Hip pain: causes and treatments

If you experience hip joint pain, you need to determine the cause.The treatment of pain depends on the pathology of which it is a symptom.Comprehensive measures and strict compliance with the recommendations will help get rid of the disease and maintain the motor activity of the joint.Impaired functioning of the hip joint makes active movement impossible.Reduced functionality limits the patient's ability to move independently and work.

Anatomical features

A 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 deformities, limit movement and cause pain.

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

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

Causes of hip pain

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

The cause of the pain determines its nature and intensity.Acute pain occurs due to injuries, inflammatory and purulent processes, while painful and not intense sensations arise from chronic diseases.

Numerous pathologies of unknown origin and congenital defects lead to the appearance of symptoms.The syndrome is present initially or can occur following the progression of the pathological condition.

Cause disease

• Traumas of varying severity are one of the most common causes.Bruises, sprains and fractures cause mechanical damage to bones and ligaments.On the first day after the injury, severe pain in the hip joint is observed.Subsequently the pain subsides, easing.Frequent injuries: pelvic fracture, hip dislocation, femoral neck fracture.All of the above injuries occur after a direct and serious injury resulting from a fall or blow.The situation becomes more complicated if a person has a history of osteoporosis or degenerative changes in the cartilage and bone tissues of the joint.
• Myositis ossificans is characterized by inflammation of the connective tissues of the joint capsule.It appears after an injury or if inherited from parents.The progressive course leads to morphological changes in the cartilaginous tissue, which over time degenerates into bone formations.
• A dislocated hip, whether it occurs at birth or develops in the womb, leads to deformity, limited movement, and nerve compression.With this pathology occurs not only somatic, but also neuropathic pain in the hip joint.
• Coxarthrosis is a common pathology among older people who lead a sedentary lifestyle or perform heavy physical work.Dystrophic changes in cartilage and resulting bone deformation cause pain.The first symptoms appear due to intense stress.The advanced course is accompanied by a dull, constant 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 of the joint capsule is accompanied by severe stabbing 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, which occurs most often after infectious pathologies.There are cases when the condition develops after chlamydia or gonococcus penetrates 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 cells recognize healthy tissue as a foreign organism and try to destroy it.This condition leads to changes in joint tissues against the background of severe inflammatory processes.
• Ankylosing spondylitis is a chronic systemic joint disease.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 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 blockage occurs due to the presence of necrotic cartilaginous 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 impaired.It is characterized by gradual necrosis of the femoral head, accompanied by pain and gait disturbances due to acquired shortening of the limb.The disease is considered pediatric, since children of preschool and primary school age are most often affected.
• Bursitis is an inflammation of the synovial bag followed by its filling with pathogenic fluid.The disease appears in the bags located near the hip joint, causing pain mainly during exercise or palpation.
• Synovitis is an inflammatory lesion of the synovial membrane that lines the walls of the joint capsule.In the acute period, a strong constant pain appears in the hip joint;during the chronic course, symptoms subside.
• Symphysitis: changes in the tissues of the pubic symphysis with divergence of the pubic bones.It occurs during pregnancy and childbirth.The pathology is inflammatory in nature, accompanied by severe pain in the pubic area, extending to the hip joint area.
• Radicular syndrome in the pelvic area is represented by neuropathic pain.The syndrome occurs due to compression of the large nerves located in the area of the junction of the femur and pelvic bones by bone growths and deformed tissues.
• The pes varus deformity, or clubfoot, can be a congenital defect or an acquired condition.Improperly distributed load on the feet, due to displacement of the forefoot inward, negatively affects the hip and knee joints.Over time, with improper actions or lack of treatment, the hip joint becomes deformed, causing pain.
• Enthesopathy is a degenerative-dystrophic process in the ligamentous apparatus of the joint.The processes are often accompanied by inflammation.The painful condition leads to the weakening of the structure of the ligaments and tendons with possible rupture of the connective tissue.Furthermore, ossification of some areas occurs, which reduces the functionality of the joint.
• Intermittent hydrarthrosis is a chronic joint pathology in which there is increased synthesis of synovial fluid, 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 movements, a decrease in amplitude up to complete blockage of the hip joint.
• Juvenile epiphysiolysis is a pathological displacement of the femoral head downward and backward.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 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 drastically 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 tumors in the bones or surrounding tissues.

Symptoms

Hip joint pain 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 – manifests itself with dystrophic, inflammatory and infectious pathologies, can be local in nature or radiate to the lower limb or pubic bone;
3. strong - appears with bone fractures, severe dislocations, accompanied by severe limitation of joint movements and sometimes paralysis.

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

Many diseases manifest themselves 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 skin color over the sore spot: from moderate red to bluish;
• a local increase in temperature in the joint area is due to a reaction to acute inflammation;
• a severe course causes general intoxication of the body, which is accompanied by headache, joint pain and fever.

Methods for diagnosing the hip joint

For a detailed examination, numerous 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 indicate latent or obvious inflammation, the presence of rheumatoid factor;
• bacteriological examination of synovial fluid to determine the causative agent of inflammation;
• biopsy of tissue suspicious 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 evaluating 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 set of procedures is determined by medications, physiotherapeutic treatments, therapeutic exercises and methods of alternative medicine.Strict compliance with the recommendations and fulfillment of all prescriptions leads to normalization of the condition.Only a doctor should prescribe drugs and medications.

Drug therapy

1. Anesthetic drugs may be used to temporarily relieve pain.Pain relievers 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 from non-narcotic painkillers, a block 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 dosage, so as not to cause side effects affecting the gastrointestinal tract.
4. For 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 diseased joint during a 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.The medicines will reduce the 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 is indicated to strengthen immunity and improve general well-being.The biochemical processes that ensure the body's vital functions proceed at 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 recover independently.The drugs contain chondroitin and glucosamine, the deficiency of which creates an imbalance in the joint.The drugs are used in the form of tablets 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 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 numerous methods to relieve hip joint pain.

Each of the methods is assigned with the purpose of:

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

Laser therapy allows you to influence the joint, penetrating up to 9 cm.Laser beams directed towards the affected area heat the thickness of the tissue up to the bones.The healing effect on nervous processes dulls 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.A direct electric current of low intensity and low voltage is prescribed in combination with anti-inflammatory or analgesic drugs, for their administration through a chemical reaction.

Magnetotherapy guarantees the penetration of the magnetic pulsed current to a depth between 7 and 12 cm.The treatment is carried out in cycles, the effect is achieved by the end of the treatment period and is maintained until the start 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 kind of high-frequency massage.Enhanced 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 orthotics and rehabilitation items.Modern developers of medical products have worried in advance about the possible difficulties that patients will face.

Injuries involving the femoral neck 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 "derotational boot".It is convenient for the patient to use the product in practice, safe from the point of view of allergenicity (the patch causes skin irritation and allergies) and for others to take care of the victim's leg.

An anti-decubitus mattress is essential if a person has to lie on it for long months.During the rehabilitation period, when taking the first steps after an injury, a walker is first used for independent movement.When greater stability is found, crutches are used and then a cane, which provides support during walking.

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

Choosing the right shoes is of great importance for the correct unloading of the hip joint.Preventive shock-absorbing insoles for daily use will relieve many problems not only with the joint, but also with the spine.

The applicator has been proven 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 up to 6 times a day, for chronic pain – 15 minutes up to 3 times a day.

Therapeutic gymnastics

Physical therapy 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 functioning of the tissues.A set of exercises is compiled by a medical instructor for each patient individually.

Exercises are performed in the remission phase, 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 sudden or large;the number of repetitions should be exactly as indicated.

Therapeutic exercise improves blood flow, tones the thigh muscles, increases the motor capacity of the pelvic joint, facilitates walking and improves immunity.Each exercise must be coordinated;incorrect actions cause an attack of pain, increased blood pressure and the appearance of microtraumas leading to inflammation.

A series of exercises to perform at home:

• in a lying position, bend your knees at a right angle, simultaneously bring both legs closer to your chest, creating light resistance with your hands;
• Without changing position, lift your bent legs one by one, holding the position for a few seconds;
• lying on your right side, raise your left leg, bent at the knee, repeat the same action with the other leg;
• in the stomach position, stretch your arms along the body, raise the straight leg 15 cm, hold it 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 bring the desired result, surgery is performed to alleviate the patient's condition.There are several methods of surgical treatment:

1. Arthroscopic debridement: cleaning the internal walls of the joints from necrotic particles, followed by washing with a medicinal solution.The manipulation is carried out 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. Endoprosthesis is the replacement of a diseased joint with an artificial one;the method involves active rehabilitation actions after the intervention.

Traditional medicine

Convenient and safe recipes from healers with centuries of experience help relieve pain in the hip joint and speed up recovery.Before use, it is necessary to consult to exclude contraindications.

1. Peel and chop a head of garlic, add finely chopped celery root and a lemon with zest.Mix all the ingredients and add hot water, leaving for a day in a cool place.Take 1 tablespoon for thirty days.
2. Lime and birch herbal tea can be drunk every day to reduce inflammation.A teaspoon of linden flowers and birch buds is brewed with hot water.After 30 minutes the decoction is ready for use.
3. Prepare the herbal mixture: St. John's wort, chamomile and immortelle, combine 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 turnips, add a little honey and 30 ml of vodka.Apply the resulting mixture to the sore joint, fixing it with plastic wrap on top.The compress is covered with a warm blanket on top throughout the 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 compress for no more than 60 minutes.
6. Wash the cabbage leaf and grease it with honey, apply it to the hip joint area.Honey has antibacterial and anti-inflammatory properties, and cabbage relieves pain in the affected joint.
7. Chopped leaves of celandine 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 chop and combine the hop cones and St. John's wort, add petroleum jelly until an ointment-like consistency is obtained.Rub on the painful joint 2 times a day.
9. Mix chilli, kerosene and vegetable oil and leave for 3 weeks.Use for rubbing no more than once a day.

Prevention of hip joint

To avoid the appearance of pain in the hip joint, simple recommendations will help:

• lifestyle should be active with periodic light physical exercises;
• correct nutrition is the basis of health: exclude fatty, salty and smoked foods, alcohol, sausages, chocolate, sweets;
• do not overload the joints with strenuous 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 hip joint area, consult a doctor for examination and prescribe effective treatment.