Do you ever notice a pop or snap in your hip? Certain movements may cause the sound or sensation as a hip tendon or muscle slides over the bone. This condition is commonly known as snapping hip syndrome (SHS). It can also be referred to as dancer’s hip or as coxa saltans.
In many cases, SHS is not a cause for concern. Often painless, it’s more of a nuisance than anything else.
There are certain times, however, when getting treatment will help ease any pain and prevent more serious complications.
So why does the hip snap? The hip’s anatomy is a great place to start taking a look.
Understanding the Hip
As one of the largest joints in the body, the hip joint is an important weight-bearing structure. It allows you to walk, jump, run, and perform various lower body movements. When healthy, it is one of the most flexible joints in the body.
The top of your thigh bone fits into a cup-shaped socket in the pelvis. This ball-and-socket joint uses ligaments to keep everything in place. Above the ligaments, tendons attach muscles in the buttocks, thighs, and pelvis to the bones. A very slippery liquid, known as synovial fluid, protects the bones and helps the joints to flex.
These layers of protection make your hip one of the most durable, stable joints in the body. Unfortunately, even with all its protection, the hip may suffer injury.
What Causes the Hip to “Snap”?
When tendons or muscles slide over the bony knobs of the hip, snapping occurs. This can affect various areas of the hip. These areas include:
Outside of the Hip
Known as external snapping hip syndrome, this occurs when a tendon or muscle slides over the bony knob on top of the thigh bone. This bony mass, known as the greater trochanter, can either catch on the iliotibial band or on the gluteus maximus muscle.
This is typically caused by muscle tension in the iliotibial band or gluteus maximus. You may notice the snapping when climbing stairs, running, or carrying heavy loads like shopping bags. Some may feel a sudden, sharp pain outside the hip.
Inside the Hip
Referred to as internal snapping hip syndrome, this involves the sliding of tendons or muscles over bony structures at the front of the hip joint. The two common hip flexors involved are the iliopsoas tendon connecting to the iliopsoas muscle and the quadriceps muscle known as the rectus femoris.
You may notice internal snapping when getting up from a chair, running, or rotating the legs away from the body. Sometimes this condition causes sudden pain, deep inside the groin area.
Injury to Hip Cartilage
When the cartilage protecting the hip socket tears or gets injured, snapping may occur. This is usually due to a sudden trauma like falling or chronic conditions like hip arthritis. Damaged cartilage usually causes pain and the hip joint to lock up.
Symptoms of snapping hip syndrome can range from mild irritation to dehabiliting pain. Common symptoms include:
- Popping or snapping in any area of the hip when rotating, lifting, lowering, or swinging the leg.
- Leg weakness when making forward or sideways movements.
- Swelling or tightness in the side, front, or back of the hip.
- Problems walking, running, exercising, or getting up from a chair.
- Feeling like the hip will detach from the socket.
- Locking up of the hip when performing certain movements.
Risk Factors for Snapping Hip Syndrome
Just about anyone can develop this condition, but there are certain factors that make snapping hip syndrome more likely. These include:
- Athletes and others who regularly recruit extreme range of motion in the hips, such as ballet dancers, those who practice martial arts, and football players.
- Young athletes who are going through growth spurts.
- Those with arthritis or other chronic conditions that affect the hips.
- People who are recovering from knee or hip surgeries.
- Those with jobs that involve frequent bending at the hips.
- People who dramatically increase their activity level or exercise routines.
Treatment for Snapping Hip Syndrome
For many, a snapping hip isn’t much cause for concern. Others may experience pain because of this condition, making treatment a necessity. Pain occurs when the snapping tendon or muscle becomes inflamed or injured, usually over time. In addition, the snapping can irritate a fluid-filled structure that helps to lubricate the bone and soft tissue. The inflammation of this structure, known as hip bursitis, can be quite painful.
In many cases, conservative treatments can help to reduce pain. These include:
- Resting the Area: Athletes and others with this condition can take a short break from the motions that cause the irritation. This helps the muscles, tendons, and other structures to recover.
- Anti-Inflammatory Medicine: Over-the-counter aspirin or ibuprofen can relieve pain and reduce swelling in the affected areas.
- Physical Therapy: A physical therapist can stretch and massage the area, helping to relieve any muscle tension. In addition, your therapist can suggest modifications to your everyday activities that allow your hip to rest.
- Corticosteroid Injection: If the pain prevents you from engaging in your daily activities, a physician may prescribe a steroid injection to reduce the inflammation.
These treatments have an excellent chance of improving your condition. If you’re still not experiencing relief, however, then other options are still available.
Surgical Treatments for Snapping Hip Syndrome
In rare cases, a surgical treatment may be the best answer to resolve your pain. After a full medical evaluation and diagnostic imaging, an orthopedic surgeon may recommend one of the following procedures:
- Iliopsoas Tendon (IT) Release: Typically used for internal snapping hip syndrome, a surgeon makes strategic cuts in the IT band to reduce tension and lengthen it. This should decrease (or even stop) the snapping.
- Hip Arthroscopy: The surgeon inserts a tiny camera into your hip joint to find and remove loose pieces of cartilage that have become caught in the ball-and-socket joint.
- Acetabular Labrum Repair: If imaging tests determine a tear in the ring of cartilage on the outside rim of the hip joint (labrum), then your surgeon can use a tiny camera and instruments to repair the damage.
In many cases, these minimally invasive procedures will eliminate the snapping and pain caused by this condition.
When Surgery is Necessary…
Although snapping hip syndrome rarely requires surgery, consulting with a qualified orthopedic surgeon can provide solutions to help ease your pain and get your life back on track.
Our experts at Orthopedic & Laser Spine Surgery believe that you can return to a pain-free life. Our team is ready to meet with you, review any previous MRIs or imaging results, and determine the best course of action for your pain. From nagging pain to sports medicine issues, we will help you pinpoint the source of your hip pain and find the best solutions.
Calling the Orthopedic & Laser Spine Surgery clinic may be the next step in getting your life back. Our surgeons are leaders in their fields, with decades of experience in helping others. Don’t hesitate to call or schedule an appointment today!
An Epidural Steroid Injection (ESI) is commonly used to treat inflammation in the lower back, as well as any related neck and leg pain. In these conditions, spinal nerves become inflamed as the passages where these nerves travel down the spine begin to narrow. (ESIs) can resolve that pain. In addition, your doctor can also use (ESIs) to diagnose which nerves in the spine are causing problems.
Normally, your doctor will inject (ESIs) into the lower back in sets of 2 or 3. This helps to reduce pain, as well as strengthen the lower back. It is important to note that (ESIs) are meant to manage lower back pain, not cure it. With that said, a patient’s mobility will improve and their back will heal quicker because of the decrease in pain. The injections only take less than a minute to administer. And, the performing physician will often follow up an (ESI) with an immediate examination.
How are Epidural Steroid Injections (ESIs) Performed?
Your physician can deliver the steroid into the epidural space through three methods: the caudal, interlaminar, and transforaminal approaches. The common trend between these methods involves placing a needle through the use of fluoroscopic guidance. Before you receive the injection, a nurse or doctor will thoroughly clean the treatment area. Contrast dyes are used to ensure that the steroid travels to the correct area. In many cases, your doctor will use a local anesthetic along with the steroid to make the process less painful for the patient.
The interlaminar approach involves placing the needle into the back of the epidural space, which allows for your doctor to deliver the steroid over a wider area. The caudal method is not too different, injecting the needle in a small boney opening just above the tailbone. This allows for your doctor to place the needle into the bottom of the epidural space. Using these methods, the steroid will spread over multiple spinal segments which allows for the medication to reach both sides of the spinal canal. With transforaminal (ESIs), or nerve blocks, the needle is placed beside the nerve as it leaves the spine. After which, medication is placed into the nerve sleeve, which then travels up into the epidural space from the side. Using this method, a concentrated dose of the steroid can seep into the affected area.
These (ESIs) can be performed on an outpatient basis, allowing the patient to return to their previous activities the following day. Patients can request mild sedation for the procedure, but most just stick with local anesthesia.
What To Expect
(ESIs) normally begin working within 1-3 days following treatment. However, in rare cases, it may take up to 7 days for you to feel pain relief. Most patients tolerate the injection very well and experience only mild side effects, which resolve within a few days. Diabetics and those with allergies to contrast dyes should discuss these conditions with their doctor before receiving an (ESI).
(ESIs) have been performed for many years and are considered a safe and effective treatment for neck, back, leg, and arm pain. Serious complications are rare and minimized through the use of x-ray guidance. Overall, most patients tolerate (ESIs) very well.
Injections can provide patients with improvement in both pain and function for several months or longer. If the patient notices significant relief, then your physician can repeat these injections without risk to maintain these improvements. (ESIs) are commonly used with other treatments, such as medications and physical therapy, in order to maximize their effects.
Am I A Candidate For An (ESI)?
Patients with low back, neck, arm, or leg pain may benefit from an (ESI). Most commonly, orthopedists use this treatment to address the following conditions:
- Herniated Disc: Irritation, pain, and swelling caused by the gel-like material within spinal discs squeezing out and coming in contact with spinal nerves.
- Sciatica: Pain in the sciatic nerve that travels from the buttocks and down to the legs. Compression of the 1st sacral nerve and the 5th lumbar nerve often leads to this condition.
- Degenerative Disc Disease: Breakdown/aging of vertebrae caused by collapsing disc spaces, annular tears, and bone spur growth.
- Spinal Stenosis: Back and leg pain caused by the narrowing of the spinal canal as well as the nerve root canal.
- Spondylolisthesis: Caused by vertebral fractures/weaknesses that lead to the vertebrae slipping forward and compressing nerve roots
(ESIs) are particularly helpful in treating painful inflammatory conditions. Doctors also use (ESIs) for diagnostic purposes, such as determining whether surgery could help the pain associated with a herniated disc.
In addition to people with diabetes and pregnant women, these injections should not be performed on patients who have bleeding problems or an infection.
What Happens After Treatment?
Patients will be able to walk around directly after receiving an (ESI). Usually, doctors will observe the patient for a short time before allowing them to leave the center. Rarely, temporary numbness or weakness can occur in the legs. So, your physician will advise that you bring someone along who can take you home afterward.
You should be able to resume full activity the next day. However, you may notice some soreness around the treated area, but you can easily treat this by using ice and OTC medicines such as Tylenol. Your doctor will recommend that you keep track of your pain levels as the numbing medicine wears off and the (ESI) takes effect.
Patients may want to schedule a follow-up visit with their doctor to address any and all concerns.
Are you considering an (ESI) for your treatment? If so, contact our board-certified spine and orthopedic experts at OLSS. Our practice has clinics in Florida, New Jersey, and New York, as well as a team of award-winning experts whom you can trust.
The spinal cord links the brain to all other parts of the body. When an abnormal growth, otherwise known as a tumor, appears on the spine it can be painful and dangerous. By knowing the warning signs of a spinal tumor, you have a better chance of early diagnosis and exploring appropriate treatment options.
Understanding the Spinal Column and Spinal Cord
The spinal cord serves a key role in the central nervous system (CNS). This long cylinder of nerves starts at the brain and runs through the spinal column. Since the brain controls our thoughts, movements, and interprets our external environment, it needs a way to communicate. This series of nerves in the spinal cord allows the brain to communicate with the rest of the body.
How important is this communication? Well, it’s is keeping you alive and moving. The CNS controls voluntary movements like talking, walking, and eating. It also controls involuntary functions like breathing, interpreting sensations, and digestion.
The spinal column is a series of bones, known as vertebrae, starting from the base of the skull to the backbone. In addition to protecting the spinal cord, it supports the upper body’s weight and helps with flexibility, movement, and posture.
In addition to the 33 bones of the spine, the spinal column has thin layers of cartilage known as discs. These discs prevent the vertebrae from rubbing together and also support the body’s weight. Small spaces, known as intervertebral canals, allow spinal nerves to exit the spinal cord and reach different areas of the body.
Types of Spinal Tumors
As you probably know, tumors are abnormal masses of tissue. They grow uncontrollably despite the body’s best efforts to destroy them. While some causes of tumors are unknown, others may be a result of exposure to cancer-causing agents or genetics.
A vertebral column tumor can be either primary or secondary. A primary spinal tumor develops in the spinal cord or column. In many cases, these tumors are benign–or not cancerous. These tumors don’t usually spread to other parts of the body. A secondary spinal tumor occurs when cancers from other parts of the body spread (or metastasize) to the spine. These malignant (cancer-filled) tumors often start in the lungs, breasts, or prostate.
Doctors also classify spinal tumors based on their location. The 3 basic types of spinal tumors include:
- Intramedullary tumors: Growths that occur inside the spinal column. These usually occur in the cervical, or neck, region.
- Intradural-extramedullary tumors: Growths that develop outside of the spinal cord but inside a spinal canal membrane called the dura mater.
- Extradural tumors: Growths that start outside the dura mater, usually in the bones around the spinal cord. This is the most common type of spinal tumor.
What are the Signs of a Spinal Tumor?
The signs and symptoms of a spinal tumor vary. It typically depends on the type of tumor and its location. One of the most common signs of a spinal tumor is back pain. Of course, back pain isn’t always caused by a tumor. In fact, muscle or ligament strain, bulging discs, arthritis, and other issues with the vertebrae may be the source.
Back pain not due to activity or muscle strain, however, may be caused by a spinal tumor. This is especially true if the back pain gets worse at night and medications don’t seem to lessen the pain.
If a spinal tumor presses on the spinal cord causing spinal stenosis, certain neurological symptoms may occur. These include numbing or loss of sensation, muscle weakness, and trouble walking. Tumors in the neck region tend to affect the arms. In contrast, tumors in the lower and mid-back may affect the legs and chest.
Some of the more severe signs of a spinal tumor include trouble controlling the bladder or bowels, partial paralysis, and scoliosis (sideways curvature of the spine).
If you suspect any of your symptoms could result from a spinal tumor, it is important to consult with a doctor right away. Early diagnosis and prompt treatment often lead to better outcomes.
Diagnosing a Spinal Tumor
Thanks to modern imaging technology, diagnosing a spinal tumor is easier than ever. After a doctor reviews your medical history, current symptoms, and performs a thorough physical exam, the next step typically involves taking images of spine. Imaging occurs in a couple of different ways. These include:
- X-Rays: Although x-rays aren’t the most reliable way to diagnose tumors, they provide an image of the bones in the spine. This can help to rule out fractures and some infections.
- Computed Tomography Scan (CT): CT scans use computer technology and x-rays to create a cross-sectional image of the spine. This helps to get a better idea of the size and shape of the spinal canal.
- Magnetic Resonance Imaging (MRI): This test creates a 3D image of the spine. Unlike x-rays, these images show the soft tissues of the spinal column like the spinal cord, nerve roots, and tumors.
In addition to diagnostic images, doctors may order a blood test to determine if there is cancer in your system.
Once a doctor locates a tumor, a biopsy generally comes next. Depending on the location of the tumor, the doctor performs a minimally invasive procedure to sample a small piece of the tumor. The doctor then examines the tissue under a microscope to determine if it contains cancer cells.
Treatment Options for Spinal Tumors
Research has shown the best approach to battling tumors often uses a combination of treatments. The type of treatment varies based on the kind of tumor, where it is located, and your current health condition.
A primary spinal tumor may only require monitoring to keep track of any growth. In other cases, however, radiation therapy or chemotherapy may be necessary. Some smaller, non-cancerous tumors can also be removed with minimally invasive surgery.
A secondary spinal tumor presents other challenges since cancer from another area has spread to the spine. Some patients may respond to radiation only. Others may require a combination of radiation, chemotherapy, and surgery.
Surgery may be necessary to remove all or part of the tumor. It can also be used to stabilize the spine if the tumor caused any damage.
Hospital stays for spinal tumors can last 5 to 10 days. After surgery, rehabilitation, like physical or occupational therapy, helps with recovery and regaining function in the body. Total recovery varies depending on the type of surgery and how your body responds.
When Spinal Surgery is Necessary…
Operating on the spine is serious business. You want the comfort of knowing the most trusted experts in the field are taking care of you.
Orthopedic & Laser Spine Surgery (OLSS) has an award-winning team of experts specializing in multiple treatment options, including minimally invasive surgery. The surgeons at OLSS have the training, experience, and technology–boasting a 95% success rate for their treatments.
If you’re seeking a diagnosis for your pain or want a second opinion, see how the team at OLSS can help. You can even bring in your previous MRIs for a free review. Now is the time to find the best solution to get your life back on track!
7 Common Causes of Hip Pain
Your hip is among the largest—and most vulnerable—joints in your body.
Like the shoulder, your hip is considered to be a “ball-and-socket” joint. The ball-like head of the femur (aka the thighbone) fits into a shallow divot in the pelvis, known as the acetabulum. This ball-and-socket-esque structure affords your hip with the freest range of motion of any joint type in the body.
Imagine, for example, all of the ways in which you can use your hip to revolve your extended leg. Now, imagine the limited ways in which you can use your knee (a hinge joint) to give motion to your calves. In comparison, you’re pretty much limited to up and down extension and flexion of the knee.
Because the hip is so mobile, it’s also prone to injury and wear and tear. We use our hips constantly in daily life: to walk, climb the stairs, support our weight, and maintain our balance. Congenital defects in hip anatomy, repetitive strain, a misstep while walking… all of these things can affect the mobility of the hip and lead to hip pain.
Added to this is the fact that your hip is rich with anatomy. A fine system of muscles, nerves, tendons, and ligaments support the hip and pelvis. For example, your gluteus maximus, quadricep, hamstring, abductor, and adductor muscles all assist your hip in creating movement. The sciatic and femoral nerves also pass through the hip to supply sensation to the thighs. And, interspersed between all of these structures are fluid-filled sacs called bursae that reduce friction as muscles, tendons, and bones slide and glide past one another. Inflammation in any one of these areas can (and often does) lead to hip pain.
General Sources of Hip Pain
It can be useful to break hip pain down into categories based upon more generic causes. For example: Is the source of your hip pain congenital (or present at birth)? Or, did your hip pain emerge after years of overuse? Did your hip pain result from an injury? Or, do you simply have a pinched nerve? As we review the most common sources of hip pain, we’ll keep these considerations in mind. However, of the many conditions that we’re about to discuss, most don’t fall neatly into any one category.
Congenital Hip Disorders
Congenital hip disorders are a class of hip problems that are present at birth. And—by far and away—the most common of these deformities is hip dysplasia.
- Hip Dysplasia: Also known as Developmental Dislocation of the Hip, hip dysplasia occurs when the ball-and-socket joint of the hip does not fit together properly. This can arise when:
- The head of the femur isn’t round enough
- The acetabulum (socket) that holds the femur into place isn’t deep enough
This excess wiggle in the joint can lead to dislocations at birth and accelerated wear and tear in later life.
Wear & Tear Disorders:
Degenerative (or “wear and tear”) disorders develop after the hip has sustained years of repetitive strain or overuse. Because your hips are weight-bearing structures, these disorders occur commonly with obesity or with occupations that involve all-day sitting, standing, or heavy lifting. A lot of the following disorders can also be caused—or worsened—by injuries.
- Hip Osteoarthritis: Osteoarthritis of the hip occurs when the cartilage that coats the femoral head and acetabulum begins to break down. Because cartilage serves to reduce friction, it’s absence means that the femur and pelvis will grind together instead of glide. In addition, this can cause inflammation, bone spur development, the hardening of hip ligaments, and pinched nerves.
- Sacroiliitis: Your sacroiliac joint is formed by the meeting of the sacrum (the triangular bone at the bottom of the spine) and the ilium (or pelvis). Sacroiliitis literally means inflammation of the sacrum and it is caused by excess wobble in this joint. Like hip dysplasia, this disorder can be congenital. But, more often than not, sacroiliitis results from chronic strain or lax ligaments during pregnancy.
- Tendinitis: Tendons are soft tissues that connect muscles to bone. When a muscle becomes overworked, tight, or weak, it can pull on the tendon in unusual ways. Ways that often lead to tenderness or hip pain. The sore tendons in question may connect the hip to the glutes, hamstrings, hip flexors, quadriceps, psoas, or groin muscles.
- Trochanteric Bursitis: Your femur (or thighbone) contains several raised ridges and knobs of anatomical significance. Not counting the head of the femur, one of the largest of these is the greater trochanter. Your greater trochanter is lined with bursae, or fluid-filled sacs that facilitate the movement of muscles and tendons over bone. Inflammation of these bursae can lead to hip, thigh, or buttocks pain.
Injury-Related Hip Disorders
Hip injuries can occur instantaneously—regardless of how healthy your hip joint may be. Car accidents, falls, sports injuries… Each of these events can cause a variety of hip injuries, from hip fractures and dislocations to soft tissue injuries. Some of the most common hip injuries that we see in our practice include:
- Strains & Sprains: A strain occurs when a tendon or muscle that supports your hip suffers a sudden tear. In contrast, sprains involve the ripping of ligaments. (Although the distinction seems a little like splitting hairs.) Both of these traumatic events can result from collisions (whether with the ground or your opponent in sports) or from overworking the muscles without properly stretching first.
- Hip Labral Tears: Your labrum is a swatch of cartilage that wraps around and protects your acetabulum, or hip socket. (Incidentally, you also have a labrum that lines each shoulder socket, aka the glenoid cavities.) Hip labral tears occur when this cartilage rips, leaving the hip socket exposed to direct contact from the femur.
Nerve Impingement Disorders:
The last class of hip disorders that we’ll be discussing involves interruption or damage to the nerves that pass over and through the hips. These disorders include:
- Pinched Nerves / Sciatica: A pinched nerve in the hip occurs when either bony anatomy or soft tissue swelling compresses nerve tissue, firing signals of pain into the hips and/or legs. If the sciatic nerve is the pinched nerve in question, then the resultant disorder is known as sciatica. However, many nerves—including the femoral nerve—can suffer pinching and produce symptoms of hip pain.
A Final Word on Hip Pain & Disorders
The hip is a complex joint, rich in anatomy and rife with the potential for things to go wrong.
If you have been suffering from hip pain, then don’t hesitate to contact your doctor. Many of the disorders that produce hip pain have similar symptoms. So, diagnosing hip pain can be a challenge. You need the expert wisdom of a board-certified orthopedist, who can accurately diagnose your pain and get you on the road to recovery.
To discuss minimally invasive and conservative treatments for hip pain, contact our award-winning hip specialists at Orthopedic & Laser Spine Surgery today!
You have a series of bones, called vertebrae making up your spinal column. These are all stacked on one another. From the top down, your spine includes:
- Seven cervical spine bones
- Twelve thoracic spine bones
- Five lumbar spine bones
- A sacrum bone
- A coccyx bone (at the base)
Discs cushion these bones and protect them by absorbing the shocks that day-to-day activities — like walking, twisting and lifting — can cause. When the bones, discs, muscles, tendons and nerves in and surrounding your spinal column are working as they should, you may not think about your spine, neck or back often. They’re just a part of your anatomy. You know your spine keeps you upright, but that’s about all the attention you give it — unless you’re in pain.
Once confronted with pain, though, all your focus is likely on relief, and you seek a doctor’s help to examine your vertebrae and discs, diagnose what’s wrong and get treated.
Two conditions leading to back and neck pain are herniated disc and a bulging disc. People often use these terms interchangeably, but in reality, they are different. Learning about the differences between the two could be extremely beneficial to you if you or a loved one is suffering from one of these conditions.