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Archive for the ‘Joint Pain’ Category

Hip Impingement

Posted on: 28th October 2015

What is hip impingement?

The medical term most commonly used is femoroacetabular impingement, which is the relationship between the acetabular rim and proximal femur.

Who will be at risk?

It is a common cause of hip pain and is found in athletes, adolescents and adults. It injures the labrum and articular cartilage and can lead to osteoarthritis of the hip.


Patients with hip impingement, typically have hip pain in the front and outside (antero lateral). They often cup the hip with the thumb and fore finger in the shape of a C. Pain is sharp when turning or pivoting, especially in the affected area. It can worsen with prolonged sitting and getting in and out of a car. Pain is usually gradual and progressive.

 Hip HI


Physical examination is the first step, specifically moving the affected hip into flexion, adduction and internal rotation (fadir) and getting a positive response. Diagnostic testing usually takes the form of an x-ray, but care should be taken that the hip is in flexion 90° and adduction 20° to increase the chance of identifying any lesions and osteophytes. It is also quite possible that an MRI will also be taken with the extra steps including a local anaesthetic. Of particular interest will be to determine if there is a labrum tear.


hip 2 HI


There is no real evidence than non-surgical treatment has any lasting benefit. Certainly a course of manual therapy and chiropractic would be advisable, partly to treat the effects of the hip impingement or other structures.

Referral to an orthopaedic consultant will involve an arthroscopy, designed to alleviate the impingement, to repair or remove injured tissue and to prevent or delay osteoarthritis. Success rates seemed to range from 75-84%.

Source – GS Kuhlman and BG Domb 2009 American Family Physician

Knee problems and keyhole surgery

Posted on: 14th October 2015

Should keyhole surgery for knee problems be stopped?

The procedure, known as arthroscopy, increases the risk for deep vein thrombosis, pulmonary embolism (a blockage of the main artery of the lung), infection and even death.

What research found

The benefits of surgery seemed to disappear within one to two years, researchers from the University of Southern Denmark discovered. As such, arthroscopy is not suitable for middle-aged and older patients with knee pain, whether or not they have osteoarthritis, they concluded. They based their findings on a review of nine studies, involving 1,270 patients aged between 48 and 63 years.

Source – BMJ, 2015; 350: h2747

Parkinson’s Easy Detection

Posted on: 25th June 2015

Is there a problem diagnosing Parkinson’s?


  1. Symptoms of Parkinson’s are currently difficult to measure objectively after the patient leaves the doctor’s clinic, so new smartphone software has been developed at Ashton University to bring the doctor into the patients pocket to assess their movements and speech at home.

How does it work?

  1. Diagnosis is based on symptoms including tremor, stiffness and difficulty with movements and speech. The research team at Ashton has developed the software that uses the microphone and motion detector of a standard smartphone to provide data to supplement traditional clinical assessment.

Does it benefit the patient?

  1. Smartphone applications could play an important role in empowering patients to make treatment decisions based on quantitative data they collect for themselves.

Source – Institute of Neurology, University College London 2014

Joint Pain

Posted on: 13th February 2015

What causes joint pain?

After lower back pain and neck pain, the most common joint pain chiropractors treat is what is often referred to as peripheral joint pain. This will include shoulder, hip and knee pain. These joints are more prone to wear and tear and early signs of osteoarthritis.

The risks associated with joints include old injuries, obesity, repetitive activity, weak muscles and to a lesser extent heredity factors. Other factors that can have an adverse effect on our joints include posture, footwear, and lifestyle.

Why it is important to understand the causes 

To offer the most appropriate treatment the causes of joint pain must first be understood, e.g. sprains and strains, tendinitis, and secondly those key factors that are placing the patient at risk, e.g. posture, muscle imbalances and excessive use.

What treatment protocols work?

As well as chiropractic treatment consideration will also be given to soft tissue massage, acupuncture, kinesiology and a rehabilitation program tailored to the specific needs of the patient.