From Dr. Natalie Meiri’s Clinical Pearl Stories:
Relief From Hip Pain and Osteoarthritis: Chiropractic Care is Effective
This is my clinical pearl story about Relief From Hip Pain and Osteoarthritis: Chiropractic Care is Effective. The patient was a 70 year old male patient. His chief complaints were low back and right hip pain. To be HIPAA compliant, I will call him Jacob instead of his real name.
Jacob’s right hip pain had come on 6 months ago following a fall. The low back pain he stated he had “on and off for over 30 years”. Jacob had always been active. In addition to physically demanding jobs, he had a history of many sports injuries and several car accidents. Jacob had been under chiropractic care previously for his low back pain.
Jacob came to see me when a course of physical therapy didn’t help his right hip pain after his fall. The orthopedic doctor had told him he had a right hip sprain from the fall. Additionally, the orthopedist’s x-ray report noted Jacob had moderate to severe osteoarthritis (wear and tear arthritis) in his right hip. And Jacob had noticed his hip feeling “more stiff” when he got up in the morning or from prolonged sitting over the years.
Jacob’s Examination and Imaging
Upon examination, Jacob tested positive for his low back and hip pain conditions. His x-rays from the orthopedist showed degenerative arthritis (osteoarthritis) in his lumbar spine and right hip.
Jacob had a right hip sprain complicated by Osteoarthritis.
Hip Anatomy
The hip, like the shoulder, is considered a ball-and-socket joint. It is formed by the head of the femur (thigh bone) which sits in what’s called the acetabulum, a part of the pelvis. The head of the femur is large (ball) and the acetabulum (socket) is deep. The soft tissues (refers to non-bony structures that connect, support, or surround other structures) in your hip are:
- the muscles, which allow you to move.
- the tendons, which connect your muscles to the bone.
- the ligaments are bands of tough elastic tissue around your joints. They connect bone to bone, give your joints support, and limit their movement.
- the fascia – stretchy, thin, white fibrous tissue. All your muscles are enveloped in fascia.
- the bursae – fluid-filled pads that act as cushions at the joints. Bursae reduce friction between the surfaces of a bone and soft tissue.
What is a Sprain?
A sprain is a sudden or violent twisting injury (e.g. fall) of a joint with stretching or tearing of ligaments. As opposed to a strain which occurs when a muscle or tendon is overstretched or torn.
What is Osteoarthritis?
Primary Osteoarthritis occurs usually in middle-aged to elderly people (>45 years old). It is more prevalent in women (female to male 10:1). Primary means this osteoarthritis develops due to aging and the wear and tear that comes along with it.
An example would be Jacob’s hip: primary femoroacetabular (hip) osteoarthritis. Typically, your symptoms consists of hip and possibly buttock, groin, or knee pain that was insidious (came on gradually) in onset. Additionally, you note a slow stiffening, specifically internal (inward) rotation. This often results in walking with the hip held in external (outward) rotation. You may complain of low back pain due to excessive extension with weight bearing. The low back pain is really due to compensating for limited hip movement due to hip osteoarthritis.
Common joints involved in primary osteoarthritis are the hips, knees, sacroiliac joint, acromioclavicular (shoulder and collar bone), first metacarpophalangeal (part of thumb joint), first metacarpotrapezium (part of thumb joint closer to wrist), and the distal interphalangeal joints (joints at tips of fingers).
Often initially asymptomatic, you will have a gradual increase in joint stiffness and pain. Moreover, deformity may be apparent such as herberden’s nodes in the hands (bony bumps). If not treated, primary osteoarthritis may eventually lead to joint subluxation (dislocation) and instability.
Cause of Osteoarthritis
Primary osteoarthritis is due to progressive degeneration of the joint or joints involved by an accumulation of microtrauma. A microtrauma is an injury resulting from repetitive stress to tissues.
Jacob’s Treatment and Outcome
Treatment focuses on restoring normal mobility to the hip joint and pelvis. These treatments at Meiri Chiropractic include:
-Chiropractic manipulative therapy- to the hip joint, pelvis and associated regions.
-Gentle myofascial release and/or post isometric relaxation techniques- to the soft tissues (e.g. muscles, tendons, ligaments, fascia) involved.
-Electric Muscle Stimulation, Ice and Heat Therapies for pain relief and inflammation reduction.
-Therapeutic exercise- with gentle stretching and a long-term goal of restrengthening.
-Finally, recommendations for prevention of further injury for the spine, pelvis, and hip.
Jacob went through a general program of corrective care for 2-3 months for his hip and low back. Thereafter, he came in for “maintenance of normal joint motion and function of the spine and extremities by adjusting/manipulation” (1).
Furthermore, therapeutic exercises for strengthening of the osteoarthritic joints were ongoing throughout his supportive care. Finally, recommendations on an anti-inflammatory diet were beneficial.
Jacob started feeling better within the first few visits. Indeed, Jacob made great improvement in the end becoming pain-free and gaining increased range of motion in his right hip. Also, Jacob’s hip felt less “stiff” when he woke up in the morning or sat for long periods of time.
Research on How Chiropractic Adjustments Can Help With Arthritis
A 2017 review in the Journal of the American Medical Association, found that spinal manipulation reduces lower back pain. And a 2013 study published in Osteoarthritis and Cartilage found that patient education combined with 12 chiropractic treatments (twice a week for six weeks) were more effective for hip Osteoarthritis than a daily stretching program or patient education alone.
Are you looking for the best chiropractor in West Palm Beach? Dr. Natalie Meiri can definitely help you. Find out more about Relief From Hip Pain and Osteoarthritis: Chiropractic Care is Effective. Call 561-253-8984 today for an appointment.
References:
Thomas Bergman, David Peterson, Chiropractic Technique Principles and Procedures, 3rd edition, 2011 (1)