What we usually call “hip pain” is medically known as hip pain. The hip joint is an important structure connecting the trunk and the lower limbs, with the pelvis on one side and the femur on the other.
The hip joint is the largest joint in the human body and is surrounded by muscles, ligaments and other soft tissues with complex structures. There are many diseases that cause hip pain, such as femoral head necrosis, synovitis, sciatica and lumbar disc herniation.
I. Femoral head necrosis
Femoral head necrosis is a common disabling disease of the hip joint in China, which is caused by the impaired circulation in the bone and the death of bone cells, which then leads to the structural change of the femoral head and the later collapse of the femoral head, hip joint pain and functional impairment.
1, traumatic: trauma leads to femoral head necrosis, such as femoral neck fracture caused by external impact, hip dislocation, hip trauma, hip sprain and contusion, etc. It can directly or indirectly damage the blood flow of the femoral head, thus leading to ischemic necrosis of the femoral head.
Trauma is the main factor causing femoral head necrosis. However, the occurrence and extent of traumatic ischemic necrosis of femoral head mainly depends on the degree of vascular destruction and the compensatory ability of collateral circulation.
2.Non-traumatic: There are many causative factors of non-traumatic femoral head necrosis, including alcoholism, after high-dose hormone therapy, after local radiation therapy, decompression sickness, systemic lupus erythematosus, coagulation dysfunction, hemoglobinopathy, and so on. Among them, alcoholism and hormones causing femoral head necrosis are the most common causes in China.
Drugs lead to femoral head necrosis, such as long-term use of hormonal drugs due to bronchitis, asthma, rheumatism, rheumatoid, neck, shoulder, back and leg pain, diabetes, skin disorders, etc.
Alcohol stimulation leads to femoral head necrosis. The accumulation of alcohol in the body due to long-term heavy drinking leads to the increase of blood lipids and damage to liver function. The increase in blood lipids causes an increase in blood viscosity, slows down blood flow, and changes blood coagulation, which can lead to blockage of blood vessels, bleeding or fat embolism, resulting in osteonecrosis. Clinical manifestations include aggravation after drinking, walking duck walk, heart failure, weakness, abdominal pain, nausea and vomiting, etc.
Second, hip arthritis
The initial performance of hip arthritis is not obvious, and the symptoms are mostly intermittent, plus the symptoms are not systemic, so it is difficult to attract the attention of friends. With the further development of the disease, the symptoms of hip arthritis will gradually become obvious, with stiffness, soreness, pain, and even limited activity.
The occurrence of this disease may be related to the following factors.
1, obesity: the increase in weight and the onset of hip arthritis are directly proportional to each other. Obesity is a factor that aggravates the disease. Weight loss in obese people can reduce the onset of hip osteoarthritis.
2, bone density: when the cartilage becomes thin and stiff, its tolerance to pressure is reduced, therefore, the chances of hip arthritis increase in osteoporotic people.
3, trauma and external force bearing: when the joint bears muscle force imbalance and coupled with local pressure, degenerative changes in cartilage will occur. Normal joints and activities or even after strenuous exercise is not osteoarthritis.
4, genetic factors: different races of joint involvement is different, in the white race is more common, but people of color and the country is rare, gender also has an impact, the disease is more common in women.
The hip joint bears a tremendous amount of body weight, and deformation of its articular cartilage occurs earliest and has characteristic lesions. When the cartilage matrix loses glycoprotein, the cartilage on the surface of the joint softens and breaks at the site of pressure, leaving the cartilage surface in the form of a fine filamentous material. Later, the cartilage is gradually shed in sheets and the cartilage layer becomes thin or even disappears.
Small fractures and necrosis of the subchondral bone occur, and the osteophytes in and around the joint surface constitute osteosclerosis and osteophytes and bone cystic changes on the x-ray. The synovial membrane of the joint may show luminal proliferative changes including proliferation of synovial cells and infiltration of lymphocytes due to destruction of cartilage and bone and shedding of metabolites such as the joint cavity. In severe hip osteoarthritis, there is fibrosis of the joint capsule wall and the surrounding tendons are also damaged.
Third, the hip joint structure itself is abnormal
These patients may have a special history of hip joint, such as congenital diseases of the hip joint or a history of hip joint dislocation, etc. They often have occasional joint pain, which can be improved by resting and taking some anti-inflammatory and analgesic drugs in general. If the joint pain does not improve even after taking medication and resting, you should consult a specialist to seek effective treatment solutions to relieve hip pain as soon as possible.
Fourth, periarticular tissue injury
Most of these patients have a history of trauma or prolonged walking and standing. Rest or oral anti-inflammatory and analgesic drugs can relieve the pain.
Warm tip: hip joint lesions often manifest as pain, soreness and swelling and joint movement restrictions. If the pain in the hip joint increases when squatting, it indicates that hip joint pathology may exist. It is difficult to prevent hip joint disease, so when faced with pain, you should go to a specialist as soon as possible and seek regular treatment.