid pain relief. Patients suffering from hip pathology often require outpatient care.
reasons
Pain in the hip joint is caused by the following pathological processes:
- Tendinitis (inflammation of tendons);
- Muscle rupture;
- Iliotibial Band Syndrome;
- Other local changes in 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 as a result of 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 occupational stress or crystal deposition.
Pain in the hip joint is a symptom of the following diseases:
- osteoarthritis;
- Radicular syndrome;
- Rheumatoid arthritis;
- Coccyx.
Hip pain can bother people who are overweight, have different leg lengths, or have flat feet. Pain syndrome can occur after a lower limb amputation or hip replacement. With avascular necrosis of the head and fracture of the neck of the femur, patients complain of acute pain in the hip joint. The pain syndrome often develops with dysplasia (violation 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 diseases of the spine, malignant bone tumors and age-related changes.
Research methods
During the first consultation, rheumatologists conduct 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;
- The external examination allows the doctor to determine visible deviations from the norm. To understand the nature of the pain and the area of its distribution, the doctor asks the patient to perform various movements of the lower limb in the hip joint. The presence of pathology of the hip joint can be indicated by bad posture;
- Palpation (feeling). The doctor can detect rheumatoid and rheumatic nodes, determine the exact localization of pain when moving the legs, determine the humidity and temperature of the skin in the area of the hip joint.
Then the doctor conducts goniometry - a study using a goniometer. It allows you to determine the range of motion of the joint. Then the rheumatologist prescribes clinical and biological blood tests and a general urine test. Laboratory technicians of the hospital carry out tests using high-quality reagents and modern equipment, which allows you to get accurate test results.
With inflammation of the hip joint, the number of leukocytes in the blood increases and the rate of sedimentation 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.
The immunological blood test 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 rises sharply. The content of lysosomal enzymes (acid proteinase, acid phosphatase, cathepsins, deoxyribonuclease) in blood serum and synovial fluid is changed 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 urine analysis.
Doctors at the clinic perform X-rays on patients with hip pain. It is shown in the following cases:
- Presence of chronic or acute pain in the hip joint at rest and during movement;
- The appearance of difficulties in the movement of the lower limb;
- The appearance of swelling and discoloration of the skin in the area of the hip joint.
With the help of computed tomography, the doctors at the clinic evaluate the bones that are involved in the formation of the hip joint. On the computed tomogram, the radiologist found changes in the structure of the bone tissue, cartilaginous growths and osteophytes.
With the help of nuclear magnetic resonance, doctors assess the condition of the soft tissues around the hip joint.
Radionucleotide research methods make it possible to recognize the pathology with the help of 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 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 turn to the doctor. It can be located in the joint area or extend to the hip, buttock 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 in the movement of the hip joint, especially in external and internal rotation of the leg.
Pain in the area of 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 deformation of the femoral head, the mobility of the hip joint is limited. In the 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 (tingling, burning, crawling) due to compression of the femoral nerve. The patient experiences pain in the hip joint with flexion and extension of the lower limb. Pain is also detected during deep palpation in the area of the femoral triangle (formation limited by the inguinal ligament, the outer edge of the long adductor, the inner edge of the sartorius muscle).
Pain in the outer part of the hip joint is a sign of iliotibial band syndrome. Accompanied by a clicking sound when moving, pain in the outer part of the knee joint, which increases with movement.
Roth's myalgia presents with burning pain in the anterior outer part of the hip joint and thigh that is aggravated by walking and straightening the leg. Hip pain occurs with dysplasia. Over time, the patient develops a characteristic "duck" gait (walks wobbling from side to side).
Pain in 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 the elderly. With age, the cartilage tissue of the joint loses its elasticity, thins 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 significantly limit movement in the joint. Deformation of the joint surfaces develops, which leads to severe pain. The treatment of the disease depends on the severity of the joint damage. Doctors provide drug therapy. If ineffective, endoprosthesis is performed or palliative treatment is administered.
After establishing 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 worried about 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 causing pain in the hip joint is the elimination of the 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 significantly improves with the use of local methods of treatment - external application of gels and ointments, patches that contain non-steroidal anti-inflammatory drugs. They reduce pain in the hip joints in 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 in a specialized clinic perform the procedure under X-ray control. In the presence of 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. In case of spasm of the muscles that are involved in the movements in the hip joint, muscle relaxants are prescribed to reduce the tone of the skeletal muscles.
Drug therapy is complemented by physical therapy procedures. They are of secondary importance in hip pain. The effectiveness of physiotherapeutic methods of treatment is reduced due to their deep location. Severity of hip pain 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 recovery. The intensity of pain, which 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 conduct therapeutic exercises. For each patient, an individual complex of exercises is developed for the rapid recovery of the function of the lower limb. When the structures involved 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 cartilage tissue. The 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, it is necessary to replace the joint with an endoprosthesis, 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 recovery 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 physiotherapy procedures combined with physical education are prescribed.
What diseases cause joint pain
Pain in the hip joint on the right or left 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, normalizing the muscles of the limb and maintaining the functionality of the joint. The patient is prescribed pain-relieving and anti-inflammatory drugs, vitamins, physical therapy procedures and therapeutic gymnastics. 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 suppurative 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 conduct 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 with anti-inflammatory drugs and glucocorticoids. If purulent inflammation develops, the cavity of the periarticular bursa is cleaned. In severe cases, the joint capsule, which has undergone irreversible changes, is removed using a surgical endoscopic technique.
Osteoporosis often results in a fracture of the femoral neck. Patients are concerned about sharp, severe pain with movement in the hip joint that radiates to the groin and inner thigh. The leg turns outward. Bruising and swelling occur in the hip joint area. In this case, the treatment is carried out by professional orthopedists.
Traumatic hip dislocation is accompanied by hip pain. The hip is reduced under general anesthesia. Congenital hip dislocation is diagnosed immediately after birth. It manifests itself as severe pain when extending the legs and bending the knees. The treatment is carried out with the help of special orthopedic structures.
If you or a loved one has hip pain, you should not self-medicate. Seek professional medical attention immediately. Patients with acute pain are usually hospitalized at the clinic for at least one week. If the pain is not intense, 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.