One of the most common symptoms with which patients visit a medical facility is pain in the hip joint. The causes, treatment and possible diseases causing such a manifestation cannot be identified without qualified medical care. Discomfort in any part of the musculoskeletal system may indicate the development of serious pathologies, therefore dysfunction of the hip joint 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 and can withstand high loads both when standing and walking upright.
Bones that form a joint
The hip joint consists of the femoral head and the hip socket of the 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, as well as the ability to withstand body weight during movement. Most hip joint diseases begin with damage to the acetabulum, the immobile part of the joint. It has the shape of a bowl, the center of which is directed slightly upwards, which ensures an even distribution of the load between the pelvic bones.
The glenoid cavity is a strong and solid structure consisting of three types of pelvic bones:
- Ileum
- ischiadic
- shame
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 edge on the edge of the socket, the femoral head is completely immersed in the "shell", which provides strong support to the limb. The movable part of the joint is the femur (head, neck, greater trochanter and lesser). The shapeof the head corresponds to the cavity of the joint cavity. It is covered with cartilage tissue, which ensures perfect alignment of the articular elements and their free sliding. In the center of the head there is a strong ligament that connects the bone to the hip socket and provides additional support andStop ensures.
The neck emerges from the femoral head at an obtuse angle, which ensures mobility of the joint and an even distribution of loads between the limbs. The trochanters are bony projections to which muscle tendons are attached.
Materials and structures
The normal function of the joint is ensured by a large number of structures, each of which performs corresponding functions.
Blood supply, performance and reduced sensitivity of the joint are ensured 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 hip socket.
- Subcartilaginous areas are bone tissue composed of cells and extracellular connective substance.
- The joint membrane or capsule is the source of a special secretion - synovial fluid for lubrication of the joint parts.
- The acetabular labrum connects the edge of the acetabulum and the transverse ligament.
The supply of nutrients to the hip joint occurs via a fairly isolated network of vessels and arteries. The blood supply to the internal parts of the joint comes from the acetabular branch of the obturator artery, while the capsules, ligaments and surrounding muscles are supplied from the deep arteries of the thigh and buttock.
Anatomical formations next to the hip joint
The cause of pain in the hip joint is often damage to the adjacent anatomical structures. These elements include:
- Skin and subcutaneous tissue – the outer covering of the body
- The muscles of the thigh, pelvis, lower back and buttocks ensure the mobility of the joint and additionally strengthen it from the outside
- Extra-articular ligaments – perform a strengthening function and are located around the joint capsule
- Periarticular bursae are bundles of connective tissue that prevent friction between soft and hard tissue
Risk factors
Inflammatory processes in the pelvic area arise as a result of mechanical damage or damage to certain types of bacteria. Both the joint elements and the anatomical structures surrounding them can be exposed to pathological effects.
As a rule, one or more structures become inflamed:
- leather
- Muscles
- Ligaments (extra-articular, femoral heads)
- periarticular bursa
- TBS capsule
- 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 also occur frequently:
- Immune system disorders
- Joint injuries caused by excessive physical activity
- high age
- Metabolic disorders
- Other diseases
Characteristics of pain
When diagnosing hip pain, other symptoms play an important role and may indicate the cause of the problem.
Pain in the hip joint that radiates into the leg
If the pain radiates from a painful joint to the groin, knees, or buttocks, the problem is most likely due to damage to the nerve that supplies the leg area, due to one of the following reasons:
- Joint tumor
- infectious arthritis – occurs due to damage caused by a pathogen
- Fracture of the femur (in the head or neck area)
- Legg-Calvé-Perthes pathology – necrosis of the cartilage tissue of the femoral head
- juvenile epiphysiolysis - disruption of the structure of the joint head and its inflammation
Pain in the hip joint radiating to the leg may indicate pathologies of the cartilage tissue and periarticular structures, lack of joint lubrication, and damage to the synovial membrane. Painful symptoms may appear suddenly or worsen gradually.
Pain when walking
Pain in the hip joint can occur when walking if the hip socket comes into contact with the cartilage tissue of the femoral head and an inflammatory process occurs. The cause of this phenomenon can be mechanical damage and inflammation of anatomical formations adjacent to the joint.
By the intensity of pain in the hip joint when walking, you can identify the root cause of the problem:
- Discomfort that occurs at the beginning of walking and gradually decreases - a sign of inflammation of the periarticular bursa
- Complaints that gradually increase from the moment you start walking – inflammation of the articular surfaces of the hip joint
- persistent pain of high intensity, accompanied by limited functionality of the joint – occurs with dislocations and fractures
- Pain occurs closer to night - a consequence of the deformation of the cartilage of the femoral head and (or) the acetabulum, which rub against each other and become inflamed
- Pain of moderate intensity is a sign of minor injuries and bruises
Pain when spreading the leg
Pain when spreading the leg is caused by inflammation of the tissues and structures that provide movement: muscles, periarticular bursa, tendons. Similar symptoms often occur with myositis (inflammation of muscle tissue), bursitis (inflammation of the periarticular bursa) and tendinitis (inflammation of the tendons).
causes
In most cases, pelvic pain is caused by the patient having one of the following problems:
- arthritis
- Coxarthrosis
- Bursitis of the trochanteric bursa
- Tendinitis
- infectious pathologies
- Hereditary diseases
- Tumor formation in the pelvic area
Without timely treatment, any of these causes can lead to serious complications, including loss of joint mobility.
arthritis
Arthritis (coxitis) is a disease of the joint tissue caused by immune system dysfunction or damage by pathogens (viruses and bacteria).
Arthritis Symptoms:
- Temperature rise
- Pain and swelling in the joint area
- motor impairment
The disease occurs 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 the cartilage tissue, which leads to their death. The cause of this phenomenon can be injuries, circulatory disorders, excessive physical activity, age over 45 years and heredity. The main symptom of coxarthrosis is pain in the lower back, groin and buttocks, which gradually increases with physical activity and leads to lameness. The symptoms decrease 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 severe pain in the joint area. Athletes and the elderly are susceptible to the disease. The main symptom of trochanteric bursa inflammation is pain in the greater trochanter area, which increases when trying to support yourself on the affected leg.
Tendonitis
Inflammation of the tendons is called tendinitis. This is a disease that occurs in acute or chronic form and leads to degenerative changes in the tissue. Often the pathology occurs in athletes who do not follow their running technique, as well as after heavy loads on the hip muscles.
Typically, tendonitis is a complication of another disease:
- Thyroid pathology
- Metabolic disorders
- arthritis
- arthrosis
- inflammatory process of systemic or infectious origin
- Hip dysplasia
Tendinitis causes the patient to have difficulty moving, pain, changes in gait and clicking noises in the joint area when walking.
Infections
Some infectious diseases cause inflammation of the joint tissues, as well as neighboring 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 groin, leading to tissue death. The pain associated with this disease is acute and intense. The problem occurs more often in men.
- Purulent arthritis is a serious disease that requires immediate treatment. If you don't seek immediate medical attention, sepsis may occur. Accompanying symptoms include general intoxication, pain and swelling in the area of the affected joint, difficulty in motor activity.
- Tuberculosis arthritis is common in children and is characterized by a slow progression. Accompanying symptoms include increased fatigue, reduced motor activity and muscle wasting. Pain of varying intensity increases when a purulent abscess appears.
Infectious diseases of the hip joint lead to serious complications and therefore require immediate treatment.
Hereditary diseases
Hereditary pathologies of the hip joint usually occur between the ages of 1 and 10 and are characterized by pathological changes in the tissue of the joint socket and/or the femoral head. The most common hereditary disease of the hip joint is Legg-Calvé-Perthes syndrome, which is characterized by pain and gait disturbances due to the death of the joint's cartilage tissue.
Tumors of bones and soft tissues
Benign or malignant growths of bone and soft tissue in the hip joint can cause pain when walking or at rest. The tumor can occur in bone tissue (osteomyelitis), cartilage tissue (chondroblastoma, chondroma) and osteochondral tissue (osteochondroma). Neoplasms usually cause discomfort and can be felt on 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 deals with the diagnosis and treatment of tumors in the hip and pelvic area.
What to do
With serious diseases of the hip joint, a person feels severe pain. Pelvic discomfort is a reason to visit a medical facility for examination and treatment.
Particular attention should be paid to the intensity of pain:
- lung- occur when bruises occur after an injury. To reduce swelling, cold should be applied to the sore area. To relieve the pain, taking a non-steroidal anti-inflammatory drug is recommended. It is advisable to see a doctor.
- Moderate- usually occur in diseases of the hip joint, which are accompanied by motor difficulties and increased body temperature. The symptoms increase with physical activity. It is necessary to see a rheumatologist.
- Strong- caused by dislocations and fractures. Accompanied by a limitation or impossibility of physical activity. If you experience severe pain in the hip joint due to an 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 they are all suitable for symptomatic treatment and pain relief, but do not help eliminate the cause of the problem. Effective treatment is carried out only under the supervision of a qualified doctor.
Which doctor should I contact?
If you have pain in the hip joint, you should contact your family doctor or family doctor, who will refer you to a specialist. Diseases of the musculoskeletal system are treated:
- Traumatologist— Pain in the hip joint due to physical activity, sprains, falls and other injuries
- rheumatologist- Sudden joint pain for no apparent reason
You may also need to consult other doctors: a surgeon, an oncologist, an infectious disease specialist, etc.
diagnosis
The first important step in diagnosing pain in the hip joint is an external examination, which necessarily includes 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, precise diagnostic methods that allow you to obtain extremely informative images of the joint and the surrounding area
- microbiological examination of a sample of biological materialallow detecting the presence of pathogenic microorganisms: viruses and bacteria
- immunological blood test- allows you to detect immune disorders and determine the presence of certain autoantibodies
- Arthroscopy (endoscopic examination)— Examination with a probe, possibility of taking a sample of joint tissue for further examination
- Laboratory examination of the effusion- Taking a sample of intra-articular fluid during puncture and identifying the pathogen of an infectious disease contained in it, as well as checking its 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 the examination and diagnosis. As a rule, drug therapy or surgery is prescribed.
Medication
Treatment of pain in the hip joint should be comprehensive and aimed at eliminating the symptoms and, most importantly, eliminating the cause of the problem. For this purpose, drug therapy is used, which involves the use of:
- Non-steroidal anti-inflammatory drugs- help relieve pain and relieve swelling
- Means for improving microcirculation- help restore blood circulation and nutrition to joint tissues
- Chondroprotectors- promotes the restoration of cartilage tissue
- Muscle relaxants- Relieve pain, improve blood circulation in the damaged area
- hormonal medications- to relieve pain and suppress inflammation
In the treatment of pain in the hip joint, physiological procedures are highly effective: massage, acupuncture, cryotherapy and laser therapy. Special therapy exercises and manual therapy are also used.
Surgical
In advanced cases, surgical intervention is indicated if conservative treatment does not help the patient. The diseased joint is partially or completely replaced with a prosthesis.
prevention
By reducing the load on the legs, the pathological processes in the joint are slowed down. Therefore, people who are overweight are recommended to start losing weight.
Preventive measures will help relieve pain in the hip joint:
- regular walking
- physical therapy
- a balanced diet rich in vitamins A, C, E
Timely consultation with a doctor at the initial stage of the disease increases the effectiveness of treatment, and also reduces the risk of complications and serious consequences for the body.