Femoroacetabular impingement, or FAI, is a medical state where additional bone develops in a single or multiple of the bones which make up the hip joint, giving the bones an irregular form. As a result, the bones may rub against each other since they do not fit together properly. This friction can ultimately harm the joint, causing pain, discomfort and limiting movement.
Anatomy
The hip is commonly characterized as a ball-and-socket joint. The acetabulum, which is part of the large pelvis bone, forms the socket of the joint. The ball of the joint is the femoral head, that is the upper end of the thighbone or femur. A type of soft tissue, known as articular cartilage, covers the surface of the ball-and-socket hip joint.
Articular cartilage makes a smooth, low friction surface which aids the bones to slide easily across each other through movement. The acetabulum is also lined by strong fibrocartilage, known as the labrum. The labrum shapes a gasket across the socket, forming a tight seal to provide stability as well as to help properly support the hip joint.
With femoroacetabular�impingement, bone spurs or bone overgrowth, surround the femoral head, across the acetabulum. The extra bone causes the hip joints to come into close contact and prevents them from gliding smoothly and without friction during movements. With age, this can cause labrum tears and osteoarthritis, or the breakdown of articular cartilage.
Types of Femoroacetabular Impingement
According to doctors, there are three types of femoroacetabular impingement, or FAI: pincer, cam,�and combined impingement.
Pincer:�This variety of impingement develops when bone extends outwards from the standard rim of the acetabulum. As a result, the labrum is crushed beneath the rim of the acetabulum.
Cam: In cam,�impingement of the femoral head causes the joint to be unable to rotate smoothly. A bump forms on the border of the femoral head which grinds the cartilage inside the acetabulum.
Combined: Combined impingement suggests that both pincer and cam types of femoroacetabular�impingement are found.
Causes of FAI
Abnormal development of the hip bones and joints throughout childhood is the most common cause of femoroacetabular impingement. However, it is the deformity of a pincer bone spur�or a cam bone spur which leads to joint damage and hip pain. If the hip bones and joints do not form normally, there’s little which can be done to prevent femoroacetabular�impingement.
Many people may have FAI and never�experience symptoms from the condition. When symptoms develop, however, it generally indicates that there is damage to the cartilage or labrum and the health issue may progress. Moreover, athletes are more likely to experience symptoms of femoroacetabular impingement, although exercise does not cause FAI.
Symptoms of FAI
The most common symptoms of femoroacetabular impingement include: pain and discomfort; stiffness; and limping.�Pain associated with FAI frequently occurs in the region of the groin, although it may also occur toward the exterior of the hip. Twisting, turning, and squatting may cause a sharp, stabbing pain while the pain is generally described as a dull ache.
Diagnosis of FAI
For the first consultation, the healthcare professional will discuss the patient’s hip symptoms and talk about their general health and wellness. They will also examine the patient’s hip. As part of the physical evaluation, the doctor will conduct an FAI impingement test by bringing up the patient’s knee then rotating it towards their opposite shoulder. If this recreates hip pain, the test is positive for femoroacetabular impingement.
Imaging Diagnostics
The healthcare professional may also order imaging diagnostics to help determine whether the patient has femoroacetabular impingement, or FAI. The following imaging diagnostics below can be used.
X-rays: These will show whether the hip has shaped bones of FAI, and provide images of the bone. X-rays may also reveal signs of arthritis.
Computed tomography (CT) scans: More comprehensive than a plain x-ray, CT scans help the healthcare professional determine the specific contour of the patient’s hips.
Magnetic resonance imaging (MRI) scans: These tests create pictures of soft tissue. They will help the doctor find harm to the labrum and articular cartilage. Injecting dye into the joint may make the damage or injury show up more clearly.
Local anesthetic: The doctor can also inject a numbing medication into the hip joint as a test. It affirms that FAI is the problem if temporary pain relief is provided by the local anesthetic.
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Femoroacetabular impingement, or FAI, commonly affects the hip joint of many young and middle-aged adults. FAI occurs when the ball-and-socket joint of the hip causes abnormal friction and restricts range of movement. Furthermore, damage or injury to the articular cartilage or the labrum can affect the femoral head or the acetabular socket. Treatment options for FAI can range from alternative treatment options to surgery.
Dr. Alex Jimenez D.C., C.C.S.T. Insight
Treatment for Femoroacetabular Impingement
Non-Surgical Treatment
Lifestyle modifications:�The healthcare professional may recommend changes in physical activities that cause symptoms, simply altering the patient’s regular everyday routine.
Drugs and/or medications: The use of drugs and/or medications, such as ibuprofen, can be offered to help decrease painful symptoms and inflammation. The relief may only be temporary.
Alternative treatment options:�Treatment approaches like chiropractic care and physical therapy can help provide pain relief to patients with femoroacetabular impingement. Moreover, specific stretches and exercises can strengthen the muscles which support the joint and can boost range of movement. This can help relieve some stress and pressure on articular cartilage or the labrum.
Surgical Treatment
If imaging diagnostics and physical evaluations reveal additional hip joint damage and/or injury as well as the presence of other conditions and non-surgical treatment does not relieve the patient’s pain, the healthcare professional may recommend surgical interventions or surgery.
Arthroscopy
Femoroacetabular impingement can be treated with arthroscopic surgery. Arthroscopic surgical interventions are performed with thin instruments using little incisions. The surgeon then utilizes a small camera to look�inside the hip. The doctor can fix or clean out any damage to the labrum and articular cartilage by shaving the bulge on the femoral head and also trimming the bony rim of the acetabulum.
As the results of operation enhance, physicians will recommend surgery that is earlier for FAI. Surgical techniques continue to progress and at the future, computers may be utilized to guide the physician in reshaping and correcting the hip. 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.
With the increase of osteoporosis in older adults, the diagnosis and treatment�of abnormal hip fractures, such as�bisphosphonate-related proximal femoral fractures,�has become more important. According to Dr. Edward J. Fox, MD, obesity is often managed through the long-term�use of bisphosphonate treatment, which can inhibit�osteoclast-mediated bone regeneration. Over the prolonged utilization of bisphosphonate, patients� may develop atypical proximal femoral fractures.
Understanding Atypical Femur Fractures
Atypical femur fractures are characterized as stress fractures which commonly occur in the proximal one-third of the diaphyseal bone, although they might also occur more distally, developing in the lateral cortex and slowly progressing medially. “With irregular fractures, a small ‘beak’ of bone can form on the lateral surface of the femur and that is where the fracture generally begins,” explains Dr. Fox. This contrasts with stress fractures which occur laterally in the medial portion of the bone.
As a result, when a patient with osteoporosis reports feeling hip and knee pain without previous damage or injury, healthcare professionals will ask about bisphosphonate treatment. It is essential for the�doctor to request x-rays of the hip and femur shaft for proper diagnosis.�It is also important to request x-rays of the opposite femur, as atypical bisphosphonate-related proximal femoral fractures frequently occur bilaterally. Dr. Edward J. Fox urges patients to discontinue bisphosphonate use in the case of hip fractures,�followed by the subsequent use of crutches or a walker. Patients will eventually be able to resume regular physical activities.
Approximately more than 250,000 hip fractures occur in the United States, causing significant patient disability. The variety of hip fractures in older adults, including bisphosphonate-related proximal femoral fractures, often need several treatment approaches which depend on different considerations, such as the mechanism of injury, location and degree of the fracture, as well as the patient’s age and overall health and wellness.
Dr. Alex Jimenez D.C., C.C.S.T.
The precise mechanism of injury by which bisphosphonates cause atypical femur fractures is unknown. Research studies have demonstrated that the suppression of osteoclast activity prevents the clearance of bone fragments which build up on the bone surface during regular daily tasks; decreasing the strength of the bones which lead to fracture. “We all know that the threat of those fractures increases with the extended duration of bisphosphonate exposure, particularly after five decades. Bisphosphonates are stored with a half-life of at least eight decades in bone matrix. To reduce over-exposure and risk of atypical fracture, passing medication discontinuance has been speculated to be beneficial,” explained Dr. Fox
Dr. Edward J. Fox, MD, stated that until research studies find the exact mechanism of injury and treatment for bisphosphonate-related proximal femoral fractures, healthcare professionals should continue to determine the best treatment option for each patient, carefully weighing the benefits and risks of individual patients. 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 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.
Hip fractures are characterized as any type of break in the upper region of the femur or thigh bone. The variety of broken bones generally depends on the circumstances and the force applied to the bone, where some can be more common than others. Impacted femoral neck fractures are common hip fractures which occur in many older adults in the United States.
Anatomy of Impacted Femoral Neck Fractures
The hip is a ball-and-socket joint which provides the femur the ability to bend and rotate at the pelvis. While any form of broken bones in the thigh bone or femur is considered a hip fracture, damage or injury to the socket, or acetabulum, itself is not considered a hip fracture. Below we will discuss hip fractures, particularly impacted femoral neck fractures, among others.
Causes, Symptoms and Diagnosis
Hip fractures frequently�occur due to a slip-and-fall accident or due�to a direct blow to the hip. Various health issues, including osteoporosis and stress injuries, as well as cancer, can sometimes weaken the bones and make the pelvis more vulnerable to fractures.�The neck of the femur is located under the ball of the hip joint. Impacted femoral neck fractures occur when a force presses against both ends of the femur at the femoral neck, pushing the broken ends of the bone together.
Patients with hip fractures experience symptoms of pain on the upper thigh or in the groin. They may also experience considerable discomfort with any attempt to flex or rotate the hip. In comparison to impacted femoral neck fractures, if the bone is completely broken, the leg may appear to be shorter than the non-injured leg. Also, the patient will hold the injured leg in a still position with the foot and knee turned outward in external rotation.
Diagnosis�for hip fractures commonly involves the use of x-rays of the hip, pelvis and/or femur. In several instances, if the patient experiences a slip-and-fall accident or a direct blow to the hip resulting in impacted femoral neck fractures, they may not be seen on a regular x-ray. Magnetic resonance imaging, or MRI, may be recommended to view some cases of hip fractures. The MRI scan will typically demonstrate any hidden hip fractures. Computed tomography, or CT, scans may also be utilized instead.
Impacted femoral neck fractures are hip injuries which occur just below the femoral head, or the ball-and-socket hip joint, where the broken ends of the bone are jammed together by the force of the injury. This area of the thigh bone, or femur, is known as the femoral neck. Treatment for impacted femoral neck fractures may include rest and physical rehabilitation. Diagnosis for impacted femoral neck fractures is important for treatment.
Dr. Alex Jimenez D.C., C.C.S.T.
Treatment of Impacted Femoral Neck Fractures
Once a healthcare professional has diagnosed the patient’s hip fracture, their overall health and wellness will also be evaluated.�Treatment for femoral neck stress fractures depends on the patient’s age and on the extent of the broken bone. Treatment for femoral neck stress fractures�include bed rest for several days followed by a physical rehabilitation program.
Many femoral neck stress fractures are treated with surgery. It’s essential for the patient to talk to their doctor to discuss the best treatment option.�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.
Back pain can be debilitating, causing immobility, inflexibility, and have a significant impact on a person�s quality of life. It can make even the most mundane daily activities extremely difficult � and even excruciating. Building the muscles that make up your core (abdominals and back) can help support your spine and reduce back pain. In many cases, strengthening these muscles can assist a patient to avoid medication with its unpleasant side effects and even avoid surgery. With just a few smart moves you can significantly decrease your back pain, increase your mobility, and take back your life.
The Role of Abs and Back Muscles
The spine is the supporting structure for the back, but it also is a vital infrastructure for the entire body. It houses the central nervous system, and neural impulses are transferred along what is�a spinal superhighway.
The arms, legs, neck, and head are all connected and stabilized by the spine through an intricate network of ligaments and muscles. The back muscles and abs, or abdominal muscles, are at the center, or core, of this muscle network. They keep the body upright and facilitate movement. When these core muscles are not in good condition, it puts stress on the spine, impacting its ability to support the body. This often results in back pain and even injury in some cases.
Postural Alignment
Postural alignment is a frequent contributor to back pain. This is often due to weak core muscles.
As the muscles fail to do their job to stabilize the spine, the body adjusts structurally to accommodate the weakness. This can result in postures that cause joint pain as well as muscular pain and even headaches.
For instance, stooped or hunched shoulders can cause back pain, but it can also create tension in the shoulders and neck. This, in turn, can cause tension headaches and migraines in patients.
A sway back, where the lower back bows, causing the pelvis to tilt up, can cause severe lower back pain, especially after standing for long periods of time. Swayback can be the result of weakened core muscles or a combination of a weak core, combined with obesity or pregnancy.
The weight in the abdominal area pulls the spine forward so that it curves. A pregnancy sling can sometimes help with the pain, but it is just a band-aid. The real cure is to strengthen the core muscles so that they are better able to support the spine and body adequately.
Foundation Training
Eric Goodman, a chiropractor, developed Foundation Training as a way to help his patients who suffer from lower back pain but are not physically able to do Pilates or yoga. It is also designed to help those who sit for long periods of time to counteract the associated adverse health effects.
Foundation training incorporates powerful yet straightforward movements that work to integrate the body�s muscular chains, increasing strength and realigning the core and spine. It does not require any equipment so the actions can be performed anywhere. The muscles are trained how to move correctly and work together so that you the body learns to move how it is designed to move. The critical, essential exercise can be viewed in this video.
Creating a strong core can help relieve back pain but also have added benefits such as increasing energy, better mobility, and an improved mood. By allowing the body to support itself, it can naturally relieve pain and heal certain conditions without invasive surgery or medication which can have unpleasant or even harmful side effects. When you take good care of your body, it will take good care of you.
The hip is a ball-and-socket joint composed of the head of the thigh bone, or femur,�which acts as the ball and fits into the round socket of the hip bone, or acetabulum. The neck of the femur is located under the ball of the hip joint. Stress fractures to the femoral neck can entirely or partially detach the femoral head from the rest of the femur.
Femoral neck stress fractures can be either displaced, where the bone is transferred out of its normal position, or non-displaced, where the bone remains stable. These fractures may interrupt blood flow to the portion of the broken bone. In recovery, the blood supply prevents severely displaced femoral neck stress fractures from healing correctly.
Causes and Symptoms of Femoral Neck Stress Fractures
Femoral neck stress fractures can result due to: a small slip-and-fall accident or twisting of the hip in older adults, osteoporosis, a high-impact�injury, such as from an automobile accident, and�sudden strenuous physical activity or changes in physical activity in younger individuals unaccustomed to the events, including from sports injuries.�
The symptoms of femoral neck stress fractures generally include: pain and discomfort, radiating pain which extends to the knee, inability to bear weight on the affected lower extremity, shortening or sideways rotation of the leg, increased pain in the hip during the rotation of the leg, and inflammation on the side of the hip with the femoral neck stress fractures.
Diagnosis and Treatment of Femoral Neck Stress Fractures
A healthcare professional will diagnose femoral neck stress fractures based on the causes and symptoms of the health issue, followed by clinical evaluation. Many doctors order x-rays to diagnose femoral neck stress fractures. The doctor may also order�magnetic resonance imaging, or MRI, and computer tomography, or CT, scanning for a better diagnosis.
Treatment for femoral neck stress fractures depends on the patient’s age as well as on the extent of the broken bone. Treatment for femoral neck stress fractures may include�bed rest for several days followed by a physical rehabilitation program. A healthcare professional may prescribe drugs and/or medications to relieve pain, prevent blood clots and treat infection.
Many femoral neck stress fractures are treated through surgical interventions. Surgery for femoral neck stress fractures involves hip pinning if the bone is minimally displaced and the patient has�enough bone density. The surgeon performs this by making a small incision and then inserting several screws to stabilize the bones which are broken.
Hip hemiarthroplasty or partial hip replacement is utilized for displaced fractures where the surgeon will replace the�femoral head with a metal implant. The socket is not replaced in a partial hip replacement procedure. For total hip replacement, the surgeon will replace the socket of the hip joint, as well as the femoral head, with artificial metallic implants.
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Femoral neck stress fractures are hip injuries which occur just below the femoral head, or the ball-and-socket hip joint. This area of the thigh bone, or femur, is known as the femoral neck. Femoral neck stress fractures happen when the ball is disconnected from the rest of the femur, or thigh bone. Treatment for this health issue includes rest and physical rehabilitation.
Dr. Alex Jimenez D.C., C.C.S.T.
Conclusion
Femoral neck stress fractures occur�in the hip area below the ball-and-socket joint of the hip. A healthcare professional will suggest treatment based on the severity of the femoral neck stress fractures and the patient’s age.�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.
Pain along the pelvis and groin region is known as osteitis pubis. Osteitis pubis develops through the inflammation of the pubic symphysis, or the joints of the major pelvic bones found at the front of the pelvis.
The pubic symphysis is a thin joint which generally provides very minimal motion. The joint retains the two sides of the pelvis together in the front, where they connect�at the sacrum in the rear side of the pelvis.
Osteitis Pubis Symptoms
Osteitis pubis is commonly characterized by pain in the front of the pelvis. Other causes of pelvic pain, such as a strain or a sprain, are frequently confused and diagnosed as osteitis pubis. While many patients report painful symptoms on one side, the�pain�typically occurs in the middle of the pelvis. Other symptoms of osteitis pubis include limping and weakness.
Osteitis Pubis Causes
For some patients, the pubic symphysis itself can become irritated and inflamed, causing the well-known symptoms of osteitis pubis. Other common causes of osteitis pubis comprise of: sports injuries, particularly from football, hockey, and soccer; pregnancy; gynecologic or abdominal surgical interventions; and trauma or injury from accidents.
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Osteitis pubis is known as the inflammation of the pubis symphysis which causes various degrees of lower abdominal, pelvic, and groin pain. Symptoms of osteitis pubis include pain and discomfort in the region of the pelvis when engaging in physical activities, and loss of flexibility. A variety of causes, including sports injuries, can cause osteitis pubis. Fortunately, rest alone can help treat this painful health issue.
Dr. Alex Jimenez D.C., C.C.S.T.
Osteitis Pubis Diagnosis
Diagnosis of osteitis pubis generally involves x-rays which demonstrate an irregular pubic symphysis with sclerotic, or thick, bone borders as a result of chronic inflammation. An MRI test is generally not required, however, it will help demonstrate the inflammation of the bone and the joint.
Additional tests may be performed to ensure there’s no infection in the bone which could also be causing symptoms similar to osteitis pubis. This complication is more of a concern for those patients who have had recent surgery or for those who are more prone to suffer from infections.
Osteitis Pubis Management
The most recommended treatment for osteitis pubis is rest. Since inflammation is the problem, the human body often only requires the joint to rest in order to heal correctly. Other treatment, however, consists of:
Rest
An essential treatment for osteitis pubis is rest as this will permit the intense inflammation in the pelvis and groin to subside. For many patients, rest alone is the only treatment necessary for their�osteitis pubis. If the pain is severe, crutches or a cane may provide additional assistance.
Ice and Heat
Ice packs and heating pads are among the most commonly used remedies for inflammation. Make sure to follow the instructions of your healthcare professional before utilizing ice and heat for your osteitis pubis symptoms.
Chiropractic Care
Chiropractic care is a well-known, alternative treatment option for osteitis pubis. A doctor of chiropractic, or chiropractor, will utilize a variety of treatment methods and techniques, to help restore strength, mobility, and flexibility while rest is needed to subside the painful symptoms. Chiropractic care can also help correct any spinal misalignments which may be causing additional pain and discomfort for the patient.
Drugs and/or Medications
Nonsteroidal anti-inflammatory drugs and/or medications, commonly referred to as NSAIDs, are frequent prescriptions provided for patients with hip pain brought on by problems like arthritis, bursitis, and tendonitis.
Treatment of osteitis pubis may take some time to completely relieve the painful symptoms. The use of drugs and/or medications is demonstrated to be better than the other treatment options listed above, although attempts to heal osteitis pubis with cortisone injections have been tested.
Surgical interventions are generally not necessary for patients with osteitis pubis.�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 the most prevalent cause of disability worldwide and 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.
Ankylosing Spondylitis is a type of arthritis that typically begins during adolescence or in a person�s early twenties and occurs more often in men than in women. However, once experiences onset, they are affected for the rest of their lives. It is estimated that between 0.2% and 0.5% of individuals in the United States suffers from ankylosing spondylitis. �It can cause significant pain, discomfort, and immobility. While there is no cure for the condition, the symptoms can be treated, bringing some degree of comfort and mobility.
What is Ankylosing Spondylitis?
Ankylosing Spondylitis, or AS, is a type of arthritis that causes inflammation in the spine. While the vertebrae are primarily involved, it can also affect other joints as well, including the hips, shoulders, heels, ribs, and the small joints of the feet and hands.
In some cases, the heart, lungs, and even eyes can be involved. If left untreated, the condition can progress, causing chronic pain that can be severe as the spinal inflammation increases. More advanced cases can cause the spine to grow new bone formations so that it is immobile, or fixed, sometimes resulting in kyphosis, which is a bowed or forward-stooped posture.
What Causes Ankylosing Spondylitis?
While genetics is believed to be a key player in the development of Ankylosing Spondylitis, the exact cause has not yet been determined. The majority of people who have AS also carry a specific gene that has been linked to the condition.
This gene produces HLA-B27, a protein or genetic marker, that more than 95% of Caucasians with ankylosing spondylitis have. However, some people don�t have this protein who develop AS and many people do carry this marker yet never develop the condition.
Researchers theorize that there may be other genes that may be involved, as well as environmental factors that trigger the gene activation, such as a bacterial infection, causing people who are susceptible to AS to activate it. Scientists have identified more than 60 genes that are believed to be associated with AS with only about 30% that are linked to HLA-B27 regarding overall risk. Other genes that have been identified as key to AS include IL-23, IL-17, IL-12, and ERAP.
It is also believed that AS can be triggered when the intestinal defenses break down, allowing certain bacteria into the bloodstream. This can, in turn, cause an immune response.
How is Ankylosing Spondylitis Treated?
AS cannot be cured, but the symptoms can be treated to relieve stiffness and pain as well as delay or prevent spinal deformity and other complications. The damage that it does to the joints is irreversible, so it is best if treatment is started before that occurs. There are several ways that AS is treated:
Medication � Nonsteroidal anti-inflammatory drugs (NSAIDs) like indomethacin (Indocin) and naproxen (Naprosyn) are commonly used to treat the symptoms of AS. They can be useful in relieving pain, inflammation, and stiffness but may cause some side effects, including gastrointestinal bleeding. This makes long-term use impractical and even unsafe. If NSAIDs do not help, other medications may be prescribed, including:
Golimumab (Simponi; Simponi Aria)
Certolizumab pegol (Cimzia)
Adalimumab (Humira)
Etanercept (Enbrel)
Infliximab (Remicade)
Physical therapy – PT is often recommended to help with flexibility, strength, and pain relief. It can help with posture and prevent some of the more debilitating symptoms.
Surgery � Most people with AS do not require surgery, but it may be recommended if there is severe joint damage or pain. In some cases, it can cause significant damage to hip joints, and they will need to be replaced.
Chiropractic � Many patients with AS have with outstanding results with chiropractic treatment. It is non-invasive and does not have the unpleasant side effects that many medications have.
Chiropractic Treatment for Ankylosing Spondylitis
Chiropractors strongly recommend chiropractic treatment for the non-acute inflammatory stage of AS. Once the condition has progressed to acute joint disease, there is a very high risk of injury or damage to the connective tissue. Adjustments and exercise are used to relieve symptoms, but some of the traditional spinal manipulation treatments are not performed.
A chiropractor will also make recommendations to the patient regarding lifestyle changes that can help with symptoms, such as stopping smoking. Tobacco use can increase inflammation and damage connective tissue. They may also advise increasing their intake of omega three fatty acids in their diet. Regular chiropractic care can help patients manage symptoms and prevent disease progression, improving their quality of life.
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