The hip joint is the largest joint in the human body. Every day he makes thousands of movements while walking, running, climbing stairs, and doing physical exercises. Constant loads, inflammatory processes, injuries and diseases can cause coxalgia - pain in the hip joint. It is necessary to establish the cause of its occurrence as soon as possible in order to avoid limitation of mobility and disability.
Classification of pain sensations
During a visit to the doctor, it is necessary to describe in detail the nature of the pain: the degree of its 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 intense, even unbearable. It can appear suddenly and also disappear suddenly. As a rule, a patient with acute pain can quite accurately indicate the area of its localization. Acute pain can radiate, spreading to the areas closest to the source of pathology.
- Aching.The pain is not so intense, sometimes it can be felt as discomfort and does not have an exact localization. Aching pain may intensify during movement or after exercise and disappear for a while.
- Chronic.This category usually includes pain that occurs with varying regularity for more than six months. Chronic pain is generally the most difficult to treat.
Possible sources of pain
The main causes of pain in the hip joint are:
- injuries,
- infectious diseases,
- inflammatory processes,
- degenerative tissue changes,
- pathologies of development of the musculoskeletal system.
Injuries
With traumatic damage to the hip joint and femur, pain occurs immediately, accompanied by redness and swelling of the tissue, limited mobility of the limb, and the formation of extensive hematomas. Depending on the severity of the lesion, pain may be more or less intense.
If you hit or fall on your side, soft tissue bruises may occur. It is characterized by the formation of hematomas, the pain at the site of the lesion intensifies when palpated. Unlike a dislocation and a fracture, with a bruise there is no restriction in the mobility of the injured leg, there are no visually discernible deformities, and the limb completely retains its functions.
Dislocation of the hip joint in a healthy person can only occur under very strong physical impact, for example, when falling from a great height or in a car accident.
The limb takes a forced rotational position, most often inward, less often outward. The pain is intense, accompanied by swelling, numbness (if the nerves are affected), the victim cannot move the injured limb.
Femoral neck fracture
The cause of pain in the hip joint may be a violation of the integrity of the femoral neck - an injury that mostly affects older women who have crossed the threshold of 60 years. Age-related and hormonal changes in the body after menopause accelerate the process of calcium leaching, making bones brittle and brittle even with minor exposure. A fall, a bruise, or even a careless movement can lead to a fracture of the femur in its thinnest place, where the diaphysis connects to the head embedded in the hip joint.
Symptoms of a hip fracture are:
- pain in the pelvic area, radiating to the groin and lower back, aggravated by tapping the heel;
- shortening of the injured leg;
- limited mobility, inability to lean on the injured leg;
- outward rotational position of the limb;
- "stuck heel" syndrome – the inability to lift the straight leg from the surface from a lying position.
A fracture of the femoral neck can be impacted - in this case, bone fragments wedge into each other. In this case, the functions of the limb may be partially or even fully preserved, but when the fragments are crushed, signs of injury will appear in full. Such an injury requires immediate intervention, so if you suspect a fracture, you should seek medical help as soon as possible.
Inflammatory processes
One of the main causes of coxalgia is inflammatory processes in the tissues of the joint or its surroundings.
Arthritis is inflammation of the cartilage tissue of the joint. The causes may be infections, chronic injuries, metabolic disorders, excessive stress, systemic connective tissue diseases. Symptoms of the disease, in addition to pain, which intensifies after exercise or at night, are redness and swelling of the tissues in the area of the affected joint, a local increase in temperature, and limited mobility of the leg.
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, most often paired ones. Characteristic symptoms of rheumatoid arthritis:
- pain in the joints, worsening at night and subsiding after movement;
- formation of subcutaneous compactions in the area of the affected joint, so-called rheumatic nodules;
- redness, swelling and local increase in temperature in the affected joints.
Bursitis is an inflammatory process that develops in the synovial bursa of a joint, accompanied by a pathological accumulation of exudative fluid in the tissues of the joint. The main causes of the development of the disease are considered to be injuries, excessive physical activity, infections and complications of arthritis of various etiologies. Pain from bursitis occurs deep inside, spreading to the outer surface.
Ankylosing spondylitis is an idiopathic disease, that is, the exact causes of its occurrence in most cases cannot be established. There is an assumption that the pathology is genetically determined, and hereditary predisposition plays a large role in its development.
Most often, the manifestation of the disease occurs at the age of 20-30 years, its first symptoms are pain in the lower back, hips and buttocks, worsening at night, stiffness, rapidly developing ankylosis - immobility of the joints. In the later stages, if left untreated, the disease causes severe deformations of the joint tissue, leading to profound disability.
Degenerative tissue changes
Coxarthrosis, or osteoarthritis of the hip joints - a degenerative change in cartilage tissue - is a common cause of coxalgia in people over 40-45 years of age. The disease is chronic and steadily progressive. The causes of its development are considered to be chronic injuries, hereditary predisposition, age-related changes, and concomitant inflammatory diseases of the joints. In young people, the development of coxarthrosis may be due to congenital dysplasia of the hip joint.
Symptoms of pathology:
- pain in the groin, lower back, buttock, thigh, increasing with movement and subsiding at rest;
- muscle weakness;
- intermittent claudication, "duck" gait with bilateral joint damage;
- dysfunction of the limb, difficulties with abduction, adduction, rotation.
Infectious diseases
Infectious arthritis, which is also a common cause of coxalgia, can develop as a result of pathogenic microorganisms entering the joint tissue from a distant focus of 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 infectious 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 injuries, inflammation and infections, pain in the hip joint can be caused by:
- Innervation disorders.Inflammation and pinched nerve roots, particularly the sciatic nerve, can cause pain in the hip, inguinal triangle, and buttocks.
- Formation of neoplasms, including malignant ones, in the tissues of the joint and its surroundings.
- 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 bone structures.
- Juvenile epiphysiolysis.Chronic pain in the hip joint in children and adolescents can be caused by the development of epiphysiolysis, a pathological displacement of the femoral head caused by 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 delays in sexual development and endocrine disorders.
Pain in the hip joints is a common occurrence in women in the 3rd trimester of pregnancy. Causes of coxalgia in pregnant women:
- an increase in body weight and a shift in the center of gravity, redistribution of the load on the musculoskeletal system;
- natural hormonal changes: shortly before giving birth, a woman’s body begins to produce a hormone that relaxes the ligaments;
- pressure of the enlarged uterus on large vessels and nerves, disruption of innervation and blood circulation in the pelvic organs and lower extremities;
- calcium deficiency in the body of the expectant mother.
If pain during pregnancy was caused by the above factors, a few weeks after birth they should disappear without a trace. If, a month after the birth of the child, pain is still present, you should consult a doctor.
Alarming symptoms
Pain in the hip joint is an alarming symptom, which is a mandatory reason for a visit to the doctor. The sooner the cause of coxalgia is identified, the higher the likelihood of a complete cure. However, there are cases when seeking medical help should be immediate:
- pain in the joint area occurs after a fall, blow, bruise or any other injury, while the mobility of the limb is impaired;
- the tissues around the joint are red and swollen, and the general body temperature rises to febrile levels (38 and above);
- there are problems with defecation and urination.
Diagnostics
The first step to determining the cause of hip pain is to see a doctor. The surgeon or orthopedist will collect anamnesis, find out the nature of the pain, the frequency and degree of its manifestation, and also examine the patient to assess the mobility of the joint and the condition of the tissues surrounding it. To make an accurate diagnosis, laboratory and instrumental diagnostic methods can be prescribed:
- general, biochemical, serological, immunological blood tests;
- radiography of the pelvic bones, thighs, 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 picture of the affected area;
- endoscopy of the joint using a probe inserted into its cavity;
- puncture to study effusion - pathological fluid accumulating in the joint capsules;
- tissue biopsy.
Treatment methods
Treatments for conditions that cause hip pain depend on the underlying cause. In cases where pain was caused by injury, the main conservative treatment method will be joint immobilization; in some cases surgery may be required. If the pain is inflammatory in nature, non-steroidal or hormonal anti-inflammatory drugs can be prescribed; For general infectious diseases, antibiotic therapy or antiviral medications will be required.
Pain syndrome, regardless of the cause of its occurrence, is relieved by taking analgesics or injection blockades.
Immobilization
Immobilization is most often prescribed for joint injuries. Tight bandages, plaster splints or plastic orthoses can be used for fixation.
Drug therapy
Depending on the cause of coxalgia, the following may be prescribed:
- non-steroidal anti-inflammatory drugs or glucocorticoids to relieve inflammatory processes;
- chondroprotectors to slow down degenerative changes in joint tissues;
- antibiotics and antiviral drugs in case of arthritis of an infectious nature;
- muscle relaxants to reduce muscle spasms.
Physiotherapeutic procedures
At the stage of rehabilitation after injuries, as well as during the period of remission of diseases, the following physiotherapy methods are used to restore joint mobility, improve blood circulation and restore limb function:
- physiotherapy,
- massage,
- magnetotherapy,
- balneotherapy,
- laser therapy,
- UHF heating,
- hirudotherapy.
Endoprosthetics
In some cases, conservative treatment of pain in the hip joint may be ineffective. Aseptic necrosis, coxarthrosis at a late stage, fracture of the femoral neck in elderly people are direct indications for endoprosthetics surgery - replacement of the head and acetabulum of the hip joint with a prosthesis made of chemically and biologically inert materials.
The operation allows you to shorten the rehabilitation process and return the patient to full movement.
Prevention of coxalgia
A set of preventive measures will help prevent the occurrence of pain in the hip joints, including:
- regular feasible physical activity to strengthen muscles and ligaments;
- nutritious and balanced nutrition;
- body weight control, since overweight and obesity create additional stress on the musculoskeletal system;
- avoiding injuries and excessive physical activity;
- rejection of bad habits;
- timely and adequate treatment of inflammatory and infectious diseases;
- regular preventive examinations with a doctor.