Chiropractic and Active Release: Ulnar Nerve Compression.

A 41-year-old woman with ulnar tunnel compression complained of poor grip strength and numbness in her right forearm and middle fingers. She was treated with chiropractic care including manipulative therapy, Active Release Techniques, and elastic therapeutic taping. Home exercises and improvements to her workstation ergonomics were also implemented. After her first treatment, immediate improvements were noted regarding weakness and numbness. The patient’s symptoms resolved completely after 11 treatments.
Journal of Chiropractic Medicine, June 2013

What happened in Vegas, Dr. Stripling’s Self-Help video for Neck Pain, and this week’s 1-Page Health News, from Denver Chiropractic Center

This weekend Meredith and I (Glenn) jetted off to Las Vegas so I could teach at the Active Release Techniques seminar there, and so we could hang out at night. Meredith saw (or almost saw, I never did get the story straight) the Victoria Secret models and Magic Johnson (not together). I did not. Anyway, as always Vegas was fun for a couple of days and then got really old really quickly.

Dr. Stripling and Keri held down the fort here at the office, and shot a video on a great neck stretch for those of you who work at a desk all day. The link is below.

Next week is the last week of the year for us, and we’ll be closed from December 22 through January 1, opening back up on January 2. Dr. Hyman will be on call in case of emergency. His cell phone # will be on our voicemail.

Mental Attitude: Reaction To Stress. How people react to stress determines how that stress will affect their health. Study volunteers were separated in two groups: 1) those who let their troubles affect their emotional state and 2) those who didn’t let stress bother them at all. At a 10-year follow up, those who let stress affect them (group 1) were more likely to suffer from chronic health problems. Penn State, November 2012

Health Alert: Hip Replacement and Stroke Risk. Hemorrhagic stroke and ischemic stroke risk is ~4% higher within 2 weeks of total hip replacement surgery. A hemorrhagic stroke is brought on by bleeding in the brain, while an ischemic stroke is brought on by arterial blockage. Total hip replacement is extremely common in the United States. Around 1 million hip replacement surgeries are done around the world every year, 300,000 in the United States alone. Stroke, November 2012

Diet: Vitamin D Levels Decreasing? Women with health issues such as arthritis, hypothyroidism, cancer, high blood pressure, and osteoporosis are much more likely to have inadequate levels of vitamin D during seasons with decreased daylight. 28% of women had deficient levels and 33% had insufficient levels of vitamin D. Women taking supplements were able to significantly elevate their vitamin D levels.
American Society for Clinical Pathology, November 2012

Exercise: Exercise When You’re Sick? The choice to exercise or not sometimes depends on the sickness or disease. Our bodies work harder and use more energy when we are fighting an illness. If symptoms are above the neck (sore throat, runny nose), it is probably okay to exercise. If you’re sick but still want to exercise, simply reduce your intensity and duration. You should not exercise if you have body aches, fever, diarrhea or vomiting, shortness of breath or chest congestion, dizziness or light-headedness. When resuming your regular exercise routine, try starting with 50% effort and 50% duration. Loyola University Health System, November 2012

Active Release Techniques: Sliding Nerves? Nerves need to slide past muscles and other structures in your body. As tight muscles put pressure or pinch nerves, they interrupt the blood’s circulation to the nerve. This can cause symptoms like carpal tunnel in the wrist sciatica in the hip and thigh, and many more problems. Active Release Techniques is the only system that specifically includes treatment protocols for releasing nerve entrapments. Note: Dr. Glenn Hyman is still the only Active Release Techniques instructor practicing in Denver.

Wellness/Prevention: Staying Healthy! “Check out Dr. Stripling’s Self-Help video for Neck Pain:
http://www.denverback.com/?p=966

Quote: “So many people spend their health gaining wealth, and then have to spend their wealth to regain their

Dr. Stripling’s Self-Help Video for Neck Pain, from Denver Chiropractic Center

Common Car Accident (Whiplash) Myths

Last month, we began discussing common myths about whiplash injuries, and this month, we will continue on that course. Remember, the amount of injury that occurs in an acceleration/deceleration injury is dependant on many factors, some of which include gender (females>males), body type (tall slender = worse), the amount of vehicular damage (less is sometimes worse as the energy of the strike was not absorbed by crushing metal), head position at the time of impact (rotation is worse than looking straight ahead), and more. Therefore, each case MUST be looked at on its own merits, not just analyzed based on a formula or accident reconstruction.

MYTH #5: THERE MUST BE DIRECT CONTACT WITH THE NECK FOR INJURY TO OCCUR. Injury to the neck most commonly occurs due to the rapid, uncontrolled whipping action of the head, forcing the neck to move well beyond its normal range of motion in a forwards/backwards direction (if it’s a front or rear-end collision) or, at an angle if the head is rotated or when the strike occurs at an angle.

When this occurs, the strong ligaments that hold the bones together stretch and tear in a mild, moderate, or severe degree, depending on the amount of force. Once stretched, increased motion between the affected vertebra results as ligaments, when stretched, don’t repair back to their original length and, just like a severe ankle sprain, future problems can result. This excess motion between vertebra can result in an accelerated type of arthritis and is often seen within five years following a cervical sprain or whiplash injury.

MYTH #6:  SEAT BELTS PREVENT WHIPLASH INJURIES. It’s safe to say that wearing seat belts saves lives and, it’s the law! So, WEAR YOUR SEAT BELTS! They protect us from hitting the windshield or worse, being ejected from the vehicle. But, as far as preventing whiplash, in some cases (low speed impacts where most of the force is transferred to the car’s occupants), the opposite may actually be true. (This is not an excuse to not wear a seatbelt!)

The reason seat belts can add to the injury mechanism is because when the chest or trunk is held tightly against the car seat, the head moves through a greater arc of motion than it would if the trunk were not pinned against the seat, forcing the chin further to the chest and/or the back of the head further back. The best way to minimize the whiplash injury is to have a well-designed seat belt system where the height of the chest harness can be adjusted to the height of the driver so that the chest restraint doesn’t come across the upper chest or neck.

Move the side adjustment so the chest belt crosses between the breasts (this also reduces injury risk to the breasts) and attaches at or near the height of the shoulder (not too high). Another preventer of whiplash is positioning the head restraint high enough (above the ears typically) and close to the head (no more than ½ to 1 inch) so the head rest stops the backwards-whipping action. Also, keep the seat back more vertical than reclined so the body doesn’t “ramp” up the seat back forcing the head over the top of the head restraint.

If you’ve been in a car accident, Denver Chiropractic Center can help you with Active Release Techniques, chiropractic care, and physical therapy. We accept Med Pay and will work with any auto insurance carrier. 303.300.0424. Call us today.

How Does Chiropractic Help Headaches?

Headaches are one of the most common reasons people seek out Denver Chiropractic Center for care. Many patients with headaches benefit significantly from specific muscular treatments made to the upper cervical region. So, the question is, how does muscular treatment (with Active Release Techniques) the neck help headaches? To help answer this question, let’s look at a study that was recently published that examined this exact issue…

It’s been said that if one understands anatomy, determining WHERE the problem is located becomes easy. So, let’s take a look at the anatomy in the upper most part of the neck. In the study previously mentioned (http://www.ncbi.nlm.nih.gov/pubmed/21278628), the authors found an intimate relationship between the muscles that connect the upper 2 cervical vertebra (C1 and 2) together and their anatomical connection to the dura mater (the covering of the spinal cord). They identified this anatomical connection between the muscles that span between the back aspect of C1/2 and the dural connection as having a significant role in the development of headaches usually referred to as cervicogenic headaches.

There are several reasons why ART to the muscles of the upper cervical (suboccipital) helps to reduce the intensity, frequency and duration of headaches. If one or both of the upper 2 vertebrae (C1 and C2, also referred to as the atlas and axis, respectively) are either blocked or fixed and cannot properly move independently, then there is an abnormal change in the biomechanics in that region. You can take all the ibuprofen, Aleve, Tylenol or other perhaps stronger, prescription medication for the headache, but it is not logical that the biomechanical problem at C1 and/or C2 is going to change by inducing a chemical change (i.e., taking a pill). All you’re doing is masking the symptoms for a while, at best.

Many people find that after Active Release Techniques soft tissue treatments to the associated muscles, their headaches are significantly improved. This is because restoring proper biomechanics to the C1/2 region reduces the abnormal forces on the vertebrae as well as any abnormal pull or traction of the posterior cervical muscles on the dural attachment.

It has been reported that the function of this muscle/dura connection is to resist excessive movement of the dura towards the spinal cord when we look upwards and forwards. During neurosurgery, observation of mechanical stress on the dura was found to be associated in patients with headaches. In chronic headache sufferers, adjustments applied to this area results in significant improvement.

In our opinion, there is no other treatment approach that matches the ability that targeted and specific muscle work have in restoring the C1/2 biomechanical relationship thus, helping the headache sufferer. Another treatment option that has been shown to benefit the headache patient is injections to this same area. However, given the side effects of cortisone, botox, and other injectable chemicals, it’s clear that treatment with ART should be utilized first. It’s the safest, most effective, and fastest way to restore function in the C1/2 area, thus relieving headaches.

We realize that you have a choice in where you receive your healthcare services.  If you, a friend or family member requires care for headaches, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Carpal Tunnel Syndrome – Natural Treatment Options

Carpal Tunnel Syndrome (CTS) is a condition characterized by pain, numbness and/or tingling in the hand. This includes the palm and the 2nd, 3rd, and half of the 4th finger, usually sparing the thumb. Another indication of CTS is weakness in grip strength such as difficulty opening a jar to even holding a coffee cup. CTS can occur from many different causes, the most common being repetitive motion injuries such as assembly line or typing/computing work.

Here is a PARTIAL list of potential causes of CTS: heredity (a small sized tunnel), aging (>50 years old), rheumatoid arthritis, pregnancy, hypothyroid, birth control pill use, trauma to the wrist (especially colles fractures), diabetes mellitus, acromegaly, the use of corticosteroids, tumors (benign or malignant), obesity (BMI>29 are 2.5 more likely), double crush (pinching of the nerve in more than 1 place such as the neck and the carpal tunnel), heterozygous mutations in a gene (associated with Charcot-Marie-Tooth), Parvovirus b19, and others. Again, repetitive trauma is still the most common cause. Once the cause(s) of CTS has been nailed down, then treatment options can be considered.

From a treatment perspective, we’ve previously discussed what chiropractors typically do for CTS (spinal and extremity joint manipulation, muscle/soft tissue mobilization, physical therapy modalities such as laser, the use of a wrist splint – especially at night, work task modifications, wrist/hand/arm/neck exercises, vitamin B6, and more). But, what about using other “alternative” or non-medical approaches, especially those that can be done with chiropractic treatment? Here is a list of four alternative or complementary treatment options:

  1. Anti-inflammatory Goals: Reducing systemic inflammation reduces overall pressure on the median nerve that travels through the limited space within the carpal tunnel at the wrist. An “anti-inflammatory diet” such a Mediterranean diet, gluten-free diet, paleo-diet (also referred to as the caveman diet) can also help. Herbs that can helps include arnica, bromelain, white willow bark, curcumen, ginger, turmeric, boswellia, and vitamins such as bioflavinoids, Vitamin B6 (and other B vitamins such as B1 and B12), vitamin C, and also omega 3 fatty acids.
  2. Acupuncture: Inserting very thin needles into specific acupuncture points both near the wrist and further away can unblock energy channels (called meridians), improve energy flow, release natural pain reducing chemicals (endorphins and enkephlins), promote circulation and balance the nervous system. For CTS, the acupuncture points are located on the wrist, arm, thumb, hand, neck, upper back and leg. The number of sessions varies, dependant on how long the CTS has been present, the person’s overall health, and the severity of CTS.
  3. Laser acupuncture: The use of a low level (or “cold” laser) or a class IV pulsed laser over the same acupuncture points as mentioned above can have very similar beneficial effects (without needles)! One particular study of 36 subjects with CTS for an average of 24 months included 14 patients who had 1-2 prior surgeries for CTS with poor post-surgical results. Even in that group, improvement was reported after 3 laser treatments per week for 4-5 weeks! In total, 33 of the 36 subjects reported 50-100% relief. These benefits were reportedly long-term as follow-up at 1-2 years later showed only 2 out of 23 subjects had pain that returned and subsequent laser treatment was again successful within several weeks.
  4. Active Release Techniques (ART): ART releases scar tissue in the muscles that surround the median nerve. This release takes the pressure off of the nerve, and often resolves CTS. We’ve been treating Carpal Tunnel with ART successfully since 2000, and Dr. Hyman is the only ART provider in Denver who is also an ART instructor. Call us today to schedule your CTS evaluation. 303.300.0424

A spicy election day & this week’s 1-page health news

Giving your spice rack a work-out is just as brilliant as eating fruit and veggies. Take oregano. Prized in Italian and Greek cuisine, these tasty little leaves boast 30 times more polyphenols than potatoes, 12 times more than oranges, and 4 times more than blueberries. You’d never munch a bunch of oregano that’s as big as a potato, but even a pinch packs a wallop. A tablespoon of fresh oregano’s got as much antioxidant power as a medium-sized apple!

Here’s the lowdown on herbs and spices that punch up the flavor of popular ethnic cuisine, along with ways you can use them to get healthier as you spice up whatever you’re cooking tonight.

Turmeric: The compound curcumin, found in yellow mustard (not so much in brown mustard, as that has real mustard seed.. but there’s true value in its less expensive yellow imitation). Turmeric and curry powder have anti-inflammatory, antiviral, antibacterial, and antifungal properties, and may offer protection from cancer, diabetes, arthritis and Alzheimer’s disease. It is a premiere flavor in Indian cuisine and you can use it on veggies, sautéed chicken, or salad dressing.

Garlic: Munching a clove a day could help lower your cholesterol by as much as 9%. Garlic contains tons of tangy compounds that may help protect against cancers of the breast, stomach, colon, esophagus, and pancreas — and soothe high blood pressure a bit, too. Garlic’s a favorite from Scandinavia to Spain and China. Use it to spice up veggies, fish, and your next pan of brown rice. It seems to make everything taste better (you could even try it on fruit and all veggies).

Rosemary: A top seasoning in Mediterranean cooking (the French roast it with almonds, the Italians add it to herb mixes), rosemary’s antioxidant capabilities make it a must for 21st-century grill masters. Adding this herb to meat, fish, and veggie marinades before grilling reduces cancer-causing compounds, called heterocyclic amines, by up to 80%

Cinnamon: A compound in this tasty spice called hydroxychalcone makes receptors on cells work better, so your body absorbs blood sugar more easily. Getting ½ to 1 teaspoon a day, sprinkled on food, could lower blood sugar 10 points. It’s a favorite in German baked goods and Greek main dishes like hearty moussaka. Cinnamon is also delicious on oatmeal, in hot cocoa, and sprinkled on fresh fruit, like apples and bananas.

Ginger: This popular flavor in Thai cuisine may also cut your odds for inflammatory diseases like arthritis, as well as cancer and migraine headaches. You can also eat some if you’re prone to motion sickness or are nauseous, too. Try grated fresh ginger in salad dressings and shake powdered ginger into whole-grain muffins.

Here is this week’s 1-Page Health News:

Mental Attitude: What Is Dementia? Dementia is not a specific disease. It’s a term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities. Alzheimer’s disease accounts for 60-80% of cases. Vascular dementia, which occurs after a stroke, is the 2nd most common type of dementia. At least two of the following core mental functions must be significantly impaired to be considered dementia: memory, communication and language, ability to focus and pay attention, reasoning and judgment, and visual perception. Alzheimer’s Association

Diet: Tomatoes! Men who eat lots of tomatoes and tomato-based products may have a lower risk for stroke. Tomatoes are rich in the antioxidant lycopene. Men who had the highest levels of lycopene in their blood (compared to their peers with the lowest levels) were 55% less likely to have a stroke and 59% less likely to have an ischemic stroke. Neurology, October 2012

Exercise: Move It! Even 30 minutes of physical activity 5 days a week (20 minutes 3 times a week for vigorous exercise, such as jogging) can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol. You don’t have to exercise for 30 minutes straight; you can break it up into 10-minute increments. (Note- check out crossfit.com and crossfitendurance.com for daily workouts that are almost always under 30 minutes) American Council on Exercise, October 2012

Active Release Technique: How Important Is Motion? After soft tissue injuries to the muscles, ligaments, tendons, and fascia that result in motion restriction, a high incidence of osteoarthritis (degeneration) can be seen on x-ray within 5 years. (Note-This is why it’s so important to get ART work to improve joint mobility. Stiff backs become arthritic) American Journal of Medicine, 2001

Wellness/Prevention: Safety For Your Children. 37% of all children under 16 years old are incorrectly restrained in the car. 23% are so poorly restrained that a collision would have very serious consequences. With the correct use of safety equipment, fewer children will be injured and killed in traffic accidents. Safety errors are highest in children aged 4-7 years. The 5 most common mistakes are misplaced seat belts, twisted belts, loose straps, belt under the arm instead of over the shoulder, and young children (<135 cm or <4.5 feet) sitting in a seat without side support. (Note- While you’re at it, consider restraining your dog, too. We’ve seen many car accidents that cause a dog to go flying through the car, injuring both the dog and people in the car) Norwegian Institute of Public Health, October 2012

Quote: “The Constitution only gives people the right to pursue happiness. You have to catch it yourself.” ~ Ben Franklin

Dr. Glenn Hyman back from surgery, Denver Chiropractic Center’s awesome Halloween idea, and this week’s 1-Page health news

I (Glenn) want to apologize for being unavailable last week from Monday through Wednesday. I had surgery on Monday and was required to take a few days to recover before going back to work. (I actually went back Thursday before I was supposed to. Don’t tell.) I’ll have more to say about this in the near future, but for now, just know that I am back and ready to help you.

Best Halloween idea I’ve ever heard of:

I got this one from a patient years ago: The Halloween Goblin. In order to cut down on how much junk the kids get in relation to Halloween, we offer them the opportunity to pick out a few pieces from their Halloween bounty, and then trade the rest to the Halloween Goblin for a toy. They simply leave the candy on the porch, and the toys magically appear the next day. We’ve been doing this for 5 years now and it works great. I don’t have a problem with the candy per se, but it’s the way it tends to hang around the house that I don’t like. The Halloween Goblin takes care of that. The key is giving the kids the option to participate instead of forcing it on them.

And here is this week’s 1-Page Health News.

Mental Attitude: Benefits of Green Tea. Previous studies have shown that green tea consumption aids in both weight loss and lowering cholesterol levels. Green tea is full of anti-oxidants and has also been known to reduce the risk of esophageal cancer, depression symptoms, wrinkles, the risk of high blood pressure. Green tea also benefits diabetics because it slows the rise of blood sugar after eating. A new study reveals that it may also benefit memory and spatial awareness. (Note: Green tea decaffeinated with CO2 retains as much as 95% of the original anti-oxidant levels. If the ethyl acetate process was used, only about 30% of the anti-oxidants will be retained.) Molecular Nutrition & Food Research, September 2012

Health Alert: $750 Billion Lost A Year! America’s health care system is inefficient, suffers from data overload, and is both complex and costly. Each year, $750 billion (roughly $.35 per dollar spent) is wasted nationwide on inflated administration costs, fraud, and pointless services. These problems can also result in needless patient suffering and deaths. Institute of Medicine. September 2012

Diet: Anorexia. Patients with anorexia have trouble accurately judging their own body size, but not the bodies of others. In a test, when asked if they could pass through a doorway, anorexic patients felt they could not pass through the door even when it was easily wide enough. However, anorexic patients were more accurate at judging others’ ability to pass through the doorway than their own. The study also found a correlation between the perception of the patients’ own ability to pass through the aperture and their body size prior to becoming anorexic, suggesting that the patients may still think of themselves as their previous size. PLOS ONE, August 2012

Exercise: The Elderly. The benefits of exercise are positive for all seniors, including those who are considered frail. The advantages appeared after just three months and included increased cognitive and physical abilities, as well as increased quality of life. Journals of Gerontology, August 2012

Active Rlease Technique / Chiropractic: Lack of Motion. A joint that is not mechanically stimulated will atrophy, leading to degeneration. However, even passive motion (ex: someone else bending your leg for you) is beneficial to cartilage regeneration. (Our work at Denver Chiropractic Center is all about improving joint mobility). Arthritis Care and Research, 2006

Wellness/Prevention: Coconut Oil and Tooth Decay. Digested coconut oil is able to attack the bacteria that cause toothdecay. The study found that enzyme-modified coconut oil strongly inhibits the growth of most strains of Streptococcus bacteria, including Streptococcus mutans (an acid-producing bacterium that is a major cause of tooth decay). Society for General Microbiology, September 2012

Quote: “Ouch.” ~ Glenn Hyman, after surgery.

My hips don’t lie…Think you’re fat?…and the 1-Page Health News

Some people object to the idea of squatting. They say it’s bad for you, not something anyone ever does, blah, blah, blah. I can tell you from 15 years of experience that the hips don’t lie: People who can’t drop into a full-range unweighted squat sooner or later will have back problems. It’s that simple.

The picture is me cleaning my grill before my dad arrived last weekend. If I couldn’t get into this squat easily, I’d be standing there stooped over at the waist. When stooping instead of squatting becomes a habit, something bad eventually happens. This is the person who blows out his or her back tying a shoe or picking up an empty dog food bowl.

Next time you’re in ask either myself or Dr. Stripling to check your squat for you. IF you can’t do it, we can probably teach you.

Mental Attitude: Think You Are Fat? Researchers found that normal weight teens who perceive themselves as fat are more likely to grow up to be fat. 59% of girls who felt fat as a teen became overweight in adulthood while 31% of girls who did not consider themselves fat during adolescence were found to be overweight. Normal weight girls were more likely than boys to rate themselves as overweight (22% of girls vs. 9% of the boys). One reason for weight gain in later years may be due to psychosocial stress, which can be associated with gaining weight. Under this scenario, the psychosocial stress related to having (or not having) an ideal body type, along with the perception of oneself as overweight, can result in weight gain. Another explanation may be that young people who see themselves as fat often change their eating habits by skipping meals, which can

lead to obesity. Also, a diet you can’t maintain over time will be counterproductive, as the body tries to maintain the weight you had before you started to diet. Norwegian University of Science and Technology, July 2012

Health Alert: Depression Is A World-Wide Problem. It’s widely believe that depression is a phenomenon of Western culture, but researchers who analyzed studies involving over 480,000 people across 91 countries have found the opposite is true. They estimate the rate of depression in Middle Eastern and some Asian countries (~9%) is twice that found in countries like the United States and Australia (~4%). World Health Organization, 2010

Diet: Bad BBQ News! Barbecue can sabotage your waistline. A 20 ounce T-bone steak can weigh in at 1,540 calories, with

124 grams of fat.  A corn-fed 85% ‘lean’ cheeseburger has 750 calories and 45 grams of fat. Pork or beef ribs come from the fattiest part of the animal. Healthier options include pork tenderloin, skinless chicken breast, and lean ground beef. American Heart Association

Exercise: Good Reasons. Regular exercise maintains or improves joint flexibility, improves your glucose tolerance and reduces workdays missed due to illness. Surgeon General’s Report on Physical Activity and Health, 1996

Chiropractic: Motion and Nutrition. Cartilage is avascular, meaning it does not receive nutrition via blood vessels. Like a sponge, it takes in fluid and releases the fluid when compression is applied. This alternating compression and re-expansion allows it to receive its supply of nutrients and remove metabolic waste. Arthritis & Rheumatism, 1984

Wellness/Prevention: Lose To Gain? People who are overweight or obese could gain ten years worth of health benefits by simply losing 20 pounds. Modest weight loss (average 14 lbs) reduced the risk of individuals developing Type 2 diabetes by

58%. Weight loss of just 10% of a person’s body weight has been shown to have long-term impact on sleep apnea, hypertension, quality of life, and to slow the decline in mobility that occurs as people age. American Psychological Association, July 2012

Quote: “We can’t solve problems by using the same kind of thinking we used when we created them.” ~ Albert Einstein

Low Back Pain or Hip Arthritis: Which One is it? How the Active Release doctors at Denver Chiropractic Center can help you

Low back pain (LBP) can have many causes. Our job is to identify the main pain generator(s) and manage the patient accordingly. This requires a careful history, examination, and a short trial of treatment with conservative methods, like Active Release Techniques Soft Tissue Treatment.

When first presenting for care, the patient tells us about their complaint in the history portion of our evaluation. Here, we not only ask about the main reason for their appointment or, what’s bothering them now but also their past history. We also discuss old injuries such as slips and falls, sports injuries that date back to high school, motor vehicle induced injuries, as well as family history (we ask if family members have or have had low back trouble since it’s been reported that there is a genetic link identified for osteoarthritis).

We also inquire about the patient’s current activity level and how well those activates are tolerated, often using tools completed by the patient that can be scored and compared periodically during care to track the benefits of treatment. When we finally return to the primary complaint history, we ask about the location, mechanism of injury, notable changes in the course of the condition, the onset date, pain related activities that increase or decrease pain, the quality of pain, radiation patterns, severity levels (such as a 0-10 scale), and timing issues such as, worse in the mornings vs. evenings.

When patients say, “…I have low back pain,” they may point to anywhere between the lower rib cage and their hip area. In other words, everyone interprets where their low back is located differently. So, when differentiating between low back pain and hip pain, one would think that the patient would either point to their low back or their hip, right? Well, where does hip osteoarthritis usually hurt? That’s what makes it so hard! The pain location can vary and move around in the same patient anywhere in the pelvic region including the groin (which is common), to the side of the pelvis, to the buttocks, the sacrum and in the low back.

To make it even more challenging, degenerative or injured disks in the lower lumbar spine can refer pain directly into the hip area and also create localized low back pain. In fact, patients often have BOTH conditions simultaneously. Usually, during examination, we move the hip in the socket and feel for reduced motion and watch for pain patterns in certain positions. When comparing the two sides, we both can feel, “…a difference between the two.”

The osteoarthritic (OA) hip is comparably more tight and painful with rotation movements. For example, the patient is seated with their leg crossed, trying to touch their knee to their opposite shoulder. In the OA hip patient, they may only be able to get it half way there compared to the other side and often complain of groin pain. The “ultimate test” is the x-ray that reveals the loss of the joint space – the “cartilage interval” – which narrows on the OA hip side.

How often is hip OA found? In a recent article, after reviewing 2000 patient files and 1000 x-rays of patients 40 years or older, 19% (~1 out of 5) demonstrated x-ray findings of hip OA. THAT’S A LOT!  At Denver Chiropractic Center, management of hip OA includes mobilization, manipulation, stretching the muscles surrounding the hip joint with Active Release Techniques, exercise/stretch instruction, nutritional strategies and others. If/when the time comes, we will help set up a referral to the orthopedic surgeon for joint replacement, as any “quarterback” of your care should.

In our experience, using Active Release Techniques to manages the soft tissues (muscles, tendons) that are associated with the hip joint –and there are a lot of them – is the best option to both manage the pain and stiffness in the hip joint.

It all starts with the initial exam. To schedule yours (or schedule one for someone that you care about), call us at 303.300.0424.