Hip pain

您的臀部是一个非常稳定且结实的关节。

它被称为球锁接头。这是因为大腿骨的顶部形状像球。这个“球”位于骨盆中的空心插座内。

Ball-and-socket joints give the most movement of all the different types of joints in the body.

髋关节通过肌肉的覆盖固定在一起，这些肌肉被称为肌腱固定在骨骼上的肌肉。

这些肌肉和肌腱在关节周围形成胶囊并支撑其运动。它们有助于移动关节，支撑您的腿和上身运动。

Inside the capsule is the synovium, which lubricates the joint with synovial fluid and keeps the cartilage healthy. The cartilage sits between the bones of your hip joint to stop them rubbing together and reduces any impact when you walk or move your hip.

With all this support, it is unusual for the hip to become dislocated, even after a high-impact injury.

Most of the time you can treat your hip pain yourself with simple self-help treatments. If your pain is extremely bad or hasn’t improved after two weeks of regularly taking止痛药，您应该去看医生。

You should see your doctor straight away if:

• 您跌倒或臀部受伤
• 痛苦越来越严重
• you’re having difficulty with daily activities, for example walking, going up stairs or leaning forwards when sitting
• 您感到发烧或不适，或者一直在减肥。

Most of the time there is a very simple explanation for hip pain, for example if you’ve overdone it while exercising. In this case your pain is usually caused by strained or inflamed soft tissues, such as tendons, and it often clears up within a few days.

长期髋部疼痛可能是由特定条件引起的。

如果您的臀部关节有问题，您可能会在腹股沟，腿部和膝盖的前面感到疼痛。有时，膝盖疼痛是髋关节问题的唯一迹象 - 这称为引用疼痛或辐射疼痛，很常见。

您可能会在臀部或臀部的外侧感到疼痛 - 尽管这也可能是由于下背部的问题而引起的。

If your hip pain hasn’t improved after two weeks you should see your doctor.

It’s a good idea to make some notes about your condition before you go, so you can be sure to discuss everything that’s bothering you.

您的医生会询问您的痛苦以及什么动作使情况变得更糟。他们会问您的症状是如何开始的，它们如何影响您的日常活动以及您是否在晚上痛苦。

当您弯曲臀部上楼梯或穿上袜子时，疼痛通常是髋关节问题的标志。

他们将检查您的臀部以了解其移动的能力，这通常会提供足够的信息来计划您的治疗方法。但是您可能需要其他测试来诊断某些情况。

有哪些测试？

X射线

X射线通常是找出臀部出现骨骼状况的髋关节问题的最佳方法。他们可能还会在骨盆中显示出问题，可以解释您的痛苦。它们对于查看关节周围的软组织并不有用。

CT扫描

CT(计算机断层扫描)扫描通常可以very helpful to work out if the hip joint has an unusual shape. CT scans use x-rays to show sections or ‘slices’ of the hip, which a computer then puts together to form a 3D image of the hip.

在某些情况下，臀部的插座可能非常浅，并且CT扫描可以显示出来。

MRI扫描

MRI（磁共振成像）扫描使用无线电波来构建图片，以显示臀部内部软组织发生的事情，例如肌肉和肌腱。它们特别有助于诊断疼痛状况的血管坏死，从而减少了血液流到骨头的末端，从而导致它们崩溃（有关更多信息，请参见特定的髋关节条件部分）。

血液检查

如果您的医生认为您的疼痛是由感染或rheumatoid arthritis，血液检查通常可以帮助您。

如果您的臀部疼痛无法通过简单的药物（例如扑热息痛和布洛芬）以及休息和温和的锻炼来改善，您应该去看医生以获取进一步的建议。他们可能建议采取以下治疗：

Drugs

非甾体类抗炎药（NSAIDS）

Your doctor may prescribe strongerNSAIDS, such as diclofenac, naproxen, or a higher dose of ibuprofen, to help ease your pain.

像所有药物一样，NSAID有时会产生副作用。如果您要服用处方nsaids，您的医生将采取预防措施来降低这些风险 - 例如，通过在最短的时间内开处方最低剂量。

双膦酸盐

双膦酸盐用于治疗paget病of the bone和osteoporosis。They work by slowing bone loss, which reduces the risk of hip fractures.

理疗

Aphysiotherapist通过向您展示特定于您的病情的柔和运动练习和活动，可以帮助您帮助您的臀部运动。

They are trained specialist who can show you how to help reduce your hip pain and how to improve the way your hip works in future by using a variety of strengthening and stretching exercise,massage和其他治疗技术。

They’ll work with you to help get your hip moving properly again. Their approach will depend on whether your problem is short-term or a long-standing condition. Almost everyone will benefit from physiotherapy, and they can recommend things such as:

• 锻炼以增强肌肉削弱，改变协调并提高功能
• advice on improving your posture
• exercises to ease or prevent stiffness
• 练习以增加联合运动的范围
• 将胶带放在皮肤上，以减少组织上的压力，并帮助您提高您对臀部和后背的位置的认识
• 软组织和关节的手动处理 - 例如按摩和操纵
• how to walk when your hip hurts
• how to use a walking stick or crutch.

It can take a while to get your referral to an NHS physiotherapist. You could see one quicker if you go privately but you’ll have to pay for this. You can find more information about private physiotherapists in your area on the特许理疗协会网站。

职业治疗

If you think your work or certain activities might be the main cause of your pain, it’s worth discussing this with an occupational therapist.

职业治疗师是一个专家培训to help you regain your independence by showing you how to change the way you do things. They can also advise you on how equipment or adaptations could reduce the strain on your hip at home, work, or while you’re driving.

They’ll be able to give you advice on how to change your movements to help prevent pain continuing or returning. If your place of work has an occupational health department, they may also be able to help.

You can also see an occupational therapist privately. You’ll be able to get an appointment quicker, but it will cost you money. The皇家职业治疗师网站可以帮助您在您所在地区找到私人职业治疗师。

Your GP or hospital consultant can refer you for physiotherapy and occupational therapy, or you may be able to refer yourself.

Steroid injections

如果您的疼痛是由于臀部或臀部周围或周围的炎症引起的steroid injections可以帮助。

A They’re often given with a local anaesthetic which numbs the area to reduce the pain of the injection. They are usually very helpful in treating conditions affecting the trochanteric area on the outside of the hip.

有时，它们也可以有效治疗Iliopsoas肌腱炎 - 尽管放射科医生需要使用超声检查注射，因为Iliopsoas肌腱非常深。

A radiologist is a doctor who specialises in imaging techniques – like x-rays, MRI and ultrasound imaging – and forms a diagnosis from the results. They can use ultrasound to pinpoint the place that a steroid injection would be most effective.

A snapping iliopsoas tendon can also be treated with steroid injections with the guidance of a type of x-ray, called video fluoroscopy, to make sure it’s given in the right place. Ultrasound-guided injections are also becoming more popular.

外科手术

并非每个患有髋关节疼痛的人都需要手术。但是，髋部骨折几乎总是需要手术来稳定骨骼并将其固定在适当的位置。也可能需要更换臀部的球。

老年人通常会经历髋部骨折，这可能需要很长时间才能完全康复。人们经常可以在医院待几周或更长时间以克服秋季和随后的手术，许多人通常在出院后在家中需要额外的帮助。

Hip replacement surgery

If your hip pain is caused by arthritis and other treatments haven’t helped, your doctor may talk to you about hip replacement surgery. The modern techniques used in a hip replacement make the surgery very safe and people usually have extremely good outcomes after it.

• 超过90％的髋关节替代人发现疼痛大大减轻了。
• A modern artificial hip should last at least 15 years.

通常，您只需要在手术后几天留在医院。物理治疗师通过向您展示简单的练习以及进行日常活动的方法，将有助于再次移动臀部。

如果您被考虑接受髋关节置换手术，那么重要的是身体健康，并尝试减轻体重。

您的总体健康状况可能会在医院预约之前进行评估，您的外科医生还将与您谈论该手术。您还可以遇到物理治疗师和occupational therapistswho’ll be involved in your treatment after surgery.

翻新手术

如果您的髋关节置换变得松动，感染或以其他方式失败，则可以通过进一步的手术进行纠正。现代修订手术技术正在迅速发展，大多数髋关节置换术都可以处理。

You’ll be in hospital longer than your first hip replacement, and it might take longer to recover.

髋臼唇部手术

外科手术to reshape the hip can improve your ability to move the joint and reduce your pain and stiffness. In some cases, this procedure is performed using keyhole surgery as a hospital day case or you may stay a night in hospital.

您需要休假一到两个月。我们目前不知道此操作是否可以阻止您的臀部患者的关节炎。

您有多种方法可以帮助您的臀部疼痛，例如使用止痛药，锻炼并减轻臀部的压力。

Painkillers

Simple止痛药或非甾体类抗炎药（NSAID）such as paracetamol or ibuprofen tablets or gels – from a chemist or supermarket can help. A pharmacist should be able to give you good advice on what could work best for your condition. But don’t use them for more than two weeks without speaking to your GP.

You can try rubbing anti-inflammatory creams or gels onto affected areas, but some hip problems are so deep within the joint that this may not help. A pharmacist can advise you on what’s best for your condition.

Exercise

Your hip pain may improve with a few days’ rest, but as soon as the pain begins to ease, start some gentle exercise to keep your muscles working and stop your hip getting stiff.

如果您不开始移动臀部，它可能会开始变得越来越弱和灵活，这将降低您出门，过着充实生活的能力。

Simple exercises can also help keep the muscles strong, which will provide support to your hip and improve your symptoms. There are examples of练习您可以尝试我们的臀部页面练习。

Before you begin, it’s a good idea to get advice from a doctor, physiotherapist or personal trainer in a gym about specific exercises. Start by exercising very gently and build up gradually.

As with any physical activity, it’s normal to feel some discomfort or aching in your muscles after exercising. But you should stop if you get any joint pain that doesn’t go away quickly.

除了进行特定的锻炼以帮助您的臀部外，最好尝试改善您的一般健身。诸如每天散步或游泳之类的事情将通过增强体内其他肌肉来改善您的总体健康状况并减轻臀部的压力。

有时人们一旦疼痛消失就停止运动，但是当他们这样做时，他们很常见，很快就开始遇到问题。即使您感觉好多了，也很重要的是，您必须定期锻炼以阻止疼痛恢复。

Reducing the strain

It’s generally best to carry on doing your normal activities – but try not to overdo things. You might need to pace yourself and do a little more each day. There are ways you can do some daily activities slightly differently, so you don’t hurt your hip.

• Avoid sitting in low chairs as this bends the hip more and might increase your pain.
• 不要携带重量。购物时，请尝试使用手推车，如果不舒服携带篮子。
• 通过找到舒适的坐姿来减轻工作中臀部的压力。您的工作场所可能能够提供脚凳，背部支撑或其他设备来帮助您。您可以要求进行工作站评估并谈论您的病情。
• Talk to your line manager or HR department about any parts of your job you’re struggling with.
• Ask anoccupational therapist或者您的全科医生是否使用手杖可以使其更容易获得。他们可以以正确的长度和使用棍棒的最佳方式为您提供建议。
• 如果您超重，减肥 - 您的臀部会带来很多体重，因此采取步骤减少这会有所帮助。
• Avoid standing on one leg – for example, when you get into a car, sit on the side of the seat and swing both legs in rather than stepping in one leg at a time.

互补疗法

有几个补充治疗that some people find relieve their hip pain. Some are available on the NHS, such as针刺。但是没有很多证据，因此NHS并不总是可用。

互补治疗通常相对安全。但是，在开始使用医生之前，您应该始终与您的医生交谈，以防它们干扰特定的治疗方法。

在开始任何疗法或治疗之前，重要的是要确保治疗师或供应商具有固定的道德规范，并已在法律上注册并完全保险。

We have more information about the organisations that oversee complimentary treatment practitioners and what you should expect from complementary and alternative therapists.

因为您很有可能会为任何补充治疗付费，所以您应该考虑他们是否在决定是否要继续使用它们之前对您的病情有所帮助。

We have information on complementary treatments, including针刺,芳香疗法,操纵疗法– such as chiropractic or osteopathy treatments, supplements, and much more.

影响髋关节的一些特定条件是：

Osteoarthritis

骨关节炎是成人髋关节疼痛的最常见原因之一。它主要影响手指，膝盖和臀部的关节。

Your hip joint can become painful, swollen and stiff because OA thins the cartilage that stops your bones rubbing together and causes bony lumps known as osteophytes to form on the bones of the joint.

You can feel a great deal of pain from osteoarthritis of the hip which can restrict your movement and sometimes makes you limp.

臀部的骨关节炎会引起大量疼痛，受限运动和li行。在极端情况下，腿会变短，臀部可以固定在弯曲的位置，使运动变得困难。

有关更多信息,请参见我们的部分osteoarthritis。

paget病of bone

paget病affects the way bone develops and renews itself, causing it to become weaker. It usually affects the pelvis, causing it to grow out of shape. This can often lead to hip pain, but it is treatable with a group of drugs called bisphosphonates.

双膦酸盐是用于防止骨骼质量损失和治疗骨骼疾病（例如）的药物osteoporosis和佩吉特’s disease.

有关更多信息，请参见我们的部分paget病和bisphosphonates.

其他类型的关节炎

Inflammatory conditions, such as rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis can all cause hip pain. This can be managed with specific medications for each condition.

有关更多信息，请参见我们的部分rheumatoid arthritis,银屑病关节炎和ankylosing spondylitis。

Hip fractures

如果您摔倒并伤害了臀部，您应该紧急看医生，因为臀部周围的骨折非常普遍，尤其是在骨质疏松症的老年人中。

骨质疏松症使骨骼的密度较小和脆弱，因此它们更容易折断或骨折。您可能需要手术来解决损害。

For more information see our section onosteoporosis。

Avascular necrosis (osteonecrosis)

Avascular necrosis is a rare and painful condition that can affect any joint in the body in young-to-middle-aged adults. It occurs in the hip when the blood supply to the ball at the end of the thigh bone is lost. This causes the bone to die and the ball to collapse, which results in arthritis.

这可能是血流的永久或暂时损失。有时，对于癌症或哮喘等疾病，类固醇治疗会导致血管坏死作为副作用。另外，您可能会出现一个非常严重的骨折，会影响血液流到骨头末端。

血流的这种损失会导致骨骼和周围的组织逐渐死亡 - 改变骨头末端的球形状，使髋部疼痛和僵硬。它可能导致关节中的球塌陷，从而导致关节炎。

It’s often referred to as idiopathic, which means that it doesn’t have any clear cause. However, it’s linked with the following:

• Drinking too much alcohol.
• 长期使用高剂量皮质类固醇，例如泼尼松。
• 镰状细胞疾病（一种遗传性疾病，可阻止红细胞正确地通过身体携带氧气）。
• Radiotherapy.

如果您的医生认为您的血管性坏死，那么他们重要的是，他们向您推荐您进行紧急MRI扫描以确认诊断。一旦您有诊断，就可以开始治疗，这可能会阻止疾病造成更多损害并阻止您患关节炎。

Femoroacetabular impingement (FAI)

股骨轨迹撞击（FAI）是球和插座无法在正常运动范围内自由移动的条件。这可能是因为球的顶部不是完全圆形的，或者插座太深。

尚不完全了解为什么会发生这种情况，在大多数情况下，不需要特定的治疗方法。

In some cases, surgery can improve the range of movement in the hip, but it’s not clear whether this helps prevent arthritis developing in the long-term.

如果髋关节的X射线和扫描正常，则症状可能是由背部引用的疼痛引起的。由于臀部的后部，在臀部关节的外侧，偶尔在臀部的前面，臀部的后部，腿后部下方，臀部的后部下方，臀部的后部有疼痛。

软组织条件

横向髋部疼痛

There are a number of conditions that can affect the outside of your hip joint. Your diagnosis will depend on how wide the affected area is.

弯曲囊炎

毛毛是小液体填充的小袋，其作用像垫子，可以减少身体部分相互移动的摩擦，例如肌腱或韧带经过骨骼。

如果您对臀部关节的骨部分有压痛，则可能患有转子囊炎。这是由于大腿顶部的Bursa发炎引起的。炎症是对感染或损伤的正常反应，导致囊虫变得肿胀，炎热而痛苦。

这是一个非常普遍的条件，但通常没有明显的原因。您可能只是在这个骨点上感到痛苦，但是它可以散开腿，或者似乎来自臀部关节本身。

双子骨性囊炎经常发生在两个臀部。它通常通过休息，止痛药和物理疗法改善。

偶尔情况，这种情况可能会持续时间比预期的时间更长，并且有时与下背部的腰椎区域的问题有关。注意自己的姿势可能会有很大的不同。这种病很常见，通常是慢性的，在许多情况下，这是一个诊断过多的诊断。

现在众所周知，它也会影响您的肌肉和肌腱，而不仅仅是Bursa。这可能意味着您可能会被转介给运动医学，骨科，风湿病或脊柱医学专家。

现在，此情况也有许多名称，具体取决于医生的诊断类型以及受影响的区域的宽度。您可能会被告知您患有更大的动物疼痛综合征，骨骨尾刺炎或臀肌肌病。

Iliopsoas肌腱炎

Iliopsoas肌腱炎is inflammation of the iliopsoas tendon that runs over the edge of the pelvis and helps you bend your leg up. This usually gets better on its own.

捕捉iliopsoas肌腱

折断的iliopsoas肌腱通常不会引起髋部疼痛。“捕捉”是指您可能意识到的点击噪声，因为移动时肌腱在骨盆边缘上的触发，这并不意味着肌腱断裂。

有人说，这种感觉就像他们的臀部在弹出。如果您的医生认为您患有这种情况，他们通常会建议您休息并使用止痛药，直到结算为止。很少需要测试和手术。

Torn acetabular labrum

The acetabular labrum is a thick ring of cartilage around the hip socket. It can be torn if the ball or socket of the hip are misshapen. This can be the result of hip problems in childhood or changes to the shape of the hip as it develops, but in most cases the cause is unknown.

如果髋关节的球受到影响，则称为凸轮病变。当插座受到影响时，它被称为钳子病变。我们尚不知道治疗手术问题是否会阻止您在以后的生活中患骨关节炎。

If your doctor thinks you have a torn acetabular labrum, they may recommend you have an arthrogram investigation. This is where a small amount of dye is injected into the hip joint before an MRI or CT scan. This gives a clear image of the surface of the bones, soft tissues and cartilage in the joint.

Other causes of groin pain

Groin pain is very commonly caused by problems with the hip. However, it can also be a symptom of other conditions, such as:

• 疝气 - 疼痛的肿块，经常在腹股沟中，可能需要手术
• 腹股沟中的淋巴结 - 通常会在下腿感染中出现这些淋巴结
• 妇科问题，偶尔会被视为髋关节疼痛。

Not everybody with hip pain will need surgery, but hip fractures almost always need fixation, which stabilises the bone and helps it to heal, or replacement of the ball of the hip. Hip fractures often occur in elderly people, and they can take a long time to fully recover from. People can often be in hospital for a couple of weeks or more to get over the fall and the operation, and many often need extra help at home after discharge.

Hip replacement surgery

如果您的臀部疼痛是由关节炎引起的，并且越来越恶化，您的医生可能会与您谈论髋关节置换。

Hip replacement is an extremely good treatment for arthritis-related hip pain, and modern techniques make the operation very safe with good outcomes.

Nowadays, many people only need to stay in hospital for a few days after their hip replacement, but it may be helpful if somebody is available to stay with you for a couple of weeks as your mobility and confidence improves.物理治疗师will help you become mobile when you’re in hospital, and they’ll help you practise getting in and out of bed, out of chairs and up and down stairs safely.

如果您被考虑进行髋关节置换，那么在手术前身体健康很重要。

在手术之前，您可能会转介医院进行评估，他们会检查您的一般健康状况。

您的外科医生会与您谈论手术本身，您将遇到物理治疗师和occupational therapistswho’ll be involved in your treatment after surgery.

The outcomes of hip replacements are extremely good – 90% or more of people who have had a hip replacement find their pain is greatly reduced. Modern hip replacements should last many years – around 80% of cemented hips should last for 20 years.

翻新手术

If your hip replacement becomes loose, infected or otherwise fails, it’s possible to have surgical treatment. Modern revision surgery techniques are developing quickly and most failed hip replacements can be dealt with, which can restore function and activity.

翻新手术is carried out by specialists in the field. You’ll be in hospital longer than for your first hip replacement, and it might take longer to recover. You’ll need physiotherapy after revision surgery to help you gain confidence in your new joint, and you’ll need someone to help you out for a couple of weeks or more when you go home.

髋臼唇部手术

A torn acetabular labrum can be repaired by surgical reshaping of the hip. In some cases this procedure can be performed through just a small incision (arthroscopically), so your joint doesn’t have to be opened up. This is also known as keyhole surgery, and it can be done as a day case or one-night stay in hospital.

您需要休假一到两个月。

我们还不知道髋臼唇手术的长期影响是什么，但是由于它，您可能会获得更好的髋关节运动。

Our research has shown that certain occupations, such as farming, can put you at greater risk of developing hip osteoarthritis.

Because of this hip osteoarthritis in farmers and other high-risk jobs is now recognised as an occupational injury, which entitles these people to claim Industrial Injuries Disablement Benefit.

我们目前正在为研究提供资金developing new techniques to measure hip shape and abnormalities in babies and children。

Children with hip problems are more likely to develop osteoarthritis and to need hip replacement surgeries as young adults. This study will develop a tool to identify children who would most benefit from treatment as early as possible, reducing long-term pain and disability.

我们的研究人员运动，运动和骨关节炎中心are also studying the reasons why hip pain is commonly seen in young footballers.

We're also funding research looking into whether it is possible to predict the success of joint replacement surgery by looking at genetic risk factors.

This study will help doctors understand which patients are most likely to have good outcomes from joint replacement. It aims to improve patients’ experiences of surgery and make their new joints last longer.

我们的研究人员还在开发一种工具，以帮助患者根据他们的生活方式和需求做出有关治疗的明智决定。