One of the common symptoms of patients coming to a medical facility is pain in the hip joint. The cause, treatment, and possible diseases that cause such manifestations cannot be identified without qualified medical care. Discomfort in any part of the musculoskeletal system may indicate the development of a serious pathology, 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 when walking upright.
Bones that make up joints
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 hip joint pathologies begin with damage to the acetabulum, the non-moving part of the joint. It is shaped like a bowl, the middle 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 dense formation, which consists of 3 types of pelvic bones:
- ileal
- ischial
- penis
The most vulnerable area of the articular cavity is in children whose bone tissue is not strong enough. Due to the presence of a small bone ridge on 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 perfect alignment of joint elements and 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 joint mobility and uniform distribution of the load between the limbs. The trochanter is a bony projection that attaches to a muscle tendon.
Fabric and structure
The normal function of the joint is ensured by various structures, each of which performs a corresponding function.
Blood supply, performance and decreased 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.
- The subcartilaginous region is bone tissue composed of connective cells and extracellular material.
- The joint membrane or capsule is the source of a special secretion - synovial fluid to lubricate the joint.
- The acetabular labrum connects the edge of the acetabulum and the transverse ligament.
The hip joint is supplied with nutrients through a relatively isolated network of channels and arteries. The blood supply to the interior of the joint is provided by the acetabular branch of the obturator artery, and the capsule, ligaments and surrounding muscles are supplied by the internal thigh and buttock arteries.
The anatomical formation is located next to the hip joint
Often the cause of pain in the hip joint is damage to the anatomical structure 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 provide joint mobility and also strengthen it from the outside.
- Extra-articular ligaments - perform a strengthening function, located around the joint capsule
- A periarticular bursa is a bundle of connective tissue that prevents friction between soft and hard tissue
Risk factors
The inflammatory process in the pelvic area occurs as a result of 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:
- skin
- muscles
- ligaments (extra-articular, femoral head)
- periarticular bursa
- TBS capsules
- vulnerable
- acetabular labrum
- subcartilaginous area
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
- aged
- metabolic disorders
- other diseases
Characteristics of pain
When diagnosing hip pain, additional symptoms play an important role, which may indicate the cause of the problem.
Pain in the hip joint and radiating to the leg
If pain from a painful joint spreads to the groin, knee or back, the problem is most likely caused by damage to the nerves that surround the leg area for one of the following reasons:
- joint tumor
- Infectious arthritis - occurs as a result of damage by pathogens
- femur fracture (in the head or neck area)
- Legg-Calvé-Perthes pathology - necrosis of the cartilage tissue of the femoral head
- Juvenile epiphysiolysis - structural disorder of the joint head and its inflammation
Pain in the hip joint, radiating to the leg, can indicate pathology of cartilage tissue and periarticular structures, lack of joint lubrication, and damage to the synovial membrane. Painful symptoms may occur suddenly or increase gradually.
Pain when walking
Pain in the hip joint can occur when walking if the acetabulum comes into contact with the cartilage tissue of the femur head, resulting in an inflammatory process. The cause of this phenomenon can 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 subsides - a sign of inflammation of the periarticular bursa
- discomfort that gradually increases from the moment you start walking - inflammation of the articular surface of the hip joint
- persistent pain with high intensity, accompanied by impaired joint function - occurs with dislocations and fractures
- pain occurs closer to the night - due to 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 when abducting the leg 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 tendons).
Cause
In most cases, pain in the pelvic area is caused by patients who have one of the following problems:
- arthritis
- coxarthrosis
- bursitis of the trochanteric bursa
- tendinitis
- infectious pathology
- inherited disease
- tumor formation in the pelvic area
Without timely treatment, each of these causes can lead to severe complications, including loss of joint mobility.
Joint pain
Arthritis (coxitis) is a joint tissue disease caused by immune system disorders or damage to pathogens: viruses and bacteria.
Symptoms of arthritis:
- temperature rise
- pain and swelling in the joint area
- motor damage
This 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 cartilaginous tissue, resulting in their death. The cause of this phenomenon may be injuries, impaired 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 the elderly are susceptible to this disease. The main symptom of trochanteric bursitis is pain in the area of the greater trochanter, which increases when trying to lean on the affected leg.
Tendinitis
Inflammation of the tendon is called tendinitis. This is a disease that occurs in an acute or chronic form and leads to degenerative changes in the tissue. Often pathology occurs in athletes who do not follow their running technique, as well as after heavy loads on the hip muscles.
Usually, tendinitis is a complication of other diseases:
- thyroid pathology
- metabolic disorders
- arthritis
- arthrosis
- inflammatory process of systemic or infectious origin
- hip dysplasia
Tendonitis causes patient discomfort during movement, pain, changes in gait, and clicks when walking in the joint area.
Infection
Some infectious diseases cause inflammation of joint tissue, as well as nearby anatomical structures, resulting in severe pain in the hip joint. Often, the following pathologies have the same symptoms:
- Aseptic necrosis of the femoral head is a disruption of 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 arthritis is a serious disease that requires immediate treatment. If you don't get medical help right away, sepsis may occur. Related symptoms are general intoxication, pain and swelling in the affected joint area, 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 when a purulent abscess occurs.
Infectious pathology of the hip joint leads to severe complications and therefore requires urgent treatment.
Hereditary disease
Hereditary pathology of the hip joint usually appears between the ages of 1 and 10 years, and is 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 impaired walking due to the death of joint cartilage tissue.
Bone and soft tissue tumors
Benign or malignant growths of bone and soft tissue in the hip joint can cause pain when walking or resting. Tumors can occur in bone tissue (osteomyelitis), cartilage tissue (chondroblastoma, chondroma), osteochondral tissue (osteochondroma). As a rule, neoplasms cause discomfort and are felt upon palpation. Benign tumors are treated with surgery; some of them can turn into cancerous tumors.
Soft tissue tumors of the thigh:
- lipoma
- rhabdomyoma
- fibroma
- hemangioma
- neuroma
Oncologists are involved in the diagnosis and treatment of tumors in the hip and pelvis.
What to do
With severe pathology 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- occurs with bruising after injury. Cold should be applied to the affected area to reduce swelling. To reduce pain, it is recommended to take non-steroidal anti-inflammatory drugs. It is advisable to consult a doctor.
- Simple- usually occurs in hip joint disease, accompanied by difficulty in motor activity and increased body temperature. Discomfort increases during physical activity. It is necessary to consult a rheumatologist.
- strong- caused by dislocations and fractures. Accompanied by limitation or impossibility of physical activity. In case of severe pain in the hip joint caused by an injury, you should call 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 to 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 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 joint pain for no apparent reason
You may also need to consult with other doctors: surgeons, oncologists, infectious disease specialists, etc.
Diagnostics
The first important stage 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 certain areas of the body
- CT and MRI- a modern accurate diagnostic method that allows you to get a very informative image of the joint and the area around it
- microbiological examination of biological material samplesallows 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 effusion- take a sample of intra-articular fluid during puncture and identify the causative agent of infectious diseases 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 examination and diagnosis. As a rule, drug therapy 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 therapy is used, which includes the use of:
- nonsteroidal anti-inflammatory drugs- helps reduce pain, relieve swelling
- means to improve microcirculation- helps restore blood circulation and joint tissue nutrition
- chondroprotectors- promotes the recovery of cartilage tissue
- muscle relaxant- reduces pain, improves 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 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.
Prevention
Reducing the load on the legs will slow down the pathological process in the joints, so obese people are recommended to start losing weight.
Preventive measures will help reduce pain in the hip joint:
- normal walk
- physiotherapy
- balanced diet rich in vitamins A, C, E
Timely consultation with a doctor at the first stage of the disease increases the effectiveness of treatment and also reduces the risk of complications and serious consequences for the body.