The hip joint is the largest joint in the human body. Every day, he makes thousands of movements as he walks, runs, climbs stairs and 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 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 strong, even unbearable. It can appear suddenly and suddenly disappear. As a rule, a patient with acute pain can quite accurately indicate the area of its localization. Sharp pain can radiate, spreading to the areas closest to the source of pathology.
- Pain.The pain is not so intense, sometimes it feels like discomfort and there is no exact localization. The pain may increase 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 usually the most difficult to treat.
Possible sources of pain
The main causes of hip pain are:
- injuries,
- infectious diseases,
- inflammatory processes,
- degenerative changes in tissues,
- pathologies of the development of the musculoskeletal system.
Injuries
In case of traumatic damage to the hip joint and femur, pain immediately appears, 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, the pain may be more or less intense.
If you bump 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. In contrast to dislocation and fracture, with a contusion there is no limitation in the mobility of the injured leg, there are no visually noticeable deformations, and the limb fully retains its functions.
Dislocation of the hip joint in a healthy person can occur only with a very strong physical impact, for example, when falling from a great height or in a car accident.
The limb occupies a forced rotational position, most often inwards, less often outwards. The pain is intense, accompanied by swelling, numbness (if the nerves are affected), the victim cannot move the damaged limb.
Fracture of the neck of the femur
The cause of pain in the hip joint can be a violation of the integrity of the neck of the femur - an injury that mostly affects elderly 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 careless movement can cause the femur to break at its thinnest point, where the shaft connects to the head embedded in the hip joint.
Symptoms of a hip fracture are:
- pain in the pelvis, 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;
- external rotation position of the limb;
- Stuck heel syndrome – inability to lift a straight leg off the surface from a lying position.
A fracture of the neck of the femur can be affected - in this case, the bone fragments wedge into 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 seek medical attention as soon as possible.
Inflammatory processes
One of the main causes of coxalgia is inflammatory processes in the tissues of the joint or around it.
Arthritis is an inflammation of the cartilage tissue of a joint. The causes can be infections, chronic injuries, metabolic disorders, excessive stress, systemic connective tissue diseases. The symptoms of the disease, in addition to the pain that intensifies after physical exertion 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 small and large joints, most often paired. Characteristic symptoms of rheumatoid arthritis:
- pain in the joints, worse at night and abating after movement;
- formation of subcutaneous seals in the area of the affected joint, the so-called rheumatic nodes;
- redness, swelling and local increase in temperature in the affected joints.
Bursitis is an inflammatory process that develops in the synovial bursa of the joint, accompanied by a pathological accumulation of exudative fluid in the tissues of the joint. The main reasons for the development of the disease are injuries, excessive physical activity, infections and complications of arthritis of different etiology. Bursitis pain 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 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 changes in tissues
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 old. The disease is chronic and gradually progresses. The reasons for its development are considered to be chronic injuries, hereditary predisposition, age 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 decreasing at rest;
- muscle weakness;
- intermittent limp, "duck" gait with bilateral joint damage;
- limb dysfunction, difficulty with abduction, adduction, rotation.
Infectious diseases
Infectious arthritis, which is also a common cause of coxalgia, can develop as a result of the entry of pathogenic microorganisms into the joint tissue from a distant focus of viral or bacterial infection through the bloodstream. It can be caused by streptococci, staphylococci, Pseudomonas aeruginosa and tubercle bacilli, spirochetes pallidum, 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 injury, inflammation, and infection, hip pain can be caused by:
- Innervation disorders.Inflammation and pinched nerve roots, especially the sciatic nerve, can cause pain in the thigh, inguinal triangle, and buttocks.
- Formation of neoplasms, including malignant, in the tissues of the joint and around it.
- Aseptic necrosis of the femoral head.Chronic poor circulation in tissues causes degenerative changes in cartilage and bone tissue and can lead to complete 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 head of the femur 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 a delay in sexual development and endocrine disorders.
Hip pain is common among women in the third trimester of pregnancy. Causes of coxalgia in pregnant women:
- increase in body weight and displacement of the center of gravity, redistribution of the load on the musculoskeletal system;
- natural hormonal changes: shortly before childbirth, 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 limbs;
- calcium deficiency in the body of the expectant mother.
If the pain during pregnancy is caused by the above factors, a few weeks after delivery they should disappear without a trace. If a month after the birth of the child the pain is still present, you should consult a doctor.
Worrying 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 greater 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 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.
Diagnosis
The first step in determining the cause of hip pain is to see a doctor. The surgeon or orthopedist will collect an anamnesis, understand 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 around it. In order to make an accurate diagnosis, laboratory and instrumental diagnostic methods can be prescribed:
- general, biochemical, serological, immunological blood tests;
- radiography of pelvic bones, hips, hip joints;
- ultrasound examination of the tissues of the joint and the tissues around 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 for examination of effusion - pathological fluid accumulating in the joint capsules;
- tissue biopsy.
Methods of treatment
Treatment for conditions that cause hip pain depends on the underlying cause. In cases where the pain is caused by an injury, the main conservative method of treatment will be to immobilize the joint; in some cases, surgery may be required. If the pain is of an inflammatory nature, non-steroidal or hormonal anti-inflammatory drugs may be prescribed; For common infectious diseases, antibiotic therapy or antiviral drugs will be necessary.
The pain syndrome, regardless of the cause of its occurrence, is relieved by taking analgesics 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 may be prescribed:
- non-steroidal anti-inflammatory drugs or glucocorticoids to relieve inflammatory processes;
- chondroprotectors to delay degenerative changes in joint tissues;
- antibiotics and antiviral drugs in case of arthritis of an infectious nature;
- muscle relaxants to reduce muscle spasms.
Physiotherapy procedures
At the stage of rehabilitation after injuries, as well as during the period of disease remission, the following physiotherapeutic methods are used to restore joint mobility, improve blood circulation and restore limb function:
- physical therapy,
- massage,
- magnetic therapy,
- balneotherapy,
- laser therapy,
- UHF heating,
- hirudotherapy.
Endoprosthetics
In some cases, conservative treatment of hip pain may be ineffective. Aseptic necrosis, coxarthrosis in the late stage, fracture of the neck of the femur in the elderly are direct indications for endoprosthetics - 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 onset of hip pain, including:
- regular feasible physical activity to strengthen muscles and ligaments;
- nutritious and balanced diet;
- body weight control, as overweight and obesity create additional stress on the musculoskeletal system;
- avoiding injuries and excessive physical activity;
- giving up bad habits;
- timely and adequate treatment of inflammatory and infectious diseases;
- regular preventive examinations with a doctor.