The hip joint is the largest joint in the human body. He makes thousands of movements every day as he walks, runs, climbs stairs and does physical exercises. Constant loads, inflammatory processes, injuries and diseases can cause coxalgia - pain in the hip joint. It is necessary to determine the cause of its occurrence as soon as possible in order to avoid limitation of mobility and disability.
Classification of pain sensation
When visiting a doctor, it is necessary to describe the nature of the pain in detail: its degree of 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, even unbearable. It can appear suddenly, but it can also disappear suddenly. As a rule, a patient with acute pain can indicate the area of its localization quite precisely. Acute pain can radiate, spreading to the areas closest to the source of the pathology.
- Aching.The pain is not so intense, sometimes it can be felt as discomfort and has no exact localization. Aching 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 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
In the case of traumatic damage to the hip joint and femur, pain appears immediately, followed by redness and swelling of the tissue, limited mobility of the extremities and the formation of large hematomas. Depending on the severity of the lesion, the pain can be more or less intense.
If you bump or fall on your side, soft tissue bruising may occur. It is characterized by hematoma formation, pain at the site of the lesion intensifies when palpated. Unlike dislocation and fracture, with a bruise there is no limitation in the mobility of the injured leg, there are no visually noticeable deformities, and the limb fully retains its functions.
Dislocation of the hip joint in a healthy person can occur only under a very strong physical impact, for example, when falling from a great height or in a traffic accident.
The limb takes a forced rotational position, most often inwards, less often outwards. The pain is intense, accompanied by swelling, stiffness (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 neck of the femur - an injury that mostly affects older 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 less 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 meets 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 the injured leg;
- limited mobility, inability to lean on the injured leg;
- external rotational position of the limb;
- Stuck heel syndrome - the 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 fragments of the bone become wedged into each other. In this case, the functions of the limbs may be partially or even completely preserved, but when the fragments are crushed, the signs of injury will appear completely. 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 the tissues of the joint or its surroundings.
Arthritis is an inflammation of the cartilaginous tissue of the 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 increases after exercise or at night, are 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 of an autoimmune nature. Women are more susceptible to this disease. It affects both small and large joints, most often pairs. Characteristic symptoms of rheumatoid arthritis:
- joint pain, which worsens at night and disappears after movement;
- formation of subcutaneous compactions in the area of the affected joint, 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, followed by the pathological accumulation of exudative fluid in the joint tissues. The main causes of the development of the disease are injuries, excessive physical activity, infections and complications of arthritis of various etiologies. 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 determined. There is an assumption 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, its 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 serious deformations of joint tissue, which leads to deep 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 older than 40-45 years. The disease is chronic and steadily progressive. The causes of its development are considered to be chronic injuries, hereditary predisposition, age changes and accompanying inflammatory diseases of the joints. In young people, the development of coxarthrosis can be a consequence of congenital dysplasia of the hip joint.
Symptoms of pathology:
- pain in the groin, lower back, buttocks, thighs, which increases with movement and subsides at rest;
- muscle 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 entry of pathogenic microorganisms into joint tissue from a distant focus of viral or bacterial infection through the bloodstream. They can be caused by streptococcus, staphylococcus, Pseudomonas aeruginosa and tuberculosis bacilli, spirochetes pallidum, influenza virus and other pathogens.
In infectious arthritis, pain in the joints 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 hip, inguinal triangle, and buttocks.
- Formation of neoplasms, including malignant ones, 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 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 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, the pathology is accompanied by a delay in sexual development and endocrine disorders.
Pain in the hip joints is a common occurrence in women in the 3rd trimester of pregnancy. Causes of coxalgia in pregnant women:
- increasing body weight and moving the center of gravity, redistributing the load on the musculoskeletal system;
- natural hormonal changes: just before childbirth, a woman's body begins to produce a hormone that relaxes 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 the pain during pregnancy is caused by the above factors, a few weeks after birth they should disappear without a trace. If the pain is still present a month after the birth of the child, you should consult a doctor.
Alarming symptoms
Pain in the hip joint is an alarming symptom, which is a mandatory reason to visit a doctor. The sooner the cause of coxalgia is determined, the greater the probability of a complete cure. However, there are cases when you should urgently seek medical help:
- pain in the joint area occurs after a fall, blow, bruise or any other injury, while the mobility of the extremities 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.
Diagnostics
The first step to 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, frequency and degree of its manifestation, and will also examine the patient in order to assess the mobility of the joint and the condition of the tissues surrounding it. To establish an accurate diagnosis, laboratory and instrumental diagnostic methods can be prescribed:
- general, biochemical, serological, immunological blood tests;
- radiography of pelvic bones, thighs, hip joints;
- ultrasound examination of the tissue of the joint and the tissue around it;
- MRI and computed tomography to obtain a precise three-dimensional image of the affected area;
- joint endoscopy using a probe inserted into its cavity;
- puncture for the study of effusion - pathological fluid that accumulates in 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 method of treatment will be immobilization of 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; General infectious diseases will require antibiotic therapy or antiviral drugs.
The pain syndrome, regardless of the cause of its occurrence, is alleviated by taking analgesics or injection blocks.
Immobilization
Immobilization is most often prescribed for joint injuries. Firm bandages, plaster casts 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 alleviate inflammatory processes;
- chondroprotectors for slowing down degenerative changes in joint tissues;
- antibiotics and antiviral drugs in case of infectious arthritis;
- muscle relaxants to reduce muscle spasms.
Physiotherapy procedures
In the rehabilitation phase after injuries, as well as in the period of disease remission, 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.
Endoprosthetics
In some cases, conservative treatment of hip pain may be ineffective. Aseptic necrosis, coxarthrosis in the late stage, femoral neck fracture in the elderly are direct indications for endoprosthetic surgery - replacing 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 hip joint pain, including:
- regular feasible physical activity to strengthen muscles and ligaments;
- nutritious and balanced diet;
- weight control, because overweight and obesity create additional stress on the musculoskeletal system;
- avoiding injuries and excessive physical activity;
- rejection of bad habits;
- timely and adequate treatment of inflammatory and infectious diseases;
- regular preventive examinations at the doctor.