- Men's Health, Orthopedics, Senior Care, Women's HealthGeneral Page Tier 3BlogSometimes it’s hard for you to pinpoint the source of your pain when it comes to back and hip problems. This can lead to problems in diagnosis, and without the proper diagnosis, your treatment is often ineffective. It’s likely my hip causing me pain Most true hip problems are, surprisingly, felt in the groin. The common culprit is osteoarthritis in the hip joint. In addition to the groin pain, you’ll often experience: Pain when walking, pivoting and other physical activities. Relief when sitting, although you may have stiffness. Limping You’ll usually have a history of loss of motion at the hip, which can make it difficult for you to put on shoes and socks or to cut your toenails. You may also have difficulty getting in and out of cars, and going up and down steps. Your groin pain may extend down the front of the thigh as far as the knee. Hip arthritis may rarely present as knee pain rather than groin pain. But, if your pain radiates past your knee, there’s numbness or tingling in the leg, or weakness such as dragging your foot, hip arthritis is not the cause. It’s likely my back causing me pain When the pain is in the middle of the lower back, or when your back tightens up so that you can hardly move, there is generally no problem with the diagnosis. This is particularly true when the pain radiates into the leg, especially below the knee, and is associated with numbness, tingling or weakness. However, not all back symptoms are so straightforward. I often see patients with pain in one or the other buttock, and they almost always tell me they have a hip problem, but most of the time pain in the buttock actually originates in the lower spine. This is called referred pain, similar to when a heart attack patient complains of pain in the left arm. Your lower back can refer pain from an impinged nerve to both your buttocks and legs. And, where it refers the pain to depends on which joint in your spine is causing the issue. A lot of lower back problems that show as hip pain are caused by a herniated disc that presses on nerves in the spinal column. This produces pain known as sciatica, which you’ll often feel in the hip. You may have a herniated disc in your lower back if your pain: Shoots down your leg below the knee, with numbness, tingling or weakness. Becomes worse when you sit or bend. Improves when you stand or walk. Treatment Both back and hip pain may respond to anti-inflammatory medication like ibuprofen or naproxen. Physical therapy often helps back pain, and a lightweight back support may also be useful. If these initial measures fail to provide relief, targeted cortisone injections may be helpful. This is where a correct diagnosis is so important. You’ll often feel no relief if the wrong area is injected. If you’re experiencing back and neck pain, you can find out what factors may play a role and get recommendations for follow-up steps by taking a free back pain assessment at askAAMC.org/SpineHealth. Author Stephen Faust, MD, is the Co-Director of AAMC Orthopedics where he specializes in total joint replacements and spine care. You can reach his practice at 410-268-8862. Originally published October 9 , 2017. Last updated July 5, 2018.0
- Men's Health, Women's Health, Patient StoriesGeneral Page Tier 3BlogMost of us are comfortable sharing with family and friends our woes of back, neck or leg pain. But what about when you have pain in a place where—ahem—no one really talks about? Enter Karen Dobbs. A physical therapist specializing in the pelvic floor, Karen helps men and women suffering from muscle and nerve pain associated with sex, going to the bathroom, wearing underwear, and even sitting or standing. “Because of the sensitive nature of my patients’ problems, during the first session, my goal is to make them feel comfortable and gain their trust,” says Karen, who lives in West River, Md. “We sit in a private room and have a confidential, personal conversation about what’s going on.” Karen is one of four practitioners at Anne Arundel Medical Center who focuses on pelvic health issues. She says it is an emerging field with few professionals trained to do this kind of work. Every person is different, says Karen. “Each condition I treat is very specific and the treatment is customized to the patient’s needs.” The goal of pelvic floor physical therapy is either muscle strengthening—often associated with urinary or fecal incontinence, or muscle relaxation, which is frequently associated with sexual pain; for example, pudendal neuralgia, a nerve condition that leads to pain in the clitoris/penis, vulva/scrotum, perineum, and rectum. Treatment also can involve the back and leg muscles because they are connected to the pelvic floor. “Often, patients cannot share their problem with friends, family or even their doctor,” says Karen. “Sometimes it takes a few sessions before they open up.” But once they begin to have pain relief as a result of the therapy, they become more comfortable and willing to try different treatment options. Karen talks to her patients about anatomy, how muscles work, and how you can relax or strengthen them. Patients are usually given a home program to follow, which is very important. They only progress at the rate the patient is comfortable.0
- Women's HealthGeneral Page Tier 3BlogWhether it’s a ‘small tinkle’ with a sneeze or a ‘potty dance’ while headed toward the bathroom, the uncontrolled leakage of urine is called urinary incontinence. This condition can be a real bother for many ladies. Do you skip gym class for fear of leaking urine? Are your daily trips planned around restroom breaks? Have you ever heard yourself say, “Stop, don’t make me laugh!”? When the bladder is functioning normally, you should be able to delay a bathroom break until a socially acceptable time and not worry about leaking during activity. You do not need to have pelvic organ prolapse (or a collapsed bladder) for urine to leak. You may look and feel the same, however, the dampness signals a problem. Sometimes this condition can be temporary, such as with a urinary tract infection or during pregnancy. If so, urinary incontinence will quickly resolve after the temporary condition has passed. At other times, leakage may start slowly and worsen over time. Many women wear panty-liners or change their underwear frequently because of urinary incontinence, a condition that according to the National Association for Continence affects close to 18 million women. Urinary incontinence may be common but it’s not normal and, thankfully, there is often a cure. Here are some things you can do to help: Do Kegel exercises. These exercises help muscle strength and endurance training for the pelvic floor. Try core muscle strengthening exercises, like Pilates and yoga. The core muscle and pelvic floor muscles work closely together. Getting one region stronger can help the other. Wear a tampon during exercise, or a pessary vaginal insert made to help with stress leakage. Achieve normal body weight through nutrition or lower impact exercise. Consider a surgical procedure to support the urethra (the tube that empties urine from the body). READ MORE: Bladder control problems: 5 ways women can manage There are other cases when medical conditions or prior surgeries are causing the leakage. Even issues that limit the speed and ease of walking can contribute to leakage. Urinary incontinence and constant dampness can cause skin irritation in the regions of dampness. I have seen firsthand how urinary incontinence can affect day to day activities, plans for the future and even self-esteem. If this problem continues, talk to your healthcare team. Details about treatment can be discussed with your provider or a pelvic floor physical therapist. Leakage can control your life. Even though you can live with these problems, ask yourself, ‘Why should I?’ Would you give your daughter or girlfriend the same advice? Let’s do better for ourselves. For more information on urinary incontinence, visit us today! Author Kay Hoskey, MD is a board certified urogynecologist at the Women’s Center for Pelvic Health at Anne Arundel Medical Center.0
- Men's Health, Orthopedics, Women's Health, UncategorizedGeneral Page Tier 3BlogDry needling is a procedure similar to acupuncture, but based on Western medicine. It uses a very thin, solid-filament needle inserted at myofascial trigger points where multiple top bands of tissues come together. Dry needling is used to help reduce muscle pain at the site or referred pain in the adjacent area. Referred pain is when a problem exists somewhere else in the body other than where you feel the pain. Dry needling can help anyone with chronic tension, spasms or soreness in the muscles, tendons or ligaments. It is also good for treating migraines and tension headaches. While it uses similar tools as acupuncture — in fact, the needles are the same — dry needling is based on Western medical practice and long-term research into how nerve signals travel from the point of pain and are perceived by the brain. The research shows insertion of one or more needles at the point of pain or in the tissue nearby can help lessen pain. For example, if you experience pain in your ankle, you might be helped by having dry needle insertion in the muscle that runs from the calf to the foot in order to “re-route” the pain signals. Dry needling is used to help any musculoskeletal problems, such as chronic calf tightness, tennis elbow or for a sciatic issue that hasn’t responded to treatment. Sports medicine specialists, physical therapists or physiatrists often refer patients when standard manual techniques in physical therapy haven’t reduced pain sufficiently. Author By James Bickley, a physical therapist and dry needling site coordinator at AAMG Physical Therapy in Odenton. To reach his practice, call 410-674-1650.0
- Physical Therapy, Women's HealthGeneral Page Tier 3BlogHave you ever experienced leakage after having a baby? Does it happen when you are hiking with family? Or when your cough or sneeze? Have felt embarrassed to go out with your girlfriends because you fear laughing with them will cause you to pee? Has it ever crossed your mind that maybe there’s something you can do to prevent this from happening? These are a lot of questions, I know. But many women feel these things are an inevitable part of aging, or something that’s normal after you have a child. Leakage — also called incontinence — is not something you have to live with. It’s one of many pelvic floor disorders that can strip women of their confidence in doing normal, everyday things they like to do. But I have good news for you. There is a solution — preventative pelvic floor therapy. What is it? Pelvic floor physical therapy involves the pelvic floor muscle group. A person might consider this type of therapy to help treat incontinence, difficulty with urination or bowel movements, constipation, chronic pelvic pain and painful intercourse. Pelvic floor disorders are very common, affecting nearly 25 percent of women in the United States, according to research. Women’s bodies go through many changes in their life from puberty to menopause. These changes come with a torrent of hormonal and physical imbalances that can wreak havoc on the pelvic floor. Many women endure urinary and fecal incontinence as well as acute pelvic pain, back pain, muscle tears, tailbone fractures and other fractures, prolapsed bladders and rectum, painful sexual intercourse and abdominal separation. Some experience this at some point in their lives, most commonly after childbirth. READ MORE: The importance of good pelvic health Can you prevent a pelvic floor disorder? There are many things you can do to prevent or lessen pelvic floor damage. You don’t have to wait to have signs or symptoms — such as incontinence — to work on strengthening your pelvic floor. Here are a few tips to reduce incontinence and other issues and to help prevent future problems: Do your Kegels. Kegel exercises strengthen the pelvic floor muscles, which support the uterus, bladder, small intestine and rectum. These exercises can help you prevent or better control incontinence and other pelvic floor problems. Check for organ prolapse. Bladder, rectal and/or uterine prolapse can cause bowel and bladder control issues, feeling of heaviness/bulging in vagina, incomplete emptying, and pain with intercourse among other things. Work with your urogynecologist and a pelvic floor rehab specialist to help alleviate and prevent future problems. Small changes count. Take control of constipation to prevent undue stress on the pelvic floor and strain on these muscles by drinking more water, eating fiber rich foods and using a squatty potty to relax the muscles during bowel movements. Take care of your diet. Decreasing bladder irritants such as coffee, soda, carbonated beverages, spicy foods and artificial sugars can slow down an overactive bladder and urgency that can lead to leakage. Check your bathroom schedule. Avoid going to bathroom less than every two hours but do not hold more than four hours. The ideal range is between two and four hours to avoid creating any future problems related to overactive bladder or retention. You shouldn’t feel ashamed or embarrassed if you’re experiencing a pelvic floor issue. In fact, I encourage you to be open and reach out to a specialist with any questions or concerns you might have related to your pelvic health. At Anne Arundel Medical Center, we have specialists who can review with you all the above tips to alleviate any question and decrease or prevent any problems to help you improve your quality of life. Just remember, it’s completely normal and there are ways to help. We’re here to help you get back to leading a more confident life! Author Kinnariben Patel is a physical therapist at AAMG Physical Therapy. To reach her, call 443-481-1140. Originally published Oct. 2, 2018. Last updated Feb. 4, 2020.0
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