Causes, characteristic symptoms and treatment of pain in the hip joint, radiating to the leg

Pain is a sensation that never occurs on its own. It is the body’s response to negative influences exerted on it. This is a kind of defensive reaction. With the help of such a symptom, our body reports danger. Therefore, it cannot be ignored. Especially if such an unpleasant feeling occurs in the lumbar region and integrates into other parts of the body. This may indicate a variety of problems and diseases. They can be associated either with ordinary hypothermia or speak of serious diseases of the bones, joints and internal organs.

Thigh muscles and hip joint

general description

Aching pain in the right or left hip joint is usually associated with inflammation, pinching or irritation of the sciatic nerve. Moreover, it can radiate to the leg, thigh and buttock. This pain is especially pronounced when walking and exercising.

This is interesting! Sciatica is called pain in the right or left hip joint, which radiates to the leg and buttock and is caused by pinching or inflammation of the sciatic nerve.

This pain often spreads from the hip joint and tailbone, gradually moving to the gluteal muscle, the back of the thigh and calf, integrating into the foot, but not affecting the toes. Thus, it spreads throughout the lower limb. Usually this sensation affects only the right or left side. But in some cases it can affect both limbs at once.

This symptom often affects the general condition and gait of a person. The patient experiences severe discomfort while walking and, trying to reduce the load on the affected limb, begins to limp.

Integrating pain

Causes of pain not related to joints

There are various reasons why pain in the hip joint may appear, radiating to the leg and buttock. Treatment for such a problem largely depends on what factors contributed to its occurrence.

The causes of discomfort may lie in diseases of the joints or internal organs, or may not be associated with illnesses at all.

Where does the pain come from if the joints are healthy:

1. Pregnancy is one of the factors that causes lower back pain. Moreover, in this case, such a feeling is caused by a number of factors. This is a restructuring of the body, and the pressure of the pregnant uterus on the organs, and the load on the joint. Therefore, in an interesting situation, even young women experience this kind of discomfort.
2. Infectious and inflammatory diseases that affect nerves and tissues can also cause this type of pain. At the same time, it can be both acute and aching.
3. Also, excess weight puts a lot of stress on the spine, which is why the described sensations may appear.
4. Banal hypothermia is also fraught with severe discomfort. Moreover, because of such a nuisance, diseases of the bones and joints often occur.
5. Also among the possible causes is neoplasms in the spine. Moreover, discomfort can be caused by both malignant and benign tumors.
6. Muscle diseases also often cause pain in the back, buttocks and legs.
7. Diseases that affect metabolism, such as diabetes, are often accompanied by similar symptoms.

Pain in the lower back and lower extremities can be caused by a pinched sciatic nerve. Even a sedentary and lying lifestyle and an uncomfortable mattress can lead to a similar problem.

• Lower back pain, radiating to the buttock and leg: reasons, how to treat

In addition, age and related diseases are often the cause of the problem. For example, the same osteochondrosis.

Types of pain

Back pain when walking can have different severity and character. It depends on what caused it, as well as on the pain defect of a particular person and on the neglect of the problem.

The pain may be severe or mild. They also distinguish between the aching, sharp, stabbing, dull and pulling nature of this sensation. When visiting a doctor, you should try to describe exactly what type of pain is inherent in a particular case.

Types of painful sensations:

1. Acute pain is very intense, but does not last long. Moreover, it is felt most strongly in the problem area; this sensation passes to the leg and buttock in a weaker form. The easiest way to deal with such discomfort is to deal with it.
2. With aching pain, the sensation quite evenly integrates into the limbs located near the site of the lesion. The pain may ache and drag. This makes diagnosing the problem difficult.
3. Chronic pain syndrome is the most painful. It may be present continuously for several months. Treatment of such discomfort is the most difficult.

Types of pain

Joint diseases and their characteristic symptoms

Often the spine ache very much precisely because of problems with bones and joints. These factors are the most common cause of discomfort. Moreover, both injuries and diseases of the musculoskeletal system can cause such a problem.

Joint diseases that cause pain in the joint:

1. With osteoarthritis, pain mainly occurs in the morning. It gradually fades away over the course of the day. However, it returns under load. The more advanced the stage of the disease, the longer the pain syndrome does not go away.
2. Bursitis makes itself felt with cramping pain. With this problem, it seems that the discomfort comes from deep within the tissues.
3. Coxarthrosis is typical for older people. For a long time, this disease makes itself felt by pain only while walking. And only after severe destruction of the joints does it begin to manifest itself at rest.
4. With arthritis, discomfort is expressed by severe aching pain.
5. When the ligaments become inflamed, the pain is very pronounced and painful. They appear at the slightest load.
6. Neuralgia of the cutaneous femoral nerve is expressed by severe and burning pain. The thigh and buttock may also ache.

In addition to painful symptoms, some other signs can indicate the presence of problems with the joint. Among them are a crunch in the joint, loss of flexibility and mobility of the back, general or local temperature, and a change in gait.

Treatment with exercise therapy

The use of rehabilitation techniques in the treatment of the hip joint allows you to maintain its mobility, improve blood circulation in the joint, and accelerate the restoration of cartilage tissue. Specialists at the rehabilitation department select a set of physical therapy exercises taking into account the patient’s joint disease. Rehabilitation classes are conducted daily under the supervision of an instructor. For rehabilitation therapy, special simulators are used, and physiotherapeutic procedures are prescribed in combination with physical education.

Diagnosis of pathology

Pain can indicate a variety of diseases. Therefore, it is useless to relieve this symptom with tablets, ointments or manual therapy until its real cause is identified.

To determine the factor causing such discomfort, doctors use a variety of methods. First of all, this is, of course, a visual examination of the patient, palpation of the diseased area, as well as an oral questioning about the nature of the pain and accompanying symptoms. Based on this, the doctor draws conclusions about which examination methods are best prescribed to the patient.

• Causes of pain in the hip joint at night while lying on your side, accompanying symptoms

The most frequently prescribed examinations:

1. General blood and urine tests. This research method allows you to check biological fluids for the number of bodies responsible for inflammation and pathogenic processes in the body.
2. A group of blood tests for the various components contained in it. We are talking about a biochemical study, as well as checking the presence of various pathogenic bodies in the blood.
3. X-ray diagnostics. This research method is the main one in diagnosing diseases associated with the musculoskeletal system. It allows you to examine the joint in detail for the presence of osteophyte damage.
4. Taking rheumatic samples. Such a study allows you to accurately determine the presence or absence of rheumatism.
5. Proteinogram.
6. MRI and CT. These types of diagnostics allow you to examine the ligaments and muscles in detail and identify inflammation and other problems present in them.
7. Checking the patency of blood vessels.
8. Diagnosis of tendon reflux.

The type of diagnosis required in a particular case is chosen by the doctor. However, if a specialist suspects that the cause of discomfort does not lie in diseases of the bones and joints, he may prescribe other tests and examinations. For example, he will ask you to donate blood to determine the amount of sugar in it.

Diagnosis of the problem

It is very important to consult a doctor before starting treatment. Indeed, due to the wide range of possible causes of discomfort, it is impossible to independently determine the disease that caused it.

Features of the treatment of pain of different types

Treatment options for pain depend on the cause that caused it. Of course, you can take a painkiller to temporarily eliminate the symptom. However, this will not solve the problem, and after the effect of the drug wears off, the painful sensation will return again. In addition, such medications have a lot of contraindications, in the presence of which they cannot be taken.

For joint disease, drug therapy is often prescribed. It includes steroidal or non-steroidal anti-inflammatory drugs, vasodilators, chondroprotectors, etc. Physiotherapy can also be prescribed in combination with medications.

In advanced stages, conservative treatment may be useless. In this case, surgical intervention is prescribed. Moreover, various techniques can be used. In extremely advanced cases, total joint replacement is used.

Treatment

Pain is a sign that indicates the presence of a problem in the body. Therefore, you should not try to eliminate this symptom without identifying its cause. Don't self-medicate and stay healthy.

Good day, dear guests of the site! This article will tell you what pain in the hip joint on the left side indicates.

This joint faces a lot of stress every day and therefore discomfort in this area can cause great inconvenience.

• Remedies for pain in the hip joint - medicines and traditional medicine recipes

The hip joint includes the femoral head, neck and socket, which enters the articular cavity. Therefore, the appearance of pain cannot be ignored.

Pain in the thigh muscles: treatment

Since there are too many causes of pathological processes accompanied by painful sensations, uniform standards for therapeutic measures have not been developed. Treatment is carried out based on the most likely etiological factor. The first task is to relieve pain, for which analgesics and non-steroidal anti-inflammatory drugs can be used. Other treatment measures depend on the cause of pain in the thigh muscle.

Degenerative-dystrophic diseases of the spine and joints require the following treatment methods:

• use of NSAIDs;
• use of muscle relaxants;
• physiotherapy;
• massage;
• exercise therapy;
• with severe coxarthrosis – endoprosthetics.

Pain is usually relieved with high doses of NSAIDs in combination with muscle relaxants and sedatives. Complete recovery is possible only with surgical treatment - endoprosthetics or elimination of compression of the nerve root in the lumbosacral spine.

Systemic diseases require the following treatment approaches:

• detoxification;
• pathogenetic treatment - hormones, cytostatics;
• NSAIDs;
• analgesics for severe pain;
• immunosuppressants in combinations.

Getting rid of pain is difficult to predict, as it depends on the activity of the inflammatory systemic process and the correctness of the treatment regimen. With adequate control of the disease, it is possible to stabilize the condition of muscle tissue and relieve immune inflammation in a relatively short time. However, therapeutic measures should be carried out constantly, periodically monitoring the state of acute-phase blood parameters.

Injuries are usually easy to diagnose and treat. In most cases, local anesthetic therapy with ointments containing NSAIDs or heparin is sufficient. For severe pain, parenteral administration of analgesics is used in a short course for 1-2 days. As the damaged tissues heal, the need for drug support subsides.

The situation is much more complicated if vascular pathology is suspected. Usually the process is acute, and the condition threatens human life. Therefore, quick and adequate treatment includes:

• hospitalization;
• bed rest;
• detoxification;
• antiplatelet agents and anticoagulants in high doses;
• antibiotics;
• vasodilators.

The pain usually resolves quickly with anticoagulant therapy. Since the basis of pain is a mechanical obstacle to normal blood flow, significant relief occurs during even the initial recanalization of the blood clot. Additionally, non-narcotic analgesics can be used in maximum tolerated doses. If pain in the thigh muscles is reduced, it is necessary to maintain bed rest until blood flow in the vascular bed normalizes. Control is carried out visually, palpation and using Dopplerography.

If parasites are present, treatment is complicated by the fact that a capsule is formed around it in the muscle tissue, protecting it from the effects of drugs. The selection of anthelmintic drugs is a complex procedure, requiring continuous monitoring of the patient’s condition and laboratory parameters. Albendazole or Praziquantel are usually used over a long period on an individual basis. Single parasites in muscle tissue can be removed surgically.

Myositis usually requires local therapy with warming and anti-inflammatory ointments, and sometimes antibiotics. As a rule, the disease is mild and fleeting. If the cause of muscle pain cannot be determined, and empirical therapy does not bring results, there may be rare genetic abnormalities that manifest themselves in adulthood. In this case, specific laboratory tests will help determine the nature of the pain syndrome.

Causes

Let's look at the main reasons why the joint area on the left side hurts. The problem lies in pathologies, dysfunction of internal organs and injuries.

This problem occurs more often in women than in men. The following factors can cause pain:

1. Injuries.
2. Damage to joint tissue. In this case, arthritis can form.
3. Joint diseases cause tissue disorders.
4. Pathologies during skeletal development.
5. Painful sensations during pregnancy.
6. Pain when walking can cause inflammation in the soft tissues.

At the initial symptoms of the disease, you should go to the doctor. Discomfort in this area can be caused by injuries such as congenital hip dislocation, fracture, joint bruise or ordinary dislocation.

Soreness occurs with rheumatoid arthritis or degenerative diseases. In the latter case, a burning and nagging pain is felt.

This may be a viral deformity or coxarthrosis. Pain can occur in women during pregnancy. They worry in the last stages with weight gain.

Unpleasant symptoms may occur for the following reasons:

1. Large weight gain.
2. Hormonal changes.
3. Lack of vitamin D and calcium.
4. Spinal diseases.
5. Arthrosis.
6. Past traumas.

Pain occurs after loading the joint. To determine an accurate diagnosis, a comprehensive blood test and ultrasound of the joint are prescribed.

Causes of pain in the hip joint

High loads placed on the natural “hinges” of the human body lead to the development of various diseases. Both old and recent traumas contribute to subsequent disorders. One of the common anomalies is a fracture or destruction of the femoral neck, adjacent pubic joint or sacral bone, which can be recognized not only on x-rays, but also on MRI. The hip joint suffers from severe bruises, muscle and ligament sprains.

In some cases, mechanical abrasion of cartilage fibers occurs. This pathology affects people who are forced to engage in heavy physical labor at a professional level, or who engage in sports with a high level of physical stress. Problems may also arise in persons with congenital anomalies in the development of this part of the body. Inflammatory processes also lead to tissue and nerve damage.

The pelvis and its adjacent joints suffer from systemic and degenerative diseases. Bone fibers are susceptible to necrosis if the blood supply to the department is disrupted. Endocrine disruptions lead to the development of joint pathologies, manifested in the following diseases:

• Arthritis, arthrosis and coxarthrosis - abrasion and inflammation of the cartilage layers and outer surfaces of the bones.
• Bursitis is inflammation as a result of mechanical damage or internal infection of the joint capsule, accompanied by severe swelling and sharp pain.
• Tendinitis is an inflammatory irritation of the ligamentous apparatus, covering both the articular areas of the pelvis and the rest of the leg, down to the toes.
• Anomalies of bone growth due to congenital predisposition and the influence of other pathologies.
• Irradiation from nearby organs of the genitourinary system or gastrointestinal tract.
• Tumor formations that put pressure on nerve endings.

If any of these diseases are suspected, a targeted examination is prescribed to differentiate pathologies and identify the root cause of the painful condition.

Inflammation and infections

Pain in the joint may occur due to infection or inflammation.

Here are the problems that may arise:

1. With purulent arthritis, the temperature rises, the joint swells and turns red. Even with light loads, lumbago occurs.
2. Tuberculous arthritis occurs with reduced immunity.
3. Necrosis of the femoral head is tissue death. There are also sharp pains radiating to the groin area. Analgesics are used to relieve pain symptoms.
4. Bursitis is an inflammatory process that is localized in the joint capsule. In this case, a sharp pain is felt along the surface of the leg.

The pain associated with the development of inflammatory processes is nagging and dull in nature. In this case, a burning sensation occurs.

Such pathologies require urgent medical intervention.

Pain when walking

Before you begin to treat pain that occurs when walking, it is worth finding out why it appeared.

The following reasons may impair the functionality of the joints:

1. Fracture of the femoral neck.
2. Trauma with destruction of cartilage, bones and muscles.
3. Bruises, sprains and dislocations.
4. Inflammatory process in tissues.
5. Tissue death due to poor blood circulation.
6. Inflammatory process in the hip joint. This results in pain and limited mobility.
7. Tendon inflammation.
8. Bursitis.
9. Hereditary predisposition.
10. Elderly age.

It is important to start treatment immediately. Pain when walking can signal a developing pathology.

In this case, it is necessary to determine the nature of the painful symptom. Discomfort may occur after sleep and then go away during the day. Acute pathology appears in the hip area.

Night pain occurs when blood stagnates inside the muscles. Mechanical occurs after severe physical exertion.

Pain when the joint capsule is stretched occurs when walking and at rest. The nature of the pain depends on the type of pathology:

1. With fractures, the pain becomes dull and aching.
2. In the morning hours, a negative symptom manifests itself in joint pathologies.
3. With osteochondrosis or neuralgia, the discomfort is aching in nature and occurs with sudden movements.
4. With systemic pathologies, initial pain occurs that does not disappear when walking.

Examination methods

During the first consultation, rheumatologists at the Yusupov Hospital conduct a comprehensive examination of the patient:

1. Collection of complaints, clarification of the nature of pain in the hip joint;
2. Obtaining information about the course of the disease, the onset of pain, the progression of pain, household and professional factors that, in the patient’s opinion, caused the pain;
3. An external examination allows the doctor to determine visible deviations from the norm. To understand the nature of the pain and the area of ​​its spread, the doctor asks the patient to perform various movements of the lower limb in the hip joint. The presence of pathology of the hip joint may be indicated by poor posture;
4. Palpation (feeling). The doctor can find rheumatoid and rheumatic nodules, detect the exact location of pain during leg movements, determine the humidity and temperature of the skin in the hip joint area.

Next, the doctor conducts goniometry - an examination using a goniometer device.
It allows you to determine the range of joint mobility. Then the rheumatologist prescribes clinical and biological blood tests and a general urine test. Laboratory assistants at the Yusupov Hospital perform research using high-quality reagents and modern equipment, which allows them to obtain accurate test results. With inflammation of the hip joint, the number of leukocytes in the blood increases and the erythrocyte sedimentation rate increases. The inflammatory nature of the disease is indicated by an increase in the content of C-reactive protein in the blood serum.

An immunological blood test shows the presence of antinuclear antibodies in the blood in rheumatic inflammatory diseases. In patients suffering from arthritis, the concentration of uric acid in the blood serum increases sharply. The content of lysosomal enzymes (acid proteinase, acid phosphatase, cathepsins, deoxyribonuclease) in blood serum and synovial fluid changes in patients with rheumatism, psoriatic polyarthritis, rheumatism, and ankylosing spondylitis. In severe forms of hip joint pathology, significant deviations from the norm are observed in urine analysis.

Doctors at the Yusupov Hospital conduct x-ray examinations of patients with pain in the hip joints. It is indicated in the following cases:

• The presence of chronic or acute pain in the hip joint at rest and during movement;
• The occurrence of difficulties when moving the lower limb;
• The appearance of swelling and discoloration of the skin in the hip joint area.

Using computed tomography, doctors at the Yusupov Hospital evaluate the bones that participate in the formation of the hip joint.
On computed tomograms, the radiologist finds changes in the structure of bone tissue, cartilaginous growths, and osteophytes. Using magnetic resonance imaging, doctors evaluate the condition of the soft tissues that surround the hip joint.

Radionucleotide research methods make it possible to recognize pathology using radiopharmacological drugs.

Ultrasound examination of the hip joint is performed for injuries, inflammatory diseases, rheumatism and rheumatoid arthritis. The attending physician individually selects in each case the research methods necessary to determine the cause of pain in the hip joint.

Features of treatment

After identifying the cause, a specific treatment regimen is prescribed.

The following methods are used:

1. Medications, including painkillers, vasodilators and anti-inflammatory drugs.
2. Physiotherapy consists of magnetic therapy, phonophoresis and laser therapy.
3. Therapeutic gymnastics are individually selected exercises that do not put stress on the joints.

Drug treatment

Treatment with medications is a complex administration of drugs of various types:

1. Muscle relaxants that reduce spasms during pain symptoms.
2. Anti-inflammatory drugs. Non-steroidal drugs include Idomethacin and Diclofenac. Steroids include Prednisolone and Cortisan.
3. Drugs that improve microcirculation. They reduce hypoxic phenomena in the diseased area and reduce swelling.
4. Diuretics can reduce swelling in the inflamed area.

After a medical prescription, treatment can be continued at home.

If you want to share your experience, you can do so in the comments.

Treatment of joints » Joint pain » Article publication date: 01/26/2016 Article update date: 12/06/2020

The content of the article:

Pain in the hip joint that radiates to the leg occurs due to injuries, inflammation of tendons and joints, infections, and also as a local manifestation of general diseases of the body.

At the initial stages of pathologies, when only intra-articular structures are destroyed or injured, pain sensations are localized in the joint itself. When the structures surrounding the joint (ligaments, muscles, nerve bundles) are involved in the pathological process, the pain spreads beyond the joint - this is how irradiation (“recoil”) appears in the leg.

The greatest danger of pathologies that cause such discomfort lies in their complications. In most cases, pain radiating to the leg occurs against the background of the following four changes:

1. reducing the amount of joint lubrication,
2. pathological changes in periarticular structures,
3. lesions of the synovial membrane,
4. damage to cartilage tissue.

These are dangerous conditions. Ignoring pain, which indicates pathology of the hip joint (abbreviated HJ), leads to disruption of its function or to its complete immobilization.

The good news: timely consultation with a doctor can stop the progression of the disease and eliminate (or greatly alleviate) discomfort in the joint and leg. Treatment of such pain (and its causes) is carried out by rheumatologists, traumatologists, orthopedists and neurologists - depending on the pathology - the cause of the problem.

General rules of treatment

When determining treatment tactics, the doctor takes into account the type of disease, stage and form of its course, complications that have developed, and the severity of symptoms. Almost all pathologies that manifest as pain when walking require an integrated approach. The therapy uses local and systemic medications, physiotherapeutic and massage procedures, exercise therapy, and orthopedic correction.

Drug therapy

To relieve acute pain, intramuscular or intra-articular administration of injection solutions is practiced. You can get rid of mild discomfort with the help of ointments, creams, and gels. Taking analgesics will help eliminate pain of moderate severity.

Physiotherapy

To directly relieve pain, patients are prescribed electrophoresis or ultraphonophoresis with anesthetics, analgesics, and glucocorticosteroids. These physiotherapy procedures are based on the maximum possible delivery of drugs to the joint through pulses of electric current or ultrasonic vibrations. And during the remission stage the following activities are carried out:

• magnetic therapy;
• laser therapy;
• galvanic currents;
• UHF therapy;
• shock wave therapy.

After 5-10 sessions of physiotherapy, blood circulation in the hip joint area improves, metabolism and restoration of damaged tissues are accelerated. Patients may also be recommended applications with ozokerite or paraffin, hirudotherapy, and balneotherapy.

Traditional methods and recipes

Before consulting a doctor and carrying out basic treatment, folk remedies cannot be used. They have a weak analgesic effect, which, however, will distort the clinical picture and complicate diagnosis. During the recovery period, rheumatologists and orthopedists allow the use of compresses, infusions, and rubbing to eliminate discomfort arising from hypothermia, walking long distances, and ARVI. Which folk remedies are most therapeutically effective:

• compress. In a mortar, grind fresh leaves of dandelion, coltsfoot, burdock, horseradish until pasty, add a tablespoon of honey. Apply a thick mass to the thigh, secure with film and gauze bandage, hold for about an hour;
• herbal tea from St. John's wort, oregano, thyme, elecampane, sage. Pour 0.5 teaspoon of dry plant material into a thermos, pour in 2 cups of boiling water, leave for 2 hours. Cool, strain, take 100 ml 2-3 times a day after meals.

Homemade ointment also helps to cope with painful sensations. In a mortar you need to grind 25 g of lanolin and a teaspoon of alcohol tincture of red pepper. Without ceasing to mix, add 2 drops of essential oils of juniper, thuja, rosemary and 100 g of fatty baby cream.

Seven causes of pain in the hip joint with kickback to the leg

1. Injuries;
2. arthritis;
3. arthrosis;
4. inadequate blood supply to joint segments;
5. infections;
6. a change in the normal anatomy of the joint, when, as a result of dislocation or subluxation (congenital or acquired), the head of the femur occupies an incorrect position in the acetabulum;
7. diseases of other organs and systems, when joint pain radiating to the leg occurs against the background of neurological disorders: lumbar radiculitis, sciatic nerve neuritis and piriformis syndrome.

Hip dislocation

Diagnostics

The examination is usually carried out by orthopedic traumatologists. In case of purulent processes, patients are examined by a surgeon, in case of neurological pathology - by a neurologist. At the initial stage, the doctor finds out the history of life and illness, and conducts an external examination. The following additional studies are prescribed:

• X-ray of the hip.
  A basic diagnostic method that allows you to identify all major bone pathologies: fractures, cancer, osteomyelitis, periostitis. In case of lesions of soft tissue structures, it is performed to exclude bone lesions and conduct differential diagnosis.
• CT scan of bone.
  It is used at the final stage of the examination to clarify the results of radiography, planning conservative therapy or surgical intervention. Makes it possible to accurately determine the size, configuration and structural features of the pathological focus in bone tissue.
• Ultrasound.
  Sonography of soft tissues in myositis and tendonitis reveals areas of inflammation or degeneration. Ultrasound scanning of the veins of the lower extremities is effective in assessing the condition of the veins and lymphatic vessels in patients with phlebitis and lymphangitis, and in identifying blood clots in thrombophlebitis.
• MRI of soft tissues.
  Recommended for ambiguous results of other diagnostic procedures. It is carried out to determine the localization of deep hematomas, confirm degenerative or inflammatory changes in tendinitis and myositis.
• Electrophysiological studies.
  For patients with pain of neurological origin, ENMG, ENG or EMG are indicated to clarify the level of nerve damage and study the condition of nerve and muscle tissue.
• Lab tests
  . They are performed to determine the severity of the inflammatory process in purulent diseases, assess the condition of organs and systems in malignant neoplasms.

Types of pain radiating to the leg

Pain in the hip joint radiating to the leg can occur suddenly and be pronounced or increase slowly and gradually. Depending on this, the doctor suggests what kind of disease we are talking about.

(if the table is not completely visible, scroll to the right)

Diagnostic features

The most difficult thing is not treating the pain syndrome, but finding out the reasons that caused the pathological condition. The sooner a person seeks medical help, the more accurately and timely the diagnosis will be made. For this purpose, clinical, laboratory and instrumental methods are used to verify the disease state. The table below presents the differential diagnosis of the main causes of pain in the thigh muscles.

Each case of pain in the thigh muscles requires an individual approach to the diagnostic and treatment process. In difficult situations, it is necessary to conduct all types of examinations, including laboratory and instrumental methods.

Characteristic and accompanying symptoms

Joint pain radiating to the leg is always accompanied by symptoms that indicate the nature of the pathology that caused it. Examples:

• Inflammation of other joints accompanied by elevated temperature is a sign of rheumatoid arthritis.
• Pain of an indeterminate nature, radiating not only to the leg, but also to the buttock, lower back and knee, is a signal of avascular necrosis (a very serious disease).
• If the discomfort increases gradually, covers the entire leg, intensifies during movement or when forced to sit still, and changes the gait, these are signs of arthrosis.
• The combination of pain radiating to the leg with lumbar pain indicates the development of radiculitis of the lumbosacral region.

Three main pathologies that cause pain and their treatment

Arthritis of the hip joint

The disease is more common in old age.

A characteristic symptom is severe aching pain in the hip joint.

When only joint structures are involved in inflammation, the discomfort is localized within the joint itself.

If discomfort begins to spread along the front surface of the thigh up to the knee, this indicates the transition of inflammation to the periarticular structures. In this case, when walking and moving the leg, sharp acute pain attacks occur with shooting pain in the front of the thigh. Gradually, stiffness of movements joins the pain syndrome.

Treatment

Main methods of therapy:

1. hormonal and anti-inflammatory drugs;
2. exercise therapy, massage and physiotherapy courses.

Coxarthrosis – arthrosis of the hip joint

Click on photo to enlarge

Typically, this pathology is diagnosed in people aged 40–60 years. It is characterized by an imperceptible onset, with vague pain sensations on only one side (in the right or left hip joint). The pain symptom practically subsides during rest and appears only in the joint during loading.

As the intra-articular cartilage tissue is destroyed, the severity of the pain increases, it becomes constant, and it radiates into the leg due to compression and pinching of the ligaments and nerve bundles. By this time, they can become unbearable when trying to perform any movement, which results in shooting in the groin and knee.

Treatment

Conservative treatment is effective only at stages 1 and 2 of the disease. To do this, the rheumatologist selects a course of therapy, which includes: chondroprotectors, NSAIDs, painkillers, exercise therapy and massage.

In later stages, joint replacement surgery is indicated.

Bursitis

Hip bursitis is an inflammation of the joint capsules.

There are two possible courses of the disease:

1. Vertical bursitis, in which pain radiates to the leg along the lateral surface of the thigh.
2. Ischiogluteal bursitis, when the pain symptom becomes especially acute when trying to sit down.

Bursitis is characterized by cramping pain deep in the tissues. The patient cannot lie on the affected side, as the discomfort immediately increases. With this pathology, the pain is never limited to just the joint - it always radiates to the leg.

Treatment

A course of injection therapy with NSAIDs together with corticosteroids and restriction of mobility is effective.

Hip pain. Pain in the groin or buttocks

Pain in the thighs and buttocks is usually caused by

• Arthrosis of the hip joint - coxarthrosis;
• Aseptic necrosis of the femoral head - hip joint infarction, avascular necrosis;
• Inflammation of the femoral tendons - trochanteritis;
• Piriformis syndrome due to injuries of the lumbar spine;
• Arthritis is inflammation of the joints.

Arthrosis of the hip joint (coxarthrosis)

Arthrosis of the hip joint (coxarthrosis) - this diagnosis is made very often. Much more often than necessary. When a patient consults a doctor about hip pain, in at least half of the cases he will be diagnosed with coxarthrosis - arthrosis of the hip joint. Fortunately, coxarthrosis is actually less common. Competent doctors know that of those who come in for pain in the hips, patients with coxarthrosis make up approximately 25–30%.

Coxarthrosis usually occurs after 40 years of age, slightly more often in women than in men. The disease can affect either one or both hip joints. As a rule, coxarthrosis develops slowly, over 1–3 years. Although there are exceptions - sometimes, after an injury, overload or severe stress, pain increases quite quickly, in a matter of days or weeks.

A distinctive symptom of coxarthrosis is pain in the groin, radiating down the front and side of the thigh. Sometimes such pain also spreads to the buttock or radiates to the knee. The pain occurs mainly when walking and when trying to get out of a chair or bed. At rest they almost always subside.

Another distinctive symptom of coxarthrosis is limited mobility of the affected leg. It is difficult for a sick person to move his leg to the side, it is difficult to pull his leg to his chest; difficult to put on socks or shoes. A sick person is unlikely to be able to sit on a chair “astride”, with his legs spread wide apart, or will do it with great difficulty. The leg almost stops rotating (from the hip) to the right and left or rotates due to movements of the lower back. Read more about arthrosis of the hip joints >>

Aseptic necrosis of the femoral head

Aseptic necrosis of the femoral head (infarction of the hip joint, avascular necrosis) - approximately 5–10% of the number of patients referred for hip pain.

The symptoms of aseptic necrosis almost completely coincide with the symptoms of coxarthrosis; one disease is very difficult to distinguish from another. But unlike coxarthrosis, aseptic necrosis most often develops quickly, in a matter of days. Quite often, the pain increases to a maximum and becomes unbearable within the first two to three days. Moreover, for many sick people, the pain does not completely go away even with rest; aching in the leg can exhaust a person almost all night. Rest from it comes only at dawn, at 4–5 o’clock.

Another difference from coxarthrosis: aseptic necrosis most often affects relatively young men, aged 20 to 45 years. Men over 45 years of age develop avascular necrosis much less frequently. Women get sick even less often (7–8 times less often than men). Read more about avascular necrosis >>

Inflammation of the femoral tendons - trochanteritis

Inflammation of the femoral tendons (trochanteritis): this disease occurs very often - approximately 30-35% of the number of patients referred for pain in the hips.

Trochanteritis can be either unilateral, when only one leg becomes ill, or bilateral, when the femoral tendons become inflamed on both legs at once. Women get sick much more often than men, and the peak incidence occurs during menopausal changes in the body, when tendon and muscle tissue weakens. Although there are cases when young women also become ill with trochanteritis. The disease usually develops quite quickly, within 3–15 days. Trochanteritis manifests itself as attacks of pain on the outer surface of the thigh (the “breeches” area).

Pain occurs most often when walking or lying down on the affected side. The pain from the very beginning can be quite intense, but unlike coxarthrosis, with trochanteritis there is no shortening of the leg and no restriction of movement in the hip joint. The leg can be easily moved to the side and rotates freely in all directions. Unlike a person suffering from coxarthrosis, a person suffering from trochanteritis can freely cross his legs, tie his shoelaces without difficulty, and can easily sit “astride” on a chair with his legs spread wide. Read more about trochanteritis - inflammation of the femoral tendons >>

Piriformis syndrome

Piriformis syndrome due to injuries of the lumbar spine. It occurs very often - approximately 30–35% of the number of people seeking treatment for hip pain.

The disease is often unilateral (right or left). The pain increases quickly, most often within 1–3 days, after an unsuccessful movement, heavy lifting or strong emotional experience or stress. In some cases, the attack is preceded by acute or chronic pain in the lower back. The greatest intensity of pain in piriformis syndrome is observed in the buttock area; the sacrum and lower back may hurt at the same time; in some cases, the pain can go down along the back of the leg, all the way to the heel. Unlike coxarthrosis, pain very rarely radiates to the groin - and in any case, with piriformis syndrome, pain in the buttock will be much stronger than groin pain.

Pain in the buttock can be severe both during the day and at night. Sometimes it is difficult for a patient to find a comfortable position in the first half of the night, and sometimes a sick person wakes up from pain at 3–4 am. However, in half of the patients, pain occurs only when moving and walking. In this case, there is no restriction of movement in the hip joint when rotating the leg: the leg rotates in full. But then, acute pain often occurs in the lower back or in the gluteal region when trying to lift a straightened leg or lean forward while standing with straight legs. Piriformis syndrome is caused by damage to the lumbar spine >>

Polymyalgia rheumatica

Polymyalgia rheumatica is quite rare - approximately 1% of those treated for hip pain. Women over 50 years of age are more likely to get sick. In 70–80% of cases, the disease begins after severe stress or a severe cold (flu).

The disease develops quite quickly, within 3–20 days. As a rule, the first symptoms of the disease are pronounced symmetrical (i.e., the same on the right and left) stiffness and pain in the hips (the pain does not go below the knees) and mild pain in the shoulder joints. Painful sensations are accompanied by incredible weakness of the patient. Such patients are brought to the doctor literally “under arms”, but not because of pain, but precisely because of weakness. It is incredible weakness that is the key point in making a diagnosis. Often weakness and pain with polymyalgia rheumatica are accompanied by decreased appetite, weight loss and increased body temperature. Read more about polymyalgia rheumatica >>

Arthritis - inflammation of the joints

Arthritis - approximately 2-4% of the number of people consulted for hip pain. Some types of arthritis lead to inflammation of the hip joints and, accordingly, are accompanied by pain in the groin or hips. And although this happens quite rarely, we must remember it.

In the most typical cases, the hip joints are affected by arthritis almost last, much later than other joints. Then the differential diagnosis between arthritis and, for example, coxarthrosis is not difficult - after all, by the time the hip joints become inflamed, the patient usually already knows that he has arthritis, and most often knows which one.

However, with certain types of ankylosing spondylitis and with some rare variants of reactive arthritis, inflammation of the hip joints may precede other manifestations of the disease or even be the only symptom of the disease. And then it can be very difficult to make a correct diagnosis - such inflammation of the hip joints is very easy to mistake for arthrosis. In such cases, even a competent doctor can make a mistake.

But there are still some “special” signs that make it possible to distinguish arthritic inflammation of the hip joints from other diseases of the hips, and primarily from coxarthrosis. The main warning sign that may indicate the arthritic nature of joint inflammation is morning stiffness and aches throughout the body and joints, which occurs immediately after waking up and then goes away within an hour or during the first half of the day. Such stiffness is typical specifically for inflammatory diseases of the joints, primarily for ankylosing spondylitis and rheumatoid arthritis.

Secondly, unlike coxarthrosis, in arthritis, pain usually reaches its greatest intensity at night, around 3–4 am. The intensity of such pain can be very high, and the pain does not decrease with a change in body position, as happens, say, with trochanteritis. When moving and walking, pain, unlike arthrosis, on the contrary, most often decreases somewhat, rather than increases. By the evening, after the sick person has “dispersed,” the pain may disappear altogether, only to flare up with renewed vigor at night, in the morning.

In addition, the age of the patient can serve as a clue. These types of arthritis most often affect young people, aged 15 to 40 years. And trochanteritis, polymyalgia rheumatica and coxarthrosis, with rare exceptions, begin over the age of 40 years. Read more about arthritis symptoms >>

An article by Dr. Evdokimenko for the book “Pain in the Legs”, published in 2004. Edited 2012

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