• George Hardas

Hip Pain Assessment & Treatment

As Chiropractic specialists, tests can be conducted to see whether or not a patient does have a hip impingement. These tests include:

  1. The Thomas/ Fixed Flexion Deformity Test

  2. Internal/ External Rotation of the hip joint.

Relative to the Thomas test, an exaggerated lower back curvature means it may be due to spine pathology or hip pathology. Extension of the hip is the initial movement the patient loses in hip pathology, resulting in fixed flexion deformity. Further tests will require the patient to lie facing upwards and the clinician will place their hand beneath the lower back. They will ask the patient to flex both the hip and knee of the side opposing the affected one, holding their knee towards their chest, leaving the other leg straightened out. If a deformity is present, the patient will instinctively lift that affected leg up, causing an angle to be formed between their thigh and the surface, creating a flattening of the lower back, which, in turn, determines the fixed flexion deformity degree. The Internal/ External Rotation of the hip joint requires a clinician to flex the hip of a patient, then to internally and externally rotate the hip passively to exacerbate any labral/bony impingement that will also illicit pain.

Where these aforementioned tests provide positive results, other common reasons for these impingements can be caused by trochanteric bursitis and arthritis. Trochanteric bursitis is the swelling of the bursa which is located on the area of the hip musculature adjacent to the greater trochanter. Arthritis is a degeneration of the articular cartilage surfaces, which in itself creates pain signals to be generated.

The treatment of the above conditions can be done through simple methods such as anti-inflammatory/analgesic medications, or through the implementation of chiropractic care.

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