Hip Pain Treatment

Dr. Melander treats more hips than any other body region at North Shore Spine and Sport.  The reasons for this are many, but the good news is that whether you are suffering from a sport or exercise-related strain, a cumulative issue like bursitis, a pinch in the front of the hip, or numbness/tingling/shooting pain from a sciatic nerve irritation, we have multiple methods of both mobilizing the hip and strengthening the hip so you can stop suffering!

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(FAQs) Hip Pain & Hip Injury

Hip Pain: Causes and Symptoms


What causes hip pain that radiates down the leg?

There are 3 common issues that cause hip pain that radiates down the leg.  In no particular order, those 3 issues are lumbopelvic joint pain referral, lumbar disc derangement, peripheral sciatic nerve entrapment/irritation.

In the case of lumbopelvic joint pain referral, an inflammatory reaction to a lumbar joint structure or pelvic (sacroiliac) joint structure due to some kind of strain can cause a referred pain experience in the hip (buttock or groin) that may even be felt throughout the entire leg.

This is an example of a hip pain NOT being a true hip problem, rather, a purely referred pain for which treatment to the appropriate lumbar or pelvic joint can have immediate and sometimes total resolve.

In a disc derangement scenario, a lumbar disc may be bulged, herniated, or sequestered causing a pressure to develop on the adjacent nerve root, and sometimes, a pain, numbness, tingling, or weakness into the same side hip or leg.

In a peripheral sciatic nerve irritation scenario, most commonly the sciatic nerve is being frictioned by the deep hip rotator muscles causing a localized hip pain and sometimes a referred pain down the leg.

A peripheral sciatic nerve irritation is often easily managed with Active Release Techniques® to the appropriate structures intended to help the sciatic nerve glide more easily through its pathway.  Dr. Melander evaluates these sorts of issues every day at North Shore Spine and Sport.


Hip Injury and Hip Pain Symptoms:

Hip pain treated at North Shore Spine and Sport by Dr. Melander include all of the following:

  • Outside hip pain (the lateral side of the buttock and thigh), IE: Trochanteric Bursitis, piriformis syndrome, Glute tendinosis 
  • Inner hip pain (the groin and medial thigh), IE: Hip Impingement, groin or adductor strains, psoas tendinosis 
  • Hip pain when walking, IE: buttock area, groin area discomfort 
  • Hip pain when sitting, IE: Ischial bursitis aka Runner’s Butt aka Benchwarmer Syndrome 
  • Hip pain when lying down 
  • Hip pain when sleeping 
  • Hip pain when running, IE: Runner’s butt, piriformis syndrome, glute tendinosis, groin or adductor strains 
  • Hip pain when lying on side, IE: trochanteric bursitis 
  • Hip pain when standing 
  • Hip pain at night lying on side, IE: trochanteric bursitis 
  • Hip pain at night sleeping, IE: bursitis, piriformis syndrome, sciatica 
  • Hip pain at night after running, IE: runner’s butt, piriformis syndrome, sciatica 
  • Hip pain from back pain, IE: sciatica, Sacroiliac joint dysfunction, facet joint irritation, disc derangement 
  • Hip pain from sciatica

    Hip Pain Treatment (FAQs)


    Which is better for hip pain ice or heat?

    In Dr. Melander’s opinion, neither ice or heat is especially helpful for any pain scenario.  That being said, in situations of hip pain secondary to cumulative strain then heat may be helpful in temporary increasing blood flow to tissue and providing a transient relief.

    What are some hip pain treatment exercises, hip pain relief exercises, or hip pain therapy exercises?

    While the best answer is that these exercises should be highly specific to an individual, Dr. Melander can safely recommend a few ideas.    Many people enjoy foam rolling the back of the hip whereby they sit on the floor, cross an ankle over the opposite knee, then rolling the hip on the ankle side effectively massaging into the glutes and hip rotators.

    Another generally safe exercise for most varieties of hip pain is to perform hip CARs through the largest range of motion possible with no pain.  Ideally, hip pain relief exercises should be based on an objective evaluation of a patients range of motion and strength, and include exercises that improve range of motion and strength IE: squat variations, deadlift variations, PAILs/RAILs.

    What is a hip flexor pain relief exercise?

    One example of an exercise Dr. Melander uses at North Shore Spine and Sport frequently for hip flexor area discomfort is hip flexion passive range holds, or hip extension PAILs/RAILs.

    What is a sciatica hip pain relief exercise?

    Assuming there is some kind of true nerve compromise contributing to sciatica, then Dr. Melander recommends hip figure 4 PAILs/RAILs targeting external rotation of the hip or Romanian Deadlifts through the non-painful range of motion only.  One must be careful with sciatica to not place too much tension on the sciatic nerve as that can be aggravating.

    What is a hip pain treatment without surgery?

    Every hip pain that Dr. Melander treats at North Shore Spine and Sport is managed non-surgically!  ART, FRC, strength/conditioning are all used by Dr. Melander in the management of nearly all hip pains.  However, some cases of significant clinical compromise may warrant referral to an orthopedist for surgical consultation.

      Common Hip Pain Questions


      What are the first signs of hip problems?

       In Dr. Melander’s opinion, the first sign of potential hip problem is a loss of range of motion and eventually pain.

      Where do you first feel hip pain?

      This is completely individualistic as people can experience pain in the groin side of the hip, the outside of the hip, or deep in the buttock area of the hip.  The most common area that people complain of hip pain in Dr. Melander’s office is the buttock area.

      Does walking help hip pain?

      Hopefully!  With any injury evaluated at North Shore Spine and Sport, Dr. Melander wants his patients to remain as active as possible.  Generally speaking any movement of a painful area that does not clearly aggravate pain is a good thing.

      How do you stop hip pain?

      This completely depends on the individual and their hip pain experience.  Generally efforts made to facilitate strength and range of motion of the hip will help to mitigate the likelihood of injury and pain.  If pain starts or persists despite efforts at self-care, Dr. Melander highly recommends people seek the evaluation of a trained provider in the rehab field like chiropractors and physical therapists.

      How do I know if I have sciatica or hip pain?

      Usually sciatica is a pain experience that is experienced not just in the hip but also further down the leg and also very often begins in the lower back.  Hip pain on the other hand is likely more localized.

      How do I know if my hip pain is serious?

      An evaluation by a trained healthcare professional is the fastest route to learning about the severity of a hip pain experience.

      Curious about hip pain?  Dr. Melander treats people with hip pain every day at North Shore Spine and Sport and he’d be happy to discuss your issue anytime!

      our Chiropractic
      Approach

      Dr. Melander has often described his work as new-school rehab, which is to say, an amalgamation of current best practices regarding pain or injury management, hands-on manual therapy or strength/mobility training, and endless advocacy and support for his patients.

      In Dr. Melander’s opinion, the best providers in the field of musculoskeletal injury are able to draw from multiple disciplines to create the most efficient and impactful care strategy for their patients.  If you are injured or hurting and not sure what to do, please reach out, it will be our greatest pleasure to help you.

      We serve Newburyport and surrounding North Shore communities, including: Newbury, West Newbury, Rowley, Byfield, Georgetown, Amesbury, Salisbury, Ipswich, Seabrook NH, Hampton NH, Rye NH.

      Chiropractic FAQs


      We've compiled a list of common chiropractic questions to help you get all the answers you are looking for. If you have additional questions if our chiropractic and treatment services in North Shore would be a good fit for you, please contact our team. 

      How do I know if I should see a chiropractor?

      Chiropractors are trained in the evaluation and management (IE: treatment) of issues affecting the neuromusculoskeletal system (muscles, joints, connective tissue, nerves).  Many people associate chiropractic care with the spine only, but this is an inaccurate reflection of many chiropractors in the 21st century who are experts in treating spinal issues AND extremity issues (arms and legs).  As a general rule of thumb, if you have a painful condition that does not get better given a few days of activity modification you may want to consult a professional like a chiropractor.  Your chiropractor should be able to evaluate your painful condition, offer you some perspective and guidance relative to the painful condition, and help you care for the painful condition if treatment is warranted.  Like any profession though, each chiropractor has different clinical experience and different post-graduate education that may lend their practice toward a focus on sports injuries or pregnancy/neonatal care or neurologic issues or nutritional issues to name just a few.  If you are considering seeing a chiropractor, make sure that their experience and skill set seems like a proper match for your complaint and your ultimate goals.

      How do I choose a good chiropractor?

      Choosing a good chiropractor does not have to be a complicated process.  To begin with, ask your friends or family if they know someone they trust and can vet for you.  Next, check online as most chiropractors should have fairly informative websites relative to their clinical interests and experience that may help indicate whether they are a good fit for your issue.  If you are still not sure who to see after taking those steps, call your prospective chiropractor’s office as either the staff or the chiropractor will be more than happy to answer any questions and tell you if your issue is something commonly treated in that office.  Many people also like to read online reviews and while some online reviews can be misleading, if the significant majority of a chiropractor’s reviews are super positive then chances are you can trust the expertise of that provider.  Lastly, and arguably the most important step in choosing a good chiropractor, remember that you are in total control of your healthcare decision making.  If you go to an initial or follow-up appointment and you are not absolutely confident in the assessment and plan your chiropractor has rendered, then seek a second opinion.

      What can a chiropractor fix?

      A chiropractor can help you fix a wide variety of painful conditions related to the neuromusculoskeletal system such as headaches, back/neck pain, shoulder/elbow/wrist/hand pains, hip/knee/ankle/foot pains to name just a few.  Injuries of actual orthopedic compromise like fractures are best handled by orthopedists, but chances are if your pain/injury is non-surgical in nature then a chiropractor may be a great option to help you.  The best chiropractors will explain what they can about your pain/injury, offer guidance and likely treatment as efficiently as possible (days to weeks, maybe months in extreme situations), and then remove themselves and let your brain/body do the rest.  A great deal of research these days indicates that in many healthcare interactions providers should try and limit their patient’s dependency on them, opting instead for interventions and language that fosters resiliency and self-efficacy (independence).

      What happens at your first chiropractic appointment?

      Your first chiropractic appointment should include a detailed discussion of your health history and presenting complaint(s), an examination of your complaint(s), a discussion regarding what is indicated by the examination relative to prognosis and treatment plan, and finally some form of treatment/intervention assuming time permits.  Many painful conditions can be evaluated thoroughly and completely in a matter of minutes and certain treatment interventions could yield immediate relief, while other conditions may require more complex evaluations and more lengthy treatment plans.  Above all, you should leave your first chiropractic appointment feeling confident that your chiropractor is the best option to help you with your problem and you should leave feeling confident that you are on the road to recovery.

      How often should you see a chiropractor?

      You should see a chiropractor as often as you want or need.  Perhaps the most common criticism of chiropractors is that chiropractors “need to see you for the rest of your life”, and while there are unfortunately examples of chiropractors who advocate for this kind of dependency, the significant majority of chiropractors today want to help you as quickly as possible with no long-term commitments of any kind.  The best chiropractor will see you the minimally necessary number of times to help you overcome your issue and suggest you follow-up if there are any residual issues or new complaints sometime in the future.  Many patients however recognize how good they feel after chiropractic care and therefore wish to see their chiropractor with some kind of recurring frequency (IE: once/month, twice/year, or more).  These examples though should be dictated by the patient based on their assessment of their body’s needs and absolutely not dictated by the chiropractor based on some kind of pseudoscientific reasoning.

      Does insurance pay for chiropractor?

      In many cases, yes, insurance will help pay for chiropractic care assuming the chiropractor is participating with your health insurer.  If your chiropractor is not participating with health insurance, then it is still possible you have an out-of-network benefit with your insurer and can seek reimbursement that way.

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