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Hip Pain & Disorders

Back Clinic Hip Pain & Disorders Team. These types of disorders are common complaints that can be caused by a variety of problems. The precise location of your hip pain can give more information about the underlying cause. The hip joint on its own tends to result in pain on the inside of your hip or groin area. Pain on the outside, upper thigh, or outer buttock is usually caused by ailments/problems with the muscles, ligaments, tendons, and soft tissues surrounding the hip joint. Hip pain can also be caused by diseases and conditions in other areas of your body, i.e. the lower back. The first thing is to identify where the pain is coming from.

The most important distinguishing factor is to find out if the hip is the cause of the pain. When hip pain comes from muscles, tendons, or ligament injuries, it typically comes from overuse or Repetitive Strain Injury (RSI). This comes from overusing the hip muscles in the body i.e. iliopsoas tendinitis. This can come from tendon and ligament irritations, which typically are involved in snapping hip syndrome. It can come from inside the joint that is more characteristic of hip osteoarthritis. Each of these types of pain presents itself in slightly different ways, which is then the most important part in diagnosing what the cause is.


Alleviating Hip Pain With Decompression Therapy

Alleviating Hip Pain With Decompression Therapy

Introduction

The body is a marvelous functional machine that requires constantly moving worldwide. The body can do everyday movements from the head to the feet and be in weird positions without feeling pain. However, ordinary factors like natural aging, wear and tear, and issues affect the body over time. When these factors start to affect the body, they can cause unwanted symptoms that can inflict pain on specific areas around the body. Some areas that suffer pain include the hips, lower back, neck, the body’s internal systems, and the spine, causing the individual to be miserable. Luckily many treatments do relieve pain in the body and help dampen the effects of the unwanted symptoms that are hindering the individual. Today’s article focuses on hip pain, its symptoms, and how decompression therapy can help many individuals suffering from hip pain. By referring patients to qualified and skilled providers specializing in spinal decompression therapy. To that end, and when appropriate, we advise our patients to refer to our associated medical providers based on their examination. We find that education is the key to asking valuable questions to our providers. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

 

Can my insurance cover it? Yes, it may. If you are uncertain, here is the link to all the insurance providers we cover. If you have any questions, please call Dr. Jimenez at 915-850-0900.

G-9 - DRX_ClinicalTrial

 

What Is Hip Pain?

 

Are you feeling stiffness from your lower back and hips? Do your hips hurt after falling due to playing sports? How about pain from the lower back to the hips down to the feet? You might be experiencing hip pain. Research studies have stated that hip pain can be associated with many factors that can cause many individuals to be in distress, impair their daily activities, and affect their quality of life. Hip pain can be associated with simple movements that are damaged, like sitting and standing, which can be hard after a while. Other associations that hip pain can occur can be lower back painneuropathiesherniation, or chronic pain. According to research studies, hip pain is considered a musculoskeletal disorder. It shows that posterior hip pain in adults is caused by osteoarthritis or traumatic causes like sacral stress fractures that can affect the hips. This musculoskeletal disorder can become a problem for many older adults suffering from hip issues. 

 

The Symptoms

Research studies have found that hip pain is a musculoskeletal complaint affecting young and old adults. Since hip pain is associated with various chronic issues, it can cause many individuals to be miserable and be in constant pain. For adults, hip pain can be one of the issues for those suffering from osteoarthritis in the anterior hip region. As research shows, in the posterior hip region, hip pain can be associated with chronic conditions like piriformis syndrome and lumbar radiculopathy that are centralized in the lower back. Other symptoms that hip pain cause on its own do associate with other chronic conditions, including:


Preparing For Lubar Traction Therapy-Video

Are you experiencing discomfort from your hips while sitting or standing? How about sharp, throbbing pain coming from your lower back and affecting your hips and legs? Do you feel tenderness and swelling on your joints? These symptoms are various forms of hip pain, and lumbar traction can help lower hip pain symptoms. The video above mentions how to prepare for lumbar traction therapy and how it can alleviate symptoms caused by hip pain. Lumbar traction helps compressed disc in the lumbar region of the spine to be restored to its original state and even takes the pressure off the sciatic nerve and other nerve roots that are causing hip pain to the body. Utilizing traction therapy increases the disc height and allows the lumbar spinal discs to be rehydrated again. Suppose you want to learn more about lumbar traction or decompression and how it can benefit you? In that case, this link will explain what decompression does for the lumbar area in the spine and provide relief from hip pain and its associates.


How Decompression Therapy Helps With Hip Pain

 

Since hip pain is associated with various other conditions that can affect the body, the most common condition that the body has suffered from is low back pain. There are ways to treat hip and low back pain; some individuals utilize heat and ice to neutralize the pain to go away, and others use chiropractic therapy to get the joints to realign themselves. One of the treatments used to relieve hip and low back pain is decompression therapy. Research studies have found that decompression therapy is safe and effective in helping to improve the blood circulation to the hips to provide relief to the hips. Since hip pain is associated with low back pain, decompression allows the herniated discs to be taken off the nerves surrounding the hips and provide pain relief. Other research studies show that traction is used to create negative gravity pressure to help reduce the pressure that is causing pain to the soft tissues and the nerve roots. This negative gravity allows the spine to separate and create more height for the disc to rehydrate while relieving the individual.

 

Conclusion

Overall the body is a marvelous machine that has the ability to move without pain. When issues start to affect the body, like the hips and lower back, it can cause the individual to suffer from various forms of pain. Since hip pain is associated with low back pain, it can lead to other chronic issues like sciatica or osteoarthritis, affecting the joints and causing them to swell. Treatments like decompression or traction therapy are used to alleviate the pain caused by the hips or lower back. When people incorporate decompression or traction into their wellness journey, they relax a bit as they are laid down and have their spine stretched slowly. This will cause them relief and take the pressure off the nerve roots that are sending pain signals to the brain. This ensures them that they can take back their lives pain-free.

 

References

Ahuja, Vanita, et al. “Chronic Hip Pain in Adults: Current Knowledge and Future Prospective.” Journal of Anaesthesiology, Clinical Pharmacology, Wolters Kluwer – Medknow, 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8022067/.

Battaglia, Patrick J, et al. “Posterior, Lateral, and Anterior Hip Pain Due to Musculoskeletal Origin: A Narrative Literature Review of History, Physical Examination, and Diagnostic Imaging.” Journal of Chiropractic Medicine, Elsevier, Dec. 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5106442/.

Choi, Jioun, et al. “Influences of Spinal Decompression Therapy and General Traction Therapy on the Pain, Disability, and Straight Leg Raising of Patients with Intervertebral Disc Herniation.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Feb. 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339166/.

Lee, Yun Jong, et al. “Causes of Chronic Hip Pain Undiagnosed or Misdiagnosed by Primary Physicians in Young Adult Patients: A Retrospective Descriptive Study.” Journal of Korean Medical Science, The Korean Academy of Medical Sciences, 11 Dec. 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300658/.

Wilson, John J, and Masaru Furukawa. “Evaluation of the Patient with Hip Pain.” American Family Physician, U.S. National Library of Medicine, 1 Jan. 2014, https://pubmed.ncbi.nlm.nih.gov/24444505/.

Disclaimer

Out Of Alignment Hips Decompression

Out Of Alignment Hips Decompression

Healthy hips are necessary for standing, sitting, walking, running, bending, twisting, lifting, etc. Hip problems can seriously interfere with everyday activities. Out of alignment hips don’t just cause pain and soreness in the hip area but can radiate to other body areas. When the hip joint is out of alignment, the rest of the body has to start compensating for the misalignment, which can cause chronic pain in the back and/or legs.

Out Of Alignment Hips Decompression

Out of Alignment Hips

Discomfort and soreness begin as occasional but can quickly become regular. Individuals may also begin to limp when they walk, have a reduced range of motion in the hips, and pain that escalates with physical activity and improves with immobility/rest. Out of alignment hips can be caused by:

  • Lifting incorrectly
  • Repetitively carrying heavy loads on one side of the body places uneven pressure on the pelvis, causing an imbalance.
  • Performing repetitive motions that begin to stress the joint
  • Wearing shoes that do not provide proper support
  • Standing and leaning on one leg regularly
  • Injury/trauma
  • Physical leg length discrepancy
  • Functional leg length discrepancy
  • Scoliosis

Physical Leg Length Discrepancy

If the legs are different lengths, this can cause the hips to go out of alignment. Using a foot wedge/foot orthotic in the shoe can remedy the situation.

Functional Leg Length Discrepancy

Functional leg length discrepancy is a common cause of hip misalignment, meaning that leg length is equal, but the individual is doing something to cause the hips to go out of alignment. It usually involves posture, standing, walking, sitting, lifting, and carrying improperly or awkwardly and repetitively could create functional leg length discrepancy.

Scoliosis

Scoliosis is only one cause of hip misalignment. It is not likely that an individual has scoliosis if they are an adult and have not previously been diagnosed with the condition. If a child has what looks like a misaligned hip, it is recommended to take them to get tested for scoliosis. Most children with the disorder will outgrow it, but they need to be monitored by a medical professional.

Symptoms include:

  • Uneven gait
  • Uneven shoulders
  • Hip pain on one side
  • Groin pain
  • Tight buttock muscles
  • Tight leg muscles
  • Back pain – upper and lower
  • Sciatica
  • Knee pain
  • Ankle pain

One of the most prominent signs that it is a hip problem is the presence of groin pain. Groin pain can radiate downward toward the buttocks, front of the thighs, and knees. The hip joint is located behind the groin; pain usually means the hip is the root cause.

Chiropractic Decompression

A chiropractic examination can identify uneven hips. Chiropractic and motorized spinal decompression can reset the hips to their proper position. A chiropractor will be able to rebalance the hips and help avoid invasive surgical treatments and long-term rehabilitation.


DRX9000 90 Seconds Spinal Decompression


References

Battaglia, Patrick J et al. “Posterior, Lateral, and Anterior Hip Pain Due to Musculoskeletal Origin: A Narrative Literature Review of History, Physical Examination, and Diagnostic Imaging.” Journal of chiropractic medicine vol. 15,4 (2016): 281-293. doi:10.1016/j.jcm.2016.08.004

Jones HR, Burns TM, Aminoff MJ, Pomeroy SL. Pain. Chapter: Diagnosis of Low Back, Buttock, and Hip Pain. Netter Collection of Medical Illustrations: Spinal Cord and Peripheral Motor and Sensory Systems, Section 8, 201-224.

Khamis, Sam, and Eli Carmeli. “A new concept for measuring leg length discrepancy.” Journal of orthopedics vol. 14,2 276-280. 27 Mar. 2017, doi:10.1016/j.jor.2017.03.008

Miyagi, Masayuki, et al. “Hip-spine syndrome: cross-sectional-study of spinal alignment in patients with coxalgia.” Hip international: the journal of clinical and experimental research on hip pathology and therapy vol. 29,1 (2019): 21-25. doi:10.1177/1120700018803236

Nunes, Guilherme S et al. “Acute Effects of Hip Mobilization With Movement Technique on Pain and Biomechanics in Females With Patellofemoral Pain: A Randomized, Placebo-Controlled Trial.” Journal of sport rehabilitation vol. 29,6 707-715. 18 Oct. 2019, doi:10.1123/jsr.2018-0497

Hip Sprain

Hip Sprain

The hips are highly active joints. Hip sprains are rare but do occur. A hip sprain is caused by tearing or stretching the ligaments that surround the hip and join the bones to each other. This is different from a hip strain, which is an injury to the muscles and is generally caused by over-use of the hip flexor muscles and tendons, causing them to tear. Hip sprains usually happen after a fall or a sudden twisting motion, which can occur during sports or an accident.

Individuals involved in sports that require quick stops, body shifting, and sudden direction changes, like soccer, football, basketball, tennis, volleyball, etc., have an increased risk. Most hip sprains can be effectively treated with conservative treatments like self-massage, rest, ice, and nonsteroid anti-inflammatory medications. For more severe cases, physical therapy and chiropractic can treat the condition.

Hip Sprain

Hip Sprain Symptoms

  • Tenderness in the hip increases when lifting the thigh.
  • Cramping sensation/s in the muscles of the upper leg.
  • Swelling in the hip or thigh
  • Bruising in the hip or thigh.
  • Sudden pain in the hip or pelvis.
  • Sharp pain in the hip or pelvis.
  • Pain that worsens when walking, running, or stretching the hip muscles.
  • Loss of strength in the front of the groin.
  • Tugging or pulling sensation.
  • Limping.

Diagnosis

The doctor or chiropractor will:

  • Look into medical history.
  • Inquire about symptoms.
  • Inquire about activities that could cause symptoms.
  • Perform a physical examination.
  • Ask the individual to perform a variety of movements to determine what type of injury has been sustained.
  • Other conditions could cause radiating pain.
  • Pain in one or both hips might not have anything to do with the hips but a pinched nerve root in the lower back.
  • Sciatica can develop when certain nerve roots in the lower back are irritated or compressed, causing symptoms to travel down the sciatic nerve and radiate around the pelvis and leg.
  • X-rays can help rule out hip stress fractures, which can have similar symptoms.
  • MRI or CT scans are used to see if any soft tissue damage has occurred.

Hip Sprain Treatment

  • Treatment usually begins with over-the-counter pain medications and anti-inflammatories to reduce swelling and relieve pain.
  • Resting the hip will help prevent further damage.
  • Applying ice will help prevent tissue damage and reduce swelling.
  • It is recommended to use an ice pack several times a day for the first 48 hours after an injury.
  • Once the swelling goes down, a chiropractor and physical therapy team will create a personalized treatment plan that includes:
  • Adjustments.
  • Exercise therapy.
  • Posture training.
  • Stretching.
  • Massage.

Treatment/Rehabilitation Objectives

  • Reduce inflammation.
  • Relax muscle spasms.
  • Strengthen weakened muscles.
  • Improve joint mobility.

Individuals will be shown how to prevent the risk of sprains in the future. This includes:

  • Avoiding exercising when the body is tired
  • Wearing proper footwear and protective equipment
  • Warming up properly before exercise/physical activities.

Depending on the severity of the sprain, surgery could be the last resort to repair the ruptured or torn ligaments.


Body Composition


Realistic Goals

Not seeing results after putting in the work through exercise and diet can be frustrating. Setting realistic goals can help when results are not showing.

Realistic Fat Loss

  • Do not expect actual fat loss without being in a caloric deficit.
  • The body needs to use more energy than the amount of food/energy taken in; otherwise, excess energy/food gets stored, primarily as adipose tissue.
  • Total Daily Energy Expenditure or TDEE is necessary to set a realistic caloric deficit to achieve measurable fat loss.
  • There are caloric deficit variations, but most doctors, dieticians, trainers, and fitness experts agree that a caloric deficit of around 500 calories a day that equals to about 3,500 calories a week will result in a pound of fat loss per week.
  • One pound of fat a week lost might seem slow, but the one pound of fat is a real pound removed.
  • The long-term goal is not to fall back into unhealthy habits and develop and maintain new healthy ones.
References

Brantingham JW, Globe GA, Cassa TK, et al. A single-group pretest posttest design using full kinetic chain manipulative therapy with rehabilitation in the treatment of 18 patients with hip osteoarthritis. Journal of Manipulative and Physiological Therapy 2012; 33(6): 445-57.

Kamali, Fahimeh and Esmaeil Shokri. The effect of two manipulative therapy techniques and their outcome in patients with the sacroiliac joint syndrome. Journal of Bodywork and Movement Therapies. 2012; 16: 29-35.

McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ. Manipulation or microdiscectomy for sciatica? A prospective randomized clinical study. Journal of Manipulative and Physiological Therapeutics. 2010; 33(8): 576-584.

Tibor, Lisa M, and Jon K Sekiya. “Differential diagnosis of pain around the hip joint.” Arthroscopy: the journal of arthroscopic & related surgery: official publication of the Arthroscopy Association of North America and the International Arthroscopy Association vol. 24,12 (2008): 1407-21. doi:10.1016/j.arthro.2008.06.019

Wedro, Benjamin. “Hip Pain: Causes, Symptoms, Treatment Information and Diagnosis-eMedicineHealth.” http://www.emedicinehealth.com/hip_pain/article_em.htm.

Tense Hips, Hamstrings, and Back Pain

Tense Hips, Hamstrings, and Back Pain

The body is a connected whole and more than just separate parts and regions. When back pain presents, it might not be the back muscles or spine but could be tense, tight hips, and hamstrings causing low back pain. How it happens, how to stretch and loosen up, and target these areas could help alleviate the pain.

Tense Hips, Hamstrings, and Back Pain

The Hips and Hamstrings

When the hip flexors and hamstrings become tense, the tightness can alter the pelvic alignment. This affects spinal alignment leading to discomfort and low back pain. The hip flexors are a group of muscles around the front of the hips, and they activate when moving the leg and knee upward. The hamstrings are the muscles in the back of the thighs that allow for flexion of the knees and hip extension. Muscle tightness in the hips and/or hip joint stiffness can also contribute to low back pain. Not being able to rotate, flex, or extend the hip forward or backward can affect:

  • Walking
  • Running
  • Swinging
  • Twisting movements
  • This increases mechanical strain on the lower back.

Hamstring tightness can be a side effect of:

  • Low back pain
  • Pelvic positioning
  • Muscle guarding
  • Weakness
  • All can contribute to the hamstrings feeling tight.

Tense Hips and Hamstrings

The factors creating this tightness can come from:

  • A sedentary lifestyle
  • Little to no physical activity
  • Sitting too long with no stretching or movement.
  • Injury
  • Intense workout

Losing the ability to function through the entire length of motion can also indicate muscle weakness and a lack of joint movement where the joint around the muscle becomes stiff. This can be caused by:

  • A lack of movement
  • Arthritis
  • Age-related changes

Stretching and Treatment

Stretching exercises can be the first line of treatment. It is recommended to start with gentle stretches targeting these areas. What works best for the individual is the stretch they are comfortable repeating enough to make a difference. Warming up the muscles first will generate the best results. An easy place to begin is a gentle forward fold stretch.

  • Stand up straight, or sit with the legs extended out in front.
  • Then, reach with the fingers toward the toes. Don’t worry if you can’t reach them.
  • Don’t bounce.
  • Hold the position for a few seconds.
  • Repeat five to 10 times.

For the hip flexors, stretches include:

If the stretching does not bring relief, it is recommended to progress to a personalized treatment and stretching program with a chiropractor or physical therapist. Chiropractic and physical therapy can relieve the problems without medication, injections, or surgery and provide lifelong techniques for maintaining optimal flexibility, mobility, and strength. The hands-on treatment loosens and relieves the tense tightness, reinforcing the flexibility and range of motion. Treatment includes:

  • Joint mobilization to the hips and spine.
  • Soft tissue mobilization.
  • A personalized strengthening program with stretches and exercises that target the specific muscles.
  • Health coaching.
  • Anti-inflammatory diet recommendations.

Body Composition


Monounsaturated Fats

Monounsaturated fat is considered healthy fat. This type of fat makes up a significant component of the Mediterranean diet. Studies have shown monounsaturated fats like extra-virgin olive oil can help prevent adverse events related to cardiovascular disease. A meta-analysis evaluating diets high in monounsaturated fats indicated a significant reduction in:

  • Triglycerides
  • Bodyweight
  • Systolic blood pressure in individuals with type II diabetes.
  • A significant increase in HDL or good cholesterol.

Another study showed the protective effects of monounsaturated fatty acids reduced the risk factors associated with metabolic syndrome and cardiovascular disease. Monounsaturated fats can have a positive impact on overall health. Monounsaturated fat sources include:

  • Olive, peanut, and canola oil
  • Avocados
  • Almonds
  • Pecans
  • Hazelnuts
  • Sesame and pumpkin seeds
References

Estruch, Ramón et al. “Retraction and Republication: Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. N Engl J Med 2013;368:1279-90.” The New England journal of medicine vol. 378,25 (2018): 2441-2442. doi:10.1056/NEJMc1806491

Gillingham, Leah G et al. “Dietary monounsaturated fatty acids are protective against metabolic syndrome and cardiovascular disease risk factors.” Lipids vol. 46,3 (2011): 209-28. doi:10.1007/s11745-010-3524-y

American College of Physicians. (February 2017) “American College of Physicians issues guideline for treating non-radicular low back pain” https://www.acponline.org/acp-newsroom/american-college-of-physicians-issues-guideline-for-treating-nonradicular-low-back-pain

MedlinePlus. (2019) Hip flexor strain – aftercare https://medlineplus.gov/ency/patientinstructions/000682.htm

NCBI. (2021) Hamstring Injury https://www.ncbi.nlm.nih.gov/books/NBK558936/

Scoliosis and Hip Pain

Scoliosis and Hip Pain

Scoliosis causes the spinal curvature to go sideways and can cause various symptoms. One of the most common symptoms is scoliosis hip pain. This happens because the spine’s curvature can pull the hips out of alignment, causing one side to be raised higher than the other. A result of this is one hip begins to take on more weight. This overloads the hip causing strain, soreness, aches, and pain, especially after standing or walking.

Scoliosis and Hip Pain

Scoliosis Hip Pain

Idiopathic scoliosis typically occurs in children, but often there are no pain symptoms. This type of scoliosis can go on unnoticed and undiagnosed for years even until adulthood. When the spine stops growing, even a small scoliosis curve can cause hip pain. The hip pain varies but generally presents with:

  • Sharp pain.
  • Throbbing pain.
  • Pain that increases with activity like walking, running, standing for a long time.
  • Stiffness with combined pain after sitting or lying down for a long time.
  • Sciatica.
  • Numbness.
  • Tingling.
  • Tight hip flexors.

The amount of pain depends on:

  • The misalignment severity.
  • The type of scoliosis – degenerative or idiopathic.
  • Bodyweight. Individuals that are obese are more likely to have severe hip pain because of the added weight.
  • Activity level. Physical activity can cause the pain to worsen.
  • Lifestyle.
  • It varies from person to person.

The Higher Hip

When scoliosis has progressed enough, the curvature and uneven hips are pretty apparent. However, only around 10% of scoliosis cases get this far. If the curvature is minimal, which is usually the case, trying to determine which hip is higher usually requires medical assistance.

  • The hip that presents with pain is generally the one taking on more weight.
  • This causes the muscles to fatigue faster and places added stress on that hip joint.
  • A way to tell which hip is higher stand on bare feet in front of a mirror holding a piece of yarn, or string with both hands.
  • Place the heel of each hand on the corresponding hip bone.
  • The string will be tilted if the hips are uneven or will be straight if they are not.

Adult Scoliosis

Hip pain caused by scoliosis is most common in adults. However, it is not the only cause of hip pain. Unless diagnosed with scoliosis as a child, individuals may be suffering from de novo scoliosis or degenerative scoliosis.

De Novo/Degenerative Scoliosis

As the body ages, the spinal discs between the vertebrae begin to wear down. The worn-down discs can cause the spine to develop a sideways curve, that can pull the hips out of alignment. Studies are showing that this type of scoliosis is widespread. Loss of bone density can be a contributor to scoliosis in older adults. Bone density loss from menopause means women are more susceptible than men. Past the age of 70, both men and women lose on average, the same amount of bone density. There are effective integrative, natural treatment therapies that incorporate:

  • Exercises
  • Nutrition
  • Posture correction
  • Chiropractic
  • Physical therapy

Scoliosis Hip Exercises

For uneven hips, there are exercises to help relieve pain and strengthen weak muscles.

Hip Stretch

  • Lie on the back with both legs straight out.
  • Lift the right leg
  • Using the hands pull the knee toward you, keeping the foot pointed up.
  • Pull the knee to your chest as far as you can without causing discomfort or pain.
  • Hold for 5 to 8 seconds.
  • Release.
  • Switch to the other leg.
  • Repeat 4 to 6 times on each leg.

Wide Leg Stretch

  • Sit on the floor with the legs as wide as they can go.
  • With the right hand, reach toward the left foot, touching if possible.
  • Return to the original position.
  • With the left hand, reach toward the right foot.
  • Repeat 6 to 8 times.

Chiropractic

If misaligned and uneven hips are causing pain, chiropractic care for scoliosis is recommended. Spine and hip realignments help relieve pain, stretch the muscles, and corrects posture. One study showed that multi-approach chiropractic for adult scoliosis was found to be beneficial even two years after treatment was finished. Injury Medical Chiropractic and Functional Medicine Clinic can help with recommending nutrition and lifestyle tips. Instead of just treating symptoms, our team helps manage the cause.


Body Composition


Body Analysis for Disease Prevention

Early identification of disease is imperative for developing the proper treatment plan. Testing can help improve long-term health outcomes. Testing is made easy with the data being easily implemented into patient management software. A comprehensive printout is ready for engaging and educating patients in understanding health risk management and reduction. In 60 seconds, an InBody Test will generate easy-to-understand, accurate, and objective measurements to evaluate potential disease risk. Medical providers can use the InBody to:

  • Monitor muscle, and visceral fat to provide an accurate measure of health risk.
  • Monitor muscle distribution to determine specific health risks related to diseases.
  • Identify fluid imbalances associated with certain diseases.
  • Track changes for effective long-term risk identification and reduction.
References

https://www.aafp.org/afp/2001/0701/p111.html#afp20010701p111-b1

https://link.springer.com/content/pdf/10.1007/s00586-020-06453-0.pdf

https://www.healthline.com/health/uneven-hips

https://www.sciencedirect.com/science/article/abs/pii/S1556370711000915

Anterior Pelvic Tilt Downward Posture Hip and Back Pain

Anterior Pelvic Tilt Downward Posture Hip and Back Pain

APT is short for anterior pelvic tilt.  APT is when the pelvis tilts more down than forward, which can cause strain on the surrounding muscles and the spine to hold the torso up. The body’s own anatomical structure causing the condition and/or part of a bad habit that an individual has grown accustomed to. This can be from injury/s, back, and/or hip pain causing an individual to take on awkward postures to compensate for the discomfort and try and avoid it. However, these unhealthy postures cause their own set of musculoskeletal problems. Addressing this form of poor posture can help reduce and alleviate low back and hip pain and prevent further injuries.  Chiropractic can pinpoint an anterior pelvic tilt and fix it.

Anterior Pelvic Tilt

What happens is the pelvis becomes tilted or rotated forward. Place the hands, specifically the fingertips, on the hips. There are bone ridges. These are the iliac crests. If they’re facing more toward the ground than directly forward, this could be an anterior pelvic tilt. It usually happens when the hip flexors become tight and pull the pelvis down. Another contributor is the glute and hamstring muscles have weakened and are not strong enough to counteract the forward pulling. This can be caused by sitting for long periods, poor posture, and for women who wear high heels regularly. These contribute to tightening the hip flexors and the glutes, hamstrings, and core muscles.

Anterior Pelvic Tilt Downward Posture Hip and Back Pain

 

An anterior pelvic tilt causes an increase in the curve of the lower back. It can feel like the hip flexors are tightening up. It typically affects the lower back at the lowest two levels, which are L4-5 and L5-S1. There can be long-term issues if an anterior pelvic tilt is left untreated. The spine becomes more vulnerable to disc issues that can include:

  • Compressed degenerative disc
  • Disc tears, aka annular tears
  • Disc bulges
  • Herniation

Exercises

An anterior pelvic tilt is a repairable condition. Several exercises can help loosen/relax the hip flexors and strengthen the core and posterior muscle chain. This in addition to walking and reducing wearing high heels regularly. A few exercises for anterior pelvic tilt.

The Tail Tuck

This is literally trying to tilt the tailbone forward, like tucking in an imaginary tail. This can be done for 10-12 reps and up to 3 times.

Plank

Core-strengthening exercises can help with all types of back and hip problems. If possible, do the exercises in front of a mirror to ensure no arching of the back or the butt sticking out. If it is too difficult on the hands, go to the elbows. If there are wrist or shoulder issues, planks can be done on a raised surface, like a table or couch. Hold as long as possible, maintaining proper form. Start with 10-30 seconds and build up to minutes.

Strengthening the Glutes

It is recommended to strengthen the glute muscles. This can be done with exercises like clams or side-stepping with resistance bands. For clams, lie on the side and raise each leg up and down 10-12 times, up to 3 sets. For side-stepping, place resistance bands around the ankle/shin area and step to the side for 8-10 steps. Then go the other direction for the same number of steps. Repeat up to 3 sets.

Hip Flexor Stretch

Lunge forward while standing or lunge and kneel with the other leg on the ground. Then move the torso back a little and engage the core to stretch the hip flexors in the front of the thigh/pelvis area. Hold for 30 seconds, then release. Repeat 3-5 times per leg.

Lifestyle

These exercises can help, but if there is no progress around a month, contact a qualified chiropractor or physical therapist for further instruction and supervision. Also, if any neurological symptoms present like:

  • Sciatica
  • Shooting pain
  • Numbness
  • Tingling
  • Weakness
  • See a doctor as soon as possible.

Fixing posture-related problems require individuals to learn to be posture aware along with making some lifestyle adjustments. One way to do these exercises is to tack them onto a workout. Also, set reminders on a calendar to get up, stretch, and move around if sitting most of the day.


Body Composition Health


Difference between Processed sugar and Natural sugar

There are different types of sugar. There are natural sugars that are found in:

  • Fruits
  • Vegetables
  • Nuts
  • Whole grains
  • Beans

All sugar is broken down into glucose. However, foods that contain natural sugar are also rich in nutrients, including:

  • Vitamins
  • Minerals
  • Fiber
  • Protein
  • All which the body requires for optimal health.

Natural sugar does not lead to excess sugar intake; it happens with processed sugar. Processed sugar is extracted from sugarcane or sugar beet and is normally found as sucrose. This is present in cakes, cookies, cereal, and beverages. Processed sugar is also hidden in foods that are not sweet, like:

  • Microwave meals
  • Spaghetti sauce
  • Low-fat yogurt
  • Ketchup
  • Sports drinks

Foods that contain processed sugar are an energy source, but they contain little or no nutrients and can cause blood sugar levels to spike. In addition, consuming too much sugar is linked to an increased risk of:

  • Diabetes
  • Accelerated aging
  • Weight gain

Research has found that added sugar contributes to around 17% of the total calorie intake for adults. The recommended daily amount of calories from added sugar is 10%.

References

Azaïs-Braesco, Véronique et al. “A review of total & added sugar intakes and dietary sources in Europe.” Nutrition journal vol. 16,1 6. 21 Jan. 2017, doi:10.1186/s12937-016-0225-2

Centers for Disease Control and Prevention (CDC). (May 2020) “Acute Low Back Pain” https://www.cdc.gov/acute-pain/low-back-pain/index.html

National Institute of Neurological Disorders and Stroke. (March 2020) “Low Back Pain Fact Sheet” https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet

Orlando Health. (2019) “Bad Posture Often to Blame for Chronic Pain and Health Issues, But Survey Finds Too Few Americans Are Concerned” https://www.orlandohealth.com/content-hub/bad-posture-often-to-blame-for-chronic-pain-and-health-issues

Pelvic Pain and Chiropractic Relief

Pelvic Pain and Chiropractic Relief

The pelvis is designed to bear and distribute the weight of the body along with regular everyday movement. It is built to properly distribute weight between the upper and lower body that utilizes the core muscles, ligaments, and joints creating a complex pelvic girdle that helps the body function properly. The bones of the pelvis house and protect organs like the:

  • Reproductive system
  • Bladder
  • Below the digestive tract

When pain in the pelvis presents, daily physical activities can become difficult to get through. Chiropractic treatment combined with lifestyle adjustments can bring pain relief and strengthen the pelvis muscles/bones to maintain optimal function.

11860 Vista Del Sol, Ste. 128 Pelvic Pain and Chiropractic Relief

Causes of Pelvic Pain

When pain presents there can be a variety of underlying causes contributing to it. Certain causes are more serious than others. This is why seeking professional medical guidance is highly recommended for the best outcomes. Possible causes include:

11860 Vista Del Sol, Ste. 128 Pelvic Pain and Chiropractic Relief

These are a few causes that can contribute to mechanical changes and imbalances within the pelvis anatomy. If the pain is thought to be caused by an internal organ issue with nausea, fever, vomiting, or severe pain contact a healthcare provider immediately.

Chiropractic Relief

The pelvis can be thought of as a direct continuation of the spine. The lowest fused five vertebrae are known as the sacrum and are part of the pelvic girdle complex. Individuals dealing with pelvic pain typically experience the sensation within the joints themselves. These are the pubic symphysis and/or sacroiliac joints. These joints interact with the entire skeletal system. Learning how they operate can help bring relief and recovery. This is where a chiropractor can help.

11860 Vista Del Sol, Ste. 128 Pelvic Pain and Chiropractic Relief

Chiropractors are experts in total body alignment, restoring balance to the pelvis and spine. Plus through the treatment, they help increase the body’s natural ability to heal itself. When the lower back or pelvis is out of alignment the entire body along with its systems can be thrown off balance causing dysfunction. Chiropractic promotes and increases balance with pelvic adjustments and diverse therapies that include:

  • Manual adjustments
  • Mobilization
  • Therapeutic Massage
  • Physical activity/exercise training
  • Neutral spine training
  • Health coaching
  • Nutrition
  • Body Composition Analysis

Restoring Pelvic Balance

A professional chiropractor is one of the best options for the management and alleviation of pelvis pain. Pelvis misalignment can impede nerve energy and adequate blood flow. Chiropractic restoration strengthens and maintains optimal long-lasting results. Whether the pelvic pain comes from an injury, pregnancy, or pelvic shift/imbalance, a chiropractic provider can help address and alleviate the pain.

Body Composition

Lifestyle Adjustments for Optimal Kidney Health

The kidneys are small organs that work twenty-four-seven to filter blood and flush waste. In one day the kidneys pump more than 400 gallons of recycled blood throughout the body. When the kidneys do not function properly the body can be engulfed with waste. This is why it is vital to keep them healthy. Individuals usually don’t realize how an unhealthy lifestyle can harm/injure the kidneys. Chronic kidney disease slowly progresses over years, and it is not reversible. Incorporating some basic healthy lifestyle adjustments can lower the risk of developing kidney-related diseases. Here are a few lifestyle adjustments that can keep the kidneys healthy.

Drinking plenty of water

An adequate supply of water in the kidneys flushes out sodium, urea, and toxins helping avoid kidney stones. The goal is to drink eight 8-ounce glasses of water every day. Everyone’s water levels are different but body composition analysis can calculate what a normal level should be.

Healthy foods maintain a healthy body

Poor diet and visceral fat gain have been linked to chronic kidney disease. Reducing visceral fat can be achieved by eating a restricted caloric diet of vegetables, fruit, and lean protein, as well as cutting back on processed foods.

Be cautious consuming supplements, antibiotics, and over the counter medications

Regular use of common medications and supplements can cause kidney damage and disease. Consult with a doctor before taking medications and supplements if there is kidney function impairment.

Fitness and activity

Individuals need to participate in regular cardiovascular and weight-resistance physical activity/exercise. High blood sugar levels have been shown to stress the kidneys. Building adequate muscle mass helps control blood sugar.

Smoking and kidney health issues

Smoking narrows the blood vessels in the kidneys. This reduces proper blood flow and accelerates kidney malfunction.

Disclaimer

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP, CIFM, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico

References

Harvard University. (07/2013)  
“Fight Kidney Disease with a Better Diet, weight loss and smoking cessation.” https://www.health.harvard.edu/diseases-and-conditions/fight-kidney-disease-with-a-better-diet-weight-loss-and-smoking-cessation

Kim DH, Cho D, Dickman CA, Kim I, et al. Surgical Anatomy & Techniques to the Spine. 2nd Ed. Saunders, Elsevier, Inc. Philadelphia, PA.

Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: An Overview of the Anatomy, Etiology, and Treatment of Coccyx Pain. Ochsner J. 2014 Spring;14(1): 84-87.

Mayo Clinic, 10.12.20, “Kidney Infection” (08/2020)  https://www.mayoclinic.org/diseases-conditions/kidney-infection/diagnosis-treatment/drc-20353393

The University of Michigan Medicine. (06/2019) “ Upper and Middle Back Pain” https://www.uofmhealth.org/health-library/aba5320#:~:text=In%20most%20cases%2C%20upper%20and,muscle%20or%20group%20of%20muscles

Hip Realignment for Imbalanced Hips with Chiropractic

Hip Realignment for Imbalanced Hips with Chiropractic

The number of individuals experiencing hip along with back pain is increasing and could benefit from chiropractic hip realignment. Chiropractic treatment is the recommended first-line option for hip pain and other issues related to misaligned hips. It is non-invasive and allows the body to heal naturally.

Shifted Hips

Hips that fall out of proper alignment have the potential to cause a variety of health issues in the body. The hips support a great deal of the body�s weight and facilitate substantial movement. The hips need to be properly balanced to allow for optimal mobility without compensation from the lower back and legs. A shift in the hips can occur from:
  • A sedentary lifestyle can cause anterior pelvic shifts
  • Repetitive/Overuse injury/s
  • Sports injury/s
  • Work/Personal injuries
  • Arthritis
  • Osteoporosis
  • Pinched nerve/s
  • Trauma
11860 Vista Del Sol, Ste. 128 Hip Realignment for Imbalanced Hips with Chiropractic
Shifted hips can cause pain in the low back, hips, and legs. This occurs from an altered gait and range of motion in this region. However, the hip joints, pelvic bones, muscles, and ligaments can all contribute to hip shifting and pain. Hip issues can also cause sciatica.

Hip Function

The hips do not receive as much attention until aches and pain start to present. Our hips are involved in nearly everything we do, providing numerous functions. It is no wonder they can cause tremendous pain when they’re out of alignment. The hips:
  • Keep the body upright
  • Bear the body’s weight
  • Allow for smooth:
  1. Walking
  2. Kicking
  3. Running
  4. Jumping
  5. Sitting
hips

Hip Adjustment

How to know if a hip adjustment is necessary? If there is any type of discomfort, soreness, and especially pain, a chiropractor is the best medical professional to perform an examination and recommend if an adjustment is necessary or could just need ice/heat and rest. However, if the source is being caused by another condition or injury the chiropractor will recommend the proper health care professional/specialist that can treat the issue. Hip pain can also be brought on from a different part of the body having its own issues. One of the most common types of hip pain is actually from a hernia or sciatica.
11860 Vista Del Sol, Ste. 128 Hip Realignment for Imbalanced Hips with Chiropractic

Chiropractic Hip Realignment

Chiropractic techniques focus on rebalancing the body, especially when realigning the hips. Manual manipulation and mobilization treatment techniques can improve flexibility, strength, and positioning to promote optimal balance and hip realignment. A combination of adjustment techniques can be performed on the hip and spinal joints. Massage treatment can be incorporated into the treatment plan to loosen tight muscles, as the hips are realigned and are able to move freely. The holistic nature of chiropractic doesn’t just treat just the symptoms but identifies and treats the root cause. If the pain continues or worsens then the possibility for hip surgery could be recommended.

Complex Treatment

 
Working on imbalanced hips is not as straightforward as adjusting the low back. This is because there are a variety of arteries, nerves, joints, muscles, and other tissue structures that need to be considered during hip realignment. A chiropractor will use a careful combination of techniques when treating an imbalanced hip due to the complex nature of the area. In addition to chiropractic adjustments, chiropractors will suggest ways to improve hip mobility at home. This includes:
  • Stretches
  • Posture work
  • Exercises
These will help prevent the hips from shifting out of alignment. Treating pain at its source is what chiropractors do. Chiropractic hip realignment along with the realignment of the spine will allow the body to move freely, maintain balance and strength.
 

Hip Labral Tear Rehabilitation


 

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Okuzu, Yaichiro et al. �Hip-Spine Syndrome: Acetabular Anteversion Angle Is Associated with Anterior Pelvic Tilt and Lumbar Hyperlordosis in Patients with Acetabular Dysplasia: A Retrospective Study.��JB & JS open access�vol. 4,1 e0025. 29 Jan. 2019, doi:10.2106/JBJS.OA.18.00025
Osteonecrosis of Femoral Head Misdiagnosed As Sciatica

Osteonecrosis of Femoral Head Misdiagnosed As Sciatica

Osteonecrosis is a condition that causes the death of bone tissue from temporary or permanent loss of blood supply to the affected area. It is commonly known as Avascular necrosis and can lead to miniature/tiny breaks in the bone and the bone/s eventually collapsing. Specifically, it affects the upper part of the femur or femoral head and surrounding joints.  
11860 Vista Del Sol, Ste. 128 Sciatica or Osteonecrosis of Femoral Head? A Common Misdiagnosis
 
It can occur in any bone however, osteonecrosis typically affects the hip/s. Pain associated with osteonecrosis of the hip can be localized to the center of the groin, thigh, or buttock. Because of the hip joint’s close proximity to the sciatic nerve, misdiagnosis for sciatica is common.  
 

Mimicking Sciatica Symptoms

Unfortunately, many health care providers can misdiagnose osteonecrosis hip pain as sciatica. Whatever the cause of the hip injury, most individuals with hip pathology report pain in the groin, upper thigh, and buttocks. That is why a trained medical professional that knows the differences in the symptoms of each condition can make all the difference in making a proper diagnosis. And a proper diagnosis leads to proper and complete treatment of whichever condition it may be. With osteonecrosis, misdiagnosis often delays the proper treatment and continues to progress. Common symptoms of sciatica:
  • Leg pain is the primary symptom can be mild to severe
  • Low back pain is secondary can be mild to severe
  • Nerve-related symptoms
  • Numbness
  • Tingling
  • Shooting pain
  • Pins-and-needles sensation
  • Muscle weakness
  • Hip pain especially flexion and internal rotation of the hip.
  • Leg or foot weakness
11860 Vista Del Sol, Ste. 128 Osteonecrosis of Femoral Head Misdiagnosed As Sciatica
 

Osteonecrosis Symptoms and Similarities

For many, there are no symptoms in the early stages of osteonecrosis. As the condition worsens, the affected joint could present pain symptoms only when weight is placed on it. Eventually, individuals begin to feel the pain even when lying down. Pain can be mild to severe with a gradual development. Other symptoms that mimick sciatica:

Walking Inability

Walking gait is complicated with both conditions which is a major cause behind the misdiagnosis.

Limping

Individuals often limp with osteonecrosis of the hip and spinal disc problems. This is another reason that the condition is misdiagnosed as a spinal disc problem or nerve root compression of the sciatic nerve.

Hip Pain

The tributaries/veins of the sciatic nerve also supply the hip area and often cause confusion between the two conditions.  
 

Differences

Despite all of the similarities. There are differences in both conditions.

Nature of The Pain

  • With sciatica, the pain is related to the nervous system. Movement can complicate the pain. While rest helps to reduce the pain.
  • With Osteonecrosis the pain is geared toward the muscular. Rest does not help reduce the pain. In fact, the pain increases at night.

Location

  • Sciatica pain can radiate through the whole leg from the low back to the toe.
  • Osteonecrosis pain is confined to the hip joint, groin, and radiates to the knee joint only. Osteonecrosis pain does not radiate below the knee joint.

Restricted Movement

  • Osteonecrosis of the hip joint, means the movements involving the hip joint are restricted. Individuals cannot rotate the leg to the right and left. Individuals cannot bend or fold from the hip.
  • With sciatica, the rotation of the leg is not affected. Movements involving stretching the sciatic nerve can cause relief or pain.

Walking Gait Differences

Gait is the way an individual stands and walks.
  • Osteonecrosis of the hip joint causes individuals to not be able to open the hip joint properly or to step properly.
  • With sciatica, an individual tends to lean on their side to relax the compression on the nerve.

Risk Factors

More than 20,000 people enter hospitals for the treatment of osteonecrosis of the hip yearly. Other than the hip, areas of the body likely to be affected are the shoulder, knee, hand, and foot. The condition can occur for a variety of reasons. A few of these include:
  • Fracture – a broken bone can interrupt the blood flow to other sections of the bone.
  • Dislocation of bone or joint/s
  • Alcoholism
  • Trauma
  • Radiation damage
  • Steroid use
Some individuals can have more than one condition or injury that contributes to hip flexor pain. An example is that it is possible to have both hip osteoarthritis and hip impingement. Without proper treatment, the condition can worsen, causing joint or hip pain from the degradation of the bone.  
11860 Vista Del Sol, Ste. 128 Osteonecrosis of Femoral Head Misdiagnosed As Sciatica
 
Anyone can be affected, but osteonecrosis is most common in individuals aged 30 to 50. Treatment options include a total replacement of the hip known as arthroplasty. And if it is sciatica then chiropractic treatment is a first-line treatment protocol. However, a chiropractor can make the distinction between the two and treat sciatica or refer the patient to the proper specialist.
 

Lower Back Pain Relief


 

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Li, Wen-Long et al. �Exploring the Risk Factors for the Misdiagnosis of Osteonecrosis of Femoral Head: A Case-Control Study.��Orthopaedic surgery, 10.1111/os.12821. 16 Oct. 2020, doi:10.1111/os.12821
Hip Issues Could Be Source of Lower Back Pain

Hip Issues Could Be Source of Lower Back Pain

Back discomfort and pain could be caused by hip issues and could be resolved with hip replacement. According to a recent study, a total hip replacement solved back pain in four out of five individuals dealing with spinal discomfort and pain. When the hip/s are stiff or cannot move normally, this places added pressure on the spine. Studies show that low back pain was resolved in 82% of individuals after a total hip replacement known as total hip arthroplasty or THA. The body is designed as a fluid chain with fluid motion connecting the neck all the way down to the toes. When a region like the hip tightens/stiffens, it generates added stress/pressure on the other areas of the body, which in this case happens to be the lower spine. Individuals with mild arthritis of the spine are able to experience increased pain reduction than individuals with severe arthritis. An insight into the relationship between the hips and low back that can lead to accurate diagnoses and optimal treatment plans.  
11860 Vista Del Sol, Ste. 128 Hip Issues Could Be Source of Lower Back Pain
 

Hip Issues

The hip/s move with the lower back during activities like walking, sitting, bending, etc. Tight muscles, normal wear-and-tear, and osteoarthritis can reduce hip movement, forcing the lower back to make awkward and poor posture causing adjustments. Individuals usually relieve the painful position by increasing the curve of their lower back. If an individual has severe arthritis of the hip, they put a lot of stress and pressure on the low back that often results in low back pain. Advanced hip osteoarthritis is the breakdown of joint cartilage and the most common type of arthritis. Individuals with this type experience low back pain 50% of the time, and even higher depending on the individual’s condition. 80% to 90% of individuals with hip or knee arthritis, unfortunately, develop low back arthritis. There is not yet a clear reason as to why this occurs. It is theorized that some osteoarthritis risk factors like obesity and high-impact/force activities can be modified with lifestyle adjustments. Other risk factors that include injury, trauma, age, and congenital conditions like hip dysplasia, cannot be avoided. Hip osteoarthritis isn�t the only hip issue that can also cause lower back pain. Other hip issues.

Sacroiliac joint dysfunction

The sacroiliac joint connects the sacrum to the pelvis. It is a shock absorber between the upper body, the pelvis and can stiffen with time. Sacroiliac joint pain affects around 15% to 25% of individuals with low back pain. It worsens when climbing stairs, getting up from a seated position or running. Symptoms include:
  • Low back pain
  • Pain in buttock/s
  • Groin pain
  • Stiffness
  • Instability

Piriformis syndrome

About 200,000 individuals each year are affected with piriformis syndrome and is often misdiagnosed as symptoms resemble sciatica. What happens is the piriformis muscle, which connects the sacrum to the top of the femur, tightens/irritates the sciatic nerve. Symptoms are often mistaken for sciatica with pain in the buttocks, numbness, and tingling that travels down the back of the leg and into the feet.  
11860 Vista Del Sol, Ste. 128 Hip Issues Could Be Source of Lower Back Pain
 

Diagnosis

A doctor or chiropractor will use a combination of diagnostic tools. This typically includes a physical exam, X-rays with other specific tests to help identify the source of pain. What typically happens is a patient will undergo a hip and lumbar spine X-ray, but the thoracic spine, pelvis, and hip areas are missed. Getting the middle segment is critical to see how the spine and hips are working together. It is critical to understand the hip-spine connection. All spine patients should have X-rays of the hips to make sure any problems don’t go undetected. The overlap of symptoms with these two areas could be overlooked. If necessary a diagnostic injection into the hip joint can help precisely locate the pain source. This can be done at the clinic or doctor’s office using ultrasound or X-ray to guide the needle. If no pain relief results from the injection, hip replacement is still not considered because the pain could be coming from the spine. A critical part of the diagnosis is not just imaging. One of the most important parts is getting a thorough history of symptoms. X-rays and MRI show what the problem could be, however, the symptoms could coming from another area.

Treatment Options

Before total hip replacement is considered there are nonsurgical approaches to be considered. All diagnoses should start with conservative treatment. Physical therapy, chiropractic, gait training, and core strengthening can optimize the spine to better manage hip issues and arthritis. Conservative therapies could also include:
  • Weight loss
  • Activity modification like walking instead of running
  • Anti-inflammatory medication
  • Cortisone injections
Total hip replacement is the last option for individuals experiencing pain, difficulty walking, and limited mobility. The procedure removes the damaged cartilage and bone from the hip joint. This includes the head of the thighbone along with the socket where it fits and replaces it with artificial parts.  
 

Conclusion

Get a second opinion. Individuals are encouraged to educate themselves as much as possible on the condition. The hip and spine is a complex relationship. The most important information for patients is that they understand along with their doctor where the pain is coming from, the hip, spine, or both.

Reduce Plantar Fasciitis Foot Pain

 

 

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
Sacroiliac Joint Stretches and Exercises for Pain Relief

Sacroiliac Joint Stretches and Exercises for Pain Relief

A doctor, chiropractor, or physical therapist could recommend therapeutic stretches along with exercises as part of a sacroiliitis or sacroiliac joint pain treatment plan. Sacroiliitis refers to inflammation in one or both of the sacroiliac joints. This could be caused by:
  • Pregnancy
  • Injury
  • Infection
  • Arthritis
  • Ankylosing spondylitis
Sacroiliac joint pain is a symptom related to sacroiliac joint dysfunction. The symptoms of sacroiliitis and sacroiliac joint pain can be felt in the lower back, buttocks, hips, and legs. These symptoms can be similar to sciatica and can mimic other lower back disorders.  
 
Blog Image  Treating Sacroiliac Diagram
 
Some of the stretches and exercises included are common for treatment plans for various low back conditions/problems. Talk with a chiropractor or doctor to get their recommendation prior to starting any exercise or stretching program.

Stretches

Piriformis stretch

The piriformis muscle extends over the hip and can aggravate the sacroiliac joint when it becomes tight. To help stretch the muscle:
  • Lie on back with knees bent
  • Feet flat on the floor
  • Slowly raise the right leg
  • Bring the right knee toward chest
  • Gently pull the leg in until there is a comfortable stretch in the buttock
  • Exhale during the stretch movement
  • Hold the stretch for 30 seconds
  • Lower leg
  • Repeat on the left leg
  • Repeat each side 3 times daily, as needed
The stretch helps the muscle fibers to lengthen/elongate and relax.  
 

Trunk rotation

Trunk rotation increases flexibility in the low back and hips. This can help relieve pressure on the sacroiliac joints. To do this stretch:
  • Lie on back with knees bent
  • Feet flat on the floor
  • With knees together
  • Slowly rotate to one side
  • Feet, hips, and back should stay on the floor
  • Hold 3-5 seconds
  • Move knees to the opposite side
  • Repeat 5-10 times on each side
 

Bridge

This is a stretch that strengthens the muscles in the lower back, buttocks, and hips.
  • Lie on back with arms at side
  • Knees should be bent, and feet flat on the floor
  • Slowly raise hips while squeezing buttocks and hamstrings
  • Hold raised position for 5 seconds
  • Repeat 10 times
11860 Vista Del Sol Ste. 128 Sacroiliac Joint Stretches and Exercises for Pain Relief
 

Water Therapy and Yoga Exercises

Aquatics and yoga are a gentle and natural form of exercise that is recommended for staying active. Talk to a doctor before starting any exercise program. Aquatic therapy, known now as hydrotherapy/water therapy, is one of the gentlest forms of exercise and is highly effective. Exercising in water creates an almost weightless environment without gravity. Hydrotherapy uses the resistance from the water to improve strength and flexibility without straining the muscles. Regular exercise can cause pain by placing added pressure on the sacroiliac joints. Water therapy conditions the spine and hip muscles without generating muscle stress. Another option for individuals with back pain is yoga. The following poses are recommended and beneficial for the sacroiliac joints:

Child�s pose

This pose stretches the hips and thighs and is a great yoga pose for beginners.  
11860 Vista Del Sol Ste. 128 Sacroiliac Joint Stretches and Exercises for Pain Relief
 

Cobra

Cobra pose can help strengthen and stabilize the sacroiliac joints.
  • Lie flat on the stomach
  • Hands beneath the shoulders
  • Slowly push up as far as the arms extend
  • Bring upper body off the ground
  • Keep the pelvis and legs on the floor
  • When extended, be sure low back and buttocks are relaxed
  • Hold for 15 to 30 seconds
  • Gently lower to the floor
 

Triangle pose

Triangle pose helps to strengthen the sacroiliac joints and makes them less susceptible to pain. However, this pose involves twisting, so make sure to do this pose only when the joints are stable and pain-free.  
 

Before stretching and exercise

Before starting any stretching or exercise program, check with a doctor or chiropractor, if the joints are able then the stretching/exercise could begin right away. However, in most cases, a doctor will refer the patient to a physical therapist or chiropractor to create a customized exercise and stretching plan. The therapist will show exactly what activities will strengthen the joints and how to do them properly and safely. These movements can help condition the spinal and abdominal muscles. This can help prevent future episodes of back pain. If an individual just had surgery for sacroiliac joint pain, the surgeon more than likely prescribed a customized rehabilitation stretching/exercise program. Follow instructions, and get the surgeon�s approval before engaging in anything outside of the plan.

Staying fit safely

When dealing with sacroiliac joint dysfunction or sacroiliitis, physical activity may need to be redefined after treatment. As regular exercise could mean strenuous activity and could do more damage. Exercises like heavy weightlifting, contact sports, and intense biking could place excessive pressure on the joints. A doctor or chiropractor will offer the best stretching and exercises for every individual. Physical activity combined with gentle stretching and conditioning exercises can effectively reduce low back and hip pain. Talk to a doctor, chiropractor, or physical therapist about incorporating healthy exercise into a daily regimen. For some, the workout might not feel like there’s anything going on, but the effects on the pain will be.

Chiropractic Hip Pain Treatment

 
 

Dr. Alex Jimenez�s Blog Post Disclaimer

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Sacroiliac Joint Dysfunction Back Pain and Chiropractic El Paso, TX.

Sacroiliac Joint Dysfunction Back Pain and Chiropractic El Paso, TX.

Sacroiliac joint dysfunction and its symptoms can also be a cause for low back pain conditions and disorders.

This condition is also known as:

  • Sacroiliitis
  • SI joint inflammation
  • SI joint syndrome
  • Sacroiliac joint dysfunction
  • SI joint strain

It can make regular activities like sitting, standing, walking, and sleeping frustrating, difficult and unbearable. It has been found in around 30-35% of individuals.�Many individuals can spend months or even years dealing with symptoms but are never aware that it’s not the correct diagnosis. Sacroiliac joint dysfunction can sometimes be difficult to diagnose. These joints are so close to the hip and low back, that it is common for sacroiliac joint dysfunction to be mistaken for other causes/conditions of low back pain, like a herniated, slipped or bulging disc.

 

11860 Vista Del Sol, Ste. 126 Sacroiliac Joint Dysfunction Back Pain and Chiropractic El Paso, TX.

Sacroiliac Joint Dysfunction Symptoms

When low back pain is present, it can be quite difficult for a doctor to figure out the exact source/cause of your pain.

These are a few recognizable symptoms of sacroiliac joint dysfunction.

  • Low back pain is the most common.
  • Pain could also present in the hips, buttocks, thighs, and possibly the groin area.
  • The pain can be so severe that just touching the area is unbearable.

Other activities that can cause symptoms:

Common movements like climbing stairs, sitting down/getting up out of a seat, can cause pain. Pain can also be aggravated from standing or walking for extended periods but improve when relaxed or lying down. Stiffness or a burning sensation in the pelvis can also present.

 

11860 Vista Del Sol, Ste. 126 Sacroiliac Joint Dysfunction Back Pain and Chiropractic El Paso, TX.

Causes of Joint Dysfunction

A variety of conditions can cause sacroiliac joint dysfunction. The most common:

Arthritis

Joint pain can be caused by spinal osteoarthritis because as the cartilage around the sacroiliac joint wears down, the bones can start to rub against each other. Ankylosing spondylitis is an inflammatory arthritis that affects the spine that can also cause joint dysfunction.

Pregnancy

Pregnant women can experience low back pain or pelvic pain from sacroiliac dysfunction because the joints get stretched and lose their elasticity during pregnancy. Hormone changes and added weight during pregnancy can place added stress on the sacroiliac joints.

Accident Trauma

High impact from an auto accident, slip and fall injury, or sports injury could damage the sacroiliac joint/s.

Viral Infection

Infections are extremely rare but could be another cause of joint pain.

There are a variety of treatment options that can help reduce and prevent low back pain.

 

sciatica vs piriformis el paso tx.
Exercise/Physical Therapy

Exercise and physical therapy are therapies that doctors highly recommend before other treatments like pain medications or surgery. Exercise, chiropractic and physical therapy can help manage pain and other symptoms. Consult your doctor before starting any physical therapy or exercise program. Your doctor can recommend a chiropractor or therapist that can help get you started with the proper exercise treatment plan.

 

Physical Therapy

Physical therapy can help reduce stress on the joints, that are strained and tight. It also helps maintain joint flexibility. A physical therapist will perform passive and active treatment therapies to help manage joint pain.

  • Passive treatments – the physical therapist does the majority of the work. An example of passive treatment applying heat or ice along with massaging the area.
  • Active treatments – the patient participates in the treatment with at-home exercise routines is an example of active treatment.

A combination of passive and active treatment provides the best outcomes and offers the most benefits, as the patient has the know-how of proper posture, exercises that they can do and injury prevention. A chiropractor and physical therapist can build a physical therapy program to help address your symptoms.

 

Exercise

With sacroiliac joint dysfunction, you do not have to do hard intense exercise. The benefits come from a consistent gentle exercise routine with an emphasis on consistency. Exercising stretches and strengthens muscles of the low back muscles and helps maintain joint flexibility.

An overall exercise plan should incorporate the three main types:

  • Aerobic workout
  • Stretching
  • Strengthening

There are a variety of gentle exercises and stretches to help decrease pain. Adding exercise and physical therapy to the treatment plan can significantly help you manage and reduce pain symptoms.


 

Labrum Tear Hip Treatment

 


 

NCBI Resources

Sacroiliac joint dysfunction is known to cause low back pain, but diagnosing can be hard for some doctors. Especially those that do not have a great deal of experience in sacroiliac joint pain. However,�chiropractors specialize in this area as the SI joint is an important part of the musculoskeletal system.

 

Back Pain or Hip Pain? Getting to the Root of the Problem El Paso, TX.

Back Pain or Hip Pain? Getting to the Root of the Problem El Paso, TX.

Pain in the low back, hips, and other areas of the lower body, the source isn�t always easy to pinpoint.

Pain may originate in the lumbar spine (low back) the hip or both.

It�s important that a doctor identify the source of the problem, in order to create the correct treatment plan.

Because the hips and lower spine are located so close it can be easy to mistake back pain for hip pain the other way around.

Most low back pain and hip pain share a common cause:

Normal wear and tear on the body due to aging or triggered by overuse injuries (possibly referred to as degeneration or degenerative changes).

  • Lumbar sprains
  • Strains
  • Osteoarthritis
  • Herniated discs

Are common degenerative culprits behind low back and hip pain.

 

11860 Vista Del Sol, Ste. 128 Back Pain or Hip Pain? Getting to the Root of the Problem El Paso, TX.

 

Symptoms that the Hip Is the Root

One of the biggest symptoms that pain is caused by a problem in the hip is groin pain.

The hip joint is located behind the groin, which is why groin pain typically means the hip is the root.

In some cases, the groin pain will radiate downward toward the knee.

Another symptom that the hip is the source is pain around or over the hip joint.

Hip problems can also refer pain to the low back.

This is what causes the confusion over where the true source of the pain.

Hip-related pain is most often caused by osteoarthritis in the hip.

Osteoarthritis in the hip can cause pain in the:

  • Buttocks
  • Front of the thighs
  • Knees

Limping when walking and a reduced range of motion in the hips, along with pain that worsens with activity and improves with rest.

Osteoarthritis is the most common cause, hip pain can also come from:

  1. Piriformis syndrome will cause dull, mild pain in the low back, buttocks and can radiate down the leg.
  2. Hip pain attributed to avascular necrosis will be severe and constant.
  3. Sacroiliac joint pain could be attributed to the hip and the low back because the sacroiliac joints connect the sacrum in the spine to the hip bones.

11860 Vista Del Sol, Ste. 128 Back Pain or Hip Pain? Getting to the Root of the Problem El Paso, TX.

Symptoms that the Spine Is the Root

Where groin pain is a sign that the pain is linked to the hip when the pain is above the waistline and travels down the body usually indicates a low back issue.

Among the most common degenerative conditions that affect the lumbar spine are:

  • Herniated discs
  • Spinal stenosis
  • Spondylolisthesis

Pain is caused by irritating the low back nerves, which result in pain shooting down the leg/s and:

  • Weakness
  • Numbness
  • Reduced range of motion

Arthritis of the spine brings on pain usually when first getting out of bed or rising up after sitting.

It usually improves after beginning to move.

Spinal stenosis or nerve pressure compression pain worsens with prolonged standing or walking, while relief comes with sitting.

Getting to the Root

When there is pain in the lower body and are not sure whether it’s the back or hip, the first course of action is to visit your doctor or a chiropractor.

They will review your medical history and perform a series of physical exams, such as various movements to get an idea of what is going on.

Your primary doctor may refer you to a doctor/chiropractor who specializes in hip or spinal conditions to make an accurate diagnosis.

The doctor will ask you to describe the:

  • Pain
  • Location
  • When it worsens
  • When it’s relieved
  • What the pain feels like (e.g., sharp, dull).

The doctor may have you perform various movements to observe your biomechanics.

The goal is to determine what movements trigger the pain.

One such maneuver called the Flexion Abduction External Rotation (FABER) test helps determine if the pain is sourced in the hip and possible sacroiliac joint problems.

For this test, you lie on your back while flexing and rotating the hips.

The doctor will also palpate (press) on the pain area.

The doctor may order image scans, like x-ray, MRI that can reveal the root of the spine or hip problem.

The Source

Treating Back Pain and Hip Pain

Once the pain is identified whether the hip or low back, your doctor will work with you to create a treatment plan.

This regimen includes a specially designed physical therapy program to teach:

  • Movements
  • Stretches
  • Physical therapy

To help alleviate symptoms and prevent their return.

Once the nature of the pain is determined, your doctor may recommend lifestyle changes:

For both spine and hip pain, surgery is rarely necessary and only utilized as the last-resort option.


 

Labrum Tear Hip Treatment El Paso, TX Chiropractor

 

 

Andrew Hutchinson turned into chiropractic care and Crossfit rehab after suffering a high ankle sprain and a hip labrum tear for which he moved through with surgery to repair it. After being bedridden for weeks so as to correctly recuperate, Andrew Hutchinson transitioned to chiropractic care and Crossfit rehab to regain his strength, freedom, and flexibility before returning to perform. Although he has suffered other sports accidents, Andrew Hutchinson continues to trust in chiropractic care and Crossfit rehab to keep his spine properly aligned and maintain overall health and wellbeing.

Labrum tears in athletes may occur from a single event or recurring trauma. Running may lead to labrum tears as a result of labrum being used more for weight-bearing and taking excessive forces while at the end-range motion of the leg. Sporting activities are likely causes, especially the ones that require frequent hip rotation or pivoting to some wealthy femur as in ballet or hockey. Continuous hip rotation places increased pressure on the capsular tissue and injury to the iliofemoral ligament. This then causes hip instability placing increased stress on the labrum and resulting in a cool labrum tear.


 

What’s Afoot

Muscle imbalances in the hip, such as tight hip flexors, can cause low back pain � or at least contribute to it. When the hip flexor muscles are too tight, it causes what is known as an anterior pelvic tilt. In other words, the muscles cause an anterior pull on the pelvis. This affect posture and throws the entire lower body out of alignment. It can also affect the knees and feet if left untreated.

 

VasyliMedical The Effect of Weak Hip Abduction

 

 

NCBI Resources

Hip flexors can become too tight if the person sits for extended periods of time or engages in activities like cycling and jogging. A chiropractor can guide you through exercises that will help release the tight muscles and stop the micro spams that occur as a result. They will also assess your knees, feet, and ankles to ensure that the issue has not through them out of alignment as well. Correcting the cause of the problem will often correct the associated issues and resolve the pain allowing you to return to your normal activities.

 

How Chiropractic Helps to Overcome Hip Pain El Paso, TX.

How Chiropractic Helps to Overcome Hip Pain El Paso, TX.

Although hip pain is most often associated with older individuals, in reality, it can affect people from all age groups. The hips are complex joints, which means there are many things that can go wrong in the hips�complications that can lead to pain and discomfort in the hip area. Whatever your age, when hip pain strikes you naturally want to know if there is a way to make it better or eliminate it altogether. Fortunately, chiropractic offers effective methods for addressing hip pain.

Causes of Hip Pain?

There are a surprising number of ways that hip pain can develop. It may show up at one or both sides of your hips, or on the front of your hip. It can also show up on the back of one or both hips. Where the pain develops can serve as an indicator of what is actually causing the pain. Your chiropractor will look closely at your condition to determine the cause, which may be attributed to the following:

Osteoarthritis

The cartilage that surrounds your joints can begin to wear down over time. The degeneration of cartilage around joints is known as osteoarthritis. Many times, osteoarthritis can develop due to normal wear and tear, which is why the condition is so often associated with aging. However, it is possible for younger individuals to develop osteoarthritis as well.

Transient Osteoarthritis

Both middle-aged men and pregnant women can suffer from transient osteoarthritis. It is a painful condition, but fortunately, it is reversible with proper treatment.

11860 Vista Del Sol, Ste. 128 How Chiropractic Helps to Overcome Hip Pain El Paso, TX.

Bursitis

Bursa are sacs filled with fluid found in your joints, including the hips. The bursa are supposed to provide cushioning to your joints and lessen the friction created as your joints move. However, the bursa can become inflamed, which can lead to pain each time the joint is used.

Muscle Strain

There are a multitude of muscles that support the hips and make it possible for them to function. If one or more of those muscles is strained, it can lead to pain. Muscle strain is common in active individuals.

Overuse

Any joint and the soft tissues that support it can be overused. Overuse is common in individuals who perform repetitive motions, such as having to do the same motion hundreds of times a day for particular job activity.

Chiropractic Can Help

Studies have shown that chiropractic can increase mobility and lessen the pain when patients are experiencing hip pain. Treatment can be quite effective for many hip conditions, including all of those listed above. Since chiropractic steers clear of unnecessary medications and surgery, it is non-invasive and can be used regularly with minimal risk of side effects. Even if the condition you suffer from is not completely eliminated by treatment, it can make your symptoms much more tolerable by reducing pain and improving mobility.

Some common treatments for hip pain in chiropractic include:

Adjustments

By realigning your spine, adjustments can reduce or eliminate strain that may be placed on your hips. Regular adjustments can help ensure that your body maintains alignment and minimizes the amount of unnecessary strain might be impacting your hip area.

Exercises

Sometimes the best long-term solution to hip pain is to strengthen the muscles surrounding the hips. Your chiropractor can give you personalized exercises based on your body�s needs to help you get stronger so that your body supports your hips day in and day out.

Stretches

Hip pain can lead to loss of mobility. Appropriate stretches can help you regain some of that mobility.

Contact Us & Schedule An Appointment for Hip Pain Relief

If you would like to learn more about how chiropractic can help with your hip pain, please contact us. Our team is ready and waiting to answer your questions.


 

Labrum Tear Hip Treatment El Paso, TX Chiropractor

 

 

Andrew Hutchinson turned into chiropractic care and Crossfit rehab after suffering a high ankle sprain and a hip labrum tear for which he moved through with surgery to repair it. After being bedridden for weeks so as to correctly recuperate, Andrew Hutchinson transitioned to chiropractic care and Crossfit rehab to regain his strength, freedom, and flexibility before returning to perform. Although he has suffered other sports accidents, Andrew Hutchinson continues to trust in chiropractic care and Crossfit rehab to keep his spine properly aligned and maintain overall health and wellbeing.

Labrum rips in athletes may occur from a single event or recurring trauma. Running may lead to labrum tears as a result of labrum being used more for weight-bearing and taking excessive forces while at the end-range motion of the leg. Sporting activities are likely causes, especially the ones that require frequent hip rotation or pivoting to some wealthy femur as in ballet or hockey. Continuous hip rotation places increased pressure on the capsular tissue and injury to the iliofemoral ligament. This then causes hip instability placing increased stress on the labrum and resulting in a cool labrum tear.


 

Hip Weakness

Muscle imbalances in the hip, such as tight hip flexors, can cause low back pain � or at least contribute to it. When the hip flexor muscles are too tight, it causes what is known as an anterior pelvic tilt.�Hip flexors�can become too tight if the person sits for extended periods of time or engages in activities like cycling and jogging. A chiropractor can guide you through exercises that will help release the tight muscles and stop the micro spams that occur as a result.

 

VasyliMedical The Effect of Weak Hip Abduction


 

NCBI Resources

Treating your hip is successful when the focus is on restoring the balance and function of the entire body. This starts from the ground up with the feet along with a chiropractic examination that determines the root cause, which in turn helps in making an informed decision on a treatment plan. This instead of merely reducing the pain and inflammation in the irritated areas.

 

 

Acute Pelvis & Hip Trauma Imaging Diagnosis Part II | El Paso, TX.

Acute Pelvis & Hip Trauma Imaging Diagnosis Part II | El Paso, TX.

 

pelvis trauma el paso tx.

 

pelvis trauma el paso tx.

 

Hip Fractures

 

pelvis trauma el paso tx.

 

  • Garden Classification (above) helps with Dx and correct management of patients
  • M/C Fx are subcapital (80%)
  • Fxs differentiated as intra-capsular (high risk of AVN) & extra-capsular (lower risk of AVN)
  • Garden 1: incomplete undisplaced Fx typically impaction with valgus off-set of the head (15-20% AVN) patient able to ambulate
  • Garden 2: complete, undisplaced Fx (30% AVN)
  • Garden 3: complete, partially <50% displaced
  • Garden 4: complete, 100% displaced Fx, pt collapsed with entire LE in ER (below image)
  • Most osteoporotic Fx are intracapsular

 

Complete Displaced Femoral Neck Fracture Clinical Presentation

 

pelvis trauma el paso tx.

 

pelvis trauma el paso tx.

 

Imaging: Begins with X-radiography with Most Fxs

 

  • CT scanning may help with further delineation of Fx complexity/displacement and Dx of additional regional Fxs
  • MRI can be helpful if x-radiography fails to Dx fx
  • X-radiography pitfalls: some undisplaced Garden 1 & 2 Fxs may be missed d/t pre-existing DJD and osteophytes along the femoral head-neck junction that may overly the Fx line
  • Fx line is incomplete and too small/subtle especially if the study is read by non-radiologists
  • Incomplete Fxs if left untreated will not heal and likely to progress to complete Fxs

 

pelvis trauma el paso tx.

 

  • AP hip spot view: note valgus deformity of the head (above yellow arrow) with a small/subtle line of sclerosis in the sub-capital region representing Garden 1 Fx. MRI may help with Dx of subtle radiographic Fxs. If MRI contraindicated, Tc 99 radionuclide bone scan may help demonstrate high uptake of the radiopharmaceutical in Fx (below image)

 

pelvis trauma el paso tx.

 

Above – Tc99 Radionuclide Bone Scan Reveals Left Subcapital Femoral Neck Fx

 

pelvis trauma el paso tx.

 

  • Garden 2 complete undisplaced (above green arrows) Fx

 

pelvis trauma el paso tx.

 

  • AP hip: Garden 3 complete partially displaced Fx (above the first image)
  • AP pelvis: complete displaced Garden 4 Fx (above the second image)
  • Clinical pearls: in some cases of Garden 4 Fx, DDx may be difficult to differentiate from OSP vs. pathologic fx d/t to bone Mets of Multiple myeloma (MM)
  • Management: depends on patients age and activity level
  • Garden 3 & 4� require total hip arthroplasty in patients <85-y.o.
  • Garden 1 & 2 may be treated with closed reduction of fx and open capsule and 3-cannulated fixating screws
  • Pre-existing DJD may require total arthroplasty
  • Occasionally observation may be performed on patients who are not active and significant risks of surgery and depends on surgical centers

 

pelvis trauma el paso tx.

 

  • m/c Rx of Garden 1 & 2 undisplaced Fx with 3-screws. Screws proximity depends on the bone quality and Fx type

 

pelvis trauma el paso tx.

 

  • THA aka hip replacement: cemented THA with bone cement (above the first image) vs. non-cemented (biologic) that is used mostly in younger patients
  • 2-types: metal on metal vs. metal on polyethylene
  • The femoral angle of the prosthesis should have slight valgus but never >140 degrees
  • The non-cemented component uses porous metal allowing the bone to integrate sometimes coating in bone cement from osteoconduction
  • THA has good outcome and prognosis
  • Occasionally cement failure, fractures, and infections may complicate this procedure

Supplemental Reading

 

Acute Pelvis & Hip Trauma