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Very nice article. It was very comprehensive. In my practice, I find that sometimes people get confused by where their hip is. When we are speaking about the hip medically, it means the hip joint which is the head of the femur and the acetabulum. Sometimes patients come in with pain at the iliac crest, which they think is the hip. That type of pain is usually a biomechanical/musculoskeletal problem, which chiropractic care and possibly massage therapy is perfect for.

If the cause is osteoarthritis, bursitis, or other things mentioned in the article, this may be the long time accumulation of abnormal biomechanical stresses that lead to some of the symptoms mentioned.

I frequently get this response when a patient comes in with hip pain on one side, but not the other, and they tell me, "My doctor says it's old age." I facetiously ask, "OK, how old is the other hip?" My point being is that some biomechanical issue that caused asymmetrical stress and therefore wear on the hip joint caused that problem. It may be helped by mechanical aids, like shoes, walkers, orthotics, etc. If you rely on a walker, a cane or other aid, I'm a firm believe in "use it or lose it." If you have to use a walking aid, hopefully it's only temporary, or you may develop a dependence on it, which can permanently alter your biomechanical movement pattern.

The point of biomechanics is very similar to the alignment on a tire. If the tire is putting more stress on one side of the tire, and the stress is not uniformly distributed, the tire will wear unevenly. That's just common sense. A similar process happens in our bodies with uneven biomechanical processes, your MD, or orthopedic surgeon will likely give you a similar explanation, but limited treatment options including medication, injections, surgery and maybe PT, which all may help, but usually not the first choice of patients.

For side sleepers, I usually recommend putting a pillow between your knees to prevent asymmetry.

Sometimes surgery may be necessary, if the hip pain has degenerated too far, before that, many of the remedies mentioned in the article may be effective for symptom relief. Although I don't do them myself, under some circumstances, I recommend that a patient may see an orthopedic surgeon about a possible cortisone injection. That is not a first choice as it's a fairly invasive treatment (most people don't want needles), but after conservative treatment is attempted, and not successful, may be an option to calm the area down, then resume with functional treatment, i.e., chiropractic. Physical therapy or a personal trainer may be helpful after the biomechanical/functional problem has been addressed and muscle weaknesses still need to be addressed.

Even though acupuncture was mentioned as a possible alternative therapy, which may be effective for pain, chiropractic care was not mentioned, but can be very effective in mobilizing and improving the function of the hip and lower extremity.

Modern chiropractic care and/or massage therapy may be helpful for many of the biomechanical issues mentioned above including bursitis, osteoarthritis, tendonitis, sciatica and many other conditions that are likely due to abnormal biomechanical function, asymmetry, tight muscles, etc. Chiropractic can help to restore movement and function that allows those painful areas to better distribute stress, like I mentioned earlier in the misaligned tire example.
A good chiropractor can help you know what your options are because chiropractic care is a good option if your problem is not surgical, but painful enough to require treatment. Not all chiropractors are the same, however, modern chiropractic may be a valid option for some.

February 16, 2012 - 10:48am


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