One of the common symptoms with which patients come to a medical institution is pain in the hip joint. The causes, treatment and possible diseases that cause such a manifestation cannot be identified without qualified medical attention. Discomfort in any part of the musculoskeletal system can indicate the development of serious pathologies, so hip joint dysfunction should not be ignored.
Anatomy of the hip joint area
The hip joint plays an important role in motor activity. This is one of the largest human joints, which can withstand heavy loads in a standing position, as well as while walking.
Bones that form a joint
The hip joint is formed by the head of the femur and the acetabulum of the innominate pelvic bone - the strongest and largest parts of the human skeleton. The minimum number of anatomical elements of the joint ensures its strength and reliability, the ability to withstand the weight of the body during movement. Most pathologies of the hip joint begin with damage to the acetabulum, the immovable part of the joint. It has the shape of a bowl, the center of which is directed upwards at a slight angle, which ensures equal distribution of the load between the bones of the pelvis.
The glenoid cavity is a solid and strong formation, which consists of 3 types of pelvic bones:
- ileal
- ischial
- pubic
The most vulnerable area of the joint cavity is in children, whose bone tissue is not strong enough. Due to the presence of a small bony ridge at the edge of the socket, the head of the femur is completely immersed in the "bowl", which provides strong support for the limb. The moving part of the joint is the femur (head, neck, greater and lesser trochanters). The shape of the head corresponds to the cavity of the articular cavity. It is covered with cartilaginous tissue, which ensures the perfect alignment of the joint elements and their unhindered sliding. In the center of the head is a strong ligament that connects the bone to the acetabulum, providing additional grip and support.
The neck protrudes from the head of the femur at an obtuse angle, which ensures mobility of the joint and uniform distribution of the load between the limbs. Trochanters are bony projections to which muscle tendons are attached.
Fabric and structure
The normal functioning of the joint is ensured by a number of structures, each of which performs the corresponding functions.
Blood supply, performance and reduced joint sensitivity are provided by:
- Ligaments and tendons surround the joint on all sides, covering and protecting the femur and its neck, as well as the socket itself.
- Cartilage covers the head of the femur and part of the acetabulum.
- Subcartilaginous areas are bone tissue composed of cells and extracellular connective substances.
- The joint membrane or capsule is the source of a special secret - synovial fluid for lubricating the joint parts.
- The acetabular labrum connects the edge of the acetabulum and the transverse ligament.
The hip joint is supplied with nutrients through a fairly isolated network of vessels and arteries. The blood supply to the internal parts of the joint is provided by the acetabular branch of the obturator artery, and the capsules, ligaments and surrounding muscles are supplied by the deep femoral and buttock arteries.
Anatomical formations located near the hip joint
Often the cause of pain in the hip joint is damage to the anatomical structures located next to it. These elements include:
- Skin and subcutaneous tissue - the outer covering of the body
- The muscles of the thigh, pelvis, lower back and buttocks ensure joint mobility and also strengthen it externally.
- Extra-articular ligaments - perform a strengthening function, located around the joint capsule
- Periarticular bursae are bundles of connective tissue that prevent friction between soft and hard tissues
Risk factors
Inflammatory processes in the pelvic area occur due to mechanical damage or damage to certain types of bacteria. In this case, both the joint elements and the anatomical formations surrounding them can be exposed to pathological effects.
As a rule, one or more structures become inflamed:
- LEATHER
- muscle
- ligaments (extra-articular, femoral heads)
- periarticular bursa
- TBS capsules
- cartilage
- acetabular labrum
- subcartilaginous areas
Pain in the hip joint is often caused by harmful microorganisms that provoke the development of infectious arthritis. Other reasons are also common:
- disorders of the immune system
- joint injuries due to excessive physical activity
- old age
- metabolic disorders
- other diseases
Characteristics of pain
When diagnosing hip pain, additional symptoms play an important role, which can indicate the root cause of the problem.
Pain in the hip joint and radiates to the leg
If the pain from an injured joint radiates to the hips, knees or buttocks, then the problem is most likely caused by damage to the nerve that innervates the leg area due to one of the following reasons:
- common tumor
- Infectious arthritis - occurs due to damage from a pathogen
- femur fracture (in the head or neck area)
- Legg-Calvé-Perthes pathology - necrosis of the cartilage tissue of the femoral head
- Juvenile epiphysiolysis - destruction of the structure of the joint head and its inflammation
Pain in the hip joint, radiating to the leg, can signal pathology of cartilage tissue and periarticular structures, lack of joint lubrication and damage to the synovial membrane. Painful symptoms can appear suddenly or gradually increase.
Pain while walking
Pain in the hip joint can occur while walking if the acetabulum comes into contact with the cartilaginous tissue of the femoral head, resulting in an inflammatory process. The cause of this phenomenon can be mechanical damage, inflammation of anatomical formations located near the joint.
Based on the intensity of pain in the hip joint while walking, you can identify the root cause of the problem:
- discomfort that appears at the beginning of walking, gradually decreasing - a sign of inflammation of the periarticular bursa
- discomfort that gradually increases from the moment you start walking - inflammation of the articular surfaces of the hip joint
- constant pain of high intensity, accompanied by impaired functioning of the joint - occurs with dislocations and fractures
- the pain occurs closer to the night - a consequence of the deformation of the cartilage of the femoral head and (or) acetabulum, which rub against each other and become inflamed.
- pain of moderate intensity is a sign of minor injuries and bruises
Pain during leg abduction
Pain during leg abduction is caused by inflammation of tissues and structures that provide movement: muscles, periarticular bursae, tendons. Similar symptoms often result from myositis (inflammation of muscle tissue), bursitis (inflammation of the periarticular bursa) and tendinitis (inflammation of the tendons).
Causes
In most cases, pain in the pelvic area is caused by the patient having one of the following problems:
- arthritis
- coxarthrosis
- bursa of the trochanteric bursa
- tendinitis
- infectious pathologies
- hereditary diseases
- tumor formation in the pelvic area
Without timely treatment, each of these causes can lead to serious complications, including loss of joint mobility.
Arthritis
Arthritis (coxitis) is a disease of joint tissues caused by disorders of the immune system or damage by pathogens: viruses and bacteria.
Symptoms of arthritis:
- increase in temperature
- pain and swelling in the joint area
- motor impairment
The disease appears in acute, subacute and chronic forms.
Coxarthrosis
Another name for coxarthrosis is osteoarthritis of the hip joint. This pathology is caused by metabolic disorders in cartilaginous tissues, resulting in their death. The cause of this phenomenon can be injury, damaged blood supply, excessive physical activity, age over 45 years and heredity. The main symptom of coxarthrosis is pain in the lower back, hips and buttocks, which gradually increases during physical activity and leads to lameness. Discomfort decreases during periods of inactivity.
Bursitis of the trochanteric bursa
The presence of an inflammatory process in the bursa (trochanteric bursa) is characterized by the appearance of intense pain in the joint area. Athletes and the elderly are susceptible to the disease. The main symptom of bursitis of the trochanteric bursa is pain in the area of the greater trochanter, which increases when you try to lean on the affected leg.
Tendonitis
Inflammation of tendons is called tendinitis. This is a disease that occurs in acute or chronic forms and leads to degenerative changes in tissues. Often the pathology appears in athletes who do not follow their running technique, as well as after a heavy load on the hip muscles.
Typically, tendinitis is a complication of another disease:
- thyroid pathology
- metabolic disorders
- arthritis
- arthrosis
- inflammatory process of systemic or infectious origin
- hip dysplasia
Tendonitis causes the patient discomfort during movement, pain, changes in gait and clicking when walking in the joint area.
Infections
Some infectious diseases cause inflammation of joint tissues, as well as nearby anatomical structures, resulting in severe pain in the hip joint. Most often, the following pathologies have similar symptoms:
- Aseptic necrosis of the femoral head is a disruption of the blood supply to the hip area, resulting in tissue death. The pain associated with this disease is acute and intense. The problem is more common in men.
- Purulent arthritis is a serious disease that requires immediate treatment. If you do not seek medical help immediately, sepsis may occur. Accompanying symptoms are general intoxication, pain and swelling in the area of the affected joint, difficulty in motor activity.
- Tuberculous arthritis is common in children and is characterized by slow progression. Accompanying symptoms are increased fatigue, decreased motor activity and muscle atrophy. Pain of varying intensity increases when a purulent abscess appears.
Infectious pathologies of the hip joint lead to serious complications and therefore require immediate treatment.
Hereditary diseases
Hereditary pathologies of the hip joint usually appear between the ages of 1 and 10 years and are characterized by pathological changes in the tissue of the glenoid cavity and/or the femoral head. The most common hereditary disease affecting the hip joint is Legg-Calvé-Perthes syndrome, which is characterized by pain and difficulty walking due to the death of joint cartilage.
Bone and soft tissue tumors
Benign or malignant bone and soft tissue growths in the hip joint can cause pain while walking or at rest. The tumor can appear in bone tissue (osteomyelitis), cartilaginous tissue (chondroblastoma, chondroma), osteochondral tissue (osteochondroma). As a rule, neoplasms cause discomfort and are felt by palpation. Benign tumors are treated surgically; some of them can turn into cancerous tumors.
Soft tissue tumors of the thigh:
- lipoma
- rhabdomyoma
- fibroma
- hemangioma
- neuroma
An oncologist is involved in the diagnosis and treatment of tumors in the hip and pelvis.
What should be done
With severe pathologies of the hip joint, a person feels severe pain. Discomfort in the pelvic area is a reason to visit a medical institution for examination and treatment.
Special attention should be paid to the intensity of the pain:
- The lungs- occur with bruises after an injury. Cooling should be applied to the injured area to reduce swelling. To reduce pain, it is recommended to take a non-steroidal anti-inflammatory drug. It is advisable to consult a doctor.
- Moderate- usually occur in diseases of the hip joint, accompanied by difficulties in motor activity and increased body temperature. Discomfort increases during physical activity. It is necessary to consult a rheumatologist.
- Strong- arise due to dislocations and fractures. Accompanied by limitation or impossibility of physical activity. In cases of severe pain in the hip joint caused by injury, you should contact an ambulance.
There are many folk recipes that are used for pain in the hip joint. It is important to remember that all of them are suitable for symptomatic treatment and pain reduction, but will not help eliminate the cause of the problem. Effective treatment is carried out exclusively under the supervision of a qualified doctor.
Which doctor should I contact?
If you have hip pain, you should contact your family doctor or general practitioner, who will refer you to a specialist. Diseases of the musculoskeletal system are treated:
- the traumatologist— pain in the hip joint due to physical activity, sprains, falls and other injuries
- the rheumatologist- sudden onset of joint pain for no apparent reason
You may also need to consult with other doctors: surgeon, oncologist, infectious disease specialist, etc.
Diagnosing
The first important stage in the diagnosis of pain in the hip joint is an external examination, which necessarily includes taking an anamnesis and palpation. Depending on the severity of the disease and the patient's complaints, laboratory tests and instrumental diagnostic methods are prescribed:
- radiography- the use of x-rays to examine a specific area of the body
- CT and MRI- modern accurate diagnostic methods that allow you to get very informative images of the joint and the area around it
- microbiological examination of the sample of biological materialallow to detect the presence of pathogenic microorganisms: viruses and bacteria
- immunological blood test- allows you to identify immune disorders, determine the presence of certain autoantibodies
- arthroscopy (endoscopic examination)— examination using a probe, the possibility of taking a sample of joint tissue for further research
- laboratory examination of the effusion- taking a sample of intra-articular fluid during puncture and identifying the causative agent of an infectious disease in it, checking sterility
The use of several diagnostic methods in combination allows us to identify the cause of pain in the hip joint with high accuracy.
Treatment
Treatment of pain in the hip joint should be prescribed by a doctor based on examination and diagnosis. As a rule, drug therapy or surgery is prescribed.
Treatment
Treatment of pain in the hip joint should be comprehensive, aimed at eliminating the symptoms and most importantly, eliminating the cause of the problem. For this purpose, drug therapy is used, which includes the use of:
- non-steroidal anti-inflammatory drugs- help reduce pain, relieve swelling
- means to improve microcirculation- helps restore blood circulation and nutrition of joint tissues
- chondroprotectors- promotes the restoration of cartilage tissue
- muscle relaxants- reduces pain, improves blood circulation in the damaged area
- hormonal drugs- to relieve pain and suppress inflammation
In the treatment of pain in the hip joint, physiological procedures are very effective: massage, acupuncture, cryo and laser therapy. Special therapeutic exercises and manual therapy are also used.
surgery
Surgical intervention is indicated in advanced cases when conservative treatment does not help the patient. This involves partial or complete replacement of the diseased joint with a prosthesis.
Preventing
Reducing the load on the legs will slow down pathological processes within the joint, so people who are obese are recommended to start losing weight.
Preventive measures will help reduce pain in the hip joint:
- regular walking
- physiotherapy
- A balanced diet rich in vitamins A, C, E
Timely consultation with the doctor in the early stages of the disease increases the effectiveness of the treatment and also reduces the risk of complications and serious consequences for the body.