Why does the hip joint hurt: possible causes, diagnosis and treatment

The hip joint is the largest joint in the human body. Every day he makes thousands of movements while walking, running, climbing stairs, and doing physical exercises. Constant loads, inflammatory processes, injuries and diseases can cause coxalgia - pain in the hip joint. It is necessary to determine the cause of its occurrence as soon as possible to avoid limitation of mobility and disability.

Classification of pain sensations

Pain in the hip joint can be acute, painful or chronic

During a visit to the doctor, it is necessary to describe in detail the nature of the pain: severity, intensity, frequency - the accuracy of the diagnosis depends on this. Depending on the nature of the pain, it can:

  • spicyIn this case, the pain is intense, even unbearable. It can appear suddenly and also disappear suddenly. As a rule, patients with acute pain can accurately indicate the area of its localization. Acute pain can radiate, spreading to the area closest to the source of the pathology.
  • heartacheThe pain is not very strong, sometimes it can be felt as discomfort and does not have precise localization. The aching pain may worsen during movement or after exercise and disappear for a while.
  • Chronicle.This category usually includes pain that occurs with varying regularity for more than six months. Chronic pain is usually the most difficult to treat.

Possible sources of pain

The main causes of pain in the hip joint are:

  • injury,
  • contagious disease,
  • inflammatory process,
  • degenerative tissue changes,
  • developmental pathology of the musculoskeletal system.


With traumatic damage to the hip joint and femur, pain occurs immediately, accompanied by redness and swelling of the tissue, limited mobility of the limbs, and extensive hematoma formation. Depending on the severity of the lesion, the pain may be more or less intense.

If you are hit or fall on your side, soft tissue bruising may occur. It is characterized by the formation of a hematoma, the pain at the site of the lesion intensifies when palpated. Unlike dislocations and fractures, with bruises there is no restriction in the mobility of the injured leg, there is no visually visible deformity, and the limb retains its full function.

Dislocation of the hip joint in a healthy person can only occur under a very strong physical impact, for example, when falling from a great height or in a car accident.

Limbs take a forced rotational position, most often inward, less often outward. The pain is intense, accompanied by swelling, numbness (if the nerves are affected), the victim cannot move the injured limb.

Femoral neck fracture

The cause of pain in the hip joint may be a violation of the integrity of the femoral neck - an injury that mostly affects older women who have passed the threshold of 60 years. Age-related and hormonal changes in the body after menopause accelerate the process of calcium leaching, making bones fragile and brittle even with minor exposure. A fall, bruise, or careless movement can cause a fracture of the femur at its thinnest point, where the diaphysis connects to the head embedded in the hip joint.

Symptoms of a hip fracture are:

  • pain in the pelvic region, radiating to the groin and lower back, aggravated by tapping the heel;
  • shorten the injured leg;
  • limited mobility, inability to lean on the injured leg;
  • external rotation position of the limb;
  • "Stuck heel" syndrome - the inability to lift the leg straight off the surface from a lying position.

Fractures of the femoral neck can be affected - in this case, bone fragments fuse with each other. In this case, the function of the limb may be partially or even completely preserved, but when the fragments are destroyed, the signs of injury will fully appear. Such injuries require immediate intervention, so if you suspect a broken bone, you should seek medical help as soon as possible.

Inflammatory process

One of the main causes of coxalgia is the inflammatory process in the joint tissue or its environment.

Arthritis is inflammation of joint cartilage. The cause may be infection, chronic injury, metabolic disorders, excessive stress, systemic connective tissue disease. Symptoms of the disease, in addition to pain, which increases after exercise or at night, are redness and swelling of the tissue in the affected joint area, increased local temperature, and limited movement of the legs.

Rheumatoid arthritis is an autoimmune systemic connective tissue disease. Women are more susceptible to this disease. It affects both small and large joints, most often in pairs. Characteristic symptoms of rheumatoid arthritis:

  • pain in the joints, worse at night and relieved after movement;
  • formation of subcutaneous compaction in the affected joint area, called rheumatic nodule;
  • redness, swelling and increased local temperature in the affected joint.

Bursitis is an inflammatory process that develops in the synovial bursa of the joint, accompanied by the pathological accumulation of exudative fluid in the joint tissue. The main causes of the development of this disease are considered to be injuries, excessive physical activity, infections and complications of arthritis of various etiologies. Pain due to bursitis occurs deep inside, spreading to the outer surface.

Ankylosing spondylitis is an idiopathic disease, that is, the exact cause of its occurrence in most cases cannot be determined. There is an assumption that pathology is determined genetically, and hereditary predisposition plays a large role in its development.

Most often, the manifestation of the disease occurs at the age of 20-30 years, the first symptoms are pain in the lower back, hips and buttocks, worse at night, stiffness, rapidly developing ankylosis - joint immobility. In the final stages, if not treated, the disease causes severe deformation of the joint tissue, which leads to profound disability.

Degenerative tissue changes

Coxarthrosis, or osteoarthritis of the hip joint - degenerative changes in cartilage tissue - is a common cause of coxalgia in people over 40-45 years old. This disease is chronic and progressive. The causes of its development are considered to be chronic injuries, hereditary tendencies, age-related changes, and concomitant inflammatory arthritis. In young people, the development of coxarthrosis may be caused by congenital dysplasia of the hip joint.

Pathological symptoms:

  • pain in the groin, lower back, buttocks, thighs, increases with movement and subsides during rest;
  • muscle weakness;
  • intermittent claudication, "duck" gait with bilateral joint damage;
  • limb dysfunction, difficulty with abduction, adduction, rotation.

Contagious disease

Infectious arthritis, which is also a common cause of coxalgia, can develop as a result of pathogenic microorganisms entering the joint tissue from a distant focus of viral or bacterial infection through the bloodstream. Can be caused by streptococci, staphylococci, Pseudomonas aeruginosa and tuberculosis bacilli, spirochetes pallidum, influenza virus and other agents.

With infectious arthritis, joint pain is accompanied by redness and swelling of the surrounding tissue, as well as general symptoms - fever, malaise, and weakness.

Another reason

Necrosis of the femoral head is one of the causes of pain in the hip joint

In addition to injury, inflammation and infection, pain in the hip joint can be caused by:

  • Innervation disorders.Inflammation and pinched nerve roots, especially the sciatic nerve, can cause pain in the hip, inguinal triangle and buttock.
  • Neoplasm formation, including malignant ones, in joint tissue and its environment.
  • Aseptic necrosis of the femoral head.Chronic poor circulation in tissues causes degenerative changes in cartilage and bone tissue, and can lead to the destruction of the entire bone structure.
  • Juvenile epiphysiolysis.Chronic pain in the hip joint in children and adolescents can be caused by the development of epiphysiolysis, a pathological displacement of the femoral head caused by hormonal disorders in the body. Boys are more susceptible to this disease, but in rare cases it is also diagnosed in girls. As a rule, the pathology is accompanied by a delay in sexual development and endocrine disorders.

Pain in the hip joint is common in women in the 3rd trimester of pregnancy. Causes of coxalgia in pregnant women:

  • weight gain and shift of the center of gravity, redistribution of load on the musculoskeletal system;
  • natural hormonal changes: just before giving birth, a woman's body begins to produce hormones that relax the ligaments;
  • pressure of the enlarged uterus on large vessels and nerves, disorders of blood conservation and circulation in the pelvic organs and the lower part of the legs;
  • lack of calcium in the body of the expectant mother.

If the pain during pregnancy is caused by the above factors, a few weeks after birth they will disappear without any effect. If, a month after the birth of the child, the pain is still there, you should see a doctor.

Worrying symptoms

Pain in the hip joint is a worrying symptom, which is a mandatory reason for a visit to the doctor. The sooner the cause of coxalgia is identified, the higher the chance of complete recovery. However, there are cases when seeking medical help should be immediate:

  • pain in the joint area occurs after a fall, blow, bruise or any other injury, while the mobility of the limb is affected;
  • the tissue around the joint is red and swollen, and the general body temperature rises to the level of fever (38 and above);
  • have problems defecating and urinating.


The first step in determining the cause of hip pain is to see a doctor. The surgeon or orthopedist will collect the anamnesis, find out the nature of the pain, its frequency and level of manifestation, and also examine the patient to assess the mobility of the joint and the condition of the surrounding tissue. To make an accurate diagnosis, laboratory and instrumental diagnostic methods can be prescribed:

  • general blood tests, biochemistry, serology, immunology;
  • radiography of pelvic bone, thigh, hip joint;
  • ultrasound examination of joint tissue and surrounding tissue;
  • MRI and computed tomography to obtain an accurate three-dimensional image of the affected area;
  • joint endoscopy using a probe inserted into its cavity;
  • puncture to study effusion - pathological fluid accumulated in the joint capsule;
  • tissue biopsy.

Treatment methods

Treatment for conditions that cause hip pain depends on the underlying cause. In cases where the pain is caused by an injury, the main conservative treatment method is joint immobilization; in some cases surgery may be required. If the pain is inflammatory, non-steroidal anti-inflammatory drugs or hormones can be prescribed; For general infectious diseases, antibiotic therapy or antiviral drugs will be necessary.

The pain syndrome, regardless of the cause of its occurrence, is relieved by taking analgesics or injection blocks.


Immobilization is most often prescribed for joint injuries. Tight bandages, plaster splints or plastic orthoses can be used for fixation.

Drug therapy

Depending on the cause of coxalgia, the following may be prescribed:

  • non-steroidal or glucocorticoid anti-inflammatory drugs to relieve the inflammatory process;
  • chondroprotectors to delay degenerative changes in joint tissue;
  • antibiotics and antiviral drugs in case of infectious arthritis;
  • muscle relaxant to reduce muscle spasms.

Physiotherapy procedures

At the recovery stage after an injury, as well as during the period of disease remission, the following physiotherapy methods are used to restore joint mobility, improve blood circulation and restore limb function:

  • physiotherapy,
  • massage,
  • magnetotherapy,
  • balneotherapy,
  • laser therapy,
  • UHF heating,
  • hirudotherapy.


Total hip replacement

In some cases, conservative treatment of pain in the hip joint may not be effective. Aseptic necrosis, late-stage coxarthrosis, femoral neck fractures in the elderly are direct indications for endoprosthetics surgery - replacement of the head and acetabulum of the hip joint with a prosthesis made of chemically and biologically inert materials.

This operation allows you to shorten the recovery process and return the patient to full movement.

Prevention of coxalgia

A set of preventive measures will help prevent the occurrence of pain in the hip joint, including:

  • physical activity that can be performed regularly to strengthen muscles and ligaments;
  • nutritious and balanced diet;
  • weight control, because overweight and obesity create additional stress on the musculoskeletal system;
  • avoid injury and excessive physical activity;
  • rejection of bad habits;
  • timely and adequate treatment of inflammatory and infectious diseases;
  • regular preventive checkups with a doctor.