Powerful, complex in structure, resistant to huge loads, the hip joint is prone 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 disturbances.
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:
- begin (until you "disperse");
- night;
- evening;
- constant (light, medium, strong).
Why does the leg hurt in the hip area
There are many articular and extra-articular conditions leading to pain syndrome. Among them:
- coxarthrosis;
- arthritis of various nature;
- pseudogout;
- Kening's disease;
- fractures, dislocations, bruises;
- tendonitis;
- myositis;
- bursitis.
Painful hip joint: which doctor should I go to?
It is obvious that the many pathologies that lead to pain or numbness in the hip cannot be treated by a single specialist. Most likely, you should contact a traumatologist or rheumatologist. A consultation with a surgeon may be necessary. Due to the fact that the "pushing" pain in the groin, buttocks, lower abdomen, a person can be referred to a neurologist. So coxarthrosis "masquerade" as sciatica, nerve root problems, herniated discs. But the opposite situation is also possible, when neurological pathologies are suspected, but joint disease is detected.
Women often cannot differentiate the cause of groin pain - the 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 pathologies of the prostate.
Diagnostic measures
In medical practice, a well-coordinated scheme has been developed, the use of which makes it possible to completely 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 an anamnesis. A person is asked about his lifestyle, physical activity, whether there were relatives with 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 conditions that cause pain.
In addition, various laboratory tests and material studies are assigned. As a general rule, resort to:
- tomography;
- x-ray;
- endoscopy.
You will need immunological and microbiological blood tests, a test for rheumatoid factor. You may need to examine the joint's synovial fluid.
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 an injured doctor. 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 undergo a course of antibiotics.
Inflammatory and degenerative diseases require the use of the following groups of drugs:
- nonsteroidal;
- diuretics;
- chondroprotectors;
- muscle relaxants;
- vitamin complexes.
In this case, the treatment is long, carried out in several cures, which can last several years. In addition to drug therapy, a person performs exercises, makes efforts to lose weight, undergoes physiotherapy procedures. If it is not possible to help the patient with conservative methods, then surgical methods should be used.
How the hip joint hurts, what symptoms characterize diseases that can cause pain, we considered folk methods of treatment. However, various joint diseases have been known to man for 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 addition to the main therapy. Itself, without consulting a specialist, you can not drink or apply anything, as there is a risk of an allergy, burning or simply wasting time and effort without achieving results.
Treatment of pain in the hip joint with folk remedies helps to achieve an anesthetic effect, strengthen the body. Most often, alternative medicine offers public components: burdock roots, pork fat, garlic, potentilla, dandelion, berry leaves, 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, thereby 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 ofloinsin the lower leg or localized in the hip area, you should consult a doctor. Diseases of the hip joints, which experience high loads duringwhile walking, running, fitness classes progress rapidly 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 suppress the inflammatory process, stop or slow down their destruction.
general description
The hip joint is multiaxial, cup-shaped. It combines the pelvis and femur into one system, which allows a person to walk, liftleglift and set aside. It works with every step, squatting. As long as the joint is healthy, we don't feel it. But with the inflammation, the pinchnerves, there is aching, intense or sharp pain. It is located inthigh, but with the progression of the disease it spreads,makesinleg, inloins.
Otherwisetreatinflammatory process:
- the size of the joint bag is reduced, which contains synovial fluid - an intra-articular lubricant that reduces friction and slows down joint wear;
- 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 into old age, if you monitor your health. Diseases of the musculoskeletal system cause excess weight. This increases the load on the joints and they wear out faster. Not only body weight in kilograms and height are important, but also the ratio of muscle tissue to fat 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 mineral-vitamin complexes recommended by your doctor. Avoid injury. Do not wear uncomfortable shoes. Walk more, 2-3 times a weekdoexercises to strengthen and stretch the muscles.
Causes of pain
Hipperhapsget sick:
- after a clumsy fall, blow - if the pain does not go away in 2-3 days, you need to consult a traumatologist,dox-ray;
- with the development of arthrosis - the joint becomes inflamed, the pain is felt at rest and intensifies withwhile walking;
- with arthritis - aching pain, worse at night;
- in violation of metabolism, blood flow - tissues do not receive enough nutrients, oxygen, elimination of toxins is delayed;
- if an infection penetrates - abrasions, scratches, purulent rashes on the thigh can become a gateway for infection, penetrating into the joint, it causes acute infectious bursitis with unbearable sharp 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 pains that do not go away for 2-3 days, you need to consult a doctor,doinvestigation.
Varieties of pain
Acute pain in the hip joint occurs with injuries and local inflammatory processes. It can start withrightWhereleftside, but with the development of inflammation, covers the circumferencehips,makesinloins, inlegs. The doctor, after examination, will prescribe anti-inflammatory drugs that will quickly relieve pain. But sometimes it is necessary to continue treatment after its disappearance in order to eliminate the causes that caused the inflammation.
With aching pain, it is more difficult for a doctor to make a correct diagnosis. It can arise in one place and give in another. If it appears periodically, you need to notice what its manifestations are connected with: at rest, withwhile walking, squats, lunges.
If the painful symptoms appear for more than 6 months, the disease has become chronic. To establish the diagnosis, physical examinations are carried out: X-ray, ultrasound, MRI,is being doneblood test.
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 joint bag. It is manifested by acute pain, fever, impaired general well-being. Under the skin, a painful, hot bump forms.HealsThis disease is an orthopedic traumatologist.
Osteoarthritis
Chronic disease in which the bone and cartilage tissues of the joint are destroyed. It develops after injuries, during menopause in women, with metabolic disorders, with excessive stress in sportsmen and during heavy physical work. feeling tired at firstwhile walkingpain with sudden movementsfeet.If you start treatment at an early stage, the progression of arthrosis can be significantly slowed down and motor activity can be maintained in old age. At the second stage, destructive processes in the joint affectnerves. The pain appears in the morning and disappears in the afternoon. She canrevealon the knees,loins. 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 each 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 withrightWhereleftside while walking. In case of deformationpinched nerves, pain intensifies, lameness appears. At the third stageleftWhererightthe leg is shortened due to the deformation of the femoral head, the difference may be 1-1. 5 cm.
Arthritis
aching pain outsidehipsbuttocks many consider the symptomsosteochondrosis. But when diagnosing 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 are manifested by unbearable pain, swelling, redness of the skin, creaking when walking, fever. Inflamed tissue canpinchnerve endings, which improves the symptom of pain. It's forbiddentreathis own painkillers. Such treatment can lead to complications - the development of tendinosis, when the inflamed ligaments begin to collapse.
Neuralgia
If athe hip hurts, gives way in the legburning pain along its lateral surface, additional examinations are performed to confirm neuralgia,pinched nerve causes.
Other symptoms
To understand whether there is a pathology in the hip joint or whether the pain is caused by the fact thatosteochondrosis gives in the leg, the following symptoms will help:
- when walking, running, bending, the joint cracks or snaps;
- 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 are manifested when walking, trying to lift, pull out the leg, but movements of the body, hands do not cause discomfort.
Pathology diagnosis
Toosteochondrosisand pathologies of the hip joint similar symptoms. To establish an accurate diagnosis, the doctor examines the patient, clarifies complaints, the nature and localization of pain. Determine,how to treat the diseasewhat drugs are contraindicated for the patient, additional examinations are prescribed:
- a blood test - it shows whether there is an inflammatory process in the body, its strength;
- 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 nonspecific markers;
- rheumatic tests - determining the rheumatoid factor;
- proteinogram - reveals inflammatory processes, malignant and benign neoplasms, characterizes the composition of protein compounds in the blood;
- x-ray - shows the condition of bones, cartilage, tendons, reveals fractures, cracks, ruptures, dislocations, the level of destruction or deformation;
- magnetic resonance or computed tomography is necessary 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 only needs medication ifpinchedthe nerve endings are different. The doctor, having diagnosed, 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 performed.
Bursitis is treated with nonsteroidal anti-inflammatory drugs. If the tests show a strong inflammatory process, the 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 carried out.
In the early stages of coxarthrosis, treatment with anti-inflammatories is effective. But if the patient did not go to the doctor when he felt thatit hurtsleg when walking and the disease is advanced, a complete or partial arthroplasty is necessary. To restore cartilage tissue, chondoprotectors are prescribed.
In connective tissue pathologies, glucocorticosteroids are prescribed.
It is impossible to use strong drugs on your own, without the supervision of a doctor. During treatment, 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 locations: 70% of cases occur in children under 4 years old. 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.
Into research, in which the authors excluded all patients who refused to walk due to obvious previous pathology, it was found that in 21 of the 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 occurred in a significant number of cases.
IncreaseTemperaturewas in 82% of patients with bacterial infection, but only in 17% of those without infection. Blood leukocyte count and ESR did not increase.
Pathogenesis of septic arthritis of the hip joint
Toseptic arthritis of the hipIn the inflammatory process, Staphylococcus aureus is most often sown. The infection usually affects the joint cavity from an osteomyelitis 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 as 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 sepsis.
articular cartilagedoes not support the increase in intra-articular pressure caused by pus produced by staphylococci. In addition, staphylococcus produces a staphylokinase activator, which contributes to the destruction of articular cartilage. The cartilage can withstand these forces for 4-5 days before the destructive changes begin. Other organisms that can cause septic arthritis of the hip in children include streptococcus pyogenic and Pfeiffer's bacillus.
streptococcal infectionusually accompanied by a much more rapid increase in signs and symptoms. Pfeiffer's bacillus infection is usually responsible for septic arthritis which develops in children during the first 12 months of life, although it can occur during 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 room with high fever, irritability and severe pain in the affected hip joint, accompanied by severe limitation of movement in all directions and muscle spasms. The child hobbles 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, it is on average 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 relative to its content in the blood in most of the patients examined. 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 he is to detect an expansion of the joint space. In another study, many patients had normal x-rays at the start. The most typical was a pathological subluxation of the hip with widening of the joint line. 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 manifest as intense pain, severe lameness, and limitation of movement in the hip joint. The scintigraphy helps to differentiate this disease from septic arthritis. If it is not possible to achieve this, a skin traction on the bed in the hospital will help establish 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 these patients are usually registered for this disease. If this disease is suspected, urgent decompression is indicated to avoid 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 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, poor outcome was noted in almost all cases when treatment was started more than 4 days after symptom onset.
Purpose of processing- 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 insufficient 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 part 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 stain play an important role in the choice of antibiotic.
We most often findstaphylococcal arthritis, susceptible to treatment 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 there. Of course, the earlier the diagnosis is made, the easier it is to control the disease and prevent relapses. With stage 1-2 disease, it is quite possible to live and feel comfortable if you follow certain rules and restrictions.
Treatment will be effective only after a complete diagnosis. The task of the 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 overlook it. Will it be possible to detect the disease at an early stage? You can stop the disease and prevent its development. If you like the doctor in 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 sounded.