As a chiropractor, when I ask people to point to their hip pain it is very interesting to see the vast number of places where people point– the low back, the hip pocket area, the side of the pelvis, in the groin and more!
This article will provide information about the human hip, some sources of hip pain and introduce ideas pertaining to conservative hip pain relief treatment.
The true hip joint is a ball and socket joint located on either side of our pelvis. The ball part of the joint is from the top of the thigh bone, called the femur. The socket part of the joint is an indentation of the side of the pelvis. The hip joint is the largest joint of the body. It is one of the few joints that moves in every direction.
The ball of the joint is held into the socket by strong ligaments. It is also held against the socket by a structure called the labrum. The labrum is a rubbery tissue that forms a rim around the outer edge of the socket. Sometimes hip pain can be attributed to a tear of the labrum. This may be seen on an MRI. However just because the MRI shows a tear, it doesn’t necessarily determine it is the source of hip pain. In fact, a research study showed that 66% of a group of people having no hip pain, who underwent MRIs were diagnosed by certified radiologists as having labral tears. Again, these people had no hip pain!
Closely associated with the hip joint are the bones of the pelvis. The pelvis is not just one bone, but is made up of three. The two outside “wing” bones are called the iliac bones. The centrally located “tailbone” is called the sacrum. The joints between the sacrum and either iliac bone are called the sacroiliac joints. These joints are gliding joints, but sometimes they can become misaligned or move improperly. This can cause the pelvis to have improper, altered alignment and/or movement biomechanics. This can cause pain of the sacroiliac joints and can cause associated pain in the hip joints.
Some orthopedic hip specialists may only focus on the hip joint itself when the patient has pain in this area. However, doctors of chiropractic, look at the entire person having hip pain. Chiropractors are trained to identify the origins of hip pain which may arise from the lower back, pelvis, hip, or possibly the knee, ankle and foot. Utilizing information from a careful history, examination, imaging (when appropriate), and functional tests, allow chiropractors to offer a noninvasive, nonsurgical, safe, conservative approach to relief of hip pain.
In my chiropractic practice of 35 years I have heard my patients say, many times, that their lower back pain “made them feel old.” Anyone suffering from discomfort of the back can readily understand and sympathize with that sentiment and look forward to the time back pain relief will arrive. When the back is acting up it limits us in practically all of our activities of daily living. Conversely, if our back feels well and our general health is good, we can not only function normally but optimally.
Over the course of decades there has been an evolution of knowledge about back disorders. This article will review the progression of non-credible and credible evidence-based care of mechanical pain of the back. It will discuss the numerous benefits of chiropractic evaluation and treatment in the quest for relief of lower back pain.
Some of the earliest scholarly literature regarding back conditions made the erroneous declaration that lower back pain was short lived, self-limiting and self-resolving. The authorities who made these statements had no scientific research evidence. It was simply opinion.
Unfortunately, this dogma became ingrained in the perspective of some healthcare professionals, the insurance industry and governmental agencies. Despite knowledge to the contrary, which will be discussed further in this article, many inaccurate healthcare guidelines detailing care of painful back conditions persist to this day.
In the mid-1990s several studies were published in prominent research journals such as Spine and the British Medical Journal which were contrary to earlier scholarship. These scientific articles, backed with research and evidence, noted that conditions of a painful back came as recurrent episodes. In other words, patients would have ongoing numerous times when their back was painful with intervals of less or no pain. These studies made clear that back pain could be an ongoing, unresolved chronic condition. It was discovered that over time recurrences of painful episodes worsened and became a huge problem for the individual and society.
Unsuccessful treatment by many healthcare practitioners included use of medications, recommendations of rest, exercise programs and ultimately, surgery. Evidence showed that while there may be short-term symptomatic relief with these regimens, the underlying problem continue to exist for all concerned.
Currently, this ongoing problem has contributed to the United States having an opioid epidemic. Many people hooked on narcotic drugs attribute their addiction to initial opioid prescriptions for their painful back. In addition, society expends huge financial costs in the treatment of back pain.
In the 2000’s research revealed that the majority of back conditions was a result of a specific, underlying biomechanical cause. Treatment mentioned previously did nothing to correct the biomechanical problem. However, scholarship did reveal an underutilized profession that had been successfully treating lower back pain for over 100 years.
The profession of chiropractic focuses on the evaluation and treatment of the cause of the majority of lower back pain. Specifically, misalignments and improper motion of the joints of the spine and pelvis create back discomfort. By restoring proper movement and alignment of the spine and pelvis chiropractors are able to address the underlying cause of conditions of the back. Whereas other types of care are nonspecific, a doctor of chiropractic’s focus is on correction of the mechanical problem. Without the use of drugs or surgery chiropractors utilize a chiropractic adjustment to address the exact problem. Chiropractic adjustments are a safe, gentle technique to physically create realignment and proper movement, specifically where it is needed in the spine and/or pelvis.
Numerous research studies confirm that chiropractic is considered the gold standard for alleviation of pain in the back. This has numerous benefits. Some scientists feel that chiropractic care for lower back pain could greatly improve the opioid epidemic in the United States. Studies show that alleviation of back pain also allows individuals to continue with their normal life working, attending school, keeping up a house and yard, sleeping well and maintaining agreeable family and social relationships.
This all tends to benefit cost savings to individuals, families and society. Since back pain can cause people to be in a situation of financial disability a huge burden can be created on many levels. Keeping people employed versus having to accept government disability payments should create a financial incentive for back ache sufferers to be encouraged to seek chiropractic care.
The increasing range of scientific published research studies, supporting chiropractic care, for the management of spinal pain, has not only evolved over recent decades but clearly shows that there are many benefits for the inclusion of chiropractic relief of back complaints.
Many people experience pain in the mid back and around the shoulder blades. For some, it is an intermittent pulling. For others it is a constant nagging ache. There are those who get an intense sharp, stabbing pain which can be nearly incapacitating. Everyone suffering these symptoms would enjoy pain relief. Fortunately, during my 35 years as achiropractor I have found there is hope and an approach for resolution of their pain.
This article will discuss how mid back pain and factors involving the neck are related. It will explain a specific cause of this condition and how it can be corrected. It will also introduce recent scientific research discussing this topic.
It is very common for patients initially coming to my chiropractic office to say they are experiencing extreme pain in the shoulder blade areas. It may be difficult for them to realize that a related, but less symptomatic neck injury, is hiding in the shadows. This can be explained by understanding how our bodies respond to injury.
When a part of our body is injured there is a natural response for that area to be protected. We all know that swelling of a sprained finger or ankle joint causes loss of normal joint movement. That is because the swelling, like a cast surrounding the joint, limits movement so we don’t hurt it any further. Other areas, when injured, create a protective mechanism by causing muscle spasm. Although we don’t like muscle spasms, they limit movement of the area so that we don’t cause further injury.
When the neck is injured the muscles will go into reactive spasm. However, since these muscles are small, they typically don’t create much protective spasm. In contrast, the muscles of the upper back and upper shoulders are large and powerful. When they react protectively, they will create a mechanism of spasm that inhibits harmful movement of the entire neck and upper back. Correspondingly, the significant spasm of these large muscles creates severe pain.
That is why extreme mid back pain and neck problems are commonly related.
A scientific study in the Annals of Rehabilitative Medicine, February 2020 details research where examination of 78 individuals revealed an association between chronic neck pain and abnormal mid back curvature, reduced thoracic mobility and impaired respiratory strength.
Chiropractic management of mid back pain relief focuses on the entire person. Relief of mid back pain should involve uncovering the source of the complaint in other spinal regions like the neck. Chiropractic adjustments to correct misalignments and improper movement of the spinal joints of the neck and mid back can cause a reduction of irritated and pinched nerves. This allows muscle spasms to relent and a corresponding enjoyment of pain relief results.
To gain middle back pain relief chiropractors focus on examination and treatment of the entire person. This is vitally important in obtaining satisfactory patient outcomes.
Many people suffer from lower back pain. They seek pain relief from various healthcare providers such as PCPs, orthopedic specialists, chiropractors and physical therapists. A multitude of factors can cause pain of the back. The pelvis is one area of the human body that can be the cause of a back pain condition. This article will discuss the pelvis and how it may relate to back conditions.
The pelvis is at the base of the spinal column. It is not one solid bone but, is made up of three separate bones. The two bones on either side are called the iliac bones (they are the “wings” of the pelvis). The bone in the center is called the sacrum (this is the tailbone). Between both sides of the sacrum and the iliac bones are two large joints called the sacroiliac joints. The sacroiliac iliac joints are gliding type joints– for instance they glide back and forth when we walk. The pubic joint is in the front of the pelvis. The pelvis and the thigh bones, called the femurs, form the ball and socket joints of our hips.
Many muscles attach to different areas of the pelvis. The abdominal muscles, the buttock and gluteal muscles, the thigh muscles and the hamstrings all originate or insert into the pelvic bones.
If the pelvic bones become misaligned, or if there is improper movement of the joints, problems can occur. Pain can arise from the joints between the top of the sacrum and the lower spine. Discomfort can also occur from affected sacroiliac joints. The hip joints can also be involved.
Any altered mechanical movement patterns of these joints can cause pain and dysfunction. For instance, it is very common for women during and just after pregnancy to experience lower back discomfort. Athletes may find they have back problems with the exertion of their sports. Anyone doing physical construction, landscaping or service work may be hindered due to pain. Even office workers may find they cannot sit required long hours comfortably.
If a person has a pelvic imbalance and altered movement pattern, they may carry more weight on one lower extremity versus the other. Left unattended over many years this could lead to degeneration of the hip and/or knee joint which might require surgical replacement with an artificial hip or knee.
Doctors of chiropractic are healthcare practitioners that specialize in diagnosing structural misalignments, imbalances and faulty and improper movement of the joints associated with the pelvis. Chiropractors can perform a treatment called manipulation which can realign the pelvis, so the patient is bearing weight evenly on both lower extremities. A chiropractic manipulation can also restore proper movement to the joints of the pelvis and hips. This will bring pain relief that may be occurring in the back, pelvis and hips.
The chiropractic profession has been helping patients suffering from these types of musculoskeletal conditions with conservative treatment to relieve pain and resume their normal activities for 125 years.