In the vast 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 talk 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 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 femoral head in the articular acetabulum is disturbed. This joint is one of the most loaded. It accounts 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, the cartilage tissue secretes synovial fluid, and when straightened, it absorbs 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 during the work of the muscles surrounding the joint. It penetrates into the joint capsule by diffuse exchange. Maintaining a sufficient level and optimal viscosity of the synovial fluid is the key to longevity and health of the hip joint.
Unfortunately, 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 begins the process of destruction of 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 a surgical operation for hip arthroplasty 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 may be due to a traumatic lesion of the ligamentous and tendon apparatus. If a person has even minor problems with the lumbosacral spine, then he does 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 injury. In these places, cicatricial deformities are formed and gradually they begin to exert a compressive effect on the adjacent nerve fibers. This provokes the appearance of pain.
In middle age, pain in the hip joint can also be associated with damage to the lumbosacral spine. But in this case, the likelihood 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 muscle wall of the bloodstream is disturbed. As a result, the tissues around the hip joint, like other parts of the lower extremities, do not receive sufficient nutrition. Ischemic processes begin.
With prolonged combined load on the hip joint against the background 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 you in case of any discomfort in the hip joint, contact an orthopedic doctor in a timely manner. He, if necessary, will appoint a consultation with a vertebrologist, neurologist or angiosurgeon.
Causes of severe aching 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 - this is:
- hip fracture is a serious injury that most often requires surgical intervention to restore integrity;
- fissure of the hip ilium or femur;
- dislocation or subluxation with stretching of the joint capsule, accumulation of capillary blood and the subsequent process of development of hemarthrosis;
- rupture of the joint capsule;
- violation of the integrity of the articular bags (burs);
- stretching and ruptures of the ligamentous and tendon fibers, including with the subsequent process of deformation scarring.
Aching pain in the hip joint may be the result of dystrophic processes. They can affect both the outer soft tissues and the cartilaginous synovial membranes inside the articulation of the bones. 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 disability due to the destruction of the hip joint.
Note that pain and stiffness in the hip joint may be signs of developing ankylosis. This disease can be post-traumatic or rheumatoid. In the first case, contracture develops first, then 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 pain in the hip joint 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 huge load on all joints and the spinal column, 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 disrupted, the efficiency of the synovial fluid decreases and the process of disintegration of cartilaginous protective tissues starts;
- smoking and drinking alcoholic beverages - changes biochemical processes, provokes a sharp spasm of the capillary bloodstream;
- heavy physical labor and lifting of extreme weights without prior training;
- incorrect installation of the foot in the form of flat feet or clubfoot;
- the wrong choice of shoes for everyday wear and physical education;
- violation of the rules of ergonomics when arranging your sleeping and working place.
All these risk factors must be excluded. An experienced doctor during the initial collection of anamnesis data will try to identify all the alleged causes and factors of negative influence. 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. Therefore, be sure to follow all the recommendations of your doctor.
Which doctor should I contact for pain in the hip joint?
The answer to the question of which doctor treats hip pain depends largely on the circumstances in which such a clinical symptom appeared. For example, if you fell, slipped, or were involved in an accident, you must first contact a traumatologist. This doctor will exclude the possibility of violation of the integrity of the tissues. If necessary, will provide all the necessary assistance.
Then, for a full 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 frame of the body after forced immobilization. This will prevent the risk of developing deforming osteoarthritis and other serious degenerative pathologies in the future.
If pain in the hip joint bothers you all the time - which doctor should you consult? We strongly recommend that you find a manual therapy clinic near your place of residence. Usually there are doctors with vast experience in working with such patients.
Unfortunately, in most city clinics it is either impossible to get an appointment with an orthopedist, or this specialist deals exclusively with symptomatic treatment of the identified pathology. Those. 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. Therefore, in addition to consulting an orthopedist, you may also need to see a vertebrologist or neurologist. As a rule, doctors of this profile successfully practice in specialized manual therapy clinics.
Treating hip pain
It is possible to start treatment of pain in the hip joint only after an accurate diagnosis has been made. This is a clinical symptom of various pathologies. And the right 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 spinal column, it makes sense to restore the normal position of the vertebral bodies and eliminate compression pressure from the cartilaginous tissues and radicular nerves;
- then, with the help of massage, the doctor can eliminate the syndrome of excessive tension of the muscle fiber and improve the elasticity of all soft tissues, speed up the process of their blood supply;
- osteopathic influence triggers the disturbed process of blood microcirculation, lymphatic and intercellular fluid, which has a positive effect on tissue trophism, elimination of infiltrative edema of the soft tissues surrounding the joint;
- physiotherapy accelerates metabolic processes, removes decay products, enhances the synthesis of new cells, etc. ;
- laser exposure stimulates reparative processes;
- reflexology has a stimulating effect due to the fact that it affects the biologically active points on the human body;
- therapeutic gymnastics in combination with kinesiotherapy develops the muscular frame of the human body, starts the processes of disturbed trophism of cartilage tissues inside the joints and in the area of affected cartilaginous intervertebral discs.
The course of treatment for hip pain is always developed individually. Do not rush to take medications without a doctor's prescription. Most of them may be completely useless in your case. The second part of pharmacological agents can significantly accelerate the process of tissue breakdown inside the hip joints.
If you have unpleasant sensations in the area of this articulation of the bones, then in no case tolerate them. Make an appointment with the specialist who will be available. Ask for an X-ray of the joint, as needed, an MRI examination. For treatment, look for a manual therapy clinic in your area.