Pain in the hip 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, proven treatment methods and effective preventive measures - plus practical exercises for the home.

No other joint wears as often as our hips: "Osteoarthritis is the most common cause of pain and restricted mobility in this area," emphasizes Dr. med. Martin Rinio, medical director of the Joint Clinic Gundelfingen. The treacherous thing about it: As a rule, the disease process runs creeping and unnoticed for years. If the first symptoms appear, the cartilage layer is usually already severely damaged. The hips become immobile, painful and stiff.

Bone infarction of the hip (hip head necrosis) often manifests itself at the beginning by a slow onset in the groin or sudden groin pain. (Image: Bolko von Haslingen / fotolia.com)

At the end of a hip osteoarthritis, also known as coxarthrosis, is often the complete failure of the joint. "In this case, a prosthesis can well support or replace the function and components of the natural hip joint," assures the orthopedist. But that does not have to be the case: osteoarthritis can be favorably influenced by a plant-rich diet with many fruits and vegetables. Applied in good time, physiotherapy and muscle training help to correct the movement and relieve the joint. "In any case, you should avoid being overweight and protect your joints through exercise and a well-trained surrounding musculature," Dr. Rinio.

In the early stages of injury, mechanical cartilage friction or entrapment can often be eliminated by minimally invasive arthroscopy (articular mirroring). If the defect is not too big, it can often be "repaired" by a cartilage transplant. "As true tissue grows back, the buffer function of the cartilage is restored reliably," explains the specialist. The disadvantage of this method: Two operations are required, the removal and planting, as well as a longer rehabilitation with relief of the joint.

When the femoral head hits the roof

Wear the hips, so it often leads to deformity of the joint bones. These no longer glide, but hitting each other in the hip joint. Experts speak in this case of a hip impingement (English "to impinge" = to strike). "The recurrent bumping and resulting entrapment causes injuries to the joint of the acetabulum and articular cartilage," says Dr. Rinio. Although pain medication, electrotherapy, baths and fango usually bring noticeable relief. "However, due to the still existing mechanical problems and the associated further joint destruction, surgery is usually impossible", says the specialist.

Not infrequently an 'activated osteoarthritis' also leads to acute inflammation in the joint. This is due to the increased cartilage abrasion - similarly fatal for the functioning of the joint as 'sand in the transmission'. The result: a clear debility and pain. If fever, fatigue and pulse rate increase are added, then there is probably a bacterial hip inflammation. This infectious disease is caused by pest bacteria.

In both cases, a strict restraint of the leg to relieve or avoid a joint Auskugelung required. Also recommended in bacterial inflammation is an immediate puncture of the hip joint. "In the process, pus is sucked off and examined for germs in a microbiological laboratory." Rinio. Then you can start with the antibiotic therapy. "To stop the destruction of the hip joint, however, usually an operation to relieve the burden can not be avoided," said the orthopedist.

When the joint dampers fail

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, so to speak, as dampers between two joints and thus protect them from friction damage. If they are subjected to pressure for too long, they may become inflamed, which can lead to severe hip or groin pain. Helpful in this case is a physical therapy with cold application. Due to the high-energy focused shockwave therapy, the irritated structures can usually be well calmed. An operation with arthroscopic removal of the bursa can be avoided so often.

Hüftkopfnekrose (bone infarction of the hip) is a serious bone disease of the hip joint. Due to strong circulatory disorders, the bone tissue on the femoral head dies in places - with serious consequences: The affected bone components lose strength and break apart. As with a heart attack, smoking, high blood lipid levels, and too much alcohol are the main risk factors in this typical lifestyle disease. The proven therapeutic measures include the mechanical relief of the hip joint by physiotherapy, a protection by absolute renunciation of sports and the immobilization of the hip joint (for example, orthoses). Hyperbaric oxygen therapy (hyperbaric oxygenation) may also be helpful at a very early stage.

Even with harmless falls consult the doctor

What many do not know: even seemingly harmless, since relatively quickly decaying pain - such as after a fall on the hip joint - can lead to irreversible damage to important structures of the hip. In order to rule out such consequences, an examination by the orthopedic hip specialist with imaging techniques (X-ray, ultrasound, MRI) is recommended. Fortunately, there are not always serious health problems behind hip pain. In many cases, only strains of the musculature - such as after a football game - trigger the complaints. There are also often back problems behind hip pain (very often after a herniated disc, for example). Sometimes the nerves or internal organs near the hip are the cause of the pain, not the hip itself. In general, the earlier the cause of the pain is recognized, the faster and better the patient can be helped.

So stay hip-fit

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