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 stress, inflammatory processes, injuries and illnesses can cause coxalgia - pain in the hip joint. In order to avoid limitation of mobility and disability, it is necessary to determine the cause of its occurrence as quickly as possible.
Classification of pain sensations
When visiting a doctor, it is necessary to describe in detail the type of pain: severity, intensity, frequency - the accuracy of the diagnosis depends on this. Depending on the type of pain it can be:
- Sharp.In this case, the pain is severe, even unbearable. It can appear suddenly and also disappear suddenly. As a rule, a patient with acute pain can indicate the area of its localization quite accurately. Acute pain can radiate and spread to the areas closest to the source of pathology.
- Pain.The pain is not that severe, sometimes it can be felt as discomfort and cannot be precisely localized. Aching pain may increase with exercise or after exercise and may disappear for a while.
- Chronic.This category usually includes pain that occurs with varying regularity over 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 the 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 tissues, 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 severe.
A collision or fall on the side can result in soft tissue bruising. It is characterized by the formation of hematomas, the pain at the site of the lesion increases upon palpation. In contrast to a dislocation and a fracture, a bruise does not limit the mobility of the injured leg, there are no visually noticeable deformations, and the limb fully retains its functions.
A dislocation of the hip joint in a healthy person can only occur in the event of very strong physical impact, such as a fall from a height or a car accident.
The limb assumes a forced rotational position, most often inward, less often outward. 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 can be a violation of the integrity of the femoral neck - an injury that primarily affects older women who have exceeded the threshold of 60 years. Age-related and hormonal changes in the body after menopause accelerate the process of calcium leaching, causing bones to become brittle and brittle even under minimal stress. A fall, a bruise, or even a careless movement can result in 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 and 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 – the inability to lift the straight leg off the surface from a lying position.
A femoral neck fracture can be impacted - in this case, bone fragments become wedged together. In this case, the functions of the limb may be partially or even completely preserved, but when the fragments are squeezed, the signs of injury appear completely. 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. Causes can be infections, chronic injuries, metabolic disorders, excessive stress, systemic connective tissue diseases. In addition to pain that increases after physical activity or at night, symptoms of the disease include redness and swelling of the tissue 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 with an autoimmune nature. Women are more susceptible to the disease. It affects both small and large joints, most commonly in pairs. Characteristic symptoms of rheumatoid arthritis:
- Pain in the joints that worsens at night and subsides after exercise;
- Formation of subcutaneous densities in the area of the affected joint, so-called rheumatoid 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 and is accompanied by a 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. Pain from bursitis occurs deep inside and spreads outward.
Ankylosing spondylitis is an idiopathic disease, which means that in most cases the exact causes of its occurrence cannot be clarified. It is believed that the pathology is genetic and hereditary predisposition plays a large role in its development.
Most often the disease manifests itself between the ages of 20 and 30. The first symptoms are pain in the lower back, hips and buttocks, which worsens at night, stiffness and rapidly developing ankylosis - immobility of the joints. In later stages, if left untreated, the disease leads to severe deformation of the joint tissue, leading to severe 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 old. The disease is chronic and constantly progressive. The causes for the development are chronic injuries, hereditary predisposition, age-related changes and accompanying 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, buttocks, and thigh that increases with movement and decreases with rest;
- muscle weakness;
- Intermittent claudication, "duck gait" with bilateral joint damage;
- Limb dysfunction, difficulty in abduction, adduction, rotation.
Infectious diseases
Infectious arthritis, which is also a common cause of coxalgia, can arise due to the penetration of pathogenic microorganisms into the joint tissue through the bloodstream from a distant focus of a viral or bacterial infection. Can be caused by streptococci, staphylococci, Pseudomonas aeruginosa and tuberculosis bacteria, spirochete pallidum, influenza viruses and other pathogens.
In infectious arthritis, joint pain is accompanied by redness and swelling of the surrounding tissue as well as general symptoms - fever, malaise and weakness.
Different reasons
In addition to injuries, inflammation and infections, pain in the hip joint can also have the following causes:
- Innervation disorders.Inflammation and pinched nerve roots, especially of the sciatic nerve, can cause pain in the hip, inguinal triangle, and buttocks.
- Formation of neoplasms, including malignant ones, in the tissue of the joint and its surroundings.
- Aseptic necrosis of the femoral head.Chronic poor blood circulation in the tissue leads to degenerative changes in the cartilage and bone tissue and can lead to the complete destruction of the 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 due to hormonal imbalances in the body. Boys are more susceptible to the disease, but in rare cases girls are also diagnosed with it. As a rule, the pathology is accompanied by delays in sexual development and endocrine disorders.
Pain in the hip joints is common 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;
- Lack of calcium in the body of the expectant mother.
If pain during pregnancy was caused by the above factors, it should disappear without a trace a few weeks after childbirth. If pain persists even a month after the birth of the child, you should consult a doctor.
Alarming symptoms
Pain in the hip joint is an alarming symptom that is a compelling reason to see a 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 other injury, while mobility of the limb is impaired;
- the tissue around the joint is red and swollen and the general body temperature rises to feverish levels (38°C and above);
- There are problems with bowel movements and urination.
diagnosis
The first step in determining the cause of hip pain is to see a doctor. The surgeon or orthopedist will take an anamnesis, determine 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 pelvic bones, thighs, hip joints;
- Ultrasound examination of the joint tissue and the tissues surrounding it;
- MRI and computed tomography to obtain an accurate three-dimensional image of the affected area;
- Endoscopy of the joint with a probe inserted into its cavity;
- Puncture to examine an effusion – pathological accumulation of fluid 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 is caused by an injury, the main conservative treatment method is immobilization of the joint; In some cases, surgery may be necessary. If the pain is inflammatory in nature, non-steroidal or hormonal anti-inflammatory drugs may be prescribed; For general infectious diseases, antibiotic therapy or antiviral drugs are required.
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. Firm bandages, plaster splints or plastic orthoses can be used for fixation.
Drug therapy
Depending on the cause of coxalgia, the following may be prescribed:
- nonsteroidal anti-inflammatory drugs or glucocorticoids to relieve inflammatory processes;
- Chondroprotectors to slow down degenerative changes in joint tissue;
- Antibiotics and antiviral drugs for arthritis of an infectious nature;
- Muscle relaxants to reduce muscle spasms.
Physiotherapeutic procedures
In the rehabilitation period after injuries, as well as during remission of diseases, the following physiotherapeutic methods are used to restore joint mobility, improve blood circulation and restore limb function:
- Physical therapy,
- Massage,
- magnetic field therapy,
- balneotherapy,
- laser therapy,
- UHF heater,
- Hirudotherapy.
Endoprosthetics
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 endoprosthetic surgery - replacement of the head and acetabulum with a prosthesis made of chemically and biologically inert materials.
The operation allows you to shorten the rehabilitation process and restore the patient to full mobility.
Prevention of coxalgia
A number 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;
- Control of body weight, as overweight and obesity place additional strain on the musculoskeletal system;
- avoiding injuries and excessive physical activity;
- rejection of bad habits;
- timely and appropriate treatment of inflammatory and infectious diseases;
- regular check-ups with the doctor.