One of the common symptoms with which patients present to a medical institution 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 can indicate the development of serious pathologies, therefore hip joint dysfunction should not be ignored.
Anatomy of the hip joint area
The hip joint plays an important role in motor activity. It is one of the largest human joints, capable of supporting heavy loads when standing as well as when walking upright.
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 most powerful 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 body weight during movement. Most hip joint pathologies 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 upwards at a slight angle, which ensures uniform distribution of the load between the pelvic bones.
The glenoid cavity is a solid, solid formation, consisting of 3 types of pelvic bones:
- ileal
- ischiatic
- pubic
The most vulnerable area of the joint cavity is found 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 solid support to the limb. The movable part of the joint is the femur (head, neck, greater and lesser trochanter). 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 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 emerges 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. The trochanters are bony projections to which muscle tendons are attached.
Fabrics and structures
Normal joint function is ensured by a variety of structures, each performing 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 acetabulum.
- Subcartilaginous areas are bone tissue made up of cells and connective extracellular substance.
- The joint membrane or capsule is the source of a special secretion - synovial fluid to lubricate 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 by 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 surrounding capsules, ligaments and muscles are supplied by the deep arteries of the thigh and buttocks.
Anatomical formations located next to the hip joint
The cause of pain in the hip joint is often due to damage to the anatomical structures located next to it. These elements include:
- Skin and subcutaneous tissues - the outer covering of the body
- The muscles of the thigh, pelvis, lower back and buttocks provide joint mobility and additionally strengthen it from the outside.
- Extra-articular ligaments - perform a reinforcing 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 region occur due to mechanical damage or damage to certain types of bacteria. In this case, the elements of the joint and the anatomical formations surrounding them may be exposed to pathological effects.
Typically, 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 reasons are also common:
- immune system disorders
- joint injuries due to excessive physical activity
- old age
- Metabolic disorders
- other diseases
Pain characteristics
When diagnosing hip pain, additional symptoms play an important role, which may indicate the root cause of the problem.
Pain in the hip joint and radiating down the leg
If pain from a sore joint radiates to the groin, knees, or buttocks, the problem is most likely due to damage to the nerve innervating the leg area for 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 cartilaginous 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 of the cartilaginous tissue and periarticular structures, lack of lubrication of the joints and damage to the synovial membrane. Painful symptoms may come on suddenly or increase gradually.
Pain when walking
Pain in the hip joint can occur during walking if the acetabulum comes into contact with the cartilaginous tissue of the head of the femur, leading to an inflammatory process. The cause of this phenomenon may be mechanical damage, inflammation of the anatomical formations located next to the joint.
Depending on 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, gradually subsiding - 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 impaired functionality of the joint - occurs with dislocations and fractures
- pain occurs closer to 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 when abducting the leg
Pain during leg abduction is caused by inflammation of the 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 one of the following problems in the patient:
- arthritis
- coxarthrosis
- bursitis of the trochanteric bursa
- tendonitis
- infectious pathologies
- hereditary diseases
- formation of tumors in the pelvic region
Without prompt treatment, any 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 caused by pathogens: viruses and bacteria.
Arthritis Symptoms:
- temperature increase
- pain and swelling in the joint area
- motor impairment
The disease presents in acute, subacute and chronic forms.
Coxarthrosis
Another name for coxarthrosis is hip osteoarthritis. This pathology is caused by metabolic disorders of cartilaginous tissues, leading to their death. The cause of this phenomenon can be injury, impaired blood supply, 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 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 severe pain in the joint. Athletes and the elderly are susceptible to the disease. The main symptom of bursitis of the trochanteric bursa is pain in the region of the greater trochanter, which increases when trying to lean on the affected leg.
Tendonitis
Inflammation of the tendons is called tendonitis. This is a disease that occurs in acute or chronic forms and leads to degenerative changes in tissues. Often, pathology occurs in athletes who do not follow their running technique, as well as after a strong load on the hip muscles.
Usually, tendinitis is a complication of another disease:
- thyroid pathology
- Metabolic disorders
- arthritis
- osteoarthritis
- inflammatory process of systemic or infectious origin
- hip dysplasia
Tendinitis causes the patient to experience discomfort during movement, pain, changes in gait and clicking sounds when walking in the joint area.
Infections
Some infectious diseases cause inflammation of joint tissues, as well as nearby anatomical structures, leading to severe pain in the hip joint. Most often, the following pathologies have similar symptoms:
- Aseptic necrosis of the femoral head is a disruption of blood supply to the groin area, leading to tissue death. The pain associated with this disease is sharp 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 attention promptly, sepsis may occur. Associated symptoms are general intoxication, pain and swelling in the affected joint, and difficulty in motor activity.
- Tuberculous arthritis is common in children and is characterized by slow progression. Associated symptoms are increased fatigue, decreased motor activity and muscle atrophy. Pain of varying intensity increases in case of purulent abscess.
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 1 and 10 years of age and are characterized by pathological changes in the tissue of the glenoid cavity and/or the head of the femur. The most common hereditary disease affecting the hip joint is Legg-Calvé-Perthes syndrome, characterized by pain and difficulty walking due to the death of the cartilage tissue in the joint.
Bone and soft tissue tumors
Benign or malignant growths in the bones and soft tissues of the hip joint can cause pain when walking or at rest. The tumor can occur in bone tissues (osteomyelitis), cartilaginous tissues (chondroblastoma, chondroma), osteochondral tissues (osteochondroma). As a rule, neoplasms cause discomfort and are 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 helps diagnose and treat tumors of the hip and pelvis.
What to do
In case of serious pathologies of the hip joint, a person experiences severe pain. Discomfort in the pelvic region is a reason to visit a medical institution for examination and treatment.
Particular attention should be paid to the intensity of the pain:
- Lungs- occur with bruising after injury. Cold should be applied to the painful area to reduce swelling. To reduce pain, it is recommended to take a nonsteroidal 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 an increase in body temperature. Discomfort increases during physical activity. It is necessary to consult a rheumatologist.
- Strong- occur due to dislocations and fractures. Accompanied by a 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 used to relieve 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 experience 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, an oncologist, an infectious disease specialist, etc.
Diagnostic
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:
- x-ray- the use of x-rays to examine a specific area of the body
- CT and MRI- modern and accurate diagnostic methods that allow you to obtain highly informative images of the joint and the area around it
- microbiological examination of a sample of biological materialallow detection of the presence of pathogenic microorganisms: viruses and bacteria
- immunological blood test- helps identify immune disorders, determine the presence of certain autoantibodies
- arthroscopy (endoscopic examination)— examination using a probe, possibility of taking a sample of joint tissue for subsequent research
- laboratory examination of the effusion- take a sample of intra-articular fluid during the puncture and identify the causative agent of an infectious disease, check its sterility
The combined use of several diagnostic methods allows us to identify with high accuracy the cause of pain in the hip joint.
Treatment
Treatment of pain in the hip joint should be prescribed by a doctor based on examination and diagnosis. Typically, drug treatment or surgery is prescribed.
Medicine
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 treatment is used, which includes the use of:
- non-steroidal anti-inflammatory drugs- helps reduce pain, relieve swelling
- ways to improve microcirculation- help restore blood circulation and nutrition to joint tissues
- chondroprotectors- promotes the restoration of cartilaginous tissue
- muscle relaxers- reduce pain, improve 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, cryotherapy and laser therapy. Special therapeutic exercises and manual therapy are also used.
Surgical
Surgical intervention is indicated in advanced cases where conservative treatment does not help the patient. This involves the partial or complete replacement of the diseased joint with a prosthesis.
Prevention
Reducing the load on the legs will slow down pathological processes inside the joint, therefore obese people 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 early stages of the disease increases the effectiveness of treatment, and also reduces the risk of complications and serious consequences for the body.