As a weight-bearing joint, the hip joint creates a situation that negatively affects the quality of life when it is painful. Pain in the hip area may be due to diseases of the hip joint itself, or it may be due to soft tissue pathologies such as muscle and tendon bursa around the hip. Again, pain reflected from the waist or knee joint regions other than the hip can also be felt in the hip.
The hip joint has a ball-and-socket joint structure and is the largest joint of the body. The hip is also one of the most mobile joints in the body. When using the hip joint, that is, when walking or running, cartilage pads prevent the bone from rubbing in the socket. However, with age or overuse, the cartilage structure may be damaged, and soft tissues such as muscles or tendons may also be damaged. Additionally, especially in those with osteoporosis, there may be fractures or cracks in the hip bone due to major or minor injuries. All of these can cause pain in the hip.
We can list the events that most commonly cause pain in the hip area as follows.
Arthritis: It is the most common condition that causes pain in the hip. The most common cause is calcification that occurs secondary to congenital hip developmental disorders. In addition, secondary calcification may develop in the hip, as it is one of the joints most affected by inflammatory rheumatic diseases. Previous traumas and fractures can also cause arthritis.
Arthritis (rheumatic diseases): Inflammatory rheumatic diseases (such as rheumatoid arthritis, ankylosing spondylitis) frequently affect the hips. They can keep it as.
Hip fractures: Hip fractures may occur after falls, especially in cases where bone fragility increases in the elderly.
Bursitis: Inflammation may develop as a result of straining and excessive use of the fluid-filled cushions that protect the muscles and tendons and may lead to hip pain. Pain in the hip is a very common condition, especially due to inflammation of the bursa on the protruding bone on the side of the hip (trochanteric bursitis).
Muscle and tendon (tendon) Impingementsmay occur as a result of overuse or trauma and may cause hip pain.
Hip impingement syndrome (Femoroacetabular impingement syndrome): Ball in the hip It is a condition that occurs especially in young people as a result of the structurally thick head or the structurally shallow socket part.
Cancers: Involvement of the hip bone itself or the spread of cancer to another region also causes hip pain.
Avascular necrosis: Hip pain may develop as a result of death in bone cells due to impaired blood flow to the hip bone. This condition, which develops due to many different reasons such as congenital hip dislocation or long-term cortisone use, causes pain in the hip.
Infections: Poor circulation of the hip joint or the soft tissues around it. They are very rich regions and these regions may be highly exposed 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 may also occur in kidney diseases.
Congenital disorders: Congenital hip dislocation and structural deformities in the hip can also cause hip pain in the future.
Vessel and nerve pathologies: Compression of the vessels or nerves passing close to the hip joint or problems due to vascular pathologies may cause pain in the hip area.
Hip pain. symptoms
The most common symptoms in the hip area are pain and limitation of movement. Accordingly, the patient's walking ability may be negatively affected. The pain may be felt to come from the knee, or the patient may present with knee pain due to its potential to spread to the knee.
Diagnosis in hip pain
In hip pain, questioning the characteristics of the bee, previous trauma or The presence of congenital pathologies should be investigated. Accompanying systemic symptoms (such as fever, weight loss, night pain) should be carefully evaluated. This In the presence of symptoms, a blood test should be added. Many hip problems can be diagnosed with direct radiography. 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 because the hip is a very deep joint. Then advanced imaging methods (MRI, tomography, scintigraphy) can also be used. In physical examination, patient walking, examination of adjacent joints, sensitivity to palpation and neurological examination are important.
Treatment of hip pain
1. Drugs: Medicines can be used to reduce pain in hip pain. For this purpose, painkillers/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 area, rest can be applied to reduce the load on the area. For hip pain, short-term rest is recommended rather than direct bed rest, except for a situation such as trauma. For example, the patient is recommended to lie down for an hour in the morning and in the afternoon.
3. Complementary medicine methods: Complementary medicine methods such as acupuncture, neural therapy, ozone therapy, mesotherapy, and prolotherapy can be used to control hip pain. Acupuncture, electroacupuncture, neural therapy and ozone therapy are used in our clinic.
4. Physical therapy: The combined use of physical therapy tools for hip pain is recommended as it has been used for many years and is one of the successful treatment methods. It can control the 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 carried out by injecting a fluid similar to joint fluid into the hip.
7. Cortisone treatment: In hip calcification Oral cortisone treatment has no place. In very rare cases of painful attacks, if there is increased fluid in the hip and the temperature is too high, cortisone may be administered into the hip joint to relieve the patient. After the fluid decreases, it must be supported with other treatments.
8. Cartilage protective and supportive nutritional supplements: There are many nutritional supplements, but some are not suitable for diabetics or disrupt insulin resistance. Therefore, we recommend that you use it by consulting your doctor.
9. Exercise: It is recommended to do both hip and aerobic exercises. For the hip, it is recommended to regularly perform exercises that strengthen the muscles that provide stability of the hip, stretch the painful leg, and develop deep sensation. Aerobic exercises should also be added for both pain and weight control.
10. Weight control: It is recommended to lose weight as every weight lost due to load-bearing will reduce the load on the hips.
Hip joint protective recommendations:
• The load on the hip can be reduced by using a cane
• Foot deformity If it is present, it should be corrected with insoles
• Patients should not walk uphill or downhill in uneven areas
• If walking causes pain, sports that do not put a load on the hip (such as swimming, static cycling) may be preferred.
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