Hip pain: causes and treatment

If you feel pain in the hip joint, it is necessary to determine the cause.Treatment of pain depends on the pathology of which it is a symptom.Comprehensive measures and strict adherence to recommendations will help to get rid of the disease and maintain the motor activity of the joint.Dysfunction of the hip joint prevents active movement.Reduced functionality limits the patient's ability to move and work independently.

Anatomical characteristics

The large joint connects the femur and pelvic bones and provides the ability to move in three directions: flexion and extension, abduction and rotation of the lower limb.Degenerative changes that lead to deformity, limit movement and cause pain.

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

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

Causes of hip pain

The development of diseases of various etiologies 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 in 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 feelings 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 the progression of the pathological condition.

Provoking disease

• 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, a sharp pain is observed in the hip joint.After that, the pain weakens, becomes muffled.Frequent injuries: pelvic fracture, hip dislocation, femoral neck fracture.All of the above-mentioned injuries occur after a direct, severe injury from a fall or impact.The situation becomes more complicated if the 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.It appears after an injury or when it is inherited from a parent.The progressive course leads to morphological changes in the cartilage tissue, which over time degenerates into bone formations.
• A hip dislocation, whether it occurs at birth or develops in the womb, leads to deformity, limited movement and nerve entrapment.Along with this pathology, not only somatic, but also neuropathic pain in the hip joint occurs.
• Coxarthrosis is a common pathology of elderly people who lead a sedentary lifestyle or perform heavy physical work.Dystrophic changes in the cartilage and subsequent deformation of the bones cause pain.The first symptoms appear as a result of intense 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 the progressive changes in the hip joint.
• Arthritis - inflammation in the joint capsule is accompanied by strong throbbing pain.It can appear as an independent disease or as a complication after an injury or an infectious disease.
• Reiter's syndrome is a reactive lesion of an allergic nature, which most often occurs after infectious pathologies.There are cases that the condition develops after chlamydia or gonococcus penetrates the joint capsule.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 try to destroy it.This condition leads to the modification of joint tissue 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 area, which progresses mainly at night.The patient's pain intensifies in the morning, stiffness disappears after active movements or exercise.
• Osteochondritis dissecans, also known as Koenig's disease, develops in the cartilage that contacts the femur.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 blockage 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 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 the acquired shortening of the extremities.The disease is considered pediatric, as children of preschool and primary school age are more likely to get sick.
• Bursitis is inflammation of the synovial bursa followed by its filling with pathogenic fluid.The disease occurs in the bursa located near the hip joint, causing pain mainly during exercise or palpation.
• Synovitis is an inflammatory lesion of the synovial membrane lining 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.It occurs during pregnancy and childbirth.The pathology is of an inflammatory nature, accompanied by severe pain in the pubic area, which spreads to the area of the hip joint.
• Radicular syndrome in the pelvic area is represented by neuropathic pain.The syndrome is caused by the compression of large nerves located in the area of the junction of the femur and pelvic bones by bony growths and deformed tissues.
• Varus foot deformity, clubfoot, can be a congenital defect or an acquired condition.Improperly distributed load on the feet, due to the inward movement of the front foot, negatively affects the hip and knee joints.Over time, improper action or lack of treatment, the hip joint deforms, causing pain.
• Enthesopathy is a degenerative-dystrophic process in the ligament apparatus of the joint.The processes are often accompanied by inflammation.The painful 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 hydratrosis is a chronic joint pathology in which there is an increased synthesis of synovial fluid, followed by an increase in joint volume and a decrease in motor activity due to pain.
• Synovial chondromatosis is the degeneration of the area 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 until the hip joint is completely blocked.
• Juvenile epiphysiolysis is a pathological displacement of the head of the femur downwards and backwards.Boys get sick at puberty, when there is a malfunction due to an imbalance in the synthesis of sex hormones and growth hormones.Pain in the hip joint appears when trying to move the leg.
• Aseptic necrosis of the femoral head can develop due to acute circulatory deficiency 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 next acute phase begins.
• Cases of gout development in the hip joint are known.Excessive formation of uric acid with insufficient excretion crystallizes and settles in the joint cavity, gradually filling it.During a gout attack, there is pain that cannot be tolerated.
• Malignant neoplasms in bones or surrounding tissues.

Symptoms

Pain in the hip joint is divided into 3 degrees:

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

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

Many diseases occur with inflammation in 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 skin color over the painful point: from moderately red to bluish;
• local increase in temperature in the joint area is a consequence of the reaction to acute inflammation;
• A severe course causes general intoxication of the body, which is followed by headache, joint pain and fever.

Methods for diagnosing 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 resulting disease:

• a laboratory blood test will indicate latent or obvious inflammation, the presence of rheumatoid factor;
• bacteriological examination of synovial fluid to determine the cause of 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.A set of procedures is determined from medicines, physiotherapeutic treatment, therapeutic exercises and methods of alternative medicine.Strict adherence to recommendations and compliance with all regulations leads to normalization of the condition.Medicines and drugs should only be prescribed by a doctor.

Drug therapy

1. Anesthetic drugs can be used for temporary pain relief.Analgesics do not treat the cause of hip pain, but they are effective in relieving symptoms for a short time.
2. In case of severe pain, if there is no effect of non-narcotic painkillers, blockade is performed.
3. Nonsteroidal anti-inflammatory drugs are used as anti-inflammatory, analgesic and antipyretic agents.The medicine is taken strictly according to the instructions, without exceeding the dose, in order to avoid unwanted effects from the gastrointestinal tract.
4. For severe inflammations that cannot be treated with non-hormonal drugs, glucocorticosteroids have a positive therapeutic effect.Steroid hormones provide anti-inflammatory, analgesic and antihistaminic effects.They can be injected directly into the affected joint during puncture.
5. Antibiotics are prescribed for associated purulent infections.Antibacterial agents have a harmful 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 relax 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 cardiac activity.
8. Vitamin therapy is indicated for strengthening immunity and improving overall well-being.Biochemical processes that ensure the vital functions of the organism take place at an optimal speed.
9. In the case of degenerative processes that destroy the joint, chondroprotectors are taken for a long time in order to stop the degenerative process and recover on its own.The drugs contain chondroitin and glucosamine, the lack of which creates an imbalance in the joint.Medicines are used in tablet form and are also injected into the joint.
10. Sedatives for unbalanced mental states.A nervous system disorder occurs when a person experiences constant, debilitating pain in the hip joint.
11. Angioprotectors for improving blood microcirculation.They improve metabolic processes in the walls of blood vessels, increasing their permeability.

Physiotherapy treatment of hip pain

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

Each of the methods is assigned with a purpose:

• improve blood circulation in the tissues of the hip joint;
• reduce inflammation;
• relieve pain;
• prevent the development of edema;
• improve metabolic processes in cells;
• start the tissue self-healing processes;
• strengthen the immune system.

Laser therapy allows you to affect the joint, penetrating up to 9 cm.Laser beams directed at the affected area heat the thickness of the tissue down to the bones.Medicinal action on nerve processes dampens pain.This method is designed to reduce 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 in combination with anti-inflammatory or analgesic drugs, for their application through a chemical reaction.

Magnetotherapy ensures the penetration of magnetic pulse current to a depth of 7 to 12 cm.Treatment is carried out in courses, the effect is achieved by 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 initiates regenerative processes is suitable.

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

Orthopedic medical products

Reducing the manifestation of pain in the hip joint can be achieved with the help of orthoses and objects for rehabilitation.Modern manufacturers of medical products have taken care of possible difficulties that patients will have to face in advance.

Injuries involving the neck of the femur require complete immobilization for several months.In order not to apply a massive cast to 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 necessary if a person 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 greater stability appears, crutches are used, and then a cane, which provides support while walking.

Symphysitis causes a lot of suffering due to severe pain in the pubic and pelvic area.An orthopedic corset for the pelvic ring is used to alleviate the painful condition, relieve the hip joint, compress and support it with the help of rigid ribs.

Choosing the right shoes is of great importance for proper relief of the hip joint.Preventive insoles for daily wear will alleviate many problems not only with the joint, 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.During the acute period, the duration of the session is 5 minutes to 6 times a day, for chronic pain – 15 minutes to 3 times a day.

Therapeutic gymnastics

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

Exercises are performed in the phase of remission, when there is no pain.The technique of correct execution of movements is explained by a physiotherapist and reproduced under the supervision of a specialist.Movements should not be sharp or sweeping;the number of repetitions should be in accordance with the instructions.

Therapeutic exercise improves blood flow, tones thigh muscles, increases motor skills in the pelvic joint, facilitates walking and improves immunity.Every exercise must be coordinated;improper procedures cause pain attacks, increased blood pressure and the appearance of microtraumas that lead 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 slight resistance with your hands;
• Without changing the position, pull the bent legs one at a time, holding for a few seconds;
• lying on the right side, raise the left leg, bent at the knee, repeat the same action with the other leg;
• in a prone position, stretch your arms by your body, raise your straight leg by 15 cm, hold for 5 seconds, perform movements alternately 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 bring the desired result, surgery is performed to alleviate the patient's condition.There are several methods of surgical care:

1. Arthroscopic debridement - cleaning the inner walls of the joints from necrotic particles, followed by rinsing with a medicinal solution.Manipulation is performed in the operating room.
2. Periarticular osteotomy - a fracture of the bones of the joint is done in order to connect them at a different angle in order to reduce the load on the affected joint.
3. Endoprosthetics is the replacement of a diseased joint with an artificial one;the method includes active rehabilitation after surgery.

Traditional medicine

Affordable and safe recipes of healers with centuries of experience help relieve pain in the hip joint and speed up recovery.Before use, it is necessary to consult in order 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 tablespoon for thirty days.
2. You can drink linden and birch bud tea every day to reduce inflammation.One teaspoon each of linden flower and birch buds is boiled in hot water.After 30 minutes, the decoction is ready for use.
3. Prepare a herbal mixture: St. John's wort, chamomile and immortelle, mix 1 tablespoon each.Pour the composition into 500 ml of water and boil 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 painful joint, secure it with plastic film from above.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 immersed in the composition and applied to the joint.Keep the wrap no longer than 60 minutes.
6. Wash the cabbage leaf and spread it with honey, apply it to the hip joint area.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 the painful area is rubbed with it.
8. It is necessary to chop and combine the cones of hops and St. John's wort, add vaseline to a grease-like consistency.Rub into the painful joint 2 times a day.
9. Mix red pepper, kerosene and vegetable oil and leave for 3 weeks.Use for rubbing no more than once a day.

Hip joint prevention

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

• 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, sweets;
• do not overload the joints with tiring physical activity or heavy work;
• use preventive bandages to relieve the pelvic joint;
• wear comfortable footwear that meets orthopedic standards;
• If unpleasant symptoms appear in the area of the hip joint, consult a doctor for an examination and prescribe an effective treatment.