Associated symptoms

The symptoms accompanying the pain can also be very helpful for the diagnosis. For example, overheating, swelling and redness of the joint indicate an inflammatory process. If the inflammation is of rheumatic origin, other joints are usually also affected.In rheumatoid arthritis, the finger joints are particularly affected.

Bechterew’s disease usually involves the spinal joints and the sacroiliac joint. In addition, this clinical picture often leads to stiffening of the joints and inflammation of muscle tendons. A iritis of the eye can also occur.

This is also present in arthritis associated with psoriasis. It is important here that the extent of the skin finding of psoriasis does not have to run parallel with the joint complaints. In the case of wear-related joint arthrosis, there are usually no other symptoms apart from the pain, which may initially be present only during movement, but later also at rest at night.

If the cause of the night-time hip pain is due to a malignant tumor, it can lead to fever, an unintended weight loss of more than 10% of the body weight and increased sweating during the night. If a poorly fitted mattress is the cause, there is usually not only hip pain, but also back or neck pain. The muscles are tense and aching.

Diagnosis

The diagnosis can be made by an orthopedist. The orthopedist will take into account the symptoms described, the results of the physical examination and an X-ray examination of the hip. For example, arthrosis can be reliably detected on the X-ray image. If rheumatic diseases are to be clarified, a blood test to test for certain antibodies can also be helpful. Under certain circumstances, an MRT examination can also be performed.

Treatment

Depending on the cause of the night-time pain, the therapy can either consist entirely of tablet therapy or be based primarily on physiotherapy. Surgical therapy is also possible for a few causes. Hip joint arthrosis is initially treated with the help of targeted physiotherapy, consistent training and a temporary intake of painkillers.

If the symptoms do not improve in the long term, an artificial hip joint can be fitted. The prognosis in this case is very good. An inflammation of the bursa is usually treated conservatively.

This means that immobilization and cooling of the leg or hip joint are the main focus. In addition, painkillers, such as ibuprofen, can be taken for a short period of time. If it is a bacterial inflammation that involves the entire body, antibiotics may be useful.

Likewise, surgical relief of the pus cavity in the bursa should then also be considered. Also with rheumatic illnesses physical training plays a large role in the long term. In acute attacks, the affected joint should be cooled and protected.

In addition, cortisone can provide short-term relief. In order to avoid further attacks, long-term treatment is carried out with so-called basic therapeutics (DMARD) such as methotrexate, which is also used for psoriasis. If this does not improve, immunosuppressive drugs such as cyclosporine or new antibody drugs such as Infliximab can be used. The suitability of the various drugs must be discussed individually with a doctor.