Hip pain: these are the causes and therapies

Osteoarthritis, inflammation, bone infarction: This is how experts get painful hip problems under control

An expert explains the most common orthopedic hip complaints, tried and tested treatment methods and effective preventive measures - plus practical exercises for at home.

No other joint wears out as often as our hips: "Osteoarthritis is the most common cause of pain and restricted movement in this area," emphasizes Dr. Martin Rinio, medical director of the Gundelfingen joint clinic. The tricky thing about it is that the disease process usually proceeds slowly and unnoticed for years. If the first symptoms appear, the cartilage layer is usually already severely damaged. The hip becomes immobile, painful and stiff.

At the end of a hip osteoarthritis, medically also called coxarthrosis, there is often the complete failure of the joint. "In this case, a prosthesis can support or replace the function and components of the natural hip joint," the orthopedist assures. But it doesn't have to go that far: Osteoarthritis can be influenced favorably through a plant-rich diet with lots of fruits and vegetables. When used in good time, physiotherapy and muscle training help to correct the movement and relieve the strain on the joint. "In any case, you should avoid being overweight and protect the joints through exercise and a well-trained surrounding muscles," advises Dr. Rinio.

In the early stages of damage, mechanical cartilage rubbing or pinching can often be removed by minimally invasive arthroscopy (mirror examination). If the defect is not yet too large, it can often be “repaired” by a cartilage transplant. "Since real tissue grows back, the buffer function of the cartilage is reliably restored," explains the specialist. The disadvantage of this method: Two operations are required, the removal and implantation, and a longer rehabilitation with relief of the joint.

When the femoral head hits the roof

If the hips wear, this often leads to deformed bones in the joints. These no longer slide, but hit each other in the hip joint. In this case, experts speak of a hip impingement (“to impinge”). "The recurring bumping and the resulting pinching cause injuries to the joint lip of the acetabulum and the articular cartilage," reports Dr. Rinio. Pain medication, electrotherapy, baths and fango usually bring noticeable relief. "But because of the mechanical problems that still exist and the associated further joint destruction, an operation is usually unavoidable," said the specialist.

Not infrequently, ‘activated arthrosis’ also leads to acute inflammation in the joint. This is due to the increased cartilage abrasion - similarly fatal to the functionality of the joint like ‘sand in the transmission’. The result: a significant inability to exercise and pain. If fever, fatigue and an increase in pulse rate are added, there is probably a bacterial hip joint infection. This infectious disease is caused by pus bacteria.

In both cases, a strict, careful posture of the leg is required to relieve or prevent articulation of the joint. In the case of bacterial inflammation, an immediate puncture of the hip joint is also recommended. "Pus is sucked off and examined for germs in a microbiological laboratory," explains Dr. Antibiotic therapy can then be started. "In order to stop the destruction of the hip joint, an operation to relieve the pressure can usually not be avoided," said the orthopedist.

If the joint damper fails

Hip or groin pain is the most common symptom of bursitis in the hip joint. There are over 150 bursae in the human body. These serve as a kind of damper between two joints and thus protect them from friction damage. If they are exposed to pressure for too long, they can catch fire, which can lead to severe hip or groin pain. In this case, physical therapy with cold application is helpful. The highly energetic focused shock wave therapy can usually calm the irritated structures well. An operation with arthroscopic removal of the bursa can often be avoided.

Femoral head necrosis (bone infarction of the hip) is a serious bone disease of the hip joint. Due to severe circulatory disorders, the bone tissue on the femoral head dies in places - with serious consequences: the affected bone parts lose strength and break apart. As with a heart attack, smoking, high blood lipid levels and excessive alcohol are the main risk factors in this typical lifestyle disease. The tried and tested therapeutic measures include mechanical relief of the hip joint through physiotherapy, protection through absolute sports avoidance and immobilization of the hip joint (e.g. orthoses). At a very early stage, hyperbaric oxygen therapy (hyperbaric oxygenation) can also be helpful.

Consult a doctor even if the fall is harmless

What many do not know: Even apparently harmless, since pain subsides relatively quickly - for example after a fall on the hip joint - can lead to irreversible damage to important structures of the hip. To rule out such consequences, an examination by the orthopedic hip specialist with imaging methods (X-ray, ultrasound, MRI) is recommended. Fortunately, hip pain does not always have serious health problems. In many cases, just pulling the muscles - for example after a football game - triggers the symptoms. There are often back problems behind hip pain (very often, for example, after a herniated disc). Sometimes the nerves or internal organs near the hip are the cause of the pain, and not the hip itself. In general, the earlier the cause of the pain is identified, the faster and better the patient can be helped.

How to stay fit

The hip is the most stressed joint in humans. It connects the trunk to the legs and enables extensive movements of the legs. It also acts as a "shock absorber" when walking, running and jumping. To ensure smooth mobility, the femoral head and socket are covered with a smooth, up to 5 mm thick cartilage layer in a healthy joint. Since it has no blood vessels, a minimum amount of movement is required to supply it with important nutrients via the synovial fluid and thus keep it alive.

Author and source information

Video: Hip pain from Bursitis and Common Treatment Methods (January 2022).