Back Clinic Back Pain Chiropractic Treatment Team. At the El Paso Back Clinic, we take back pain very seriously.
After diagnosing the root cause of your discomfort/pain, we’ll do everything within our power to cure the area and relieve your symptoms.
Common causes of back pain:
There is an infinite number of forms of back pain, and a variety of injuries and diseases may cause discomfort in this area of the body. One of the most Frequent ones we see one of our patients in East Side El Paso and surrounding areas comprise:
Disc Herniation
Inside the backbone are flexible discs that cushion your bones and absorb shock. Whenever these discs are broken, they may compress a nerve leading to lower extremity numbness. StressWhen a muscle at the trunk is overexerted or hurt, causing stiffness and pain, this type of injury is generally classified as a back strain. This can be the consequence of attempting to lift an item that can result in excruciating pain and impairment and is too heavy. Diagnosing the underlying cause of your pain.
Osteoarthritis
Osteoarthritis is characterized by the slow wearing down of protective cartilage. When the back is affected by this condition, it causes damage to the bones that results in chronic pain, stiffness, and limited mobility. SprainIf ligaments in your spine and back are stretched or torn, it’s called a spine sprain. Typically, this injury causes pain in the region. Spasms cause back muscles to overwork they may start to contract, and can even stay contracted– also called a muscle spasm. Muscle spasms can present with pain and stiffness until the strain resolves.
We want to accomplish the diagnosis straight away, integrating a background and exam along with state-of-the-art imaging, so we can provide you with the most efficient therapy choices. To begin, we will speak with you regarding your symptoms, which will provide us with critical information regarding your underlying condition. We’ll then perform a physical exam, during which we’ll check for posture issues, evaluate your spine and assess your backbone. If we guess injuries, like a disk or neurological injury, we’ll probably order imaging tests to obtain an analysis.
Regenerative remedies to your back pain. At the El Paso Back Clinic, you may be certain that you’re in the best possible hands with our Doctor of Chiropractic and Massage Therapist. Our purpose during your pain treatment isn’t only to relieve your symptoms — but also to avoid a recurrence and to treat your pain.
Sciatica is a collection of symptoms in the low back, which radiate down one or both legs. Sciatica is generally caused by the compression or irritation of the sciatic nerve, the largest nerve in the human body. One of the most common health issues that cause sciatic nerve pain is called piriformis syndrome. The piriformis muscle stretches from the front of the sacrum, the triangle-shaped bone between the hipbones on the pelvis.
The piriformis muscle extends to the top of the femur around the sciatic nerve. The femur, as previously mentioned, is the large bone in the upper leg. The piriformis muscle functions by helping the thigh move from side to side. A piriformis muscle spasm, or any other type of injury and/or condition along the piriformis muscle, can place pressure on the sciatic nerve and cause pain and discomfort. The result is piriformis�syndrome.
Piriformis Syndrome Causes and Symptoms
Sciatic nerve pain,�or sciatica, is one of the most prevalent�symptoms of piriformis syndrome. The pain and discomfort, however, may be felt in another part of the body. This is known as referred pain. Other common symptoms of piriformis syndrome include tingling sensations and numbness; tenderness;�difficulty sitting along with�pain while sitting and pain in the buttocks and thighs with physical activities.
The piriformis muscle can easily become damaged or injured from periods of inactivity or an excessive amount of exercise. Some common causes of piriformis syndrome include overuse; repetitive movements involving the legs; sitting for lengthy periods of time; lifting heavy objects; and extensive stair climbing. Sports injuries or automobile accident injuries can also harm the piriformis muscle and cause it to compress the sciatic nerve.�
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Piriformis Syndrome Diagnosis
A doctor appointment for diagnosis of piriformis syndrome may include a review of the patient’s health history, their symptoms, and other probable causes of their pain and discomfort. If you recall straining a muscle during physical activity, be sure to share that information with your doctor. The�doctor may also perform a physical exam. The patient will participate in a series of range of movements to determine the cause of symptoms.
Some imaging tests may also be essential to help rule out other causes of piriformis syndrome. A CT scan or an MRI scan may help the healthcare professional determine whether even a herniated disc or arthritis is causing the patient’s pain and discomfort. An ultrasound of the piriformis muscle may also be helpful in diagnosing the problem if it seems that piriformis syndrome is causing the patient’s overall symptoms.
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Piriformis syndrome is a health issue associated with the compression or impingement of the sciatic nerve around the piriformis muscle. Symptoms may include pain and discomfort, tingling sensations and numbness along the low back, or sciatica. Chiropractic care is a well-known alternative treatment option which can help reduce the compression of the sciatic nerve and improve piriformis syndrome.
Dr. Alex Jimenez D.C., C.C.S.T.
Piriformis Syndrome Treatment
Piriformis syndrome may often not need any treatment to�relieve its symptoms. Just avoiding the physical activities which caused the pain and discomfort to manifest and rest can help improve the health issue. If symptoms do persist, however, alternating between ice and heat can help decrease pain. Apply ice for 15 to 20 minutes then use a heating pad on the affected area. Try that every couple of hours to help relieve symptoms.
Over-the-counter painkillers�may also help decrease pain and discomfort. The symptoms associated with piriformis syndrome can go away with no additional treatment, however, if it doesn’t, the patient might benefit from alternative treatment options, such as chiropractic care or physical therapy. Chiropractic care is a treatment approach which utilizes spinal adjustments and manual manipulations to treat a variety of injuries and/or conditions.
A chiropractor,�or doctor of chiropractic, may also provide piriformis syndrome relief through the use of transcutaneous electrical nerve stimulator, or TENS, treatment. A TENS device is a handheld unit which sends electrical charges directly to the affected region of the piriformis muscle. The nerves are then stimulated by the electric energy, which interferes with pain signals being transmitted to the brain.
The chiropractor or physical therapist may also recommend a series of lifestyle modifications, including physical activity guidance and nutritional advice. Various stretches and exercises can help improve the strength, flexibility, and mobility of the�piriformis muscle. In severe cases of piriformis syndrome, corticosteroid injections or even surgical interventions may be required to help alleviate the symptoms.�The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Chiropractic for Athletes with Back Pain
Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain is the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
Athletic pubalgia is a debilitating health issue which affects the groin. The injury commonly happens through sports that use sudden changes of direction or intense twisting motions. Also referred to as a sports hernia, athletic pubalgia is characterized as a tear or strain in any soft tissue (muscle, tendon, ligament) of the abdominal or lower abdomen region.
Physiology of Athletic Pubalgia
The soft tissues most often affected by athletic pubalgia are the oblique muscles found in the lower abdomen, especially in the tendons that attach the oblique muscles to the pubic bone. In many instances, the joints that connect the thigh muscles to the pubic bone,�known as the adductor muscles, are also stretched or torn as a result of athletic pubalgia.
Physical activities which involve planting the feet and twisting with maximum exertion can cause athletic pubalgia. A sports hernia is most prevalent in vigorous sports, such as hockey, soccer, wrestling, and football. Athletic pubalgia�causes pain and discomfort in the groin region which typically gets better with rest but comes back with physical activity.
A sports�hernia does not result in a visible bulge in the groin, such as the well-known inguinal hernia does. As time passes, athletic pubalgia can lead to an inguinal hernia, and abdominal organs can push against the diminished cells to form a visible bulge. Without treatment, this sports injury could lead to chronic, disabling pain and other symptoms.
Healthcare Professional Diagnosis
During the first consultation, a doctor will discuss the individual’s symptoms and how the injury happened. To�diagnose athletic pubalgia, the healthcare professional will look for tenderness in the groin or above the pubis. Although a sports hernia may be related to an inguinal hernia, the doctor may not find any hernias during a physical examination.
Furthermore, to help determine the presence of athletic pubalgia, the healthcare professional will probably ask the patient to perform a sit-up or to�bend the trunk against resistance. If you have a sports hernia, these tests will be painful. The doctor may also require�x-rays or magnetic resonance imaging (MRI) to help determine whether you have athletic pubalgia.�The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Acute Back Pain
Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain attributes to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
Athletic pubalgia, also known as a hockey hernia,�hockey groin, Gilmore’s Groin,�sports hernia, or groin disruption, is a health issue of the pubic joint. It is a condition characterized by chronic groin pain in athletes and identified by a dilated ring of the inguinal canal. Soccer and ice hockey players are the athletes most commonly affected by athletic pubalgia, and both recreational and professional athletes can be impacted.
Athletic Pubalgia Symptoms
Symptoms of athletic pubalgia�generally manifest as pain following physical activity, most frequently through hip extension, and twisting and turning movements. The painful symptoms usually radiate into the adductor muscle region and the testicles, although it is often difficult for the individual to pinpoint the exact location of the�symptoms. Athletes with athletic pubalgia�experience soreness and stiffness after physical activity.
Any exertion which increases intra-abdominal pressure, such as sneezing or�coughing, as well as physical activity, can lead to pain. While pain in the stomach and pelvis can occur due to a variety of health issues, including injuries to the low back, or lumbar spine, the hip joint, the sacroiliac joint, and the abdomen, along with the genito-urinary system, diagnosis of athletic pubalgia demands skillful differentiation and evaluation.
Clinical Presentation of Athletic Pubalgia
The diagnosis of athletic pubalgia is based on the patient’s history, where healthcare professionals may also depend on the use�of magnetic resonance imaging,�or MRI. Symptoms can frequently be reproduced by certain movements, such as performing crunches or sit-ups. Pain associated with athletic pubalgia may also be elicited with the patient in a “frog posture,” in which the individual is supine with knees bent and heels together.
Many athletes experience concomitant fatigue or tearing of the�adductor muscles or labral tears of the hip. If there is stiffness in the adductor muscles post-injury, painful symptoms can manifest. Alternative treatment options should be to restore normal movement after the adductor has begun to heal, normally 6 to 8 weeks post-injury. Moreover, sleeping in a prone position with the hip on the affected side flexed and externally rotated can offer relief to some athletes with athletic pubalgia.
The precise prevalence of this health issue is unknown. Conservative therapies,�such as gentle stretching, may temporarily alleviate painful symptoms, however, definitive treatment options should be considered for long-term relief.�The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Acute Back Pain
Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain attributes to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
Hip pain is a well-known health issue which can be caused by a wide array of problems, however, the site of the patient’s hip pain can provide valuable information regarding the underlying cause of this common health issue. Pain on the inside of the hip or groin can be due to problems within the hip joint itself while pain on the outside of the hip, upper thigh and outer buttocks may be due to problems with the ligaments, tendons and muscles, among other soft tissues, surrounding the hip joint. Furthermore, hip pain can be due to other injuries and conditions, including back pain.
Abstract
Hip pain is a common and disabling condition that affects patients of all ages. The differential diagnosis of hip pain is broad, presenting a diagnostic challenge. Patients often express that their hip pain is localized to one of three anatomic regions: the anterior hip and groin, the posterior hip and buttock, or the lateral hip. Anterior hip and groin pain is commonly associated with intra-articular pathology, such as osteoarthritis and hip labral tears. Posterior hip pain is associated with piriformis syndrome, sacroiliac joint dysfunction, lumbar radiculopathy, and less commonly ischiofemoral impingement and vascular claudication. Lateral hip pain occurs with greater trochanteric pain syndrome. Clinical examination tests, although helpful, are not highly sensitive or specific for most diagnoses; however, a rational approach to the hip examination can be used. Radiography should be performed if acute fracture, dislocations, or stress fractures are suspected. Initial plain radiography of the hip should include an anteroposterior view of the pelvis and frog-leg lateral view of the symptomatic hip. Magnetic resonance imaging should be performed if the history and plain radiograph results are not diagnostic. Magnetic resonance imaging is valuable for the detection of occult traumatic fractures, stress fractures, and osteonecrosis of the femoral head. Magnetic resonance arthrography is the diagnostic test of choice for labral tears.
Introduction
Hip pain is a common presentation in primary care and can affect patients of all ages. In one study, 14.3% of adults 60 years and older reported significant hip pain on most days over the previous six weeks.1 Hip pain often presents a diagnostic and therapeutic challenge. The differential diagnosis of hip pain (eTable A) is broad, including both intra-articular and extra-articular pathology, and varies by age. A history and physical examination are essential to accurately diagnose the cause of hip pain.
Anatomy
The hip joint is a ball-and-socket synovial joint designed to allow multiaxial motion while transferring loads between the upper and lower body. The acetabular rim is lined by fibrocartilage (labrum), which adds depth and stability to the femoroacetabular joint. The articular surfaces are covered by hyaline cartilage that dissipates shear and compressive forces during load bearing and hip motion. The hip’s major innervating nerves originate in the lumbosacral region, which can make it difficult to distinguish between primary hip pain and radicular lumbar pain.
The hip joint’s wide range of motion is second only to that of the glenohumeral joint and is enabled by the large number of muscle groups that surround the hip. The flexor muscles include the iliopsoas, rectus femoris, pectineus, and sartorius muscles. The gluteus maximus and hamstring muscle groups allow for hip extension. Smaller muscles, such as gluteus medius and minimus, piriformis, obturator externus and internus, and quadratus femoris muscles, insert around the greater trochanter, allowing for abduction, adduction, and internal and external rotation.
In persons who are skeletally immature, there are several growth centers of the pelvis and femur where injuries can occur. Potential sites of apophyseal injury in the hip region include the ischium, anterior superior iliac spine, anterior inferior iliac spine, iliac crest, lesser trochanter, and greater trochanter. The apophysis of the superior iliac spine matures last and is susceptible to injury up to 25 years of age.2
The hip joint is one of the larger joints found in the human body and it serves in locomotion as the thigh moves forward and backward. The hip joint also rotates when sitting and with changes of direction while walking. A variety of complex structures surround the hip joint. When an injury or condition affects these, it can ultimately lead to hip pain.
Dr. Alex Jimenez D.C., C.C.S.T.
Evaluation of Hip Pain
History
Age alone can narrow the differential diagnosis of hip pain. In prepubescent and adolescent patients, congenital malformations of the femoroacetabular joint, avulsion fractures, and apophyseal or epiphyseal injuries should be considered. In those who are skeletally mature, hip pain is often a result of musculotendinous strain, ligamentous sprain, contusion, or bursitis. In older adults, degenerative osteoarthritis and fractures should be considered first.
Patients with hip pain should be asked about antecedent trauma or inciting activity, factors that increase or decrease the pain, mechanism of injury, and time of onset. Questions related to hip function, such as the ease of getting in and out of a car, putting on shoes, running, walking, and going up and down stairs, can be helpful.3 Location of the pain is informative because hip pain often localizes to one of three basic anatomic regions: the anterior hip and groin, posterior hip and buttock, and lateral hip (eFigure A).
Physical Examination
The hip examination should evaluate the hip, back, abdomen, and vascular and neurologic systems. It should start with a gait analysis and stance assessment (Figure 1), followed by evaluation of the patient in seated, supine, lateral, and prone positions (Figures 2 through 6, and eFigure B). Physical examination tests for the evaluation of hip pain are summarized in Table 1.
Imaging
Radiography. Radiography of the hip should be performed if there is any suspicion of acute fracture, dislocation, or stress fracture. Initial plain radiography of the hip should include an anteroposterior view of the pelvis and a frog-leg lateral view of the symptomatic hip.4
Magnetic Resonance Imaging and Arthrography. Conventional magnetic resonance imaging (MRI) of the hip can detect many soft tissue abnormalities, and is the preferred imaging modality if plain radiography does not identify specific pathology in a patient with persistent pain.5 Conventional MRI has a sensitivity of 30% and an accuracy of 36% for diagnosing hip labral tears, whereas magnetic resonance arthrography provides added sensitivity of 90% and accuracy of 91% for the detection of labral tears.6,7
Ultrasonography. Ultrasonography is a useful technique for evaluating individual tendons, confirming suspected bursitis, and identifying joint effusions and functional causes of hip pain.8 Ultrasonography is especially useful for safely and accurately performing imaging-guided injections and aspirations around the hip.9 It is ideal for an experienced ultrasonographer to perform the diagnostic study; however, emerging evidence suggests that less experienced clinicians with appropriate training can make diagnoses with reliability similar to that of an experienced musculoskeletal ultrasonographer.10,11
These are numerous causes for hip pain. Although some hip pain may only be temporary, other forms of hip pain can become chronic if left untreated for an extended period of time. Several common causes of hip pain include, arthritis, fracture, sprain, avascular necrosis, Gaucher’s disease, sciatica, muscle strain, iliotibial band syndrome or IT band syndrome and hematoma, among others described below.
Dr. Alex Jimenez D.C., C.C.S.T.
Differential Diagnosis of Anterior Hip Pain
Anterior hip or groin pain suggests involvement of the hip joint itself. Patients often localize pain by cupping the anterolateral hip with the thumb and forefinger in the shape of a �C.� This is known as the C sign (Figure 1A).
Osteoarthritis
Osteoarthritis is the most likely diagnosis in older adults with limited motion and gradual onset of symptoms. Patients have a constant, deep, aching pain and stiffness that are worse with prolonged standing and weight bearing. Examination reveals decreased range of motion, and extremes of hip motion often cause pain. Plain radiographs demonstrate the presence of asymmetrical joint-space narrowing, osteophytosis, and subchondral sclerosis and cyst formation.12
Femoroacetabular Impingement
Patients with femoroacetabular impingement are often young and physically active. They describe insidious onset of pain that is worse with sitting, rising from a seat, getting in or out of a car, or leaning forward.13 The pain is located primarily in the groin with occasional radiation to the lateral hip and anterior thigh.14 The FABER test (flexion, abduction, external rotation; Figure 3) has a sensitivity of 96% to 99%. The FADIR test (flexion, adduction, internal rotation; Figure 4), log roll test (Figure 5), and straight leg raise against resistance test (Figure 6) are also effective, with sensitivities of 88%, 56%, and 30%, respectively.14,15 In addition to the anteroposterior and lateral radiograph views, a Dunn view should be obtained to help detect subtle lesions.16
Hip Labral Tear
Hip labral tears cause dull or sharp groin pain, and one-half of patients with a labral tear have pain that radiates to the lateral hip, anterior thigh, and buttock. The pain usually has an insidious onset, but occasionally begins acutely after a traumatic event. About one-half of patients with this injury also have mechanical symptoms, such as catching or painful clicking with activity.17 The FADIR and FABER tests are effective for detecting intra-articular pathology (the sensitivity is 96% to 75% for the FADIR test and is 88% for the FABER test), although neither test has high specificity.14,15,18 Magnetic resonance arthrography is considered the diagnostic test of choice for labral tears.6,19 However, if a labral tear is not suspected, other less invasive imaging modalities, such as plain radiography and conventional MRI, should be used first to rule out other causes of hip and groin pain.
Iliopsoas Bursitis (Internal Snapping Hip)
Patients with this condition have anterior hip pain when extending the hip from a flexed position, often associated with intermittent catching, snapping, or popping of the hip.20 Dynamic real-time ultrasonography is particularly useful in evaluating the various forms of snapping hip.8
Occult or Stress Fracture
Occult or stress fracture of the hip should be considered if trauma or repetitive weight-bearing exercise is involved, even if plain radiograph results are negative.21 Clinically, these injuries cause anterior hip or groin pain that is worse with activity.21 Pain may be present with extremes of motion, active straight leg raise, the log roll test, or hopping.22 MRI is useful for the detection of occult traumatic fractures and stress fractures not seen on plain radiographs.23
Transient Synovitis and Septic Arthritis
Acute onset of atraumatic anterior hip pain that results in impaired weight bearing should raise suspicion for transient synovitis and septic arthritis. Risk factors for septic arthritis in adults include age older than 80 years, diabetes mellitus, rheumatoid arthritis, recent joint surgery, and hip or knee prostheses.24 Fever, complete blood count, erythrocyte sedimentation rate, and C-reactive protein level should be used to evaluate the risk of septic arthritis.25,26 MRI is useful for differentiating septic arthritis from transient synovitis.27,28 However, hip aspiration using guided imaging such as fluoroscopy, computed tomography, or ultrasonography is recommended if a septic joint is suspected.29
Osteonecrosis
Legg-Calv�-Perthes disease is an idiopathic osteonecrosis of the femoral head in children two to 12 years of age, with a male-to-female ratio of 4:1.4 In adults, risk factors for osteonecrosis include systemic lupus erythematosus, sickle cell disease, human immunodeficiency virus infection, smoking, alcoholism, and corticosteroid use.30,31 Pain is the presenting symptom and is usually insidious. Range of motion is initially preserved but can become limited and painful as the disease progresses.32 MRI is valuable in the diagnosis and prognostication of osteonecrosis of the femoral head.30,33
Differential Diagnosis of Posterior Hip and Buttock Pain
Piriformis Syndrome and Ischiofemoral Impingement
Piriformis syndrome causes buttock pain that is aggravated by sitting or walking, with or without ipsilateral radiation down the posterior thigh from sciatic nerve compression.34,35 Pain with the log roll test is the most sensitive test, but tenderness with palpation of the sciatic notch can help with the diagnosis.35
Ischiofemoral impingement is a less well-understood condition that can lead to nonspecific buttock pain with radiation to the posterior thigh.36,37 This condition is thought to be a result of impingement of the quadratus femoris muscle between the lesser trochanter and the ischium.
Unlike sciatica from disc herniation, piriformis syndrome and ischiofemoral impingement are exacerbated by active external hip rotation. MRI is useful for diagnosing these conditions.38
Other
Other causes of posterior hip pain include sacroiliac joint dysfunction,39 lumbar radiculopathy,40 and vascular claudication.41 The presence of a limp, groin pain, and limited internal rotation of the hip is more predictive of hip disorders than disorders originating from the low back.42
Differential Diagnosis of Lateral Hip Pain
Greater Trochanteric Pain Syndrome
Lateral hip pain affects 10% to 25% of the general population.43 Greater trochanteric pain syndrome refers to pain over the greater trochanter. Several disorders of the lateral hip can lead to this type of pain, including iliotibial band thickening, bursitis, and tears of the gluteus medius and minimus muscle attachment.43�45 Patients may have mild morning stiffness and may be unable to sleep on the affected side. Gluteus minimus and medius injuries present with pain in the posterior lateral aspect of the hip as a result of partial or full-thickness tearing at the gluteal insertion. Most patients have an atraumatic, insidious onset of symptoms from repetitive use.43,45,46
In conclusion, hip pain is a common complaint which may occur due to a wide variety of health issues. Moreover, the precise location of the patient’s hip pain can provide valuable information to healthcare professionals regarding the underlying cause of the problem. The purpose of the article above was to demonstrate and discuss the evaluation of the patient with hip pain. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Data Sources: We searched articles on hip pathology in American Family Physician, along with their references. We also searched the Agency for Healthcare Research and Quality Evidence Reports, Clinical Evidence, Institute for Clinical Systems Improvement, the U.S. Preventive Services Task Force guidelines, the National Guideline Clearinghouse, and UpToDate. We performed a PubMed search using the keywords greater trochanteric pain syndrome, hip pain physical examination, imaging femoral hip stress fractures, imaging hip labral tear, imaging osteomyelitis, ischiofemoral impingement syndrome, meralgia paresthetica review, MRI arthrogram hip labrum, septic arthritis systematic review, and ultrasound hip pain. Search dates: March and April 2011, and August 15, 2013.
Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain attributes to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
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The workstation is one of the most damaging places you can spend your day when it comes to your spine. Office chairs are not designed to promote good posture or spinal health while desks and computer monitors are notorious for being too low or too high. The result can cause pain in your neck and back, headaches, and a variety of other conditions.� A stability ball could be the answer.
However, if you have a job that requires you to sit at a desk for an extended period, what can you do? Are you stuck with an achy, stiff neck and back because your workstation doesn�t promote a healthy posture? You don�t have to suffer; you can work healthier and smarter. Using an exercise ball as your chair is a great way to combat the painful and even detrimental effects of the traditional desk and chair.
Stability Ball as an Office Chair
A stability ball, also known as a Swiss ball, exercise ball, or physioball, is a large, inflatable ball used for training. A stability ball helps to increase pillar strength, improve stability and have better balance. It is large, making it high enough that it can easily be used as a desk chair.
At least one company has combined the fitness benefits of a stability ball with some of the convenient features of an office chair (wheels, lumbar support, etc.). Gaiam Balance Ball Chairs are stability balls that are intended to be used as chairs. The ball needs to be inflated before use and may need to be reinflated from time to time. It also has a 300-pound weight capacity. It is a somewhat pricier alternative to the plain stability ball.
How Sitting on a Stability Ball Benefits your Spine
There are at least three outstanding benefits you can enjoy by using a stability ball as your chair. Try it for just 30 days and see the difference for yourself. In that time you will see:
Your core muscles are toned. As you balance on the stability ball, it forces you to engage your core muscles including those in your low back, abdominal, and pelvic floor. It will keep your muscles engaged for extended periods of time but also encourage you to move for little extra core work. This, in turn, will help to keep your spine correctly aligned and stabilized.
Your back pain is relieved. Sitting on your stability ball improves your circulation, encouraging blood flow throughout your body. An office chair, on the other hand, does just the opposite. This is helpful in relieving pain. It keeps your spine aligned which also helps with any back pain you may experience. This is in part to the core strength you develop, but also because you are less likely to slouch or sit in a position that puts a strain on your back.
You have better posture.�A better-aligned spine naturally leads to better posture. Sitting on the ball works your core, strengthening those muscles so that your spine is supported, resulting in better posture. You will find that you sit up straighter and over time you will walk taller. Better posture is perfect for your spine, making it more flexible and stronger.
It should be noted that it isn�t healthy to sit in any position for too long. Stand up and move about every hour or so. While the stability ball causes you to change positions throughout the day, you also need full body movement, which includes standing, stretching and walking.
Achondroplasia is a genetic disorder that leads to dwarfism. In those with the condition, the legs and arms are short, while the chest is generally of regular length. Those affected have an average adult height of 131 centimetres (4 ft 4 in) for males and 123 centimetres (4 feet ) for females. Other features include a prominent forehead and an enlarged head. Intelligence is typically considered normal in people with achondroplasia. The condition affects approximately 1 in 27,500 individuals.
Diagnosis for Achondroplasia
Achondroplasia is the result of a mutation in the fibroblast growth factor receptor 3 (FGFR3) gene. This occurs during early development as a new mutation. It is also inherited from the parents in an autosomal dominant way. Those with two affected genes do not survive. Testing if uncertain of diagnosis based on symptoms is often strongly encouraged.
Achondroplasia can be detected before birth�through the use of prenatal ultrasound. Moreover, a DNA test can also be performed to identify homozygosity, where two copies of the gene are inherited causing the deadly condition resulting in stillbirths. Clinical features include megalocephaly, short limbs, prominent forehead, thoracolumbar kyphosis and mid-face hypoplasia. Complications such as dental malocclusion, hydrocephalus and replicated otitis media may also develop. The risk of death in infancy may be increased as a result of the probability of compression of the spinal cord with or without upper airway obstruction.
Achondroplasia and Sciatica
Individuals with achondroplasia commonly experience back pain, which may often progress to sciatica symptoms, such as pain and discomfort, tingling and burning sensations in the lower extremities, and numbness, among other consequences. Both children and adults with achondroplasia have hip flexion contractures which have been found to be a contributing factor for sciatica and muscle fatigue reported by individuals with achondroplasia. Individuals with achondroplasia also typically demonstrate a mixed pattern of joint mobility, including joint contracture and joint hypermobility at characteristic joints.�
Achondroplasia Management
There is no known cure for achondroplasia even though the cause of the mutation has been found. Management for the condition might include support groups and growth hormone treatment. Efforts to treat or prevent complications like obesity, hydrocephalus, obstructive sleep apnea, middle ear infections, or spinal stenosis may be required for the management�of achondroplasia. Life expectancy of those affected is approximately 10 years less than ordinary.�The scope of our information is limited to chiropractic, spinal injuries, and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Acute Back Pain
Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain attributes to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Alternative treatment options, such as chiropractic care, can help ease back pain through spinal adjustments and manual manipulations, ultimately improving pain relief.
Spondylolisthesis occurs when a�vertebra of the spine slips forward over the vertebra below it. Spondylolisthesis can be categorized as: congenital spondylolisthesis, which means the disorder is present at birth; isthmic spondylolisthesis, which occurs when a defect occurs in a supportive vertebral structure of the spine; and degenerative spondylolisthesis, which is more common and is frequently associated with degenerative disc disease, or DDD, where the intervertebral discs lose hydration with age.
Development of Spondylolisthesis
The spinal column is exposed to directional pressures while it carries, absorbs, and also distributes most of the fat of the body throughout physical activities and during rest. To put it differently, while the spine is consuming and carrying body fat, additionally, it moves in different directions (e.g., rotate, bend forwards ). This mixture of functions causes unnecessary stress to be placed onto the vertebra and the supportive vertebral�structures of the spine, and it might result in one of these slipping forwards over the ones beneath it, ultimately developing into spondylolisthesis.
Grading spondylolisthesis
Doctors “grade” the severity of spondylolisthesis utilizing five descriptive categories. Even though there are several factors your physician notes when evaluating your spondylolisthesis, the grading scale (below) relies on how far forward a vertebral body has slid over the vertebra beneath it. Often, the doctor uses a lateral (side view) x-ray to examine and grade�spondylolisthesis. Grade I is a smaller slide than Grade IV or V.
Grade I: Less than 25% slip
Grade II: 25% to 49% slip.
Grade III: 50% to 74% slip.
Grade IV: 75% to 99% slip.
Grade V: The vertebra has fallen forward off the vertebra below it. This�grade is the most severe type of spondylolisthesis and is medically referred to as�spondyloptosis.
Who Might be at Risk
If a family member has spondylolisthesis, your risk for developing the disorder may be higher. Also, some physical activities can make you more vulnerable to developing spondylolisthesis. Gymnasts, linemen in football, and weightlifters, all put pressure and stress on their spine. Picture the movements gymnasts perform on a regular basis: they bend backward and twist through the air, landing quickly and absorbing the impact through their legs and back. Those motions can place strain on the spine, potentially causing spondylolisthesis.�The scope of our information is limited to chiropractic, spinal injuries, and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Scoliosis Pain and Chiropractic
The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, other aggravated conditions can also cause back pain.�Scoliosis�is a well-known, health issue characterized by an abnormal curvature of the spine and it is subcategorized by cause as a secondary condition, idiopathic, or of unknown cause, or congenital. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain associated with scoliosis through the use of spinal adjustments and manual manipulations, ultimately improving pain relief. Chiropractic care can help restore the normal curvature of the spine.
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