Author: Sean Flynn, DC

Bursitis or Gluteal Tendinopathy?

Do you have pain on the side of your hip that might extend into the buttock and/or the upper thigh?  It is common for pain on the side of your hip to be diagnosed as bursitis.  New evidence suggests bursitis is rare and if it occurs it is due to another underlying dysfunction, like gluteal tendinopathy.   Gluteal tendinopathy is the irritation of one or more of the tendons that attach the buttock muscles to your hip.    

Symptoms may start without any known reason.  You may notice pain when standing with your weight on the affected leg, walking, and climbing stairs.  Symptoms may be present at night especially lying on the affected side.  The primary trigger for gluteal tendinopathy is compression or excessive tension of the tendon.  This can occur with running, hill climbing, repetitive movements, gluteus medius weakness, and obesity.  Repeated irritation of the gluteal tendons cause an altered healing of the tendon fibers and can lead to pain and dysfunction.  

Gluteal tendinopathy can be treated with soft tissue work to help with tendon healing and targeted exercises to strengthen the gluteus medius.  Avoiding aggravating postures such as standing with your weight shifted on one leg, sitting or standing with legs crossed, and sleeping on your side can also help.  Cycling or water exercises are low stress options while the tendons are healing.   

Sean Flynn, DC
Sioux City, IA Chiropractor

Lumbar Facet Syndrome

The facets are located on the left and right side of the back of each vertebra.  Facet syndrome means that your facet joint has become irritated and inflamed.  This can be caused by sprains, strains, or joints that are not moving properly. People are more likely to develop facet syndrome if they have suffered an injury, overuse their back, have arthritis, or are overweight.

The symptoms of lumbar facet syndrome are felt on one side of your low back and may radiate into your flank, hip, and thigh. Symptoms of facet syndrome usually do not go past your knee. The pain may come and go. Your pain may increase when you arch backwards or return to an upright position after bending forward.  Many patients report relief when they sit or lie down.

Chiropractic adjustments help relieve lumbar facet syndrome by opening the joint spaces, restoring motion, and breaking up adhesion between the joints. 

Flynn Chiropractic
2300 Hamilton Blvd
Sioux City, IA 51104
(712) 224-2747

Piriformis Syndrome

The piriformis is a muscle in the buttocks which rotates the leg outwards.   The sciatic nerve usually runs under the piriformis.  However as much of ¼ of the population’s sciatic nerves run through the piriformis muscle.  These people are more likely to have piriformis syndrome.  Tightness or spasms in this muscle can compress the sciatic nerve causing sciatica. 

Symptoms of pain, numbness, or tingling can come on suddenly or gradually over time.  Causes could include a fall on the buttocks, sitting on the edge of a hard surface, walking long distances, or a new exercise routine.  Sometimes the cause is unknown.

Symptoms start in the buttocks and can radiate down the leg and into the foot.  Walking, running, climbing stairs, and sitting or standing for longer than 15 minutes may increase symptoms. 

Ice, stretching, soft tissue release, and chiropractic can help relieve sciatica caused by piriformis syndrome. 

Sciatica

Sciatica is pain down the back of the leg that follows the path of the sciatic nerve, the largest nerve in the body.  The pain can occur with or without lower back pain and may travel from the buttock, down the back of the thigh and calf, and into the foot.  

Symptoms can be mild to severe and may include aching, burning, sharp, shooting, or dull pain, numbness or tingling.  With increasing compression, people may have a loss of sensation or muscle strength.  You may notice an increase of pain while coughing, sneezing, straining, and sitting. Symptoms can occur suddenly or gradually over time.

Sciatica is caused by irritation or compression of the sciatic nerve. Common causes include herniated or bulging discs, degenerative discs, stenosis, piriformis syndrome, or spondylolisthesis.

Sciatica can be extremely painful and worrisome, but it is also treatable. Very few cases will require surgery. It can respond well to conservative treatments like chiropractic. In this office, I use a special adjustment, Cox Flexion Distraction, that lowers disc pressure and creates space for the irritated nerves. It has been shown to be more effective than an exercise program for relieving leg pain.1

An at home exercise that can help is nerve flossing. Irritated nerves are more sensitive to pressure and are wider than normal nerves due to swelling. This sciatic nerve flossing technique can help decrease pain and improve the mobility of the sciatic nerve. Flossing may release adhesions along the path of the nerve.

Do the flossing on the painful side. Do 10 repetitions or about 30 seconds. Start with your chin tucked to your chest and knee flexed. Then look up to the ceiling as you extend your leg. Then return to the starting position. The movements are the same for the side lying position. You may feel a stretch but you should not feel an increase in pain. Stop immediately if this causes an increase in your symptoms. If your sciatic nerve is very irritated, you may have to wait for the irritation to lessen before attempting this move.

Call the office if you need help and you are tired of letting sciatica stop you from doing the things you want to do.

Sean Flynn, DC
Sioux City, IA Chiropractor

  1. https://www.ncbi.nlm.nih.gov/pubmed/16341712

Lumbar Degenerative Disc Disease

You have 5 lumbar vertebrae or spinal bones in your lower back.  Between each vertebra is a disc.  The disc acts as a cushion between the vertebrae.  Degenerative disc disease is essentially arthritis of the spine.  It is a process of changes that occur over time.  As we age the disc thins and wears over time.  This leads to formation of bone spurs and a narrowing of the openings where the nerves leave the spine. 

Disc degeneration is common.  It affects 16% of those in their 20s and as many as 80% of those in their 40s.  Lumbar disc degeneration occurs most in the lower lumbars. 

As the disc breaks down it can cause inflammation, bone spur formation, and alter spinal motion which can irritate nerves and cause lower back pain.  If the degeneration is advanced it can lead to stenosis or narrowing of the spine which can cause radiation of pain into the buttock or leg. 

Exercise to increase strength and stability of the spine can help.  Proper lifting techniques and avoiding repetitive lifting and twisting are important.  Chiropractic treatment can help reduce pain and improve mobility.  Call the office if you need help with your lower back pain.  

Lumbar Stenosis

Lumbar Spinal Stenosis Sioux City Chiropractor

Lumbar stenosis is the narrowing of the spinal canal in your lower back.  The narrowing can put pressure on the spinal cord and nerves.  It most commonly occurs in those over the age of 50.  It can be caused by wear and tear, injuries, and age-related changes such as degenerative discs, ligamentous thickening, or spinal arthritis. 

Symptoms can include chronic lower back pain that may radiate into the buttocks or legs.  Numbness, burning, fatigue, weakness, and heaviness may occur in the legs.  Symptoms are aggravated by standing and walking. 

Sitting or bending forward when standing decreases the pain.  Many will find leaning forward on a shopping cart decreases the pain and allows them to walk longer in stores. Those with stenosis may find sleeping on their sides in the fetal position is more comfortable than sleeping on their back. 

Surgery has not been shown to be significantly better than non-surgical treatments, so it is best to try conservative methods such as chiropractic first. Chiropractic treatment goals include restoring mobility, improving function, and decompressing nerves.  Forceful adjustments may increases symptoms for those with stenosis so it is important to use gentle adjustments.  Flexion-distraction is a low force adjustment that has been proven to increase the area in the spinal canal during adjustments, which takes the pressure off the nerves.  

A study comparing the effectiveness of nonsurgical treatment methods in patients with lumbar spinal stenosis looked at 3 nonsurgical interventions. Medical care consisted of medications and/or epidural injections provided by a physiatrist. Group exercise classes were supervised by fitness instructors in senior community centers. Manual therapy/individualized exercise consisted of spinal mobilization, stretches, and strength training provided by chiropractors and physical therapists. The care provided by the chiropractors and physical therapists resulted in greater short-term improvement in symptoms and physical function and walking capacity than medical care or group exercise.1

In addition to in-office care it is also important to do at-home exercises. Water aerobics and exercise bikes are tolerable for those with stenosis. The following stretches can help provide relief for lumbar stenosis. It is best to consult your doctor before beginning any exercise routine. Stop immediately if the stretch causes an increase in your symptoms.

Knee To Chest Stretch Sioux City Chiropractor
Seated Lumbar Flexion Sioux City Chiropractor
Sciatic Nerve Floss. Seated and Side Lying.
Cat Camel Stretch

This article is for education purposes and is not intended to replace diagnosis or treatment by a healthcare provider.

Sean Flynn, DC
Sioux City, IA Chiropractor

  1. https://www.ncbi.nlm.nih.gov/pubmed/30646197