The hip joint is the largest joint in the human body. You make thousands of movements every day while walking, running, climbing stairs and doing physical exercises. Constant loads, inflammatory processes, injuries and diseases can cause coxalgia - pain in the hip joint. The cause of its occurrence must be discovered as soon as possible in order to avoid mobility and disability.
Classification of pain sensations
During the visit to the doctor, the nature of the pain must be described in detail: 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 and even unbearable. It can suddenly appear and suddenly disappear. Usually, a patient with acute pain can indicate the area of localization quite accurately. Acute pain may radiate and spread to areas closest to the source of the pathology.
- Sore.The pain is not so intense, sometimes it can be felt as an unpleasant sensation, and it does not have an exact localization. The aching pain may intensify during movement or after exercise and may disappear for a while.
- Chronic.This category usually includes pain that occurs with variable regularity for longer 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 tissue changes,
- pathologies of the development of the locomotor system.
Injuries
In the case of traumatic damage to the hip joint and femur, pain appears 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, the pain can be more or less intense.
If you are hit or fall on your side, soft tissue contusions may occur. It is characterized by the formation of hematomas, the pain intensifies at the site of the lesion. In contrast to dislocation and fracture, in a contusion, the mobility of the injured leg is not limited, there are no visually noticeable deformations, and the limb fully preserves its functions.
In a healthy person, dislocation of the hip joint can only occur in the event of a 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 intense, accompanied by swelling and numbness (if the nerves are affected), the victim cannot move the injured limb.
Femoral neck fracture
Hip joint pain can be caused by a violation of the integrity of the femoral neck - this injury mostly affects older women who have crossed the 60-year threshold. After menopause, age-related and hormonal changes in the body accelerate the process of calcium leaching, making bones brittle and fragile even with minor exposure. A fall, a bruise, or even a careless movement can lead to a fracture of the femur at its thinnest point, where the diaphysis connects to the head embedded in the hip joint.
Symptoms of a hip fracture include:
- pain in the pelvic area radiating to the groin and lower back, aggravated by tapping the heel;
- shortening the injured leg;
- limited mobility, inability to lean on the injured leg;
- outwardly rotated position of the limb;
- "stuck heel" syndrome - inability to raise the straight leg from a lying position on the surface.
A fracture of the femoral neck can impinge - in this case, the bone pieces become wedged together. In this case, the functions of the limb are partially or even completely preserved, but when the fragments are crushed, the signs of the injury 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 or around the tissues of the joint.
Arthritis is inflammation of joint cartilage tissue. The causes can be infections, chronic injuries, metabolic disorders, excessive stress, and systemic connective tissue diseases. The symptoms of the disease include, in addition to pain that intensifies after exercise or at night, redness and swelling of the tissues in the area of the affected joint, a local increase in temperature, and limited movement of the leg.
Rheumatoid arthritis is a systemic connective tissue disease of an autoimmune nature. Women are more prone to the disease. It affects both small and large joints, most often paired joints. Typical symptoms of rheumatoid arthritis:
- joint pain that worsens at night and decreases after movement;
- formation of subcutaneous compactions in the area of the affected joint, so-called rheumatic nodules;
- redness, swelling and local temperature increase in the affected joints.
Bursitis is an inflammatory process that develops in the synovial bursa of the joint and is accompanied by an abnormal accumulation of exudative fluid in the tissues of the joint. The main causes of the disease are injuries, excessive physical activity, infections and complications of arthritis of various etiologies. The pain caused by bursitis occurs deep inside and spreads to the outer surface.
Ankylosing spondylitis is an idiopathic disease, i. e. the exact causes of its occurrence cannot be established in most cases. It can be assumed that the pathology is genetically determined, and hereditary predisposition plays a major role in its development.
Most often, the manifestation of the disease occurs at the age of 20-30 years, the 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 not treated, the disease causes severe deformations in the joint tissues, leading to profound disability.
Degenerative tissue changes
Coxarthrosis or arthrosis 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 constantly progressive. Its causes are chronic injuries, hereditary predisposition, age-related changes, and simultaneous inflammatory diseases of the joints. In young people, the development of coxarthrosis can be caused by congenital dysplasia of the hip joint.
Symptoms of pathology:
- pain in the groin, lower back, buttocks, thighs, increases with movement and decreases with rest;
- muscle weakness;
- periodic claudication, "duck" gait with bilateral joint damage;
- dysfunction of the limb, abduction, adduction, rotation difficulties.
Infectious diseases
Infectious arthritis, which is also a common cause of coxalgia, can develop as a result of pathogenic microorganisms entering the joint tissue through the bloodstream from a distant focus of viral or bacterial infection. It can be caused by streptococci, staphylococci, Pseudomonas aeruginosa and tuberculosis bacilli, spirochetes pallidum, influenza virus and other pathogens.
In the case of 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 also be caused by:
- Innervation disorders.Inflammation and entrapment of nerve roots, especially the sciatic nerve, can cause pain in the hips, inguinal triangle, and buttocks.
- Formation of neoplasms, including malignant ones, in and around the tissues of the joint.
- 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, which is 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. In general, the pathology is accompanied by a delay in sexual development and endocrine disorders.
Hip pain 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, a 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;
- lack of calcium in the expectant mother's body.
If the pain during pregnancy was caused by the above factors, they should disappear without a trace a few weeks after birth. If the pain persists a month after the birth of the child, 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 greater the likelihood of complete recovery. However, there are cases when you need to seek immediate medical help:
- pain in the joint 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 a feverish level (38 and above);
- have defecation and urination problems.
Diagnostics
The first step in determining the cause of hip pain is to see a doctor. The surgeon or orthopedist collects an anamnesis, finds out the nature of the pain, its frequency and extent, and examines the patient to assess the mobility of the joint and the condition of the tissues surrounding it. In order 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 joint and surrounding tissues;
- MRI and computer tomography to create an accurate three-dimensional image of the affected area;
- endoscopy of the joint with a probe inserted into its cavity;
- puncture to study effusion - the pathological fluid that accumulates in the joint capsules;
- tissue biopsy.
Treatment methods
Treatment for conditions that cause hip pain depends on the underlying cause. In cases where the pain was caused by an injury, the main conservative treatment method is immobilization of the joints; in some cases, surgery may be necessary. If the pain is inflammatory, non-steroidal or hormonal anti-inflammatory drugs may be prescribed; Common infections will require antibiotic therapy or antiviral medications.
The pain syndrome, regardless of the cause of its occurrence, can be alleviated with painkillers or injection blocks.
Immobilization
Immobilization is most often prescribed for joint injuries. A tight bandage, a plaster splint or a plastic orthosis 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 antivirals for infectious arthritis;
- muscle relaxants to reduce muscle spasms.
Physiotherapy procedures
In the phase of rehabilitation after injuries, as well as in the remission period of diseases, the following physiotherapy methods are used to restore the mobility of the joints, improve blood circulation and restore the function of the limbs:
- physiotherapy,
- massage,
- magnetotherapy,
- balneotherapy,
- laser therapy,
- UHF heating,
- hirudotherapy.
Endoprosthesis
In some cases, conservative treatment of hip joint pain may be ineffective. Aseptic necrosis, late-stage coxarthrosis, fracture of the femoral neck in the elderly are direct indications for endoprosthesis surgery - replacement of the head and acetabulum of the hip joint with a prosthesis made of chemically and biologically inert materials.
The operation makes it possible to shorten the rehabilitation process and restore 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 physical activity to strengthen muscles and ligaments;
- nutritious and balanced diet;
- weight control, as overweight and obesity cause additional stress on the skeletal and muscular system;
- avoiding injuries and excessive physical activity;
- rejection of bad habits;
- timely and appropriate treatment of inflammatory and infectious diseases;
- regular preventive examinations with a doctor.