In the majority of cases, pain in the hip joint is associated with degeneration of the cartilaginous synovial layer and the development of deforming osteoarthritis. But this is if we are talking about patients over the age of 45. But at a younger age, the causes of the appearance of such a clinical symptom can be completely different pathological processes. And very often they are directly related to the defeat of the lumbosacral spine and lumbago syndrome. Most of them are complications of long-term osteochondrosis without proper treatment.
Pain in the hip joint is a signal that the position of the head of the femur in the articular acetabulum is disturbed. This joint is one of the most loaded. It takes into account the maximum cushioning load both when 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, cartilage tissue releases synovial fluid, and when straightened, it reabsorbs. In this way, the simultaneous distribution of the amortization load and the protection of the bone tissue from damage and cracking are carried out.
Synovial fluid is produced during the work of the muscles around the joint. It penetrates the joint capsule by diffuse exchange. Maintaining a sufficient level and optimal viscosity of synovial fluid is the key to the longevity and health of the hip joint.
Unfortunately, a sedentary lifestyle, malnutrition, traumatic effects, excess weight and other risk factors lead to the fact that the synovial fluid becomes small or loses its physiological properties. This starts the process of breaking down the cartilaginous synovial layer.
Bone tissues are destroyed and begin to be covered with deposits of calcium salts - osteophytes. The joint loses its mobility. Ankylosis and contracture are formed. In the later stages of coxarthrosis, only hip replacement surgery can help the patient. It is the most dangerous disease that can lead to disability in adulthood. In the early stages, it is successfully treated with manual therapy methods.
At an early age, pain in the hip joint when walking can be due to traumatic damage to the ligament and tendon apparatus. If a person has even minor problems with the lumbosacral spine, then he does not have an even distribution of the cushioning load. As a result, there is a high mechanical load on the ligaments and tendons. They are subject to periodic microscopic injuries. In these places, cicatricial deformations are formed, which gradually begin to exert a compressive effect on the neighboring nerve fibers. This provokes the appearance of pain.
In middle age, hip 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 a violation of the tone of the muscle wall of the blood stream. As a result, the tissues around the hip joint, like other parts of the lower limbs, do not receive enough nutrition. Ischemic processes begin.
With long-term combined loading of the hip joint against the background of an ischemic process, there is a risk of developing aseptic necrosis of the bone tissue. This is a very dangerous disease that, if delayed treatment, can lead to disability in adulthood. A person loses his ability to work, needs surgical intervention and long-term rehabilitation.
We strongly recommend that you contact an orthopedic doctor promptly in case of discomfort in the hip joint. He, if necessary, will appoint a consultation 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 occur as a result of a traumatic effect - this is:
- hip fracture is a serious injury that most often requires surgical intervention to restore integrity;
- fissure of the hip or femur;
- dislocation or subluxation with stretching of the joint capsule, accumulation of capillary blood and subsequent process of development of hemarthrosis;
- rupture of the joint capsule;
- violation of the integrity of joint bags (borers);
- stretching and tearing of ligament and tendon fibers, including with a subsequent process of deformation scars.
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 inside the bone articulation. Violation of the tone of the vascular wall against the background of lumbosacral osteochondrosis is the most common cause of destruction of the tissues of the hip joints. If we add to this the negative impact of the forced curvature of the spine due to the muscle fiber tension syndrome, it becomes clear that the pathology of the cartilaginous intervertebral discs can lead to damage due to the destruction of the hip joint.
Be aware that hip pain and stiffness may be signs of developing ankylosis. This disease can be post-traumatic or rheumatoid. In the first case, a contracture first develops, after which the amplitude of mobility is reduced to complete immobility. Rheumatic lesions are the articular form of ankylosing spondylitis, systemic lupus erythematosus, scleroderma, polyarthritis, etc.
Potential causes of hip pain are musculoskeletal disorders. They develop under the influence of the following risk factors:
- overweight and obesity (each additional kilogram of weight puts a huge load on all joints and the spine, provokes their accelerated destruction);
- maintaining a sedentary lifestyle with insufficient physical activity and sedentary work - the process of blood supply to the tissues of the hip joint is disturbed, the effectiveness of the synovial fluid decreases and the process of disintegration of the protective cartilage tissues begins;
- smoking and drinking alcoholic beverages - changes biochemical processes, provokes a sharp spasm of capillary blood flow;
- hard physical labor and lifting heavy weights without prior preparation;
- improper installation of the foot in the form of flat feet or flat feet;
- wrong choice of shoes for daily wear and physical education;
- breaking the rules of ergonomics when organizing your sleeping and workplace.
All these risk factors should be excluded. An experienced doctor during the initial history taking will try to identify all suspected causes and factors of negative influence. After that, he will give the patient individual recommendations, compliance with which will eliminate the risk of recurrence of the identified disease in the future. Therefore, do not forget to follow all recommendations of your doctor.
Which doctor should I see for hip pain?
The answer to the question of which doctor treats hip pain depends largely on the circumstances under which such a clinical symptom appeared. For example, if you have fallen, slipped or been involved in an accident, you should first contact a trauma specialist. This doctor will exclude the possibility of a violation of the integrity of the tissues. If necessary, will provide all necessary assistance.
After that, for 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 body's muscular framework after forced immobilization. This will prevent the risk of developing deforming osteoarthritis and other serious degenerative pathologies in the future.
If hip pain is bothering you all the time - which doctor should you consult? We highly recommend you find a manual therapy clinic near where you live. There are usually doctors with extensive experience in dealing with such patients.
Unfortunately, in most urban clinics it is either impossible to find an appointment with an orthopedist, or this specialist deals exclusively with symptomatic treatment of the identified pathology. These. takes an extremely formal approach to solving the patient's problem.
With prolonged pain, it is very important to exclude the possibility of destruction of the lumbosacral spine. Therefore, in addition to a consultation with an orthopedist, a vertebrologist or a neurologist may also be necessary. As a rule, doctors of this profile successfully practice in specialized clinics for manual therapy.
Hip pain treatment
Treatment of hip pain can only begin after an accurate diagnosis has been made. It is a clinical symptom of various pathologies. And the correct course of therapy should take into account their causes.
For example, if the destruction of the cartilage layer inside the joint is provoked by muscle weakness against the background of insufficient innervation due to the destruction of the intervertebral discs in the lumbosacral spine, then the course of treatment can 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 from the cartilaginous tissues and radicular nerves;
- then, with the help of massage, the doctor can eliminate the syndrome of excessive tension of muscle fibers and improve the elasticity of all soft tissues, speed up the process of their blood supply;
- the osteopathic effect activates the disturbed microcirculation process of blood, lymph and intercellular fluid, which has a positive effect on tissue trophism, removal of infiltrative edema of the soft tissues around the joint;
- physiotherapy accelerates metabolic processes, removes decay products, enhances the synthesis of new cells, etc. ;
- laser exposure stimulates reparative processes;
- reflexotherapy has a stimulating effect due to the fact that it affects the biologically active points of the human body;
- Therapeutic gymnastics in combination with kinesitherapy develops the muscular framework of the human body, starts the processes of impaired trophism of the cartilage tissues inside the joints and in the area of the affected cartilage intervertebral discs.
The course of treatment for hip pain is always developed individually. Do not rush to take medicines without a doctor's 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 degradation in the hip joints.
If you have unpleasant sensations in the area of this articulation of the bones, then in no case do not tolerate them. Make an appointment with the specialist who will be available. Ask for an X-ray of the joint, if necessary, a nuclear magnetic resonance. For treatment, look for a manual therapy clinic in your area.