Tag Archives: back pain

The Most Common Cause of Hip Pain in Active Adults

9 Oct

Femoroacetabular impingement (FAI) is a painful hip condition that occurs when there is abnormal contact between the femoral head/neck junction and the rim of the acetabulum (hip socket) during certain movements, especially hip flexion, internal rotation, and adduction (inward motion). While hip problems are often associated with older adults, the vast majority of FAI cases occur in active young and middle-aged individuals.

Essentially, the condition results from bone shapes that disrupt the normal smooth motion of the hip joint. The most common type is called cam morphology, in which the femoral head/neck junction is not perfectly round, creating a bony prominence that interferes with joint motion. Cam morphology accounts for roughly two-thirds to three-quarters of symptomatic FAI cases and is most common in active young men. Another type, pincer morphology, occurs when there is excess coverage of the socket’s rim and is seen more often in active middle-aged women. These morphologies usually develop during puberty, and while they are often symptom-free, they can lead to impingement when the hip is subjected to repetitive, high-force movements such as running, jumping, or kicking—which is why active individuals are more prone to the condition.

Surgical intervention may be considered as an early option, particularly in young athletes with severe, function-limiting symptoms and clear imaging evidence of impingement. However, randomized controlled trials show that while surgery can offer faster symptom relief in the short- to mid-term, the long-term differences compared to structured non-surgical care are small, and surgery carries greater cost and risk. For this reason, clinical guidelines recommend conservative care as the first-line approach, with surgery reserved for cases that do not improve.

Conservative chiropractic management of FAI may include activity modification, anti-inflammatory measures (such as ice, dietary adjustments, or supplements), and rehabilitative strategies like stretching tight hip flexors, strengthening the core and hip extensors, and improving postural control. Chiropractors may also employ modalities such as ultrasound, electrical stimulation, laser therapy, or pulsed magnetic field therapy, along with manual techniques to restore motion in the hip. A comprehensive evaluation also considers the kinetic chain—since altered mechanics in the feet, ankles, knees, or lower back can increase stress on the hip and worsen FAI.

As with most musculoskeletal conditions, early intervention improves outcomes. Addressing FAI promptly not only reduces the risk of joint degeneration but also prevents compensatory movement patterns that can strain other areas of the body and contribute to additional painful conditions.

Pain Relief Chiropractic

4909 Louise Drive Suite 102

Mechanicsburg, PA 17055

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Monthly Pain Relief Update: Neck Pain / Headaches

28 Jul

Text Neck Syndrome and Chiropractic Care

Neck pain is a leading cause of disability worldwide, and after low back pain, it’s the second most common reason people seek chiropractic care. In the past two decades, a new contributor to neck pain has emerged: text neck syndrome, a condition linked to prolonged use of smartphones and other digital devices.

Text neck syndrome results from spending excessive time looking down at a screen. In more clinical terms, it’s caused by sustained neck and head flexion, which places strain on the muscles and soft tissues at the back of the neck. For every inch the head moves forward from its neutral position, the neck muscles must support approximately ten pounds of additional force—similar to how it’s harder to hold a bowling ball with your arm extended than when it’s held close to the body. Over time, the body adapts to this strain by altering posture, such as rounding the shoulders or altering the curves of the cervical and thoracic spine. These postural changes can impair range of motion and negatively affect joint health, increasing the risk of chronic neck pain and related conditions.

What’s especially concerning is that text neck syndrome is common among younger individuals. A history of neck pain in young adulthood is a known risk factor for more severe neck problems later in life. Research involving university students around the world has found that between half and two-thirds report signs of text neck. The risk is further increased among individuals who are overweight, physically inactive, and those who spend more than three hours each day engaged in sedentary leisure activities.

To reduce the risk of developing text neck syndrome and the neck pain that may come with it, experts recommend limiting time spent on electronic devices; taking regular breaks to stand, stretch, and walk around; holding devices at eye level; increasing physical activity; reducing sedentary behavior; maintaining a healthy weight; managing stress; and following an anti-inflammatory eating pattern, such as the Mediterranean diet.

For those already experiencing neck pain associated with device use, chiropractic care may offer relief. In addition to in-office manual therapies that help restore joint movement and reduce muscular tension, chiropractors can provide guidance on exercises to retrain the muscles of the neck, chest, and upper back, which may help correct postural faults and reduce the likelihood of recurring pain.

Pain Relief Chiropractic

painreliefcare.net

Mechanicsburg, PA

 (717) 697-1888

We are watching your back!

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Monthly update on Lower Back Pain

14 Jul

Chiropractic Treatment for Lumbar Spinal Stenosis

            Lumbar spinal stenosis is a condition caused by the narrowing of spaces within the lower spine, which can compress either the spinal cord or nerve roots. This pressure can lead to pain, numbness, or weakness—either locally or radiating down the legs—especially during activities that involve spinal extension (e.g., bending backward or prolonged standing) or compressive loading. While stenosis may result from trauma, congenital anomalies, or systemic diseases, approximately 80% of lumbar spinal stenosis cases are degenerative in origin. Common degenerative contributors include intervertebral disk bulging or herniation, facet joint hypertrophy (arthritis), ligamentum flavum thickening, spondylolisthesis (vertebral slippage), and osteophyte (bone spur) formation. How might chiropractic care help a lumbar spinal stenosis patient both avoid surgical intervention and return to their normal activities to as high a degree as possible?

In the medical model, initial treatment may include physical therapy and/or medications. If those fail to provide relief, a common next step is epidural steroid injections (ESIs), which aim to reduce nerve inflammation and provide temporary symptom relief. A 2025 systematic review of 90 randomized controlled trials found that ESIs can offer short-term improvement in pain and disability but do not result in long-term symptom resolution. If a patient experiences minimal relief after one to two injections, if relief lasts less than one month, or if neurological symptoms progress, further injections are generally not recommended. Clinical guidelines typically limit ESIs to a maximum of three per year, and suggest limiting repeated use to no more than two to three consecutive years due to risks such as bone loss, adrenal suppression, and soft tissue damage.

If the patient pursues chiropractic care, the aim of treatment would be to reduce neural compression by improving lumbar spine mobility and joint spacing. For lumbar spinal stenosis, current guidelines discourage high-velocity, low-amplitude (HVLA) spinal manipulation. Instead, they support gentler techniques such as flexion-distraction, mobilization, and instrument-assisted soft tissue therapies. Chiropractic care may also include targeted exercise, posture training, and neuromuscular re-education to support spinal health and nerve mobility.

Just as critical as in-office treatment is the home management component. Patients are encouraged to perform flexion-based and low-impact exercises—such as stationary biking, inclined treadmill walking, wall sits, and knee-to-chest stretches—which can reduce pressure on lumbar nerves. Core stabilization improves spine support, while posture training and ergonomic adjustments (e.g., lumbar support, avoiding prolonged standing, sleeping with knees elevated) help maintain relief. Lifestyle modifications such as weight loss, an anti-inflammatory diet (rich in omega-3s, vegetables, and whole foods), hydration, and use of ice, heat, or TENS units for pain control can further support long-term improvement.

The good news: with consistent effort, as many as 70% of patients with lumbar spinal stenosis can improve or maintain stable symptoms without ever needing surgery. Only about 30% of patients progress to requiring surgical intervention—typically when pain is disabling, function is severely limited, or neurologic decline occurs.

Watching your back,

Dr. Binder

Pain Relief Chiropractic

painreliefcare.net

(717) 697-1888

Member of Chiro-Trust.org

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

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Cranio-Cervical Flexion Exercises for Chronic Neck Pain

13 Mar

Chronic neck pain is defined as pain persisting for longer than three months in the area between the base of the skull (occiput) and the upper thoracic region, specifically up to the T3 level of the thoracic spine. For many patients, chronic neck pain arises from the accumulation of microtraumas to the tissues in the neck and surrounding regions, often coupled with postural faults. Over time, these issues can lead to muscle imbalances and increased strain on the soft tissues that support the head.

When examining patients with chronic neck pain, chiropractors often observe weakness in the deep neck flexor muscles, which are critical for stabilizing the cervical spine. Strengthening these deep muscles is often a key goal for recovery. Unlike the superficial neck flexor muscles, the deep neck flexors cannot be voluntarily contracted in the same way. Instead, we must inhibit the superficial muscles to engage the deeper ones.

Here’s a simple exercise to strengthen the deep neck flexors: lie on your back, tuck your chin slightly, and lift your head while keeping your eyes forward. Hold this position for ten seconds. Initially, this may be challenging, but with consistent practice, it becomes easier. Once you can hold the position for ten seconds, you can progress by increasing the duration, adding sets with brief rest periods, or applying resistance by pressing your hands against the front of your head. Your chiropractor may recommend additional or alternative exercises tailored to your specific needs. To make this routine easier to incorporate into your day, consider doing these exercises before bed or in the morning.

Your doctor of chiropractic may also have you perform these exercises during office visits as part of your treatment plan. In one study involving 58 chronic neck pain patients, researchers found that cranio-cervical flexion exercises led to greater improvements in neck range of motion and pain intensity if they were performed immediately following the application of manual therapies to improve the mobility of the upper cervical spine. This suggests that restoring cervical spine mobility may be a necessary first step to maximize the benefits of cranio-cervical flexion exercises.

This finding highlights the advantages of a multimodal treatment approach for managing chronic neck pain. By combining the strengths of different therapies, such as manual therapy and targeted exercises, patients can benefit from their synergistic effects, potentially achieving faster and more effective relief.

Pain Relief Chiropractic

4909 Louise Drive, Suite 102

Mechanicsburg, PA 17055

painreliefcare.net

Member of Chiro-Trust.org

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

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Treating the Neck of the Carpal Tunnel Syndrome Patient

6 Mar

Carpal tunnel syndrome (CTS) is the most frequently diagnosed peripheral neuropathy and one of the most common conditions affecting the hand. The disorder typically results from compression of the median nerve on the palm side of the wrist, leading to numbness, tingling, and sometimes weakness in the thumb and fingers—except for the pinky and the pinky-side of the ring finger, which are innervated by the ulnar nerve. To avoid surgery, many CTS patients seek chiropractic care, which often includes manual therapies applied beyond the wrist and even to the neck due to the nature of the median nerve.

The median nerve originates from the C6-T1 spinal nerve roots in the neck and provides sensory and motor functions to the palm-side forearm and hand. It enables gripping, forming a fist, and detecting temperature and texture. If the mobility of the median nerve is restricted along its course, the resulting symptoms may mimic or overlap with traditional CTS. To complicate matters further, compression can occur at multiple sites, all of which need to be addressed for effective treatment.

In an October 2024 study, researchers divided 48 CTS patients into two groups. Both groups received wrist-focused treatment, including ten sessions of wrist mobilization, electrotherapy, and the use of a nocturnal wrist splint to maintain a neutral wrist posture overnight. However, one group also received manual therapies targeting the cervical spine. Patients underwent motor and sensory nerve conduction testing and completed questionnaires on CTS-related disability at baseline, immediately after treatment, and at six-month follow-ups.

Initially, both groups reported similar improvements in all outcome measures. However, at the six-month follow-up, the group that received cervical spine care showed greater improvements, suggesting that long-term benefits favor incorporating cervical spine treatment into CTS care.

Doctors of chiropractic are well-equipped to assess the entire course of the median nerve—from the neck to the hand—and identify all potential areas of restriction. They can provide conservative treatments to restore normal nerve function and help patients return to their daily activities. In more complex cases, chiropractors may coordinate care with specialists or medical physicians as needed.

Pain Relief Chiropractic

4909 Louise Drive, Suite 102

Mechanicsburg, PA 17055

Painreliefcare.net

Member of Chiro-Trust.org

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

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Chiropractic Treatment for Lumbar Disk Herniation

10 Dec

The annulus of the intervertebral disk is comprised of tough, dense, and strong cartilaginous fibers that protect the nucleus within, which facilitates the movement of the spine. If the structure of the annulus is compromised, the nucleus can leak into or beyond the annulus, a condition that may be classified as a disk herniation, protrusion, extrusion, or sequestration. In the event a disk herniation in the lumbar spine places pressure on a lumbar nerve root, an individual may feel pain down into the leg, which is called lumbosacral radiculopathy or sciatica. Absence a red flag—infection, fracture, cancer, and cauda equina syndrome (loss of bowel and/or bladder control)—that may necessitate immediate emergency and/or surgical intervention, what treatment approach may best serve a patient with a newly diagnosed lumbar disk herniation?

In 2022, researchers conducted a retrospective cohort study that looked at outcomes of more than 11,000 patients under age 49 with a newly diagnosed lumbar disk herniation, half of whom received initial treatment from a doctor of chiropractic. While the authors of the study note that additional studies are needed, their analysis revealed that lumbar disk herniation patients whose first choice of treatment is chiropractic care are significantly (up to two-times) less likely to undergo lumbar diskectomy in the following two years than disk patients who initially seek out a different healthcare provider.

It should be noted that treatment guidelines generally advise conservative treatment approaches, which include chiropractic care, before consulting with a surgeon. However, another study published in 2022 found that, among a group of 144 patients who underwent back surgery, 60 (41.7%) did not receive any conservative treatment in the six months before their procedure. A 2021 study that looked at questionnaires completed by 3,724 adults revealed that the majority of respondents believe that surgery is always needed for a disk herniation, which is inaccurate.

For the management of a lumbar disk herniation, doctors of chiropractic will typically employ a multimodal approach that includes spinal manipulative therapy, mobilization therapy, soft tissue therapy, and exercise training. Chiropractors may also offer additional services such as traction or non-surgical decompression that can benefit such patients. If the patient does not experience improvement in their pain and disability or their condition worsens, they may be referred to an allied healthcare provider to explore other treatment options.

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