Hip pain

The human hip joints are subject to enormous stress. Walking, lifting and carrying heavy objects, jumping, running, bending, other physical exercises and even excess weight put pressure on the musculoskeletal system. Pain in the hip joint reduces its functionality, interferes with free movement and causes suffering to the patient not only during movement, but also at rest. It is very important not to ignore the pain and at the first symptoms of discomfort immediately seek help from qualified doctors. Orthopedists, traumatologists, surgeons, neurologists and numerous other specialists jointly evaluate the symptoms, look for the causes and treat hip joint pain.

Causes of pain

There are numerous diseases and pathological conditions that can be accompanied by pain. Pain in the hip joint on the left or right side can be caused by injuries, inflammatory and infectious pathologies, various degenerative processes, problems with the supply of useful minerals to bone tissue, etc.

Injuries to the soft tissues and osteoarticular structures of the hip area are the most common cause of discomfort. These include:

• bruises;
• penetrating wounds;
• femoral neck fracture;
• hip dislocation;
• Fractures of the acetabulum and the upper part of the femur (so-called pertrochanteric fractures).

Among traumatic causes, damage to the ligament system (sprain, tear, rupture) is less common. Most often, they are caused by serious injuries suffered by the patient as a result of an accident, prolonged exposure to rubble or extreme stunts.

Infectious, inflammatory, and degenerative diseases that can cause hip joint pain include:

• various forms of arthritis (infectious, aseptic, rheumatoid);
• panarthritis – total purulent inflammation of the hip joint;
• osteomyelitis;
• tuberculosis of the hip joint;
• coxarthrosis and other types of arthrosis;
• bursitis;
• aseptic necrosis of the femoral head, including Perthes disease;
• chondromatosis;
• trochanteritis.

Other pathological factors include:

• congenital anomalies of the development of the hip joint (dysplasia, congenital dislocation of the hip, shortening of the limbs);
• various neoplasms of a malignant and benign nature;
• sciatic nerve neuropathy;
• osteochondrosis, scoliosis, intervertebral hernia and other diseases of the spine.

Pain in the hip joint when walking or lying may indicate excessive stress on the musculoskeletal system. Discomfort may occur after strength training, carrying heavy objects, or prolonged walking or standing. The risk group includes athletes, extreme sports enthusiasts, shippers, teachers, lecturers, sellers, couriers, etc.

Other causes of severe pain in the hip joint when walking and at rest can be:

• excess weight, which significantly increases pressure on the joints;
• posture disorders;
• irrational use of some drugs;
• diabetes;
• neuropsychiatric disorders.

The largest number of patients with pain of varying intensity in this area are people over 50 years of age. This is explained by age-related changes in the periarticular tissues and the joint itself. It has been observed that women suffer from pain more often than men.

Types and symptoms of hip pain

The main manifestation is unpleasant sensations in the joint area of various types: sharp, pulsating, aching, dull, cutting, etc. The location and intensity of the pain syndrome depend on the initial disease and the patient's health characteristics (presence of concomitant pathologies, excess weight, risk factors). Often the pain syndrome extends to the surrounding structures, radiating to the limbs, the area of the sacrum and coccyx, and the lower back.

Symptoms that may accompany hip pain include:

• swelling of tissues in the joint area;
• creaks, clicks and other sounds when moving;
• limited mobility;
• numbness, decreased sensation in the leg;
• sensation of heat, pulsation in the damaged area;
• lameness, dragging of the leg;
• shortening of the limb;
• bruises;
• high body temperature.

Aching pain in the hip joint, radiating to the lower back, leg, groin, and sacral area, may indicate ankylosing spondylitis. This disease is also accompanied by stiffness of movements, knee discomfort and periodic "low back pain". Symmetrical pain in the hip area, combined with conjunctivitis and damage to the genitourinary system, may be a sign of Reiter's syndrome.

The clinical picture is determined by the primary disease or lesion. In mild cases, the patient is limited in movement, but the ability to support the leg remains. In case of severe bruises, fractures, dislocations and severe forms of infectious and inflammatory diseases, support on the affected leg is impossible; the patient can move only with the help of an auxiliary point or cannot walk at all.

Diagnostics

To establish the exact cause of pain, other symptoms of the primary disease/injury and select an effective treatment regimen, a comprehensive examination is carried out.

First of all, a physical examination is performed. The doctor evaluates the external signs of the pathology, palpates the joint area, asks detailed questions about the nature of the complaints, the time and circumstances under which they occurred, etc. The specialist must also be informed about previous surgeries and injuries, existing chronic pathologies (including those not directly related to the musculoskeletal system), lifestyle, etc.

A complete physical examination includes:

• ultrasound examination of the hip joint (ultrasound);
• x-ray of the pelvis in two projections;
• magnetic resonance imaging or computed tomography (according to indications);
• joint puncture;
• diagnostic arthroscopy;
• laboratory tests (general clinical blood and urine tests, biochemistry, rheumatoid factor analysis, tumor markers, etc. ).

The exact list of procedures is determined by the doctor based on the medical history, characteristics of the patient's current condition and the expected diagnosis.

Treatment of hip pain

The tactics of medical care depend on the cause of the pain. In case of sprains and bruises, the joint is immobilized, the patient is prescribed painkillers and is subjected to strict bed rest. In case of dislocation, the joint is realigned, followed by fixation of the limb in a stationary position. For fractures, skeletal traction, immobilization with plaster or the use of special structures are indicated.

For hip pain caused by inflammatory or infectious causes, treatment may include:

• antibacterial drugs;
• anti-inflammatory drugs;
• corticosteroid hormones;
• painkillers;
• chondroprotectors;
• cytostatics;
• ointments, creams, and other topical agents that stimulate blood flow;
• vitamin complexes;
• synovial fluid substitutes.

The patient is required to receive a complex of physiotherapy, exercise therapy and massage necessary to restore motor activity, normalize joint nutrition and eliminate signs of inflammation. This can include:

• massage;
• UHF;
• laser therapy;
• electrophonophoresis;
• magnetotherapy;
• shock wave therapy;
• hydrotherapy and swimming.

The patient's lifestyle is corrected: prevention of obesity, normalization of physical activity, limitation of strength loads, etc.

If conservative treatment does not have the desired effect or the primary disease is treated only surgically, surgical intervention is prescribed. It is performed using an open approach or using the arthroscopic technique. As part of the surgical treatment of diseases that cause pain in the hip joint, the following can be performed:

• reduction of dislocations;
• reconstruction of individual joint structures;
• endoprosthesis;
• removal of tumors;
• fixed fixation of the joint (arthrodesis);
• arthroplasty.

These and other methods of surgical treatment are selected based on the diagnosis and characteristics of the patient's current condition. After surgical treatment, the patient undergoes a course of rehabilitation.

Complications

Hip joint pain cannot be ignored. Even mild, temporary discomfort can lead to the development of serious diseases in the future. In complex cases, the consequences can be irreversible.

Possible complications include:

• limb deformities;
• lameness;
• transition of pain into a chronic form (in this case they are present almost constantly);
• violation of intra-articular bodies;
• deep vein thrombosis;
• heterotopic ossification (formation of bony plates in soft tissues);
• arthrosis;
• contractures: reduced joint mobility;
• necrosis;
• pathological fractures.

Without treatment, conditions can cause persistent impairment of mobility, the inability to live a full life and even care for oneself, and disability. With extensive purulent processes in the area of the hip joint, in the absence of treatment, toxic-infectious shock or sepsis can develop, which can be fatal.

Prevention

First of all, experts recommend leading a healthy lifestyle:

• move more, but don't overload your body with excessive training;
• monitor body weight to prevent obesity;
• follow a nutritious and varied diet (nutrition should be balanced in terms of basic macro- and micronutrients, as well as total calorie content);
• Do not use systemic medications without a prescription.

For people who, due to their professional activity, are forced to spend a lot of time on their feet, it is advisable to regularly rest the body and undergo preventive visits by an orthopedic-traumatologist at least once a year.

Patients with diseases of the musculoskeletal system must be under observation of the dispensary, strictly follow medical instructions and monitor their condition.

To prevent injury to the hip joint, it is recommended to avoid extreme sports, wear protective equipment during physical activity and not perform complex exercises without the necessary skills and physical preparation.

Elderly people are advised to move with extreme caution in icy conditions and not to go out unless absolutely necessary.

Hip pain treatment in a professional clinic

The doctors of the multidisciplinary center are high-level specialists with the necessary practical skills and extensive knowledge in various fields of medicine. They consider the patient's problem individually, developing a diagnostic and therapeutic program that takes into account all health characteristics. Specialists use an integrated approach to solve a variety of health problems. They not only eliminate a specific symptom, but also try to identify and eliminate its cause, obvious and non-obvious consequences. This is the only way to completely restore the patient's health, to give him back the opportunity to live a normal life, to move without pain or restrictions.

When asking for help from the doctors of the clinic, everyone has the right to count on the friendly attitude of the specialists and young collaborators, assistance in rehabilitation and objectivity.