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Chronic Back Pain

Chronic back pain has far reaching effect on many physiological processes. Dr. Jimenez reveals topic and issues affecting his patients. Understanding the pain is critical to its treatment. So here we begin the process for our patients in the journey of recovery.

Just about everyone feels pain from time to time. When you cut your finger or pull a muscle, pain is your body’s way of telling you something is wrong. Once the injury heals, you stop hurting.

Chronic pain is different. Your body keeps hurting weeks, months, or even years after the injury. Doctors often define chronic pain as any pain that lasts for 3 to 6 months or more.

Chronic pain can have real effects on your day-to-day life and your mental health. But you and your doctor can work together to treat it.

Do call upon us to help you. We do understand the problem that should never be taken lightly.


Upper and Mid-Back Pain Causes El Paso, Texas

Upper and Mid-Back Pain Causes El Paso, Texas

To get the best treatment for upper or mid-back back pain, you should understand what may be causing it.

A doctor or chiropractor can help you figure out what is contributing to your back pain, then determine the root cause, and set up a treatment outline. Here are some of the more common causes.

 

11860 Vista Del Sol, Ste. 128 Upper and Mid-Back Pain Causes El Paso, Texas

Improper posture

Poor posture is one of the leading causes of upper back pain because so many people spend their workdays sitting at some station for most if not the entire day. Sitting with a:

  • Rounded back
  • Shoulders hunched forward

Just these two positional behaviors can put massive stress on the back muscles.

Getting into bad habits and not sitting properly, and sitting for so many hours a day is a sure way to bring out some form of body pain.

 

Not lifting objects properly

When picking something up, you should use proper lifting body mechanics to protect the spine.

Not using proper lifting form can definitely cause injury/s.

 

11860 Vista Del Sol, Ste. 128 Upper and Mid-Back Pain Causes El Paso, Texas

 

Overloaded backpack/purse

Anyone who uses backpacks and big purses is at risk for upper back injury and consistent pain.

Over-loading backpacks and purses can be dangerous to the spine and shoulders.

Also not wearing the backpack correctly, for example just using one strap causes imbalance, which leads to soreness, and that leads to injury.

 

11860 Visa Del Sol Ste.128 Properly Carry A Backpack El Paso, TX.

Trauma Accident

Auto accidents, slips, and falls can cause all kinds of injuries including upper back pain.

Fracturing a vertebra or a spinal bone is possible.  When this happens part of the vertebrae presses on a spinal nerve and can cause pain.

 

11860 Vista Del Sol, Ste. 128 Upper and Mid-Back Pain Causes El Paso, Texas

 

Osteoporosis

This condition affects the bones, and an individual might not know they have osteoporosis until some type of fracture like a vertebral compression fracture.

It weakens the bones, which can affect how the body supports its weight. This opens the door for fractures.

Weakened vertebrae won’t support the body’s weight correctly, so the muscles, ligaments, and tendons have to work harder.

That leads to:

  • Sprains
  • Strains
  • Muscle fatigue
  • Various injuries

 

 

Kyphosis

The spine is supposed to curve outwards in the upper back; the curve is called kyphosis or a kyphotic curve.

With problematic kyphosis, the spine begins to curve outward in an exaggerated fashion that can lead to back pain.

 

Scoliosis

Scoliosis causes an unusual curve or curves in the spine. It makes the spine look like the letter “S” or “C” when seen from the back.

Non-Spine Conditions

Upper back pain can develop from other medical conditions that are not related to the spine. For example:

  • Acid reflux
  • Cardiac conditions like angina
  • Ulcer

These conditions can cause individuals to move or contort into awkward positions, and swelling of muscle tissues that radiate into the upper mid-back.

 

Upper Back Structure

The upper back is the more stable area of the spine compared to the neck and lower back. It does not move as much because part of its main job is to protect the organs in the chest. This works in conjunction with the ribs, that is attached to the mid-back.

11860 Vista Del Sol, Ste. 128 Upper and Mid-Back Pain Causes El Paso, Texas

 

Because it doesn’t move as much, joint and disc problems are not as common. But that does not mean that you can’t get a herniated disc. It’s also less common to have degenerative problems in the upper mid-back.

We want you to live a life that is fulfilled with more energy, a positive attitude, better sleep, less pain, proper body weight and educated on how to maintain this way of life. I have made a life of taking care of every one of my patients.

I assure you, I will only accept the best for you.


Lower Back Pain Specialist El Paso, TX Chiropractor

 

Mike Melgoza is a very active person who is always engaging in physical activity, as a result, he occasionally suffers from debilitating back pain symptoms. Mr. Melgoza was struggling to sleep properly due to his symptoms of back pain before receiving chiropractic care with Dr. Jimenez.

Back pain is one of the most common reasons people visit the doctor or miss work and it is also a leading cause of disability globally. The majority of people have back pain at least once throughout their lifetimes. Luckily, you can take steps to prevent or relieve back pain.


NCBI Resources

Pain in the upper and/or mid-back is not as common as lower back or neck pain. Movement in the upper back is limited because of the attachments to the rib cage.

Upper back pain is generally caused by soft tissue injuries, like sprains or strains, muscle tension, bad posture, or looking downward for extended periods like texting, over phone use.

 

Dental Care and Its Importance In Chronic Pain Mangagement El Paso

Dental Care and Its Importance In Chronic Pain Mangagement El Paso

Back pain can affect every part of the body, including the:

  • Head
  • Neck
  • Legs
  • Feet

Dental complications are common for people using medications for acute and chronic back pain. Therefore, regular dental care is necessary to spot these problems before they become serious.

Pain medications can at times be the root cause of some dental decay issues.

Myofascial pain syndrome (MPS) requires the highest level of specialized dental care because of the highly sensitive nature of the condition.

I asked a local dentist that specializes in treating patients with chronic pain conditions why dental care is important?

11860 Vista Del Sol Ste. 128 Dental Care and Its Importance In Chronic Pain Mangagement El Paso

 

Dental

Regular dental visits are as important as general check-ups with a primary doctor.

Any issues will have time to grow and become more complicated to treat once diagnosed.

Locate a dentist who treats patients with chronic pain issues, specifically in the upper body, and understands the special needs.

Ask about specific tools to help minimize and control pain:

  • Before
  • During
  • After treatment

Call your primary or pain management physician to ask if there are any specific treatment that the dentist needs to know about.

 

Dry Mouth

People with chronic pain usually have to use various medications.

These medications can cause dry mouth that can lead to tooth decay and gum disease.

Dry mouth condition is called xerostomia and can cause major issues like:

  • Normal swallowing
  • Taste problems
  • Speech problems
  • Oral tissue integrity
  • Chronic mouth irritation
  • Inflammation
  • Dental decay
  • Erosion

Stay hydrated by keeping water around throughout the day, and chew sugarless gum or keep sugarless hard candy around to keep saliva flow.

There is also moisturizing mouth spray, that a dentist can provide.

 

Periodontal Disease

Periodontal disease is when over time, gums pull away from the teeth and form pockets that can get infected.

The body’s immune system fights the bacteria as the plaque grows and begins to spread out.

Bacterial toxins and the body’s natural fight response to the infection begin to break down bone and the connective tissue that holds the teeth in place.

If left untreated the:

  • Bones
  • Gums
  • Tissue

That support the teeth are destroyed,  which means that the infected tooth has to be pulled.

 

Tooth Extraction

People with chronic pain try there best to avoid potential pain triggers, which include dental exams.

Tooth or gum pain/sensitivity usually presents in the later stages of decay when the tooth cannot be saved.

Unfortunately, the result is tooth removal.

There are medications that are known to contribute or cause tooth decay:

  • Antidepressants
  • Anti-inflammatories
  • Aspirin
  • Methadone

Best Defense Strong Offense

So brush your teeth at least twice a day and floss. Although we’ve all heard this throughout our lives, it is true. Just remember brushing and flossing can go a long way in dealing and managing chronic pain issues.

Give the tongue a good brushing to remove bacteria that can lead to plaque and chronic bad breath.

Tooth cleanings and exams are necessary to prevent any issues before they become serious and require major surgery.

Talk with your primary caregiver before visiting the dentist to figure out any special protocol or medication requirements needed.

After dental treatment, allow plenty of time to rest and recover.

Eat soft food during recovery and avoid:

  • Meats
  • Popcorn
  • Hard candy

These can become lodged in the teeth.

Prevention of dental disease will definitely pay off in the end and allow your immune system to perform at its optimal level.

It is worth the effort, I want all my patients to be in top health and proper oral hygiene can prevent so many diseases and is an essential part of a healthy lifestyle.


 

*CHRONIC* pain Chiropractic Relief | El Paso, Tx

 

 

Living with chronic pain symptoms can tremendously affect an individual’s quality of life. Neck and back pain caused by a variety of health issues, such as herniated discs and/or automobile accident injuries, can cause persistent symptoms which may last weeks, months, even years if left untreated.

Dr. Alex Jimenez is a chiropractor in El Paso, TX, who has helped his patients with chronic neck and back pain find the treatment they deserve. Patients describe how Dr. Alex Jimenez has helped them find pain relief and achieve overall health and wellness.


 

NCBI Resources

Dental visits help you maintain healthy teeth and gums. Gum disease and poor dental health have been linked to a variety of health issues, including heart disease. Researchers have drawn a direct line between tooth loss and heart disease. What’s more, regular oral exams and teeth cleaning can lead to the detection of early-stage medical conditions, some of which can be life-threatening which include:

  • Leukemia
  • Heart disease
  • Oral cancer
  • Diabetes
  • Kidney disease
  • Pancreatic cancer

 

Spinal Decompression Eliminates Herniated Discs El Paso, TX.

Spinal Decompression Eliminates Herniated Discs El Paso, TX.

FDA recognizes and approves spinal decompression and its ability to eliminate herniated discs.

On the verge of back surgery, a mason discovered the non-surgical solution to work-related chronic back pain.

A new male patient who works in construction came to see me as a last resort to lessen his back pain brought on from damaged/herniated discs.

  • His primary caregiver recommended back surgery, but that would have put him on disability for months.
  • Fortunately, before saying yes to the surgery, a co-worker recommended chiropractic care.
  • Bricklayers/masons have the highest rate of back injuries with non-paid sick leave.

Constant bending over, even with a back brace, takes its toll on the spine, which in this case resulted in two herniated discs.

Pain medications helped in the beginning but with constant use, put him in a constant brain fog state, along with the expense, which took its toll on the family budget.

 

11860 Vista Del Sol, Ste. 128 Spinal Decompression Eliminates Herniated Discs El Paso, TX.

 

Disc Injury & Back Surgery

The doctor did not discuss spinal decompression therapy

  •  A non-surgical back treatment that slowly and gently stretches the spine.
  • This stretching lessens the pressure on the compressed nerve root (herniated disc) and results in less and even complete alleviation.

The patient came twice a week with myself and the team working on him over the course of a month, however, every case is different so treatments vary depending on the condition.

With each treatment, the two herniated discs were slowly reverted back to their natural position. This is able to be achieved with less pressure between the discs.

Towards the end of treatment, the patient’s pain was gone by about 90%.

With two weeks of rest, the patient was able to return to work.

The best part was that there was no surgery, pain medications, disability, and hospital bills.

 

Spine treatment alternative

Chiropractic/Decompression therapy is way less expensive than medication and surgery. It is:

  • Non-surgical
  • Recovery time is faster
  • Completely drug-free

People suffering every day with herniated/injured discs should consider the chiropractic decompression option. You do not have to learn to live with chronic back pain.

If you suffer from:

  1. Herniated discs
  2. Bulging discs
  3. Degenerative disc disease

I encourage you to discuss the condition with an experienced chiropractor. There are many proven alternatives to back surgery and pain meds. People need to be aware of these alternatives for chronic back pain. The right-back pain treatment can definitely improve the quality of life.


 

Herniated Disc El Paso, TX

 

 

Sandra Rubio developed two herniated discs and a bulging disc after suffering from an accident at a young age, which caused her intense pain throughout her youth.

When she became a mother, her symptoms became severe.

After visiting doctors without results, Sandra found chiropractor Dr. Alex Jimenez and found relief from her sciatica and migraines.

The herniated disc treatment she received from Dr. Alex Jimenez was non-surgical.

A herniated disc, also known as a slipped disc, is a medical condition in which:

  • A tear from the outer intervertebral disc allows the soft, central area to bulge out beyond the outer rings.

 

11860 Vista Del Sol, Ste. 128 Spinal Decompression Eliminates Herniated Discs El Paso, TX.

 

Disc herniation is usually a result of:

  • Degeneration (wear/tear)
  • Trauma (auto accident/sports injury)
  • Lifting injuries
  • Straining movement

The tear can release the compounds, which cause inflammation and can cause severe pain even if the nerve root not compressed.

A physical examination is usually the first step in diagnosing a herniated disc. The chiropractor will examine the spine while the patient is standing, and while they’re lying down. Depending on the severity and location of the herniation, they may note a decrease in spine curvature.

Radicular pain will be assessed, when the spine is:

  • Unmoving
  • In motion
  • With pressure applied

Other tests may be administered.

X-rays may also be taken, but an MRI is usually more accurate and shows more detail.

Chiropractic has been very effective in helping patients manage their pain and regain their mobility so they can return to their normal life. Therefore, it should be your first option for treatment before you go down the road with drugs or surgery.


 

NCBI Resources

It is often referred to as a ruptured disc or slipped disc and occurs when the disc moves or slips out of place. It can also be the result of a disc that has a small tear and is leaking the jelly-like substance that is inside. This can put pressure on the surrounding nerves, causing pain and discomfort.

 

Chronic Back Pain Relief for El Paso, Texas (2019)

Chronic Back Pain Relief for El Paso, Texas (2019)

Chronic back pain affects many people. Whether it’s chronic neck pain, shoulder, hip, back or fibromyalgia, these symptoms seriously affect an individual’s health and disrupt their lives to the nth degree.

Dr. Alexander Jimenez is a chiropractor of 30+ years experience that focuses on diagnosing, treating, and preventing injuries, conditions and health issues.

Various individuals tell their stories and describe how Dr. Jimenez helped them recover their quality of life and their health. They recommend Dr. Jimenez as the choice for chronic pain.

El Paso Back Clinic

We are blessed to present to you El Paso’s Premier Wellness & Injury Care Clinic.

Our services are specialized and focused on injuries and the complete recovery process. Our areas of practice include Wellness & Nutrition, Chronic Pain, Personal InjuryAuto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Treatment, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Stress Management, and Complex Injuries.

As El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately are focused on treating patients after frustrating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility and agility programs tailored for all age groups and disabilities.

We want you to live a life filled with more energy, positive attitude, better sleep, less pain, proper body weight and educated on how to maintain this way of life.

Schedule An Appointment & Let Us Get Your Spine Healthy!

11860 Vist Del Sol, Ste. 128 Chronic Back Pain Relief for El Paso, Texas (2019)

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Fasting and Chronic Pain

Fasting and Chronic Pain

Chronic pain is a common health issue which affects many people in the United States. While several medical conditions, such as fibromyalgia and myofascial pain syndrome, can cause chronic pain, it may also develop due to a variety of other health issues. Research studies have found that widespread inflammation is the leading cause of chronic pain. Inflammation is a natural defense mechanism to injury, illness, or infection. But, if the inflammatory process continues for too long, it can become problematic.

Inflammation signals the immune system to heal and repair damaged tissue as well as to protect itself against bacteria and viruses. As mentioned above, however, chronic inflammation can cause a variety of health issues, including chronic pain symptoms. Healthy lifestyle modifications can help manage chronic pain, but first, let’s understand the common causes of chronic pain.

What is Acute Inflammation?

Acute inflammation, by way of instance, occurs following an injury or something as simple as a sore throat. It is a natural response with adverse effects, meaning it works locally in the region where the health issue is found. The common signs of acute inflammation include swelling, redness, warmth, pain and loss of function, as stated by the National Library of Medicine. When acute inflammation develops, the blood vessels dilate causing blood flow to increase, and white blood cells in the injured region promote recovery.

During severe inflammation, compounds called cytokines are released by the damaged tissue. The cytokines act as “emergency signals” which bring on the human body’s own immune cells, as well as hormones and numerous nutrients to repair the health issue. Additionally, hormone-like substances, known as prostaglandins, cause blood clots to heal damaged tissue, and these may also trigger fever and pain as part of the inflammatory procedure. As the damage or injury recovers, the inflammation subsides.

What is Chronic Inflammation?

Unlike acute inflammation, chronic inflammation has long-term effects. Chronic inflammation, also known as persistent inflammation, produces low-levels of inflammation throughout the human body, as demonstrated by an increase in immune system markers located in blood and cell tissues. Chronic inflammation may also cause the progression of various diseases and conditions. Elevated levels of inflammation may sometimes trigger even if there is no injury, illness, or infection, which may also cause the immune system to react.

As a result, the human body’s immune system could begin attacking healthy cells, tissues, or organs. Researchers are still trying to understand the consequences of chronic inflammation in the human body and the mechanisms involved in this natural defense process. By way of instance, chronic inflammation has been associated with a variety of health issues, such as heart disease, and stroke.

One theory suggests that when inflammation remains in the blood vessels, it can encourage the accumulation of plaque. According to the American Heart Association, or the AHA, if the immune system identifies plaque as a foreign invader, the white blood cells can attempt to wall off the plaque found in the blood flowing through the arteries. This can create a blood clot which may block the blood flow to the heart or brain, causing it to become unstable and rupture. Cancer is another health issue associated with chronic inflammation. Furthermore, according to the National Cancer Institute, DNA damage can also be caused by chronic inflammation.

Persistent, low-grade inflammation frequently doesn’t have any symptoms, but healthcare professionals can check for a C-reactive protein, or CRP, known as lipoic acid, a marker for inflammation found in the blood. Elevated levels of CRP are associated with an increased risk of cardiovascular disease. Elevated CRP levels may be found in chronic disorders like lupus or rheumatoid arthritis.

In the case of other chronic conditions, such as fibromyalgia, the nervous system over-reacts to specific stimulation, however, it’s inflammation which causes chronic pain symptoms. Subjectively, it’s almost impossible to tell the difference between the chronic pain caused by an oversensitive nervous system and the chronic pain caused by widespread inflammation. Apart from searching for clues in the bloodstream, a person’s nutrition, lifestyle habits, and environmental exposures, can also promote chronic inflammation.

Dr Jimenez White Coat

Inflammation is the immune system’s natural defense mechanism against injury, illness, or infection. While this inflammatory response can help heal and repair tissues, chronic, widespread inflammation can cause a variety of health issues, including chronic pain symptoms. A balanced nutrition, including a variety of diets and fasting, can help reduce inflammation. Fasting, also known as caloric restriction, promotes cell apoptosis and mitochondrial recovery. The fasting mimicking diet, which is a part of the longevity diet plan, is a dietary program which “tricks” the human body into a fasting state to experience the benefits of traditional fasting. Before following any of the diets described in this article, make sure to consult a doctor.

Dr. Alex Jimenez D.C., C.C.S.T. Insight

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Nutrition, Diets, Fasting and Chronic Pain

Anti-inflammatory diets mainly consist of eating fresh fruits and vegetables, fish, and fats. The Mediterranean diet plan, by way of instance, is an anti-inflammatory diet which promotes eating moderate amounts of nuts, ingesting very little meat, and drinking wine. Anti-inflammatory food parts, such as omega-3 fatty acids, protect the human body against the damage brought on by inflammation.

An anti-inflammatory diet also involves staying away from foods which could promote inflammation. It is ideal to decrease the amount of foods you eat which are high in trans and saturated fats, such as meats. Additionally, an anti-inflammatory diet limits the consumption of refined carbohydrates and foods, such as bread and rice. These also promote cutting back on the utilization of margarine and oils that are packed with omega-6 fatty acids, such as sunflower, safflower and corn oils.

Fasting, or caloric restriction, has long been known to decrease oxidative stress and slow down the mechanisms of aging in various organisms. The effects of fasting involve programmed cell death, or apoptosis, transcription, mobile energy efficiency, mitochondrial biogenesis, antioxidant mechanisms, and circadian rhythm. Fasting also contributes to mitochondrial autophagy, known as mitophagy, where genes in the mitochondria are stimulated to undergo apoptosis, which promotes mitochondrial recovery.

Intermittent fasting can help you fight inflammation, improve digestion, and boost your longevity. The human body is designed to be able to survive for extended periods of time without food. Research studies have demonstrated that intermittent fasting can have positive changes in the overall composition of your gut microbiota. Moreover, intermittent fasting can reduce insulin resistance while increasing the immune system response. Finally, intermittent fasting can promote the production of a substance, known as β-hydroxybutyrate, that blocks a portion of the immune system involved in inflammatory ailments as well as substantially reducing the production of inflammatory markers, such as cytokines and the C-reactive protein, or CRP, previously mentioned above.

The Longevity Diet Plan, presented in the book by Dr. Valter Longo, eliminates the consumption of processed foods which can cause inflammation, promoting well-being and longevity. This unique dietary program, unlike most traditional diets, doesn’t promote weight loss. Although you may experience weight reduction, the emphasis of this unique dietary program is on eating healthier. The Longevity Diet Plan has been demonstrated to help activate stem cell-based renewal, reduce abdominal fat, and prevent age-related bone and muscle loss, as well as build resistance to developing cardiovascular disease, Alzheimer’s disease, diabetes, and cancer.

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The fasting mimicking diet, or FMD, allows you to experience the benefits of traditional fasting without depriving your body of food. The main difference of the FMD is that instead of completely eliminating all food for several days or even weeks, you only restrict your calorie intake for five days out of the month. The FMD can be practiced once a month to help promote overall health and wellness.

While anyone can follow the FMD on their own, the ProLon® fasting mimicking diet offers a 5-day meal program which has been individually packed and labeled for each day, that serves the foods you need for the FMD in precise quantities and combinations. The meal program is made up of ready-to-eat or easy-to-prepare, plant-based foods, including bars, soups, snacks, supplements, a drink concentrate, and teas. Before starting the ProLon® fasting mimicking diet, 5-day meal program, or any of the lifestyle modifications described above, please make sure to talk to a healthcare professional to find out which chronic pain treatment is right for you.

The scope of our information is limited to chiropractic, spinal health issues, and functional medicine articles, topics, and discussions. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900 .

Curated by Dr. Alex Jimenez

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Additional Topic Discussion: 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. Your spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. 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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Impacted Femoral Neck Fractures

Impacted Femoral Neck Fractures

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.

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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

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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.

 

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EXTRA IMPORTANT TOPIC: Chiropractic Hip Pain Treatment

Femoral Neck Stress Fractures

Femoral Neck Stress Fractures

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

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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.

 

 
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EXTRA IMPORTANT TOPIC: Chiropractic Hip Pain Treatment

Osteitis Pubis Treatment

Osteitis Pubis Treatment

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

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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.

 

 
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EXTRA IMPORTANT TOPIC: Chiropractic Hip Pain Treatment

Piriformis Syndrome Management

Piriformis Syndrome Management

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. 

 

 

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

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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.

 

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EXTRA IMPORTANT TOPIC: Piriformis Syndrome Chiropractic Treatment

Athletic Pubalgia Mechanism of Injury

Athletic Pubalgia Mechanism of Injury

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

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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.

 

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EXTRA IMPORTANT TOPIC: Chiropractic Hip Pain Treatment

Athletic Pubalgia and Adductor Strain

Athletic Pubalgia and Adductor Strain

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

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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.

 

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EXTRA IMPORTANT TOPIC: Chiropractic Hip Pain Treatment

Evaluation of the Patient with Hip Pain

Evaluation of the Patient with Hip Pain

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.

 

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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

Dr Jimenez White Coat

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

Dr Jimenez White Coat

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-Calvé-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.

Author Information: Aafp.org

 

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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.

 

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EXTRA IMPORTANT TOPIC: Hip Pain Chiropractic Treatment

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References

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2. Rossi F, Dragoni S. Acute avulsion fractures of the pelvis in adolescent competitive athletes. Skeletal Radiol. 2001;30(3):127–131.

3. Martin HD, Shears SA, Palmer IJ. Evaluation of the hip. Sports Med Arthrosc. 2010;18(2):63–75.

4. Gough-Palmer A, McHugh K. Investigating hip pain in a well child. BMJ. 2007;334(7605):1216–1217.

5. Bencardino JT, Palmer WE. Imaging of hip disorders in athletes. Radiol Clin North Am. 2002;40(2):267–287.

6. Czerny C, Hofmann S, Neuhold A, et al. Lesions of the acetabular labrum: accuracy of MR imaging and MR arthrography in detection and staging. Radiology. 1996;200(1):225–230.

7. Czerny C, Hofmann S, Urban M, et al. MR arthrography of the adult acetabular capsular-labral complex. AJR Am J Roentgenol. 1999;173(2):345–349.

8. Deslandes M, Guillin R, Cardinal E, et al. The snapping iliopsoas tendon: new mechanisms using dynamic sonography. AJR Am J Roentgenol. 2008;190(3):576–581.

9. Blankenbaker DG, De Smet AA. Hip injuries in athletes. Radiol Clin North Am. 2010;48(6):1155–1178.

10. Balint PV, Sturrock RD. Intraobserver repeatability and interobserver reproducibility in musculoskeletal ultrasound imaging measurements. Clin Exp Rheumatol. 2001;19(1):89–92.

11. Ramwadhdoebe S, Sakkers RJ, Uiterwaal CS, et al. Evaluation of a training program for general ultrasound screening for developmental dysplasia of the hip in preventive child health care. Pediatr Radiol. 2010;40(10):1634–1639.

12. Altman R, Alarcón G, Appelrouth D, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum. 1991;34(5):505–514.

13. Banerjee P, McLean CR. Femoroacetabular impingement. Curr Rev Musculoskelet Med. 2011;4(1):23–32.

14. Clohisy JC, Knaus ER, Hunt DM, et al. Clinical presentation of patients with symptomatic anterior hip impingement. Clin Orthop Relat Res. 2009;467(3):638–644.

15. Ito K, Leunig M, Ganz R. Histopathologic features of the acetabular labrum in femoroacetabular impingement. Clin Orthop Relat Res. 2004;(429):262–271.

16. Beall DP, Sweet CF, Martin HD, et al. Imaging findings of femoroacetabular impingement syndrome. Skeletal Radiol. 2005;34(11):691–701.

17. Burnett RS, Della Rocca GJ, Prather H, et al. Clinical presentation of patients with tears of the acetabular labrum. J Bone Joint Surg Am. 2006;88(7):1448–1457.

18. Leunig M, Werlen S, Ungersböck A, et al. Evaluation of the acetabular labrum by MR arthrography [published correction appears in J Bone Joint Surg Br. 1997;79(4):693]. J Bone Joint Surg Br. 1997;79(2):230–234.

19. Groh MM, Herrera J. A comprehensive review of hip labral tears. Curr Rev Musculoskelet Med. 2009;2(2):105–117.

20. Blankenbaker DG, De Smet AA, Keene JS. Sonography of the iliopsoas tendon and injection of the iliopsoas bursa for diagnosis and management of the painful snapping hip. Skeletal Radiol. 2006;35(8):565–571.

21. Egol KA, Koval KJ, Kummer F, et al. Stress fractures of the femoral neck. Clin Orthop Relat Res. 1998;(348):72–78.

22. Fullerton LR Jr, Snowdy HA. Femoral neck stress fractures. Am J Sports Med. 1988;16(4):365–377.

23. Newberg AH, Newman JS. Imaging the painful hip. Clin Orthop Relat Res. 2003;(406):19–28.

24. Margaretten ME, Kohlwes J, Moore D, et al. Does this adult patient have septic arthritis? JAMA. 2007;297(13):1478–1488.

25. Eich GF, Superti-Furga A, Umbricht FS, et al. The painful hip: evaluation of criteria for clinical decision-making. Eur J Pediatr. 1999;158(11):923–928.

26. Kocher MS, Zurakowski D, Kasser JR. Differentiating between septic arthritis and transient synovitis of the hip in children. J Bone Joint Surg Am. 1999;81(12):1662–1670.

27. Learch TJ, Farooki S. Magnetic resonance imaging of septic arthritis. Clin Imaging. 2000;24(4):236–242.

28. Lee SK, Suh KJ, Kim YW, et al. Septic arthritis versus transient synovitis at MR imaging. Radiology. 1999;211(2):459–465.

29. Leopold SS, Battista V, Oliverio JA. Safety and efficacy of intraarticular hip injection using anatomic landmarks. Clin Orthop Relat Res. 2001; (391):192–197.

30. Mitchell DG, Rao VM, Dalinka MK, et al. Femoral head avascular necrosis: correlation of MR imaging, radiographic staging, radionuclide imaging, and clinical findings. Radiology. 1987;162(3):709–715.

31. Mont MA, Zywiel MG, Marker DR, et al. The natural history of untreated asymptomatic osteonecrosis of the femoral head. J Bone Joint Surg Am. 2010;92(12):2165–2170.

32. Assouline-Dayan Y, Chang C, Greenspan A, et al. Pathogenesis and natural history of osteonecrosis. Semin Arthritis Rheum. 2002;32(2):94–124.

33. Totty WG, Murphy WA, Ganz WI, et al. Magnetic resonance imaging of the normal and ischemic femoral head. AJR Am J Roentgenol. 1984;143(6):1273–1280.

34. Kirschner JS, Foye PM, Cole JL. Piriformis syndrome, diagnosis and treatment. Muscle Nerve. 2009;40(1):10–18.

35. Hopayian K, Song F, Riera R, et al. The clinical features of the piriformis syndrome. Eur Spine J. 2010;19(12):2095–2109.

36. Torriani M, Souto SC, Thomas BJ, et al. Ischiofemoral impingement syndrome. AJR Am J Roentgenol. 2009;193(1):186–190.

37. Ali AM, Whitwell D, Ostlere SJ. Case report: imaging and surgical treatment of a snapping hip due to ischiofemoral impingement. Skeletal Radiol. 2011;40(5):653–656.

38. Lee EY, Margherita AJ, Gierada DS, et al. MRI of piriformis syndrome. AJR Am J Roentgenol. 2004;183(1):63–64.

39. Slipman CW, Jackson HB, Lipetz JS, et al. Sacroiliac joint pain referral zones. Arch Phys Med Rehabil. 2000;81(3):334–338.

40. Moore KL, Dalley AF, Agur AM. Clinically Oriented Anatomy. 6th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2010.

41. Adlakha S, Burket M, Cooper C. Percutaneous intervention for chronic total occlusion of the internal iliac artery for unrelenting buttock claudication. Catheter Cardiovasc Interv. 2009;74(2):257–259.

42. Brown MD, Gomez-Marin O, Brookfield KF, et al. Differential diagnosis of hip disease versus spine disease. Clin Orthop Relat Res. 2004; (419):280–284.

43. Segal NA, Felson DT, Torner JC, et al.; Multicenter Osteoarthritis Study Group. Greater trochanteric pain syndrome. Arch Phys Med Rehabil. 2007;88(8):988–992.

44. Strauss EJ, Nho SJ, Kelly BT. Greater trochanteric pain syndrome. Sports Med Arthrosc. 2010;18(2):113–119.

45. Williams BS, Cohen SP. Greater trochanteric pain syndrome. Anesth Analg. 2009;108(5):1662–1670.

46. Tibor LM, Sekiya JK. Differential diagnosis of pain around the hip joint. Arthroscopy. 2008;24(12):1407–1421.

Close Accordion

Classifying Spondylolisthesis

Classifying Spondylolisthesis

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

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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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EXTRA EXTRA | IMPORTANT TOPIC: Chiropractic Massage Therapy

Scoliosis Clinical Presentation

Scoliosis Clinical Presentation

Scoliosis is a medical condition where an individual’s spine is diagnosed with an abnormal curve. The natural curvature of the spine is generally “S” shaped when viewed laterally, or from the side, and it should appear straight when viewed from the front or back. In many instances, the abnormal curvature of the spine with scoliosis increases over time, while in others, it remains the same. Scoliosis can cause a variety of symptoms.

Scoliosis affects approximately 3 percent of the population. The cause of most instances is unknown, however, it is believed to involve a mixture of environmental and genetic variables. Risk factors include having relatives with the same problem. It may also develop due to other health issues, such as Marfan syndrome, cerebral palsy, muscle spasms, and tumors like neurofibromatosis.  Scoliosis commonly develops between the ages of 10 and 20 and it commonly affects girls more than boys. Diagnosis is supported with X-rays. Scoliosis is classified as structural, in which the curve is fixed, or functional, in which the underlying spine is normal.

Treatment is based upon the level of curve, place, and trigger. Curves can be viewed periodically to record the progression of scoliosis. Bracing is frequently utilized to treat scoliosis. The brace must be fitted into the individual and used until the progression of scoliosis stops. Exercise is advocated towards the improvement of scoliosis. Other alternative treatment options, such as chiropractic care, can restore the natural curvature of the spine. 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

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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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EXTRA EXTRA | IMPORTANT TOPIC: Chiropractic Massage Therapy

Rheumatoid Arthritis of the Cervical Spine

Rheumatoid Arthritis of the Cervical Spine

Rheumatoid arthritis, or RA, is a chronic health issue which affects approximately 1 percent of the population in the United States. RA is an autoimmune disorder that causes the inflammation and degeneration of the synovial tissue, specific cells and tissue which form the lining of the joints within the human body. Rheumatoid arthritis may and generally does affect every joint in the body, especially as people get older. RA commonly develops in the joints of the hands and feet, severely restricting an individual’s ability to move, however, those with significant disease in the spine are at risk of damage like paraplegia. Rheumatoid arthritis of the spine is frequent in three areas, causing different clinical problems.

The first is basilar invagination, also referred to as cranial settling or superior migration of the odontoid, a health issue where degeneration from rheumatoid arthritis at the base of the skull causes the it to “settle” into the spinal column, causing the compression or impingement of the spinal cord between the skull and the 1st cervical nerves. The second health issue, and also the most frequent, is atlanto-axial instability. A synovitis and erosion of the ligaments and joints connecting the 1st (atlas) and the 2nd (axis) cervical vertebrae causes instability of the joint, which may ultimately result in dislocation and spinal cord compression. In addition, a pannus, or localized mass/swelling of rheumatoid synovial tissue, can also form in this region, causing further spinal cord compression. The third health issues is a subaxial subluxation which causes the degeneration of the cervical vertebrae (C3-C7) and often results in other problems like spinal stenosis.

Imaging studies are crucial to properly diagnose patients with rheumatoid arthritis of the cervical spine. X-rays will demonstrate the alignment of the spine, and if there is obvious cranial settling or instability. It can also be difficult to demonstrate the anatomy at the bottom of the skull, therefore, computed tomography scanning, or CT scan, with an injection of dye within the thecal sac is arranged. Magnetic resonance imaging, or MRI, is beneficial to assess the severity of nerve compression or spinal cord injury, and allows visualization of structures, including the nerves, muscles, and soft tissues. Flexion/extension x-rays of the cervical spine are usually obtained to evaluate for signs of ligamentous instability. These imaging studies entails a plain lateral x-ray being taken with the patient bending forward and the other lateral x-ray being taken with the individual extending the neck backwards. 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

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Additional Topics: Neck Pain and Auto Injury

Whiplash is one of the most common causes of neck pain after an automobile accident. A whiplash-associated disorder occurs when a person’s head and neck moves abruptly back-and-forth, in any direction, due to the force of an impact. Although whiplash most commonly occurs following a rear-end car crash, it can also result from sports injuries. During an auto accident, the sudden motion of the human body can cause the muscles, ligaments, and other soft tissues of the neck to extend beyond their natural range of motion, causing damage or injury to the complex structures surrounding the cervical spine. While whiplash-associated disorders are considered to be relatively mild health issues, these can cause long-term pain and discomfort if left untreated. Diagnosis is essential.

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EXTRA EXTRA | IMPORTANT TOPIC: Neck Pain Chiropractic Treatment