One of the common symptoms that patients come to a medical facility with is pain in the hip joint. The causes, treatment and possible diseases that cause such a manifestation cannot be identified without qualified medical help. Discomfort in any part of the musculoskeletal system can indicate the development of serious pathologies, so 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 that can withstand heavy loads in a standing position, as well as during upright walking.
Bones that form a joint
The hip joint is formed by the femoral head and the acetabulum of the innominate pelvic bone - the strongest and largest parts of the human skeleton. The minimum number of anatomical elements in the joint ensures its strength and reliability, the ability to withstand body weight during movement. Most pathologies of the hip joint begin with damage to the acetabulum, the immovable part of the joint. It is shaped like a bowl, the center of which is directed upwards at a slight angle, which ensures an even distribution of the load between the pelvic bones.
The glenoid cavity is a strong and solid formation, which consists of 3 types of pelvic bones:
- ileal
- ischial
- shame
The most vulnerable area in the joint cavity is in children whose bone tissue is not sufficiently strong. Due to the presence of a small ridge of bone at the edge of the socket, the head of the femur is completely immersed in the "bowl", providing strong support to the limb. The movable part of the joint is the femur (head, neck, greater and lesser trochanters). The shape of the head corresponds to the cavity of the joint cavity. It is covered with cartilaginous tissue, which ensures perfect alignment of the joint elements and their unimpeded sliding. In the center of the head is a strong ligament that connects the bone to the acetabulum, providing extra grip and support.
The neck emerges from the femoral head at an obtuse angle, which ensures mobility of the joint and uniform distribution of the load between the limbs. The trochanters are bony projections to which muscle tendons are attached.
Substances and structures
The normal function of the joint is ensured by a number of different structures, each of which performs corresponding functions.
Blood supply, performance and reduced sensitivity of the joint is provided by:
- Ligaments and tendons surround the joint on all sides and cover and protect 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 consisting of cells and connective extracellular matter.
- The joint membrane or capsule is the source of a special secretion - synovial fluid for lubricating the parts of the joint.
- The acetabular labrum connects the edge of the acetabulum and the transverse ligament.
The hip joint is supplied with nutrients through a rather isolated network of vessels and arteries. The blood supply to the internal parts of the joint is supplied by the acetabular branch of the obturator artery, and the capsules, ligaments, and surrounding muscles are supplied by the deep arteries of the thigh and buttocks.
Anatomical formations located next to the hip joint
Often the cause of pain in the hip joint is damage to the anatomical structures that lie next to it. These elements include:
- Skin and subcutaneous tissue - the outer covering of the body
- The muscles in the thigh, pelvis, lower back and buttocks provide joint mobility and also strengthen it from the outside
- 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 tissue
Risk factors
Inflammatory processes in the pelvic area occur due to mechanical damage or damage by certain types of bacteria. In this case, both the elements of the joint and the anatomical formations that surround them can be exposed to pathological effects.
As a rule, one or more structures become inflamed:
- leather
- muscles
- ligaments (extra-articular, femoral heads)
- periarticular bursae
- 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 causes are also common:
- disturbances in the immune system
- joint damage due to excessive physical activity
- old age
- metabolic disorders
- other diseases
Traction of pain
When diagnosing hip pain, additional symptoms play an important role, which can indicate the cause of the problem.
Pain in the hip joint and radiates to the leg
If pain from a tender joint radiates to the groin, knees or buttocks, the problem is most likely caused by damage to the nerve that innervates the leg area due to one of the following reasons:
- joint tumor
- infectious arthritis - occurs due to damage 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 head of the joint and its inflammation
Pain in the hip joint radiating to the leg can signal pathologies in cartilage tissue and periarticular structures, lack of joint lubrication and damage to the synovial membrane. Painful symptoms may occur suddenly or gradually increase.
Pain when walking
Pain in the hip joint can occur during walking if the acetabulum comes into contact with the cartilage tissue of the femoral head, resulting in an inflammatory process. The cause of this phenomenon may be mechanical damage, inflammation of anatomical formations located next to the joint.
Based on the intensity of pain in the hip joint when walking, you can identify the cause of the problem:
- discomfort that occurs 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
- continuous pain of high intensity, accompanied by reduced functionality of the joint - occurs with dislocations and fractures
- pain occurs closer to the night - a consequence of 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 on abduction of the leg
Pain in abduction of the leg is caused by inflammation of tissues and structures that provide movement: muscles, periarticular bursae, tendons. Similar symptoms are often caused by myositis (inflammation of muscle tissue), bursitis (inflammation of the periarticular bursa) and tendinitis (inflammation of tendons).
Reasons
In most cases, pain in the pelvic area is due to 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, each of these causes can lead to serious complications, including loss of joint mobility.
Arthritis
Arthritis (coxitis) is a disease of joint tissue caused by disturbances in the immune system or damage to pathogens: viruses and bacteria.
Symptoms of gout:
- 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 disturbances in cartilage tissue, which results in their death. The cause of this phenomenon can be injuries, reduced blood supply, excessive physical activity, age over 45 and heredity. The main symptom of coxarthrosis is pain in the lower back, groin 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 occurrence of intense pain in the joint area. Athletes and older people 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 trying to lean on the affected leg.
Tendinitis
Inflammation of the 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 occurs in athletes who do not follow their running technique, as well as after heavy strain on the hip muscles.
Typically, tendinitis is a complication of another disease:
- thyroid pathology
- metabolic disorders
- arthritis
- osteoarthritis
- 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 the joint tissues as well as nearby anatomical structures, resulting in intense 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 area, resulting in tissue death. The pain associated with this disease is acute and intense. The problem is more common in men.
- Purulent gout is a serious disease that requires immediate treatment. If you do not seek medical attention immediately, sepsis can occur. Associated symptoms are general intoxication, pain and swelling in the area of the affected joint, difficulties with motor activity.
- Tuberculous arthritis is common in children and is characterized by a slow progression. Associated symptoms are increased fatigue, reduced motor activity and muscle atrophy. Pain of varying intensity increases when a purulent abscess occurs.
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 gait disturbances due to the death of the cartilage tissue of the joint.
Tumors in bones and soft tissue
Benign or malignant growths of bone and soft tissue in the hip joint can cause pain when walking or resting. The tumor can occur in bone tissue (osteomyelitis), cartilage 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
- fibroid
- hemangioma
- neuroma
An oncologist is involved in the diagnosis and treatment of tumors in the hips and pelvis.
What to do
With severe pathologies of the hip joint, a person feels severe pain. Discomfort in the pelvic area is a reason to visit a medical facility for examination and treatment.
Particular attention should be paid to the intensity of pain:
- Lungs- occurs with bruises after an injury. Cold should be applied to the sore 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 occurs in diseases of the hip joint, accompanied by difficulties with motor activity and increased body temperature. Discomfort increases with physical activity. It is necessary to consult a rheumatologist.
- Strong- occurs due to dislocations and fractures. Accompanied by limitation or impossibility of physical activity. In case 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 are suitable for symptomatic treatment and pain reduction, but will not help to 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 general practitioner, 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 onset of joint pain for no apparent reason
You may also need to consult other doctors: a surgeon, oncologist, infectious disease specialist, etc.
Diagnostics
The first important step in diagnosing 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 precise diagnostic methods that allow you to get very informative images of the joint and the area around it
- microbiological examination of a 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, possibility to take a sample of joint tissue for further research
- laboratory examination of effusion- take a sample of intra-articular fluid during puncture and identify the cause of an infectious disease in it, check for 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 treatment or surgery is prescribed.
Medicine
Treatment of pain in the hip joint must be comprehensive, aimed at eliminating symptoms and, most importantly, eliminating the cause of the problem. For this purpose, drug treatment is used, which includes the use of:
- non-steroidal anti-inflammatory drugs- help reduce pain, relieve swelling
- means to improve microcirculation- help restore blood circulation and nutrition of joint tissue
- chondroprotectors- promotes the restoration of cartilage tissue
- muscle relaxants- reduce pain, improve blood flow in the damaged area
- hormonal drugs- to relieve pain and suppress inflammation
In the treatment of pain in the hip joint, physiological procedures are highly effective: massage, acupuncture, cryo- and laser therapy. Special therapeutic exercises and manual therapy are also used.
Surgical
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.
Prevention
Reducing the load on the legs will slow down the pathological processes inside the joint, so people who are overweight are recommended to start losing weight.
Preventive measures will help reduce pain in the hip joint:
- regular walk
- physiotherapy
- a balanced diet rich in vitamins A, C, E
Timely consultation with a doctor in the first stages of the disease increases the effectiveness of treatment and also reduces the risk of complications and serious consequences for the body.