When the hip joint is painful as a load-bearing joint, it creates a situation that negatively affects the quality of life. Pain in the hip area may be due to diseases of the hip joint itself, as well as soft tissue pathologies such as muscles around the hip, tendon bursa. Again, other than the hip, pain radiating from the waist or knee joint regions can also be felt in the hip.
The hip joint is a ball-and-crust joint and is the largest joint in the body. The hip is also one of the most mobile joints in the body. While using the hip joint, that is, while walking or running, the cartilage pads prevent the bone from rubbing in the socket (nest). However, with age or excessive use, the cartilage structure can be damaged, along with soft tissues such as muscles or tendons. In addition, especially in those with osteoporosis, there may be fractures or cracks in the hipbone due to major or minor injuries. All of these can cause pain in the hip.
We can list the most common causes of pain in the hip region as follows.
Calcification : It is the most common cause of pain in the hip. The most common cause is calcifications secondary to congenital hip developmental disorders. In addition, secondary calcifications may develop in the hip as it is one of the joints most affected by inflammatory rheumatic diseases. Past traumas and fractures can also cause calcification.
Arthritis (rheumatic diseases):Inflammatory rheumatic diseases (such as rheumatoid arthritis, ankylosing spondylitis) can frequently involve the hips.
Hip fractures:Especially in the elderly, in cases where bone fragility increases, hip fractures may develop after falls.
Bursitis: As a result of straining and overuse of fluid-filled cushions that protect muscles and tendons, inflammation may develop and cause hip pain. Inflammation of the bursa on the protruding bone on the lateral side of the hip (trochanteric bursitis) and pain in the hip is a very common condition.
Muscle and tendon (tendon) strainsIt can occur as a result of overuse or trauma and can cause hip pain.
Hip impingement syndrome (Femoroacetabular impingement syndrome):It is a condition that occurs especially in young people as a result of the structurally thick ball-shaped head on the hip or the structurally shallow part of the nest.
Cancers:Involvement in the form of the spread of cancer of the hip bone itself or another region also causes hip pain.
Avascular necrosis: Hip pain may develop as a result of death in bone cells due to the deterioration of the blood flow of the hip bone. This condition, which develops due to many different reasons such as congenital hip dislocation or long-term use of cortisone, causes pain in the hip.
Infections:The hip joint or the soft tissues around it are regions with very rich circulation, and these regions may be overexposed to infectious agents.
Referred pain: Apart from hip or knee problems, diseases of the organs in the pelvis can also spread to the hip. Pain radiating to the hip can also be seen in kidney diseases.
congenital disorders: Congenital hip dislocation, structural deformities of the hip may also cause hip pain in the future.
Vascular and nerve pathologies:Compression of vessels or nerves passing close to the hip joint or problems due to vascular pathologies may cause pain in the hip region.
Symptoms in hip pain
The most common symptom in the hip region is pain and limitation of movement. As a result, the walking ability of the patient may be adversely affected. The pain may be felt to come from the knee, or the patient may also present with knee pain due to the potential to radiate into the knee.
Diagnosis of hip pain
In hip pain, the characteristics of the bee should be questioned, the presence of previous trauma or congenital pathologies should be investigated. Associated systemic symptoms (such as fever, weight loss, night pain) should be carefully evaluated. In the presence of these symptoms, a blood test should be added. Most hip problems can be recognized with a direct X-ray. However, if the location of the pain in the hip cannot be determined with the maneuvers performed during the hip examination, it is possible to doubt the diagnosis since the hip is a very deep joint. Then, advanced imaging methods (MR, tomography, scintigraphy) can also be used. In physical examination, patient gait, examination of adjacent joints, tenderness with palpation and neurological examination are important.
Treatment of hip pain
one. Medicines: Medications can be used to reduce pain in hip pain. For this purpose, analgesic/antirheumatic drugs, muscle relaxants, adjuvant drugs, weak opioids can be used.
2. Rest: Another treatment method is rest. Since the hip is a load-bearing region, rest can be applied to reduce the load from the region. In hip pain, short-term rest is recommended rather than direct bed rest, except in a situation such as trauma. For example, the patient is recommended to lie down for one hour in the morning and in the afternoon.
3. Complementary medicine methods: Complementary medicine methods such as acupuncture, neural therapy, ozone therapy, mesotherapy, prolotherapy can be used to control hip pain. Among these treatments, acupuncture, electroacupuncture, neural therapy and ozone therapy are used in our clinic.
4. Physiotheraphy: Combined use of physical therapy tools in hip pain is recommended because it is one of the successful treatment methods that have been used for many years. It can control pain in the hip area by reducing muscle spasm, reducing edema and increasing blood flow.
5. PRP: Constructive reparative treatment can be performed by injection of platelet-rich plasma into the hip. Detailed information is available in the PRP section.
6. Intra-hip joint fluid supplementation:It is performed by injecting fluid similar to joint fluid into the hip.
7. Cortisone treatment: Oral cortisone treatment has no place in hip calcification. Very rarely, in painful attacks, if the fluid increases in the hip and the temperature is too high, cortisone can be administered into the hip joint to relieve the patient. It should be supported with other treatments following the reduction of fluid.
8. Cartilage protective and supportive nutritional supplements : There are many nutritional supplements, but some are not suitable for diabetics or impair insulin resistance. Therefore, we recommend using it in consultation with your doctor.
9. Exercise: It is recommended to do both hip and aerobic exercises. For the hip, it is recommended to strengthen the muscles that provide the stability of the hip, stretch the painful leg, and do deep sensation-enhancing exercises regularly. Aerobic exercises should also be added for both pain and weight control.
10. weight control: It is recommended to lose weight because each kilo lost due to weight bearing will reduce the load on the hips.
Hip joint protective recommendations:
• The load on the hip can be reduced by using a cane.
• In the presence of foot deformity, it should be corrected with insoles.
• Patients should not walk up or down hills in uneven areas.
• If walking is painful, sports that do not put a load on the hips (such as swimming, static cycling) can be preferred.