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Pain in leg, knee and hip

24 Sep 18

Hip and knee pain

The hip joint (HJ) is a large mechanism that ensures correct posture, active movements and supports the weight of our body. Pain in this area can indicate various problems and injuries that can reduce the quality of life. Therefore, it is important to understand the cause of unpleasant symptoms and begin treatment as soon as possible.

Features of pain in the joint

Due to the peculiarities of the innervation of the hip joint, pain in this area may be vague. This means that it can be difficult to name a specific point where the discomfort is strongest. In addition, pain in the hip joint and leg can come from the lower back, radiating to the groin and buttocks. There are many reasons for this condition.

IT IS IMPORTANT TO KNOW! The only remedy for JOINT PAIN, arthritis, arthrosis, osteochondrosis and other diseases of the musculoskeletal system, recommended by doctors! Read more.

Inflammatory processes in joints and surrounding tissues

  • Rheumatoid arthritis
  • Acute septic arthritis
  • Tenosynovitis
  • Bursitis
  • Ankylosing spondylitis
  • Pain associated with irradiation into the hip joint

  • Enthesopathy
  • Acute calcification of the buttock muscles
  • Meralgia paresthetica
  • Degenerative diseases of the joints and spine

  • Coxarthrosis
  • Osteochondrosis
  • Pathology of childhood

  • Dysplasia and subluxation of the hip joint
  • Epiphysiolysis
  • Osteochondropathies
    • Injury
    • Hip dislocation
    • Femoral neck fracture
    • Pain after surgery
    • Piriformis syndrome

      Pain associated with infection

    • Tuberculous coxitis or arthritis
    • Syphilis
    • Fungal arthritis of the hip
    • Necrosis of the femoral head

      Inflammatory processes in joints and surrounding tissues

      Arthritis (of various origins) of the hip joint

      It is characterized by inflammation of the joint due to various reasons: infection, metabolic disorders, after injury, etc. At the very beginning of the disease, pain occurs in the leg in the hip joint. Patients are often bothered by even pain while lying down and without prior physical exertion. The joint swells and, if left untreated, increases in size due to the accumulation of pathological fluid. The skin over it is hyperemic. The range of motion in it is preserved, but when it rotates, pain of moderate intensity occurs. It is important to note that the patient experiences pain when sitting.

      Rheumatoid arthritis (RA)

      RA is a chronic autoimmune disease that primarily affects small joints and leads to joint stiffness.

      The disease is based on hereditary predisposition, as well as viral load (Epstein-Barr, parvovirus B19 and others). RA begins with articular syndrome, and women are more often affected. Despite the great vulnerability of small joints, as the disease progresses, the rest are also affected, including the hip (infrequently).

      Signs of rheumatoid arthritis:

    • Pain in the joints of the hands and feet, worse in the morning and better in the evening
    • At the beginning, joint pain may disappear on its own and then return
    • The progression of the disease leads to damage to the knee, hip, elbow and other joints
    • Initially, pain occurs when walking, then it does not go away even with rest.
    • The skin over the joints is swollen and red
    • Rheumatoid nodules develop - subcutaneous compactions in the joint area
    • Morning stiffness is typical
    • Gradual restriction of joint mobility
    • If the hip joint is affected - pain in the groin and buttocks, a tendency to aseptic necrosis of the femoral head
    • Diagnosis requires a blood test, x-ray of the joints, CT or MRI. Treatment consists of taking NSAIDs, corticosteroids, methotrexate and other basic drugs.

      Acute septic arthritis

      The spread of a bacterial infection through the blood is called sepsis. As a result, the causative agent of the disease can travel through the bloodstream to any part of the body, including the hip joint. The most common source of inflammation is Staphylococcus aureus, streptococcus and some intestinal microbes. Risk factors for septic joint damage are considered to be old age, sepsis, rheumatoid arthritis, glucocorticoid use, diabetes mellitus, blood cancer, and liver cirrhosis. A separate point is gonorrhea, in which the hip joints are rarely affected.

      Signs of septic arthritis (non-gonococcal):

    • Fever, weakness
    • The hip and knee joints are most often affected
    • The process is usually one-sided, rapidly developing
    • Joint pain, limitation of its function
    • For diagnosis, X-rays, MRIs and blood tests (inflammatory markers, bacterial cultures for infections) are used. Treatment consists of the correct selection of antibiotics and drainage of the joint (removing pus out). The main goal of therapy is to eliminate sepsis, since it poses a potential threat to life.

      Tenosynovitis in the hip joint

      It is characterized by inflammation of the tendons of the thigh muscles due to injury or prolonged stress. A specific complaint of a patient with this pathology is pain in the leg in the hip joint while walking or squatting.

      Around large joints there are small “sacs” - bursae, inside of which there is synovial fluid. They are needed to reduce friction on the bones that form the joint. There are also 2 main bursae between the pelvic bones and the thigh. One is located on the femur near the trochanter, and the second is in the groin area, on the inner surface of the thigh. Inflammatory changes most often occur in the trochanteric bursa. Their reasons are varied. There are several risk factors for bursitis:

    • long-term monotonous physical activity (cycling, for example)
    • hip injuries (bruises, dislocations)
    • diseases of the lumbosacral spine
    • rheumatoid arthritis
    • operations in the joint area
    • The main symptom of trochanteric bursitis is pain. It is localized deep in the thigh, spreading to its outer surface. Later, pain may appear in other parts of the hip and pelvis, intensifying when sitting, at night, when supporting the affected leg and walking for a long time. When lying on your side, the pain in the hip joint also becomes more intense.

      Diagnosis is based on characteristic symptoms and x-rays, often requiring confirmation with MRI. Treatment of uncomplicated cases begins with unloading the limb with a cane or crutches, pain relief and taking corticosteroids. These actions usually help relieve inflammation. In some cases, persistent bursitis requires surgery. After recovery, it is necessary to follow preventive measures, not to strain the leg with unnecessary exercises and to avoid injuries.

      Bechterew's disease (idiopathic ankylosing spondylitis)

      Under this complex name lies an equally complex and unpleasant disease. Ankylosing spondylitis is a chronic inflammatory process in the joints of the spine and sacroiliac joints, leading to a decrease in quality of life and even disability.

      The causes of this pathology are not exactly clear, but hereditary predisposition plays a major role. It all starts with inflammation at the attachment points of the ligaments and tendons, and ends with damage to the joints and their complete immobility.

      Ankylosing spondylitis can be sluggish, or it can quickly lead to ankylosis (immobility) of the joints, but in any case it inevitably progresses. The whole tragedy of the pathology is that it most often affects young people (20-30 years old). At this age, many self-medicate, which is absolutely forbidden to do.

      Signs of ankylosing spondylitis:

    • Often begins with malaise, fever, weakness, weight loss
    • Pain in the sacrum, buttocks, and back of the thighs
    • The pain is usually bilateral, constant, intensifies in the second half of the night
    • Atrophy of the gluteal muscles may occur
    • Stiffness in the lower back (difficulty bending and straightening your back)
    • Gradual spread higher (stiffness in the neck, pain when moving the head, a sharp decrease in motor activity)
    • In the finale - the formation of a “suppliant pose”
    • Additionally, the hip and shoulder joints are affected, which is a sign of a severe course of the disease.
    • Associated symptoms: eye damage, inflammatory processes in the heart muscle, renal failure
    • For diagnosis, special samples and tests for sacroiliitis are used to identify restrictions in movement. Additionally, an X-ray or MRI of the sacroiliac joint and hip joints is required. Inflammatory changes (increased ESR, CRP) and HLA-B27 antigen are found in the blood.

      Treatment of the disease is based on special physical activity and physical activity (to develop joints), as well as on relieving pain and inflammation with NSAIDs, methotrexate, and corticosteroids.

      Degenerative joint diseases

      It is not difficult to completely restore JOINTS! The most important thing is to rub this into the sore spot 2-3 times a day.

      Osteoarthrosis of the hip joints (coxarthrosis) is a chronic, steadily progressive disease. Its essence is degeneration of the interarticular cartilage with subsequent changes at the ends of the bones. Often arthrosis is accompanied by an inflammatory process – arthritis.

      Coxarotrosis is the most severe form of this group of diseases. It causes dysfunction of the joint with subsequent disability. Typically, pathology occurs after 40 years, in women during menopause. An earlier onset is typical for people with hip dysplasia.

      Risk factors: hereditary predisposition, physical overload of the joint, hip dysplasia, trauma, old age, concomitant joint diseases.

    • Starts with muscle pain or weakness
    • Painful sensations first occur in the groin, buttocks, lower back, hip, knee, and then in the hip joint
    • Pain occurs when walking, subsides with rest
    • Joint function is impaired early (leg abduction, adduction)
    • Muscle spasm and developing subluxation leads to a limping gait
    • Bilateral coxarthrosis leads to a “duck walk”, with waddling from one leg to the other
    • At the end of the disease - atrophy of the muscles of the buttocks, thighs, legs
    • Coxarthrosis is practically not amenable to drug treatment. With the help of medications you can only reduce pain and muscle spasms. The main way to restore activity is surgery. In the initial stages of the disease, osteotomies are performed, which slightly change the biomechanics of the joint and increase its mobility. In case of advanced processes, it is necessary to perform endoprosthetics - a complete replacement of the joint with an artificial implant.

      Osteochondrosis, spondylolisthesis and spondyloarthrosis of the lumbar spine

      Degenerative diseases of the lumbar spine can also lead to pain in the hip area. Deformation and wear of intervertebral discs leads to damage to surrounding tissues and nerves. This causes radiating (radicular) painful sensations.

      Signs of lumbar osteochondrosis:

    • Lumbodynia (lower back pain) can radiate to the leg (lumboischialgia), or pain can be present only in the leg (sciatica)
    • More often the unpleasant sensations are one-sided, more intense when coughing or shaking
    • The radicular pain is acute, sharp. Usually starts in the gluteal area or lower back, then gradually moves down the leg
    • Pain may be relieved by lying on the healthy side
    • In the affected limb, skin sensitivity may decrease (“numbness of the leg”), and there is often a feeling of goosebumps and tingling
    • Diseases of this group are diagnosed by characteristic signs (pain in the hip joint, radiating to the leg) and changes on X-rays and MRI. The main component of treatment is lifestyle changes, dosed physical activity, and swimming. In the acute period, NSAIDs and other analgesics are used. After the pain subsides, massage and physical therapy are needed.

      Lower limb injuries

      A fall on the side or a direct blow can cause soft tissue damage, resulting in pain that sometimes resembles that of a fracture. Significantly intensifies during palpation and movements in the joint. An external sign will be a “bruise”, with pain localized on the surface. If the hematoma has formed deeper, then pain will be felt in the area of ​​the buttock and hip joint. In this case, the leg is not deformed, retains the full range of movements, and performance is not lost. If there is the slightest suspicion of a more serious injury (dislocation, fracture), then you need to urgently consult a doctor (see how to distinguish a bruise from a fracture, dislocation).

      Hip dislocation in young healthy people can only occur under the influence of intense force along the axis of the bent knee joint and a fixed torso. This usually occurs in car accidents and falls from great heights. With such a dislocation, the pain is severe, and the condition requires emergency medical attention. The pain is unbearable, the patient cannot move his leg because of it and the forced position. With concomitant nerve damage, the joint may hurt and the leg may go numb.

      In relation to the normal position of the femoral head to the articular cavity, they are distinguished: posterior, obturator and suprapubic dislocations. 9 out of 10 cases of dislocations are posterior, with the leg as if turned inward. Anterior displacement occurs much less frequently, in which case the knee and foot are opened outward.

    • Posterior dislocation is characterized by the leg being bent at the hip and knee, as well as being turned inward and brought as far as possible towards the other limb;
    • Supra pubic dislocation is characterized by the leg being straightened and turned outward, the head of the femur can be easily palpated under the inguinal ligament;
    • Obturator dislocation is characterized by a leg bent at the hip joint and simultaneously turning it outward.
    • To diagnose an injury, a doctor often only needs to look at the shape and position of a limb. To confirm the diagnosis and identify associated injuries, an x-ray examination is prescribed. Treatment begins with painkillers. Then they begin to reduce the dislocation. Full restoration of leg function occurs after 2-3 months.

      Such bone injuries are most common in older people, mainly women. A fall on the side with the hip trochanter hitting a hard surface is the main cause of such a fracture. It is considered one of the most difficult fractures and is often complicated by thrombosis, infection and bone necrosis.

    • Pain in the hip area, intensifying when trying to change the position of the leg, when trying to move the limb to the side
    • When lying down, the victim cannot lift his heel off the bed
    • Touching the skin in the joint area is painful, tapping the heel also causes discomfort - pain in the groin and joint
    • The limb looks shorter than healthy, and the foot turns outward
    • With impacted fractures, the only symptoms are pain.
    • Damage to the nerve plexuses in the joint area causes permanent numbness in the upper third of the leg.
    • A fracture can be confirmed using an x-ray. Treatment of most cases requires surgery (with the exception of impacted fractures). Before surgery, skeletal traction is performed, then at the time of surgery, the displaced ends of the bones are brought together and fixed to each other. An important point in the recovery period is early activation. Since this injury is common in older people, prolonged bed rest is often followed by pneumonia or blood clot rupture, which can be fatal. Therefore, active development of the limb, getting out of bed and gradual physical activity are the key to a good outcome.

      A separate issue is pain after surgery on the hip. Most often, complaints arise when replacing a damaged joint with an artificial one. Unpleasant sensations and discomfort usually disappear after the wound heals and physical activity begins. But if your leg hurts after joint replacement for several months, or the pain increases and is accompanied by fever, then you need to urgently consult a surgeon.

      Piriformis syndrome

      Local spasm of a muscle in the thigh called the piriformis can cause severe pain. This is due to pinching of the sciatic nerve, which occurs after an injury or due to the anatomical features of the muscle.

    • aching or burning pain
    • radiates down the outer surface of the leg
    • pain radiating to the groin and buttocks
    • The diagnosis of piriformis muscle syndrome can be established using novocaine blockade. If this procedure leads to the disappearance of pain, then further treatment is carried out with antispasmodics, NSAIDs and the same blockades until recovery.

      Pain in the hip joint in children and adolescents

      Dysplasia and congenital hip dislocation

      Underdevelopment of the elements of the hip joint in children leads to disruption of its anatomical structure. A so-called unstable hip is formed, which without treatment turns into congenital subluxation, and then dislocation. Girls are more prone to this pathology, often one-sided. The causes of joint dysplasia are not precisely understood. Intrauterine growth restriction is considered one of the determining factors; birth in a breech presentation increases the risks.

      Typically, dysplasia and dislocation are detected in babies up to 3 months, or, in extreme cases, up to a year. For this purpose, ultrasound of the joints and characteristic signs of limb asymmetry are used. But it happens that the pathology is not diagnosed, and therefore remains without treatment. Such babies later begin to walk, limp or waddle. The later the disease is detected, the more difficult and traumatic its treatment.

      With hidden hip dysplasia, symptoms may not appear until adolescence. As physical activity increases, pain occurs in the joint area and it becomes unstable. This pathology is a risk factor for arthrosis, subluxations and dislocations in older age.

      Epiphysiolysis is a pathology characteristic of children aged 8-15 years, during a growth spurt. It consists of slipping of the head of the femur onto the neck due to weakness of the growth plate. The reasons for this phenomenon are not exactly clear. Epiphysiolysis occurs much more often in obese boys. Sometimes injuries and endocrine disorders can provoke the disease.

      Most often, the pathology is stable. In this case, the child limps for a long time, but support on the leg is maintained. The pain is localized in the thigh, and can radiate to the groin and down to the knee. Over time, the full range of motion in the hip joint is lost.

      MRI images and characteristic symptoms are used for diagnosis. Treatment should begin immediately, since further slipping of the head can lead to arthrosis, arthritis and serious consequences. The femoral head must be secured with screws until the growth plates are completely closed. Timely surgery usually returns full motor activity.

      A group of diseases of bone and cartilage tissue, in which the most loaded areas of the bone undergo aseptic necrosis, are called osteochondropathy. In their development, genetic factors play a decisive role, as well as a combination of hormonal disorders and the infectious process.

      This type of pathology is more common in children and adolescents during the period of active skeletal formation. In more than 30% of cases, it is the hip joint that is affected.

      Osteochondropathy of the femoral head (Legg–Calvé–Perthes disease)

      The pathological syndrome manifests itself as necrosis of the femoral head in children under 15 years of age; it is more common in boys under 10 years of age, and the right hip joint is usually affected. This condition occurs due to circulatory problems in the thigh involving the cartilage tissue of the joint:

    • A typical clinical manifestation is the appearance of pain in the knee joint with its gradual transition to the hip joint.
    • Children report pain when walking and, as a result, lameness occurs, which worsens with physical activity.
    • Movement is limited, pain appears in the joint when the leg is moved to the side
    • The pathognomonic symptom is pain in the hip joint radiating to the leg, and this often occurs at rest.
    • More often, only one side is affected and in the later stages subluxation, coxarthrosis, leg deformity, atrophy and muscle contracture may occur.
    • Diagnosis requires x-rays or an MRI description. The main method of treatment is immediate unloading of the limb, which allows preserving the femoral head. At the same time, gentle methods of developing the joint are shown: physical therapy, swimming. To improve blood supply, antispasmodics and anticoagulants are used. If there is no effect, surgical treatment methods are used.

      Pain associated with irradiation into the hip joint

    • Enthesopathy is a pathology characterized by pain in the groin radiating to the hip joint. The pain intensifies both when walking and when standing still. In the first case, enthesopathy occurs in the femoral muscles of the adductor group, and in the second, of the abductor group.
    • Acute calcification of the muscles of the buttock - pain begins in the buttock area (right or left), and sometimes on both sides, radiating to the hip joint.
    • Meralgia paresthetica is characterized by severe burning pain with numbness in the hip joint and upper third of the thigh.
    • Pain associated with infection

      Tuberculous coxitis or arthritis

      People suffering from bone tuberculosis experience at first a slight, but then gradually increasing pain in the joint area. Sometimes this pain can radiate to the knee joint. Tuberculosis of the joints usually begins with malaise, evening fever and sweating. The main group of patients are children under 10 years of age who were born from sick mothers or who had contact with a tuberculosis infected person (see how tuberculosis is transmitted).

      As the infection progresses, patients begin to spare the knee and then the hip joint. Over time, the range of movements decreases, the leg assumes a forced abduction position. The child suffers from severe aching pain. For treatment, anti-tuberculosis drugs are used according to individual regimens.

      In recent years, the situation with tuberculosis in the country has reached epidemic proportions, and the number of its extrapulmonary manifestations, in particular osteoarticular tuberculosis, is growing. Diagnosis of this insidious disease is very difficult and sometimes the onset of the disease is subtle, manifesting itself like other diseases of the musculoskeletal system. It is generally accepted that the symptoms and manifestations of tuberculosis of the joints are always rapidly progressing, rapid, but there are often cases when the tuberculosis process lasts for years, and at first the diagnostic signs on CT and MRI are not always specific and are defined as signs of tuberculosis.

      The situation in the country is clouded by the fact that there are not enough specialists specializing in the extrapulmonary manifestations of tuberculosis, and radiography does not always provide a 100% exclusion of the tuberculous nature of the inflammatory process and a person can suffer for years and be treated for the wrong disease, because tuberculosis requires a different, specific treatment and the sooner the better.

      With bone tuberculosis, the joint needs complete rest; warming procedures, warming creams, no physiotherapeutic procedures, as well as gymnastics and massage, manual therapy (if the spine is affected) are strictly contraindicated.

      Therefore, if in arthritis, treatment with these therapeutic agents suddenly causes a sharp deterioration, inflammatory changes in the blood test (leukocytosis, increased ESR), progression of the process of joint destruction, a revision of the diagnosis in favor of the tuberculous process is required, even in the absence of x-ray confirmation of tuberculosis.

      With tertiary syphilis, pain of moderate intensity sometimes occurs in the hip and knee joints, and this process often occurs on both sides. It is important to know that inflammation of the joints and periosteum is difficult to treat, which leads to the development of osteomyelitis.

      Fungal arthritis of the hip

      Occurs after long-term antibiotic therapy and with a significant decrease in immunity, for example, AIDS. The pain is constantly aching and difficult to relieve with painkillers. The pain mainly occurs with movement and rarely at rest.

      Osteonecrosis of the femoral head

      Death of bone tissue in the hip joint area, which occurs when the blood supply is disrupted. This condition occurs due to: acute inflammatory diseases of the pancreas, taking medications (steroid hormones), radiation, alcohol and nicotine abuse. There are two types of destruction of bone tissue in the femoral head area.

    • The first is traumatic osteonecrosis. Most often it is accompanied by inflammation.
    • The second type is non-traumatic (or aseptic), which occurs without the penetration of microbes into the joint.
    • The causes and consequences of the first type are clear and simple: wound healing, antibiotic treatment and rehabilitation usually lead to restoration of joint function. But aseptic damage has been studied less well.

      Aseptic necrosis affects middle-aged people (30-60 years old). The risk factors for this disease are diverse:

    • alcohol abuse
    • taking large doses of corticosteroids
    • sickle cell anemia
    • systemic lupus erythematosus
    • bleeding disorder
    • hyperlipidemia (excess fats in the blood)
    • condition after organ transplantation
    • thyroid diseases
    • The mechanisms of bone death can be different: the proliferation of adipose tissue, leading to compression of blood vessels and necrosis; blockage of blood vessels with blood clots or fat; the entry of abnormal red blood cells into the bloodstream during anemia.

    • pain in the groin and buttocks
    • pain is pulsating, deep, aggravated when walking or at night
    • limited mobility in the joint, decreased thigh muscles
    • lameness
    • Diagnosis requires an X-ray of the hip joint or an MRI. Additionally, they may prescribe a puncture and biopsy of the affected area, blood tests for lipids and coagulation.

      Treatment of avascular necrosis can be difficult, with relapses occurring. The main method is surgery, during which dead tissue is removed and replaced with other materials. In some cases, endoprosthesis replacement is required. Conservative treatment is ineffective and is therefore prescribed only if surgery is contraindicated. They use painkillers, drugs to lower cholesterol and reduce blood clotting.

      New growths of bones and soft tissues located in the lumbosacral region, buttocks, hips and limb bones can lead to severe pain in the lower back and the joint between the hip and pelvis.

    • Benign tumors cause discomfort by pressing on nerves. The pain is similar to piriformis syndrome or radiculitis.
    • Malignant tumors, especially in bone tissue, have completely different characteristics. They grow very quickly and also compress surrounding tissues. At the same time, there is a tendency to their destruction. Tumor pain in the bones is especially painful. They are incessant, intense both day and night, gnawing in nature. Conventional NSAIDs rarely provide relief.
    • Sarcoma of the femoral neck is a malignant tumor (bone cancer) and is characterized by pathological fractures of the neck and upper third of the femur, as well as symptoms of cancer intoxication. If there are no fractures, the patient is constantly bothered by aching pain in the joint area, as well as a decrease in rotating movements in the joint.
    • Early diagnosis of tumors is important for a good prognosis. Therefore, any pain in the leg and back should cause oncological suspicion. CT or MRI can almost always exclude or confirm the diagnosis. Treatment is carried out with radiation, chemotherapy and surgery.

      Differential diagnosis for frequent joint pain

      The answer to the question: “what to do when your hip joint hurts?” It may be that first you need to consult with specialized specialists (neurologist, orthopedic traumatologist, rheumatologist). You also need to know that when such a complaint occurs, the examination is carried out using the following methods:

    • Blood tests to determine signs of inflammation or dysfunction of internal organs;
    • X-ray examination of the joint on both sides;
    • MSCT and MRI with and without contrast. In the first case, this is performed if a bone sarcoma or its decay in bone tissue is suspected;
    • Bone scintigraphy is considered the most adequate method for identifying various bone or joint anomalies. It is performed using radionuclides specific to bone tissue.
    • Ultrasound of the hip joint. An experienced diagnostician will immediately identify changes in the joint or the presence of fluid in it during the procedure.
    • Densitometry can be used to determine the density and strength of bone tissue. Thanks to this, bone necrosis and pathological fractures can be diagnosed.
    • You should immediately consult a doctor if:

    • There is a visible leg deformity
    • It is impossible to move the hip joint
    • There is no support on the affected leg
    • The leg in the hip joint hurts unbearably, up to the loss of the ability to self-care
    • Sudden swelling and redness in the joint area
    • Self-assessment of joint function before seeing a doctor

    • While lying down, turn your attention to your lower limb. The latter should normally be parallel to the median axis of the body. In case of dislocations or fractures, the limb takes a forced position.
    • Pay attention to the presence of pain in the hip joint, as well as its intensity, nature and location of irradiation.
    • To determine the mobility of a joint, it is necessary to perform active movements forward, backward, as well as rotation inward and outward. If such actions cannot be carried out due to severe pain, most likely it is a fracture or dislocation; if movements do not cause intense pain, then there is definitely no fracture or dislocation.
    • In the supine position, passive movements in the joint can be determined in all directions. In this case, you need to pay attention to the presence of a click, crackling sound in the joint area and protective tension in the thigh muscles.
    • When you see a doctor, try to carefully describe the nature of the pain at rest and during movement, as well as the most painful place on the thigh during palpation and where the pain radiates.
    • Causes of discomfort in the legs from hip to knee

      If your leg hurts from the hip to the knee, this does not mean that the cause of the discomfort is hidden in this particular area. Everything in the human body is interconnected, so hip pain can indicate problems in many different body systems. In particular, they may suffer from:

      • muscles, ligaments and tendons;
      • skin and subcutaneous layer;
      • veins and arteries;
      • hip and knee joints;
      • femur;
      • peripheral nervous system in the hip area;
      • lumbosacral spine, including the spinal cord.
      • In isolated cases of short-term numbness (paresthesia) of the thigh, there is no need to panic. Perhaps you just sat out the leg, and everything will be restored in a few minutes. In addition, “goose bumps” can be provoked by the following factors:

      • physical fatigue of the legs;
      • uncomfortable shoes and prolonged walking in heels;
      • previous operations and injuries of the lower extremities;
      • taking certain medications;
      • weather sensitivity;
      • muscle weakness;
      • overweight;
      • certain periods of growth in children;
      • senile changes;
      • hormonal changes;
      • pregnancy.
      • Short-term numbness of the hips in these conditions is completely physiological and does not require treatment. If the reasons described above are excluded, pain and numbness occur frequently and do not go away within several hours, you should immediately consult a doctor. There can be a great many reasons for the occurrence of unpleasant sensations, and an accurate diagnosis can only be made after a comprehensive examination.

        Video: A neurologist talks about the causes of leg pain

        Diseases that cause pain and numbness in the hips

        Paresthesia of the thighs is caused by a variety of diseases, and not all of them affect the legs directly. The most common ailments are listed in the following table.

        Table: Causes of pain and numbness in the hips

        With diseases of the cardiovascular system, problems often arise with the legs, since they are located furthest from the heart. Insufficient blood supply leads to poor peripheral vascular health, resulting in numbness and pain in the hip.

        Associated symptoms of heart disease are usually:

      • strong heartbeat;
      • shortness of breath and weakness;
      • change in skin color;
      • surges in blood pressure.
      • Pain in the leg can spread to the entire left half of the body or radiate behind the sternum. Treatment of such diseases consists of taking medications aimed at improving the functioning of the cardiovascular system. In severe pathologies, blood circulation is restored through surgery. If the disease is neglected, the outcome can be fatal, while early contact with specialists is the key to successful treatment.

        Cerebrovascular disorders

        The human brain is responsible for all the functions of our body, so its insufficient blood supply is fraught with serious health problems, including paralysis of the entire body or its parts. Thigh paresthesia may be the first sign of mechanical or organic brain damage. The main accompanying symptoms of circulatory disorders in this part of the body may be:

      • headache;
      • dizziness;
      • noise in ears;
      • loss of consciousness;
      • decreased hearing and vision;
      • nausea and vomiting;
      • lack of coordination.

      Blood supply to the brain is restored with the help of antihypertensive, dehydration, cardiovascular and nootropic drugs. Patients are also often prescribed mediators and B vitamins. Exercise therapy, massage and physiotherapy, in particular electrical stimulation, darsonvalization, laser and magnetic therapy, as well as other methods, have a good effect. Timely treatment and competent rehabilitation allow a person to return to a full life in most cases.

      Spinal diseases

      Most often, discomfort in the legs occurs due to osteochondrosis, intervertebral hernia or radiculitis. These diseases are provoked by a sedentary lifestyle, minimal physical activity and heavy lifting. As a rule, it all begins with osteochondrosis, which over time develops into more severe diseases of the spine. With osteochondrosis, the left thigh often hurts, the first sign of an intervertebral hernia may be tingling in the leg and nagging pain in the back of the thigh, and with radiculitis, the limb completely loses sensitivity for some time.

      Treatment for spinal diseases includes a whole range of measures, including:

    • taking anti-inflammatory and painkillers;
    • massage;
    • exercise therapy;
    • physiotherapy;
    • wearing special orthopedic devices (corsets, etc.).
    • In an acute condition, which is accompanied by severe pain, loss of coordination and pelvic paralysis, the patient may need urgent surgery. However, timely consultation with a doctor guarantees a favorable outcome of treatment and will help you quickly return to a full life.

      This disease can occur both due to diabetes and as a result of damage to the mechanical femoral nerve.

    • Diabetic neuropathy is accompanied by a number of other symptoms: loss of coordination, pain and numbness in different areas of the body, and disturbances in the functioning of internal organs.
    • Tunnel neuropathy occurs as a result of injuries, unsuccessful punctures, injections and operations. In this case, along with numbness, muscle weakness and decreased mobility of the limbs develop. Unlike diabetic neuropathy, this disease can be successfully treated with timely consultation with a doctor.
    • Treatment for neuropathy is aimed at eliminating symptoms. As a rule, doctors prescribe patients to take the following medications:

    • opiates;
    • antidepressants;
    • anticonvulsants;
    • topical creams and patches.
    • In the diabetic form, taking medications that lower blood sugar levels is also indicated. As a rule, this disease remains with a person forever, but adequate treatment will significantly improve the quality of life.

      Pathologies of veins and arteries

      Inflammation of blood vessels with the formation of blood clots in them is a fairly common cause of discomfort in the legs. Such pathologies can be provoked by the following factors:

    • changes in blood composition;
    • complications of cardiovascular diseases;
    • operations;
    • large blood loss;
    • wearing tight clothes;
    • heredity.
    • If paresthesia is provoked by vascular diseases, it may be accompanied by fever, weakness, dizziness, drowsiness, enlarged lymph nodes, swelling, redness and pain when palpating the affected veins and arteries. With thrombophlebitis, red stripes may appear on the skin.

      Mild forms of thrombosis and thrombophlebitis are treated at home with medications and bandaging. Advanced cases require hospitalization of the patient with the appointment of:

    • direct and indirect anticoagulants;
    • thrombolytics;
    • hemorheologically active drugs;
    • nonspecific anti-inflammatory drugs.
    • In severe cases, the patient is sent for surgery to remove blood clots with further rehabilitation therapy. With pathologies of the veins and arteries, complete cure is not always achieved, but improvements occur in almost all patients.

      Degenerative changes in joints can be the result of injuries, including old and undiagnosed, congenital pathologies, as well as various inflammatory diseases. As a result of damage to the articular cartilage and surrounding tissues, aching pain occurs in the hip area, which may be accompanied by additional symptoms:

    • swelling and redness of soft tissues;
    • clicking in the joints;
    • cramps of the limbs;
    • general deterioration of condition;
    • decreased visual acuity;
    • redness of the eyes.
    • Treatment of affected joints is in most cases symptomatic. As a rule, doctors make the following prescriptions:

    • taking painkillers, anti-inflammatory and hormonal drugs, as well as vitamin complexes;
    • calcium chloride injections;
    • reflexology;
    • warming up.
    • In case of joint damage, consultation with a specialist is necessary: ​​only a doctor can make a diagnosis and prescribe adequate treatment. Timely contact with specialists increases the chances of successful treatment, but complete recovery more often occurs with minor changes in the joints.

      Malignant neoplasms affecting bones and soft tissues can also cause discomfort in the hip area. Associated symptoms include the following:

    • swelling and enlargement of the affected area of ​​the thigh;
    • protrusion of the tumor over healthy areas;
    • weight loss;
    • pallor and impaired thinking;
    • lameness when walking.
    • When you palpate the affected area, you can detect a painful lump, which indicates a problem in the body. The causes of a tumor can be stress, poor nutrition, weakened immunity and many other factors.

      For oncology, surgical treatment is indicated - removal of the tumor followed by radiation therapy. Doctors do not guarantee a complete cure, but often such intervention is the only chance to prolong the patient’s life.

      Injuries and inflammation of soft tissues

      Paresthesia of the thigh often occurs with inflammatory diseases or injuries of the legs. The pain may not appear immediately, but may occur some time after the hip is sprained or damaged. Typically, this condition is accompanied by the following symptoms:

    • increased body temperature;
    • redness and swelling of tissues;
    • bruises, abrasions or hematomas;
    • increased pain when pressing on the affected area;
    • general poor health.
    • With hip injuries, the victim often feels the back of the knee bulge. Treatment of such conditions is usually carried out at home, and the patient is prescribed a number of medications:

    • non-steroidal anti-inflammatory drugs in the form of tablets, injections or ointments;
    • muscle relaxants;
    • nootropic drugs;
    • B vitamins;
    • immunomodulatory agents.
    • Physiotherapy and a complex of exercise therapy specially selected for each case are also usually effective. As a rule, with adequate treatment and following all recommendations, most patients recover.

      Bone injuries and inflammation

      Diagnosing inflammatory bone diseases is quite difficult. Most often, femoral paresthesia is caused by the following diseases.

    • Osteoporosis usually occurs due to hormonal imbalance and manifests itself in frequent fractures. Patients are prescribed antiresorptive drugs, as well as anabolic steroids, bisphosphonates, hormonal agents and calcium supplements. Additionally, doctors recommend adhering to a healthy lifestyle and engaging in exercise therapy.
    • Bone tuberculosis is caused by pathogenic bacteria that penetrate the bones. Symptoms are low-grade fever, weakness, lethargy, irritability, loss of performance, and muscle pain. In advanced cases, the temperature can rise to 40 °C, the patient experiences severe pain, and his bones and muscles atrophy. Bone tuberculosis is treated with antibiotics and surgery. After the main treatment, a long period of rehabilitation follows, when the patient is prescribed massages, a complex of exercise therapy and a number of physiotherapeutic procedures.
    • Osteomyelitis occurs due to penetration of a purulent infection into the bone tissue. In this case, an increase in temperature, pain at the site of the lesion, redness and swelling of the tissues are observed. Antibiotics and immunomodulators are used to treat this disease. Often the patient is prescribed procedures to cleanse the blood of toxins. In advanced cases, surgical treatment is possible, which consists of sanitation of the purulent focus.
    • When bones are injured, the patient experiences sharp pain, swelling and redness appear in the affected area. Treatment consists of fixing the limb and taking medications to promote bone fusion. In severe cases, the patient is prescribed an operation to combine the fragments. In the absence of complications, the chances of a full recovery after bone fusion are very high.

      Diagnosis and differential diagnosis

      An accurate diagnosis of femoral paresthesia can only be made by a doctor who will analyze the location and intensity of discomfort, collect anamnesis, identify additional symptoms and refer the patient for a series of examinations.

      1. X-ray – gives an idea of ​​the condition of the spine and bones.
      2. MRI of the lumbosacral spine - allows you to identify disorders of bone structures in the area that most often causes paresthesia of the hips.
      3. Neuromyography - checks the condition of the peripheral nervous system.
      4. Ultrasound of the vessels of the legs - determines the degree of vascular damage.
      5. Biochemical blood test - reveals serious diseases and inflammatory processes.
      6. Urinalysis - allows you to determine the presence of inflammation in the body.
      7. ECG - detects problems with the heart and circulation.
      8. Encephalography - shows the state of the brain.

      Differential diagnosis includes many examinations, on the basis of which a specialist excludes or confirms a certain diagnosis. Primary conclusions are drawn based on the nature of the unpleasant sensations.

      Table: Differential diagnosis for paresthesia of the thigh based on subjective sensations

      It should be remembered that paresthesia of the thigh can occur due to psychosomatic reasons, when psychological problems manifest themselves at the physical level. In this case, it is necessary to take care of reducing the level of anxiety and working through internal conflicts.

      Treatment of numbness and pain in the hip with traditional methods

      You can alleviate the patient’s suffering at home with the help of folk recipes. However, this should be done only after consultation with a specialist. If the condition is caused by a serious illness, there is a high risk of worsening the patient’s condition by choosing the wrong remedy for its treatment.

      The following recipes will help you quickly relieve fatigue and numbness in your legs.

    • Infusions of plants: linden, chamomile, nettle, calendula, mint, sweet clover, horse chestnut, birch leaves, oak and willow bark. A collection of these plants should be poured with hot water, left for 15–20 minutes, then cooled and added to a warm bath. This procedure improves blood circulation and dilates blood vessels, which quickly eliminates pain and “pins and needles” in the legs.
    • Ice compresses. Wrap several ice cubes in a thin cloth and rub problem areas with them for 5-7 minutes. Do not use warm compresses under any circumstances: for many diseases they can only cause harm. Applying ice is also not recommended for some ailments, so be sure to consult a specialist before the procedure.
    • Massage with essential oils. Add a drop of essential oils of tea tree, lavender and mint to 1 teaspoon of baby cream. You can also use pumpkin, St. John's wort or grape seed oil as the basis for the massage substance. Mix all the ingredients well and rub the resulting mixture into the problem area with light movements for about 10–15 minutes. Remember that massage is prohibited for any dermatological problems.
    • If you have neither the time nor the desire for such procedures, you can simply lie down with your legs raised above the level of your heart. This will help restore normal blood circulation and relieve discomfort.

      Photo gallery: Folk remedies that relieve pain and numbness in the legs

      To prevent numbness and pain in the hip, you should remember to prevent this condition.

    • Maintain an optimal water-salt balance in the body: salt your food less and drink more clean water.
    • Try to eat a healthy diet.
    • Do not abuse smoking and alcoholic beverages.
    • Take more walks in the fresh air.
    • Engage in moderate physical activity.
    • Try to give your body enough time to get a good night's rest.
    • Avoid stress and anxiety.
    • Avoid overworking your legs.
    • Do preventative massages and take foot baths.
    • Get regular medical examinations and promptly treat diseases and inflammatory processes.
    • Following these recommendations will help you protect yourself as much as possible from problems associated with numbness and pain in the hips.

      Unpleasant sensations in the thigh can indicate both an uncomfortable position and serious disorders in the body. The sooner you see a doctor, the greater your chances of prompt diagnosis, proper treatment and complete restoration of motor functions. Remember that an advanced pathological process is much more difficult to treat, and paresthesia can be the first symptom of very serious diseases.

      Characteristics of pain

      When the hip begins to hurt severely, most likely, we are talking about damage to the joint . Quite often, the cause of unpleasant sensations is defects in nearby tissues or structures: bones, muscles, cartilage, tendons and fascia. Moreover, injuries in the area of ​​the hip joint can be accompanied not only by pain in it, but also spread all the way to the lower leg. Sometimes, on the contrary, no pain occurs in the leg, but it covers the lumbar segment of the vertebra.

      In most cases, discomfort in this proximal joint occurs along with stiffness when walking or moving. With this disease, it is difficult to perform lateral movements and flex the hip.

      Causes of hip pain

      Conventionally, the causes of hip pain can be divided into the following categories:

    • Incorrect position of the head of the femoral joint in relation to the articular notch. This problem can be congenital or acquired, for example, physical strain and traumatic dislocations.
    • Diseases of the musculo-articular joint or hip joint, namely inflammatory processes, damage and degeneration.
    • Diseases of tissues and organs that are located next to the joint: innervation of nerve endings and inflammation, pathological processes in the womb, sacrum or buttocks.
    • But pain in the leg of the hip joint does not occur alone; as a rule, it spreads to the thigh , spreading in some cases to the knee. There are many factors that provoke discomfort in the hip joint, however, most often this occurs due to injury.

      The femoral neck is a fairly vulnerable part of the joint , so fractures often occur. This problem mainly affects older people, as their bones become brittle and weak due to osteoporosis. At a younger age, a similar fracture can occur after a traffic accident, sports or work injury.

      Often the hip joint is subject to dislocation , which occurs when the acetabulum is underdeveloped. In such a situation, the head of the hip bone falls outside its boundaries. Most often, such injuries occur during falls, work injuries or accidents. The key sign of a dislocation is intense pain in the hip joint.

      With subluxation, the causes and symptoms are the same as for dislocations , however, they are less pronounced. That is why such a problem is considered dangerous, because with it the leg begins to hurt only when walking, without giving a signal about the need to urgently contact a specialist.

      During pregnancy, the leg in the hip joint can also become sore, since the baby growing in the womb takes a huge amount of calcium from the mother’s body. All this makes the bones very fragile. Moreover, as the child’s weight increases, the pressure on the woman’s hip joints, which are already under enormous stress, increases.

      Dysplasia also causes pain in the leg. With this pathology, joint deviation occurs , and it can also lead to the formation of subluxations and dislocations. In most cases, this condition occurs in newborn babies, when the joints are at the wrong angle, thereby limiting the range of movement of the legs.

      Diseases that cause pain in the hip joint

      When there are no external causes of pain in the hip joint, but there is constant discomfort, there is a high probability of the development of a pathological process.

      Unpleasant sensations in the joint due to arthritis

      This disease is widespread ; its symptoms, according to statistics, can be detected in every hundredth person in old age. Although today arthritis occurs even in thirty-year-old people. With this problem, a person experiences severe pain in the leg on the affected side, and there is also discomfort in the groin area, sometimes spreading to the knee and thigh. The main signs of arthritis include an attack of acute pain when trying to get up.

      Similar symptoms appear in those who suffer from rheumatoid arthritis. The development of this disease is provoked by rheumatism. The peculiarity of this pathology is the symmetry of the lesion. Rheumatoid arthritis affects both the left and right hip joints.

      Pain in the hip joint due to bursitis

      Large joints in the body are surrounded by small sacs, in other words, bursae, containing synovial fluid inside. They are necessary to reduce friction on the bones that form the joint. There are two main bursae between the thigh and pelvic bones. The first is located in the groin area on the outside of the thigh, and the other is located at the trochanter on the femur. Inflammatory processes usually appear in the trochanteric bursa. This happens for a variety of reasons.

      There are several risk factors for developing bursitis:

    • Problems with the lumbosacral region;
    • Dislocations and bruises of the hip;
    • Surgical interventions in the joint area;
    • Long physical activity, for example, cycling.
    • Trochanteric bursitis makes itself felt by sharp pain , which is localized deep in the thigh, moving to the outer surface. After some time, pain may occur in other parts of the pelvis and thigh, which becomes more intense at night, when sitting, walking for a long time, or leaning on the injured leg. It also gets worse when lying on your side.

      Unpleasant sensations in the leg due to deforming arthrosis (coxarthrosis)

      This disease occurs quite often . The risk group usually includes people of middle age. Coxarthrosis can be asymptomatic, however, the first signs of the disease appear at the earliest stages. With this illness, a person begins to experience pain in the hip joint on the left or right side, and sometimes on both at once.

      Pain is disturbing as the pathology develops. There are three degrees of disease in total . Severe discomfort occurs in the second stage. The patient begins to complain of pain when turning the body and at the beginning of movement, radiating to the groin and knee. The muscles in the affected area are tense all the time. Moreover, they do not weaken even in sleep, so often unpleasant sensations in the hip joint with deforming arthrosis appear at night.

      Infectious diseases

      If an infection has entered the body , then the nature of the pain changes. They become more acute and are accompanied by increased temperature, hyperemia of the skin and swelling in the femoral area. Sometimes, due to pain, it is even impossible to touch the joint. Treatment in this case is carried out only in an infectious diseases hospital. After suppressing the pathological process, the unpleasant sensations go away on their own.

      Inflammation of the tendons most often occurs in people who are constantly exposed to physical activity, athletes are especially susceptible to the disease. During tendinitis, severe pain appears in the leg with heavy loads or active movements. Moreover, they may not exist at low loads.

      Hereditary diseases

      Pathologies of the hip joint are often hereditary . In this situation we are talking about Legg Calve Perthes disease. It occurs mainly in children, predominantly boys. This ailment is one-sided, in other words, unpleasant sensations appear in the left or right hip joint. Often this pathology manifests itself as pain in the knee, and not in the hip.

      Neoplasms of soft tissue and bones

      Aching pain may not be associated with problems in the joint . Sometimes they are caused by tumors in bone or muscle tissue. The nature of the pain depends on the type of tumor (malignant or benign) and its location.

      How to help if your leg hurts in your hip?

      If you experience discomfort in the hip joint, you need to take some measures. You can place an ice pack on the sore spot. Cold will help soothe joint pain. First, place a towel on your thigh and then apply ice to the affected area. It must be held for at least 15 minutes. When pain occurs as a result of an injury, and is also acute, cold cubes will have to be placed on the thigh every hour. True, if the pain is chronic, as during arthritis, twice a day is enough.

      After two days of ice treatment, you can proceed to warming procedures . A regular electric heating pad will do for this. It is better to set it to medium heat, the main thing is not to fall asleep with it. A warm bath can also help relieve pain in the hip joint. The water in it should be above 32 degrees.

      Then the affected area must be rubbed with ointment. When rubbed, tense thigh muscles relax . You should try Fastum-gel and similar products. But you cannot use ointments that contain menthol along with a heating pad, as you can get severe burns.

      After this, you need to take painkillers:

      If the dosage indicated on the package does not help get rid of pain in the hip joint, it is better not to risk it and consult a specialist.

      How to treat a damaged hip joint?

      The first thing a doctor does is send a patient with such pain in the hip joint for an X-ray examination. It is its result that will help determine the exact cause of their appearance. Only after this can a specialist prescribe complex therapy. As a rule, different treatment methods are used to get rid of pain in the hip. The patient must first remain in bed. With such an illness, nothing can be done. A state of rest will calm the pain, and recovery will come faster.

      Also, when your leg hurts in the hip joint, you can use an elastic bandage . True, it is worth wearing it only if the symptoms of the disease begin to disappear. It is advisable to spend as much time as possible motionless in order to relieve the joint from various loads.

      An equally effective method is treatment with medications . Ointments with an analgesic effect will help relieve pain: Diclofenac, Ibuprofen and others. The doctor also prescribes anti-inflammatory drugs for the patient to take orally.

      An excellent method for restoring an affected hip is massage. This procedure has become an integral part of complex therapy. Massaging movements should not cause discomfort or pain. People with similar problems are recommended to undergo about 10 massage sessions.

      During the rehabilitation period, it is imperative to perform therapeutic exercises . But exercises with damage to the hip joint should be performed only under the supervision of a specialist. By the way, for most joint pathologies, the most suitable sport is swimming.

      It should be remembered that the leg in the hip joint can hurt not only due to the development of diseases. In many cases, they become the consequences of poor weather conditions, improper and inadequate nutrition. That is why it is necessary to lead a healthy lifestyle and always be in a good mood. In addition, you should not forget to regularly perform physical therapy.

      Categories : Treatment methods

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