The hip joints bear the greatest load in the body. They are created by weight during walking, jumping, running, lifting and carrying heavy objects. Patients often feel pain in the hip joint. Orthopedists at a specialized hospital determine the cause using modern diagnostic equipment. Doctors determine the degree of joint damage, which allows them to make an accurate diagnosis and develop optimal treatment tactics.
Professional doctors provide complex therapy for diseases that cause pain in the hip joints. Patients are individually selected drugs that effectively affect the causes and mechanisms of pain development. The rehabilitation clinic's specialists provide rehabilitation therapy using the latest physiotherapy, physiotherapy and acupuncture methods. The presence of special simulators allows you to reduce the load on the joints during exercise.
In the treatment of hip pain, doctors from many fields of medicine are involved: endocrinologists, rheumatologists, orthopedists, physiotherapists, orthopedists, acupuncturist. A multidisciplinary approach to treating hip pain allows for rapid pain relief. Patients with hip pathology often require outside care.
reason
Hip pain is caused by the following pathological processes:
- Tendonitis (tendinitis);
- muscle rupture;
- Iliotibial band syndrome;
- Other local changes in surrounding tissues;
- Systemic diseases (rheumatoid arthritis, polymyalgia).
Because the gluteus medius and minimus play a key role in hip abduction, damage to them will cause hip pain. The gluteus medius and minimus tendons attach to the greater trochanter. If an inflammatory process develops in them due to microtraumas caused by excessive loading, the patient will experience discomfort from pain in the hip joint. Such disorders may be caused by infectious processes (tuberculosis), typical sports or occupational stress, or by the deposition of crystals.
Hip pain is a symptom of the following diseases:
- Osteoarthritis;
- Nerve root syndrome;
- Rheumatoid arthritis;
- Coxita.
Hip pain can bother people who are overweight, have different leg lengths, or have flat feet. Pain syndrome can occur after lower limb amputation or hip replacement. With avascular necrosis of the head and fracture of the femoral neck, the patient complains of acute pain in the hip joint. Pain syndrome often develops along with dysplasia (disorder of the anatomical structure) of the hip joint. Acute pain in the hip joint, spreading to the leg, occurs in cases where nerves are compressed due to spinal diseases, malignant bone tumors, or changes due to age.
Exam method
During the first consultation, rheumatologists conduct a comprehensive examination of the patient:
- Collect complaints, clarify the nature of hip pain;
- Collect information about the course of the disease, onset of pain, progression of pain, and family and occupational factors that, in the patient's opinion, cause pain;
- External examination allows the doctor to identify visible deviations from the norm. To understand the nature of the pain and the area of its spread, the doctor asks the patient to perform various movements of the lower limbs in the hip joint. The presence of hip pathology can be indicated by poor posture;
- Palpation (feeling). The doctor can find rheumatoid nodules, rheumatism, accurately detect the location of pain when moving the leg, determine the humidity and temperature of the skin in the hip joint area.
Next, the doctor conducts goniometry - an examination using a goniometer. It allows you to determine the range of movement of the joint. The rheumatologist then prescribes clinical and biological blood tests and general urine tests. The hospital's laboratory technicians perform research using high-quality reagents and modern equipment, allowing you to obtain accurate test results.
When you have hip arthritis, the number of white blood cells in the blood increases and the erythrocyte sedimentation rate increases. The inflammatory nature of the disease is indicated by an increase in serum C-reactive protein levels.
Immunological blood tests show the presence of antinuclear antibodies in the blood in rheumatoid arthritis. In patients with arthritis, serum uric acid levels increase sharply. The content of lysosomal enzymes (acid proteinase, acid phosphatase, cathepsin, deoxyribonuclease) in serum and synovial fluid changes in patients with rheumatism, psoriatic polyarthritis, rheumatism and ankylosing spondylitis. In severe forms of hip pathology, significant deviations from the norm are observed in urinalysis.
Doctors at the clinic conduct X-rays for patients with hip pain. It is indicated in the following cases:
- The presence of chronic or acute pain in the hip joint at rest and during movement;
- Difficulty appearing when moving the lower limbs;
- Swelling and skin discoloration appear in the hip joint area.
Using computed tomography, doctors at the clinic evaluate the bones involved in the formation of the hip joint. On computed tomography scans, radiologists find changes in the structure of bone tissue, the development of cartilage and bone cells.
Using magnetic resonance imaging, doctors evaluate the condition of the soft tissues that surround the hip joint.
Radionucleotide research method helps identify pathologies by using radioactive drugs.
Ultrasound examination of the hip joint is performed to detect injuries, inflammatory diseases, rheumatism, and rheumatoid arthritis. The attending physician will individually select the necessary research methods in each case to determine the cause of hip pain.
Differential diagnosis
Hip pain when walking is the main complaint for which patients should consult their doctor. It can be located in the joint area or extend to the thigh, buttocks or knee joints. If the hip joint hurts when moving, the patient is forced to use a cane. Often, due to pain, mobility is limited when moving the hip joint, especially when rotating the leg outward and inward.
Pain in the hip joint, buttocks, and groin is a symptom of aseptic necrosis of the femoral head. The disease is often associated with long-term use of hormonal drugs and alcohol abuse. With the development of deformity of the femoral head, the mobility of the hip joint is limited. In the early stages of the pathological process, range of motion may be normal.
Pain in the anterior part of the hip joint and a clicking sound when moving the joint bother patients with pelvic bursitis. It spreads down the thighs and is accompanied by paresthesia (tingling, burning, crawling sensation) due to compression of the femoral nerve. The patient feels pain in the hip joint when bending and extending the lower limb. Pain is also detected during deep palpation in the area of the femoral triangle (a formation limited by the inguinal ligament, the outer edge of the adductor longus, the inner edge of the sartorius muscle).
Lateral hip pain is a sign of iliotibial ligament syndrome. Accompanied by a clicking sound when moving, pain in the outer part of the knee joint, gradually increasing when moving.
Roth myalgia is manifested by a burning pain in the outer front of the hip and thigh joints, the pain increases when walking and straightening the legs. Hip pain occurs with dysplasia. Over time, the patient develops a characteristic "duck" gait (he walks, waddling from side to side).
Pain due to coxarthrosis
Hip pain occurs when you have coxarthrosis, a disease characterized by a degenerative process in the bones that form the joint. Usually the disease affects older people. With age, the cartilage tissue of the joints loses its elasticity, becomes thin and begins to wear out. As the load on the joint increases, the thin cartilage tissue is destroyed. The articular surfaces of the bones rub against each other, leading to sterile inflammation.
Growths appear on bones. They significantly limit movement in the joint. Deformation of the joint surface develops, leading to severe pain. Treatment depends on the severity of joint damage. Doctors provide drug therapy. If it is ineffective, endoscopy is performed or palliative treatment is used.
After determining the cause of hip pain, doctors begin treating the disease that caused the pain syndrome. Serious cases of illness in which the patient has pain in the hip joint will be discussed at a meeting of the professional council with the participation of professors, doctors and candidates of medical sciences, doctors of the highest category.
Treatment
An important condition for successful treatment of diseases that cause hip pain is to eliminate factors that cause changes in the structure of bone, cartilage and soft tissue in the joint area. For acute pain, the hospital's rheumatologists prescribe nonsteroidal anti-inflammatory drugs. The patient's health improves significantly when using local treatments - external application of gels and ointments, patches containing non-steroidal anti-inflammatory drugs. They relieve pain in the hip joint during inflammatory processes of soft tissues (tendinitis, bursitis, epicondylitis) after injury.
If this therapy is not effective enough, the doctor will inject glucocorticoids into the hip joint cavity. The joint space deformed by coxarthrosis is narrowed and difficult to enter. For this reason, rheumatologists at a specialized clinic perform the procedure under X-ray control. When there is pain due to inflammation of the muscles and tendons, glucocorticoid hormones are injected into the tissues around the joint.
To improve the condition of cartilage and reduce pain in the hip joint, people use cartilage protectants. The treatment process lasts several months. When there is spasm of the muscles involved in movement in the hip joint, muscle relaxants are prescribed to reduce the tone of the skeletal muscles.
Drug treatment is supplemented with physiotherapeutic procedures. They are of secondary importance for pain in the hip joint. The effectiveness of physical therapy treatments is reduced due to deep lying. The severity of pain in the hip joint decreased after ultraviolet irradiation with medium-length waves.
In the presence of an inflammatory process, high-intensity centimeter wave therapy, low-intensity infrared and UHF laser treatment are performed. Intense high-frequency magnetic field therapy, ozone therapy, shock wave therapy stimulate tissue recovery. The intensity of pain that occurs due to circulatory and nutritional disorders of the hip joint is reduced under the influence of various types of electrotherapy (exposure to electric current) and ultrasound.
To reduce the load on the hip joint, rheumatologists advise patients to use a cane if they experience acute pain. After reducing the severity of the pain syndrome, the rehabilitator proceeds to therapeutic exercises. An individual set of exercises is developed for each patient to quickly restore the function of the lower limbs. When the structures involved in forming the hip joint are destroyed, the pain can be so severe that the only method of eliminating it is to replace the joint with a prosthesis.
Nonsteroidal anti-inflammatory drugs are prescribed for pain relief. Treatment depends on the disease affecting the hip joint. Patients are prescribed chondroprotective drugs to treat cartilage tissue damage. Orthopedists prescribe effective treatments, diets and exercises to improve blood circulation in the joints, restore cartilage tissue and maintain joint mobility. In severe cases, arthroscopic joint replacement is required, which significantly improves quality of life and eliminates pain.
Treatment is with exercise therapy
The use of rehabilitation techniques in the treatment of the hip joint allows you to maintain its mobility, improve blood circulation in the joint and accelerate the recovery of cartilage tissue. Specialists at the rehabilitation department choose a set of physiotherapy exercises taking into account the patient's joint disease. Rehabilitation classes are conducted daily under the supervision of an instructor. For rehabilitation therapy, special simulators are used and physiotherapy procedures are prescribed in combination with physical education.
What disease causes joint pain?
Right or left hip pain can be a sign of avascular necrosis. The disease develops mainly in men and affects only one joint. Treatment includes eliminating pain, restoring blood supply to the joint area, normalizing the muscles of the limb and maintaining joint function. Patients are prescribed pain relievers and anti-inflammatory drugs, vitamins, physical therapy procedures, and therapeutic exercises. Patients should wear orthopedic shoes and use additional support when moving.
The cause of hip pain may be due to pus formation. Primary purulent arthritis develops when there is a wound or injury and infectious agents enter the joint cavity. A secondary purulent process develops when sepsis or infectious agents enter the joint from surrounding tissues affected by the inflammatory process. To treat purulent arthritis, professional specialists perform antibacterial therapy. If pus accumulates in the joint cavity, a hip puncture is performed, the contents are evacuated, and antibacterial agents are injected into the joint cavity.
Bursitis is an inflammation of the joint lining. To relieve pain, doctors prescribe anti-inflammatory drugs and glucocorticoids. If purulent inflammation develops, the synovial cavity around the joint is cleaned. In severe cases, using surgical arthroscopic techniques, the joint capsule that has undergone irreversible changes is removed.
In osteoporosis, femoral neck fractures often occur. The patient is uncomfortable because of sharp, intense pain when moving in the hip joint, spreading to the groin and inner thigh. Legs turned outward. Bruising and swelling appear in the hip joint area. In this case, treatment is performed by professional orthopedists.
Traumatic hip dislocation is accompanied by hip pain. The hip is reduced under general anesthesia. Congenital hip dislocation is diagnosed soon after birth. It is manifested by severe pain when spreading the legs and bending the knees. Treatment is carried out using special orthopedic structures.
If you or a loved one has hip pain, do not self-treat. Seek professional medical attention immediately. Patients with acute pain are usually hospitalized at the clinic for at least a week. If the pain is not severe, the patient may be advised by a specialist to examine the hip joint and treat it at home with strict adherence to all rules.