When walking, pain in the hip joint for natural reasons is extremely rare. Usually, their appearance indicates a developing pathology – arthritis, arthrosis, gout. At the initial stage, these diseases respond well to conservative therapy. Therefore, even slight discomfort in the thigh area during movement should be a signal for immediate medical attention.
Causes of pain
One of the physiological causes of pain in the hip joint when walking, especially climbing stairs, is intense sports training, excessive physical exertion. In the thigh muscles, lactic acid, which irritates the tissues, accumulates. As a result, there is not only pain, but also an unpleasant burning sensation. All symptoms disappear without a trace after a short rest when lying or sitting, during which lactic acid is excreted from the body.
But even if there is a relationship between the appearance of pain and sports, a doctor’s consultation is necessary. The fact is that increased loads often lead to the development of destructive-degenerative or inflammatory processes in the hip joint.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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The group of systemic diseases includes pathologies that affect several joints, provoking the development of the inflammatory process in them. First, cartilage is destroyed, which leads to instability of the joints, and then bone structures are deformed. Systemic diseases are usually autoimmune. They arise due to an inadequate response of the immune system to the penetration of infectious pathogens into the body. These include:
- Still’s disease;
- ankylosing spondylarthrosis;
- rheumatoid arthritis;
- rheumatic fever;
- systemic lupus erythematosus;
- rheumatic polymyalgia.
In addition to pain when walking, there are many joint and extra-articular symptoms. The skin in the affected area turns red, swells, becomes hot to the touch. During exacerbation, the range of movements is sharply limited. The lymph nodes can also increase, the work of the liver, kidneys, gastrointestinal tract is disrupted.
Inflammatory and infectious causes of pain
Gout pain while walking can provoke gouty, psoriatic, reactive arthritis. Their leading symptoms are redness of the skin due to overflow of blood vessels, increased local temperature, stiffness, swelling. A similar clinical picture is also characteristic of other inflammatory pathologies affecting the hip joint:
- bursitis – inflammation of the synovial bag with accumulation of exudate in the joint cavity;
- synovitis is an inflammatory process in the synovial membrane, accompanied by accumulation of fluid;
- tendonitis or tendovaginitis – inflammation of the tendons of the joint, including those having the vagina.
Infectious arthritis is especially severe. It develops against the background of gonorrhea, syphilis, tuberculosis, brucellosis or as a result of the introduction of staphylococci, streptococci, Escherichia coli into the joint. A person suffers not only from acute pain when walking – his body temperature rises sharply, chills, fever.
Pain caused by degenerative changes
Pain in the thigh when walking is the main sign of coxarthrosis. This is a degenerative-dystrophic pathology, affecting mainly middle-aged and elderly people. Coxarthrosis develops due to the destruction of cartilage and is not clinically apparent at first. Sometimes there are weak discomfort, which a person attributes to muscle fatigue after physical exertion. But over the course of several years, the severity of symptoms increases:
- pains on the side of the thigh arise not only when walking, but also at rest;
- when moving, clicks, crunching, crackling are clearly heard;
- in the morning, the skin over the joint swells, and the movements are constrained;
- at the final stage of coxarthrosis, the leg is shortened, and the muscles atrophy.
Hip pain can be reflected. Most often, their intervertebral discs and vertebral bodies are affected by osteochondrosis. When they are displaced, the spinal roots are infringed, which leads to acute lower back pain extending to the hip joint.
A fracture or dislocation of the hip joint occurs when falling from a height, during a traffic accident, a strong directional blow. There is such a sharp pain at the time of the injury that a person loses the ability to move. As a result of a fall or injury, muscles, ligaments, and tendons are often damaged. If a large number of connective tissue fibers are injured, then a person can not focus on the foot due to pain and instability of the joint.
In case of injuries of the ligament-tendon apparatus of 1 or 2 degrees of severity, the victim can move. The pains soon subside, but inflammatory edema quickly forms, and after its resorption – an extensive hematoma.
The initial diagnosis can be made on the basis of an external examination of the patient and history. For example, a gouty attack is indicated by sharp, throbbing, tugging pains and severe redness of the skin. But such symptoms are characteristic of infectious, purulent, reactive arthritis, so the doctor prescribes the following diagnostic measures:
- radiography to detect deformation of bone structures, changes in the size of the joint space;
- MRI, CT to assess the condition of cartilage, ligaments, tendons located in the hip joint of the nerve pathways and blood vessels;
- arthroscopy for a more detailed examination of the internal surfaces of the joint.
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If an autoimmune pathology is suspected, biochemical studies are performed. The level of rheumatoid factor, C-reactive protein, antinuclear antibodies is established. The species of infectious agents is determined using bacterial seeding, as well as their sensitivity to antibiotics, antiviral or antimycotic agents.
When and to which doctor to consult
If there are suspicions that the cause of pain in the hip joint when walking was the previous injury, then you need to make an appointment with a traumatologist. In other cases, it is advisable to consult a general practitioner – a therapist. He will prescribe all the necessary diagnostic tests. After studying their results, the therapist will refer the patient to doctors with a narrow specialization (orthopedist, rheumatologist), who will deal with his further treatment.
General treatment rules
When determining the tactics of treatment, the doctor takes into account the type of disease, stage and form of its course, developed complications, and the severity of symptoms. For almost all pathologies that manifest pain when walking, an integrated approach is used. In therapy, local and systemic drugs, physiotherapy and massage procedures, exercise therapy, orthopedic correction are used.
For relief of acute pain, intramuscular or intraarticular injection of injectable solutions is practiced. You can get rid of weak discomfort with the help of ointments, creams, gels. And the elimination of moderate pain will allow the administration of analgesics.
|A group of drugs to eliminate pain in the hip joint when walking||Names of medicines|
|Nonsteroidal anti-inflammatory drugs||Diclofenac, Celecoxib, Etoricoxib, Ibuprofen, Nimesulide, Ketoprofen, Meloxicam, Indomethacin, Ketorolac, Lornoxicam|
|Muscle relaxants||Baclosan, Baclofen, Sirdalud, Midokalm, Tolperizon, Tizanidine|
|Glucocorticosteroids||Methylprednisolone, Triamcinolone, Phlosterone, Kenalog, Diprospan, Dexamethasone|
|Ointments and gels with a warming effect||Capsicam, Finalgon, Apizartron, Nayatoks, Viprosal, Efkamon, Turpentine ointment|
|Chondroprotectors||Alflutop, Arthra, Structum, Chondrogard, Rumalon, Teraflex, Chondroxide, Glucosamine-Maximum|
Electrophoresis or ultraphonophoresis with anesthetics, analgesics, glucocorticosteroids are prescribed to patients directly to eliminate pain. The basis of these physiotherapy is the maximum possible delivery of drugs to the joint due to pulses of electric current or ultrasonic vibrations. And at the stage of remission, the following activities are carried out:
After 5-10 sessions of physiotherapy, blood circulation in the hip joint improves, metabolism and restoration of damaged tissues are accelerated. Patients can also be recommended applications with ozokerite or paraffin, hirudotherapy, balneotherapy.
Folk methods and recipes
Before contacting a doctor and conducting basic treatment, folk remedies can not be used. They have a weak analgesic effect, which, however, will distort the clinical picture and make diagnosis difficult. In the recovery period, rheumatologists and orthopedists are allowed to use compresses, infusions, rubbing to eliminate the uncomfortable sensations arising from overcooling, walking long distances, SARS. What folk remedies are most therapeutically effective:
- compress. In a mortar, grind to a mushy state fresh leaves of dandelion, coltsfoot, burdock, horseradish, add a tablespoon of honey. Put a thick mass on the thigh, fix with a film and a gauze bandage, hold for about an hour;
- Herbal tea from St. John’s wort, oregano, thyme, elecampane, sage. Pour 0,5 teaspoon of dry plant material into a thermos, add 2 cups of boiling water, leave for 2 hours. Cool, strain, take 100 ml 2-3 times a day after meals.
Homemade ointment also helps to cope with painful sensations. In a mortar, grind 25 g of lanolin and a teaspoon of alcohol tincture of red pepper. Without stopping mixing, add 2 drops of essential oils of juniper, arborvitae, rosemary and 100 g of oily baby cream.
In the absence of medical intervention, the destruction of cartilage and deformation of bone structures will continue. This will lead to complete or partial immobilization of the joint (ankylosis). In this state, a person is able to move only with the help of crutches.
Hip pain occurs in people with chronic injuries, especially those who underestimated the severity of injuries and did not see a doctor. Ligaments and tendons fused incorrectly, so the functional activity of the hip joint decreased significantly. In these cases, only surgery will allow you to get rid of the pain.
To avoid the development of autoimmune, inflammatory, degenerative and dystrophic diseases of the hip joint, a complete physical examination should be performed annually. It is necessary to abandon the use of alcohol, smoking, include more fresh fruits, vegetables, berries in the diet.