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One of the most common problems seen in a primary care medical practice is low back pain. It accounts for more discomfort, lost work and productivity, and frustration for many patients than any other malady. Some think it is the price we, as humans, pay for walking upright. The lower back is a complex structure made of bone, muscles, connective tissue and nerves that, along with our legs, hold us erect, allow us to bend, run, twist, catch a football, or just lay down and rest. However, once a problem arises, the complexity of its structure makes pain in the lower back difficult to diagnose and treat. The lower back consists of a spinal column from the lumbar region of the mid-back down to the tail bone or coccyx. The spinal column consists of 5 lumbar vertebrae which are cylindrical bony structures with a ring like component behind the cylinder also made of bone. In between the vertebrae are disc shaped cushions filled with a gelatinous central core known as the nucleus pulposis
In the time leading up to hip replacement surgery, you were looking forward to living pain free. But now months after the surgery, you are disappointed with your reality of living with ongoing pain or even worse pain than you had before. What went wrong? Why aren’t you experiencing the pain-free life that you dreamed of? A few things can be going wrong and preventing you from the best possible results after the replacement of your hip.
First and foremost, you might be caught in a painful triad of arthritis involving both the hips and the spine. Replacing one or both hips does not solve the back pain. And fusing the back does not solve the hip pain. The hip-spine connection is frequently encountered in the elderly because all of these parts have deteriorated over time. 1 Sometimes hip arthritis is misdiagnosed as low back pain. Sometimes low back pain is misdiagnosed as hip arthritis. And many times both are seen together in the same person. Even someone who has had t...
Pain along the back of the hip can be a very complex and puzzling condition to figure out. It's a fairly rare problem and affects athletes involved in golf, dance, or soccer most often. This article was written to help physicians diagnose with accuracy the problem and the cause. The best way to evaluate and diagnose patients with posterior hip pain is always with a systematic and logical approach. That means knowing the anatomy, possible causes of hip pain, how to classify the disorder, and ultimately, knowing how to treat the real underlying problem. Because the patient's symptoms are often vague and hard to pinpoint, special tests and imaging studies aid in the diagnostic process. The physician must also keep in mind that pain along the back of the hip could be coming from elsewhere -- like the sacroiliac joint, low back, or knee. It could be from a muscle strain, hernia, degenerative disc disease, fracture, or even from a hip dislocation. One thing we know for sure. Based on how the n...
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