One of the common symptoms for which patients seek medical attention is pain in the hip joint. The causes, treatment and possible diseases that cause such a manifestation cannot be determined without qualified medical assistance. Disturbance 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 heavy loads while standing as well as walking upright.
Bones that form a joint
The hip joint is formed by the head of the femur and the acetabulum of the innominate pelvis - the strongest 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 pathologies of the hip joint begin with damage to the acetabulum, which is the immobile part of the joint. It resembles a bowl with the center 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 bones:
- ileal
- sciatica
- pubic
The most sensitive area of the articular cavity is in children whose bone tissue is not strong enough. Due to the presence of a small bony protrusion on the edge of the socket, the head of the femur is completely immersed in the "pelvis", which strongly supports 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 cartilage tissue, which ensures perfect alignment of the joint elements and their smooth 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 protrudes from the head of the femur at an obtuse angle, which ensures the mobility of the joint and uniform distribution of the load between the limbs. Trochanters are bony projections where muscle tendons attach.
Fabrics and structures
The normal functioning of the joint is ensured by various structures, each of which performs the appropriate functions.
Decreased blood supply, performance and sensitivity of the joint is 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.
- Subcartilaginous areas are bone tissue composed of cells and connective extracellular material.
- The joint membrane or capsule is a 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 through a fairly isolated network of veins and arteries. The blood supply of 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 hip.
Anatomical formations located near the hip joint
Often, the cause of pain in the hip joint is damage to the anatomical structures located next to it. These elements include:
- Skin and subcutaneous tissue - the outer covering of the body
- The muscles of the thighs, pelvis, lower back and hips provide joint mobility and additionally strengthen it externally.
- Extra-articular ligaments - perform a strengthening function, 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 region occur due to mechanical damage or damage to certain types of bacteria. In this case, both the elements of the joint and the anatomical formations surrounding them may be subject to pathological effects.
As a rule, one or more structures are inflamed:
- skin
- 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 cause the development of infectious arthritis. Other reasons are also common:
- disorders of the immune system
- 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 spreads to the leg
If pain from a painful joint radiates to the groin, knee, or hip, the problem is most likely caused by damage to the nerve that innervates the leg area for one of the following reasons:
- joint swelling
- infectious arthritis - occurs due to pathogen damage
- fracture of the femur (in the head or neck)
- 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
In the hip joint, pain radiating to the leg can signal pathologies of the cartilage tissue and periarticular structures, lack of joint lubrication, and damage to the synovial membrane. Painful symptoms can occur suddenly or increase gradually.
Pain when walking
If the contact of the femoral head of the acetabulum with the cartilage tissue results in an inflammatory process, pain in the hip joint may occur during walking. The cause of this phenomenon may be mechanical damage, inflammation of anatomical formations located near the joint.
Based on the intensity of pain in the hip joint while walking, you can determine the root cause of the problem:
- discomfort that occurs at the beginning of the walk, gradually decreasing - a sign of inflammation of the periarticular bursa
- gradually increasing discomfort from the moment you start walking - inflammation of the articular surfaces of the hip joint
- persistent pain of high intensity accompanied by functional impairment of the joint - occurs with dislocations and fractures.
- pain occurs at night - the result of deformation of the femoral head and (or) cartilages of the acetabulum, 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 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 the tendons).
Reasons
In most cases, pain in the pelvic area is due to the fact that the patient has one of the following problems:
- arthritis
- coxarthrosis
- bursitis of the trochanteric bursa
- tendinitis
- infectious pathologies
- hereditary diseases
- tumor formation in the pelvic region
If not treated in time, each of these causes can lead to serious complications, including loss of joint mobility.
Arthritis
Arthritis (coxitis) is a joint tissue disease caused by disorders of the immune system or damage by pathogens: viruses and bacteria.
Symptoms of arthritis:
- increase in temperature
- pain and swelling in the joint area
- motor disorder
The disease occurs in acute, subacute and chronic forms.
Coxarthrosis
Another name for coxarthrosis is osteoarthritis of the hip joint. This pathology occurs as a result of metabolic disorders in cartilage tissues, resulting in their death. The cause of this phenomenon may be injury, impaired blood supply, excessive physical activity, age over 45 and heredity. The main symptom of coxarthrosis is pain in the back, groin and hips, which gradually increases during physical activity and leads to lameness. Anxiety is reduced 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 severe pain in the joint area. Athletes and elderly people are susceptible to the disease. The main symptom of bursitis of the trochanteric bursa is pain in the region of the greater trochanter, which intensifies 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 causes degenerative changes in the tissue. Often, the pathology occurs in athletes who do not follow the running technique, as well as after a heavy load on the hip muscles.
Typically, tendinitis is a complication of another disease:
- thyroid pathology
- metabolic disorders
- arthritis
- arthrosis
- inflammatory process of systemic or infectious origin
- hip dysplasia
Tendonitis causes discomfort, pain, change in gait, clicking in the joint area when walking.
Infections
Some infectious diseases cause inflammation of joint tissues as well as nearby anatomical structures, resulting in severe pain in the hip joint. Often the following pathologies have similar symptoms:
- Aseptic necrosis of the femoral head is a violation of the blood supply to the groin, resulting in 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 urgent treatment. If you do not consult a doctor in time, sepsis can occur. Associated 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. When a purulent abscess occurs, pain of varying intensity increases.
Infectious pathologies of the hip joint cause 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 femoral head. The most common inherited disease affecting the hip joint is Legg-Calvé-Perthes syndrome, which is characterized by pain and impaired gait due to the death of cartilage tissue in 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. Tumor can occur in bone tissue (osteomyelitis), cartilage tissue (chondroblastoma, chondroma), osteochondral tissue (osteochondroma). As a rule, neoplasms cause discomfort and are felt during palpation. Benign tumors are treated surgically, some can turn into cancerous tumors.
Soft tissue tumors of the thigh:
- lipoma
- rhabdomyoma
- fibroma
- hemangioma
- neuroma
An oncologist is involved in the diagnosis and treatment of tumors in the hip and pelvis.
What to do
With severe pathologies of the hip joint, a person feels severe pain. Discomfort in the pelvic region is a reason to visit a medical institution for examination and treatment.
Special attention should be paid to the intensity of pain:
- Lungs- occurs with bruises after an injury. Cold should be applied to the painful area to reduce swelling. It is recommended to take non-steroidal anti-inflammatory drugs to reduce pain. It is advisable to consult a doctor.
- Medium- usually occurs in diseases of the hip joint, which are accompanied by difficulty in motor activity and an increase in body temperature. Anxiety increases during physical activity. You need to see a rheumatologist.
- Strong- caused by dislocations and fractures. It is accompanied by limitation or impossibility of physical activity. In cases of severe pain in the hip joint caused by an injury, you should contact an emergency service.
There are many folk recipes 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 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 see?
If you have hip pain, 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, sprain, fall and other injuries
- rheumatologist- joint pains that start suddenly without any reason
It may be necessary to refer to other doctors: surgeon, oncologist, infectious disease specialist, etc.
Diagnostics
The first important step in the diagnosis of 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 certain area of the body
- CT and MRI- modern accurate diagnostic methods that allow obtaining highly informative images of the joint and the area around it
- microbiological examination of a sample of biological materialallows to detect the presence of pathogenic microorganisms: viruses and bacteria
- immunological blood test- allows to identify immune disorders, determine the presence of certain autoantibodies
- arthroscopy (endoscopic examination)— examination using a probe, the possibility of taking a joint tissue sample for further research
- laboratory examination of effusion- taking a sample of intra-articular fluid during puncture and determining the causative agent of an infectious disease, checking sterility
The use of several diagnostic methods in combination allows determining 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 treatment or surgery is prescribed.
Medicine
Treatment of pain in the hip joint should be comprehensive, aimed at eliminating the symptoms, and most importantly, at 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, eliminate swelling
- means to improve microcirculation- helps restore blood circulation and nutrition of joint tissues
- chondroprotectors- promotes cartilage tissue regeneration
- muscle relaxants- reduce pain, improve blood flow in the injured area
- hormonal drugs- to relieve pain and suppress inflammation
Physiological procedures are highly effective in the treatment of pain in the hip joint: massage, acupuncture, cryo and laser therapy. Special therapeutic exercises and manual therapy are also used.
Surgical
In advanced cases, when conservative treatment does not help the patient, surgical intervention is indicated. 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 in the joint, so 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
In the early stages of the disease, visiting a doctor on time increases the effectiveness of treatment, as well as reduces the risk of complications and serious consequences for the body.