In most cases, pain in the hip joint is associated with the degeneration of the cartilaginous synovial layer and the development of deforming osteoarthritis. But this is if we are talking about patients over 45 years old. But at a younger age, completely different pathological processes can be the reasons for the appearance of such a clinical symptom. And often they are directly related to the defeat of 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 combination is one of the most downloaded. It calculates the maximum damping load during both walking and running, as well as when a person is standing and sitting.
The head of the femur, like the acetabulum of the ilium, is covered with a cartilaginous synovial layer. Inside the joint capsule is synovial fluid. When compressed, cartilage tissue secretes synovial fluid, and when straightened, it is reabsorbed. Thus, simultaneous distribution of the damping load and protection of bone tissue from damage and cracking is carried out.
Synovial fluid is formed during the work of the muscles surrounding the joint. It enters the joint capsule by diffuse exchange. Maintaining sufficient levels and optimal viscosity of synovial fluid is key to the longevity and health of the hip joint.
Unfortunately, a sedentary lifestyle, nutrition, traumatic effects, excess weight and other risk factors cause the synovial fluid to become smaller or lose 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. Loses joint mobility. Ankylosis and contracture are formed. In the later stages of coxarthrosis, the patient can only be helped by surgery for hip arthroplasty. This is the most dangerous disease that can cause 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 while walking may be due to a traumatic lesion of the ligamentous and tendon apparatus. If a person has even small problems with the lumbosacral spine, he does not have an even distribution of the damping load. As a result, there is a high mechanical load on the ligaments and tendons. They are subject to periodic microscopic damage. In these places, cicatricial deformations are formed and gradually begin to have a compressive effect on the adjacent nerve fibers. This provokes the appearance of pain.
Hip pain in middle age can also be associated with damage to the lumbosacral spine. However, in this case, the possibility of blood microcirculation disorders 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 flow. As a result, the tissues around the hip joint, like other parts of the lower limbs, are not sufficiently nourished. Ischemic processes begin.
With a long-term 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, in case of delayed treatment it can cause disability in adulthood. A person loses his ability to work, requires surgery and long-term rehabilitation.
In case of any discomfort in the hip joint, we strongly recommend to consult an orthopedic doctor in time. If necessary, he 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. But 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:
- a hip fracture is a serious injury that most often requires surgical intervention to restore integrity;
- hip ilium or femur fracture;
- dislocation or subluxation with stretching of the joint capsule, accumulation of capillary blood and the development of subsequent hemarthrosis;
- rupture of the joint capsule;
- violation of the integrity of articular bags (bursa);
- stretching and breaking of ligamentous and tendon fibers, including subsequent deformation with the scarring process.
Aching pain in the hip joint can be the result of dystrophic processes. They can affect both external soft tissues and cartilaginous synovial membranes inside the articulation of bones. Violation of the tone of the vessel wall against the background of lumbosacral osteochondrosis is the most common reason for the destruction of the tissues of the hip joints. If we add to this the negative effect of the forced curvature of the spine due to muscle fiber tension syndrome, it becomes clear that the pathology of cartilaginous intervertebral discs can cause disability due to the destruction of the hip joint.
It should be noted that pain and stiffness in the hip joint can be signs of the development of ankylosis. This disease can be post-traumatic or rheumatoid. In the first case, contracture develops first, and then the amplitude of mobility decreases 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 spine, causing their rapid 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 efficiency of the synovial fluid decreases and the process of breakdown of cartilaginous protective tissues begins;
- smoking and drinking alcohol - changes biochemical processes, provokes a sharp spasm of capillary blood flow;
- heavy physical labor and lifting of excessive weights without prior training;
- incorrect installation of the foot in the form of a straight leg or stick;
- wrong choice of shoes for daily wear and physical training;
- Violation of the rules of ergonomics when arranging your bed and workplace.
All these risk factors should be excluded. An experienced physician will try to identify all possible causes and adverse influencing factors during the initial collection of anamnesis data. Then he will give individual recommendations to the patient, following them 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 see for hip pain?
The answer to the question of which doctor treats hip pain mainly depends on the circumstances in which such a clinical symptom appears. For example, if you have fallen, slipped or had an accident, you should first contact a traumatologist. This doctor will exclude the possibility of a violation of the integrity of the tissues. If necessary, he will provide all necessary assistance.
Then it is recommended to contact a chiropractor for complete rehabilitation. He will prepare 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 pain in the hip joint bothers you all the time - which doctor should you see? We strongly recommend that you find a hand therapy clinic near where you live. Usually there are doctors who have a lot of 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 only with the symptomatic treatment of the specified pathology. These are. takes an exclusively formal approach to solving the patient's problem.
With long-term pain, it is very important to exclude the possibility of destruction of the lumbosacral spine. Therefore, it may be necessary to consult a vertebrologist or a neurologist in addition to an orthopedist. As a rule, doctors of this profile successfully practice in specialized manual therapy clinics.
Hip pain treatment
Treatment of hip pain can begin only after an accurate diagnosis has been made. This is a clinical sign 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, the course of treatment can be approximately as follows:
- first, with the help of manual stretching of the spine, it is logical to restore the normal position of the vertebral bodies and remove the compressive pressure from the cartilage tissues and radicular nerves;
- then, with the help of massage, the doctor can eliminate the muscle fiber overexertion syndrome and improve the elasticity of all soft tissues, speeding up their blood supply process;
- the osteopathic effect triggers the disturbed process of blood microcirculation, lymph and intercellular fluid, which has a positive effect on tissue trophism, eliminates infiltrative edema of the soft tissues surrounding the joint;
- physiotherapy accelerates metabolic processes, removes decay products, increases the synthesis of new cells, etc. ;
- laser exposure stimulates reparative processes;
- reflexology has a stimulating effect as it affects biologically active points in the human body;
- together with kinesiotherapy, therapeutic gymnastics develops the muscular framework of the human body, initiates the processes of disturbed trophism of cartilage tissues inside the joints and in the area of the affected cartilaginous intervertebral discs.
The course of treatment for hip pain is always prepared individually. Do not rush to take medicine 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 breakdown in the hip joints.
If there are unpleasant sensations in this area of bone articulation, do not tolerate them under any circumstances. Make an appointment with a specialist who will be available. If necessary, request an X-ray of the joint, an MRI examination. Look for a hand therapy clinic in your area for treatment.