The hip joint is the largest joint in the human body. He makes thousands of movements every day when he walks, runs, climbs the stairs, and does physical exercises. Constant loads, inflammatory processes, injuries and diseases can cause coxalgia - pain in the hip joint. In order to prevent restriction of movement and disability, it is necessary to determine the cause of its occurrence as soon as possible.
Classification of pain sensations
During a visit to the doctor, it is necessary to describe the nature of the pain in detail: the degree of its severity, intensity, frequency - the correctness of the diagnosis depends on this. Depending on the nature of the pain, it can be:
- spicy.In this case, the pain is severe, even unbearable. It can suddenly appear and suddenly disappear. As a rule, a patient with acute pain can indicate its localization quite accurately. Acute pain can radiate to the areas closest to the source of the pathology.
- Painful.The pain is not so strong, sometimes it can be felt as discomfort and does not have a precise localization. The aching pain may intensify during movement or after exercise and disappear for a while.
- Chronic.This category usually includes pain that occurs with varying regularity over a period of 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 tissue, limited mobility of the limb, and the formation of large hematomas. Depending on the severity of the lesion, the pain may be more or less intense.
Soft tissue bruising can occur if you are hit on the side or fall. It is characterized by the formation of hematomas, pain at the site of the lesion intensifies when palpated. Unlike sprains and fractures, there are no restrictions on the mobility of a leg injured by a bruise, there are no visually noticeable deformations, and the limb completely 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 car accident.
The limb assumes a position of forced rotation, often inward, less often outward. The pain is severe, accompanied by swelling, numbness (if the nerves are affected), the victim cannot move the affected limb.
Femoral neck fracture
The cause of pain in the hip joint may be a violation of the integrity of the femoral neck - this is an injury that mainly affects older women over the age of 60. After menopause, age-related and hormonal changes in the body accelerate the process of calcium leaching, making the bones fragile and fragile, even with a small exposure. A fall, bruise, or even a careless movement can cause a fracture of the femur at the thinnest point where the diaphysis meets the head embedded in the femur.
Symptoms of a hip fracture include:
- pain in the pelvis, radiating to the groin and lower back, aggravated by hitting the heel;
- shortening of the injured leg;
- limited mobility, it is impossible to lean on the injured leg;
- external rotation position of the limb;
- "Stuck heel" syndrome - inability to raise the straight leg from the surface from a lying position.
A fracture of the femoral neck can be affected - in this case, the bone fragments stick together. In this case, the functions of the limb may be partially or even completely preserved, but when the fragments are crushed, the signs of injury will be fully visible. Such an injury requires immediate intervention, so if you suspect a fracture, you should seek medical attention as soon as possible.
Inflammatory processes
One of the main causes of cochalgia is inflammatory processes in the tissues of the joint or its surroundings.
Arthritis is an inflammation of the cartilage tissue of the joint. The causes can be infections, chronic injuries, metabolic disorders, excessive stress, systemic connective tissue diseases. Symptoms of the disease include redness and swelling of tissues in the affected joint area, local temperature increase, and limited mobility of the leg, in addition to pain that worsens after exercise or at night.
Rheumatoid arthritis is a systemic connective tissue disease of an autoimmune nature. Women are more susceptible to the disease. It affects both small and large joints, most commonly paired joints. Characteristic symptoms of rheumatoid arthritis:
- pain in the joints, worse at night and less after movement;
- the formation of subcutaneous compressions called rheumatic nodes in the affected joint area;
- 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, accompanied by the pathological accumulation of exudative fluid in the tissues of the joint. The main reasons for the development of the disease are injuries, excessive physical activity, infections and complications of arthritis of various etiologies. The pain from bursitis is deep, spreading to the inner surface.
Ankylosing spondylitis is an idiopathic disease, which means that in most cases the exact causes of its occurrence cannot be determined. There is an assumption that the pathology is determined genetically, and hereditary predisposition plays a major role in its development.
Most often, the manifestation of the disease occurs at the age of 20-30, its first symptoms are pain in the 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 the joint tissue, which leads to deep disability.
Degenerative tissue changes
Coxarthrosis, or osteoarthritis of the hip joints - a degenerative change in the cartilage tissue - is a common cause of coxalgia in people over 40-45 years old. The disease develops chronically and continuously. The causes of its development are chronic injuries, hereditary predisposition, age-related changes, accompanying inflammatory diseases of the joints. The development of coxarthrosis in young people may be due to congenital dysplasia of the hip joint.
Symptoms of pathology:
- pain in the groin, lower back, hip, thigh, increases with movement and decreases with rest;
- muscle weakness;
- intermittent claudication, "duck" gait with bilateral joint damage;
- limb dysfunction, 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 from a distant focus of viral or bacterial infection through the bloodstream. Streptococci, staphylococci, Pseudomonas aeruginosa and tubercle bacilli, spirochetes pallidum, influenza virus and other agents can cause.
Joint pain with infectious arthritis 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 be caused by:
- Innervation disorders.Inflammation and compressed nerve roots, especially the sciatic nerve, can cause pain in the buttock, inguinal triangle, and hip.
- Formation of neoplasms, including malignant ones, in joint tissues 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, which is a pathological displacement of the femoral head caused by hormonal disorders in the body. Boys are more susceptible to the disease, but it is rarely 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 phenomenon in women in the 3rd trimester of pregnancy. Causes of coxalgia in pregnant women:
- increase in body weight and shift in the center of gravity, 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 bonds;
- 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 body of the expectant mother.
If pain during pregnancy is caused by the above factors, they should disappear without a trace after a few weeks after birth. If the pain still persists a month after the birth of the child, you should consult a doctor.
Disturbing symptoms
Pain in the hip joint is an alarming symptom, which is a mandatory reason to visit a doctor. The sooner the cause of cochalgia is identified, the higher the chance of complete recovery. However, there are situations in which you should seek immediate medical attention:
- pain in the joint area occurs after a fall, blow, bruise or any other injury, when the mobility of the limb is impaired;
- tissues around the joint redden and swell, the general body temperature rises to the level of fever (38 and above);
- there are problems with defecation and urination.
Diagnostics
The first step in determining the cause of hip pain is to see a doctor. A surgeon or orthopedist collects an anamnesis, studies the nature of pain, the frequency and degree of its manifestation, and also examines the patient to assess the mobility of the joint and the condition of the tissues around it. To make an accurate diagnosis, laboratory and instrumental diagnostic methods can be prescribed:
- general, biochemical, serological, immunological blood tests;
- x-ray of pelvis, thighs, hip joints;
- ultrasound examination of joint tissues and surrounding tissues;
- MRI and computed tomography to obtain an accurate three-dimensional image of the affected area;
- endoscopy of the joint using a probe inserted into its cavity;
- puncture to study effusion - pathological fluid accumulated in joint capsules;
- tissue biopsy.
Treatment methods
Treatment of conditions that cause hip pain depends on the underlying cause. In cases where the pain is caused by an injury, the main conservative treatment will be joint immobilization; in some cases, surgery may be required. If the pain is inflammatory in nature, non-steroidal or hormonal anti-inflammatory drugs can be prescribed; Antibiotic therapy or antiviral drugs will be required for common infections.
Pain syndrome, regardless of the cause, is eliminated by taking analgesics or injection blocks.
Immobilization
Immobilization is prescribed most often for joint injuries. Tight bandages, plaster splints or plastic orthoses can be used for fixation.
Drug therapy
Depending on the cause of coxalgia, the following can be prescribed:
- non-steroidal anti-inflammatory drugs or glucocorticoids to eliminate inflammatory processes;
- chondroprotectors to slow down degenerative changes in joint tissues;
- antibiotics and antiviral drugs in case of infectious arthritis;
- a muscle relaxant to reduce muscle spasms.
Physiotherapy procedures
In the rehabilitation phase after injuries, as well as during disease remission, the following physiotherapy methods are used to restore joint mobility, improve blood circulation and restore limb function:
- physiotherapy,
- massage,
- magnetic therapy,
- balneotherapy,
- laser therapy,
- UHF heating,
- hirudotherapy.
Endoprostheses
In some cases, conservative treatment of pain in the hip joint may not be effective. Aseptic necrosis in the elderly, late-stage coxarthrosis, fracture of the femoral neck are direct indications for endoprosthetic surgery - replacement of the femoral head and acetabulum with a prosthesis made of chemically and biologically inert materials.
The operation allows to shorten the rehabilitation process and return the patient to full movement.
Prevention of cochalgia
A number of preventive measures will help prevent hip joint pain, including:
- regular possible physical activity to strengthen muscles and ligaments;
- nutritious and balanced diet;
- body weight control, as excess weight and obesity create additional stress on the musculoskeletal system;
- avoid injuries and excessive physical activity;
- giving up bad habits;
- timely and adequate treatment of inflammatory and infectious diseases;
- regular preventive examinations with a doctor.