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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.


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

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

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

www.healthline.com/health/uneven-hips

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” www.cdc.gov/acute-pain/low-back-pain/index.html

National Institute of Neurological Disorders and Stroke. (March 2020) “Low Back Pain Fact Sheet” 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” 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.” 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)  www.mayoclinic.org/diseases-conditions/kidney-infection/diagnosis-treatment/drc-20353393

The University of Michigan Medicine. (06/2019) “ Upper and Middle Back Pain” 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.

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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.

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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*