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The hip represents a very complex part of the body which enables lower limb movements, standing, sitting, and gives support to the pelvic organs. However, the hip joint is very fragile and susceptible to developmental and traumatic deformities. Therefore, when patients complain about hip pain, the cause of the problem usually lies in the hip joint.

The hip joint consists of two joint surfaces, one of which is called the acetabulum and belongs to the hip bone (coxal bone), while the other represents the upper end of the femur (thigh bone). Between those surfaces, there is a cushion of fine cartilage that reduces friction. Additionally, the joint is secured with ligaments and muscle tendons that surround it completely.

Degenerative Changes

Friction is the worst enemy of the hip joint.

Although hip joint cartilage replenishes itself, aging causes a gradual loss in its elasticity and consistency. The loss of cartilage causes joint surfaces to get closer and eventually to damage each other during movements, thus causing hip pain. As a response to increased friction, bone surfaces undergo changes such as hypertrophy and deformation which makes friction and degeneration even more pronounced. These degenerative changes can lead to disability if not treated properly before it's late. Overuse of the hip joints in some sports can increase the susceptibility to degenerative changes caused by a faster loss of cartilage.

Arthritis

Arthritis and osteoarthritis are inflammatory conditions that can affect the hip joint, and are most common in the elderly. Inflammation causes the loss of hip cartilage and starts the vicious circle that leads to degeneration. The most important medications for this condition are Non-steroidal Anti-inflammatory Drugs (NSAIDs) that can alleviate the inflammatory process and relieve pain.

Hip Fracture

Hip fractures are a very common problem in old persons due to the loss of bone density (osteoporosis), weak tendons and ligaments of the hip joint. Depending on the type of fracture, this problem may be manageable by surgical interventions, but it frequently leaves permanent consequences due to poor blood supply and poor regeneration of fractured bones in the elderly.

Distension of Ligaments and Tendons

Some exercises require overextension of hip joint ligaments and tendons which can cause distension and consequent inflammation resulting in pain and discomfort in the hip area. That usually happens if the exercises are performed before the necessary warm-up, or if the intensity of exercise is inappropriate. NSAIDs can help to lower the pain in these cases, but resting for a couple of days is crucial for complete recovery. Too much exercise can also cause bursitis - an inflammation of the small fibrous sacs (bursa) placed around joints and tendons.

Tumors

Primary and secondary (metastatic) bone tumors that affect the femur and acetabular area cause hip pain as the first sign.

In any case of new and persistent hip pain, you should contact your doctor for further examination. It is very important to diagnose hip joint diseases before they become progressive and untreatable. Mild to moderate physical activity and optimal body weight benefit cartilage replenishment, while the overuse of the hip joint and obesity cause its degeneration.

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