Pain in the hip joint - most often it occurs gradually, gradually. At first, the patient does not attach any importance to it. But in vain. Over time, the pain intensifies, becomes intolerable. But that's not all. Because of gross structural changes, the movements in the hip joint are steadily lost.
A bit of anatomy
Before we understand why hip pain develops, we should briefly discuss the peculiarities of the anatomical structure of the joint itself. The hip joint is the largest, most massive anatomical junction of the human body. It is formed by two bones - the head of the femur and the acetabular cavity of the ischium. The configuration of the hip joint approaches a spherical joint.
Like a billiard ball in the pocket, our hip bone is in the acetabulum. The articular surfaces of the bones are covered with cartilage. To supplement the congruence and increase the area of contact of articular surfaces, the acetabulum is additionally surrounded by a cartilaginous lip that is shaped like a roller. The articular surfaces are enclosed in an articular capsule, the joint is additionally strengthened by ligaments and muscles.
What causes pain in the hip joint? If not from everything, then from much. Our hip joint, being a giant, is also a hard worker. It lays down the lion's share of the load while maintaining the body in a vertical position and moving. Here movements are made in three planes - flexion-extension, reduction-lead and pronation-supination( rotation inside and out).But this giant laborer is defenseless and prone to many pathological changes accompanied by pain. All the multiple causes of hip pain can be grouped as follows:
- Congenital abnormalities( dysplasia);
- Diseases( arthritis and arthrosis);Injuries to the hip joint.
In some cases a combination of one or more of these features is noted.
Incorrect, incomplete hip joint formation( dysplasia) is the main cause of hip pain in children. Although the wrong treatment tactics can lead to chronic hip pain and in adults. But in adults this pathology is called arthrosis( with reference to the hip joint - coxarthrosis).Coxarthrosis is a chronic degenerative disease of the hip joint tissues. Initially, it is manifested by thinning of cartilage of articular surfaces. Subsequently, the subchondral bone under the cartilage suffers.
Coxarthrosis may result in:
- Severe concomitant diseases( hypertension, diabetes, atherosclerosis);
- Sedentary lifestyle;
- Calcium deficiency in bone tissue - osteoporosis;
- Age changes in the joint.
The structure of the joint with arthrosis is disrupted. This is accompanied by a crunch and pain. The volume of movements in the joint is reduced until complete immobility due to the fusion of articular surfaces - ankylosis.
In other situations, pain in the hip is due to the inflammatory process - arthritis( or coxarthritis).Inflammation in the joint leads to the accumulation of intra-articular fluid in the joint cavity. In this case, the internal synovial membrane of the joint capsule and the joint cartilage itself are affected. Among the common causes of coxarthritis: rheumatism, rheumatoid arthritis, gout. These diseases occur chronically, the pain is almost constant. Pain intensifies at night, as well as after physical exertion. In addition to pain, there are signs of inflammation, such as swelling of the joint, redness of the skin above it, an increase in local( and sometimes general) temperature.
Especially severe septic coxarthritis. Under these conditions, pyogenic infection penetrates into the joint from other foci. The disease proceeds violently, with severe pain, severe fever, defeat of other organs and extremely severe general condition of the patient. This so-called."Hot" intra-articular abscesses or abscesses. But there are also "cold" stagnant abscesses, or simply, the insects hitting the hip joint. The cause of the stitching is a tuberculosis infection. In this case, it affects the overlying structures - vertebrae( tuberculous spondylitis) lymph nodes. And then the descending way the tubercular infection penetrates into the joint. Symptoms are less pronounced here than with septic arthritis - moderate pain, low or normal temperature, a small accumulation of pus in the joint cavity.
Signs of arthrosis of the hip joint
It is noteworthy that the pains in the hip can not be connected with the pathology of the joint itself. With some diseases of the spine, pain passes from the waist to the hip joint region. Patients at the same time complain of aching pain, which they mistakenly take for the joint. This happens with osteochondrosis, radiculitis, disc hernias, curvature of the spine, ankylosing spondylitis called Bechterew's disease. In addition, with these diseases, the changed posture leads to a shift in the center of gravity. The load on the joint increases, which leads to secondary arthrosis changes in it.
In certain cases, aseptic necrosis of the femoral head develops in the hip joint. This means that some pathological processes or non-infectious factors have led to the destruction and necrosis of bone-cartilage tissue of the femur. These processes and factors are similar to those in coxarthrosis - metabolic disorders, severe co-morbidities. Aseptic necrosis is accompanied by severe pain and quickly leads to irreversible motor damage in the joint. Unlike coxarthrosis, it develops in one joint - right or left, and affects mostly men to 40-45 years.
Acute pain in the hip - a sure sign of injuries, among which:
- Dislocation - a complete displacement of the head of the femur with respect to the acetabulum;
- Subluxation - partial displacement;
- Fracture of the femoral neck - bone marrow connecting the femur with its head. The neck of the hip, as a rule, develops when it falls in the elderly and in people suffering from osteoporosis. In addition, persistent hip pain, increasing over time, should cause caution in terms of a hip joint tumor.
In order to establish the truth and find out the cause of pain, a comprehensive diagnosis is needed.
An ordinary X-ray photograph can tell a lot about the nature of pain in those cases if they are caused by gross bone defects. But the x-ray apparatus will not "see" the changes from the joint capsule, ligaments and nearby muscles. This requires more sophisticated diagnostic methods - computer tomography, nuclear magnetic resonance, conducted on modern highly sensitive equipment. Based on laboratory indicators, one can judge the nature and severity of inflammation and even exclude the tumor process.
Video with useful exercises:
All these problems are solved simply - you just need to take off the pain. And for this it is enough to drink a pill of an anesthetic drug - something like Analgin. In extreme cases, inject Analgin intramuscularly. This is the erroneous opinion of many. In fact, everything is more complicated, and pain with the help of drugs can be healed only for a while. Many of the above conditions that led to pain, are formed not in one day, but for many years. Therefore, the joint pain can not be removed immediately.
Long-term course of several groups of drugs is needed, among them - anti-inflammatory drugs( steroid and non-steroid), chondroprotectors, calcium preparations, fortifying agents. The accumulated intra-articular fluid, the pus is removed, and antibiotics, anti-inflammatory drugs are injected into the joint cavity. As soon as the pain subsides, go to restorative treatment, which includes massage, physical therapy, sanatorium treatment.
For the period of exacerbation with increased pain, the hip joint should be immobilized( immobilized) by means of orthopedic devices - orthoses
Unfortunately, all these conservative measures can not always eliminate pain and restore movement. Aseptic necrosis, the effects of arthrosis in the form of gross structural disorders are irreversible. And the fracture of the neck of the femur in the elderly itself does not grow together. All these states serve as indications for surgical intervention, namely, the complete replacement of a worn joint with a synthetic graft.