Hip pain - what could it be?
Hip pain can occur regardless of gender or age.
Hip pain is characteristic of pathological changes in the hip joint. If this is not a manifestation of any disease, then active physical activity may be the cause. The pain can be chronic or acute (recurring from time to time).
Most people go to the doctor only when they no longer have the strength to endure the pain. You should not do this, it is imperative to consult a specialist if the pain persists for more than a few days, or occurs at regular intervals.
- What can hurt in the hip?
- What kind of pain in the hip can be?
- Causes of hip pain
- Hip pain during pregnancy
- Diagnosis of hip pain
- Which doctor should I contact if I have hip pain?
- Recommendations for hip pain
- Treatment for hip pain
What can hurt in the hip?
Pain occurs when the nerve fibers that run through the thigh are affected. Through them, the pain impulse is transmitted to the spinal cord, and then to the brain.
Structures that can become inflamed in the thigh of the leg:
- Components of the hip joint.
- Thigh bones.
- Muscle fibers.
- Nerve plexuses and fibers.
The process of inflammation has a single developmental scheme. The provoking factor leads to the activation of immune cells. They gather in the pathological focus and direct all forces to neutralize it. These are cells such as: leukocytes, lymphocytes, histiocytes, etc.
Leukocytes in the focus of inflammation are destroyed, releasing serotonin, histamine and other biologically active substances. They promote vasodilation and blood flow to the affected area. The veins and arteries are overfilled with blood, the pressure in them increases, and the throughput increases. Plasma sweats through the vessels, causing tissue swelling.
The edema presses on the nerve fibers, which increases the pain. Moreover, the nerve fibers themselves during this period are most sensitive and react to irritation even more strongly. Therefore, even a slight touch to damaged tissues is painful.
What kind of pain in the hip can be?
Depending on the cause of the pain, it can be acute, somatic, cutaneous, or neuropathic.
Acute pain most often occurs during injury. A person can accurately indicate its localization. Then the sharp pain becomes aching, which is a sign of the development of inflammation.
Somatic pain most often has no clear localization. A person can only point to the area in which it arises. Such pain develops when the soft and hard structures of the thigh are affected
Skin pain lasts less than others. It develops due to the fact that nerve endings that penetrate the dermis are damaged.
Neuropathic pain develops due to damage to nerve tissue. The person indicates that some part of the hip hurts, but in fact there is no inflammatory process there.
Causes of hip pain
Pain can occur both in the thigh itself and radiate into it from other parts of the body. The following causes of pain in the hip are distinguished:
Pathology of the hip joint and femur
- Arthrosis of the hip joint. In this case, the cartilaginous tissue of the joint is destroyed, which leads to a narrowing of its gap, friction of the articular elements against each other and the occurrence of pain. They are especially intense during physical exertion.
Femoral head necrosis. Metabolic disruptions, deterioration of blood supply to tissues, etc., can provoke a violation. This process leads to the fact that the tissues of the hip joint die off. Pain bothers a person during movement, and then at rest.
- Dysplasia of the joints. Young children suffer from this congenital pathology. Pain occurs during movement.
- Epiphysis of the femoral head. This disease makes its debut at the age of 11-14 years. Hormonal imbalance becomes the cause. The strength of the bone tissue suffers, which leads to an incorrect position of the articular surfaces relative to each other. The teenager begins to complain of pain while walking.
- Fracture of the femur.
- Dislocated hip.
- Rheumatoid arthritis. This disease has an autoimmune nature, develops due to disturbances in the functioning of the body's defenses. Cells that must fight pathogens begin to attack their own joints, which leads to their destruction. Pain in the hip increases with stress on the articular structures. It increases in the evening, and weakens by the morning. First, the small joints are affected, and then the process spreads to the large joints.
- Rheumatism. The disease has an autoimmune nature, debuting after an infection caused by beta-hemolytic streptococcus. In rheumatism, the hip joint is often the first to be affected. In parallel with it, other large joints suffer.
Damage to the ligamentous apparatus or thigh muscles. This includes violations such as:
- Myositis. This is an inflammation of muscle fibers that develops with excessive physical exertion. The pain is acute, and weakens at rest. As the inflammation fades away, the painful sensations become aching.
- Trochanteritis. This is an inflammation of the tendons that attach to the femur bone next to the lesser and greater trochanters. Infections, hypothermia, excessive physical exertion can provoke a pathological reaction. In addition to acute and pressing pains, the patient will develop tissue edema.
Spine diseases. This includes osteochondrosis of the spine in the lumbar region and herniated disc. With osteochondrosis, the intervertebral discs become thinner, the distance between them decreases, which leads to infringement of the nerve fibers. As a result, pain from the lower back radiates to the thigh. The nature of the pain is sharp, pulling, can reach the foot. With a hernia, the integrity of the capsule of the intervertebral disc is violated. It falls out and begins to press on the spinal cord. The pain reaches the thigh along the nerve fibers.
Roth's disease. In this disease, the lateral cutaneous thigh is compressed in the place where it leaves the pelvic cavity. The reasons for the development of pathology can be reduced to physical inactivity, overweight, pregnancy, tumors, and operations. At first, the pain is mild, manifests itself in the form of minor tingling sensations. As the disease progresses, it intensifies, becomes burning. It is impossible to endure such pain.
- Atherosclerosis in which cholesterol is deposited in the arteries. Plaques grow, block the lumen of the vessel, disrupt the normal flow of blood to the leg. As a result, the tissues of the lower extremities do not receive enough nutrition and begin to die. Stitching pain, extending not only to the thigh, but to the lower leg, and to the foot. The pain intensifies during exercise, and subsides at rest. The more the artery suffers from a blood clot, the more intense the pain in the leg becomes.
Varicose veins. With this pathology, the valves of the veins are damaged, which provokes venous congestion, since the vessels are overfilled with blood. As a result, the veins stretch and deform. Pain with varicose veins pressing, expanding the thigh from the inside. The veins will show through the skin strongly.
- Thrombophlebitis. This condition is accompanied by inflammation of the vein wall. A thrombus forms inside it, which blocks the lumen of the vessel, which leads to a violation of the outflow of blood, the occurrence of burning and pressing pains, which are of high intensity. The pain is concentrated along the vein.
Infectious diseases. Infectious diseases that can provoke pain in the hip include a furuncle, carbuncle, abscess, phlegmon, fasciitis with tissue necrosis and osteomyelitis.
Tumor neoplasms. Tumors in the thigh area can be malignant or benign. The pain develops due to the fact that the growing neoplasm pinches the nerve endings, blood vessels and soft tissues of the thigh. Benign tumors include: lipoma, hemangioma, fibroma, osteoma, chondroma, neuroma. Cancer tumors: rhabdomyosarcoma, fibrosarcoma, hemangiosarcoma, chondrosarcoma, osteosarcoma.
Formation of hematoma in the retroperitoneal space. If blood begins to accumulate in the retroperitoneal space (if internal organs are damaged), then it will begin to press on the femoral nerve. In this case, the person will experience sharp and burning pains in the hip.
Hip pain during pregnancy
During pregnancy, hip pain can be due to a variety of reasons, including:
Hormonal imbalance. The high production of progesterone leads to relaxation of all muscles and ligaments in the body. When it comes to the hip joint, the woman will tire more quickly when walking, which is expressed by aching pain in the hip.
The increase in body weight leads to the fact that the hip joints are under excessive stress. Hip pain appears after physical exertion or standing for a long time.
Compression of blood vessels, nerve endings and spinal nerves by the growing uterus provokes the onset of pain that radiates to the thigh and to the lower extremities in general.
During pregnancy, the likelihood of exacerbation of any chronic disease increases: arthrosis, osteochondrosis, etc. In addition, the sciatic nerve may be pinched, which also leads to pain in the hip.
Diagnosis of hip pain
Depending on the cause that provoked painful sensations in the hip, diagnostic methods differ:
Diseases of the hip joint and femur:
- With coxarthrosis, a person will complain of a deterioration in mobility in the hip joint; a crunch is often heard during movement. The sore leg becomes shorter, which makes the person limp. To make a diagnosis, the patient is sent for X-ray, CT, MRI. It is possible to perform a puncture of the hip joint.
- With necrosis of the femoral head, a person experiences the same symptoms as with coxarthrosis. The most informative diagnostic method is CT and / or MRI. These techniques allow diagnosing diseases in the early stages of its development.
- With dysplasia of the hip joints, the patient has an asymmetry in the folds of the buttocks, a click is heard during the rotation of the leg. On the affected side, the leg will be shorter, and the joint itself is moved with labor. To detect pathology, ultrasound, MRI or X-ray examination are performed.
- In juvenile epiphysis of the femoral head, the femur muscle becomes smaller in size due to atrophy of its tissues. The person begins to limp, the mobility of the joint is limited. To detect pathology, it is necessary to perform an X-ray in two projections.
- Rheumatoid arthritis, in addition to pain in the hip joint, provokes edema. The affected areas are very swollen. Moreover, similar symptoms are observed not only in one, but in several joints at once. The body temperature rises to 38 ° C. In the morning, a person experiences stiffness in the joints, which lasts at least half an hour. In addition, with rheumatoid arthritis, a person complains of inflammation of the heart, kidneys, lungs and other tissues. To detect the disease, the patient is prescribed a general and biochemical blood test, a blood test is performed to detect a rheumatic factor in it. Also, the patient is prescribed a test for antibodies to his own tissues and x-rays of the joints.
- If you suspect rheumatic fever, it is necessary to clarify whether the person has recently suffered from a sore throat. With this disease, the body temperature rises to high levels, rheumatoid nodules form under the skin, and a rash appears on the dermis. In addition to the joints, other internal organs are affected. To detect pathology, a bacteriological examination of mucus from the pharynx, general and biochemical analysis, ECG are prescribed. The blood is examined for the presence of antibodies to streptococcal infection.
Ligamentous apparatus and muscle injuries:
- Diagnosis of bruises and sprains of the thigh muscles is not difficult, since a person can indicate at what time and when he was injured. Hematomas and bruises are visible in the damaged area. The person limps and complains of pain.
- With myositis, it is enough to collect anamnesis, as well as an external examination of the muscle (it is edematous). During palpation of the muscle, a seal can be found.
- Trochanteritis is manifested by pain in the hip joint and hip. Discomfort increases after physical activity, or in the supine position on the affected side. At the same time, the mobility of the joints is not disturbed, which makes it possible to distinguish the disease from other pathologies.
Diagnosis of spinal diseases is reduced to performing an X-ray examination, CT or MRI. The pain is localized in the lower back, radiates to the buttocks and thigh, and can spread throughout the leg. Possible dysfunction of the pelvic organs with frequent urination and deterioration of potency in men.
Diagnosis of vascular pathologies. To make a diagnosis, the patient is prescribed Doppler ultrasonography of the blood vessels, MRI or contrast angiography.
Diagnosis of infectious diseases. The diagnosis is made on the basis of an external examination and symptoms of the disease (increased body temperature, general intoxication of the body, increased weakness, the presence of purulent foci and tissue necrosis). Additionally, the patient is prescribed a general blood test, microscopic and bacteriological examination of tissue samples and purulent masses.
Diagnosis of tumor neoplasms is reduced to the analysis of symptoms (increased weakness, low-grade fever, weight loss). Be sure to prescribe an MRI or CT scan, as well as a histological examination of a sample of a removed tumor.
Diagnosis of retroperitoneal hematoma requires retroperitoneal ultrasound, CT, or MRI. Symptoms are determined by the underlying pathology and depend on which organ is affected in a person.
Which doctor should I contact if I have hip pain?
If a person is worried about hip pain, then you need to establish the cause of its occurrence. When the victim is seriously injured, such as an open fracture, an ambulance must be called immediately.
In other cases, you may need the help of a traumatologist, neurosurgeon or vascular surgeon, rheumatologist, oncologist, infectious disease specialist, vertebrologist. If a person has doubts about which specialist to go to, then first you need to visit a therapist.
Recommendations for hip pain
The most optimal option for reducing pain in hip pain is to minimize the load on the hip joint. Bends, squats are sharply contraindicated. All homework and necessary work is best done with the help of available tools. For arthritis, arthrosis, coxoarthrosis, it is recommended to use a special cane, which can significantly reduce the load on the joints. Moreover, the cane must be worn in the hand opposite to the affected joint.
Treatment for hip pain
It is important to reduce sports loads to a minimum as much as possible, at least for a while, until the painful sensations disappear. It is advisable to use special ointments that reduce muscle tension. Massage, enhanced on the tissues surrounding the joint, but not on the joint itself, is excellent.
Orthopedic special shoes and, if possible, a functional bed can alleviate the patient's condition several times. Also, these methods are excellent prevention of hip pain. Many experts advise you to monitor your weight and try to get rid of excess, thereby reducing the load on the joints.
Timely seeking qualified help plays a very important role in successful treatment and prevents the development of irreversible complications.
Medicines are prescribed by a doctor, self-medication is not recommended.
Author of the article: Kaplan Alexander Sergeevich | Orthopedist
Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.