Hip pain

One of the common symptoms that patients come to a medical center with is pain in the hip joint. The causes, treatment and possible diseases that cause such a manifestation cannot be identified without qualified medical assistance. Discomfort in any part of the musculoskeletal system may indicate the development of serious pathologies, therefore hip joint dysfunction should not be ignored.

Anatomy of the hip joint area

The hip joint plays an important role in motor activity. This is one of the largest human joints, which can withstand heavy loads while standing, as well as during upright walking.

Bones that form a joint

The hip joint is formed by the head of the femur and the acetabulum of the innominate pelvic bone - the largest and most powerful parts of the human skeleton. The minimum number of anatomical elements of the joint guarantees its strength and reliability, the ability to support body weight during movement. Most hip joint pathologies begin with damage to the acetabulum, the immobile part of the joint. It has the shape of a bowl, the center of which faces upwards at a slight angle, which ensures even distribution of the load between the pelvic bones.

The glenoid cavity is a strong and solid formation, which consists of 3 types of pelvic bones:

• ileal
• ischial
• pubic

The most vulnerable area of the joint cavity is in children whose bone tissue is not strong enough. Due to the presence of a small bone ridge on the edge of the alveolus, the head of the femur is completely immersed in the "bowl", which provides strong support to the limb. The movable 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 by cartilaginous tissue, which guarantees perfect alignment of the joint elements and their unhindered sliding. In the center of the head is a strong ligament that connects the bone to the acetabulum, providing additional grip and support.

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

Fabrics and structures

The normal functioning of the joint is ensured by a variety of structures, each of which performs corresponding functions.

Blood supply, performance and decreased sensitivity of the joint are provided by:

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

The hip joint receives nutrients through a fairly isolated network of vessels and arteries. The blood supply to the inner parts of the joint is provided by the acetabular branch of the obturator artery, and the surrounding capsules, ligaments and muscles are fed through the deep arteries of the thigh and buttocks.

Anatomical formations located near the hip joint

Often the cause of pain in the hip joint is damage to the anatomical structures located next to it. These elements include:

1. Skin and subcutaneous tissue – the outer covering of the body
2. The muscles of the thigh, pelvis, lower back and buttocks provide joint mobility and additionally strengthen it externally
3. Extra-articular ligaments - perform a strengthening function, located around the joint capsule
4. The periarticular bursae are bundles of connective tissue that prevent friction between soft and hard tissues.

Risk factors

Inflammatory processes in the pelvic region occur due to mechanical damage or damage to certain types of bacteria. In this case, both the elements of the joint and the anatomical formations surrounding them may be exposed to pathological effects.

As a rule, one or more structures become inflamed:

• leather
• muscles
• ligaments (extra-articular, femoral heads)
• periarticular bursae
• TBS capsule
• cartilage
• acetabular labrum
• subcartilaginous areas

Pain in the hip joint is often caused by harmful microorganisms that provoke the development of infectious arthritis. Other reasons are also common:

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

Characteristics of pain

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

Pain in the hip joint and radiates to the leg

If pain from a painful joint radiates to the groin, knees, or buttocks, the problem is likely caused by damage to the nerve innervating the leg area due to one of the following reasons:

• joint tumor
• infectious arthritis - occurs due to damage by a pathogen
• fracture of the femur (in the head or neck region)
• Legg-Calvé-Perthes pathology - necrosis of the cartilaginous tissue of the femoral head
• juvenile epiphysiolysis - disruption of the structure of the joint head and its inflammation

Pain in the hip joint, radiating to the leg, can signal pathologies of the cartilaginous tissue and periarticular structures, lack of joint lubrication and damage to the synovial membrane. Painful symptoms may occur suddenly or gradually increase.

Pain when walking

Pain in the hip joint can occur during walking if the acetabulum comes into contact with the cartilaginous tissue of the femoral head, resulting in an inflammatory process. The cause of this phenomenon may be mechanical damage, inflammation of anatomical formations located near the joint.

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

• discomfort that occurs at the beginning of walking, gradually decreasing - a sign of inflammation of the periarticular bursa
• discomfort that gradually increases from the moment you start walking - inflammation of the articular surfaces of the hip joint
• continuous high-intensity pain, accompanied by impaired functionality of the joint - occurs with dislocations and fractures
• pain occurs closer to night - a consequence of deformation of the cartilage of the femoral head and (or) the acetabulum, which rub against each other and become inflamed
• pain of moderate intensity is a sign of minor injuries and bruises

Pain when abducting the leg

Pain when abducting the leg is caused by inflammation of the tissues and structures that provide movement: muscles, periarticular bursae, tendons. Similar symptoms often result from myositis (inflammation of muscle tissue), bursitis (inflammation of the periarticular bursa), and tendonitis (inflammation of the tendons).

Causes

In most cases, pain in the pelvic region is caused by the patient having one of the following problems:

• arthritis
• Coxarthrosis
• bursitis of the trochanteric bursa
• tendonitis
• infectious pathologies
• hereditary diseases
• tumor formation in the pelvic region

Without timely treatment, each of these causes can lead to serious complications, including loss of joint mobility.

Arthritis

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

Arthritis Symptoms:

• temperature increase
• pain and swelling in the joint area
• motor disability

The disease occurs in acute, subacute and chronic forms.

Coxarthrosis

Another name for Coxarthrosis is osteoarthritis of the hip joint. This pathology is caused by metabolic disorders in cartilaginous tissues, resulting in their death. The cause of this phenomenon can be injury, impaired blood supply, excessive physical activity, age over 45 years and heredity. The main symptom of coxarthrosis is pain in the lower back, groin and buttocks, which gradually increases during physical activity and leads to limping. Discomfort lessens during periods of inactivity.

Trochanteric bursa bursitis

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

Tendinitis

Inflammation of the tendons is called tendonitis. It is a disease that occurs in acute or chronic forms and leads to degenerative changes in tissues. Pathology often occurs in athletes who do not follow their running technique, as well as after a strong load on the hip muscles.

Typically, tendonitis is a complication of another disease:

• thyroid pathology
• metabolic disorders
• arthritis
• arthrosis
• inflammatory process of systemic or infectious origin
• hip dysplasia

Tendinitis causes the patient discomfort during movements, pain, changes in gait and clicking sounds when walking in the joint region.

Infections

Some infectious diseases cause inflammation of the joint tissues, as well as nearby anatomical structures, resulting in severe pain in the hip joint. Most often, the following pathologies have similar symptoms:

1. Aseptic necrosis of the femoral head is an interruption of the blood supply to the groin region, resulting in tissue death. The pain associated with this disease is sharp 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 immediately, sepsis may develop. Associated symptoms are general intoxication, pain and swelling in the area of the affected joint, difficulty in motor activity.
3. Tuberculous 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.

Hereditary diseases

Hereditary pathologies of the hip joint generally appear between 1 and 10 years of age and are characterized by pathological changes in the tissue of the glenoid cavity and/or femoral head. The most common hereditary disease affecting the hip joint is Legg-Calvé-Perthes syndrome, characterized by pain and gait disturbances due to the death of the joint's cartilaginous 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. The tumor can occur in bone tissues (osteomyelitis), cartilaginous tissues (chondroblastoma, chondroma), osteochondral tissues (osteochondroma). As a rule, neoplasms cause discomfort and are felt on palpation. Benign tumors are treated surgically; some of them can turn into cancerous tumors.

Soft tissue tumors of the thigh:

• lipoma
• rhabdomyoma
• fibroma
• hemangioma
• neuroma

An oncologist is involved in diagnosing and treating tumors in the hips and pelvis.

What to do

With serious pathologies of the hip joint, a person experiences severe pain. Discomfort in the pelvic region is a reason to visit a medical center for examination and treatment.

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

1. Lungs- occur with bruises after an injury. Cold should be applied to the painful area to reduce swelling. To reduce pain, it is recommended to take a non-steroidal anti-inflammatory drug. It is advisable to consult a doctor.
2. Moderate- usually occur in diseases of the hip joint, accompanied by difficulty in motor activity and an increase in body temperature. Discomfort increases during physical activity. It is necessary to consult a rheumatologist.
3. Strong- arise due to dislocations and fractures. Accompanied by limitation or impossibility of physical activity. In cases of severe pain in the hip joint caused by injury, an ambulance should be sought.

There are many popular recipes used for hip joint pain. It is important to remember that all of them are indicated for symptomatic treatment and pain reduction, but they do 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 experience pain in your hip joint, you should contact your family doctor or general practitioner, who will refer you to a specialist. Diseases of the musculoskeletal system are treated:

• traumatologist— pain in the hip joint due to physical activity, sprains, falls and other injuries
• rheumatologist- sudden onset of joint pain for no apparent reason

You may also need to consult other doctors: surgeon, oncologist, infectious disease specialist, etc.

Diagnosis

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

• x-ray- the use of x-rays to examine a specific area of the body
• Computed tomography and magnetic resonance imaging- modern and accurate diagnostic methods that allow you to obtain highly informative images of the joint and the area around it
• microbiological examination of a sample of biological materialallow detecting the presence of pathogenic microorganisms: viruses and bacteria
• immunological blood test- allows you to identify immunological disorders, determine the presence of certain autoantibodies
• arthroscopy (endoscopic examination)— probe examination, possibility of taking a sample of joint tissue for future research
• stroke laboratory examination- take a sample of intra-articular fluid during the puncture and identify the causative agent of an infectious disease in it, checking its sterility

The combined use of several diagnostic methods allows you to identify the cause of pain in the hip joint with high accuracy.

Treatment

Treatment of hip joint pain should be prescribed by a doctor based on examination and diagnosis. As a rule, drug therapy or surgery is prescribed.

Medicine

Treatment of pain in the hip joint should be comprehensive, aimed at eliminating the symptoms and, most importantly, eliminating the cause of the problem. For this purpose, drug therapy is used, which includes the use of:

• nonsteroidal anti-inflammatory drugs- help reduce pain, relieve swelling
• means improving microcirculation- help restore blood circulation and nutrition to joint tissues
• chondroprotectors- promotes the restoration of cartilaginous tissue
• muscle relaxants- reduce pain, improve blood flow in the damaged area
• hormonal drugs- to relieve pain and suppress inflammation

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

Surgical

Surgical intervention is indicated in advanced cases, when conservative treatment does not help the patient. This involves partial or complete replacement of the diseased joint with a prosthesis.

Prevention

Reducing the load on the legs will slow down the pathological processes inside the joint, so obese people are recommended to start losing weight.

Preventive measures will help reduce pain in the hip joint:

• regular walk
• physiotherapy
• a balanced diet rich in vitamins A, C, E

Timely consultation with a doctor in the early stages of the disease increases the effectiveness of treatment, and also reduces the risk of complications and serious consequences for the body.