Hip pain: causes and treatment

If you feel pain in the hip joint, you need to find out the cause.The treatment of pain depends on the pathology of which it is a symptom.Complex measures and strict adherence to recommendations will help to get rid of the disease and maintain the motor activity of the joint.Impaired function of the hip joint leads to the impossibility of active movement.Reduced functionality limits the patient's ability to move independently and work.

Anatomical features

A large joint connects the femur and pelvis and provides the ability to move in three directions: flexion and extension, abduction and rotation of the lower limb.Degenerative changes leading to deformity limit movement and cause pain.

The hip joint is supplied with blood through the main femoral arteries located in the area of the joint.Pathologies that can disrupt vascular capacity lead to oxygen starvation and nutrient deficiency.

The large nerve trunks of the sciatic, obturator, and femoral nerves provide innervation.Compression or pinching of the nerve endings results in intense neurological pain in the pelvic region.
 

Causes of hip pain

The development of diseases of different etiology in the area of the hip joint leads to serious health problems, including disability.The appearance of pain in the hip joint accompanies any pathology at different stages of its development.

The cause of the pain determines its nature and intensity.Acute pain occurs due to injuries, inflammatory, purulent processes, while painful, non-intense sensations are the result of chronic diseases.

Numerous pathologies of unknown origin and birth defects lead to the appearance of symptoms.The syndrome is present initially or may appear as a result of progression of the pathological condition.

Provoking diseases

• Trauma of varying severity is one of the most common causes.Bruises, sprains and fractures cause mechanical damage to bones and ligaments.On the first day after the injury, acute pain was observed in the hip joint.Subsequently, the pain weakens, becomes muted.Common injuries: pelvic fracture, hip luxation, femoral neck fracture.All of the above injuries occur after direct severe injury from a fall or impact.The situation becomes more complicated if a person has a history of osteoporosis or degenerative changes in the cartilage and bone tissue of the joint.
• Myositis ossificans is characterized by inflammation in the connective tissue of the joint capsule.Appears after injury or when inherited from parents.The progressive course leads to morphological changes in the cartilage tissue, which over time degenerates into bone formations.
• A dislocated hip, whether present at birth or developed in the womb, results in deformities, limited movement and pinched nerves.In this pathology, not only somatic but also neuropathic pain occurs in the hip joint.
• Coxarthrosis is a common pathology in elderly people who lead a sedentary lifestyle or perform heavy physical work.Dystrophic changes in the cartilage and subsequent bone deformation cause pain.The first symptoms appear as a result of severe stress.The advanced course is accompanied by constant dull pain that does not disappear during rest or prolonged sleep.The worsening of the syndrome continues in parallel with progressive changes in the hip joint.
• Arthritis - inflammation in the joint capsule is accompanied by severe throbbing pain.It can appear as an independent disease or as a complication after an injury or infectious disease.
• Reiter's syndrome is a reactive lesion of an allergic nature, most often occurring after infectious pathologies.There are cases when the condition develops after penetration of chlamydia or gonococcus into the joint capsule.The pathology is accompanied by acute pain in the hip joint and tissue swelling.
• Rheumatoid arthritis is a systemic disease of the immune system in which the body's own cells recognize healthy tissue as a foreign organism and attempt to destroy it.This condition leads to modification of joint tissues against the background of severe inflammatory processes.
• Ankylosing spondylitis is a systemic joint disease of a chronic nature.Localization of the process in the iliosacral region is accompanied by pain in the pelvic region, progressing mainly at night.The patient's pain intensifies in the morning, the stiffness disappears after active movements or exercises.
• Osteochondritis dissecans, also known as Koenig's disease, develops in the cartilage that comes into contact with the femur.The cartilage begins to delaminate with further separation of a small area.The condition is often complicated by the addition of synovitis.Patients complain of pain in the hip joint;in the final stages, complete blockade occurs due to the presence of necrotic cartilage tissue in the joint cavity.
• Legg-Calvé-Perthess disease is a pathology similar to osteochondropathy, which develops when blood circulation and nutrition in the hip joint are disturbed.It is characterized by gradual necrosis of the femoral head, which is accompanied by pain and gait disturbance due to acquired shortening of the limb.The disease is considered pediatric, as children of preschool and primary school age are more often affected.
• Bursitis is an inflammation of the synovial bursa, followed by its filling with a pathogenic fluid.The disease occurs in the bursae located near the hip joint, causing pain mainly during loading or palpation.
• Synovitis is an inflammatory damage to the synovial membrane covering the walls of the joint capsule.In the acute period, there is constant severe pain in the hip joint;during the chronic course, the symptoms are smoothed out.
• Symphysitis - changes in the tissues of the pubic symphysis with divergence of the pubic bones.Occurs during pregnancy and childbirth.The pathology has an inflammatory nature, accompanied by severe pain in the pubic area, spreading to the area of the hip joint.
• Pelvic radicular syndrome is represented by neuropathic pain.The syndrome occurs due to compression of large nerves located in the area of the junction of the femur and pelvis by bony growths and deformed tissues.
• Varus deformity of the foot, flat feet, can be a congenital defect or an acquired condition.Improperly distributed load on the legs, due to the displacement of the front part of the foot inwards, negatively affects the hip and knee joints.Over time, with improper actions or lack of treatment, the hip joint deforms, causing pain.
• Enthesopathy is degenerative-dystrophic processes in the ligament apparatus of the joint.The processes are often accompanied by inflammation.The disease condition leads to a weakening of the structure of the ligaments and tendons with possible rupture of the connective tissue.In addition, there is ossification of certain areas, which reduces the functionality of the joint.
• Intermittent hydrarthrosis is a chronic joint pathology in which increased synthesis of synovial fluid is observed, accompanied by an increase in joint volume and a decrease in motor activity due to pain.
• Synovial chondromatosis is the degeneration of areas of the synovial membrane of the joint into cartilaginous formations.New growths can reach the size of a matchbox.Accompanied by severe pain during movement, a decrease in amplitude to complete blocking of the hip joint.
• Juvenile epiphysiolysis is a pathological downward and backward displacement of the femoral head.Boys get sick during puberty, when a malfunction occurs due to an imbalance in the synthesis of sex hormones and growth hormones.Pain in the hip joint occurs when trying to move the leg.
• Aseptic necrosis of the femoral head can develop due to acute circulatory failure in the hip joint.Against the background of the death of bone tissue, intense pain turns into a burning sensation, which sharply limits the ability to move the affected leg.Attacks last several days and pass before the onset of the next acute phase.
• There are known cases of gout developing in the hip joint.Excessive formation of uric acid with insufficient excretion crystallizes and settles in the joint cavity, gradually filling it.During a gout attack, pain occurs that cannot be tolerated.
• Malignant neoplasms in the bones or surrounding tissues.

Symptoms

Pain in the hip joint is divided into 3 degrees:

1. mild - accompanies minor injuries and consequences after intense stress on the muscles of the thigh and buttocks;
2. medium - occurs in pathologies of a dystrophic, inflammatory and infectious nature, can be local in nature or radiate to the lower limb or the pubic bone;
3. strong - occurs with bone fractures, severe dislocations, accompanied by severe limitation of movement in the joint, and sometimes paralysis.

Pain that progresses at night and disappears during the day occurs in pathologies with stasis in blood vessels.Lack of circulation can cause numbness, tingling, and a crawling sensation.

Many diseases occur with inflammation of the joint capsule, ligaments or surrounding tissues.

In this case, characteristic symptoms appear:

• swelling around the hip joint appears due to a violation of the outflow of excess fluid, while the skin stretches and becomes shiny;
• change in the color of the skin over the inflamed area: from moderate red to bluish;
• a local increase in temperature in the joint area is due to an acute inflammatory reaction;
• the severe course causes general intoxication of the body, which is accompanied by headache, joint pain and fever.

Methods of diagnosis of the hip joint

For a detailed examination, a number of studies are carried out, with the help of which it is possible to create a complete picture of the disease that has arisen:

• a laboratory blood test will show hidden or obvious inflammation, the presence of rheumatoid factor;
• bacteriological examination of the synovial fluid to determine the cause of the inflammation;
• biopsy of suspicious tissue for the presence of a malignant factor;
• X-ray examination of the hip joint from different sides will help identify signs of tissue deformation;
• ultrasound examination of the joint;
• Doppler is an ultrasound method for assessing blood circulation;
• computed tomography.

Treatment of the hip joint

If the hip joint hurts, therapeutic measures may vary depending on the disease.It all depends on the pathology, the symptom of which is unpleasant pain.The complex of procedures is determined by drugs, physiotherapy treatment, therapeutic gymnastics and methods of alternative medicine.Strict compliance with the recommendations and the implementation of all prescriptions leads to the normalization of the condition.Only a doctor should prescribe drugs and medicines.

Drug therapy

1. Anesthetics can be used for temporary pain relief.Analgesics do not treat the cause of hip pain, but they are effective in relieving the symptom for a short period of time.
2. In case of severe pain, if there is no effect of non-narcotic pain relievers, a blockade is performed.
3. Non-steroidal anti-inflammatory drugs are used as anti-inflammatory, analgesic and antipyretic agents.The drug is taken strictly according to the instructions, without exceeding the dose, so as not to cause side effects from the gastrointestinal tract.
4. In severe inflammation that cannot be treated with non-hormonal drugs, glucocorticosteroids have a positive therapeutic effect.Steroid hormones provide anti-inflammatory, analgesic and antihistamine effects.They can be injected directly into the affected joint during a puncture.
5. Antibiotics are prescribed for associated purulent infections.Antibacterial agents have a detrimental effect on the pathogen, destroying the cause of the pathology.Along with antibiotics, the patient is prescribed probiotics to normalize the intestinal microflora.
6. Muscle relaxants - effectively relaxes muscles, eliminating spasms.Medicines will reduce tone to the point of immobilization, relieving pain in the pelvic area.
7. Diuretics remove fluid, prevent swelling and negative effects on heart activity.
8. Vitamin therapy has been shown to boost immunity and improve overall well-being.The biochemical processes that ensure the vital functions of the body proceed at an optimal speed.
9. In the case of degenerative processes that destroy the joint, chondroprotectors are taken for a long time to stop the degenerative process and restore itself.The drugs contain chondroitin and glucosamine, the deficiency of which creates an imbalance in the joint.Medicines are used in the form of tablets and are also injected into the joint.
10. Sedative for unbalanced mental states.A nervous system disorder occurs when a person experiences constant, debilitating pain in the hip joint.
11. Angioprotectors to improve blood microcirculation.They improve metabolic processes in the walls of blood vessels, increasing their permeability.

Physiotherapy treatment of hip pain

Modern methods of auxiliary therapy provide pain relief in the affected area and help to quickly get rid of the pathology.Modern medicine has many methods to relieve pain in the hip joint.

Each of the methods is assigned a purpose:

• improvement of blood circulation in the tissues of the hip joint;
• reducing inflammation;
• relieve pain;
• preventing the development of edema;
• improvement of metabolic processes in cells;
• tissue self-healing processes begin;
• strengthen the immune system.

Laser therapy allows you to affect the joint, penetrating up to 9 cm. Laser rays directed at the affected area heat the thickness of the tissue next to the bones.The healing effect on the nervous processes silences the pain.This method is designed to relieve inflammation;the analgesic effect is additional.

Electrophoresis is the use of galvanic current to penetrate deep into tissue.Direct electric current of low strength and low voltage is prescribed together with anti-inflammatory or analgesic drugs, for their administration through a chemical reaction.

Magnetotherapy provides penetration of magnetic pulse current at a depth of 7 to 12 cm. The treatment is carried out in courses, the effect is achieved until the end of the treatment period and is maintained until the beginning of the next session.To improve the health of the hip joint, a device that relieves pain and triggers regenerative processes is suitable.

Shockwave therapy involves short-term exposure to low-frequency acoustic pulses.It is used to eliminate inflammatory manifestations, providing a type of high-frequency massage.Enhanced collagen synthesis begins, blood supply and tissue trophicity improve.

Orthopedic medical devices

The reduction of the manifestation of pain in the hip joint can be achieved with the help of orthoses and rehabilitation elements.Modern developers of medical products have taken care in advance of the possible difficulties that patients will have to face.

Injuries affecting the neck of the femur require complete immobilization for several months.In order not to apply a massive plaster cast on the entire lower limb, there is an orthosis with a rigid degree of fixation - a "derotation boot".It is convenient for the patient to use the product in practice, safe from the point of view of allergenicity (plaster causes skin irritation and allergies) and for others to take care of the victim's leg.

An anti-decubitus mattress is indispensable if one has to lie there for long months.During the rehabilitation period, when the first steps are taken after an injury, a walker is first used for independent movement.When more stability appears, crutches are used, and then a cane, which provides support when walking.

Symphysitis causes a lot of suffering due to severe pain in the pubis and pelvis.To relieve the painful condition, unloading the hip joint, compression and support with the help of hard ribs, an orthopedic corset for the pelvic ring is used.

Choosing the right shoes is of great importance for the proper unloading of the hip joint.Shock-absorbing preventive insoles for daily wear will relieve many problems not only with the joints, but also with the spine.

The applicator has proven to be effective in relieving pain and improving blood circulation.Plastic needles, in close contact with the painful area, first cause pain, turning into a pleasant warmth.In the acute period, the duration of the session is 5 minutes to 6 times a day, in chronic pain – 15 minutes to 3 times a day.

Therapeutic gymnastics

Exercise classes have a special role.The more movements a joint makes with a measured load, the more synovial fluid is produced, which is necessary for the nutrition and work of the tissues.The set of exercises is compiled by a medical instructor for each patient individually.

Exercises are performed in the remission stage, when there is no pain.The technique for correct execution of the movements is explained by a physiotherapist and reproduced under the supervision of a specialist.Movements should not be sudden or jerky;the number of repetitions must correspond exactly to the instructions.

Physical therapy improves blood circulation, tones the thigh muscles, increases the mobility of the pelvic joint, facilitates walking and increases immunity.Each exercise must be coordinated;incorrect actions provoke an attack of pain, an increase in blood pressure and the appearance of microtraumas leading to inflammation.

A set of exercises to perform at home:

• in a lying position, bend your knees at a right angle, pull both legs to your chest at the same time, creating a slight resistance with your hands;
• Without changing the position, pull your bent legs one by one, hold for a few seconds;
• lie on your right side, raise your left leg, bent at the knee, repeat the same action with the other leg;
• in a prone position, stretch your arms along the body, raise the straight leg by 15 cm, hold for 5 seconds, perform movements in turn with both legs;
• sitting on a chair, raise your legs parallel to the floor, repeat the movements with each leg.

Surgical treatment of the hip joint

When conservative treatment does not lead to the desired result, an operation is performed to alleviate the patient's condition.There are several methods of surgical treatment:

1. Arthroscopic debridement - cleaning of the inner walls of the joints from necrotic particles, followed by washing with a medical solution.The manipulation is performed in an operating room.
2. Periarticular osteotomy - a fracture of the bones of the joint is performed to connect at a different angle to reduce the load on the diseased joint.
3. Arthroplasty is the replacement of a diseased joint with an artificial one;the method includes active rehabilitation actions after the operation.

Traditional medicine

Affordable and safe recipes from healers with centuries of experience help relieve hip pain and speed up recovery.Before use, you should consult to rule out contraindications.

1. Peel and chop one head of garlic, add finely chopped celery root and one lemon with the peel.Mix all the ingredients and add hot water, leave for a day in a cool place.Take 1 spoon for thirty days.
2. Linden and birch bud tea can be drunk daily to reduce inflammation.One teaspoon each of linden blossom and birch buds are brewed with hot water.After 30 minutes, the decoction is ready for use.
3. Prepare a herbal mixture: St. John's wort, chamomile and immortelle, combine 1 tablespoon each.The composition is poured into 500 ml of water and boiled for 10 minutes.Take the product 50 ml 3 times a day.
4. Finely chop the turnip, add a little honey and 30 ml of vodka.Apply the resulting mixture to the affected joint, securing it with plastic wrap on top.On top, the compress is covered with a warm blanket for the whole night.
5. Mix mustard powder with honey and vegetable oil.Gauze, folded in several layers, is dipped in the composition and applied to the joint.Keep the compress for no more than 60 minutes.
6. Wash the cabbage leaf and smear it with honey, apply to the hip joint.Honey has antibacterial and anti-inflammatory properties, and cabbage will relieve pain in the affected joint.
7. Crushed celandine leaves are mixed with a small amount of olive oil.The mixture is infused for 7 days, after which it is used to rub the painful area.
8. It is necessary to cut and combine cones of hops and St. John's wort, add petroleum jelly to an ointment-like consistency.Rub into the affected joint 2 times a day.
9. Mix red pepper, naphtha and vegetable oil and leave for 3 weeks.Use for rubbing no more than once a day.

Hip prevention

To prevent the occurrence of pain in the hip joint, simple recommendations will help you:

• the lifestyle should be active with periodic light physical exercises;
• proper nutrition is the basis of health: exclude fatty, salty and smoked foods, alcohol, sausages, chocolate, confectionery;
• do not overload the joints with tiring physical activity or heavy work;
• use preventive bandages to unload the pelvic joint;
• wear comfortable shoes that meet orthopedic standards;
• If unpleasant symptoms appear in the area of the hip joint, consult a doctor for an examination and prescribe an effective treatment.