Feeling pain in your hips?

Buttock pain is a very common phenomenon in outpatient clinics. The position of the buttocks is very special. Buttock pain is usually easily confused with sciatica and lower back pain. In fact, when you have buttock pain, we need to consider whether it is a lesion in the joint itself or a lesion around the joint. We need to pay attention to buttock pain. If the buttock pain worsens, it is best to go to the hospital for relevant examinations in time.

Causes of hip pain:

First, patients who take steroids for a long time are prone to anoxic necrosis of the femoral head, so they are a high-risk group.

Second, patients with systemic lupus erythematosus are a high-risk group.

Third, alcohol abuse is also a high-risk factor.

Fourth, diving is a risk factor. This is because on the one hand, the long-term bearing of the gravity of the oxygen cylinder, and on the other hand, surfacing in a short period of time can easily turn the helium in the blood into small bubbles, causing systemic vascular embolism and diving disease. People with the above risk factors should be especially careful, as their chances of suffering from hip pain are higher than normal people.

Diagnosis of buttock pain: pain in the buttocks, lower back, lower waist, hip joints, and thigh groins.

The differential diagnosis for exertional hip pain includes arthritis, capsulitis, musculofascial pain syndrome, neuropathy, and other conditions.

There are many diseases that can cause hip pain, including inguinal hernia, simple sacroiliac osteoarthritis, and disc prolapse (highly common between L3 and L4), or kidney stones, which can directly or involve the hip. The above are all diagnoses that need to be differentiated one by one.

The differential diagnosis of hip pain includes arthritis, capsulitis, musculofascial pain syndrome, neuropathy, and other pathologies.

Osteoarthritis (OA) As the name suggests, degenerative arthritis is a degenerative disease of the joints after long-term use. Degeneration of the hip joint is one of the common diseases among the elderly. Patients often feel sore hips after exercise, especially when lifting heavy objects, and the symptoms usually improve after rest. Patients with more severe symptoms will feel soreness even when resting, and this symptom is particularly severe at night.

Infectious arthritis (infectiousarthritis). It is an inflammatory response caused by bacterial infection. The most common pathogen is Staphylococcus aureus, which enters the joint cavity through the blood circulation. Patients usually have a fever, severe hip pain, and sometimes no joint swelling or redness. On physical examination, patients are able to do only slight flexion and are usually unable to tolerate any type of movement. Once the diagnosis is established, the patient should be hospitalized immediately and given intravenous antibiotics. X-rays should be taken as soon as possible, and an orthopedic specialist should be consulted. If necessary, surgical intervention should be performed as soon as possible to remove the suppurative area to avoid permanent damage to the joint.

Inflammatory arthritis (inflammatory arthritis). It is caused by an immune rheumatic disease. Patients usually complain of stiff joints when waking up in the morning, but the symptoms usually subside after a few hours of activity. The two most common diseases in this area include rheumatoid arthritis (RA) and ankylosing spondylitis (AS). The easiest way to tell the difference is to take an X-ray. Ankylosing spondylitis will show typical sacroilitis in this area, while rheumatoid arthritis will not have such changes. If the diagnosis is established, consultation or referral to an appropriate immuno-rheumatologist should be sought.

Capsulitis. The joint capsule is a protective pad used for cushioning and lubrication, reducing direct wear on the joints from external forces. There are eighteen joint capsules in this area, and three are the most commonly inflamed. Includes the greater trochanteric joint capsule, enterolumbar joint capsule, and sciatic joint capsule. During the physical examination, different joint capsules can be tested. If there is severe pain, the diagnosis can be confirmed. X-ray examinations usually cannot show images of soft tissue inflammation, so they are not necessary.

The treatment of capsulitis must be multi-pronged. Local heat therapy, ultrasound, massage, and non-steroidal anti-inflammatory drug treatment can generally achieve satisfactory results. If the symptoms persist and cannot be relieved by the above methods, steroid injections can be performed on the local inflamed lesions. If several weeks of treatment do not produce significant results, CT may be considered to rule out other malignancies. Treatments including local heat therapy, ultrasound, massage, stretching exercises, use of anti-inflammatory drugs, or local steroid injections can effectively alleviate clinical symptoms.

Myofascial pain syndrome. The tibialis muscle fascia in this area can extend from the outer side of the femoral cavity to the outer side of the knee. Once it becomes inflamed, this area will feel painful clinically, especially when lying on the inflamed side, the pain will be more intense. When the thigh is adducted, pulling the fascia will also cause severe pain, which are all reference bases for diagnosis. Fibromuscular pain is more common in women, and clinically it can cause body aches, sleep disorders, exhaustion and weakness, and may even be accompanied by irritable bowel syndrome.

Neuropathy can also cause buttock pain. The most common cause is the pain caused by the lateral femoral cutaneous nerve (lateral femoral cutaneous nerve) being surrounded and compressed by the surrounding soft tissue. Patients will experience soreness in the buttocks and outer thighs and paralysis of the epidermal nerves. Drug treatment is less effective, and surgical incision of soft tissue can effectively reduce neuropathy.