A powerful, complex structure that withstands enormous loads, the hip joint is subject to various pathologies that lead to the appearance and development of pain.
Hip pain occurs due to:
- injuries;
- infectious infection;
- destructive processes in the joints;
- inflammation;
- metabolic disorders.
A person can feel that it "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:
- launch (while 'scatter');
- night;
- evening;
- permanent (mild, medium, strong).
Why does the leg hurt in the area of the hip joint
There are quite a few articular and extra-articular diseases leading to pain syndrome. Between them:
- coxarthrosis;
- arthritis of a different nature;
- pseudogout;
- Kening's disease;
- fractures, dislocations, bruises;
- tendinitis;
- myositis;
- bursitis.
Hip pain: which doctor should I see?
It is obvious that a number of pathologies that lead to pain or numbness in the hip joint cannot be treated by a single specialist. Most likely, you should contact a traumatologist or a rheumatologist. A consultation with a surgeon may be necessary. 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 a joint disease is detected.
Women often cannot distinguish the cause of pain in the groin - inflammation is appendages or joint disease. A visit to the gynecologist will clarify. The urologist will help men determine if there are pathologies of the prostate.
Diagnostic measures
In medical practice, a well-coordinated scheme has been developed, the use of which allows 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 anamnesis. A person is asked about the lifestyle, physical activity, find out if there are relatives suffering from joint diseases. An external examination of the joint and its palpation is also performed. In the presence of inflammation, this will help narrow down the range of hypothetical diseases that cause pain.
In addition, various laboratory tests and hardware tests are appointed. As a rule, resort to:
- tomography;
- radiography;
- endoscopy.
Immunological and microbiological blood tests, rheumatoid factor test will be required. You may need to examine the synovial fluid of the joint.
Methods of treatment
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 differ from the work of a doctor with an injury. In the case of a fracture or dislocation, a rheumatologist or surgeon will prescribe immobilization of the joint. In infectious and purulent pathologies, it is necessary to take a course of 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-term, it is carried out by several courses, which can last several years. In addition to drug therapy, a person performs exercises, makes efforts to reduce weight, undergoes physical therapy procedures. If it is not possible to help the patient with conservative methods, surgical methods should be used.
How does the hip joint hurt, what symptoms characterize diseases that can cause pain, we looked at the methods of traditional treatment. However, various joint diseases have been known to man for many thousands of years. Therefore, traditional medicine has developed a considerable amount of knowledge about how to help a patient who is concerned about the joints. Of course, herbal medicine, lotions, compresses, taking decoctions and tinctures cannot be the main method of treatment, but doctors recommend it as an addition to the main therapy. Alone, without consulting a specialist, you can not drink or apply anything, because there is a danger of getting an allergy, burning or simply wasting time and effort without getting results.
Treatment of pain in the hip joint with folk remedies helps to get an anesthetic effect, to strengthen the body. Most often, alternative medicine offers public components: burdock roots, lard, garlic, gentian, dandelion, leaves of berry bushes, buds and fruits. For example, the usual rosehip broth is a storehouse of vitamin C and an excellent diuretic that removes excess fluid and unnecessary salts, reducing the load on the legs and heart.
Pain radiates to the leg when walking - causes, symptoms
If you feel pain while walkingthighcovering the body fromlower backon the lower part of the leg or located in the area of the hip joint, you should see a doctor. Diseases of the hip joints that experience high loads duringwalking, running, fitness classes, progress quickly and can lead to disability. In order for movement to bring joy and benefit, monitor the health of the musculoskeletal system. If there are symptoms of pain, you should be examined and start treatment as soon as possible. In most diseases, bone tissue, cartilage and joints are destroyed, which cannot be restored. You can only eliminate the inflammatory process, stop or slow down their destruction.
general description
The hip joint is multiaxial, cup-shaped. It unites the pelvis and femur into one system that allows a person to walk, to lift himselflegup and set aside. Work with every step, squat. As long as the joint is healthy, we don't feel it. But with inflammation, pinchingnerves, there are pains, increasing or sharp pains. It is located inthigh, but as the disease progresses it spreads,returnsinleg, inlower back.
If nottreatmentinflammatory process:
- the size of the joint bag decreases, which contains synovial fluid - an intra-articular lubricant that reduces friction and slows down the wear of the joints;
- the membranes protecting the joint are damaged;
- cartilage, bone tissue is destroyed.
Prevention
It is possible to protect the hip joints from destruction, maintain mobility until old age, if you monitor your health. Diseases of the musculoskeletal system provoke 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 between muscle and fat tissue. Strong, trained in the gym, muscles form a muscle corset that keeps the body in an upright position, reduces the load on the spine, hip and knee joints and legs.
The destruction of cartilage, bone tissue occurs in the absence of calcium and other trace elements. Include more vegetables, lean fish, dairy products, cheeses in the menu. Take the mineral-vitamin complexes recommended by your doctor. Avoid injury. Don't wear uncomfortable shoes. Walk more, 2-3 times a weekdoexercises to strengthen and stretch the muscles.
Causes of pain
HipperhapsI'm getting sick:
- after an uncomfortable fall, blow - if the pain does not disappear after 2-3 days, you should visit a traumatologist,doradiography;
- with the development of arthrosis - the joint becomes inflamed, the pain is felt at rest and intensifies whenwalking;
- with arthritis - painful pain, aggravated at night;
- in violation of metabolism, blood flow - the tissues do not receive enough nutrients, oxygen, the removal of toxins is delayed;
- if an infection enters - abrasions, scratches, purulent rashes on the thigh can become a gateway for infection, penetrating the joint, causing acute infectious bursitis with sharp unbearable pain;
- with diabetes mellitus, other systemic diseases;
- with inflammatory processes in the body, accompanied by fever or with the risk of spreading to the joint.
It is impossible to make an accurate diagnosis yourself. For pain that does not go away for 2-3 days, you should see a doctor,doresearch.
Varieties of pain
Acute pain in the hip joint occurs with injuries and local inflammatory processes. It can start withexactlyorto the leftside, but with the development of inflammation, covers the circumferencethe thighs,returnsinlower back, inlegs. After an 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 aching pain, it is more difficult for the doctor to make a correct diagnosis. It can arise in one place and give in another. If it appears periodically, you should notice what its manifestations are associated with: at rest, withwalking, squats, sudden movements.
If the pain symptoms appear for more than 6 months, the disease has become chronic. To establish the diagnosis, hardware tests are performed: X-rays, 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 manifests itself with acute pain, fever, worsening of general well-being. A painful, hot bump forms under the skin.HealsThis disease is an orthopedic traumatologist.
Osteoarthritis
A chronic disease in which the bone and cartilage tissues of the joint are destroyed. It develops after injuries, during menopause in women, in metabolic disorders, in excessive stress in athletes and in heavy physical work. Feeling tired in the early stageswalkingpain with sudden movementslegs.If you start the treatment at an early stage, the progression of arthrosis can be significantly slowed down and motor activity can be preserved in old age. In the second stage, the destructive processes in the joint are affectednerves. The pain appears in the morning and disappears in the afternoon. She cangive outon your knees,lower back. There is tissue swelling. With the progression of arthrosis, pain continues around the clock, 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, severe pain is felt, the head of the femur is displaced and deformed. The disease develops in old age or after injuries. In the initial stage, painful pain is feltexactlyorto the leftside while walking. In case of deformationpinched nerves, the pain intensifies, lameness appears. In the third stageto the leftorexactlythe leg is shortened due to deformation of the head of the femur, the difference can be 1-1. 5 cm.
Arthritis
Pain outsidethe thighsbuttocks many consider symptomsosteochondrosis. But when making the diagnosis, it is necessary to exclude or confirm arthritis with hardware diagnostics. Different types of arthritis are diagnosed: purulent, rheumatoid, tuberculous, psoriatic, reactive.
Ligament inflammation
Tendinitis - inflammation of the ligaments, tendons manifests itself with unbearable pain, swelling, redness of the skin, creaking when walking, fever. Inflamed tissue canpinchnerve endings, which increases the pain symptom. Forbiddentreatmenthis own painkillers. Such treatment can lead to complications - the development of tendinosis, when the inflamed ligaments begin to collapse.
Neuralgia
Ifthe thigh hurts, gives in the legburning pain on its lateral surface, additional tests are carried out to confirm neuralgia,causes of pinched nerve.
Other symptoms
To find out if there is pathology in the hip joint or the pain is caused by the fact thatosteochondrosis gives in the leg, the following symptoms will help:
- when walking, running, bending, the joint crunches or clicks;
- flexibility is lost, freedom of movement is limited - it is difficult to bend down, climb stairs, sit down;
- body temperature risesosteochondrosisno such symptom;
- changes in gait;
- pain symptoms are manifested when walking, trying to raise, withdraw the leg, but the movements of the body, hands do not cause discomfort.
Diagnosis of pathology
Atosteochondrosisand pathologies of the hip joint similar symptoms. 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 tests are prescribed:
- blood test - shows whether there is an inflammatory process in the body, how strong it is;
- urine analysis - reveals hidden edema, disturbances in the excretory system, the 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 condition of bones, cartilages, tendons, reveals fractures, cracks, tears, dislocations, the level of destruction or deformation;
- magnetic resonance or computed tomography is needed to see soft tissue pathology: muscles, ligaments;
- Ultrasound - shows the condition of the joints, an increase in the volume of their membranes during inflammation, the presence of synovial fluid in different parts of the joint.
Features of the treatment of pain of a different nature
There is no single scheme for the treatment of pathologies of the hip joint. Arthritis only needs medication ifpinchednerve endings are different. After the diagnosis, the doctor prescribes treatment, taking into account the stage of the disease, gender, age of the patient, other chronic diseases and possible allergic reactions.
Pain sensations, inflammation in arthritis are suppressed by anti-inflammatory drugs. To prevent the progression of the disease, patients take hormonal drugs. In addition to drug therapy, physical therapy is conducted.
Bursitis is treated with nonsteroidal anti-inflammatory drugs. If the research shows a strong inflammatory process, injections are made directly into the joint. The doctor chooses an injection solution after studying the characteristics of the course of the disease, the general condition of the patient's body. At a high risk of complications, a severe course of the disease, corticosteroid treatment is carried out.
In the initial stages of coxarthrosis, treatment with anti-inflammatory drugs is effective. But if the patient does not go to the doctor when he feels thisIt hurtsleg when walking and the disease is in an advanced stage, a total or partial joint replacement is necessary. To restore cartilage tissue, chondroprotectors are prescribed.
Glucocorticosteroids are prescribed for connective tissue pathologies.
It is impossible to use powerful drugs on your own without the supervision of a doctor. During the therapy, the doctor monitors the general condition of the body, periodically prescribing blood and urine tests.
Sore hip joint what to do how to treat
Septic arthritis of the hip. Diagnosis and treatment
Septic arthritis- a disease of childhood, and for the hip joint the average age is even lower than for arthritis with other localization: 70% of cases occur in children under 4 years of age. The younger 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 antecedent pathology, found that in 21 of 22 patients the cause was a bacterial infection. Osteomyelitis and septic arthritis occurred with equal frequency and accounted for 14 of 22 cases. Discitis also occurs in a significant number of cases.
Elevatedtemperaturewas in 82% of patients with a bacterial infection, but only in 17% of those who did not have an infection. The number of leukocytes in the blood and ESR are not elevated.
Pathogenesis of septic arthritis of the hip
Atseptic arthritis of the hipIn the inflammatory process, Staphylococcus aureus is most often cultured. The infection usually affects the joint cavity from an osteomyelitic focus in the joint capsule. Osteomyelitis, as a rule, has a hematogenous origin and affects the metaphysis of the thigh, penetrating through the feeding vessels. The infection may come to the surface in the form of a subperiosteal abscess.
Inflammation of the hip jointusually develops due to the penetration of the pathogen from the focus of osteomyelitis in the neck of the femur into the joint capsule. There is a significant difference in the development of the disease in older and younger children. In older children, this disease usually results from osteomyelitis of the femoral neck. 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, staphylococci produce an activator of staphylokinase, which contributes to the destruction of articular 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 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
usuallykidYou come to the emergency department with high fever, irritability, and severe pain in the affected hip joint, accompanied by significant limitation of motion in all directions and muscle spasm. The child walks with a limp or refuses to walk at all. The affected hip flexes, externally rotates, and abducts. During the examination, the patient has pain in the groin and above the hip joint, intoxication.
Numberleukocytesin synovial fluid averages 57, 000 µl but can vary from 10, 000 to 250, 000 µl. A shift of 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 decreased in all cases, as well as the level of glucose compared to its content in the blood in most of the patients studied. The erythrocyte sedimentation rate is usually increased.
In one study, all patients had some degree of soft tissue swelling in the hip area. The younger the child, the more likely it is that a widening of the joint space will be found. In another study, many patients had initially normal radiographs. The most characteristic is the pathological subluxation of the hip joint with widening of the joint gap. Some patients had osteomyelitis of the proximal femur.
Differential diagnosis of septic arthritis of the hip
Septic arthritis of the hipmust be differentiated from a number of other diseases. Transient synovitis can present with severe pain, severe lameness, and limited range of motion in the hip joint. Radioisotope scanning helps distinguish this disease from septic arthritis. If it is not possible to carry out, pulling the skin at the hospital bed will help to make a differential diagnosis. Significant improvement in condition with reduction of symptoms within 24 hours indicates transient synovitis.
If the doctor suspectsseptic arthritis, puncture the joint, remove the effusion and start antibiotic treatment. Hemophilia can be difficult to distinguish, but such patients are usually registered for this disease. If this disease is suspected, urgent decompression is indicated to prevent damage to the femoral head due to increased intra-articular pressure.
Rheumatic attackmay present with significant pain and limited range of motion in the hip joint. As a rule, with this disease there is 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 needs to know is that delay in the diagnosis of this disease and late initiation of treatment worsens the prognosis and outcome of this disease. In one study, a poor outcome was noted in almost all cases when treatment was started more than 4 days after the onset of symptoms.
Treatment goal- removal of effusion from the joint to prevent destruction of the articular cartilage and formation of adhesions, as well as decompression of the joint to prevent impaired blood supply 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 microorganism suspected, based on the patient's age and onset characteristics. Inoculation and Gram stain play an important role in antibiotic selection.
It is most commonstaphylococcal arthritis, amenable to therapy with methicillin or oxacillin. If gonococcal arthritis is suspected in adults, it is recommended to prescribe penicillin intravenously at a dose of 10 million IU/day.
Unfortunately, a way to completely get rid of coxarthrosis has not yet been invented. Even joint arthroplasty does not guarantee that dystrophic changes will stop in it. Of course, the earlier the diagnosis is made, the easier it is to keep the disease under control and prevent relapses. With a disease of 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 complete diagnosis. The task of treatment of arthrosis in this case is to increase the joint space, restore the efficiency of the joint and, as far as possible, regenerate the 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 will please you with the lack of a serious diagnosis, so much the better! Continue to lead a healthy lifestyle and do not forget to regularly visit the orthopedist - after all, the first alarm bell has already rung.