In the vast majority of cases, pain in the hip joint is associated with the degeneration of the cartilaginous synovial layer and the development of deforming osteoarthritis. But that is if we are talking about patients older than 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 takes into account the maximum cushioning load both during walking and running, as well as when a person is standing and sitting.
The head of the femur, as well as 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 it back. This is how the cushioning load is distributed simultaneously and the bone tissue is protected from damage and cracking.
Synovial fluid is produced during the work of the muscles surrounding the joint. It penetrates the joint capsule by diffuse change. 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 synovial fluid becoming small or losing its physiological properties. This starts the process of destroying the cartilaginous synovial layer.
Bone tissue is destroyed and begins to be covered with deposits of calcium salts - osteophytes. The joint loses mobility. Ankylosis and contracture occur. In the later stages of coxarthrosis, only hip arthroplasty 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 the result of a traumatic lesion of 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 those places, cicatricial deformities occur, which gradually begin to exert a compressive effect on the neighboring nerve fibers. This causes pain.
In middle age, pain in the hip joint can also be associated with damage to the lumbosacral spine. But in this case, the probability of 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 bloodstream is disturbed. As a result, the tissues around the hip joint, as well as other parts of the lower limbs, do not receive sufficient nutrition. Ischemic processes begin.
With a prolonged combined load on the hip joint against the background of the 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. The person loses his ability to work, requires surgery and long-term rehabilitation.
We strongly recommend that you contact an orthopedist in case of any problems in the hip joint. 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. 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:
- A hip fracture is a serious injury that most often requires surgical intervention to restore integrity;
- fracture of the ilium of the hip or femur;
- dislocation or subluxation with stretching of the joint capsule, accumulation of capillary blood and subsequent development of hemarthrosis;
- rupture of the joint capsule;
- violation of the integrity of joint bags (pines);
- stretching and rupture of ligament and tendon fibers, including the subsequent process of scar deformation.
Painful 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 articulation. Injury to the tone of the vascular wall on the background of lumbosacral osteochondrosis is the most common cause of tissue destruction of the hip joints. If we add to this the negative influence of the forced curvature of the spine due to muscle fiber tension syndrome, it becomes clear that the pathology of cartilaginous intervertebral discs can lead to disability due to the destruction of the hip joint.
Keep in mind 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, a contracture first develops, and then the amplitude of mobility decreases to complete immobility. Rheumatic lesions are the joint 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 (every additional kilogram of weight puts a strain on all joints and the spine, causing 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 efficiency of synovial fluid decreases and the process of disintegration of cartilaginous protective tissues begins;
- smoking and drinking alcoholic beverages - changes biochemical processes, causes a sharp spasm of capillary blood flow;
- heavy physical work and lifting extreme weights without prior training;
- improper installation of feet in the form of flat feet or club feet;
- wrong choice of shoes for daily wear and physical education;
- breaking the rules of ergonomics when arranging your sleep and workplace.
All these risk factors must be excluded. During the initial collection of data from the anamnesis, an experienced doctor will try to identify all the alleged causes and factors of negative influence. Then he will give individual recommendations to the patient, compliance with 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 see for hip pain?
The answer to the question of which doctor treats hip pain largely depends on the circumstances in which such a clinical symptom appeared. For example, if you have fallen, slipped or been involved in an accident, you must first contact a traumatologist. This doctor will exclude the possibility of damage to the integrity of the tissue. If necessary, they will provide all the necessary help.
Then, 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 you are constantly tormented by pain in the hip joint - which doctor should you contact? We recommend that you find an office for manual therapy near your place of residence. There are usually doctors with extensive experience in dealing with such patients.
Unfortunately, in most city clinics, it is either impossible to schedule an appointment with an orthopedist, or this specialist deals exclusively with the symptomatic treatment of established pathology. Those. exclusively formal approaches to solving the patient's problem.
In case of long-term pain, it is very important to rule out the possibility of destruction of the lumbosacral spine. Therefore, in addition to consulting an orthopedist, you may also need to visit a vertebrologist or a neurologist. As a rule, doctors of this profile successfully practice in specialized clinics for manual therapy.
Treatment of hip pain
Treatment of hip pain can only be started 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 caused 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 the compression pressure from the cartilage tissue and radicular nerves;
- then, with the help of massage, the doctor can remove the syndrome of excessive muscle fiber tension and improve the elasticity of all soft tissues, speed up the process of their blood supply;
- osteopathic influence initiates a disturbed process of microcirculation of blood, lymph and intercellular fluid, which has a positive effect on tissue trophism, removal of infiltrative edema of soft tissues around the joint;
- physiotherapy accelerates metabolic processes, removes decomposition products, enhances the synthesis of new cells, etc. ;
- laser exposure stimulates reparative processes;
- reflexology has a stimulating effect due to the fact that it acts on biologically active points on the human body;
- Therapeutic gymnastics in combination with kinesiotherapy develops the muscular framework of the human body, initiates the processes of disturbed cartilage tissue trophism within the joints and in the area of the affected cartilage intervertebral discs.
The course of treatment for hip pain always develops individually. Do not rush to take medicines without a doctor's prescription. Most of them may be completely useless in your case. Another part of pharmacological agents can significantly accelerate the process of tissue breakdown within the hip joints.
If you have unpleasant sensations in the area of this bone articulation, do not tolerate them under any circumstances. Make an appointment with a specialist who will be available. Ask for an X-ray of the joint, if necessary, and an MR examination. For treatment, find a manual therapy clinic in your area.