What to do if a child has a leg pain in the thigh when walking: causes, treatment and folk remedies. Why did you have pain from hip to foot? Congenital cardiovascular disease

If there is pain in the hip, then the day is hopelessly ruined. It interferes with walking, it interferes with sitting, it interferes with lying. But why does the leg hurt? What does aching pain in the hip mean, and why do you most often need to call an ambulance in case of acute pain? When should you see a doctor?

In order to answer the last question, one must first assess the scale of the incident. And for this you need to figure out where and how the leg hurts in the thigh.

Pain when walking

These feelings can be triggered by:

The turning point. Neck fracture or hip bone considered one of the most difficult fractures, worse - only the heels and knees. With such a fracture, the patient feels very strong and sharp pain in the hip, practically cannot walk. He urgently needs medical attention.
Sprains, bruises, other trauma. Injuries are common and are most felt when walking. Pain after injury is usually dull, intensifies and begins to pulsate when walking. Sometimes there is a pulling pain in the hip.
Arthritis, arthrosis in the early stages manifest themselves only when walking. The patient gets tired faster, after walking, aching pain occurs in the hip.
The early stage of bursitis sometimes also shows itself only with active movements. After a short run or long walk a person suddenly discovers a sharp burning pain in the thigh.

In the thigh and groin

This symptom usually means:

Coxarthrosis. With this disease, pain forms in the groin and radiates to the thigh or to both thighs. The pain - "breaking", builds up over several weeks when moving. It passes if the patient is provided with peace. During seizures, leg movements are severely limited.
Aseptic necrosis of the head of the bone. This disease is very similar in symptoms to coxarthrosis, but the pain grows to unbearable in a few days, not weeks.
Arthritis. In advanced cases, arthritis manifests itself as pain that radiates to other parts of the body, including the groin. It manifests itself both day and night, both at rest and during exercise. Severe pain can be aching or burning.

Painful sensations that radiate to the leg

If the discomfort begins with the lower back, passes through the thigh and goes further down the leg, then the matter is in osteochondrosis or hernia of the lumbar spine. In this disease, the nerves in the lower spine are pinched by vertebral displacement, hernia, or inflammation. At the same time, the pain alternates - it can be aching, and burning, and unexpectedly shooting through the entire leg.

When walking, the condition worsens - pain is clearly felt in the leg, from the hip and below.

In the right thigh and left thigh

Asymmetrical pain (in only one hip) can indicate many possible problems. If we discard diseases in which the spine, groin, knees and other parts of the body are involved, then the cause may be:

Piriformis syndrome. Muscle squeezes sciatic nerve, and he sends out distress signals. The nature of the pain is "nervous", strong, causing weakness and numbness of the limb.
Radiculitis. Damage to the nerves, the nature of the pain is acute.
Good / malignant formations, metastases in the thigh. An aggressive neoplasm can grow rapidly, compressing tissues and nerves. At the same time, the patient feels a pressing, aching pain syndrome day and night, with exertion and at rest.
Injuries, damage to nerves, bone and muscle tissue, blood vessels. Unpleasant sensations can vary over a wide radius.

Watch the video about hip pain

Pain in the back of the thigh

Unpleasant sensations located specifically in the back most likely mean a banal sprain or other injury. The painful sensations are itchy and bothersome, recently a person performed exercises in which the legs were involved.

If there were no prerequisites for injuries, then the protrusion of the lumbar spine may be the cause - a pinched nerve in the lower back gives itself out as a single symptom.

The pain is acute and pronounced, accompanied by weakness in the leg.

Inner and outer thigh

If the inner or outer thigh suffers, then the main reasons will be:

Overvoltage. Weakness and moderate pain occurs when a person overdoes exercise. Most often, this is to blame. If the pain occurs after exercise and does not go away for 4-5 days, it is possible that there is a muscle rupture.
Muscle injury.
Rheumatism, arthritis. In these cases, in fact, the hip itself hurts, but discomfort can appear on the inside or outside. The nature of the pain is the same as for the hip as a whole.
Gout. The accumulation of lactic acid in the muscles after exercise can cause an overwhelming burning sensation in the muscle tissues.
Diseases of the veins. Varicose veins, for example, can cause pain on one side of the thigh. Unpleasant sensations are aching, persistent in nature, intensified with intense exertion.
Neuralgia. With nerve damage, symptoms can be very different, as well as pain... Only a doctor can confirm or deny neuralgia.

Front of the thigh

This pain has several diseases that are unique to it:

Hypertonicity of muscles. If the nerves in the spine are pinched, then the muscles in the front of the thigh can be in a state of constant tension, which leads to a fighting sensation comparable to constant overexertion. Sometimes the patient cannot localize the pain, his complaint is “the leg in the thigh area hurts”.
Paresthetic meralgia. It is manifested by a dull pain in the front of the thigh. It intensifies if you pull the bent leg to the stomach.
Iliopsoas syndrome. In this disease, the muscle is constantly tense, as in hypertonia. The manifestations are similar - the pain of overexertion.

Pain syndrome in the soft tissues of the thigh

Such a symptom can be caused both by pathologies of the hip itself, and by systemic diseases:

Injuries, bruises. Aching pain caused by a blow to soft tissues.
Sarcoma, other soft tissue neoplasms. The tumor presses on muscles and other structures.
Gout. If lactic acid and other waste products from the muscles build up in the body, the hip can get sore anywhere - front, back, and side. The patient feels liquid fire spreading over the soft tissues.
Diseases of veins and other vessels, diseases of nerves and muscles. Varicose veins, neuralgia, myopathy can "shoot" in any part of the body, and the hip is no exception. The nature of the pain depends on the pathology.

When and to which doctor to go?

Since hip pain can be the cause of a serious illness, you need to see a doctor when it appears. It's better to play it safe than to run to the doctors. Doctors to contact:

Therapist. A jack of all trades who will both advise and send to the right specialist if necessary.
Traumatologist. If the pain was preceded by an injury, you can immediately go to it.
Surgeon. Most likely, the therapist will refer the patient to him. The surgeon will understand the causes of pain, prescribe the necessary examinations and treatment.
Orthopedist. It makes sense to go to him if there are disorders in the development of the musculoskeletal system.
Neurologist, oncologist, cardiologist. The advice of these doctors can come in handy in some cases.

If you don't know who to contact, talk to a therapist.

Diagnostic methods

Among the required methods are anamnesis, examination, blood test. Often, doctors use palpation to feel a sore spot.

After these procedures, the doctor can decide what to do next. Some patients need CT and MRI, some need ultrasound and X-rays, and some have other tests.

Usually this is where the list of methods ends, unless the disease is very exotic or secretive.

How to relieve pain?

What to do if your hip hurts? If the pain is very severe, then you need to urgently call an ambulance - it will help eliminate discomfort and take you to the hospital. First aid consists of ensuring the rest of the diseased limb and taking analgesics; non-steroidal anti-inflammatory drugs (Diclofenac, for example) are well suited. For injuries, there are separate recommendations - in case of bruising or stretching, you can apply a cold compress to the sore spot, in case of a fracture, you need to fix the affected joint (apply a splint).

You should not use folk remedies for pain relief - for the most part they are ineffective.

The thigh is a relatively protected body structure, but even it can be hit literally and figuratively. A sore thigh gives a person a lot of trouble, therefore, the sooner he starts treatment, the better it will be for him. Pain can be a harbinger of both "minor" diseases and cancer at the last stage, so if your hip hurts, you should not postpone the visit to the doctor.

How to forget about pain in joints and spine?

zdorovya-spine.ru

Causes of hip pain in children and adults

From an anatomical point of view, the thigh is the part of the leg from the knee to the hip joint. The femur is the longest in human body... And the hip and knee joints are the largest and strongest.

Hip pain can occur in different ages... Appear during physical exertion or at rest. Temporary or permanently disturbing. It can be caused by the most different reasons... It can occur in the groin area, in the front or back of the leg, give to the knee and even to the lower back. It so happens that the hip itself has nothing to do with it, and the cause of the unpleasant sensations lies in a completely different place.

Causes

Even minor discomfort in the hip area can cause a lot of inconvenience, especially if you like an active lifestyle. The painful sensations that occur after physical exertion are considered safe. Provided that they disappear within two to three days and are not accompanied by swelling and redness of tissues, crunching or clicks in the bone.

In people leading a sedentary lifestyle, hip pain can appear when walking, with unusual, high loads or with a sudden change in position. They usually go away on their own. However, their appearance is the first signal that pathological changes which in the future may lead to the development serious illnesses.

In addition, pain in the muscles of the thigh can be caused by traumatic or non-traumatic causes.

Traumatic

Why can pain and discomfort occur? The most common cause is a variety of injuries, which include:

Ligament and muscle damage.
Closed injuries of the hip joint and damage to the pelvic bones, especially the pubic or sacrum.
Injury to the first lumbar vertebra.
Fractures of the femoral neck - the narrowest place in the femur, which is especially common in the elderly.
Knee injury.

According to statistics most of injuries, more than 6% of all possible fractures, are precisely the damage to the femoral neck. Up to 90% of cases occur in elderly age.

Non-traumatic

Pain in the muscles of the thigh can appear not only as a result of injury, but also with age. Why it happens? As a rule, the reason for this is joint wear. Often in elderly people, there is a violation of the production of synovial fluid, which serves as the main lubricant.

Excessive friction of the surfaces of the bone will initially cause pain in the hip when walking, and when serious damage and at rest. However, this is far from the only reason. If you did not fall or bump, then joint pain can be caused by:

Arthrosis of the hip joint, a disease that often occurs in people after 40 and is characterized by a slow development over two to three years. The main feature is aching pain that is localized in the groin or spreads down the front and inner surfaces, and sometimes radiates to the knee. In the early stages of development, as a rule, hip pains when walking, climbing stairs, when trying to get out of bed or a chair. Gradually, it becomes more and more difficult to do these simple actions, and unpleasant sensations and stiffness begin to appear at rest.
Inflammation of the bursa, tendons and ligaments. It can occur in the left, in the right, or in both joints at the same time. More often, because of the love for high heels, women suffer from this ailment. The main difference is that discomfort occurs in the upper region and spreads along the outer surface of the leg.
Inflammation of the hip joint itself. According to statistics, this form of arthritis occurs only in 4% of cases, more often this disease affects the knee, wrist or hand. However, it may be the reason too. If pain spreads both along the front and back surfaces, and the leg itself has begun to move poorly, then most likely it is arthritis.
Aseptic necrosis of the head of the bone. This diagnosis is made by doctors in about 5% of patients who complained of stiffness and discomfort in the leg. In many ways, the symptoms of this disease coincide with arthrosis, but unlike it, they develop in just a few days. Necrosis can be caused by injury, long-term use of high doses of corticosteroids, autoimmune diseases, and any other factors that cause poor circulation in the joint.
Polymyalgia rheumatica - rare disease, which is found in only 1% of people. Doctors cannot say for sure why such a pathology occurs. Most often it is a complication after the transferred viral infection, usually after the flu and only affects people over 50. Sometimes it can be provoked severe stress... The main symptom is severe pain arising in the upper leg, spreading down the front, inner and back of the thigh and radiating to the lower back or knee. They are accompanied by a general weakness and the inability to do something on their own. Often such patients cannot even get to the doctor themselves.

Other reasons

What to do if there is pain in the hip? First of all, do not postpone the visit to the doctor and do not self-medicate. There are many reasons why it can occur, they are not always associated with joints or muscles. In some cases, these can be diseases of completely different organs. That is why you should not try to diagnose yourself, based only on your feelings. In addition to disorders in the hip joint, pain can be caused by:

Piriformis syndrome - arises from a pinching of the sciatic nerve and is manifested by pain that spreads down the leg from the back of the thigh, radiates to the knee and sometimes to the lower back. The pinched nerve causes severe spasm muscles, which in turn limits the movement of the leg and leads to pain in the hip.
A pinched nerve in the lower spine can also cause pain radiating to the left or right hip joint.
Cardiovascular disease, which causes persistent narrowing of the aorta and iliac arteries that nourish the joints of the pelvis and lower limbs.
Iliopsoas syndrome, in which damage to the femoral nerve and adjacent muscles occurs. It can be caused by various injuries, changes in the spine, or diseases of the abdominal organs. Usually, unpleasant sensations in this case appear on the inside of the leg and in the groin.
Tumors of the femur, pelvic bones, or metastases, which can occur, for example, with prostate cancer.
Infections that affect bones and joints, such as osteomyelitis, tuberculosis of the hip, or abscesses that can occur with complicated appendicitis.
Inflammatory diseases of the female or male genital area. In this case, discomfort usually occurs in the groin and on inside legs.

If you experience pain in the hip, especially if it comes on suddenly and gets worse over time, you should see a doctor as soon as possible. Only with the correct diagnosis will you get the effect of the treatment.

Features of pain in children

Unlike an adult, pain in a child, if they are not associated with trauma, can occur for completely different reasons. This could be:

Congenital dislocation, the cause of which in most cases is the impaired formation of the hip joint. Usually, such a pathology is noticed almost immediately after birth, but in some cases it can manifest itself in a child at a later age.
Osteochondropathy of the hip joint is a pathology that can occur in a child during the period of his active growth, that is, from 4 to 14 years old and lead to a violation in the development of the joint. It manifests itself as discomfort, lameness and a gradual loss of leg mobility.
Epiphyseolysis of the head of the bone is a pathology in which a child stops bone growth, leading to asymmetry of the legs at an older age. Doctors cannot say exactly why such a violation occurs. But most often it appears due to an injury in the hip area. It is usually found in adolescents leading an active lifestyle and especially in those who are fond of football and basketball.
Osteomyelitis and, as a consequence, coxitis - inflammation of the hip joint.
Hidden fractures that can occur in a child when the process of bone formation is disturbed, for example, due to rickets.

But even this is not all the reasons that can cause hip pain in children. That is why if a child complains of discomfort in this area, you should not postpone a visit to a pediatrician or pediatric orthopedist. Timely referral to a specialist will help to avoid many problems in the future.

moyskelet.ru

How to treat hip pain

Hip pain is a common complaint of patients, including women and children. Let's analyze the causes of pain in the hip, methods of treatment.

Causes of pain in adults

Hip pains accompany the symptoms of various diseases, if pain occurs, consult a doctor who will diagnose it.

Arthrosis. It is detected in women after forty years. It is characterized by sharp painful sensations in the thigh area, slowly sinking into the knee. During rest, they are not felt, with physical exertion they reappear.
Joint infarction. The patient has severe pain in the outer thigh. The disease is characterized by a rapid course.
Lumbar injury. The cause of pain in the hip area. There are pains in the hip that do not radiate to the groin.
Heart disease is the cause of pain.
Oncological diseases.
Muscle disease of rheumatic origin. It appears as a result of a viral disease or due to excessive mental stress.
Pelvic abscesses.
Inflammation in the organs of the reproductive system.
Stenosis.
Spine diseases like osteochondrosis. Hip, groin, leg hurts.
Endocrine diseases.
If the work is connected with physical exertion, abrasion of the cartilage occurs, which leads to inflammation in the muscles, irritation of the sciatic nerve. The pathology is characterized by pain in the leg to the foot. It is difficult for the patient to sit, walk - movement causes acute pain.

Causes of pain in a child

If a child has a hip pain, this is a signal for parents to urgently consult a doctor. Causes of pain:

Inflammation of the synovium (synovitis). Synovitis in a child is an inflammation of the lining of the hip joint, which occurs against the background of viral diseases. Pathology goes away without requiring treatment. The doctor will refer the parents to an orthopedist to remove fluid from the hip joint.
Arthritis in a child occurs in children as well as in adults. It is characterized by swelling in the knee, ankle, elbow joints, fever and rash.
The femoral head can slip out of the hip joint. The condition develops in a child due to trauma. Symptoms are severe pain in the hip, displacement due to injury, stiffness in movements. The child needs to be taken to the hospital urgently. There they will give anesthesia, because the thigh is cramped, they will be sent for X-ray or ultrasound, excluding the possibility of fractures, then the doctor sets the bone in place in the hip joint.

When does hip pain appear?

Pain in the hip area can be of a different nature - acute or chronic, when the joint hurts constantly.

Often the back of the thigh, inner thigh, or top part... By nature, the pain is divided into pulling, sharp, sharp, aching. It hurts at the same time in the thigh and buttocks or the thigh and lower back.

Typical patient complaints:

Prolonged stress on the muscles causes pain in the hip joint. Redness in a sore spot, muscles go numb.
It's hard to walk, stand, lie down.
Increased pain during menstruation.

Characteristic features of pain:

If injured, it hurts instantly.
If work is associated with heavy physical exertion, pain occurs several hours after exertion.
Sometimes hip pain is accompanied by lameness. The body tries to reduce weight, which injures the diseased joint.

Types of pain

Painful sensations in each person manifest themselves in different ways:

Diagnostics

Eliminate self-medication, see a doctor. First pass initial inspection, in which the doctor asks where and how the hip joint hurts, reveals sore spots by palpation. If injuries or fractures are excluded, tests are done so that the doctor can determine the cause of the disease. The study is carried out by methods: angiography, electromyography, tomography, X-ray photo, ultrasound.

If a fracture is found, the movement in the area of the joint is limited by the imposition of a plaster cast. If the fracture is complex and you need to collect bone fragments, you will need surgical intervention In case of arthrosis, the joint is replaced with an endoprosthesis.

Treating hip pain

Than to treat, what treatment is better to choose.

If the pain is severe, the doctor will prescribe treatment with pain relievers to relieve pain. If the pain persists, stronger drugs are prescribed. For inflammatory diseases, anti-inflammatory drugs are prescribed.
Ice is used to treat an inflammatory joint. Ice is applied to the sore joint twice a day. The duration of the session is ten to fifteen minutes.
If the cause of the pain lies in arthritis, then they warm the joint area with a heating pad attached to the sore spot, or take hot baths.
In case of injury, doctors advise to observe bed rest, rest more often, with physical exertion, an inflammatory process can begin. If you are overweight, it is recommended to lose weight and buy shoes with orthopedic insoles - this will reduce the load in the thigh area.
Exercising to warm up the muscles reduces pain. Use water gymnastics, before that you need to consult a doctor. Swimming and water aerobics relieve pain in a sore joint, do not strain the muscles.
Treatment of pain in the hip is also permissible with the help of alternative methods. Take cabbage leaf, grease with honey, attach to the sore joint, cover with a plastic bag, wrap it with a woolen scarf on top. Acts as a warming compress.
Massage is helpful for treating hip pain.
Physiotherapy procedures are also required, which the doctor directs.

See your doctor to find out the cause of your hip pain. He, depending on the diagnosis, will refer you to a traumatologist, surgeon, neurologist, orthopedist, oncologist. Remember, treatment is about eliminating the cause of the pain, isolating the pain syndrome is one of the stages of treatment.

otnogi.ru

Pain in the hip in children: what is the symptom, the reasons, for what diseases it happens

Any symptom is a signal from the body that an organ, department or whole system... To find out why hip pain occurs in children, you need to rule out some diseases. Make sure that the baby undergoes modern diagnostics, clarify what caused the pain in the hip and how to quickly and effectively improve the condition.

The list of diseases in which there is pain in the hip in babies:

Injuries and bruises of the hip joint;
Spinal column injuries;
Synovitis;
Arthritis;
Epiphyseolysis of the femoral head.

Trauma is the most common cause of pain in children. The child may bump his hip, unsuccessfully step on the leg or fall on it, and notice the problem or pain after a while. An ailment such as synovitis, for example, occurs as a result of the development of a viral infection. As a result, fluid can build up in the hip joint. Therefore, you should pay close attention to the complaints of your child and immediately consult a doctor.

Only a qualified specialist should deal with the treatment of disorders in the endocrine system in children. Only a doctor can tell you how to treat hip pain, how to get rid of complications of hip pain and how to prevent its occurrence. The question of what to do if your baby has hip pain can be answered following doctors:

Osteopath;
Children's neurologist;
Children's orthopedist;
Pediatrician;
Surgeon;
Chiropractor;
Reflexologist.

Before prescribing treatment, the doctor may prescribe an x-ray or ultrasound of the hip joint, and certain tests. During the exam, the doctor will pay attention to your child's gait to understand how a hip problem is affecting the musculoskeletal system. Believing that everything will go away by itself is not worth it, some ailments that cause similar symptom can have Negative consequences for a growing organism.

Arm yourself with the knowledge and read a helpful informative article about Hip Pain in Children. After all, to be parents means to study everything that will help maintain the level of health in the family at the level of "36.6".

Find out what can cause an ailment, how to recognize it in a timely manner. Find information about what are the signs that can identify ailment. And what tests will help identify the disease and make the correct diagnosis.

In this article, you will read all about the methods of treating diseases such as hip pain in children. Clarify what effective first aid should be. How to treat: choose medications or folk methods?

You will also learn what the danger of untimely treatment of an ailment, pain in the hip in children, can be, and why it is so important to avoid the consequences. Everything about how to prevent hip pain in children and prevent complications.

A caring parents will find on the pages of the service complete information about the symptoms of hip pain in children. What is the difference between the signs of the disease in children at 1, 2 and 3 years old from the manifestations of the disease in children at 4, 5, 6 and 7 years old? What is the best treatment for hip pain disease in children?

Take care of the health of loved ones and be in good shape!

Why can the hip hurt?

How does the pain manifest itself and when?
Hip pain can occur both after heavy physical exertion, and completely independently of such. Sometimes they appear only in the morning after getting up, sometimes as constant pain in the thigh. Very often they are accompanied by a feeling of stiffness, instability and limited movement.
Distinguish pains as chronic, lasting for more than three months and acute (arising from time to time).

Where does the pain arise?
Pain occurs in the groin, in the ‘crease’ between top thighs and lower abdomen. In many cases, the pain radiates to one or both legs. Conversely, pain from the lumbar spine can be felt in the area of the hip joint.
Many patients confuse hip pain in the groin area with other complaints, such as pain in the pelvis or upper thigh bone. Sometimes the pain is caused by the muscles in the thigh area, not the thigh itself. Also, irritation of the mucous membrane of the thigh can lead to pressing pain.
In rare cases, hip pain is caused by tumors or some infectious disease.

Diseases for which this pain is characteristic

Causes of hip pain

1. The most common cause of hip pain is hip joint wear. With age, articular cartilage wears out. For many people, this natural cartilage shock absorber is so worn out that the bone hits the bone and causes severe pain.
The process of deterioration of cartilage is called arthrosis of the hip joint (the so-called Coxarthrose). Most people suffer from this disease in old age after 50 years, but in rare cases it can also affect young people. With osteoarthritis of the hip joints, pain in the hip is typical, but unpleasant sensations in the knee, groin, and buttocks can also disturb. Sometimes the intensity of pain changes depending on the weather - temperature, humidity, atmospheric pressure (meteorological dependence).

2. Along with the natural causes of arthrosis, there are other causes such as accidents or injuries, birth defects of the legs or the consequences of metabolic diseases.

3. Also the so-called systemic arthritis, in which several joints are affected, can lead to hip pain.

4. The cause may also be rheumatic processes or chronic arthritis.
Arthritis of the hip joint is observed in the following diseases:
- rheumatoid arthritis,
- juvenile rheumatoid arthritis,
- rheumatism (migratory arthritis),
- spondyloarthropathy.

5. Hip pain can be the result of emotional overload or a desire to materially benefit from your illness.
Such patients usually enter the doctor's office with a severe limp and leaning on a thick stick.
On examination, there is a limitation of active hip flexion to 90 ° with preserved rotation (with arthritis of the hip joint, first of all, internal rotation is disturbed).
Be sure to examine passive movements in the joint - they are also usually preserved in full.

6. Frequent causes of pain in the hip and buttock are osteochondrosis and osteoarthritis of the lumbar and sacral spine and, somewhat less often, diseases of the sacroiliac joints.
Pain in these diseases almost always radiates along the outer surface of the buttock and the back of the thigh.

7. Pain in the hip and buttock can also be caused by damage to the muscles and ligaments in the hip joint.

The most dangerous causes of hip pain

Pain in the hip and buttock can be observed with cardiovascular diseases, neoplasms, and severe infections:

1. Stenosis and occlusion of the aorta and iliac arteries
Pain and lameness are observed: they are often interpreted as a sign of damage to the hip joint. A characteristic symptom of arterial stenosis is a murmur over the arteries, especially after exercise.

2. Malignant neoplasms
- Primary tumors of the femur and pelvic bones are rare: they are usually lymphosarcoma and foci with multiple myeloma.
- Bone metastases are much more common (with prostate cancer and breast cancer).
Among other pelvic bones, the ilium is the most commonly affected.

3. Infections
- Osteomyelitis usually affects the proximal metaphysis of the femur.
Osteomyelitis is primarily ruled out in children with intense pain, severe lameness and fever.
- Tuberculosis is also more common in children (usually under 10 years of age) than in adults. Its manifestations may resemble osteochondropathy of the femoral head.
- The most common cause of lameness and hip pain in children is transient arthritis of the hip joint, which may be of a viral nature.
- Pain in the hip and lameness are observed with pelvic abscess (for example, with complicated appendicitis), inflammatory diseases of the female genital organs, especially pyosalpinx, and abscesses of the sciatic-rectal fossa. The pain in these diseases appears to be caused by irritation of the obturator nerve.
- Retroperitoneal hematoma is characterized by reflected pain in the hip and symptoms of a lesion of the femoral nerve.

The most dangerous causes of hip pain in children are:

Dysplasia of the hip joint, its most severe form - congenital dislocation of the hip,
- Osteochondropathy of the femoral head,
- Epiphyseolysis of the femoral head,
- Fatigue fractures of the femoral neck.

Medications for hip pain

Anti-inflammatory therapy- for this, non-steroidal drugs are used - indomethacin, diclofenac and others. Severe symptoms of pathology may require the use of steroid drugs - prednisolone, cortisone and others;

Muscle relaxants- allow you to relax the reflex muscle spasm that arose in response to pain. After all, spasmodic muscle fibers increase the degree of pinching of the sciatic nerve in sciatica.
Means that improve microcirculation- help to reduce hypoxic manifestations in the affected area, as well as reduce edema syndrome.
Chondroprotectors, vitamins and minerals improve trophism in the field of pathology;
Diuretics - reduce the degree of inflammatory edema involved in the compression of the sciatic nerve;
Manual therapy helps to release the nerve from the pinched state by releasing muscle and articular blocks in the lumbosacral area;
Therapeutic gymnastics helps to develop the mobility of muscles and joints, improving blood flow in the affected area, strengthens the muscles around the spine;
Physiotherapy, acupuncture, hirudotherapy and other techniques reinforce the success of the main treatment.

Doctors to contact

Neurologist
Rheumatologist
Traumatologist
Orthopedist
Oncologist
Surgeon

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From an anatomical point of view, the thigh is the part of the leg from the knee to the hip joint. The thighbone is the longest in the human body. And the hip and knee joints are the largest and strongest.

Hip pain can occur at different ages. Appear during physical exertion or at rest. Temporary or permanently disturbing. It can be caused by a variety of reasons. It can occur in the groin area, in the front or back of the leg, give to the knee and even to the lower back. It so happens that the hip itself has nothing to do with it, and the cause of the unpleasant sensations lies in a completely different place.

Causes

In people leading a sedentary lifestyle, hip pain can appear when walking, with unusual, high loads or with a sudden change in position. They usually go away on their own. However, their appearance is the first signal that pathological changes have begun in the joint, which in the future may lead to the development of serious diseases.

In addition, it can be caused by causes of a traumatic or non-traumatic nature.

Traumatic

Why can pain and discomfort occur? The most common cause is a variety of injuries, which include:

Closed injuries of the hip joint and damage to the pelvic bones, especially the pubic or sacrum.
Injury to the first lumbar vertebra.
- the narrowest place in the femur, which is especially common in the elderly.
Knee injury.

According to statistics, most of the injuries, more than 6% of all possible fractures, are precisely the damage to the femoral neck. Up to 90% of cases occur in old age.

Non-traumatic

Excessive friction between the surfaces of the bone will initially cause pain in the hip when walking and, if severely injured, at rest. However, this is far from the only reason. If you did not fall or bump, then joint pain can be caused by:

, a disease that often occurs in people after 40 and is characterized by a slow development over two to three years. The main feature is aching pain that is localized in the groin or spreads down the front and inner surfaces, and sometimes radiates to the knee. In the early stages of development, as a rule, hip pains when walking, climbing stairs, when trying to get out of bed or a chair. Gradually, it becomes more and more difficult to do these simple actions, and unpleasant sensations and stiffness begin to appear at rest.
Inflammation of the bursa, tendons and ligaments. It can occur in the left, in the right, or in both joints at the same time. More often, because of the love for high heels, women suffer from this ailment. The main difference is that discomfort occurs in the upper region and spreads along the outer surface of the leg.
... According to statistics, this form of arthritis occurs only in 4% of cases, more often this disease affects the knee, wrist or hand. However, it may be the reason too. If pain spreads both along the front and back surfaces, and the leg itself has begun to move poorly, then most likely it is arthritis.
Aseptic necrosis of the head of the bone. This diagnosis is made by doctors in about 5% of patients who complained of stiffness and discomfort in the leg. In many ways, the symptoms of this disease coincide with arthrosis, but unlike it, they develop in just a few days. Necrosis can be caused by injury, long-term use of high doses of corticosteroids, autoimmune diseases, and any other factors that cause poor circulation in the joint.
Polymyalgia rheumatica is a rare disease that affects only 1% of people. Doctors cannot say for sure why such a pathology occurs. Most often, it is a complication after a previous viral infection, usually after the flu, and manifests itself only in people over 50 years old. Sometimes severe stress can provoke it. The main symptom is severe pain arising in the upper leg, spreading down the front, inner and back of the thigh and radiating to the lower back or knee. They are accompanied by a general weakness and the inability to do something on their own. Often such patients cannot even get to the doctor themselves.

Other reasons

- arises from the pinching of the sciatic nerve and is manifested by pain that spreads down the leg from the back of the thigh, radiates to the knee and sometimes to the lower back. A pinched nerve causes severe muscle spasm, which in turn restricts leg movement and results in hip pain.
in the lower spine can also cause pain radiating to the left or right hip joint.
Cardiovascular disease, which causes persistent narrowing of the aorta and iliac arteries that feed the joints of the pelvis and lower extremities.
, in which damage to the femoral nerve and adjacent muscles occurs. It can be caused by various injuries, changes in the spine, or diseases of the abdominal organs. Usually, unpleasant sensations in this case appear on the inside of the leg and in the groin.
Tumors of the femur, pelvic bones, or metastases, which can occur, for example, with prostate cancer.
Infections that affect bones and joints, such as osteomyelitis, tuberculosis of the hip, or abscesses that can occur with complicated appendicitis.
Inflammatory diseases of the female or male genital area. In this case, discomfort usually occurs in the groin and on the inside of the leg.

If you experience pain in the hip, especially if it comes on suddenly and gets worse over time, you should see a doctor as soon as possible. Only with the correct diagnosis will you get the effect of the treatment.

Features of pain in children

Unlike an adult, pain in a child, if they are not associated with trauma, can occur for completely different reasons. This could be:

, the cause of which in most cases is the impaired formation of the hip joint. Usually, such a pathology is noticed almost immediately after birth, but in some cases it can manifest itself in a child at a later age.
Osteochondropathy of the hip joint is a pathology that can occur in a child during the period of his active growth, that is, from 4 to 14 years old and lead to a violation in the development of the joint. It manifests itself as discomfort, lameness and a gradual loss of leg mobility.
Epiphyseolysis of the head of the bone is a pathology in which a child stops bone growth, leading to asymmetry of the legs at an older age. Doctors cannot say exactly why such a violation occurs. But most often it appears due to an injury in the hip area. It is usually found in adolescents leading an active lifestyle and especially in those who are fond of football and basketball.
and as a consequence, coxitis - inflammation of the hip joint.
Hidden fractures that can occur in a child when the process of bone formation is disturbed, for example, due to rickets.

Due to the fact that hip pain is a very unusual manifestation in a child, this complaint always requires a visit to a doctor.

What to do with pain in the hip in a child

Making an appointment with the doctor, keep a diary where you will describe all the signs of pain that your baby is experiencing:

When and under what circumstances did the pain start?
How does the child describe her pain?
Has the baby's gait changed?
Does he limp?
Is the pain accompanied by fever or pain in other joints?
Does it hurt if you touch your hip or when he moves?
Has the child recently been involved in a new sport or other physical activity?
Are there any complaints of knee pain?
Does pain occur if he carries something heavy on the affected side?
When does the pain stop?
When does the pain get worse?

What a doctor can do for hip pain in children

Based on the child's medical history, the doctor will make a diagnosis. Your doctor will examine your child's thighs for swelling and stiffness and will do a frog test. If, in the prone position of the frog, the child is unable to bend or lay aside the diseased hip as well as the healthy one, and / or it hurts the child to do this, this is most likely one of the reasons for concern and will require more accurate research.

Your doctor will look at your child's gait to see if hip pain is affecting gait. After that, a full examination will follow in order to understand if there are any other problems that cause concern, for example, whether the tonsils are enlarged, whether the child has a rapid heart rate, fever, or there are any other signs of inflammation in the body.

The doctor, most quickly, will direct you to conduct a series of studies and blood tests. In addition to the examination, the same tests can be used to determine and subsequently treat problems with the hip joint in children:

Inflammation of the synovium (synovitis)... Hip synovitis in children is an inflammation of the lining of the hip joint, which is most often accompanied by other signs of viral diseases, for example respiratory infection upper respiratory tract. Like any other viral disease, in most cases, synovitis disappears on its own over time. Your Doctor may send you for a consultation with an orthopedic surgeon if fluid begins to accumulate in the affected hip joint, which must be removed from there.
Arthritis in a child... Children have very arthritis, just like adults, children can develop - juvenile rheumatoid arthritis (JRA). With such a disease, it very rarely affects the hip joint, but quite often there is pain and swelling in the knee, ankle or elbow joints, which can be accompanied by fever and rash, and also, as a rule, a violation of the general condition of the patient.
If the head of the femur has slipped out of the hip joint... Doctors call "epiphysis of the femoral head", occurs in an older child as a consequence of trauma, in which the head of the bone comes out of the glenoid fossa of the pelvic bone. This is a very painful condition and therefore it is easy to diagnose it: severe excruciating pain, stiffness of movement, displacement of the hip as a result of injury. Requires urgent transportation of the baby to the nearest hospital. Immediately upon arrival at the hospital, an anesthetic injection is usually given or a standard light pain reliever is given to completely relax the thigh muscles, which are already convulsively tense by that time. After relaxing them, the doctor will return the head of the femur to its original place - the hip joint. Usually, before such a procedure, an X-ray photograph or an ultrasound examination of the sore thigh is taken to make sure that there are no fractures.

As a result of the development of edema, the nerve endings in the soft tissues are compressed, which leads to pain. In addition, some biologically active substances directly affect nerve fibers, increasing their sensitivity. This explains the fact that any, even the slightest touch to the inflamed tissues will be very painful.

Types of hip pain

The tissues of the thigh have different innervation, which causes a different nature of pain during inflammation of a particular structure.

Damage to the tissues of the thigh can cause:

Sharp pain. Such pain occurs when the soft tissues of the thigh are damaged. The pain is short-term, localized ( the patient can pinpoint the pain zone). Over time, aching pains may join, indicating the onset of development inflammatory process in the tissues.
Somatic pain. It occurs with damage to tendons, ligaments, joints and bones. The number of pain receptors in these tissues is small, so patients usually complain about dull pain in a certain area, but they cannot clearly localize it.
Skin pain. Acute and the shortest pain caused by damage to the free nerve endings of the skin. Disappears immediately after the cessation of exposure to the traumatic factor.
Neuropathic pain ( neuralgia). It occurs as a result of damage to sensitive nerve fibers. In this case, the patient feels pain in a certain area of the thigh, although in fact there is no pathological process there.

Causes of hip pain

Pain can be caused by damage such as skin both soft tissues and the femur. Pain syndrome can also be caused by a pathological process at the level of the lumbar and sacral plexuses, accompanied by damage to the nerve fibers that conduct pain sensitivity from the tissues of the thigh. In addition, pain can be felt in diseases of the lower leg and foot, when the progression of the inflammatory process leads to the occurrence of so-called "reflected" pain in the thigh area.

Hip pain can be caused by:

diseases of the hip joint;
diseases of the femur;
damage to the muscles and ligaments of the thigh;
neuralgia of the lateral cutaneous nerve of the thigh ( Roth disease);
vascular lesions of the thigh;
infectious diseases;
tumors;
retroperitoneal hematoma.

Diseases of the hip joint and femur

These diseases are combined into one group, since damage to the structures of the hip joint is almost always accompanied by certain changes in the femur itself, and primary damage to the bone can cause deformation of the hip joint.

Causes of the defeat of the hip joint and femur

Name of the disease	Pain mechanism
Coxarthrosis ()	It is characterized by deformation of the articular surfaces of the bones of the hip joint, which is manifested by the destruction and thinning of the hyaline cartilage. As a result of this, the joint space narrows, the articular surfaces become uneven and begin to rub against each other during movements in the joint, which leads to the occurrence of stitching pains intensifying after physical exertion.
	The reason this disease is a violation of the blood supply to the tissue of the femoral head ( due to injury blood vessels, metabolic disorders or for other reasons). As a result, bone and cartilage structures die. Deformed and thinned cartilage is replaced first by connective tissue, and then by bone tissue, which leads to impaired mobility in the joint and pain during movement.
	Children get sick early age... With this disease, the articular bones develop abnormally, as a result of which congruence is impaired ( correspondence) of their articular surfaces. The result is an uneven distribution of the load during walking, which over time leads to deformation of the articular surfaces, narrowing of the joint space and the appearance of pain during movement.
	This disease develops in adolescents aged 11-14 years as a result of hormonal imbalance. Due to a lack of sex hormones and an excess of growth hormones, there is a decrease in strength and pathological displacement of the upper end of the femur ( pineal gland) downward and posteriorly, which leads to a violation of the congruence of the articular surfaces. The pains arising in this case are associated with increased fatigue during physical exertion and are aching, pulling in nature, can be given to the knee, to the groin area, intensify by the end of the working day and usually disappear after rest. Treatment is only surgical. The bone growth zone is removed ( epiphysiodesis) and fixation of the bone using special metal devices.
*Femur fracture*	During a fracture, a violation of the integrity of the bone occurs, which can also be accompanied by damage to the surrounding soft tissues ( muscles, ligaments), vessels and nerves. All these structures, including the bone tissue itself and the periosteum, contain painful nerve receptors, therefore, at the very moment of the fracture, a person experiences severe pain, which intensifies with any movement and touching the damaged bone. As with a closed fracture ( when bone fragments are not visible) and with open ( when the bone damages the skin and comes out) tissue damage triggers the development of the inflammatory process. The resulting edema leads to the appearance of less acute, pressing and aching pains, and as a result of the release of biologically active substances in the focus of inflammation, hyperalgesia develops ( that is, any, even the slightest touch of inflamed tissues will cause pain).
*Hip dislocation*	Hip dislocation develops as a result of indirect injury ( in case of accidents, in case of falls from a height, and so on). As a result of the impact of a force exceeding the strength of the ligamentous apparatus of the hip joint, the capsule and ligaments are ruptured and the femur leaves the acetabulum, which is accompanied by sharp intense pain.
*Rheumatoid arthritis*	The defeat of the joints with autoimmune diseases due to a malfunction of the human immune system. As a result of this failure, immunocompetent cells ( normally designed to protect the body from the invasion of foreign agents) cease to distinguish between "own" and "foreign" antigens and attack everything, damaging various organs and tissues of the body. The result of the described processes is the development of an inflammatory process in the joint cavity, which leads to the formation and accumulation of exudate in it ( inflammatory fluid). Later, erosion and deformation of the articular surfaces of the bones appears. The pain is constant, aching, aggravated by movements and loads on the joint. The pain is wavy in nature, that is, it can intensify in the evening and subside in the morning. In rheumatoid arthritis, the small joints ( brushes, stop). Inflammation of the hip joint with this disease occurs in severe cases and in the absence of adequate treatment.
*(rheumatism)*	This disease is also autoimmune in nature. It develops a few weeks after infection with B-hemolytic streptococcus ( for example, after a sore throat). This is explained by the similarity between the antigenic structures of streptococcus and some human cells. As a result of this similarity, the immune system, destroying a foreign microorganism, also attacks the cells of its own organism. Unlike rheumatoid arthritis, with rheumatism, the hip joint can be affected from the first days of the disease ( as a rule, several are affected at the same time large joints ). The nature of the pain is the same.

Injuries to the muscles and ligaments of the thigh

The cause of damage to the soft tissues of the thigh can be both trauma and systemic inflammatory disease.

Causes of lesions of the soft tissues of the thigh

Name of the disease	Pain mechanism
*Injury*	Thigh tissue contusion occurs as a result of a blow with a hard blunt object. The integrity of the skin is not disturbed, however, due to the impact, the blood vessels of the injured tissues are destroyed ( predominantly muscle and skin). The blood flowing out of them at the same time cannot flow out and accumulates in the tissues themselves, forming a hematoma. Pain during injury is acute, resulting from damage to pain nerve receptors in the skin, muscles and other tissues. After a while, an aseptic inflammatory process develops in the area of injury ( that is, there are no microbes in the focus of inflammation), which is also manifested by acute pain ( especially when moving) and hyperalgesia.
*Muscle strain*	A muscle strain usually occurs with overexertion or excessive physical exertion ( for example, athletes). During the stretching itself, the patient experiences severe acute pain, the intensity of which decreases at rest and intensifies when trying to contract the injured muscle. As a result of the rupture of muscle fibers and blood vessels, a hematoma is formed, which can lead to the development of complications.
*Myositis*	Muscle inflammation can be caused by injury, infection, or hypothermia. Autoimmune myositis is also common, in which cells of the immune system damage muscle fibers. The development of the inflammatory process in the muscle is manifested by severe sharp and / or aching pains in the affected area. The pain increases during movement ( mostly during active movements, when the affected muscle contracts) and when touching the affected area ( hyperalgesia phenomenon).
*Trochanteritis*	Trochanteritis is an inflammation of the tendons of the muscles that attach to the femur in the region of the greater and lesser trochanters. The cause of the disease can be trauma to this area, infection of muscles and tendons, hypothermia or excessive physical exertion. As a result of the influence of causative factors, an inflammatory process and tissue edema develops, which leads to the appearance of acute, pressing and aching pains.

Spine diseases

As mentioned earlier, the nerves that innervate the tissues of the hip and hip joint originate in the lumbar and sacral plexuses, formed by the spinal nerves. Damage to these nerve structures can also cause hip pain.

Spine diseases

Name of the disease	The mechanism of pain formation
*Osteochondrosis of the lumbar and sacral spine*	This disease is characterized by dystrophic lesions of the intervertebral discs, as a result of which they become thinner. The consequence of this is a decrease in the space between two adjacent vertebrae, which leads to infringement spinal nerves... Infringement of the nerves innervating the tissues of the thigh leads to the occurrence of pathological pain impulses, which are transmitted to the brain and create a sensation of pain. The pain when the spinal nerves are pinched is acute, aching, pulling, can spread from the lumbar back to the foot. The intensity of pain may increase with movement ( when bending and bending the trunk, while walking) and decrease in the supine position, since the load on the spine decreases and the distance between the vertebrae slightly increases.
*Herniated disc*	With a herniated disc, the capsule of the disc ruptures, as a result of which its substance protrudes outward and can squeeze both the spinal cord and spinal nerves, which will lead to pain in the area innervated by the affected nerve formations.

Neuralgia of the lateral cutaneous nerve of the thigh

Roth's disease ( neuralgia of the lateral cutaneous nerve of the thigh) is characterized by compression of the lateral cutaneous thigh at the point of its exit from the pelvic cavity ( where it goes under the inguinal ligament) either in upper divisions thigh, where it is located between the fibers of the fascia lata of the thigh.

The cause of squeezing can be:

passive lifestyle;
growing tumor;
poor quality surgical intervention.

As a result of damage to the nerve fibers, the patient initially feels a slight numbness, tingling or creeping creeps in the nerve innervation area ( that is, exclusively on the anterolateral surface of the thigh). As the disease progresses, the compression of the nerve may increase, leading to burning, unbearable pain. A characteristic sign of neuralgia of the lateral cutaneous nerve of the thigh is local soreness when trying to feel the nerve trunk in the place of its exit from the pelvic cavity, which makes it possible to distinguish Roth's disease from other diseases. Additional instrumental studies for this disease are not informative, therefore they are not prescribed.

Lesion of the vessels of the thigh

Damage to the vessels of the thigh can occur as a result of trauma, as well as in some systemic diseases. Regardless of the cause, damage to a large blood vessel will lead to a disruption in the blood supply to the tissues of the leg, which can lead to their necrosis ( death).

Diseases of the vessels of the thigh

Name of the disease	Pain mechanism
*Obliterating atherosclerosis*	Chronic disease characterized by damage to the vascular wall. The cause of atherosclerosis is a metabolic disorder ( cholesterol and others), which leads to the formation of fatty deposits ( plaques) on the inner surface of the arteries. These plaques increase in size over time and block the lumen of the vessel to such an extent that blood cannot flow to the tissues of the thigh and the entire leg in the required amount. Due to the lack of blood supply, the tissues do not receive the required amount of oxygen, as a result of which the cells begin to die. The process of blood outflow is also disrupted, which leads to an increase in the concentration of metabolic by-products in the tissues. The first sign of this disease is a sharp stabbing pain in the thigh, lower leg and foot that occurs after prolonged exertion. After a short rest, the pain subsides. As the disease progresses, the lumen of the artery narrows more and more, as a result of which the tissues begin to experience a lack of oxygen even with minor loads, which can lead to pain even at rest.
	The cause of this disease is damage to the valves of the superficial veins of the lower extremities, as a result of which there is stagnation of blood in them. Venous wall ( unlike arterial) does not contain such a developed muscle layer. As a result, the overflow of veins with blood leads to their overstretching and expansion. In the later stages of the disease, the blood pressure in the veins increases so much that it disrupts the normal microcirculation in the tissues ( blood from the capillaries cannot pass into the veins due to the increased pressure in them). One of the first symptoms of the disease is a feeling of discomfort, pressing and bursting pain along the superficial veins. As the disease progresses, the veins expand more and more, and the pain sensations increase ( due to lack of oxygen and impaired outflow of metabolic by-products).
*Thrombophlebitis*	Thrombophlebitis is an inflammation of the venous wall, accompanied by the formation of a blood clot ( blood clot) that overlaps ( partially or completely) the lumen of the affected vessel. The cause of the formation of a blood clot can be varicose veins, a violation of the blood coagulation system, an infectious and inflammatory lesion of the vascular wall, and so on. Blockage of large veins of the thigh with blood clots significantly complicates the outflow of blood from the tissues of the thigh, lower leg and foot, which leads to severe burning and pressing pains that do not disappear at rest and are not eliminated by conventional pain relievers. With thrombophlebitis of superficial veins, there may be painful lump in the area of a thrombus and a sharp, bursting pain along the entire affected vein.

Infectious diseases

The infection can penetrate into the tissues of the thigh both with injury, accompanied by damage to the skin, and by hematogenous ( with the spread of infectious agents from other organs with blood flow). Infection leads to the activation of the immune system and the development of an inflammatory process in the affected tissue, which is accompanied by pain.

Infectious Causes of Hip Pain

Name of the disease	Pain mechanism
*Furuncle*	A boil is characterized by purulent inflammation of the hair follicle, which develops as a result of the penetration of pyogenic microorganisms into it ( staphylococci). The release of biologically active substances leads to tissue edema, pain and hyperalgesia in the affected area.
*Carbuncle*	This term refers to the inflammation of many hair follicles, characterized by a deeper spread of the purulent process and damage to the subcutaneous fat.
*Hip abscess*	An abscess is a limited purulent focus located in the soft tissues of the thigh ( in the subcutaneous fat, in the muscles). The cause of the formation of an abscess may be infection as a result of trauma, breakthrough of a boil or carbuncle. As a result of activity immunocompetent cells the inflammatory process is limited ( a dense capsule forms around it), which prevents further spread of the infection. Pus accumulates in the abscess cavity ( consisting of dead bacteria and leukocytes), which can break into the surrounding tissue and lead to the development of complications. Pain syndrome is strongly pronounced at the initial stages of the disease, during the formation of an abscess ( that is, when the inflammatory process proceeds as intensely as possible). The pain is sharp, aching, aggravated by touching the affected area. After limiting the purulent focus, the severity of pain may subside, but in the event of a breakthrough in the tissue of the thigh, it will resume with greater force.
*Phlegmon of the thigh*	Phlegmon is called a diffuse purulent process that affects the subcutaneous fat of the thigh. The cause of phlegmon can be infection with pyogenic bacteria during an injury, with a breakthrough of a boil, carbuncle or abscess. This disease usually develops in the elderly and frail people, in whom the activity of the immune system is insufficient to limit the infectious process. Pain with phlegmon is acute, burning, noted in the area of the entire thigh. At the same time, the tissues of the thigh are edematous, hyperemic ( reddened), any touch to them is accompanied by increased pain.
*Necrotizing fasciitis*	This disease is caused by pyogenic bacteria ( pyogenic streptococcus) and anaerobic infection ( clostridia). It is characterized by lesions of the fascia of the thigh ( thin capsules surrounding muscle fiber groups), subcutaneous fat and skin. As a result of the development of a purulent-inflammatory process, thrombosis develops ( blockage) many small and large blood vessels in the affected area, which leads to severe circulatory disorders and tissue death. At the onset of the disease, the pain is acute, burning, intensified by touching the affected area. With the development of thrombosis and tissue death, the pain syndrome increases, the pain becomes unbearable.
*Osteomyelitis*	The development of a purulent-inflammatory process deep in the bone leads to an increase in pressure in it, which is manifested by pressing, bursting pains. The pain is worse when touched, and especially when tapping on the affected bone, which is characteristic feature this disease.

Tumors

Both benign and malignant neoplasms can cause hip pain. It is important to note that at the initial stages of the disease, tumors practically do not manifest themselves in any way. Pain syndrome usually occurs for more later stages when, in the process of growth, the tumor squeezes the surrounding structures.

Pain in tumors can be caused by:

Compression of soft tissues. If the tumor reaches a significant size, it can squeeze the surrounding tissues so much that this will lead to the appearance of pressing, bursting pains in the area of the neoplasm.
Compression of nerves. Even small tumors can compress nerve trunks, leading to pain in the area innervated by the affected nerve.
Compression of large arteries or veins of the thigh by a growing tumor will lead to impaired blood circulation in the lower parts of the leg. As a result of the development of tissue ischemia and the accumulation of metabolic by-products, severe excruciating pains will appear.

Tumors of the thigh tissue

Benign tumors	Malignant tumors
Lipoma - a tumor that develops in the subcutaneous fat. Fibroma - Hemangioma - vascular tumor. Angiofibroma - a tumor consisting of vascular and connective tissue fibers. Neurinoma - a tumor from cells surrounding nerve fibers. Osteoma - swelling from bone tissue. Chondroma - swelling from cartilage tissue.	Rhabdomyosarcoma - swelling originating from the cells of the muscles of the thigh. Fibrosarcoma - connective tissue tumor. Hemangiosarcoma - tumor from the cells of the vascular wall. Chondrosarcoma - malignant tumor from cartilage tissue. Osteosarcoma - malignant tumor from bone tissue.

It is also worth noting that metastasis ( migration with blood and lymph flow) tumor cells from malignant neoplasms of other areas ( for example, for prostate cancer, breast cancer and so on).

Retroperitoneal hematoma

Thigh pain can be caused by an inflammatory process in the abdomen. This is explained by damage to the nerve structures that pass near the pelvic organs and can be involved in the pathological process.

The retroperitoneal space is located in the abdomen, behind the abdominal organs. It is filled with fiber and contains various organs ( kidney, pancreas), blood vessels ( aorta, inferior vena cava) and nerves. The reason for the accumulation of blood in the retroperitoneal space is damage to the listed organs or blood vessels, followed by hemorrhage from them. The resulting hematoma can put pressure on the femoral nerve, which can lead to numbness or sharp burning pains in the front of the thigh.

Diagnosing the causes of hip pain

If there is an obvious cause of pain ( for example, in case of injury) the diagnosis is straightforward. The situation is more complicated when the pain syndrome occurs for no apparent reason. In these cases, the doctor is forced to prescribe whole complexes of additional laboratory and instrumental studies in order to make the correct diagnosis and prescribe treatment.

Which doctor should i go to for hip pain?

As follows from the above, hip pain can appear with various diseases and as a result of damage to various tissues. If the occurrence of pain is associated with life threatening state ( for example, with a fracture of the femur and injury to a blood vessel with bone fragments), you should immediately call an ambulance. An ambulance doctor will perform the necessary therapeutic measures (will stop bleeding, prescribe pain medications, provide immobilization of the thigh, and so on), then ( if necessary) transports the patient to the appropriate department of the hospital. If the pain syndrome develops gradually and does not threaten the patient's life at the moment, it is recommended to make an appointment with the family doctor, who, after a clinical examination, can refer the patient to other specialists.

If you have pain in the hip, you may need a consultation:

Traumatologist - with a fracture of the femur, dislocation of the hip, rupture of muscles and ligaments.
Surgeon - with pelvic abscess, retroperitoneal hematoma ( when surgery may be required for treatment).
Neurosurgeon - with damage to nerve fibers.
Vascular surgeon - with damage to blood vessels.
Rheumatologist - if hip pain is associated with a systemic inflammatory disease.
Infectionist - with the development of necrotizing fasciitis, osteomyelitis and others infectious diseases.
Oncologist - if you suspect a benign or malignant neoplasm in the thigh area.
Phthisiatrician - with suspicion of the presence of a tuberculous process.
Vertebrologist - with diseases of the spine.

Diagnosis of diseases of the hip joint and femur

The cause of damage to the femur and hip joint can be a variety of pathologies, therefore, for staging accurate diagnosis it is necessary to evaluate not only all the symptoms of the disease, but also the data of laboratory and instrumental studies.

Diagnosis of diseases of the hip joint and femur

Name of the disease	The main symptoms	Additional analyzes and instrumental studies
*Coxarthrosis*	Restriction of mobility in the hip joint. It develops gradually and arises as a result of thinning of the articular cartilage and the proliferation of connective tissue in the articular cavity. Without appropriate treatment, joint contracture may develop, that is, its complete immobilization will occur. Crackling in the hip joint. As a result of cartilage thinning, the articular surfaces of the bones come closer and rub against each other during movement, which is accompanied by painful clicking or crunching. Shortening of the leg on the affected side. It is the result of thinning of the articular cartilage and narrowing of the joint space. Lameness. It occurs due to severe pain in the joint during movement, as well as due to weakening of the muscles on the affected side.	Allows you to identify deformation of the articular surfaces of bones, narrowing of the joint space and the presence of osteophytes ( growths of bone tissue that appear in response to the destruction of cartilage). *CT scan ( CT scan) and magnetic resonance imaging ( MRI).* They allow you to examine in more detail the articular structures, to assess the degree of damage to the cartilage, articular capsule and ligamentous apparatus. Puncture of the hip joint. A puncture of the joint cavity is made and the fence is not a large number synovial fluid for the purpose of its further research in the laboratory. Allows you to determine the presence of an infectious or inflammatory process in the joint cavity.
*Aseptic necrosis of the femoral head*	The clinical manifestations of this disease are the same as in coxarthrosis, which greatly complicates the diagnostic process.	X-ray examination. It is informative only in the later stages of the disease, when structural deformation of the bone occurs due to a violation of the blood supply. On the roentgenogram, there may be a decrease in the size of the femoral head and its flattening, which leads to an expansion of the joint space. CT and MRI. In the early stages of the disease, it is possible to identify the presence of structural ( necrotic) changes in bone tissue. At later stages, they give more accurate information about the degree of deformation of the femoral head and about the nature of damage to other intra-articular structures ( articular cartilage capsules).
*Hip dysplasia*	Asymmetry of the gluteal folds. It develops due to a violation of the development of the hip joint on the affected side. Click symptom. Due to the underdevelopment of the articular structures in children with dysplasia, subluxation of the femoral head is noted ( that is, its exit from the articular cavity). To identify the symptom of a click, the doctor puts the child on his back, takes his legs with his hands ( by the feet) and slowly pushes them apart. If dysplasia is actually present, at some point, the dislocated femoral head will fall into place, which will be accompanied by an audible click. Shortening of the leg on the affected side. Occurs due to displacement of the femoral head. Limitation of mobility in the affected joint.	X-ray examination. It is not very informative in newborns and young children, since some areas of the femur and pelvic bones have not yet become ossified and consist of cartilaginous tissue, which is poorly visible on radiographs. Nevertheless, with the help of special tables and formulas on the roentgenogram, it is possible to identify deviations in the location of the femur, characteristic of this disease. *Ultrasound procedure ( Ultrasound).* Allows you to explore intra-articular structures ( including cartilage formations) and assess the degree of displacement of the femoral head. MRI. Allows you to more clearly visualize cartilage formations and assess the degree of underdevelopment of articular components, which significantly helps in making a diagnosis.
*Juvenile epiphysis of the femoral head*	Atrophy ( reduction in size) thigh muscles on the affected side. Lameness due to joint deformity, pain and muscle atrophy. Restriction of mobility in the hip joint ( up to the development of external rotational contracture, that is, the hip is fixed in an outward-turned position). This condition develops due to the displacement of the femoral head and its exit from the acetabulum.	X-ray examination in two projections allows you to confirm the diagnosis. On radiographs, the displacement of the femoral head is determined, as well as pathological changes in the area of its growth ( in particular, loosening of the epiphyseal zone and the disappearance of the normal bone pattern are determined). It is important that the structure of the femoral head itself is not disturbed in this disease.
*Femur fracture*	During the injury, the crunch of a breaking bone can be heard. There is a dysfunction of the leg. If the fracture is not complete, the patient can make some movements, but they are accompanied by severe pain. With a complete hip fracture, such movements are impossible. Unnatural position of the leg ( there may be a curvature of the hip, deviation of fragments from the longitudinal axis of the limb). Pathological mobility in the hip ( when trying to make movements, there may be a displacement of the underlying fragment of the femur). With an open fracture, bone fragments can come out and be determined visually in the wound.	The clinical manifestations of the disease and the evidence of the previous trauma are usually sufficient to make a diagnosis. In doubtful cases, an X-ray or CT scan is prescribed, which allows you to determine the location and nature of the fracture, identify the presence of bone fragments and plan therapeutic measures.
*Hip dislocation*	Restriction of mobility in the hip joint. Attempts to rotate or flex the hip are futile and are accompanied by increased pain. Visible deformity of the hip joint area. Swelling and swelling of tissues in the area of the affected joint ( as a consequence of the development of the inflammatory process).	X-ray examination. Allows you to confirm the presence of dislocation, to determine the nature and severity of the displacement of the femoral head. CT and MRI. Appointed, if necessary, more detailed research articular components to detect damage to the ligamentous apparatus and the articular capsule.
*Rheumatoid arthritis*	Soreness, swelling and deformation of many joints at once throughout the body. Aching muscle pains. They arise due to the progression of the systemic inflammatory process. Increase in body temperature up to 37 - 38 ° C. It occurs due to the development of the inflammatory process and the release of biologically active substances in various organs and tissues. Morning stiffness... At night, a large amount of inflammatory fluid accumulates in the joint cavity, which leads to impaired mobility and pain in the joints in the morning for at least 30 minutes. Extra-articular lesions. Thinning of the skin, the formation of subcutaneous rheumatoid nodules, inflammation of the lungs, heart tissue, kidneys, and so on may be noted.	General blood analysis. Reveals leukocytosis ( an increase in the number of leukocytes more than 9.0 x 10 9 / l) and an increase in the erythrocyte sedimentation rate ( ESR) more than 10 - 15 mm per hour. This is explained by the progression of the inflammatory process and the release of a large amount of biologically active substances and inflammatory mediators into the systemic circulation. Biochemical analysis blood. Allows to reveal an increase in the concentration of proteins of the acute phase of inflammation in the blood, which is an indicator of the activity of the inflammatory process in the body. With rheumatoid arthritis, the concentration of fibrinogen increases ( more than 4 g / l), C-reactive protein ( more than 5 mg / l), haptoglobin ( more than 2.7 g / l), ceruloplasmin ( more than 0.6 g / l). Identification of rheumatoid factor. Rheumatoid factor is a modified lymphocyte that appears in the blood of more than half of patients with rheumatoid arthritis. Detection of antibodies against the body's own tissues. This test is positive in most patients. X-ray examination. Determines the thinning of the articular cartilage, narrowing of the joint space and deformation of the articular bones.
*Acute rheumatic fever*	A history of a recent sore throat. Increase in body temperature over 38 - 39 ° C. Inflammation of several joints throughout the body. Formation of subcutaneous rheumatic nodules. A characteristic skin rash ( annular erythema). The defeat of various organs ( heart, lungs, kidneys, nervous system).	Bacteriological examination – allows you to isolate streptococcus from the nose and nasopharynx. General blood analysis - reveals leukocytosis and an increase in ESR. Blood chemistry - reveals an increase in the concentration of proteins of the acute phase of inflammation. Serological tests – reveal an increase in the concentration of anti-streptococcal antibodies in the blood, which is a sign of the fight of the immune system with the causative agent of the infection. *Electrocardiography ( ECG)–* detects arrhythmias and other signs of heart damage.

Diagnosis of muscle and ligament injuries

Muscle damage can result from injury or overuse physical activity... Make the correct diagnosis in this case a detailed survey of the patient helps ( the time and nature of the injury is being clarified) and clinical examination. Additional studies are usually not required, except in cases where the doctor may suspect the presence of a more serious pathology ( for example, if the hip is bruised, an x-ray may be done to rule out a fracture of the femur).

Diagnosis of muscle and ligament injuries

Name of the disease	The main symptoms
*Bruised thigh*	swelling and swelling of the tissues of the thigh; hematoma formation ( bruise) at the site of injury; lameness ( associated with pain).
*Muscle strain*	In the area of the affected muscle, there is swelling and swelling of the tissues. In the area of rupture of muscle fibers, a hematoma can form. Any attempt to contract a stretched muscle leads to increased pain.
*Myositis*	The main clinical manifestation of myositis is severe pain syndrome. On external examination, there is edema and swelling of the tissues over the focus of inflammation. On palpation ( probing) of the inflamed muscle, its compaction may be noted, which is caused by the spasm of muscle fibers.
*Trochanteritis*	The main symptom of the disease is the occurrence of pain in the hip joint and in the outer thighs. The pain intensifies after exertion, after a long walk, and disappears after rest. In advanced cases, pain can also occur when lying on the side on the affected side ( increased pain is due to increased pressure on the inflamed tissue). It is important to note that with trochanteritis, mobility in the hip and knee joints is not disturbed, which makes it possible to distinguish it from a number of other diseases.

Diagnostics of the spine diseases

Damage to the spinal nerves can cause serious complications, so diseases from this group should be diagnosed as early as possible in order to prescribe treatment in a timely manner.

The main clinical manifestations in these diseases are due to the so-called radicular syndrome, that is, a complex of symptoms resulting from compression of the spinal nerves. This disrupts the regulation of metabolic processes in the tissues innervated by them, and is also the cause of pain.

Diseases of the lumbosacral spine can manifest themselves:

Sharp stitching or pulling pain in the lower back, thigh, buttocks, lower leg and foot.
Violation of skin sensitivity in these areas.
Lumbago, that is, short-term attacks of sharp stabbing pains in the lumbar region, thigh and lower leg, arising from excessive physical effort.
Paresthesias ( a tingling sensation or crawling) in the leg area.
Thigh muscle atrophy ( due to a violation of their innervation).
Vegetative disorders ( redness of the skin in the lower back and legs, increased sweating).
If the sacral spine is affected, there may also be a dysfunction of the pelvic organs ( urinary incontinence, frequent urge to urinate, impotence in men).

To diagnose a disease of the spine, the following can be used:

X-ray examination. Allows to reveal the narrowing of the intervertebral spaces and the appearance of osteophytes in the long course of osteochondrosis, however, it is not very informative in the early stages of the disease.
CT and MRI. They allow you to assess in detail the nature of damage to the vertebrae and inter-articular discs, determine the localization and size of the hernia and plan the tactics of conservative or surgical treatment.

Diagnosis of vascular diseases of the thigh

It is possible to suspect a lesion of the blood vessels of the thigh on the basis of the patient's complaints and the data of the clinical examination, however, to confirm the diagnosis, determine the localization of the damaged vessel and prescribe treatment, it is necessary to carry out a number of additional research.

Name of the disease	Diagnostic measures
*Obliterating atherosclerosis*	Doppler ultrasonography. A type of ultrasound examination, in which, using special sensors, it is possible to assess the nature of blood flow through almost any blood vessel. Doppler ultrasonography can locate and determine the degree of narrowing of the femoral artery. Magnetic resonance imaging. It also allows you to determine the localization and degree of narrowing of the vessel, but does not provide accurate information about the nature of blood flow through the site of narrowing. Contrast angiography. The gold standard in the diagnosis of vascular diseases. The essence of the method is the introduction of X-ray contrast agents into the vascular bed and the subsequent examination of the affected area for computed tomography... This gives the doctor a three-dimensional image of not only the damaged vessel, but also the entire vasculature of the thigh, which makes it possible to assess the degree of blood flow disturbance and plan a therapeutic surgical intervention.
*Varicose veins of the thigh*	To assess the functional state of the leg vein valves, special functional tests are used. It is possible to assess the degree of damage to superficial and communicating veins using the Troyanov-Trendelenburg test. At the beginning of the study, the patient lies down on the couch and lifts his leg up for a few seconds. After the superficial veins have been emptied, the doctor applies a tourniquet to the upper third of the thigh and the patient is asked to stand up. The pronounced filling of the superficial veins of the leg with blood during the first 15 seconds indicates the inferiority of the valve apparatus of the communicating veins. At the same time, blood freely passes from deep veins to superficial ones, which should not normally be the case. At the next stage of the study, the tourniquet applied to the thigh is removed. If after this there is a rapid filling with blood of the superficial veins of the leg, their valve apparatus is also damaged. Additional instrumental studies ( dopplerography, angiography) can be prescribed to clarify the diagnosis and plan surgical treatment.
*Thrombophlebitis*	The diagnosis is usually made on the basis of survey data and clinical examination of the patient. In addition to the previously described pain syndrome, the patient may have an increase in body temperature up to 37 - 38 ° C, which is a systemic response to the development of an inflammatory process in the body. In doubtful cases, Doppler ultrasound, CT or MRI may be prescribed. V mandatory a study of the blood coagulation system is being carried out. Increased activated partial thromboplastin time ( APTT) more than 40 seconds and a prothrombin time of more than 16 seconds is a sign of a violation of the coagulation system.

Diagnosis of infectious diseases

The infectious process can affect both soft tissues and bone structures hips. In this case, the diagnosis is usually made on the basis of the clinical manifestations of the infection, and additional laboratory tests are prescribed to determine the severity of the patient's condition and the choice of an appropriate treatment method.

Symptoms of Infectious Hip Diseases

Name of the disease	The main symptoms
*Furuncle*	At the onset of the disease, there is redness, swelling and soreness of the tissues around the affected hair follicles. Symptoms of infectious inflammation are present ( increased body temperature up to 38 ° C and more, aches and pains in muscles, general weakness). A few days later, an abscess forms in the center of the inflamed area. A spontaneous breakthrough of a boil is usually noted 2 to 4 days after the onset of the disease and is accompanied by the release of pus.
*Carbuncle*	The onset of the disease is characterized by the formation of small abscesses in several hair follicles... Soon, these pustules merge, forming an extensive area of purulent-necrotic tissue inflammation. Symptoms of general intoxication are more pronounced than with a boil.
*Hip abscess*	During the formation of an abscess, there is swelling and redness of tissues in the area of inflammation. In this case, the body temperature can rise to 37 - 38 ° C, which is usually accompanied by symptoms of intoxication. After the purulent cavity has formed, the clinical manifestations of the disease subside. If the abscess breaks open and pus flows out of it, a connective tissue scar may form in the affected area. A breakthrough of an abscess into the tissue of the thigh will lead to the spread of infection, which will be accompanied by severe intoxication of the body.
*Phlegmon of the thigh*	Inflammatory changes ( swelling, redness, and soreness) are defined over the vast surface of the thigh. Symptoms of general intoxication are extremely pronounced ( body temperature rises above 40 ° C, patients complain of general weakness severe muscle and headaches, chills and so on). At clinical examination an increase in heart rate is determined ( more than 100 per minute) and respiration rate ( more than 20 - 22 breaths per minute).
*Necrotizing fasciitis*	The disease begins with soreness of the tissues of the thigh and an increase in body temperature. As the disease progresses, systemic manifestations of the infection increase. The body temperature can rise to 40 ° C and above, there is an increase in heart rate and respiratory rate, pronounced chills, impaired consciousness of the patient. As the necrotic process progresses, swelling of the soft tissues and skin of the thigh develops. The skin over the site of inflammation becomes dark red, and after blood vessel thrombosis and tissue necrosis changes its color to purple or black.
*Osteomyelitis*	With a local form of the disease ( when the infectious focus does not go beyond the bone tissue) the main clinical manifestations are severe pain, swelling and swelling of soft tissues in the affected area. Systemic manifestations of infection are mild. If the infection breaks into the systemic circulation and spreads throughout the body, there is a rapid increase in symptoms of intoxication and a deterioration in the patient's general condition, which requires immediate hospitalization and treatment in a hospital.

Additional laboratory research appointed:

General blood analysis. Reveals leukocytosis and increased ESR.
Microscopic examination. Allows you to identify pathogens in tissue or pus samples.
Bacteriological research. The resulting bacteria are sown on special nutrient media, after which the process and features of the growth of their colonies are investigated. This is done to establish the type of infectious agent, as well as to determine its sensitivity to antibiotics.

Diagnosis of tumors

It is rather difficult to suspect a tumor in the early stages of its development, since benign tumors can develop over many years, while not showing themselves in any way, and the primary symptoms of malignant tumors are nonspecific.

The presence of a malignant neoplasm may be indicated by:

general weakness;
increased fatigue;
emotional lability ( frequent mood swings);
slight increase in body temperature ( up to 37 - 37.5 ° C);
rapid weight loss ( more than 3 - 5 kilograms per month, provided that the patient does not follow any diet and leads a normal life).

If a patient complains about some of the above symptoms, the doctor may suspect that he has a malignant neoplasm and prescribe additional tests.

In the diagnosis of tumors of the hip, the following are used:

X-ray examinations - plain x-ray or CT.
Magnetic resonance imaging - allows you to more accurately examine the soft tissues of the thigh.
Angiography - allows you to identify the vascular structures of a growing tumor.
Scintigraphy - a special research method that allows you to assess the degree of activity of metabolic processes in tissues ( a malignant tumor is characterized by rapid division of tumor cells, as a result of which the metabolism in it will be accelerated).
Histological examination - its essence lies in the removal of the alleged tumor and the study of its cellular structure under a microscope, which makes it possible to identify tumor cells and confirm the diagnosis.

Diagnostics of the retroperitoneal hematoma

In addition to hip pain and lower back pain, there are symptoms of the underlying disease that caused the hemorrhage. The general condition of the patient in this case largely depends on the degree of blood loss. If the volume of blood flowed out is too large ( more than 1 - 2 liters), the patient may develop hemorrhagic shock (marked drop in blood pressure due to massive blood loss), which will be manifested by loss of consciousness, pallor of the skin and a decrease in body temperature.

To detect blood in the retroperitoneal space, the following can be used:

ultrasound procedure;
CT scan;
Magnetic resonance imaging.

Revealing active ( ongoing) bleeding can lead to the death of the patient in a matter of hours or even minutes, therefore it is an indication for emergency surgery ( an incision is made in the anterior abdominal wall, after which the source of bleeding is identified and eliminated).

Why does the hip hurt when walking?

Pain in the hip when walking is most often caused by abnormalities of the hip joint, the musculo-tendon apparatus of the thigh, the femur and the nerves in this area. Less commonly, pain is the result of a violation of the patency of blood vessels, as well as autoimmune diseases.

The causes of pain when walking in the hip area are:

coxarthrosis ( arthrosis of the hip joint);
aseptic necrosis of the femoral head;
juvenile epiphysis of the femoral head;
stretching one of the muscles of the thigh;
acute rheumatic fever;
thrombophlebitis.

Coxarthrosis
This is a degenerative-dystrophic disease of the articular cartilage. His debut is observed, on average, at the age of 40 - 50 years. There are many reasons for this ailment, including old injuries, frostbite, metabolic disorders, and so on. Quite often there is an idiopathic or primary form of the disease, in which the cause cannot be established.

The mechanism of the appearance of pain in the hip with this pathology is associated with the erasure of the articular cartilage and the exposure of the nerve endings. In addition to their mechanical irritation during movements in the joint, they are irritated by biologically active substances ( inflammatory mediators), which increases the severity of pain.

Aseptic necrosis of the femoral head
Under aseptic necrosis This means inflammation and death of the femoral head without microbes entering the inflammatory focus. This pathology most often develops in elderly patients after a hip fracture. An artery that feeds the head of the femur passes through the femoral neck. As a result of a fracture, this artery is compressed or ruptured, which is the cause of an acute violation of the blood supply to the head. On rare occasions this pathology can develop without prior trauma, for example, with long-term use hormonal drugs, alcohol abuse or as a result of thromboembolism ( blockage of an artery by a blood clot). In this case, the patient initially feels pain only while walking, when the tissue needs for nutrients and a deficiency of blood supply begins to be felt. After some time, the pain intensifies, reaching a peak, accompanied by a complete inability to move the leg.

Juvenile epiphysis of the femoral head
This rare disease is typical for children who are overweight, as well as a congenital imbalance between growth hormones and puberty. Because of this, excessive pressure occurs on the immature cartilage of the hip joint, which causes a pronounced violation of the shape of the upper end of the femur ( epiphysis). Initially, only one joint is affected, after which, after 10 to 12 months, the second is also affected. Pain at rest may be present, but more often they appear after a long stay in an upright position. The movements in the affected joints are painful. After rest, the intensity of pain decreases slightly.

Hip fracture
Fracture of the femoral neck can be primary or secondary ( pathological). The primary fracture develops after trauma ( blow, fall) a conditionally healthy bone. A secondary or pathological fracture develops on a bone previously destroyed by osteoporosis or metastases malignant tumor... In this case, the pressure on the bone during the fracture can be extremely small. The pain with such a fracture is extremely intense. At incomplete fracture the patient can perform certain movements with the leg, but this is very painful. With a complete fracture, the patient is unable to step on his leg. With a crack in the bone, the pain may subside at rest, but intensify with walking.

Stretching the thigh muscle
Muscle stretching occurs when a load is applied to them that exceeds the limits of its strength. Muscle stretching most often occurs when a large load is abruptly ( suddenly) on a cold, unheated muscle. The mechanism of the onset of pain is associated with direct microscopic ruptures of the muscle fiber. In this case, aseptic inflammation develops, accompanied by the release of biologically active substances into the lesion focus, causing pain upon contact with nerve endings.

Tendinitis
Tendinitis is an inflammation of muscle tendons that most often develops when they are stretched or ruptured. This disease is typical for young people who are intensively involved in heavy sports and use specialized supplements and drugs to achieve a faster effect. As a result, the volume, and therefore the strength of the muscles, is significantly increased, while the strength of the tendons remains unchanged. As a result, high muscle traction can harm untrained tendons when performing intense work.

The pain in this disease is constant, aching, does not go away even at rest and intensifies when the damaged tendon is stretched. To restore damaged tissue, rest is required for a period of several days to 2 - 3 weeks ( depending on the severity of the injury).

Acute rheumatic fever
This systemic disease characterized by damage to the heart muscle and large joints of the body ( knee, femoral, shoulder). The mechanism of development of inflammation of the hip joint lies in the damage to its tissues by its own antibodies developed against one of the types of staphylococcus. Due to the fact that the antigenic composition of these microbes has some similarities with antigens in endocardial tissues ( inner lining of the heart) and the synovial membrane of the joints, a false immune aggression against these structures develops. The inflammation is wavy in nature, with periods of exacerbations and remissions. During an exacerbation, the joints swell, movements in them are painful, an increase in body temperature is noted.

Phlebeurysm
With this pathology, the speed and linearity of blood flow in the enlarged section of the vein slows down. The main reason this state is a long-term, persistent increase in venous pressure due to the need for a prolonged stay in an upright position ( surgeons, sellers, hairdressers are at risk of developing this disease).

Deep vein thrombosis is another cause of increased pressure in the superficial veins of the legs. In this disease, blood flows out of the legs through the network of superficial veins, as a result of which they expand and the venous valve system, designed to prevent blood backflow, is ineffective. In this case, chronic venous insufficiency develops, gradually leading to progressive edema of the legs and an even greater increase in venous pressure. As the disease progresses, the walls of the veins protrude into weak points... Numerous protrusions deepen, and the vein becomes convoluted, difficult to pass.

Pain with varicose veins superficial thigh veins are explained by their excessive stretching during the growth of the next protrusion. The pain is constant, aching in nature, clearly localized along the course of the vein. While walking, the nature of the pain changes to pulsating.

Thrombophlebitis
Thrombophlebitis is an inflammation of a vein along with a thrombus located in its lumen. In most cases, blood clots form on pathologically altered veins, such as varicose veins. A thrombus in the lumen of the vein disrupts the normal blood flow and creates around itself swirl zones with high and low blood flow velocity. In areas with a low rate, pathogenic bacteria settle, for which thrombotic masses are a good nutrient substrate. As the bacterial colony grows, it spreads to the vein wall and causes a violation of its integrity. In response to this, local inflammatory response, manifested by edema and even more pronounced circulatory disorders in this vein.

Pain with thrombophlebitis is moderate at rest, but worse when walking. At the site of inflammation, there is swelling, redness, and a local increase in temperature. With a large lesion area, it is also noted general increase body temperature up to 38 ° C and above.

Why do hips and lower back hurt?

The most common causes of pain in the hip and lower back are protrusion or herniated discs, and lumbar osteochondrosis.

Protrusion and herniated disc
Protrusion is called pathological condition, in which part of the disc nucleus is displaced to the side and protrudes beyond its limits. At the same time, the integrity of the annulus fibrosus, which ensures the structural integrity of the disc, is not compromised.

A herniated disc is a condition in which the integrity of its annulus fibrosus is violated, and the nucleus is completely mixed outside of it. In this case, the cushioning function of the intervertebral disc is almost completely lost.

Both with protrusion and with a herniated disc in the lumbar or sacral the spine may be compressed spinal cord and its roots. In this case, the patient may feel numbness, a feeling of crawling, or severe pain, which are localized in the lower back and hips. Typically, pain and other abnormalities occur on only one side of the lower back and leg. Bilateral hernias are much less common.

Lumbar osteochondrosis
Lumbar osteochondrosis is a disease in which there is a gradual change in the composition and elasticity of the nucleus of the intervertebral disc. As a result, the disc becomes flatter, and the distance between the bodies and processes of adjacent vertebrae decreases. The nerve roots located between the lateral processes are compressed, so the patient experiences acute pain in the lumbosacral back, thigh and other parts of the leg. The pains can be sharp, stitching or shooting, worse with movement and subside in the supine position. Typically, pain is felt the same on both sides.

Why does hip hurt during pregnancy?

Hip pain during pregnancy can be caused by an increase in body weight and, as a result, excessive load on the lower limbs, as a result of which an exacerbation may occur hidden diseases who did not show themselves in any way before. In addition, in the process of growth and increase in the size of the fetus, compression of the nerve formations that innervate the tissues of the hip joint and thigh can be noted, which will also manifest itself as a pain syndrome.

Hip pain during pregnancy can be caused by:

Hormonal changes in the body. Due to the activity of the hormone progesterone ( the secretion of which in pregnant women is increased) there is a relaxation of all muscles and ligaments in the body. It is a physiological process designed to facilitate the passage of the baby through the birth canal. At the same time, relaxation of the muscles and ligaments of the hip joint can cause excessively rapid fatigue while walking, which will manifest itself as aching pain in the hip area.
An increase in the load on the hip joint. During gestation, a woman can gain at least 10-15 kilograms, which can cause overwork of the muscles and ligaments of the hip joint and also lead to aching pains that worsen after walking or physical work.
Compression of blood vessels. The developing fetus puts pressure on internal organs and vessels, including the inferior vena cava, which collects blood from the lower extremities and lower body. This can lead to stagnation of blood in the veins of the leg and thigh, which will be accompanied by their expansion and overstretching. The resulting pain will be localized along the course of the veins and be of an acute, aching character.
Compression of nerve fibers. An enlarging uterus can compress various nerve formations ( e.g. lateral cutaneous nerve of the thigh), which will lead to the appearance of pulling pains in the innervation area of the affected nerve.
Compression of the spinal nerves. In a pregnant woman, an increase in the load on the spine is noted, which can lead to a narrowing of the intervertebral openings in the lumbosacral region and an infringement of the spinal nerves passing there. In this case, the pain will be sharp, aching, shooting, it can give in lumbar back, groin, shin and foot.

It is also worth noting that no pregnant woman is immune from hip pain common to any other person. She may have exacerbation of lumbar osteochondrosis, arthrosis of the hip joint, the sciatic nerve become inflamed or inflamed, and so on.