In the vast majority of cases, pain in the hip joint is associated with degeneration of the cartilaginous synovial layer and the development of osteoarthritis deformans. But that is if we are talking about patients over the age of 45 years. But at a younger age, completely different pathological processes can be the causes of the appearance of such a clinical symptom. And often they are directly related to the defeat of the lumbosacral spine and lumbago syndrome. Most of them are long-term complications of osteochondrosis without proper treatment.
Pain in the hip joint is a sign that the position of the femoral head in the articular acetabulum is altered. This joint is one of the most loaded. It is responsible for the maximum depreciation load both during walking and running, and when a person is standing and sitting.
The head of the femur, like the acetabulum of the ilium, is lined with a cartilaginous synovial layer. Inside the joint capsule is synovial fluid. When compressed, cartilaginous tissue secretes synovial fluid, and when straightened, it is absorbed back. Thus, the simultaneous distribution of the depreciation load and the protection of bone tissue from damage and cracking are carried out.
Synovial fluid is produced as the muscles around the joint work. It penetrates the joint capsule by diffuse exchange. Maintaining a sufficient level and optimal viscosity of synovial fluid is key to the longevity and health of the hip joint.
Unfortunately, physical inactivity, malnutrition, traumatic effects, excess weight and other risk factors cause the synovial fluid to become small or lose its physiological properties. This initiates the process of destruction of the cartilaginous synovial layer.
Bone tissues are destroyed and begin to be covered with calcium salt deposits - osteophytes. The joint loses its mobility. Ankylosis and contracture are formed. In the more advanced stages of coxarthrosis, only a hip replacement surgery can help the patient. This is the most dangerous disease that can lead to disability in adulthood. In the early stages, it can be successfully treated with manual therapy methods.
At a young age, pain in the hip joint when walking can be due to a traumatic injury to the ligament and tendon apparatus. If a person has even minor problems with the lumbosacral spine, then he will not have an even distribution of the depreciation load. As a result, there is a high mechanical load on the ligaments and tendons. They are subject to periodic microscopic lesions. At these sites, scar deformities are formed and gradually begin to exert a compressive effect on adjacent nerve fibers. This causes the onset of pain.
In middle age, hip joint pain can also be associated with damage to the lumbosacral spine. But in this case, the probability of a violation of blood microcirculation increases. The defeat of the radicular nerves and the lumbosacral nerve plexus leads to the fact that the tone of the muscular wall of the blood stream is disturbed. As a result, the tissues around the hip joint, like other parts of the lower extremities, do not receive enough nutrition. Ischemic processes begin.
With prolonged combined loading on the hip joint in the context of an ischemic process, there is a risk of developing aseptic necrosis of bone tissue. This is a very dangerous disease, which, in case of delayed treatment, can lead to disability in adulthood. A person loses his ability to work, needs a surgical operation and long-term rehabilitation.
We strongly recommend that in case of discomfort in the hip joint, contact an orthopedic doctor in a timely manner. He, if necessary, will make an appointment with a vertebrologist, neurologist or angiosurgeon.
Causes of severe pain and stiffness in the hip joint
Some of the potential causes of severe hip pain have already been mentioned above. However, this is not a complete list of factors that negatively affect the condition of the hip joint.
Severe pain in the hip joint can appear as a result of a traumatic effect - that is:
- hip fracture is a serious injury that most often requires surgical intervention to restore integrity;
- fissure of the ilium of the hip or femur;
- dislocation or subluxation with stretching of the joint capsule, accumulation of capillary blood and the subsequent process of development of hemarthrosis;
- joint capsule rupture;
- violation of the integrity of joint bags (drills);
- stretching and ruptures of ligament and tendinous fibers, including the subsequent healing process of deformation.
Aching pain in the hip joint can be the result of dystrophic processes. They can affect both the external soft tissues and the cartilaginous synovial membranes within the bone joint. Violation of the tone of the vascular wall against the background of lumbosacral osteochondrosis is the most common cause of tissue destruction of the hip joints. If we add to this the negative impact of forced curvature of the spine due to muscle fiber tension syndrome, it becomes clear that cartilaginous intervertebral disc pathology can lead to disability due to destruction of the hip joint.
Note that pain and stiffness in the hip joint can be signs of developing ankylosis. This disease can be post-traumatic or rheumatoid. In the first case, the contracture develops first, so the range of mobility is reduced to complete immobility. Rheumatic lesions are the joint form of ankylosing spondylitis, systemic lupus erythematosus, scleroderma, polyarthritis, etc.
Potential causes of hip joint pain are diseases of the musculoskeletal system. They develop under the influence of the following risk factors:
- overweight and obesity (each extra kilogram of weight puts a strain on all joints and the spine, causes their accelerated destruction);
- maintain a sedentary lifestyle with insufficient physical activity and sedentary work - the process of supplying blood to the tissues of the hip joint is interrupted, the efficiency of the synovial fluid decreases, and the process of disintegration of the cartilaginous protective tissues begins;
- smoking and drinking alcoholic beverages - alters biochemical processes, causes an acute spasm of the capillary bloodstream;
- heavy physical work and extreme weight lifting without prior training;
- incorrect installation of the foot in the form of a flat foot or clubfoot;
- the wrong choice of shoes for daily use and physical education;
- violation of ergonomic rules when organizing your sleeping and working place.
All these risk factors must be excluded. A physician experienced during the initial collection of anamnesis data will attempt to identify all alleged causes and negative influencing factors. Then he will give the patient individual recommendations, the observance of which will eliminate the risk of recurrence of the identified disease in the future. So make sure you follow all your doctor's recommendations.
Which doctor should I contact for hip joint pain?
The answer to the question of which doctor treats hip pain largely depends on the circumstances in which this clinical symptom appeared. For example, if you have fallen, slipped or been involved in an accident, you should first contact a traumatologist. This doctor will exclude the possibility of violation of tissue integrity. If necessary, it will provide all necessary assistance.
So, for a complete rehabilitation, it is recommended to contact a chiropractor. He will develop a course of therapeutic exercises that will fully restore the working capacity of the muscular structure of the body after forced immobilization. This will avoid the risk of developing osteoarthritis deformans and other serious degenerative pathologies in the future.
If hip joint pain bothers you all the time - which doctor should you see? We strongly recommend that you find a manual therapy clinic close to your place of residence. There are usually doctors with extensive experience working with these patients.
Unfortunately, in most clinics in the city, it is either impossible to make an appointment with an orthopedist, or this specialist deals exclusively with the symptomatic treatment of the identified pathology. Those ones. approaches the solution of the patient's problem exclusively formally.
With long-term pain, it is very important to exclude the possibility of destruction of the lumbosacral spine. So, in addition to seeing an orthopedist, you may also need to see a vertebrologist or neurologist. As a rule, doctors of this profile successfully practice in clinics specializing in manual therapy.
Treating hip pain
Hip pain treatment can only be started after an accurate diagnosis. This is a clinical symptom of several pathologies. And the right course of therapy must take into account its causes.
For example, if the destruction of the cartilage layer within the joint is caused by muscle weakness against the background of insufficient innervation due to the destruction of the intervertebral discs in the lumbosacral spine, the course of treatment may be approximately as follows:
- first, with the help of manual traction of the spine, it makes sense to restore the normal position of the vertebral bodies and eliminate the compressive pressure of the cartilaginous tissues and radicular nerves;
- then, with the help of massage, the doctor can eliminate the syndrome of excessive muscle fiber tension, and improve the elasticity of all soft tissues, accelerate the process of blood supply;
- osteopathic influence triggers the disturbed process of blood, lymphatic and intercellular microcirculation, which has a positive effect on tissue trophism, elimination of infiltrative edema of soft tissues around the joint;
- physical therapy accelerates metabolic processes, removes decomposition products, increases the synthesis of new cells, etc. ;
- laser exposure stimulates repair processes;
- reflexology has a stimulating effect due to the fact that it affects the biologically active points of the human body;
- Therapeutic gymnastics in combination with kinesiotherapy develops the muscular structure of the human body, initiates the processes of disturbed trophism of the cartilaginous tissues within the joints and in the area of the affected cartilaginous intervertebral discs.
The course of treatment for hip pain is always developed individually. Do not rush to take medication without a prescription. Most of them may be completely useless in your case. The second part of the pharmacological agents can significantly accelerate the process of tissue breakdown within the hip joints.
If you have unpleasant sensations in the area of this joint of the bones, in no case tolerate them. Make an appointment with the specialist who will be available. Order an X-ray of the joint as needed, an MRI scan. For treatment, look for a manual therapy clinic in your area.