The hip joint is the largest joint in the human body. Every day he does thousands of movements while walking, running, climbing stairs and exercising. Constant loads, inflammatory processes, injuries and diseases can cause coxalgia - pain in the hip joint. It is necessary to determine the cause as soon as possible to avoid limited mobility and disability.
Classification of pain sensations
When visiting a doctor, it is necessary to describe in detail the nature of the pain: severity, intensity, frequency - the accuracy of the diagnosis depends on this. Depending on the nature of the pain, it can be:
- Spicy.In this case, the pain is very intense, even unbearable. It can appear suddenly and can also disappear suddenly. As a rule, a patient with acute pain can quite accurately indicate the area of its localization. Acute pain can radiate and spread to areas closest to the source of the pathology.
- Hurt.The pain is not too intense, sometimes it can feel uncomfortable and cannot be accurately located. The pain may increase with movement or after exercise and disappear for a while.
- Chronic.This type typically includes pain that occurs with varying frequency over six months. Chronic pain is generally the most difficult to treat.
Possible source of pain
The main causes of hip pain are:
- injury,
- Infectious Diseases,
- inflammatory process,
- degenerative tissue changes,
- developmental pathology of the musculoskeletal system.
Injury
With traumatic damage to the hip and femur joints, pain occurs immediately, accompanied by redness and swelling of the tissue, limitation of limb mobility and the formation of widespread hematomas. Depending on the severity of the damage, the pain may be more or less intense.
If you bump or fall on your side, soft tissue bruising may occur. It is characterized by the formation of hematomas, pain at the site of damage increases when palpated. Unlike dislocations and fractures, with bruises, the injured leg does not have limited mobility, there are no visually perceptible deformities, and the limb completely retains its function.
Hip dislocation in healthy people can only occur when there is a very strong physical impact, such as when falling from a great height or in a car accident.
The limb has an obligate rotation, usually inward, rarely outward. Severe pain, accompanied by swelling and numbness (if nerves are affected), the victim cannot move the injured limb.
Femoral neck fracture
The cause of hip pain can be a violation of the integrity of the femoral neck - an injury that mainly affects older women who have passed the threshold of 60 years of age. Age-related and hormonal changes in the body after menopause will accelerate the excretion of calcium, causing bones to become brittle and prone to breaking even with only small amounts of exposure. A fall, a bruise or even a careless movement can lead to a fracture of the femur at its thinnest point, where the diaphragm connects to the head located in the hip joint.
Symptoms of a hip fracture are:
- pain in the pelvic area, radiating to the groin and lower back, aggravated by touching the heels;
- shorten the injured leg;
- limited mobility, inability to rely on injured leg;
- externally rotated position of the limb;
- "Stuck heel" syndrome – inability to lift the leg straight off a surface from a lying position.
Fractures of the femoral neck can be affected - in this case, bone fragments stick together. In this case, the function of the limb may be partially or even completely preserved, but when the fragments are crushed, full signs of damage appear. Such injuries require immediate intervention, so if you suspect a fracture, you should seek medical help as soon as possible.
Inflammatory process
One of the main causes of coxalgia pain is the inflammatory process in the tissues of the joint or its surroundings.
Arthritis is an inflammation of the cartilage tissue of the joints. Causes can be infection, chronic trauma, metabolic disorders, excessive stress, systemic connective tissue disease. Symptoms of the disease, in addition to increased pain after exercise or at night, include red and swollen tissues in the affected joint area, local temperature increase and limited leg mobility.
Rheumatoid arthritis is a systemic connective tissue disease of an autoimmune nature. Women are more susceptible to the disease. It affects both small and large joints, usually the arthrodesis. Typical symptoms of rheumatoid arthritis:
- joint pain, worse at night and relieved after exercise;
- the formation of subcutaneous tumors in the affected joint area, called rheumatoid nodules;
- local redness, swelling and increased temperature in the affected joints.
Bursitis is an inflammatory process that develops in the synovium of a joint, accompanied by a pathological accumulation of exudate in the tissues of the joint. The main causes of the development of the disease are considered injuries, excessive physical activity, infections and arthritis complications of various causes. Pain from bursitis occurs deep inside, spreading to the outer surface.
Ankylosing spondylitis is an idiopathic disease, meaning that the exact cause of its occurrence in most cases cannot be determined. There is an assumption that the pathology is genetically determined and that genetic predisposition plays a large role in its development.
Usually, manifestations of the disease occur at the age of 20-30, the first symptoms are pain in the lower back, hips and buttocks, worse at night, joint stiffness, quickly developing ankylosis - joint immobility. In the later stages, if left untreated, the disease will cause serious deformation of joint tissues, leading to severe disability.
Degenerative tissue changes
Coxarthrosis, or osteoarthritis of the hip joint - a degenerative change in cartilage tissue - is a common cause of coxalgia in people over 40-45 years old. The disease is chronic and progresses gradually. The causes of its development are considered to be chronic injuries, genetic predisposition, age-related changes and concomitant inflammatory arthritis diseases. In young people, the development of coxarthrosis may be due to congenital dysplasia of the hip joint.
Pathological symptoms:
- pain in the groin, lower back, buttocks, thighs, increasing with movement and decreasing with rest;
- muscle weakness;
- limping, "duck" gait with joint damage on both sides;
- dysfunction of the limb, difficulty with abduction, adduction, rotation.
Infectious Diseases
Infectious arthritis, also a common cause of coxalgia, can develop as a result of pathogenic microorganisms entering joint tissue from a viral or bacterial infection through the bloodstream. Can be caused by streptococci, staphylococci, Pseudomonas aeruginosa and tuberculosis bacilli, spirochetes pallidum, influenza virus and other agents.
With septic arthritis, joint pain is accompanied by redness and swelling of the surrounding tissues, as well as general symptoms - fever, malaise and weakness.
Other reasons
In addition to injury, inflammation and infection, hip pain can be caused by:
- Internal disorder.Inflamed and compressed nerve roots, especially the sciatic nerve, can cause pain in the hips, inguinal triangle, and buttocks.
- Tumor formation, including malignant tumors, in the tissues of the joints and surrounding environment.
- Aseptic necrosis of the femoral head.Chronic poor circulation in tissues causes degenerative changes in cartilage and bone tissue and can lead to total destruction of the bone structure.
- Juvenile epithelial lysis.Chronic pain in the hip joint in children and adolescents can be due to the development of osteochondrosis, a pathological displacement of the femoral head due to hormonal disorders in the body. Boys are more susceptible to the disease, but in rare cases it is also diagnosed in girls. As a rule, the pathology is accompanied by delayed sexual development and endocrine disorders.
Hip pain is a common phenomenon in women during the last three months of pregnancy. Causes of coxalgia pain in pregnant women:
- increases body weight and shifts the center of gravity, redistributing the load on the musculoskeletal system;
- natural hormonal changes: just before giving birth, a woman's body begins to produce hormones that relax ligaments;
- pressure of the expanding uterus on large vessels and nerves, neurological disorders and blood circulation in the pelvic organs and lower limbs;
- Calcium deficiency in the body of the future mother.
If pain during pregnancy is caused by the above factors, then a few weeks after giving birth they will disappear without a trace. If the pain persists a month after giving birth, you should consult your doctor.
Alarming symptoms
Hip pain is an alarming symptom, a reason to see a doctor. The sooner the cause of coxalgia pain is identified, the higher the chance of a complete cure. However, there are situations where it is necessary to seek immediate medical help:
- pain in the joint area occurs after a fall, blow, bruise or any other injury, and the mobility of the limb is impaired;
- the tissues around the joints are red and swollen, the general body temperature increases to fever (38 and above);
- have problems with defecation and urination.
Diagnose
The first step in determining the cause of your hip pain is to see your doctor. The surgeon or orthopedist will take a history, find out the nature of the pain, its frequency and severity, and examine the patient to assess joint mobility and condition. condition of the tissues surrounding it. For accurate diagnosis, laboratory and instrumental diagnostic methods can be prescribed:
- General blood tests, biochemistry, serology, immunity;
- x-ray of the pelvis, thighs, and hip joints;
- Ultrasound examination of the tissues of the joint and the tissues surrounding it;
- MRI and computed tomography to obtain an accurate three-dimensional image of the affected area;
- arthroscopy using a probe inserted into its cavity;
- puncture to study effusion - pathological fluid accumulation in the joint capsule;
- tissue biopsy.
Treatments
Treatments for conditions that cause hip pain depend on the underlying cause. In cases of traumatic pain, the main conservative treatment will be joint immobilization; In some cases surgery may be required. If the pain is inflammatory in nature, nonsteroidal or hormonal anti-inflammatory drugs may be prescribed; For general infectious diseases, treatment with antibiotics or antiviral drugs will be required.
Pain syndrome, regardless of the cause of its appearance, is relieved by the use of analgesics or blockade injections.
motionless
Immobilization is often prescribed for joint injuries. Tight bandages, plaster splints or plastic orthotics can be used for immobilization.
Treatment with medication
Depending on the cause of coxalgia pain, the following may be prescribed:
- nonsteroidal anti-inflammatory drugs or glucocorticoids to reduce the inflammatory process;
- Chondroprotective agents to slow down the degenerative process in joint tissue;
- antibiotics and antiviral drugs in case of arthritis of an infectious nature;
- muscle relaxants to reduce muscle spasms.
Physical therapy procedures
At the stage of recovery after injury, as well as during periods of remission, the following physiotherapy methods are used to restore joint mobility, improve blood circulation and restore functionof genus:
- physical therapy,
- Massage,
- magnetic,
- bath therapy,
- laser therapy,
- UHF heating,
- hirudotherapy.
Endoscopic
In some cases, conservative treatment of hip pain may not be effective. Aseptic necrosis, coxarthrosis in the late stage, fracture of the femoral neck in the elderly are direct indications for arthroscopic surgery - replacement of the head and acetabulum of the hip joint with a prosthesis made of inert materialchemically and biologically.
This operation allows you to shorten the rehabilitation process and return the patient to full movement.
Prevention of coxalgia pain
A variety of preventative measures will help prevent pain in the hip joint, including:
- Regular feasible physical activity to strengthen muscles and ligaments;
- nutritious and balanced nutrition;
- control body weight, because overweight and obesity create additional stress on the musculoskeletal system;
- avoid injuries and excessive physical activity;
- refuse bad habits;
- Timely and complete treatment of inflammatory and infectious diseases;
- Get regular preventative exams with your doctor.