1. Introduction & Understanding Front Hip Pain
In truth, it can be difficult to distinguish between hip joint pain and radiating pain from the lower back since patients with the back problem can be pain-free in the back and feel increased discomfort in the hip when the joint is stressed in certain positions. The term used to classify this is impairment phenomenon where the hip pain from the back problem is true, but it increases symptoms that are, in fact, sourced from the hip joint. This raises another issue where despite a correct diagnosis, the patient is likely to be offered hip treatment for the hip symptoms which are occurring from the back problem. This can lead to inadequate results and adverse effects from unnecessary treatments for the hip joint problem. Therefore, it is important that patients are aware of the complexity of the human body, and well-informed health professionals will be able to greatly assist you in understanding how and why this treatment will benefit you.
Moving on and looking closely at what front hip pain actually is. Front hip pain is described as discomfort in the anterior (front) region of the hip or where the thigh connects to the pelvis, and there are various underlying causes. These can range from muscle-related problems such as referred pain from lower back structures, groin strains, and abdominal muscles to hip joint-specific problems such as a labral tear or femoral acetabular impingement. However, the focus of this discussion is on muscle-related problems, specifically referred pain from the lower back; nerve entrapments, and muscle strains. This is because a lower back muscle tear can cause significant pain in the hip and can lead to symptoms and functional limitations that are similar to those from an injury in the hip joint itself. This can be quite frustrating for patients as confused diagnoses are very common because symptoms usually mimic those of hip joint problems.
Now, the function of the hip is to support the weight of the body in static and dynamic postures. During static postures (standing), the pelvis on the weight-bearing side is held up by the abductor muscles, which are a group of muscles that move the leg away from the midline (laterally). Then, when weight bearing is being transitioned from one leg to the other while moving, the abductor muscles contract to support the weight of the body as the pelvis is tilted and the other leg is lifted to freely swing.
The hip is a ball and socket joint that attaches the leg to the torso of the body. In the joint, the head of the thigh bone (femur) forms the ball, and the socket is formed into the pelvis. When a person is upright, the ball-and-socket is vertical and it allows you to move your leg forward and backward, outward and inward. Looking deeper, the hip joint is classed as a synovial joint. The bones are covered with cartilage, which is a smooth substance that protects the ends of the bones and allows them to move easily without friction. Then, the whole joint is encapsulated by a synovial membrane, which forms a closed or fixed container and encompasses the joint and the synovial fluid. This fluid is a viscous fluid that acts as a lubricant and provides nourishment to the joint.
2. Treatment Options for Front Hip Pain
The treatment of front hip pain includes several different options. Hip pain is a very difficult and complex problem. This is because the hip joint is usually a non-complaining, but very honest joint. Quite often, hip pain can present without any groin pain and vice versa. It is very common for people to have a combination of both. Treatment options include rest, lifestyle changes, exercise and a variety of manual therapies and injections. The correct diagnosis is important to guide treatment. It is important to discuss with your doctor to establish a correct diagnosis of the cause of the pain and to tailor an appropriate treatment program. By addressing muscle imbalances, biomechanical faults and improving strength, many patients with hip pain will improve over time. With mild to moderate hip OA, weight loss may be an effective way to reduce symptoms and disability. Weight loss can benefit relief of pain due to the reduction of joint reaction force and symptoms. Each form of arthritis has a different method of treatment. For non-inflammatory osteoarthritis, the main focus is on rehabilitation, weight loss, activity modification, use of walking aids, physical therapy, NSAIDs and joint injections to improve the strength of muscles surrounding the hip and to increase the range of motion. Inflammatory arthritis will require a combination of pharmacological and non-pharmacological treatments, an assessment of the disease severity and monitoring the progress after the initiation of treatment. This may involve the use of disease modifying anti-rheumatic drugs and in extreme cases, a joint replacement to cease continual pain. The main drug treatments are NSAIDs, analgesics and injections of corticosteroid to the affected joint. Weight loss and exercise have been recommended for pain relief and mobility. High impact vigorous sports, especially while young, probably increase the risk of hip OA. Competitive long distance runners at elite and recreational levels have substantially higher prevalence and incidence of hip OA. Front hip pain treatment is available in Singapore.
3. Understanding Lower Back Muscle Tear
There are three different types of muscle tears, and they are classified based on the severity of the damage to the muscle. Type 1 tears are quite mild and are only a partial tear of a few muscle fibers. This results in some pain and swelling but does not hinder the overall function of the muscle. Type 2 tears are a moderate severity with the muscle being partially torn. This results in significant pain and swelling and causes the muscle to lose the majority of its function. Type 3 tears are a severe injury where the muscle has been completely torn. This type of injury causes intense pain, swelling, and even deformation of the muscle. In severe cases of type 3 tears, surgery may be required to fix the muscle.
When talking about lower back muscle tears, it is relevant to discuss the various types of muscles in this area and the different muscles of the lower back. The muscles are divided into two groups: the intrinsic muscles and the extrinsic muscles. The intrinsic muscles are the smaller muscles that connect one bone to another, while the extrinsic muscles are the larger muscles that connect the spine to the upper extremities of the body. There are many different lower back muscles, but the majority of tears occur in the Erector Spinae and the Quadratus Lumborum. These muscles are both extrinsic muscles that aid in the movement and support of spinal and abdominal health. Typically, a lower back muscle tear occurs as a result of an acute injury, improper use of the muscles, and/or chronic overuse of the muscle. This causes a disrupted muscle function and, in turn, causes swelling, pain, and bruising of the lower back. Lower back muscle tear treatment is available in Singapore.
4. Treatment Options for Lower Back Muscle Tear
Lower back muscle tears are common for athletes. This injury is in the well hamstring muscle, which is a group of three muscles that runs down the back of the thigh between the hip and the knee. It’s common among athletes who participate in a sport that requires a lot of sprinting. This injury is characterized by a sudden sharp pain in the lower back region. There may also be some swelling or bruising in the area, as well as discoloration. To determine if you have a muscle tear, you may want to consult a doctor and consider getting an MRI. An x-ray is not always sufficient in determining the magnitude of the injury. A muscle tear can have different grading levels of severity. A grade one tear is not as serious, and the muscle is still intact. A grade two tear is a partial tear in the muscle and can compromise its strength. A grade three tear is a complete tear of the muscle and is the most severe. With a tear injury, it is often recommended to utilize the RICE formula: rest, ice, compression, and elevation. This will help alleviate the swelling and speed recovery time. Typically, anti-inflammatory medications are also recommended to reduce swelling. If the muscle is partially or completely torn, crutches may be necessary to take the load of weight off the injured leg, and it could be several weeks before the leg can bear weight again. A grade one tear injury will heal over time with the muscle regaining full function. It is quite simple to treat, and a doctor may allow you to do light stretching and strengthening exercises to help repair the muscle. A grade two tear will take several months to heal. Sometimes a particular form of therapy called platelet-rich injection therapy can be used. This is a medical treatment relatively new in the USA that has been proven successful in patients from other countries. It involves a blood sample from the patient, using a centrifuge to separate platelets from the other blood cells, and then re-injecting the platelets into the injured area. Platelets release a growth factor that aids in healing the injury. The last resort to a grade two tear may be surgery to repair the muscle. This would be the same process for a grade three tear. A complete tear will require surgery, but the type of tear and location may alter the method used.
