Powerful, complex in structure, withstanding huge loads, the hip joint is subject to various pathologies that lead to the emergence and development of pain.
Hip pain occurs due to:
- injuries;
- infectious infection;
- destructive processes in the joints;
- inflammation;
- metabolic disruptions.
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:
- starting (until you "disperse");
- night;
- evening;
- constant (light, medium, strong).
Why does the leg hurt in the hip area
There are quite a lot of articular and extra-articular ailments leading to pain syndrome. Among them:
- coxarthrosis;
- arthritis of various nature;
- pseudogout;
- Kening's disease;
- fractures, dislocations, bruises;
- tendinitis;
- myositis;
- bursitis.
Sore hip joint: which doctor should I go to?
It is obvious that the number of pathologies that lead to pain or numbness of the hip cannot be treated by one specialist. Most likely, you should contact a traumatologist or rheumatologist. It is possible that a consultation with a surgeon is 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 "masquerades" as sciatica, problems with nerve roots, herniated discs. But the reverse situation is also possible, when neurological pathologies are suspected, but an articular disease is detected.
Women often cannot differentiate the cause of pain in the groin - inflammation is the appendages or joint disease. A visit to the gynecologist will bring clarity. A urologist will help men determine if there are any prostate pathologies.
Diagnostic measures
In medical practice, a well-coordinated scheme has been developed, the use of which allows one to completely establish why the hip joint hurts, what to do and how to treat it.
During the first visit, the task of the doctor is to collect an anamnesis. A person is asked about lifestyle, physical activity, find out if there were any 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 narrow the circle of hypothetical ailments that give 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 test for rheumatoid factor. You may need to examine the synovial fluid of the joint.
Treatment Methods
Due to the fact that the pathologies are quite diverse, they cannot be treated according to a single 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 the event 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, 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 physiotherapy procedures. If it is not possible to help the patient with conservative methods, surgical methods have to be used.
How the hip joint hurts, what symptoms characterize diseases that can cause pain, we have considered methods of traditional treatment. However, various joint diseases have been known to man for many thousands of years. Therefore, traditional medicine has developed a significant amount of knowledge on how to help a patient who is concerned about the joints. Of course, herbal medicine, lotions, compresses, ingestion of decoctions and tinctures cannot be the main method of treatment, but doctors recommend it as an additional to the main therapy. Himself, without consulting a specialist, you can’t drink or apply anything, because there is a danger of getting an allergy, a burn, 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, strengthen the body. Most often, alternative medicine offers public components: burdock roots, pork fat, garlic, cinquefoil, 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 backto the lower leg, or localized in the hip area, you need to see a doctor. Diseases of the hip joints, which experience high loads duringwalking, running, fitness classes, progress rapidly 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 pain symptoms, you need to 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 remove the inflammatory process, stop or slow down their destruction.
general description
The hip joint is multiaxial, cup-shaped. It combines the pelvic and femur into a single system, which allows a person to walk, liftlegup and set aside. It works with every step, squat. While the joint is healthy, we do not feel it. But with inflammation, pinchingnerves, there is aching, intensifying or sharp pain. It is localized inthigh, but with the progression of the disease, it spreads,gives backinleg, inlower back.
If nottreatinflammatory process:
- the size of the articular bag is reduced, 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;
- cartilaginous, bone tissue is destroyed.
Prevention
It is possible to protect the hip joints from destruction, to maintain mobility until old age, if you monitor your health. Diseases of the musculoskeletal system provokes excess weight. It increases the load on the articular joints, and they wear out faster. Not only body weight in kilograms and height is important, but also the ratio of muscle and adipose tissue. Strong, worked out in the gym, the 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.
The destruction of cartilage, bone tissue occurs with a lack 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 muscles.
Causes of pain
Hipmaybeget sick:
- after an awkward fall, blow - if the pain does not go away in 2-3 days, you need to visit a traumatologist,doradiography;
- with the development of arthrosis - the joint becomes inflamed, the pain is felt at rest and intensifies withwalking;
- with arthritis - aching pain, aggravated at night;
- in violation of metabolism, blood flow - 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 into the joint, it causes acute infectious bursitis with acute 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 on your own. For pain that does not go away for 2-3 days, you need to see a doctor,dosurvey.
Varieties of pain
Acute pain in the hip joint occurs with injuries and local inflammatory processes. It may start withrightorleftside, but with the development of inflammation, covers the circumferencehips,gives backinlower back, inlegs. The doctor, after examining, will prescribe anti-inflammatory drugs that will quickly relieve pain. But sometimes it is required to continue treatment after its disappearance in order to remove the causes that caused inflammation.
With aching pain, it is more difficult for a doctor to make a correct diagnosis. It can arise in one place, and give to another. If it appears periodically, you need to notice what its manifestations are connected with: at rest, withwalking, squats, sudden movements.
If pain symptoms appear for more than 6 months, the disease has become chronic. To establish the diagnosis, hardware examinations are carried out: X-ray, ultrasound, MRI,is being doneblood analysis.
Diseases and their characteristic symptoms
Pain inthighoccur with various diseases:
- bursitis;
- osteoarthritis;
- coxarthrosis;
- arthritis;
- inflammation of the ligaments;
- neuralgia.
Bursitis
Bursitis is an inflammatory process in the articular bag. It is manifested by acute pain, fever, deterioration in general well-being. Under the skin, a painful, hot bump is formed.HealsThis disease is an orthopedic traumatologist.
Osteoarthritis
A chronic disease in which bone and cartilage tissues of the joint are destroyed. It develops after injuries, during menopause in women, with metabolic disorders, with 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 down and motor activity can be maintained in old age. At the second stage, destructive processes in the joint affectnerves. The pain comes on in the morning and disappears in the afternoon. She cangive awayon the knees,lower back. There is tissue swelling. With the progression of osteoarthritis, pain persists around the clock, mobility is limited.
Coxarthrosis
With 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. At the initial stage, aching pain is felt withrightorleftside while walking. When under deformationpinched nerves, pain intensifies, lameness appears. At the third stageleftorrightthe 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 many consider symptomsosteochondrosis. But when making a diagnosis, it is necessary to exclude or confirm arthritis with hardware diagnostics. Different types of arthritis are diagnosed: purulent, rheumatoid, tuberculous, psoriatic, reactive.
Inflammation of the ligaments
Tenditis - inflammation of the ligaments, tendons is manifested by unbearable pain, swelling, redness of the skin, creaking sound when walking, fever. Inflamed tissue canpinchnerve endings, which enhances the pain symptom. It is forbiddentreathis own painkillers. Such treatment can give complications - the development of tendinosis, when the inflamed ligaments begin to collapse.
Neuralgia
If ahip hurts, gives in 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 a pathology in the hip joint or if the pain is caused by the fact thatosteochondrosis gives in the leg, the following symptoms will help:
- when walking, running, bending over, the joint crunches or clicks;
- flexibility is lost, freedom of movement is limited - it is difficult to bend over, climb stairs, sit down;
- body temperature rises,osteochondrosisthere is no such symptom;
- gait changes;
- pain symptoms manifest themselves when walking, trying to lift, take aside 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 complaints, the nature and localization of pain. To determine,how to treat diseasewhich drugs are contraindicated for the patient, additional examinations are prescribed:
- a blood test - it shows whether there is an inflammatory process in the body, how strong it is;
- urinalysis - 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, cartilage, tendons, reveals fractures, cracks, ruptures, dislocations, the level of destruction or deformation;
- magnetic resonance or computed tomography is needed to see the pathology of soft tissues: 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 various 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 needs only medicines ifpinchednerve endings are different. The doctor, after diagnosing, prescribes treatment, taking into account the stage of the disease, gender, age of the patient, other chronic diseases, and possible allergic reactions.
Painful sensations, inflammation in arthritis are suppressed by anti-inflammatory drugs. To prevent the disease from progressing, patients take hormonal drugs. In addition to drug therapy, physiotherapy is carried out.
Bursitis is treated with non-steroidal anti-inflammatory drugs. If the tests show a strong inflammatory process, injections are made directly into the joint. The doctor chooses an injection solution, having studied the features 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 a corticosteroid is performed.
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 thathurtsleg when walking, and the disease is advanced, a complete or partial joint replacement is needed. To restore cartilage tissue, chondoprotectors are prescribed.
In pathologies of connective tissues, glucocorticosteroids are prescribed.
It is impossible to use potent drugs on your own, without the supervision of a doctor. During therapy, the doctor monitors the general condition of the body, periodically prescribing 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 of childhood, and for the hip joint, the average age is even lower than for arthritis of other localization: 70% of cases occur in children under 4 years of age. 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 due to an obvious previous pathology, it was 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 cases out of 22. Discitis also occurred in a significant number of cases.
Increasedtemperaturewas 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 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. The infection usually affects the joint cavity from an osteomyelitic focus within the joint capsule. Osteomyelitis, as a rule, is 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 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 between the development of the disease in older and younger children. In older children, this disease is usually the result of osteomyelitis of the femoral neck. In infants, it may be the result of hematogenous dissemination in generalized septicemia.
articular cartilagecannot withstand the increased intra-articular pressure caused by pus produced by staphylococci. In addition, staphylococcus produces an activator of staphylokinase, which contributes to the destruction of articular cartilage. The cartilage can resist these forces for 4-5 days before the onset of destructive changes. Other organisms that can cause septic arthritis of the hip in children include pyogenic streptococcus and Pfeiffer's bacillus.
streptococcal infectionusually accompanied by a much faster increase in signs and symptoms. Pfeiffer's 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
Usually,childYou are admitted to the emergency department with high fever, irritability, and severe pain in the affected hip joint, accompanied by significant limitation of movement in it in all directions and muscle spasm. The child walks with a limp or refuses to walk at all. The affected hip is flexed, rotated outward 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. 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 lowered in all cases, as well as the level of glucose in comparison with 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 it is to detect an expansion of the joint space. In another study, many patients had normal radiographs at first. The most typical was a pathological subluxation of the hip with widening 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 differentiated 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 to differentiate this disease from septic arthritis. If it is not possible to conduct it, skin traction on the bed in the hospital will help to make a differential diagnosis. A significant improvement in the condition with a decrease in symptoms within 24 hours indicates transient synovitis.
If the doctor suspectsseptic arthritis, the joint should be punctured, the effusion removed, and antibiotic treatment initiated. Hemophilia can be difficult to differentiate, 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 are volatile arthritis and arthralgia, which helps in the differential diagnosis.
Treatment of septic arthritis of the hip
Perhaps the most importantmomentWhat the emergency physician should be aware of is that delay in 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.
Purpose of treatment- removal of effusion from the joint to prevent the destruction of articular cartilage and the 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, it is recommended to use antibiotics from the penicillin group, 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 the choice of antibiotic.
Most often foundstaphylococcal 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 at 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 the joint space, restore the efficiency of the joint, and, to the extent possible, regenerate cartilage tissue.
If you are experiencing frequent or recurring hip pain, do not close your eyes to them. 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 absence of a serious diagnosis, so much 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 been.