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Symptoms and Treatment for Common Hip, Pelvic & Back Injuries

Greater Trochanteric Bursitis | Groin Strain (Adductor Muscle Tear) | Hip Flexor Strain
Hip Fracture | Hip Pointer | Lumbar Herniated Nucleus Pulposus (HNP)
Lumbar Osteoarthritis (Degenerative Joint Disease) | Lumbar Spinal Stenosis
Osteoarthritis (Degenerative Joint Disease) of the Hip | Piriformis Syndrome
Sacroiliac (SI) Joint Dysfunction

Greater Trochanteric Bursitis

Greater trochanteric bursitis is an inflammation of the trochanteric bursa, a specific part of the hip. This bursa has the function of a shock absorber and a lubricant for the movement of the muscles adjacent to it. When the bursa becomes irritated or inflamed, it causes pain in the hip. Symptoms usually include pain on the outside of the hip, pain when lying on the affected side, pain when you press on the outside of the hip, or pain when walking up stairs. Treatment mainly includes rest, nonsteroidal anti-inflammatory medication, cortisone shots, physical therapy, or a bursectomy surgical procedure.

Groin Strain (Adductor Muscle Tear)

A groin strain is a tear or rupture of one of the adductor muscles. There are five adductors in which function to pull the legs back toward the midline. A rupture or tear in the muscle usually occurs when sprinting, changing direction or in rapid movements of the leg against resistance. There are 3 different grades of strain with different symptoms for each, but the main symptoms may include discomfort or pain in the groin, tightness of the groin muscles, bruising, swelling, or pain during movement. Treatment may include RICE (rest, ice, compression, and elevation), crutches, stretching, taping, sports massage, or a surgical operation if the strain is severe enough.

Hip Flexor Strain

The hip flexors are made up of three different muscles all working together to provide stability for the lower extremities. Hip flexor strain is a muscle strain felt in the front part of the hip. This injury is often associated with speed training or compensating for another injury, especially Achilles tendonitis or plantar fasciitis. Other causes could be from acute trauma, tight muscles, or poor flexibility. Symptoms may include pain along the front of your hip and thigh, difficulty running, jumping or walking, or a small amount of swelling. Treatment can include rest, ice, and gentle stretching.

Hip Fracture

A hip fracture is a break in the upper quarter of the femur (thigh) bone. If the actual hip socket is broken, the injury is considered to be completely different with different methods of symptoms and treatment. Hip fractures almost always occur from a fall or a direct blow to the side of the hip. A patient with a broken hip will experience pain over the outer upper thigh or in the groin. Treatment options usually include open reduction internal fixation surgery. Open reduction internal fixation (ORIF) is a method of surgically repairing a fractured bone. Generally, this involves either the use of screws and plates or an intramedullary (IM) rod to stabilize the bone. The type of surgery used to treat the fracture usually depends on which type of fracture a patient is experiencing.

Hip Pointer

A hip pointer is a contusion to the iliac crest of the pelvis, the soft-tissue structures surrounding the femur, or the greater trochanter of the femur. The term ‘hip pointer' refers to the deep bruising of the muscle and bone. Typically, the injury is caused by a direct blow or fall. Treatment options may include RICE (rest, ice, compression and elevation), physical therapy, or nonsteroidal anti-inflammatory medication. Surgery is rarely required.

Lumbar Herniated Nucleus Pulposus (HNP)

Spinal stenosis is the term used when the spinal canal becomes narrowed due to normal wear-and-tear effects of aging. When the space around the spinal cord narrows pressure is put on the spinal cord and spinal nerve root causing pain, numbness, or weakness in the legs. Lumbar spinal stenosis occurs when the injury takes place in the lower back. Arthritis, the degeneration of any joint in the body, is the most common cause of spinal stenosis. Symptoms may include back pain, numbness or burning pain in buttocks or legs, weakness in the legs, or a sudden relief of pain while leaning forward or sitting. Nonsurgical treatment may include physical therapy, lumbar traction, anti-inflammatory medications, steroid injections, acupuncture, or chiropractic manipulation. Surgical options may include a laminectomy or a spinal fusion.

Lumbar Osteoarthritis (Degenerative Joint Disease)

Spinal vertebrae are separated by cartilage disks filled with a gelatinous substance, which provide cushioning to the spinal column. Lumbar HNP, or slipped disk, is a condition in which part, or all, of the soft, gelatinous central portion of an intervertebral disk is forced through a weakened part of the disk. This results in back pain and leg pain due to nerve root irritation. This nerve damage may cause neurological symptoms such as sensory or motor changes. Other symptoms may include sharp pain in one part of the leg, hip or buttocks, numbness, weakness, or tingling sensations. Treatment may include rest, anti-inflammatory medication, physical therapy, steroid injections, or surgery.

Lumbar Spinal Stenosis

Degenerative joint disease, also referred to as osteoarthritis, is a syndrome in which a painful disc causes chronic lower back pain. The condition generally starts with a twisting injury to the disc space. The injury weakens the disc, inflames the proteins inside the disk, and begins to expose and irritate the disk which produces the pain back. For most people, this syndrome can be successfully treated with conservative care. Symptoms may include stiffness and pain in the lower back, swelling, warmth, or tenderness. Treatment may include hamstring stretching, dynamic lumbar stabilization exercises, low-impact aerobic conditioning, medication, oral steroids, epidurals, or lumbar spinal fusion surgery for extreme cases.

Osteoarthritis (Degenerative Joint Disease) of the Hip

Osteoarthritis of the hip occurs when the smooth cartilage on the ends of the hip bones, which help your hip joint glide, begin to wear thin. Those who have a family history of the disease are more likely to experience it; also those that are elderly, obese, or have an injury that puts pressure on the hip cartilage are more likely to develop the condition. Symptoms may include discomfort or stiffness in the groin, buttock, or thigh. As the disease progresses, the more painful movement will become. Nonsurgical treatment can include rest, physical therapy, nonsteroidal anti-inflammatory medication, or weight loss. If the condition is in late stages, a total hip replacement (arthroplasty) may be recommended.

Piriformis Syndrome

The piriformis muscle is one of the external rotators of the hip and leg. This means that as the muscle works, it helps to turn the foot and leg outward. When the piriformis muscle squeezes and irritates the sciatic nerve, piriformis syndrome develops. Piriformis syndrome is a neuromuscular disorder that occurs when the sciatic nerve is compressed or irritated by the piriformis muscle. Symptoms can include pain that radiates down the back of the leg, difficulty sitting, or a tingling sensation down the leg. Treatment usually begins as nonsurgical: steroidal anti-inflammatory medication, physical therapy, or botulism injection therapy. Surgery may be used as a last resort.

Sacroiliac (SI) Joint Dysfunction

The sacroiliac joints connect the spine to the pelvis, formed by the connection of the sacrum and the right and left iliac bones. The SI joints have a cartilage layer covering the bone which acts as a shock absorber between the bones. When the cartilage is damaged or worn away the bones begin to rub on each other, causing SI joint dysfunction. Other causes of this condition include pregnancy and increased stress on the SI joints. Symptoms can include pain in the lower back, groin or thighs. Pain is typically worse with standing and walking, and improved when lying down. Treatments may include cortisone injections, anti-inflammatory medications, and physical therapy. If pain persists, surgery may become an option.

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