One of the common symptoms that bring patients to the health care facility is pain in the hip joint. The causes, treatment and possible diseases that cause 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, so 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 that can withstand high loads both when standing and 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 strongest and largest part 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 pathologies of the hip joint begin with damage to the acetabulum, the immobile part of the joint. It is bowl-shaped, 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 consisting of 3 types of pelvic bone:
- ileal
- ischial
- lumbar
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 spine on the edge of the socket, the head of the femur is completely immersed in the "bowl", which provides a 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 jointof the cavity of the socket. It is covered by cartilage tissue, which ensures a perfect fit and unhindered sliding of the articular elements. In the center of the head there is a strong ligament that connects the bone to the acetabulum, providing additional grip and support.
The neck rises from the head of the femur at an obtuse angle, which ensures the mobility of the joint and the even distribution of the load between the limbs. The trochanters are bony projections to which muscles attach.
Tissues and structures
The normal functioning of the joint is ensured by various structures, each of which performs appropriate functions.
The blood supply, performance and reduced sensitivity of the joint are ensured by the following:
- The joint is surrounded on all sides by ligaments and tendons, 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 bony tissue composed of cells and connective extracellular material.
- The joint membrane or capsule is the source of a special secretion - 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 blood 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 arteries of the thigh and buttock.
Anatomical formations located next to the hip joint
The cause of pain in the hip joint is often damage to the anatomical structures located next to it. These items are:
- The 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 joints and strengthen them from the outside
- Extra-articular ligaments - perform a strengthening function, they are 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 injuries or damage caused by certain types of bacteria. In this case, both the elements of the joint and the anatomical formations surrounding them may be exposed to pathological effects.
Usually one or more structures ignite:
- Wine
- 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 trigger 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
Characteristics of pain
Additional symptoms play an important role in the diagnosis of hip pain, which may indicate the root cause of the problem.
Pain in the hip joint and radiates to the leg
If pain from a sore joint radiates to the groin, knee, or buttock, the problem is likely caused by damage to the nerve that innervates the leg area for one of the following reasons:
- joint tumor
- infectious arthritis - occurs due to damage caused by 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 - disruption and inflammation of the structure of the head of the joint
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 joint membrane. Painful symptoms can appear suddenly or increase gradually.
Pain when walking
Pain in the hip joint when walking, when the acetabulum is in contact with the cartilaginous tissue of the head of the femur, resulting in an inflammatory process. The cause of this phenomenon can be mechanical damage, inflammation of the anatomical formations located next to the joint.
Based on the intensity of the pain in the hip joint while walking, you can identify the root cause of the problem:
- discomfort, which occurs at the beginning of walking, gradually decreases - 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
- high-intensity continuous pain accompanied by impairment of joint function - associated with dislocations and fractures
- the pain appears 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 when abducting the leg
The pain that occurs when the leg is abducted is caused by inflammation of the tissues and structures that ensure movement: muscles, periarticular bursa, tendons. Similar symptoms are often the result of myositis (inflammation of muscle tissue), bursitis (inflammation of the periarticular bursa) and tendinitis (inflammation of tendons).
Cause
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
- inherited diseases
- tumor formation in the pelvic area
In the absence of timely treatment, each of these causes can lead to serious complications, including the 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:
- 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 of cartilaginous tissue, which cause its death. The cause of the phenomenon can be injury, blood supply disorder, 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. During periods of inactivity, discomfort is reduced.
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 the elderly are susceptible to the disease. The main symptom of trochanteric bursitis is pain in the area of the greater trochanter, which increases when you try to lean on the affected leg.
Tendinitis
Inflammation of tendons is called tendinitis. It is a disease that occurs in acute or chronic form and leads to degenerative tissue changes. Often, the pathology occurs in athletes who do not follow their running technique, as well as after a heavy load on the hip muscles.
Tendonitis is usually a complication of another disease:
- thyroid pathology
- metabolic disorders
- arthritis
- arthrosis
- inflammatory process of systemic or infectious origin
- hip dysplasia
Tendonitis causes discomfort to the patient during movement, pain, changes in gait and clicking in the joint area.
Infections
Some infectious diseases cause inflammation in the joint tissues and nearby anatomical structures, which causes intense pain in the hip joint. Most often, the following pathologies are associated with similar symptoms:
- Aseptic necrosis of the femoral head is a disorder of blood supply to the lumbar region, which leads to tissue death. The pain associated with the disease is acute and intense. The problem is more common in men.
- Purulent arthritis is a serious disease that requires immediate treatment. If you don't seek medical help right away, sepsis can occur. The related symptoms are general poisoning, pain and swelling in the area of the affected joint, difficulties 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 variable 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 head of the femur. 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 the cartilage tissue of the joint.
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), cartilaginous tissue (chondroblastoma, chondroma), and osteochondral tissue (osteochondroma). Neoplasms usually cause discomfort and can be felt. Benign tumors are treated surgically, some of them can turn into cancerous tumors.
Soft tissue tumors in the thigh:
- lipoma
- rhabdomyoma
- fibroma
- hemangioma
- nerve tumor
An oncologist is involved in the diagnosis and treatment of hip and pelvic tumors.
What to do
In the case of 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 the pain:
- Lungs- occur with post-injury bruises. Apply cold to the painful area to reduce swelling. In order to reduce pain, it is recommended to take a non-steroidal anti-inflammatory drug. It is advisable to consult a doctor.
- Moderate- they usually occur in hip joint diseases, which are accompanied by difficulties in motor activity and an increase in body temperature. Discomfort increases during physical activity. Consultation with a rheumatologist is necessary.
- Strong- they arise due to dislocations and fractures. It is accompanied by limitation or impossibility of physical activity. In case of severe hip joint pain caused by an injury, an ambulance should be called.
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 relief, but do 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 see?
If you have hip pain, see your GP or GP who will refer you to a specialist. They deal with diseases of the locomotor system:
- traumatologist— hip joint pain 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 with other doctors: surgeon, oncologist, infectious disease specialist, etc.
Diagnostics
The first important stage in the diagnosis of hip joint pain 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- using x-rays to examine a specific area of the body
- CT and MRI- modern accurate diagnostic methods, which enable extremely informative images to be taken of the joint and the area around it
- microbiological examination of a sample of biological materialallows detection of the presence of pathogenic microorganisms: viruses and bacteria
- immunological blood test- enables the identification of immune system disorders and the determination of the presence of certain autoantibodies
- arthroscopy (endoscopic examination)— examination with a probe, the possibility of taking a joint tissue sample for further research
- laboratory examination of the effusion- sampling intra-articular fluid during the puncture and identifying the causative agent of the infectious disease in it, checking sterility
The combined use of several diagnostic methods allows us to identify the cause of hip joint pain with great accuracy.
Treatment
The treatment of hip joint pain must be prescribed by a doctor based on the examination and diagnosis. Drug therapy or surgery is usually prescribed.
Medicine
Treatment of hip pain 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- helps reduce pain, relieves swelling
- means improving microcirculation- helps to restore the blood circulation and nutrition of joint tissues
- chondroprotectors- promotes the restoration of cartilage tissue
- muscle relaxants- reduces pain, improves blood flow in the injured area
- hormonal drugs- to relieve pain and reduce inflammation
Physiological procedures are extremely effective in the treatment of hip joint pain: massage, acupuncture, cryo- and laser therapy. Special therapeutic exercises and manual therapy are also used.
Surgical
In advanced cases, surgical intervention is recommended when conservative treatment does not help the patient. This involves partial or total replacement of the diseased joint with a prosthesis.
Prevention
Reducing the load on the legs slows down pathological processes within the joint, so it is recommended for obese people 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 stage of the disease increases the effectiveness of treatment and reduces the risk of complications and serious consequences for the body.