The hip joint is the largest joint in the human body. Every day he makes thousands of movements by 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 early as possible in order to avoid limitation of mobility and disability.
Classification of painful sensations
When visiting the doctor, it is necessary to describe in detail the nature of the pain: its degree of severity, intensity, frequency - the correctness of the diagnosis depends on this. Depending on the nature of the pain, it may be:
- Spicy.In this case, the pain is intense, even unbearable. It can appear suddenly and also disappear suddenly. As a rule, a patient suffering from 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.
- Painful.The pain is not that intense, it can sometimes be felt as discomfort and does not have an exact location. The aching pain may intensify during movement or after exercise and disappear for a while.
- Chronic.This category generally includes pain that occurs with varying regularity for more than six months. Chronic pain is usually 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,
- developmental pathologies of the musculoskeletal system.
Injuries
In case of traumatic injury to the hip joint and femur, pain occurs immediately, accompanied by redness and swelling of the tissues, limited mobility of the limb and the formation of extensive hematomas. Depending on the severity of the injury, the pain may be more or less intense.
If you hit or fall sideways, soft tissue bruising may occur. It is characterized by the formation of hematomas, pain at the site of the lesion intensifies upon palpation. Unlike a dislocation and a fracture, in case of a bruise there are no restrictions in the mobility of the injured leg, there are no visually noticeable deformations, and the limb completely retains its functions.
Dislocation of the hip joint in a healthy person can occur only under very strong physical impact, for example, when falling from a great height or in a car accident.
The limb assumes a forced rotation position, most often inwards, less often outwards. The pain is severe, 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 mainly affects older women who have crossed the threshold of 60 years. Hormonal and age-related changes in the body after menopause accelerate the calcium leaching process, making bones brittle and brittle even with minor exposure. A fall, bruise, or even careless movement can result in a fracture of the femur at the thinnest point, where the shaft connects to the head embedded in the hip joint.
Symptoms of a hip fracture are:
- pain in the pelvic region, radiating to the groin and lower back, aggravated by tapping the heel;
- shortening of the injured leg;
- limited mobility, inability to support the injured leg;
- outward rotation position of the limb;
- "Stuck heel" syndrome – inability to lift the right leg off the surface from an extended position.
A fracture of the femoral neck can be impacted - in this case, bone fragments become stuck inside each other. In this case, the functions of the limb may be partially or even completely preserved, but when the fragments are crushed, the signs of injury will fully appear. Such an injury requires immediate intervention, so if you suspect a fracture, you should see a doctor 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 an inflammation of the cartilage tissue of the joint. The causes can 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 tissues in the area of the affected joint, a local increase in temperature and mobilitylimited 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 pairs. Characteristic symptoms of rheumatoid arthritis:
- pain in the joints, worse at night and lessening after movement;
- formation of subcutaneous compactions in the area of the affected joint, 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 pathological accumulation of exudative fluid in the tissues of the joint. The main causes of the development of the disease are injuries, excessive physical activity, infections and complications of arthritis of various etiologies. The pain caused by bursitis appears deep inside and extends to the outer surface.
Ankylosing spondylitis is an idiopathic disease, that is, the exact causes of its appearance in most cases cannot be established. It is assumed that the pathology is genetically determined and hereditary predisposition plays an important role in its development.
Most often, the manifestation of the disease occurs between the ages of 20 and 30. Its first symptoms are pain in the lower back, hips and buttocks, which worsens at night, stiffness, rapidly developing ankylosis - immobility of the joints. In later stages, if left untreated, the disease causes severe deformation 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 to 45 years old. The disease is chronic and progresses regularly. The causes of its development are considered to be chronic injuries, hereditary predispositions, 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 groin, lower back, buttock, thigh, increasing with movement and easing with rest;
- muscular weakness;
- intermittent claudication, "duck" gait with bilateral joint damage;
- limb dysfunction, difficulties with abduction, adduction, rotation.
Infectious diseases
Infectious arthritis, which is also a common cause of coxalgia, can develop as a result of the penetration of pathogenic microorganisms into the joint tissues from a distant focus of a viral or bacterial infection via the bloodstream. May be caused by streptococci, staphylococci, Pseudomonas aeruginosa and tubercle bacilli, pallidum spirochetes, influenza virus and other agents.
In 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, inflammations and infections, pain in the hip joint can be caused by:
- Innervation disorders.Inflammation and pinching of nerve roots, especially the sciatic nerve, can cause pain in the hip, inguinal triangle, and buttocks.
- Formation of neoplasms, including malignant, 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, pathology is accompanied by delays in sexual development and endocrine disorders.
Hip joint pain is common among women in the third 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, the 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 future mother.
If pain during pregnancy is caused by the above factors, it should disappear without a trace within a few weeks after birth. If, one month after the birth of the child, the pain is still present, you should consult a doctor.
Alarming symptoms
Pain in the hip joint is an alarming symptom that is a mandatory reason for a visit to the doctor. The sooner the cause of coxalgia is identified, the higher the chances of complete recovery. However, there are cases where seeking medical help should be immediate:
- pain in the joint occurs after a fall, blow, bruise or other injury, while the mobility of the limb is impaired;
- the tissues around the joint are red and swollen and the general body temperature reaches feverish levels (38 and above);
- there are problems with defecation and urination.
Diagnostic
The first step in determining the cause of hip pain is to see a doctor. The surgeon or orthopedist will collect the 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;
- x-ray of the bones of the pelvis, thighs, hip joints;
- ultrasound examination of the tissues of the joint and the tissues surrounding it;
- MRI and CT scan to obtain a precise three-dimensional image 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 causing hip pain depend on the underlying cause. In cases where the pain is caused by an injury, the main method of conservative treatment will be joint immobilization; in some cases, surgery may be necessary. If the pain is inflammatory in nature, nonsteroidal or hormonal anti-inflammatories may be prescribed; For general infectious diseases, antibiotic therapy or antiviral drugs will be necessary.
Pain syndrome, regardless of the cause of its occurrence, is relieved by taking pain relievers or injection blocks.
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 products 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 cases of arthritis of an infectious nature;
- muscle relaxants to reduce muscle spasms.
Physiotherapeutic procedures
At the stage of rehabilitation after injury, 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.
Endoprostheses
In some cases, conservative treatment of hip joint pain may be ineffective. Aseptic necrosis, coxarthrosis in an advanced stage, fracture of the femoral neck in the elderly are direct indications for endoprosthetic surgery - replacement of the head and acetabulum of the hip joint with a prosthesis made of chemicallyand biologically inert.
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 appearance of pain in the hip joints, including:
- regular physical activity achievable to strengthen muscles and ligaments;
- nutritious and balanced diet;
- control of body weight, because overweight and obesity create additional stress on the musculoskeletal system;
- avoid injuries and excessive physical activity;
- rejection of bad habits;
- prompt and adequate treatment of inflammatory and infectious diseases;
- regular preventive check-ups with a doctor.