Hip pain

The human hip joint is subjected to enormous stress. Walking, lifting and carrying heavy objects, jumping, running, bending over, other physical exercises and even being overweight all put stress on the musculoskeletal system. Pain in the hip joint reduces its function, interferes with free movement and causes suffering to the patient not only during movement, but also during rest. It is very important not to ignore pain and at the first symptoms of discomfort, immediately seek help from a qualified doctor. Orthopedists, traumatologists, surgeons, neurologists and several other specialists together evaluate the symptoms, find the cause and treat pain in the hip joint.

Cause of pain

There are a large number of diseases and pathological conditions that can be accompanied by pain. Pain in the hip joint on the left or right side can be caused by injuries, inflammatory and infectious pathologies, various degenerative processes, problems with the supply of useful minerals to bone tissue, etc.

Injuries to the soft tissues and osteoarticular structures of the hip area are the most common causes of discomfort. This includes:

• bruises;
• penetrating wound;
• femoral neck fracture;
• hip dislocation;
• Fractures of the acetabulum and the upper part of the femur (the so-called pertrochanteric fracture).

Of the traumatic causes, damage to the ligament apparatus (sprain, tear, rupture) is less common. Often, it is caused by severe injuries that the patient receives as a result of an accident, prolonged exposure to debris, or as a result of performing extreme actions.

Infectious, inflammatory and degenerative diseases that can cause pain in the hip joint include:

• various forms of arthritis (infectious, aseptic, rheumatoid);
• panarthritis - purulent inflammation of the entire hip joint;
• osteomyelitis;
• hip joint dry cough;
• coxarthrosis and other types of arthrosis;
• bursitis;
• aseptic necrosis of the femoral head, including Perthes disease;
• chondromatosis;
• trochanteritis.

Other pathological factors include:

• congenital anomalies of hip joint development (dysplasia, congenital hip dislocation, limb shortening);
• various malignant and benign neoplasms;
• sciatic nerve neuropathy;
• osteochondrosis, scoliosis, intervertebral hernia and other spinal diseases.

Pain in the hip joint when walking or lying down may indicate excessive stress on the musculoskeletal system. Discomfort may occur after strength training, carrying heavy objects, or walking or standing for long periods of time. Risk groups include athletes, extreme sports enthusiasts, loaders, teachers, lecturers, salesmen, couriers, etc.

Other causes of severe pain in the hip joint when walking and resting may be:

• overweight, which greatly increases the pressure on the joints;
• posture disorders;
• irrational use of certain drugs;
• diabetes;
• neuropsychiatric disorders.

The largest number of patients with pain of varying intensity in this area are people over 50 years old. This is explained by age-related changes in the periarticular tissue and the joint itself. It has been observed that women experience pain more often than men.

Types and symptoms of hip pain

The main manifestation is an unpleasant sensation in the joint area of various types: sharp, throbbing, painful, dull, cutting, etc. The localization and intensity of the pain syndrome depends on the initial disease and the patient's health characteristics (presence of concomitant pathologies, overweight, risk factors). Often the pain syndrome spreads to the surrounding structures, radiating to the limbs, sacrum and coccyx, and lower back.

Symptoms that may accompany hip pain include:

• tissue swelling in the joint area;
• pulsating, clicking and other sounds when moving;
• limited mobility;
• numbness, decreased sensitivity in the legs;
• feeling of heat, pulsation in the damaged area;
• lameness, dragging feet;
• shorten the limbs;
• bruises;
• body temperature rises.

Pain in the hip joint, radiating to the lower back, legs, groin and sacral area, may indicate ankylosing spondylitis. The disease is also accompanied by stiffness of movement, discomfort in the knees, and periodic "lumbago". Symmetrical pain in the hip area, combined with conjunctivitis and damage to the genitourinary system, can be a sign of Reiter's syndrome.

The clinical picture is determined by the main disease or injury. In mild cases, the patient's movement is limited, but the ability to support the leg remains. With severe bruises, fractures, dislocations and severe forms of infectious and inflammatory diseases, support on the affected leg is impossible; the patient can only move with the help of additional points or cannot walk at all.

Diagnostics

To determine the true cause of pain, other symptoms of the main disease/injury and choose an effective treatment regimen, a comprehensive examination is conducted.

First of all, a physical examination is performed. The doctor evaluates the external signs of pathology, palpates the area of articulation, asks detailed questions about the nature of the complaint, the time and circumstances of its occurrence, etc. Specialists also need to know about previous surgical interventions and injuries, existing chronic pathologies (including those not directly related to the musculoskeletal system), lifestyle, etc.

A comprehensive objective exam includes:

• ultrasound examination of the hip joint (ultrasound);
• radiography of the pelvis in two projections;
• magnetic resonance or computed tomography (as indicated);
• joint puncture;
• diagnostic arthroscopy;
• laboratory tests (general clinical blood and urine tests, biochemistry, analysis for rheumatoid factors, tumor markers, etc. ).

The exact list of procedures is determined by the doctor based on the medical history, the characteristics of the patient's current condition, and the expected diagnosis.

Hip pain treatment

Medical treatment tactics depend on the cause of the pain. For sprains and bruises, the joint is immobilized, the patient is given painkillers, and placed on a tight bed. In case of dislocation, the joint is realigned, followed by fixing the limb in a stationary position. For fractures, skeletal traction, plaster immobilization, or wearing a special structure is indicated.

For hip pain caused by inflammatory or infectious causes, treatment may include:

• antibacterial drugs;
• anti-inflammatory drugs;
• corticosteroid hormones;
• painkillers;
• chondroprotector;
• cytostatic;
• ointments, creams and other topical agents that stimulate blood flow;
• vitamin complex;
• synovial fluid substitute.

Patients are required to receive a complex of physiotherapy, physical therapy and massage necessary to restore motor activity, normalize joint nutrition, and eliminate signs of inflammation. This may include:

• massage;
• UHF;
• laser therapy;
• electrophonophoresis;
• magnetic therapy;
• shock wave therapy;
• hydrotherapy and swimming.

The patient's lifestyle is corrected: prevention of obesity, normalization of physical activity, limitation of strength loads, etc.

If conservative treatment does not have the desired effect or the main disease is treated only by surgery, surgical intervention is prescribed. It is performed using an open approach or using arthroscopic techniques. As part of the surgical treatment of diseases that cause pain in the hip joint, the following can be done:

• reduction of dislocations;
• reconstruction of individual joint structures;
• endoprosthetics;
• tumor removal;
• permanent fixation of joints (arthrodesis);
• arthroplasty.

This and other surgical treatment methods are selected according to the diagnosis and characteristics of the patient's current condition. After surgical treatment, the patient undergoes a rehabilitation course.

Complications

Pain in the hip joint should not be ignored. Even small and temporary discomfort can lead to the development of serious diseases in the future. In complex cases, the consequences may be irreversible.

Possible complications include:

• limb disability;
• lameness;
• the transition of pain into a chronic form (in this case, they are present almost always);
• violation of the intra-articular body;
• deep vein thrombosis;
• heterotopic ossification (formation of bone plates in soft tissue);
• arthrosis;
• contracture: impaired joint mobility;
• necrosis;
• pathological fracture.

Without treatment, the pathology can cause persistent mobility impairment, inability to live a full life and even take care of oneself, and disability. With an extensive purulent process in the hip joint area, if there is no treatment, infectious toxic shock or sepsis can develop, which can be fatal.

Prevention

First of all, experts recommend leading a healthy lifestyle:

• move more, but do not overload the body with excessive training;
• monitor body weight to prevent obesity;
• eat a nutritious and varied diet (diet should be balanced in terms of basic macro and micronutrients, as well as total calorie content);
• Do not use systemic drugs without a doctor's prescription.

For people who, due to their professional activities, have to spend a lot of time on their feet, it is advisable to regularly rest the body and undergo a preventive examination by an orthopedic-traumatologist at least once a year.

Patients with diseases of the musculoskeletal system must be under the observation of a dispensary, strictly follow medical instructions and monitor their condition.

To avoid injury to the hip joint, it is recommended to avoid extreme sports, wear protective equipment during exercise, and do not perform complex exercises without the necessary skills and physical training.

Older people are advised to move very carefully in icy conditions and not go out unless absolutely necessary.

Treatment of hip pain in a professional clinic

The doctors of the multidisciplinary center are high-class specialists with the necessary practical skills and extensive knowledge in various fields of medicine. They consider the patient's problem individually, drawing up a diagnostic and treatment program taking into account all health characteristics. Specialists use an integrated approach to solve various health problems. They not only eliminate certain symptoms, but also try to identify and eliminate their causes, clear and unclear consequences. This is the only way to fully restore the patient's health, to return him to the opportunity to lead a normal life, to move without pain or restriction.

When seeking medical help from a clinic doctor, everyone has the right to rely on the friendly attitude of specialists and junior staff, assistance in rehabilitation, and objectivity.