Hip pain

One of the common symptoms when patients come to a medical facility is hip pain. The cause, treatment and diseases that can cause such a manifestation cannot be determined without qualified medical care. Discomfort in any part of the musculoskeletal system can indicate the development of serious pathologies, therefore dysfunction of the hip joint should not be ignored.

Hip joint surgery

The hip joint plays an important role in movement. This is one of the largest human joints, able to withstand heavy loads in a standing position as well as when walking upright.

Bones form joints

The hip joint is formed by the head of the femur and the acetabulum of the insular iliac bone - the strongest and largest part of the human skeleton. The minimum number of anatomical elements of the joint ensures durability and reliability, the ability to withstand body weight when moving. Most diseases of the hip joint begin with damage to the acetabulum, the immobile part of the joint. It is shaped like a bowl, its center is directed upward at a slight angle, ensuring an even distribution of the load between the pelvis bones.

The glenoid cavity is a strong and sturdy structure, consisting of 3 types of pelvis:

• ileum
• ischial
• pubic hair

The most vulnerable area of the joint cavity is in children whose bone tissue is not strong enough. Because there is a small bony ridge at the edge of the socket, the head of the femur is completely embedded in the "bowl", providing sturdy support for the limb. The moving part of the joint is the femur (head, neck, greater and lesser trochanters). The shape of the head corresponds to the cavity of the joint cavity. It is covered with cartilage tissue, which ensures perfect alignment of the joint parts and their ability to slide unhindered. In the middle of the head is a strong ligament that connects the bone to the acetabulum, providing additional grip and support.

The neck protrudes from the head of the femur at an obtuse angle, ensuring joint mobility and uniform load distribution between the limbs. The trochanters are bony projections to which muscle tendons are attached.

Fabric and texture

The normal functioning of the joints is ensured by many different structures, each of which performs corresponding functions.

Blood supply, activity and reduced joint sensitivity are provided by:

1. Ligaments and tendons surround the joint on all sides, covering and protecting the femur and neck as well as the joint socket.
2. Cartilage covers the head of the femur and part of the acetabulum.
3. The subchondral area is bone tissue composed of cells and connective extracellular substances.
4. The joint membrane or joint capsule is the source of the secretion of a special substance - synovial fluid to lubricate the parts of the joint.
5. The acetabular lip connects the acetabular rim and the transverse ligament.

The hip joint is supplied with nutrients through a fairly isolated network of vessels and arteries. The blood supply to the internal parts of the joint is provided by the acetabular branch of the obturator artery, and the surrounding capsule, ligaments, and muscles are nourished through the deep arteries of the thigh and gluteus.

Anatomic structure located next to the hip joint

Usually the cause of hip pain is damage to the anatomical structures located next to it. These factors include:

1. Skin and subcutaneous tissue - the outer covering of the body
2. The muscles of the thighs, pelvis, lower back and buttocks help joints move flexibly and strengthen from the outside
3. Extra-articular ligaments - perform a strengthening function, located around the joint capsule
4. The synovium around a joint is a bundle of connective tissue that prevents friction between soft and hard tissue

Risk factors

The inflammatory process in the pelvic area occurs due to mechanical damage or damage to certain types of bacteria. In this case, both the components of the joint and the anatomical structures surrounding them can be affected by pathological effects.

As a rule, one or more structures are inflamed:

• animal skin
• muscle
• ligaments (extra-articular, femoral head)
• perpendicular synovium
• TBS capsules
• cartilage
• acetabular lip
• subchondral area

Hip pain is often caused by harmful microorganisms, stimulating the development of infectious arthritis. Other reasons are also common:

• immune system disorders
• Joint injuries due to excessive physical activity
• old age
• metabolic disorder
• other diseases

Characteristics of pain

When diagnosing hip pain, additional symptoms play an important role, which can indicate the root cause of the problem.

Pain in the hip joint and radiating down the leg

If the pain from joint pain spreads to the groin, knee or buttocks, the problem is most likely due to damage to the nerves that supply the leg area due to one of the following reasons:

• joint tumors
• Infectious arthritis - occurs due to damage by pathogens
• femur fracture (in the head or neck area)
• Legg-Calvé-Perthes pathology - necrosis of cartilage tissue of the femoral head
• juvenile epithelial lysis - disruption of the structure of the joint head and its inflammation

Hip pain that radiates down the leg can signal diseases of the cartilage tissue and structures around the joint, lack of joint lubrication, and damage to the synovial membrane. Pain symptoms can occur suddenly or gradually.

Pain when walking

Hip pain can occur when walking if the acetabulum comes into contact with the cartilage tissue of the femoral head, leading to an inflammatory process. The cause of this phenomenon may be mechanical damage or inflammation of anatomical structures adjacent to the joint.

Based on the intensity of pain in the hip joint when walking, you can determine the root cause of the problem:

• Unpleasant sensations occur at the beginning of walking, gradually decreasing - a sign of periarticular synovitis
• The feeling of discomfort gradually increases from the moment you start walking - inflammation of the articular surface of the hip joint
• Continuous high-intensity pain, accompanied by impaired joint function - occurs with dislocations and fractures
• pain that occurs closer to night - a consequence of deformation of the cartilage of the femoral head and (or) acetabulum, rubbing against each other and becoming inflamed
• Pain of moderate intensity is a sign of minor injuries and bruises

Pain when spreading legs

Pain when spreading the legs is caused by inflammation of the tissues and structures that provide movement: muscles, bursae around joints, tendons. Similar symptoms often occur due to myositis (inflammation of muscle tissue), bursitis (inflammation of the bursa around joints), and tendinitis (inflammation of the tendon).

reason

In most cases, pelvic pain is caused by one of the following problems:

• arthritis
• coxarthrosis
• synovitis of the trochanteric bursa
• tendinitis
• infectious diseases
• Genetic diseases
• tumor formation in the pelvic area

If not treated promptly, each of these causes can lead to serious complications, including loss of joint mobility.

Arthritis

Arthritis (coxitis) is a disease of joint tissue caused by disorders of the immune system or damage by pathogens: viruses and bacteria.

Symptoms of arthritis:

• Increased temperature
• pain and swelling in the joint area
• movement impairment

The disease occurs in acute, subacute and chronic forms.

Coxarthrosis

Another name for coxarthrosis is osteoarthritis of the hip joint. This disease is caused by metabolic disorders in cartilage tissue leading to death. The cause of this phenomenon can be trauma, impaired blood supply, excessive physical activity, age over 45 and genetics. The main symptom of coxarthrosis is pain in the lower back, groin and buttocks, which increases with physical activity and leads to limping. Discomfort lessens during periods of inactivity.

Bursitis of the trochanteric bursa

The presence of an inflammatory process in the bursa (trochanteric bursa) is characterized by the appearance of severe pain in the joint area. Athletes and the elderly are susceptible to the disease. The main symptom of bursitis of the trochanteric bursa is pain in the greater trochanter area, which is increased when trying to lean on the affected leg.

Tendonitis

Inflammation of the tendon is called tendinitis. This is a disease that occurs in an acute or chronic form and leads to degenerative changes in tissues. Pathology often occurs in athletes who do not follow their running technique, as well as after the hip muscles are subjected to heavy loads.

Often, tendinitis is a complication of another disease:

• thyroid disease
• metabolic disorder
• arthritis
• arthritis
• Inflammatory process of systemic or infectious origin
• hip dysplasia

Tendinitis causes the patient discomfort when moving, pain, changes in gait, and clicking sounds when walking in the joint area.

Infection

Some infectious diseases cause inflammation of joint tissues as well as nearby anatomical structures, leading to severe pain in the hip joint. Usually, the following diseases have similar symptoms:

1. Aseptic necrosis of the femoral head is a condition in which the blood supply to the groin area is interrupted, leading to tissue death. The pain associated with this disease is acute and intense. The problem is more common in men.
2. Purulent arthritis is a serious disease that requires immediate treatment. If you do not seek medical help promptly, sepsis may occur. Associated symptoms are general intoxication, pain and swelling in the affected joint area, difficulty in movement.
3. Tuberculosis arthritis is common in children and is characterized by slow progression. Associated symptoms are increased fatigue, decreased motor activity, and muscle atrophy. Pain of varying intensity increases when a purulent abscess occurs.

Infectious pathologies of the hip joint lead to serious complications and therefore require immediate treatment.

Genetic diseases

Hereditary pathologies of the hip joint usually appear between the ages of 1 and 10 years and are characterized by pathological changes in the tissues of the glenoid cavity and/or femoral head. The most common genetic disease affecting the hip joint is Legg-Calvé-Perthes syndrome, which is characterized by pain and gait disturbances due to the death of the joint's cartilage tissue.

Bone and soft tissue tumors

Benign or malignant growths of bone and soft tissue in the hip joint can cause pain when walking or at rest. Tumors can occur in bone tissue (osteomyelitis), cartilaginous tissue (chondroblastoma, enchondroma), bone and cartilage tissue (osteochondroma). As a rule, tumors cause discomfort and are felt when palpated. Benign tumors are treated with surgery; Some of them can turn into cancerous tumors.

Soft tissue tumor in the thigh:

• lipoma
• rhabdomyosarcoma
• fibroids
• hemangioma
• neuroma

An oncologist is involved in the diagnosis and treatment of tumors of the hip and pelvis.

what must you do

With serious pathologies of the hip joint, a person feels severe pain. Feeling uncomfortable in the pelvic area is a reason to go to a medical facility for examination and treatment.

Particular attention should be paid to the intensity of the pain:

1. Lung- Bruises appear after trauma. Apply cold compresses to the painful area to reduce swelling. To relieve pain, non-steroidal anti-inflammatory drugs should be used. It is advisable to consult a doctor.
2. Medium- often occurs in diseases of the hip joint, accompanied by difficulty in movement and increased body temperature. Discomfort increases with physical activity. It is necessary to consult a rheumatologist.
3. Strong- Arising due to dislocations and fractures. Accompanied by limitation or inability to exercise. In case of severe pain in the hip joint due to injury, you should contact an ambulance.

There are many folk recipes used to treat hip pain. It is important to remember that they are all suitable for treating symptoms and relieving pain, but will not help eliminate the cause of the problem. Effective treatment is carried out exclusively under the supervision of a qualified physician.

Which doctor should I contact?

If you have hip pain you should contact your family doctor or general practitioner, who will refer you to a specialist. Diseases of the musculoskeletal system are treated:

• trauma doctor- hip pain due to physical activity, sprains, falls and other injuries
• rheumatologist- Sudden joint pain without clear cause

You may also need to consult other doctors: surgeons, oncologists, infectious disease specialists, etc. v.

Diagnose

The first important stage in diagnosing pain in the hip joint is an external examination, which necessarily includes memorization and palpation. Depending on the severity of the disease and patient complaints, laboratory tests and instrumental diagnostic methods are prescribed:

• X-ray- the use of X-rays to examine a specific area of the body
• CT and MRI- modern accurate diagnostic methods allow you to obtain informative images of the joint and the area around it
• Microbiological examination of a sample of biological materialallows detecting the presence of pathogenic microorganisms: viruses and bacteria
• immune blood test- allows you to identify immune disorders, determine the presence of certain autoantibodies
• arthroscopy (endoscopic examination)- examination with a probe, possibility of taking samples of joint tissue for further study
• effusion testing- take a sample of intra-articular fluid during puncture and determine the infectious agent in it, check for sterility

The combined use of several diagnostic methods allows us to determine the cause of hip pain with high accuracy.

Treatment

Treatment of hip pain needs to be prescribed by a doctor based on examination and diagnosis. As a rule, medical or surgical treatment is prescribed.

Medicine

The treatment of hip pain must be comprehensive, aimed at eliminating the symptoms and, most importantly, eliminating the cause of the problem. For this purpose, drug treatment is used, which includes the use of:

• non-steroidal anti-inflammatory drugs- Helps relieve pain and reduce swelling
• Meant to improve microcirculation- Helps restore blood circulation and nutrition of joint tissues
• chondroprotector- Promotes cartilage tissue recovery
• muscle relaxants- Reduce pain, improve blood flow in the damaged area
• Hormonal drugs- to relieve pain and inhibit inflammation

In the treatment of hip pain, physiological procedures are highly effective: massage, acupuncture, cryotherapy and laser. Special therapeutic exercises and manual therapy are also used.

Surgery

Surgical intervention is indicated in severe cases when conservative treatment does not help the patient. This involves replacing part or all of the diseased joint with a prosthetic joint.

Prevent

Reducing the load on the legs will slow down the pathological process inside the joints, so obese people should start losing weight.

Preventive measures will help relieve hip pain:

• Walk regularly
• physical therapy
• Balanced diet rich in vitamins A, C, E

Timely consultation with a doctor in the early stages of the disease will increase the effectiveness of treatment, while reducing the risk of complications and serious consequences for the body.