Pain in the hip joint

Strong, complex in structure, withstands enormous loads, the hip joint is subject to various pathologies that lead to the appearance and development of pain.

Hip pain is caused by:

• injuries;
• contagious infection;
• destructive processes in joints;
• inflammation;
• metabolic disorders.

A person can feel that he "gives" in the groin, buttocks, knee. Perhaps the appearance of lameness, muscle atrophy, their weakness, limited functionality of the limbs.

Practice shows that the nature and intensity of the pain syndrome can be different:

• start (until you "disperse");
• night;
• night;
• constant (light, medium, strong).

Why does the leg hurt in the hip area

There are many articular and extra-articular diseases that lead to pain syndrome. Among them:

• coxarthrosis;
• arthritis of various nature;
• pseudogout;
• Kenning's disease;
• fractures, dislocations, bruises;
• tendinitis;
• myositis;
• bursitis.

Pain in the hip joint: which doctor should I see?

It is obvious that the number of pathologies that lead to hip pain or numbness cannot be treated by one specialist. Most likely, you should consult a traumatologist or a rheumatologist. A consultation with a surgeon may be required. Due to the fact that the pain "shoots" in the groin, buttocks, lower abdomen, a person can be referred to a neurologist. So, coxarthrosis is "masked" as sciatica, problems with nerve roots, disc herniation. But the opposite situation is also possible, when neurological pathologies are suspected, but joint disease is detected.

Women often cannot distinguish the cause of pain in the groin - inflammation of appendages or joint disease. A visit to the gynecologist will bring clarity. A urologist will help men determine if there are prostate pathologies.

Diagnostic measures

In medical practice, a well-coordinated scheme has been developed, the use of which makes it possible to fully determine why the hip joint hurts, what to do and how to treat it.

During the first visit, the doctor's task is to collect the medical history. The person is asked about lifestyle, physical activity, to find out if there are relatives suffering from joint diseases. An external examination of the joint and its palpation are also carried out. In the presence of inflammation, this will help to narrow down the range of hypothetical diseases that cause pain.

Further, various laboratory tests and hardware studies are assigned. As a rule, resort to:

• tomography;
• radiography;
• endoscopy.

You will need immunological and microbiological blood tests, a rheumatoid factor test. You may need to examine the joint's synovial fluid.

Treatment methods

Due to the fact that pathologies are quite diverse, they cannot be treated according to one scheme. For example, inflammation of the hip joint, its symptoms and treatment will be different from the work of a doctor with an injury. In case of fracture or dislocation, the rheumatologist or surgeon will prescribe immobilization of the joint. In case of infectious and purulent pathologies, it is necessary to take antibiotics.

Inflammatory and degenerative diseases require the use of the following groups of drugs:

• non-steroidal;
• diuretics;
• chondroprotectors;
• muscle relaxants;
• vitamin complexes.

In this case, the treatment is long, it is carried out in several courses, which can last several years. In addition to drug therapy, a person performs exercises, makes efforts to reduce weight, undergoes physiotherapy procedures. If it is not possible to help the patient with conservative methods, surgical methods must be used.

How does the hip joint hurt, what symptoms characterize diseases that can cause pain, we considered the methods of traditional treatment. However, various joint diseases have been known to people for thousands of years. Therefore, traditional medicine has developed a significant amount of knowledge about how to help the patient who cares about the joints. Of course, herbal medicines, lotions, poultices, taking decoctions and tinctures cannot be the main method of treatment, but doctors recommend it as a supplement to the main therapy. You cannot drink or apply anything on your own, without consulting a specialist, because there is a risk of allergy, burns or simply wasting time and effort without results.

Treatment of pain in the hip joint with folk remedies helps to achieve an anesthetic effect, strengthening the body. Most often, alternative medicine offers public components: burdock root, lard, garlic, five-leaf clover, dandelion, berry bush leaves, buds and fruits. For example, common rosehip soup is a storehouse of vitamin C and an excellent diuretic that removes excess fluid and unnecessary salt, reducing the load on the legs and heart.

Pain spreads to the leg when walking - causes, symptoms

If you feel pain while walkingthighcovers the body oflower backto the lower leg, or localized in the hip area, it is necessary to visit a doctor. Diseases of the hip joints, which experience heavy loads duringwalking, running, fitness classes, progress quickly and can lead to disability. In order for the movement to bring joy and benefit, monitor the health of the musculoskeletal system. If there are symptoms of pain, you must be examined and begin treatment as soon as possible. In most diseases, bone tissue, cartilage and joints are destroyed, which cannot be restored. You can only remove the inflammatory process, stop or slow down their destruction.

general description

The hip joint is multiaxial, cup-shaped. It combines the pelvis and the femur into one system, which allows a person to walk, lift himself uplegslift and set aside. It works with every step, squat. While the joint is healthy, we don't feel it. But with inflammation, pinchingnerves, there is aching, increasing or sharp pain. It is located inthigh, but as the disease progresses, it spreads,returnsinlegs, inlower back.

If notto treatinflammatory process:

• the size of the joint bag decreases, which contains synovial fluid - an intra-articular lubricant that reduces friction and slows the wear and tear of the joints;
• the membranes that protect the joint are damaged;
• cartilage, bone tissue is destroyed.

Prevention

It is possible to protect hip joints from destruction, maintain mobility until old age, if you monitor your health. Diseases of the musculoskeletal system cause excess weight. It increases the load on the joints and they wear out faster. It is not only body weight in kilograms and height that is important, but also the ratio of muscle and fat tissue. Strong, developed in the gym, muscles form a muscular corset that supports the body in an upright position, reduces the load on the spine, hip and knee joints, and feet.

Destruction of cartilage and bone tissue occurs with a lack of calcium and other trace elements. Include more vegetables, lean fish, dairy products, and cheeses in your menu. Take the mineral-vitamin complexes recommended by your doctor. Avoid injury. Do not wear uncomfortable shoes. Walk more, 2-3 times a weekdoexercises for strengthening and stretching muscles.

Causes of pain

Hipmaybeget sick:

• after an accidental fall, blow - if the pain does not disappear in 2-3 days, it is necessary to visit a traumatologist,doradiography;
• with the development of arthrosis - the joint becomes inflamed, the pain is felt at rest and intensifieswalking;
• in arthritis - aching pain, which worsens at night;
• in case of violation of metabolism, blood flow - tissues do not receive enough nutrients, oxygen, removal of toxins is delayed;
• if the infection enters - scratches, scratches, purulent rash on the thigh can become a gateway for infection, penetrating the joint, causing acute infectious bursitis with acute unbearable pain;
• in diabetes mellitus, other systemic diseases;
• with inflammatory processes in the body, accompanied by an elevated temperature or with the risk of spreading to the joint.

It is impossible to make an accurate diagnosis on your own. For pain that does not go away for 2-3 days, it is necessary to visit a doctor,dosurvey.

Types of pain

Acute pain in the hip joint occurs with injuries and local inflammatory processes. It can start withrightorto the leftsides, but with the development of inflammation, covers the circumferencehips, returnsinlower back, inlegs. After the examination, the doctor will prescribe anti-inflammatory drugs that will quickly relieve the pain. But sometimes it is necessary to continue the treatment after its disappearance in order to eliminate the causes that caused the inflammation.

With excruciating pain, it is more difficult for the doctor to make a correct diagnosis. It can be created in one place and given in another. If it appears occasionally, you need to notice what its manifestations are associated with: at rest, withwalking, squats, sudden movements.

If the symptoms of pain appear for more than 6 months, the disease has become chronic. To establish a diagnosis, hardware examinations are carried out: X-ray, ultrasound, MRI,is being doneblood analysis.

Diseases and their characteristic symptoms

Pain inthighoccur in various diseases:

• bursitis;
• osteoarthritis;
• coxarthrosis;
• arthritis;
• inflammation of the ligaments;
• neuralgia.

Bursitis

Bursitis is an inflammatory process in the joint bag. It is manifested by acute pain, increased temperature, worsening of the general condition. A painful, hot lump forms under the skin.It healsThis disease is an orthopedic traumatologist.

Osteoarthritis

A chronic disease in which the bone and cartilage tissue of the joint is destroyed. It occurs after injuries, during menopause in women, in metabolic disorders, in excessive stress in athletes and during heavy physical work. Feeling tired in the early stageswalkingpain with sudden movementsfeet.If you start treatment at an early stage, the progression of osteoarthritis can be greatly slowed and motor activity can be maintained in old age. In the second phase, destructive processes in the joint affectnerves. The pain occurs in the morning and disappears in the afternoon. She canTo giveon my knees,lower back. There is tissue swelling. With the progression of osteoarthritis, pain lasts 24 hours, mobility is limited.

Coxarthrosis

In coxarthrosis, the composition of the synovial fluid changes. It does not lubricate the components of the joint, and with every movement there is severe pain, the head of the femur is displaced and deformed. The disease develops in old age or after injuries. In the initial stage, aching pain is felt withrightorto the leftside while walking. When under deformationpinched nerves, pain intensifies, lameness appears. In the third phaseto the leftorrightthe leg is shortened due to the deformity of the femoral head, the difference can be 1-1. 5 cm.

Arthritis

Aching pain on the outsidehipsButtocks are considered by many to be symptomsosteochondrosis. But when making a diagnosis, it is necessary to rule out or confirm arthritis with hardware diagnostics. Different types of arthritis are diagnosed: purulent, rheumatoid, tubercular, psoriatic, reactive.

Inflammation of the ligaments

Tenditis - inflammation of the ligaments, the tendon is manifested by unbearable pain, swelling, reddening of the skin, squeaking sound when walking, elevated temperature. Inflamed tissue canpinchnerve endings, which increases the symptom of pain. That is forbiddento treathis own painkillers. Such treatment can cause complications - the development of tendinosis, when the inflamed ligaments begin to collapse.

Neuralgia

If ahurts the hip, hurts the legburning pain along its lateral surface, additional examinations are carried out to confirm neuralgia,causes of pinched nerve.

Other symptoms

To understand if there is pathology in the hip joint or if the pain is caused by itosteochondrosis gives in the leg, the following symptoms will help:

• when walking, running, bending, the joint creaks or clicks;
• flexibility is lost, freedom of movement is limited - it is difficult to bend down, climb stairs, sit down;
• body temperature rises, osteochondrosisno such symptom;
• gait changes;
• pain symptoms are manifested when walking, trying to lift, moving the leg to the side, but body and hand movements do not cause discomfort.

Diagnosis of pathology

Atosteochondrosisand hip joint pathology similar symptoms. In order to make an accurate diagnosis, the doctor examines the patient, clarifies the complaints, the nature and localization of the pain. In order to determinehow to treat the diseasewhich drugs are contraindicated for the patient, additional examinations are prescribed:

• blood test - shows whether there is an inflammatory process in the body, how strong it is;
• urine analysis - reveals hidden edema, disorders in the excretory system, degree of intoxication of the body;
• blood test for the amount of fibrinogen, other non-specific markers;
• rheumatic tests - determine the rheumatoid factor;
• proteinogram - reveals inflammatory processes, malignant and benign neoplasms, characterizes the composition of protein compounds in the blood;
• radiography - shows the state of bones, cartilage, tendons, reveals fractures, cracks, ruptures, dislocations, degree of destruction or deformation;
• magnetic resonance or computer tomography is needed to see the pathology of soft tissues: muscles, ligaments;
• Ultrasound - shows the condition of the joints, the increase in the volume of their membranes during inflammation, the presence of synovial fluid in different parts of the joint.

Features of treatment of pain of different nature

There is no single scheme for the treatment of hip joint pathologies. Arthritis only needs medication ifto tightennerve endings are different. After establishing the diagnosis, the doctor prescribes the treatment, taking into account the stage of the disease, gender, age of the patient, other chronic diseases and possible allergic reactions.

Painful sensations, inflammations in arthritis are controlled with anti-inflammatory drugs. To prevent the progression of the disease, patients take hormonal drugs. In addition to drug therapy, physiotherapy is also carried out.

Bursitis is treated with non-steroidal anti-inflammatory drugs. If the tests show a strong inflammatory process, injections are given directly into the joint. The doctor selects a solution for injection, studying the characteristics of the course of the disease, the general condition of the patient's body. With a high risk of complications, a severe course of the disease, treatment with corticosteroids is carried out.

In the initial stages of coxarthrosis, treatment with anti-inflammatory drugs is effective. But if the patient did not go to the doctor when he felt ithurtsleg when walking, and the disease is advanced, a complete or partial joint replacement is required. Chondoprotectors are prescribed to restore cartilage tissue.

Glucocorticosteroids are prescribed for connective tissue pathologies.

It is impossible to use strong drugs on your own, without the supervision of a doctor. During therapy, the doctor monitors the general state of the body, periodically prescribes blood and urine tests.

Inflamed hip joint what to do how to treat

Septic arthritis of the hip. Diagnosis and treatment

Septic arthritis- a disease in childhood, and for the hip joint the average age is even lower than in arthritis of other locations: 70% of cases occur in children younger than 4 years. The smaller the child, the worse the outcome of hip arthritis. A child's refusal to walk is often associated with bacterial infections of the hip joint.

In oneresearch, during which the authors excluded all patients who refused to walk because of obvious previous pathology, 21 of 22 patients were found to be the cause of bacterial infection. Osteomyelitis and septic arthritis occurred with equal frequency and accounted for 14 cases out of 22. Discitis also occurred in a significant number of cases.
Increasedtemperatureit was present in 82% of patients with bacterial infection, but only in 17% of those without infection. The number of leukocytes in the blood and ESR were not increased.

Pathogenesis of septic arthritis of the hip joint

Atseptic arthritis of the hipIn the inflammatory process, Staphylococcus aureus is most often sown. Infection usually involves the joint cavity from an osteomyelitic focus within the joint capsule. Osteomyelitis is, as a rule, of hematogenous origin and affects the metaphysis of the thigh, penetrating through the supply vessels. The infection may come to the surface in the form of a subperiosteal abscess.

Inflammation of the hip jointit usually develops due to the penetration of pathogens from the foci of osteomyelitis in the neck of the femur into the joint capsule. There is a significant difference between the development of the disease in older and younger children. In older children, this disease is usually the result of femoral neck osteomyelitis. In infants, it may result from hematogenous dissemination in generalized septicemia.

articular cartilagecannot withstand the increased intra-articular pressure caused by pus produced by staphylococci. In addition, the staphylococcus produces an activator of staphylokinase, which contributes to the destruction of joint cartilage. Cartilage can withstand these forces for 4-5 days before destructive changes begin. Other organisms that can cause septic arthritis of the hip in children include pyogenic streptococci and Pfeiffer's bacillus.

streptococcal infectionusually accompanied by a much more rapid increase in signs and symptoms. Pfeiffer bacillus infection is usually responsible for septic arthritis that develops in children in the first 12 months of life, although it can also occur in the first 2 years of life. Gonococcal arthritis should be suspected in young adults.

Clinical picture of septic arthritis of the hip joint

usually,childYou were admitted to the Emergency Department with a high temperature, irritability and severe pain in the affected hip joint, accompanied by significant limitation of movement in it in all directions and muscle spasms. The child limps or refuses to walk at all. The affected hip is flexed, externally rotated, and abducted. During the examination, the patient has pain in the groin and above the hip joint, intoxication.

Numberleukocytesin synovial fluid, on average, it is 57, 000 µl, but it can vary from 10, 000 to 250, 000 µl. Shifting the formula to the left is characteristic, blood cultures are positive in more than 50% of cases. The level of mucin in the joint fluid was lowered in all cases, as well as the level of glucose in relation to its content in the blood in most of the examined patients. The erythrocyte sedimentation rate is usually increased.

In one study, all patients had some degree of soft tissue swelling in the hip area. The smaller the child, the more likely they are to detect joint space widening. In another study, many patients initially had normal X-rays. The most typical was pathological subluxation of the hip with expansion of the joint space. Some patients had osteomyelitis of the proximal femur.

Differential diagnosis of septic arthritis of the hip

Septic arthritis of the hipshould be distinguished from a number of other diseases. Transient synovitis can be manifested by intense pain, severe lameness and limitation of movement in the hip joint. Radioisotope scanning helps distinguish this disease from septic arthritis. If this is not possible, bedside skin traction in the hospital will help in establishing a differential diagnosis. Significant improvement of the condition with reduction of symptoms within 24 hours indicates transient synovitis.

If the doctor has doubtsseptic arthritis, the joint should be punctured, the effusion removed and antibiotic therapy started. Hemophilia is difficult to distinguish, but such patients are most often registered for this disease. If this disease is suspected, immediate decompression is indicated to prevent damage to the femoral head due to increased intra-articular pressure.

Rheumatic attackit can present with significant pain and limited range of motion in the hip joint. As a rule, this disease has volatile arthritis and arthralgia, which helps in the differential diagnosis.

Treatment of septic arthritis of the hip

Perhaps the most importanta momentWhat the emergency physician should be aware of is that the delay in the diagnosis of this disease and the late initiation of treatment worsen the prognosis and outcome of this disease. In one study, a poor outcome was reported in almost all cases when treatment was started more than 4 days after the onset of symptoms.

Purpose of treatment- removal of effusion from the joint to prevent the destruction of joint cartilage and the formation of adhesions, as well as joint decompression to prevent impaired blood flow to the epiphysis. Adequate doses of parenteral antibiotics are required. Initially, the use of antibiotics from the penicillin group was recommended, but recently other drugs have been preferred. An important component of the treatment is the puncture of the joint cavity and its washing. The physician should select the appropriate antibiotic based on the most likely suspected microorganism based on the patient's age and onset characteristics. Inoculation and Gram staining play an important role in antibiotic selection.

They are most often foundstaphylococcal arthritis, amenable to methicillin or oxacillin therapy. If gonococcal arthritis is suspected in adults, intravenous penicillin at a dose of 10 million IU/day is recommended.

Unfortunately, the way to completely get rid of coxarthrosis has not yet been invented. Even joint arthroplasty does not guarantee that dystrophic changes in it will stop. Of course, the earlier the diagnosis is made, the easier it is to keep the disease under control and prevent relapses. With the disease in stages 1-2, it is quite possible to live and feel comfortable if you follow some rules and restrictions.

Treatment will be effective only after a comprehensive diagnosis. The task of treating osteoarthritis in this case is to increase joint space, restore joint efficiency and, as far as possible, regenerate cartilage tissue.

If you experience frequent or recurring hip pain, don't turn a blind eye to it. Will it be possible to detect the disease at an early stage? You can stop the disease and prevent its development. If the doctor makes you happy with the absence of a serious diagnosis, all the better! Continue to lead a healthy lifestyle and do not forget to visit the orthopedist regularly - after all, the first alarm bell has already sounded.