What to do if hip hurts at night

You suffer from pain in the hip joint at night, making sleep impossible? It should be noted that night pain not only testify to the defeat of the hip joint (TBS), but also lead to disorders of the nervous system that can manifest in inattentiveness, aggression, chronic fatigue, depression, anxiety, and it is fraught with unpleasant consequences, especially for professions where lack of attention can cost lives.

pelvic Pain at night

Children up to 18 years old complaints on pain in area of hip are found every tenth, in adults up to 50 years every third. With regard to the elderly, from pain in the hip affects about 60%. Women are more prone to the appearance of pain syndrome localization of this than men.

Peculiarities of the symptoms depending on the type of pathology

let's look at diseases that can affect the hip joints and be accompanied by the occurrence of pain at night. Pay attention to the peculiarities of each disease, causes, contributing to its development, and specific differences of pain.

disease NameCauses and predisposing factorsFeatures of pain and other symptomsIntensityPrevalencePrimary/secondary
Rheumatoid arthritisJoint:
Immunological damage to the articular connective tissue. Extra-articular:
1. Genetic predisposition.
2. Hypothermia.
3. Stress.
4. Physical stress.
5. Recent illness (influenza, tonsillitis, otitis media, etc.).
the Disease begins with small joints (most often both hands, symmetrically) and associated with pain, stiffness at night and in predawn hours. Further, when the progression of the disease in the pathological process involved and the large joints in particular can cause pain in the hip joint. The highest intensity of pain syndrome observed in the second half of the night or in the morning. Increasing pain during active movements in the hip joint. They are accompanied by the appearance of the effusion, and the skin over them becomes swollen and hot to the touch. Reduced range of motion in affected joints, over time they are deformed up to complete immobility. Pain decreases in the supine position, without making active movements in the modified joint.Medium to high0,5 – 1,5 %Secondary
OsteoarthritisArticular: 1. Increased load on articular cartilage. 2. Changes in the structure of articular cartilage. 3. Injury. 4. The perfusion of the cartilage.
Extra-articular:
1. Abnormalities of the skeleton.
2. The metabolic disorder, overweight.
3. Genetic predisposition.
Pain initially moderate nature, the intensity and power of his growing. In the first stage of disease is characterized by starting pain, pain associated with the beginning of active movements in the affected joint, at rest significantly reduced or disappear entirely, on stage 2-3 can be observed at rest and at night. When movement occurs crepitus and crunching, there is a limitation of mobility, decreased range of motion. Typical deformity of TBS. The patient is lame by movement, pain aggravated by body position change, the beginning of the walk, and eventually at the slightest movement. The pain may radiate to the knee, groin. The muscles surrounding the joint, tense, characteristic of antalgic position of the leg (adduction, flexion and rotation, rotation outwards).Medium to high10 – 15 %Primary
Bechterew's Disease (Rhizomelic form)Articular: 1. Immunological damage to the articular connective tissue. 2.The formation of the syndesmosis. Extra-articular: a genetic predisposition.the Disease occurs with the appearance of pain in lumbar-sacral region (involvement of the spine and iliosacral joint), possible involvement in the pathological process of TBS. With the defeat of the hip joints of the patient concerned constant dull pain that may radiate to the groin, elbow or sacrum. Pain maximum during night and predawn hours. Over time, limited joint mobility and decreases the volume of its movements against the deformation. The disease occurs in the form of remissions and exacerbations. Complete immobility occurs after 15-20 years of onset.Medium0,8 – 1 %Secondary
Infectious arthritisthe Presence of focus of infection in the body (Lyme disease, tuberculosis, pyogenic infection less likely).the Disease begins gradually in the case of tuberculosis or Lyme disease, acutely in the case of a pyogenic infection. Pain, usually unilateral, localized in the joint region with possible radiation to the groin and knee. Amongadditional symptoms disorders of the joint, its deformation and defigure (shape change), limited mobility, redness around the joint. The General symptoms of intoxication, fever (from low grade to hectic - from 38 to 40).High2-10:100000Secondary

Diagnosis

It Should be noted that night pain in the hip joint can be associated with articular pathology and may be a concomitant symptom of other diseases, for example, trochanteric bursitis, and dysfunction of the sacroiliac joint, enthesopathy, tendinitis, tumors (e.g., myeloma bone of the pelvis). Only a specialist can conduct a rational diagnosis and to differentiate joint disease from complications of another disease. For diagnostic use the following laboratory and instrumental methods:

  1. a Common blood test. Will provide an opportunity to confirm or deny the presence of inflammation in the body.

Normal blood work

  1. Biochemical analysis of blood. To assess the state of metabolism, kidney function, liver, and bone tissue for the presence/absence of osteoporosis, and helps to eliminate some cancers (multiple myeloma).

the Results of specific tests

  1. Specific tests. Include the determination of rheumatoid factor, antinuclear antibodies (ANA), the test ACPP, NFA-B27, determination of antibodies, antigens (PCR) for chlamydial and other infections that confirm or deny the presence of rheumatoid arthritis, reactive arthritis, ankylosing spondylitis.
  2. Morphological study of biopsy specimens and the study of synovial fluid. Allows to study the degree of change in cartilage and synovium during osteoarthritis, rheumatoid arthritis or ankylosing spondylitis, the chemical and cellular composition of synovial fluid.
  3. x-ray examination. Is the most simple and at the same time the most informative method of research. Will give the opportunity to immediately make a diagnosis in coxarthrosis by the presence of osteophytes and changes in the size of the joint cavity. Visualizes bone and indirect signs of rheumatoid arthritis and ankylosing spondylitis, in integrated assessment analyses will provide an opportunity to make a diagnosis.

of the Hip on x-ray

  1. Computed tomography. Gives you the opportunity to inspect the condition of the bone and cartilage in several projections. More expensive and reliable method than x-ray examination.

Problems with the hip joint in the fMRI

  1. Magnetic resonance imaging. Visualizes pathologically changed cartilage, muscle and ligaments.
  2. ultrasound of the joint and arthroscopy.
  3. bone scan.

Please note! Only timely treatment to the doctor gives the rheumatologist can diagnose and prescribe appropriate treatment. Because early treatment is the maximum benefit, it allows you to bring the disease under control and to prevent disability.

Sources:

  1. Marx V. O. Orthopedic diagnosis (manual guide) – 1978 – 512 page
  2. Mironov S. P., Kotelnikov G. P. Orthopaedics: the national guide – 2008 – 832 pages
  3. Kornilov Traumatology and Orthopaedics 2000, p. 265