Does your pelvis or hip joint hurt? Causes, diagnosis and treatment of pelvic pain in men and women

JSC "Medicine" (clinic of academician Roitberg) operates a Pain Treatment Center. More details about the Pain Treatment Center

Pain in the hip joint, as a rule, indicates the appearance of a pathological process in the anatomical structures of the joint itself or adjacent tissues and organs. Most often, pain is caused by mechanical damage, an inflammatory process, an infectious or endocrine disease. It is possible that there are other factors that can trigger the appearance of this symptom. Let's look at why the hip joint hurts and how to deal with this problem.

Causes

Among the factors that provoke the appearance of pelvic pain, we should first of all mention:

infectious inflammatory process in the tissues of the joint capsule (arthritis);
degenerative tissue changes, osteoarthritis;
traumatic injury - dislocation or fracture of the femoral neck;
aseptic necrosis affecting the head of the femur;
inflammatory process in the tissues forming the joint capsule (bursitis);
non-infectious inflammation caused by an autoimmune disease;
tuberculosis process;
pregnancy.

Pain in the pelvic bones is much less common in young patients than in older people. In the older age category (over 60 years), it is periodically or constantly present in 60-60% of patients, while children under 18 years of age suffer from it in barely 10% of cases.

Exostosis of the humerus

The humerus is one of the most common sites of osteochondroma. During its formation, the following may be observed:

dull pain in the shoulder area that occurs when moving the arm with a large amplitude;
a feeling of stiffness in movements, present mainly in the morning, until you manage to warm up;
limited mobility of the upper limb in the shoulder;
dystrophy of the muscles of the shoulder and forearm, which in difficult cases can be seen with the naked eye.

Pelvic pain in women

The joint connecting the pelvic and femur bones bears the heaviest load in a woman’s body, so its wear and tear is also extremely high. A common cause of its damage is a fracture of the femoral neck - an injury that most often affects women over 60 years of age. At this age, many of them develop osteoporosis after menopause. Bones become fragile, and any fall from height can lead to a severe fracture. In old age, its treatment usually requires surgery.

Another disease that often affects women is coxarthrosis, which is characterized by the gradual destruction of interarticular cartilage tissue. One of the typical manifestations is pain in the hip joint when walking, which subsides with rest. In women, the disease begins during menopause and progresses steadily, sometimes leading to complete inability to move independently.

Treatment at the Rehabilitation Medicine Clinic “Quality of Life”

The “Quality of Life” Rehabilitation Medicine Clinic provides comprehensive diagnostics and treatment for patients with pelvic bone displacement. We work with patients of any age, including young children, detecting the problem at the earliest stages, when it has not yet had time to lead to complications. The sooner a pelvic distortion is diagnosed, the more successful and faster its treatment will be. Therefore, you should visit osteopathic specialists for preventive purposes in childhood.

Features of the treatment of bone displacement in the pelvis in the clinic: – In-depth comprehensive examination of patients. Each client undergoes a series of diagnostic measures, during which doctors identify the exact cause of the development of displacement. We do not treat individual muscle groups or bone structures simply with exercises or osteopathic techniques, but try to balance the functioning of the body as a whole.

– Comprehensive treatment according to an individual plan includes not only the work of an experienced osteopath, but also a physical therapy specialist, and, if necessary, a psychologist and neurologist. This approach allows you to achieve overall health of the body.

– Osteopathic treatment is safe and has proven effectiveness. It can be performed even on newborn children and pregnant women. – Application of effective exercise therapy techniques. Kinesio taping is the application of special tapes to improve microcirculation, relieve pain, and restore the functional activity of muscles and ligaments. The PNF technique allows you to work with isolated body segments, while taking into account the physiological chains of movements. – The use of the modern REDCORD system, with which you can work with the patient without axial load on his spine. The technique allows you to turn on certain areas of a person’s muscles that are not used under normal conditions. The clinic’s specialists are qualified doctors with medical education who have undergone additional training. We work with clinical cases of any complexity and do not simply eliminate symptoms or influence the mechanisms of development of the problem, but establish interactions between all organs and systems.

Pelvic pain in men

The only pathology of the pelvic joint that affects only men is Perthes disease. This is a hereditary disease that consists of deformation of the head of the femur: it becomes flat rather than round. When walking, the patient has pain in the hip joint on the left side, if the pathology is localized on the left, or on the right side, if the head is deformed on the right.

A disease that is more common in men is tendonitis, or an inflammatory process that affects the tendons. This is a disease of athletes and people forced to perform heavy physical work for a long time - loaders, masons, heavy weights, etc. Pain appears during heavy exertion, during active movements. With moderate and light loads, as a rule, there is no pain.

The next typically “male” disease is necrosis of the femoral head, and about a third of patients become ill at a young age - up to 30 years. The disease goes through several stages, and already at the very beginning the patient has pain in the hip joint on the right side (or on the left), and the pain is felt in the groin area, less often it radiates to the hip, knee or lower back. If left untreated, lameness appears over time and disability develops.

Exostosis of the calcaneus (calcaneal spur)

This is a well-known type of osteochondroma. The growth can take on different shapes, which determines the characteristics of the symptoms that arise. With a spherical or mushroom-shaped neoplasm, after it reaches a size of 3-4 cm, pain appears when walking and the inability to fully step on the foot. Since the growth is located in an area that is constantly subject to friction from shoes, the skin in its projection gradually becomes coarser and thickens. A characteristic symptom is an increase in pain in the morning and a gradual decrease in its severity during the day. In the evening, swelling of the lower extremities is often observed.

Pelvic pain in pregnant women

There are several reasons why hip joints may hurt in women:

in recent weeks - lack of calcium or vitamin D;
increased production of the hormone relaxin, which promotes sprains;
exacerbation of latent hip dysplasia or osteoarthritis;
increased stress on the joint due to weight gain;
old injury.

Women who have pelvic pain during pregnancy should be more attentive to their health, because this condition can lead to an exacerbation of even minor diseases.

Causes and risk factors for developing pelvic bone cancer

Factors that predispose to the development of the disease are some disembryonic disorders, as well as radiation and chemical effects on the body. As a result of an experiment on animals, the occurrence of bone cancer was revealed after the effect of radioactive strontium on the body. Precancerous conditions are considered to be osteochondral exostoses and deforming ostosis (Paget's disease).

Chronic pelvic pain

Chronic is any pain in the pelvic area that continues with varying intensity for several months. Aching pain in the hip joint and surrounding area often occurs in women, but men also suffer from diseases that cause pain in the pelvic area. The causes of pain are varied, from osteochondrosis to urological and gynecological diseases. In each case, a thorough examination is necessary to identify the disease and prescribe adequate treatment.

Exostosis in a child

It is in children that osteochondroma is most often first diagnosed, which is due to its formation from cells of the epiphyseal plate that is present only until the end of the growth period, which is adjacent to the metaphysis. It is also called the bone growth zone, since it is a hyaline cartilage whose cells are in constant miotic division. As a result, new chondrocytes (cartilaginous tissue cells) are formed, forming the epiphyseal plate, and the old ones are shifted to the metaphysis and subsequently replaced by osteoblasts (bone tissue cells).

In infants, violation of the rules for the prevention of rickets, in particular excessive use of vitamin D preparations, increases the likelihood of the formation of exostoses.

After puberty, the growth plates gradually close and are replaced by bone tissue, transforming into a thin epiphyseal line. If hormonal imbalances occur during this period, it is possible that the growth zones may remain open, which creates the preconditions for the formation of osteochondromas.

Usually, until the age of 7-8 years, bone exostosis does not manifest itself in any way in a child and makes itself felt only during the period of intensive growth, i.e., at 8-16 years, since it also begins to grow actively. In young children, such growths are present in the metaphysis area immediately near the epiphyseal plate, but subsequently move away from it and approach the diaphysis. Therefore, by how far the bone exostosis in children is from the epiphysis, the time of its formation is determined.

The growth of the neoplasm continues until the end of the growth period.

Diagnostics

To determine the disease that causes constant pain in the hip joint, it is necessary to undergo a fairly extensive examination, which includes:

X-ray of the hip joint, which allows you to detect or exclude traumatic damage, identify bone defects, growths and other pathologies;
Ultrasound of the hip area, which reveals inflammatory processes and degeneration of soft tissues, calcified areas and other pathologies;
CT scan of the hip joint, which is prescribed to clarify the diagnosis or in unclear cases;
MRI to clarify the condition of the soft tissues of the joint capsule;
puncture of joint fluid to remove effusion and study the composition of the infiltrate in order to detect the causative agent of infection;
joint arthroscopy - endoscopic examination of the joint capsule using a probe inserted through a small incision.

In addition, the orthopedist, surgeon or rheumatologist prescribes laboratory tests for the patient in accordance with the presenting symptoms:

general urine and blood tests;
immunological blood test;
biochemical blood test for rheumatic markers, etc.

Causes of blood stagnation in the pelvis

The blood supply to the pelvic organs is carried out through the large abdominal aorta, the outflow occurs through the venous network, which has a special structure - without valves. Arterial vessels for guaranteed blood supply to each organ have redundant branches.

The main reasons that lead to stagnation of blood in the pelvis:

Physical inactivity. With a sedentary lifestyle, the amount of adipose tissue increases, flabby muscles compress the blood vessels;
Tight or tight underwear that compresses blood vessels also impairs blood flow;
Varicose veins are a violation of the elasticity of blood vessels, their deformation;
Bad habits: alcohol, smoking lead to vasospasm, and this undoubtedly affects blood circulation;
Unbalanced diet. The vascular tissues are constantly renewed and, obviously, for a healthy state you need proper replenishment of nutrients that will maintain the elasticity of the walls;
Problems with the nervous system. Prolonged stress leads to vasospasm, and, accordingly, blood flow worsens;
Prolapse of internal organs. This may be due to childbirth, heavy pregnancy, or heavy lifting. Displaced organs compress the vessels and impede outflow;
In women, stagnation can be caused by structural features of the uterus, for example, a bend, a side effect of taking oral contraceptives, or abortion.

Treatment

Clinic JSC "Medicine" offers the services of the "Pain Treatment Center". Experienced specialists will help solve the problem with any type of pain.

Since there are quite a lot of diseases that cause pelvic pain, the methods of treating them depend on the symptoms and disorders detected during diagnosis. For pathologies of bone and joint tissue, the following are usually prescribed:

chondroprotectors, complexes of minerals and vitamins to strengthen bones, cartilage tissue and ligaments;
muscle relaxants to reduce muscle spasms and relax tense muscles;
non-steroidal anti-inflammatory drugs, in case of severe symptoms - steroids;
drugs that improve capillary circulation to reduce swelling and manifestations of hypoxia;
diuretics to stimulate fluid exchange and reduce swelling.

For inflammatory diseases, physiotherapeutic sessions have a good effect. Patients are prescribed electrophoresis, laser therapy, medicinal phonophoresis and other procedures. They are carried out at the end of the acute phase of inflammation to stimulate the recovery process.

If conservative methods are not effective enough, the patient may be prescribed:

therapeutic blockade - the introduction of an anesthetic drug into the selected area to block the transmission of pain impulses along the nerve fiber, due to which spasmed muscles relax, the trophism of periarticular tissues improves, and blood flow normalizes;
radiofrequency denervation - elimination of nerve fibers using a radiofrequency pulse through needles inserted into the joint tissue, which allows the patient to permanently relieve pain in the hip joint, radiating to the groin, knee or lower back;
surgical opening and drainage - for purulent inflammation of the joint, followed by antibacterial therapy;
removal of the tumor - in case of a malignant tumor process, after which chemical and radiation therapy is carried out to reduce the risk of relapse;
hip replacement - in case of destruction, the head of the femur is removed and an implant is installed in its place, but in some cases not only part of the femur is replaced, but also the acetabulum of the pelvic bone.

The choice of method depends on the degree of damage to the joint and other tissues.

Surgery to remove exostosis

Surgical intervention is indicated for:

large size of osteochondroma and the presence of persistent pain;
development of complications (tendinitis, bursitis, vascular, neurological disorders, etc.);
bone deformations as a result of the growth of exostosis;
fracture of the base leg;
malignancy of the tumor.

For children with bone exostosis, surgery is prescribed only in extreme cases. As a rule, it is carried out only if the testimony remains after reaching adulthood.

But if there are contraindications, surgery is not performed. This:

purulent-inflammatory processes in the area of the upcoming intervention;
exacerbation of chronic diseases;
decompensated form of diabetes mellitus;
acute infectious diseases.

Treatment of exostosis with surgery involves its complete excision with capture of the cartilaginous cap. There are several methods for removing osteochondral growth. A specific one is selected based on the location of the osteochondroma and its size. Usually preference is given to marginal resection of the growth, i.e., its removal within healthy tissue. Only in some cases is it necessary to resort to corrective osteotomy with concomitant resection of osteochondroma, but the cost of removing exostosis in this way is higher, since the operation also corrects bone deformation.

After surgery, complete recovery is observed in 98% of cases. Therefore, almost everyone who has once removed an exostosis forgets about it forever.

Marginal resection is a relatively simple type of surgery. Its essence is to expose the affected bone and remove the entire neoplasm in the front of healthy tissue along with the surrounding capsule using a sharp chisel, drill, oscillating saw or bur. After removal of the pathological formation, curettage of the maternal bone is performed using cutters and bur. In some cases, the extent of resection can be large and create the need for bone grafting using autografts or special implants. It is important to remove the entire cartilaginous cap and neoplasm, otherwise a relapse may develop.

Carrying out a corrective osteotomy involves cutting the mother's bone using an osteotome and removing the osteochondroma. After this, the bone fragments are fixed in the desired position using special plates, screws or knitting needles.

Prevention

To avoid diseases that cause pain in the hip joint, you must:

adhere to healthy eating principles, monitor body weight;
maintain moderate physical activity, walk regularly;
avoid heavy loads associated with lifting and carrying heavy objects;
protect joints from hypothermia;
avoid injury.

Exercises to correct protruding bones

Training for the oblique abdominal muscles
A sedentary lifestyle and minimal stress on the abdominal muscles weaken the abdominal muscles. Physical exercise will help you correct your figure. Pumped up abdominal muscles will visually change the structure of the body. To figure out what to work on, you need basic knowledge of anatomy. The press consists of several muscle groups:

The rectus muscle is located vertically from the sternum to the pubis and is responsible for straightening the torso.
The external and internal oblique muscles, in the form of several layers, are located in the lateral part of the abdomen. They will help girls hide their protruding hip bones.
The transverse muscle lies horizontally and is the lower layer of the abs. Its function is to support internal organs.

Before starting the main exercises, light gymnastics is performed to warm up the muscles. You can train at home or in the gym under the guidance of a specialist. Most classes are conducted on the floor, so a special mat will be required. The abdominal muscles are involved in all exercises that require core movement. Lying crunches are considered the most effective. Straight twists are performed by lifting the body with the shoulder blades lifted off the floor. To pump the oblique muscles, the body turns, turning the twists into diagonal ones. Reverse crunches are also recommended, in which the legs are pulled towards the chest. You shouldn’t do long workouts; it’s enough to do 10-15 repetitions of each exercise.

Protruding pelvic bones are not a medical problem, but an aesthetic one. Their perception is individual, in many cases it is considered attractive and sexy. If this is a problem for a girl, it can be solved using a set of exercises to strengthen the body muscles in combination with a diet to increase body weight.

How the research is carried out

No special preparation is required. When planning a contrast examination, it is recommended not to eat 6 hours before the examination. In some cases, the doctor may recommend following a diet for 2-3 days (exclude foods that increase gas formation).

The procedure lasts 5 minutes, with contrast up to 30 minutes.

The patient is placed on the tomograph table and lies on his back during the scan.

The patient receives the images immediately after the examination. If desired, pictures can be recorded on a flash card or disk.

The conclusion is provided by experienced radiologists after examination and processing of the results. If any pathology is detected, the radiologist recommends that the patient consult a specialist.

At the Yauza Clinical Hospital, patients can undergo the procedure at a time convenient for them and without queues, using expert-class equipment.

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