Why does sitting cause discomfort in your lower back and buttocks. How can you differentiate between piriformis syndrome and other conditions. What are effective treatments for alleviating pain associated with piriformis syndrome. How does prolonged sitting affect your overall health and well-being.

The Anatomy Behind Piriformis Syndrome

Piriformis syndrome is a condition that can cause significant discomfort, particularly when sitting. To understand why this occurs, it’s essential to examine the anatomy of the affected area.

The piriformis is a small muscle located in the buttock region, stretching from the hip to the sacrum (the triangular bone at the base of the spine). Beneath this muscle runs the sciatic nerve, one of the largest nerves in the body. This nerve originates in the lower back and extends down the back of the leg to the foot.

When the piriformis muscle becomes tight or inflamed, it can compress the sciatic nerve. This compression is exacerbated by sitting, as the act of sitting puts additional pressure on the muscle and nerve. The result is pain that can range from a dull ache to intense discomfort, often radiating from the lower back through the buttock and into the upper thigh.

Key Anatomical Points:

• Piriformis muscle: Located in the buttock, connecting the hip to the sacrum
• Sciatic nerve: Runs beneath the piriformis muscle
• Compression: Occurs when the tight piriformis muscle puts pressure on the sciatic nerve

Recognizing the Symptoms of Piriformis Syndrome

Identifying piriformis syndrome can be challenging, as its symptoms often mimic other conditions. However, there are several key indicators that can help differentiate it from other issues.

The primary symptom of piriformis syndrome is pain while sitting. This pain typically manifests in the lower back, buttock, and the back of the upper thigh. The intensity of the pain can vary significantly between individuals and may change depending on the duration of sitting or the position of the body.

Common Symptoms:

• Pain in the lower back, buttock, and upper thigh
• Discomfort that worsens with prolonged sitting
• Potential numbness or tingling in the affected area
• Pain that may be alleviated by standing or walking

Can piriformis syndrome cause sciatica-like symptoms? Yes, piriformis syndrome can indeed mimic sciatica, as both conditions involve compression of the sciatic nerve. However, there are subtle differences in the presentation of symptoms that can help distinguish between the two.

Differentiating Piriformis Syndrome from Other Conditions

While piriformis syndrome shares symptoms with other conditions, such as herniated discs or sciatica, there are ways to distinguish it from these ailments. Understanding these differences is crucial for proper diagnosis and treatment.

One key differentiator is the extent of pain radiation. In piriformis syndrome, pain typically radiates down the back of the leg but usually doesn’t extend beyond the knee. In contrast, pain from a herniated disc often travels past the knee and may reach the calf, ankle, or foot.

Diagnostic Considerations:

1. Pain location and radiation pattern
2. Aggravating and relieving factors
3. Response to specific movements or positions
4. Presence of neurological symptoms (e.g., numbness, weakness)

How can healthcare professionals accurately diagnose piriformis syndrome? A comprehensive approach involving a detailed patient history, physical examination, and potentially imaging studies is often necessary for an accurate diagnosis.

Effective Treatment Options for Piriformis Syndrome

Managing piriformis syndrome often requires a multifaceted approach. While treatment may vary depending on the severity of the condition and individual patient factors, several strategies have proven effective in alleviating symptoms and promoting recovery.

1. Active Release Technique (ART)

This specialized soft tissue treatment, described as a “movement-based massage,” can be highly effective in restoring soft tissue function and mobility. ART targets the affected muscles and surrounding tissues to release tension and improve flexibility.

2. Chiropractic Adjustments

Chiropractic care focuses on restoring normal joint function in the pelvis, which can help relieve strain on the piriformis muscle. These adjustments may also improve overall spinal alignment, potentially reducing pressure on the sciatic nerve.

3. Stretching Exercises

Targeted stretching exercises can help alleviate tightness in the piriformis muscle and surrounding areas. These exercises should be performed under the guidance of a healthcare professional to ensure proper technique and prevent exacerbation of symptoms.

4. Physical Therapy

A comprehensive physical therapy program can address muscle imbalances, improve flexibility, and strengthen the supporting muscles around the hip and lower back. This approach can help prevent recurrence of symptoms and promote long-term relief.

5. Lifestyle Modifications

Simple changes to daily habits, such as improving posture, using ergonomic seating, and taking regular breaks from sitting, can significantly reduce the strain on the piriformis muscle and alleviate symptoms.

What is the most effective treatment for piriformis syndrome? The most effective treatment often involves a combination of approaches tailored to the individual’s specific needs and symptoms. Working with a healthcare professional to develop a personalized treatment plan is crucial for optimal results.

The Impact of Prolonged Sitting on Overall Health

While piriformis syndrome is a specific condition related to sitting, it’s important to recognize that prolonged sitting can have broader implications for overall health and well-being. The sedentary nature of many modern jobs has led to a range of health concerns beyond musculoskeletal issues.

Health Risks Associated with Prolonged Sitting:

• Increased risk of cardiovascular disease
• Higher likelihood of developing type 2 diabetes
• Potential for weight gain and obesity
• Weakening of muscles and bones
• Decreased mental health and cognitive function

How can individuals mitigate the health risks associated with prolonged sitting? Incorporating regular movement breaks, using standing desks, and engaging in physical activity outside of work hours can help counteract the negative effects of a sedentary lifestyle.

Ergonomic Solutions for Desk-Based Workers

Creating an ergonomic work environment is crucial for preventing and managing conditions like piriformis syndrome, as well as promoting overall health and productivity. Proper ergonomics can significantly reduce the strain on muscles and joints, leading to improved comfort and reduced risk of injury.

Key Ergonomic Considerations:

1. Chair selection: Choose a chair that provides proper lumbar support and allows for adjustments in height and tilt.
2. Desk setup: Ensure that your desk is at the appropriate height to maintain proper posture while working.
3. Monitor positioning: Place your computer monitor at eye level to reduce neck strain.
4. Keyboard and mouse placement: Position these tools to minimize reaching and maintain neutral wrist positions.
5. Footrest: Use a footrest if your feet don’t comfortably reach the floor when seated.

Can ergonomic improvements in the workplace lead to increased job satisfaction? Research suggests that implementing ergonomic solutions not only reduces physical discomfort but can also boost employee morale and productivity.

Strategies for Incorporating Movement into the Workday

Breaking up long periods of sitting with movement is essential for maintaining health and preventing conditions like piriformis syndrome. Incorporating regular movement into your workday doesn’t have to be time-consuming or disruptive to your productivity.

Simple Ways to Add Movement:

• Set reminders to stand and stretch every hour
• Take short walking breaks during the day
• Use a standing desk for part of your workday
• Perform simple desk exercises or stretches
• Consider walking meetings for discussions with colleagues

How frequently should one take movement breaks during the workday? Experts recommend standing or moving for at least 2-3 minutes every 30-60 minutes of sitting to maintain optimal health and reduce the risk of sedentary-related issues.

Long-Term Prevention and Management of Sitting-Related Pain

While addressing acute symptoms of piriformis syndrome and other sitting-related pain is important, developing a long-term strategy for prevention and management is crucial for maintaining overall health and well-being. This approach should encompass various aspects of physical and mental health.

Components of a Comprehensive Prevention Strategy:

1. Regular exercise routine: Incorporate strength training, flexibility work, and cardiovascular exercise into your weekly schedule.
2. Posture awareness: Practice maintaining good posture throughout the day, both while sitting and standing.
3. Stress management: Implement stress-reduction techniques such as meditation or deep breathing exercises.
4. Nutrition: Maintain a balanced diet to support overall health and manage inflammation.
5. Sleep hygiene: Prioritize getting adequate, quality sleep to support physical recovery and mental well-being.

How can individuals create sustainable habits for long-term pain prevention? Gradually introducing new habits and setting realistic goals can help in developing a sustainable approach to managing and preventing sitting-related pain.

In conclusion, understanding the causes and effects of piriformis syndrome and other sitting-related issues is crucial for maintaining health in our increasingly sedentary world. By implementing ergonomic solutions, incorporating regular movement, and adopting a holistic approach to health, individuals can significantly reduce their risk of developing these conditions and improve their overall quality of life. Remember, while professional medical advice is essential for addressing specific health concerns, taking proactive steps to manage your physical well-being can lead to lasting improvements in comfort and productivity.

It Hurts When I Sit

Published on January 5, 2019

“Why does it hurt when I sit?”

Pain while sitting is a common complaint. Unfortunately, the cause of the pain can vary. For this post, we’ll focus on a condition call “piriformis syndrome”. This syndrome typically causes pain in the low back, buttock and backside of the upper thigh. One of the most common complaints with this issue is pain while sitting.

Let’s dive a little deeper into the anatomy of the area to figure out why this happens. The piriformis is a small muscle that stretches across the buttock from the hip to the sacrum (just above the tailbone). The sciatic nerve is a large nerve that starts in our low back and runs down the backside of the leg all the way to the bottom of the foot. This nerve travels under the piriformis in the buttock area. If it’s tight, the extra compression of sitting will irritate the nerve and cause pain in the areas I mentioned earlier. This condition can span the spectrum of pain intensity. On one end, it can be an occasional dull background pain and on the other end, it can be a constant intense pain that limits function.

Sometimes it can be hard to differentiate between piriformis syndrome and other conditions, like disc herniations, which can cause the radiating pain down the back of our leg. Typically, piriformis syndrome radiates down the back of the leg but doesn’t cross the knee. If it’s a disc herniation, the pain will often times radiate down the leg past the knee and into the calf, ankle or foot. This isn’t always the case but along with a good history and exam, it can be helpful in determining the root cause.

How do you treat piriformis syndrome?

There are a lot of options for treatment of this condition. Dr. Crabtree uses a specialized soft tissue treatment called, Active Release Technique®. He likes to describe it as a movement based massage. It’s a technique that is effective at reviving soft tissue function and mobility. Chiropractic adjustments can help restore normal joint function in the pelvis to help relieve strain on the piriformis. Stretching is another important piece to recovering from piriformis syndrome. Whatever you do, it’s important to seek help from a healthcare professional when dealing with issues like this. It’s important to have an accurate diagnosis before beginning any treatments or rehab options.

5 Physical Problems You Have From Sitting Still All Day,…

We go to work hoping our days spent at the office will challenge us professionally, but in reality, living the 9-to-5 (or 6 or 7) desk jockey life can be demanding on the health and wellness front, too.

In fact, according to the U.S. Bureau of Labor Statistics, work-related musculoskeletal problems—from muscle strains to carpal tunnel syndrome—made up 32% of all worker injury and illness cases in 2014. Sure, many of those injuries were suffered by people working production lines or doing other physically taxing jobs. But sitting hunched over a computer, typing furiously and staring at screens all day can also wreak havoc on the body.

In general, the blame lies squarely on how long you sit working at your desk. “The issue that we’re really up against is that we’re not made to sit—certainly not for extended periods of time,” says Michael Fredericson, sports medicine physiatrist at Stanford Health Care. But when your office job calls for you to sit at a desk for hours on end, “you tend to hunch forward, and your neck protrudes, and there’s eye strain. It’s stress that goes through your whole body.”

The good news is that, along with doing some simple stretches, making ergonomic adjustments to your work environment can significantly reduce the daily discomfort most desk jockeys deal with. And the benefits go beyond the physical. A 2014 study found that creating more ergonomic workstations in the office not only reduced musculoskeletal and vision problems, but also boosted employees’ job satisfaction and happiness.

Of course, whenever you’re in pain, you should consult your physician to get a handle on any underlying problems or treatment concerns. But with some of the following moves and expert tips, you could be on your way to keeping the most notorious desk job dangers at bay.

Desk Job Danger #1: Lower Back Pain

Whether it’s an occasional twinge or an ongoing ache, back pain can keep you from performing at your best. Sitting chained to your desk for hours at a time can lead to lower back pain, the most common work-related back problem.

So what exactly is going on back there? Slumping back in your desk chair or slouching forward means your spine is out of alignment. That puts a strain on the ligaments and muscles in your back.

How to Quickly Relieve Tension

To tame muscle tension when it crops up, rock your pelvis back and forth while seated in your desk chair, tilting your hips up and rounding your back, and then tilting your hips back. “That will help get those back muscles loosened up,” says Stephen Aguilar, occupational therapist and certified ergonomic assessment specialist at UCLA Rehabilitation Services.

The Long-Term Fix

Get some support. The length of your back should reach the back of your chair to help you sit upright. If there’s a gap, use a lumbar pillow for cushioning to help prevent yourself from collapsing forward or backward into poor posture. Also, make sure your feet are resting flat on the floor, with your thighs parallel to the ground. “You want to avoid having your feet dangling off your chair,” Aguilar says. “Otherwise, the weight of your leg isn’t supported, which puts more strain on your back.” Using a foot stool can help nix the discomfort.

Breaking a sweat can also help. Abdominal exercises, such as crunches, two to three times a week can strengthen your core. That takes pressure off your back and makes it easier to maintain good posture.

Desk Job Danger #2: Wrist Strain

Spending your days and nights pounding away at your keyboard responding to emails or writing reports can cause injuries that can become a serious health issue.

A combination of overuse and how you’re positioning your wrists at your keyboard are to blame. “Whenever you operate a keyboard or mouse, the tendons in your wrists go back and forth,” Aguilar says. “These tendons are parallel to each other, so they glide back and forth and create friction, which [is called] a microtrauma. That repetitive motion causes fatigue, and the tendons may become inflamed.”

A less obvious factor that plays a role in wrist pain: Poor posture, in particular having your shoulders hunched forward. That’s because the position decreases the blood flow downstream, including to your hands, causing soreness or in some cases, a tingling sensation or numbness.

How to Quickly Relieve Tension

Perform a prayer stretch, also known as a Buddha stretch: Place your fingers and palms together with your hands in front of your chest, fingers pointing upward. While keeping your palms together and your elbows moving out, lower your hands until you feel a good stretch in your wrists. Hold for five seconds.

The Long-Term Fix

When you’re using the keyboard or mouse, hold your wrists naturally so they’re floating horizontally in the air—not perched higher than your hands or resting on your desk. Also, get a wrist rest for your keyboard and mouse, suggests Aguilar, and use it to take occasional breaks over the course of the day. “The key word there is rest,” he says.

Related: 5 Ways Your Health Can Impact Your Financial Well-Being

Desk Job Danger #3: Neck and Shoulder Pain

You never realize just how much you move your neck and shoulders until they’re injured—and then you feel every single shift and twist. These aches and pains may come from placing your keyboard or computer monitor too far away on your desk, causing you to jut your neck and shoulders forward, throwing them out of alignment with the spine and straining the muscles and soft tissue.

How to Quickly Relieve Tension

It may be tempting to pop a couple of ibuprofen to dull the discomfort, but a 2012 study found that frequent neck and shoulder stretches on a daily basis were more effective at easing pain than over-the-counter and prescription anti-inflammatory drugs—or even seeing a chiropractor.

To release a tight neck, Fredericson recommends trying a chin tuck exercise, also known as neck retraction. While standing or sitting upright, keep your spine straight and push your head forward, jutting your chin out as far as possible. Slowly reverse the movement by pulling your head back as far as possible, as if recoiling away from someone. Your head should stay level throughout the stretch, which you’ll feel at the base of your neck. Repeat up to four times.

To relieve tension in your neck and shoulders simultaneously, face forward, tilt your right ear down towards right shoulder, leaving your left arm hanging straight down to increase the stretch. Hold for 20 to 60 seconds and repeat on the left side up to four times.

The Long-Term Fix

Station the computer monitor directly in front of you—not angled to the side, which forces your neck into an awkward position. If you’re on the phone frequently, use a headset rather than cradling the phone between your ear and shoulder, which can cause muscle strain, says Jeffrey A. Goldstein, medical director of NYU Langone Seaport Orthopaedics. Use a chair with adjustable arm rests that allow your elbows to form a 90-degree angle. Aguilar explains that the arm rest and the arm angle help take tension off the shoulders.

“Good posture is also a longer term solution,” he says. Try using an app that helps you work on improving your posture, like PostureZone, which is free. If you’re really serious about your efforts, Lumo Lift ($79.99) uses a lightweight wearable sensor that vibrates when you’re slouching and an app that tracks your posture habits.

Desk Job Danger #4: Eye Strain

Staring at your computer for hours at a time can cause eye fatigue, as can having a computer monitor that’s too far away (making your eyes strain to read the small print) or too close (making your eyes work harder to focus). People also tend to blink less often while staring at their computer, which leads to dry eyes and fatigue.

How to Quickly Relieve Tension

Every 20 to 30 minutes, look at something off in the distance, such as a window across the length of the office, for 20 seconds to give your eyes a break. Better yet, get up and chat with a co-worker in another area of the office or run to the supply closet to grab a new pen—anything to give your eyes a break from the computer.

The Long-Term Fix

The Occupational Safety & Health Administration recommends ensuring that your computer monitor is 20 to 40 inches away from you so it’s not too close or too far from where you’re sitting. The top of the computer monitor should be roughly at eye level. You can also place a filter over your monitor to reduce glare, which contributes to eye strain.

If you wear glasses at work, do a ballpark measurement of the space between your eyes and the computer monitor. Then check with your optometrist to make sure you have the right prescription for that distance. “Many people wear glasses or corrective lenses, but they’re designed for reading or distance,” Aguilar says. “But the computer is in between both distances. Get a prescription for that computer distance and leave the pair at your office. ”

Desk Job Danger #5: Tight Hips

Over time, being stuck sitting in a bent position on a daily basis—from your desk at work to your couch at home—shortens your hip flexors, a group of muscles located at the front of your hips, causing pain. Tight hip flexors also contribute to lower back soreness, another common complaint.

How to Quickly Relieve Tension

Try doing a stretch to release tight hip flexors. Kneel on your left knee—like you are about to propose to someone—and place your right foot forward with your right knee bent at a 90-degree angle. Shift your pelvis forward, bend your front knee and tuck your butt under until you feel a deeper stretch in the left hip. Hold for 30 seconds. Switch legs.

The Long-Term Fix

Stand up from your desk at regular intervals to give your muscles a break and increase circulation. “In a perfect world, get up from your desk every 20 to 30 minutes,” Aguilar says. “Your body has to move.”

Try using a free app, such as Stand Up! or Break Reminder, that lets you set a recurring timer to remind you to get up at certain intervals over the course of the day.

By talking with your doctor and checking out some of these moves, you should be able to help yourself feel good at work—or at least make your body more comfortable.

Related: 5 No Good, Very Bad Office Behaviors That Could Be Holding You Back at Work

Photo of woman stretching courtesy of Shutterstock.

Why Your Pain Worsens While Lying Or Sitting Down

Have you ever wondered why your back pain or hip pain worsens when you lie or sit down? There are a number of reasons for this, but it could also indicate a particular problem that a physical therapist can help diagnose and fix.

It’s a problem many people experience when they have chronic pain, particularly back or hip pain. Often, the pain worsens when they lie down or are sitting for prolonged periods of time. After being sedentary, movement increases the pain in the troublesome area. It makes resting difficult and can keep you from getting a good night’s sleep. It can make mornings terrible and, if you have a desk job, it can make your days more painful.

It’s common to believe that when you’re in pain the best option to stay still. However, that can lead to more problems and pain. Furthermore, pain worsening during rest can indicate particular problems that a physical therapist can help fix. This is why it’s so important to let your doctor and physical therapist know that your pain worsens during and after rest.

Pain Worsens Due To Lack Of Circulation

There are a number of reasons why your pain may worsen while sleeping, lying down, or sitting for a long period of time. One of these reasons is directly related to your circulation or lack thereof. When you’re sedentary for a prolonged period of time, your circulation decreases. This is why many people find themselves feeling stiff when waking up or after sitting and watching a movie. This stiffness can cause your pain to worsen, especially around the joints. It can also cause an increase in pain in the lower back and hip area.

Moving around every 15-20 minutes during the day can help keep your blood circulating, which help eliminate stiffness and pain. During the night, however, this is impossible. Instead, doing light exercises first thing in the morning to get your blood moving, along with stretching, can help eliminate morning stiffness. This exercising doesn’t need to be nor should be intense, but rather just enough to get your heart pumping and blooding circulating.

Sitting Wrong

Just like any position, whether standing, sitting, lying down, or moving, the wrong posture or alignment can cause pain or contribute to the pain you’re already experiencing. Sitting incorrectly, especially for a prolonged period of time, can cause back pain, neck pain, and hip pain. As with any position, the goal is to keep the body aligned naturally. For sitting, this means the knees kept straight and at a ninety-degree angle. The head should also be straight to avoid straining the neck. However, even sitting and resting in the proper position can add to your pain if you sit for too long, causing stiffness. Changing positions and even getting up to move around can help prevent stiffness and pain.

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Sleeping Wrong

Indeed, even when you’re lying down and sleeping, your posture matters. Sleeping in the wrong position could be contributing to your pain and even be the reason for pain. Stomach sleepers often report increased lower back pain. While the “halfsies” – those that sleep half on their stomach and half on their side – may find more pain in their hips.

Sleeping positions can vary greatly. There is no “one size fits all” correct sleeping position. Rather it depends on the person’s condition and problem. Furthermore, there are ways to alter how you sleep without changing your position, as this can take days and even months to fix. For example, belly sleepers may have increased neck and back pain. However, using a soft pillow or none at all can help keep your body aligned in a natural position. Similar to those who experience hip pain, your position could be the one to blame. Keeping your hips aligned with a pillow between your legs could help. Your mattress and pillow can also affect your pain over your sleeping position.

A sleep specialist can help you determine the best position and if your current position is contributing to the problem. Speaking to someone who specializes in body alignment can also help you work on positions that will decrease and even eliminate your pain.

Related Content:
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Goats and Soda : NPR

My back hurts when I sit down.

It’s been going on for 10 years. It really doesn’t matter where I am — at work, at a restaurant, even on our couch at home. My lower back screams, “Stop sitting!”

To try to reduce the pain, I bought a kneeling chair at work. Then I got a standing desk. Then I went back to a regular chair because standing became painful.

I’ve seen physical therapists, orthopedic surgeons and pain specialists. I’ve mastered Pilates, increased flexibility and strengthened muscles. At one point, my abs were so strong my husband nicknamed them “the plate.”

All these treatments helped a bit, at first. But the pain never really went away. So a few years ago, I decided to accept reality: Sitting down is — and will always be — painful for me.

Then back in November, I walked into the studio of Jenn Sherer in Palo Alto, Calif. She is part of a growing movement on the West Coast to teach people to move and sit and stand as they did in the past — and as they still do in other parts of the world. For the past 8 years, Sherer has been helping people reduce their back pain.

I was interviewing Sherer for a story about bending. But she could tell I was in pain. So I told her my story.

Her response left me speechless: “Sitting is a place where you can find heaven in your joints and in your back,” she says. “It’s not sitting that’s causing the pain, it’s how you’re sitting.

“Do you want me to show you how?”

Do hunter-gatherers sit less than we do?

Recently there’s been a lot of talk about how much Americans sit.

There’s a perception that we sit way more than any other culture out there — or even any culture throughout time. For the first time in human history, we sit for these long stretches, day after day.

Anthropologist David Raichlen at the University of Arizona says that is not accurate.

“No. Not from our data,” says Raichlen.

Raichlen studies modern hunter-gatherers called Hadza, in Tanzania. They live primarily off wild foods, such as tubers, honey and barbecued porcupines. And to acquire this food, there’s no doubt they are active.

They climb and chop trees to get honey. They dig for tubers and pound nuts.

“They do a lot of upper body work,” Raichlen says. “And they spend quite a bit of time walking — at a pretty high rate of speed.”

On average, Hadza adults spend about 75 minutes each day exercising, Raichlen says. That amount is way more than most Americans exercise. Many of us can’t muster a measly 2.5 hours each week, as recommended by the Centers for Disease Control and Prevention. So there’s no doubt the Hadza are in better cardiovascular health than most Americans.

But do the Hadza actually sit less than we do?

A few years ago, Raichlen and colleagues decided to find out. They strapped heart-rate monitors onto nearly 50 Hadza adults for eight weeks and measured how often each day, they were just, well . .. sitting around. The results shocked Raichlen.

“The Hadza are in resting postures about as much as we Americans are,” he says. “It’s about 10 hours a day.”

By comparison, Americans sit about nine to 13 hours each day, on average, a study reported in 2016.

But here’s the thing: The Hadza don’t seem to have the back issues that we Americans have, even as they age.

“Not that we have found,” Raichlen says. “There hasn’t been a ton of studies looking into muscle and joint pain in the Hadza groups, but people are highly active across the life span. There are some declines in activity with age but nowhere near what you get in the U.S.”

Not how much, but how we sit

So maybe Sherer is right. Maybe the problem, when it comes to back pain, isn’t how much Americans are sitting, but the way we’re sitting.

“Yes, I think that’s probably a big part of the story,” Raichlen says.

Orthopedic surgeon Nomi Khan agrees.

“Most of us do not sit well, and we’ve certainly been putting a lot more stress on our spines,” says Khan, who operates on spines at Sutters Health’s Palo Alto Medical Foundation.

If we change the way we sit, Khan says, it will help to decrease back problems.

“We should sit less, and we should sit better,” he says.

Over the past century or so, many Americans have lost the art of sitting, he says. Most people in the U.S. — even children — are sitting in one particular way that’s stressing their backs. You might not realize you’re doing it. But it’s super easy to see in other people.

Here’s how: Take a look at people who are sitting down – not face-on but rather from the side, in profile, so you can see the shape of their spine.

There’s a high probability their back is curving like the letter C — or some version of C. Or it might make you think of a cashew nut, sitting in the chair. There are two telltale signs: Their shoulders curve over and their butts curve under. That posture is hurting their backs, Khan says.

“Most people tend to round out their backs when they sit,” Khan says. “Their spine is in an improper position, and they will tend to have more back problems.”

Back problems crop up because sitting like a C — or a cashew nut — can damage the little shock absorbers in the spine, called the intervertebral disks.

“You can think of a disk as a jelly doughnut,” Khan says. “Sitting like a C puts a lot more pressure on the front of the doughnut than on the back.”

And what happens when you press down on one side of a jelly doughnut but not the other side? Jelly can squirt out.

Your spinal disks aren’t much different. Sitting in a C-shape, over time, can cause disk degeneration. Or one side of a disk can start to bulge. “The disk can then push against nerves, or it can rupture,” says biomechanist William Marras, who directs the Spine Research Institute at Ohio State University.

“When the disks get messed up, you’ve got real problems,” Marras says. “So everything we do in biomechanics is to try to protect the disks.”

Straightening out the C

At Sherer’s studio, she pulls a up a photo of gray-haired man sitting at a loom. He must be at least in his 60s.

“This is taken in Rajasthan, India,” Sherer says. “The man sits at the loom weaving, for hours and hours every day, just like we do at a computer,” she says. “And yet his spine is still elongated.”

No special chair required: A man in Rajasthan, India, sits at his loom, weaving for hours each day with exemplary posture. He untucks his pelvis and elongates his spine.

Jean Couch

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Jean Couch

No special chair required: A man in Rajasthan, India, sits at his loom, weaving for hours each day with exemplary posture. He untucks his pelvis and elongates his spine.

Jean Couch

Elongated is an understatement. This man’s spine is straight as an exclamation point. His shoulders are rolled back. His muscles looked relaxed and flexible.

I’ve seen similar sitting postures in other rural pockets around the world — for example, in eastern Liberia during the Ebola outbreak and in the Yucatán countryside. (Basically anywhere people still do a lot of hip-hinging when they bend over. Because what do you do when you sit down? First you bend over.)

In fact, you don’t have to go back very far in history to find the same posture here in the U.S. Photos and drawings from the early 20th century show that many Americans sat with straight backs and shoulders rolled back, similar to the man at the loom. Today, you can find a similar posture with babies and young children.

So what happened?

One of the problems, Sherer says, is our culture focuses on trying to fix the upper body. “Sit up straight,” parents and teachers say, and most of us immediately stick our chests out.

But that’s the last thing you want to do, Sherer says.

“Even just hearing the word ‘spine’ makes people lift their chest because they want to have ‘proper posture,’ ” she adds. “But when I see it, I’m like, ‘No! That’s what causes back pain. Lifting your chest is going to make your back pain worse.’ “

Instead of focusing on the chest or shoulders, Sherer says, we need to turn our attention to a body part that is lower down, below the waist: the pelvis.

Or to put another way — your butt.

“The most important thing to change to reduce back pain is your pelvis position,” she says. “It’s like a stack of toy blocks. If the blocks at the bottom aren’t sturdy, then the top has no chance.”

Pull your tail out so it can wag

Sitting in Sherer’s studio, I glance over at my profile in the mirror. And right away, I see the cashew shape. It doesn’t look pretty. My shoulders are rolled over my chest, and my pelvis is tucked under my spine.

To figure out how to shift your pelvis into a healthier position, Sherer says to imagine for a minute you have a tail. If we were designed like dogs, the tail would be right at the base of your spine.

“When you sit with a C shape in your spine, you’re sitting on this tail,” Sherer says. “It’s kind of like a dog with its tail between its legs, who is scared and frightened.”

To straighten out the C shape, Sherer says, “we need to position the pelvis in a way that this tail could wag.”

In other words, we need to untuck our tails. To do that, Sherer says, you need to bend over properly when you go to sit down.

“Bend over?” I ask. “Do I bend when I sit down?”

“Yes!” Sherer exclaims. “Every time you sit down, you bend somewhere.”

And where you bend determines how you will sit.

If you bend at the waist, which many Americans do, then you will likely sit with a C or cashew shape.

If you bend at the hips (as we learned about in a previous story), you’re more likely to sit correctly with your tail untucked.

“Bending at the hips can be hard for many people to figure out,” Sherer says. “It’s a bit counterintuitive.”

But she has a trick to help people learn.

“Stand up and spread your heels about 12 inches apart,” she says. Now, put your hand on your pubic bone — like a fig leaf covering up Adam in the Bible, she explains.

“When you bend over, you want to let this fig leaf — your pubic bone — move through your legs,” she says. “This creates a crease between your pelvis and legs.”

This action also pretty much pokes your butt out, behind your spine. “Now go ahead, sit down,” Sherer says.

Now my butt — or my imaginary tail — is behind my spine.

The next step is to relax the muscles in your back and chest. “Stop sticking your chest,” Sherer says. Then the rest of the spinal vertebrae can stack up in one straight line, like an I instead of a C.

The crazy part, Sherer says, is that when the tail comes out, some of the tight muscles in your legs will actually start to relax or stretch.

“If you untuck your pelvis while you sit, your quadriceps muscles can relax, and then your hamstrings can stretch,” Sherer says.

I could definitely feel my quads relax. The muscles felt like butter set on a warm pan: They softened and seemed to melt.

Man, this felt good. “Oh wow!” I exclaimed, as a chill went up my body.

If you don’t feel your hamstrings stretch — and your quads don’t relax — you’re probably not doing the action correctly, Sherer says.

“Then you’re probably using your lower back muscles to push your butt out,” she says. “That can cause more back pain. You don’t want to do that.”

How am I sitting now?

After leaving Sherer’s studio, I realized that I had been sitting with my tail — or pelvis— tucked for decades. And it wasn’t easy to fix. I had to return to Sherer’s studio for many appointments and work hard, every day, to learn how to untuck my pelvis while sitting at my desk.

But little by little, the muscles around my hips started to loosen up. The pain began to dissipate, very slowly.

After mastering the new sitting position, I decided to visit Khan to get his opinion. “Do you want to look at my pelvis and see what you think about how I’m sitting?” I asked the spine surgeon.

Khan took his hand and placed it on the base of my spine, right at the top of my pelvis.

“You’re sitting perfectly,” he said nonchalantly. “Because you’re basically sticking your butt back and creating this little curve at the lower part of your spine.”

“If you sit like this, you’re going to put a lot less stress on your spine and have less back issues,” Khan added.

And as an added bonus, I feel like I’m following the spinal pose of Jennifer Lopez: curvy on the bottom and straight on top.

13 Reasons Why Sitting Too Much Is Bad for Your Health

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SOURCES:

University of Minnesota: “London Transport Workers Study.”

BC Medical Journal: “Exercise and the heart: A review of the early studies, in memory of Dr R.S. Paffenbarger.”

Harvard Health Publishing: “Too much sitting linked to heart disease, diabetes, premature death.”

apache.org/xalan”>National Institutes of Health: “Prediabetes & Insulin Resistance.”

American Journal of Epidemiology: “Associations of Accelerometer-Measured and Self-Reported Sedentary Time With Leukocyte Telomere Length in Older Women.”

PloS One: “Long Leukocyte Telomere Length at Diagnosis Is a Risk Factor for Dementia Progression in Idiopathic Parkinsonism,” “Minimal Intensity Physical Activity (Standing and Walking) of Longer Duration Improves Insulin Action and Plasma Lipids More than Shorter Periods of Moderate to Vigorous Exercise (Cycling) in Sedentary Subjects When Energy Expenditure Is Comparable.”

Mayo Clinic Proceedings: “Physical Exercise as a Preventive or Disease-Modifying Treatment of Dementia and Brain Aging.”

Alzheimer’s Association: “Risk Factors. ”

NIH News In Health: “Don’t Just Sit There!”

Mayo Clinic: “Deep vein thrombosis (DVT): Overview,” “What are the risks of sitting too much?”

Journal of Epidemiology: “Television viewing time is associated with overweight/obesity among older adults, independent of meeting physical activity and health guidelines.”

Applied Physiology, Nutrition, and Metabolism: “Appetite regulation in response to sitting and energy imbalance.”

Exercise and Sports Sciences Reviews: “Too Much Sitting: The Population-Health Science of Sedentary Behavior.”

BMC Public Health: “The association between sedentary behaviour and risk of anxiety: a systematic review.”

apache.org/xalan”>UCLA Health: “Ergonomics for Prolonged Sitting.”

Johns Hopkins Medicine: “Varicose Veins.”

Journal of Physical Activity & Health: “Sedentary time in U.S. older adults associated with disability in activities of daily living independent of physical activity.”

Diabetologia: “Sick of sitting.”

Journal of the National Cancer Institute: “Sedentary behavior increases the risk of certain cancers.”

Cancer Causes & Control: “Associations of change in television viewing time with biomarkers of postmenopausal breast cancer risk: the Australian Diabetes, Obesity and Lifestyle Study.”

Pain in the Buttocks when Sitting? Use these Tips

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If you (or your client) has ever had sensations like sharp pain, numbness, or tingling in your lower back and buttocks (glute) region that travels down the back of your leg, you’re not alone. And, a muscle called the piriformis could be to blame.

This small muscle plays a big role in keeping lower body movements smooth and balanced, particularly during extension, abduction, and external hip rotation. And, when you know how it affects movement and pain, you can help clients avoid what’s called avoiding piriformis syndrome. Simple mobility and flexibility exercises can help alleviate the symptoms and stay pain free.

What is Piriformis Syndrome?

The piriformis is a small, flat, band-like muscle that originates on the anterior surface of the sacrum and connects the most inferior part of the vertebrae to the upper part of your leg. A simple reference point for this muscle is the back of the hip, because it sits on top of the hip joint.

The sciatic nerve, on the other hand, runs alongside or through the piriformis muscle, traveling down the back of the leg and branching into smaller nerves that end in the feet. Much of the pain as described above that many of your clients’ experience is from the interaction between the piriformis muscle and the sciatic nerve.

When people have symptoms of piriformis syndrome, sometimes they assume it to be a herniated disc. But, an alternative cause, proposed by Freiberg and Vinke and developed by Robinson who coined the term “piriformis syndrome,” is compression of the sciatic nerve from a tight piriformis muscle.

How Does Piriformis Syndrome Happen?

Reciprocal inhibition is a common phenomenon that happens when muscles on one side of a joint contract and opposing (muscles on the other side of the joint) relax. This allows movement to take place. So, tight hip flexors will cause the glute max to become inhibited, or “silent.” This doesn’t mean movement at the joint can’t occur. Instead, another muscle must pick up the slack and in this instance it’s the piriformis. Since the piriformis is small and not intended to do all this work, it can get overactive and spasm easily in these cases. When this happens, it can compress the sciatic nerve, leading to pain, numbness, and tingling sensations. Because it’s an overactive muscle, spasming from too much work, it just needs a break. By doing hip flexor and piriformis flexibility exercises, these symptoms of tightness and pain subside, restoring normal movement and function.

The pain from piriformis syndrome can occur during many movements since this muscle is so integral in lower body mechanics. But when it’s over-activated, and nerve compression is happening, you or your client might feel pain just sitting at a desk, in the car, or even while standing.

Clients who are extremely active and prone to developing this condition include soccer players, track and field athletes, runners, and triathletes. This is due to the constant lifting and rotation of the thigh away from the body. Including piriformis syndrome stretches into their exercise programming is essential.

Special Considerations with Clients

According to Harvard Health, it is also important to have a full health history on your clients, as other medical issues will also accelerate the pain associated with piriformis syndrome. Some of these conditions include:

• Previous Injury
• Abnormal development of sciatic nerve or muscle
• Postural deviations
• Leg length discrepancy
• Unusually vigorous exercise
• Excessive bouts of sitting
• Previous foot issues

Prevention and Pain Management

Piriformis syndrome doesn’t have to sideline your clients’ goals and successes. Simple mobility exercises will help keep this tiny muscle from tightening and causing pain and dysfunction. Keeping the body’s strength work balanced will help to avoid overcompensation issues, and including strengthening work specifically on the hip adductors is essential.

Check (and share!) out this great resource of the best ways to deal with pain in the buttocks- piriformis syndrome.  And, if you want to be an expert at working with clients who have these types of symptoms (and so, so much more) then you should be a Corrective Exercise Specialist. Get this advanced certification and bring even more value to the clients you work with.

Share these exercise recommendations with your clients by clicking HERE.

Lindsay Kent

References

1. Ask Dr. Rob about piriformis syndrome – Harvard Health. (n.d.). Retrieved August 20, 2018, from https://www.health.harvard.edu/diseases-and-conditions/ask-dr-rob-about-piriformis-syndrome

2. Carro, L. P., Hernando, M. F., Cerezal, L., Navarro, I. S., Fernandez, A. A., & Castillo, A. O. (2016). Deep gluteal space problems: piriformis syndrome, ischiofemoral impingement and sciatic nerve release. Muscles, Ligaments and Tendons Journal, 6(3), 384–396. https://doi.org/10.11138/mltj/2016.6.3.384
3. Hopayian, K., Song, F., Riera, R., & Sambandan, S. (2010). The clinical features of the piriformis syndrome: a systematic review. European Spine Journal, 19(12), 2095–2109. https://doi.org/10.1007/s00586-010-1504-9

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Corrective Exercise Specialist

The ISSA’s Corrective Exercise Course will help you learn how to identify and correct the most common movement dysfunctions that you are likely to see in a wide range of clients, from the weekend warrior to the serious athlete. Both health care professionals and certified personal trainers can benefit from this distance education course, learning more about how people move incorrectly and how to guide them to correct those dysfunctions.

Please note: The information provided in this course is for general educational purposes only. The material is not a substitute for consultation with a healthcare provider regarding particular medical conditions and needs.

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A side effect of working from home

When I started medical school after a few years away from being a student, I expected having to adjust to all that studying. What I didn’t expect was the lower back pain that came with sitting at my computer for hours. Health professional students are told to treat school like a full-time job, which in the case of quarantine means sitting at a computer screen for hours on end—for lectures, studying, and Zoom meetings. 

This virtual reality for school and work is one many people across the world are adjusting to since the start of the COVID-19 pandemic, and with that adjustment has come an increase in lower back pain.

What are the causes of lower back pain when sitting? 

Lower back pain is a common health condition typically affecting the lower portion of the spine and can stem from an injury (muscle strain or a sprained ligament from improper lifting for example), or a spinal problem such as arthritis or sciatica. Common causes of lower back pain when sitting include prolonged time spent in a chair, lack of regular exercise, and poor posture.

Prolonged sitting

Sitting for prolonged periods of time increases stress and strain on the back muscles and spinal discs. Spinal discs act like support pads in your spine, and pressure on these pads results in pain. Pressure is typically highest when sitting, and lowest when lying down. 

“The walk to the water cooler is now replaced with the much shorter walk to the fridge,” Dr. Siddiqi explains. “All of that physical activity built into your day that you don’t think about has been taken away from you in these settings. All that plays into a heightened pain experience,” explains Asad Siddiqi, DO, an associate professor of clinical rehabilitation medicine at Columbia University Medical Center. 

The impact of prolonged sitting typically isn’t as bad when you break up long periods of sitting to do things like traveling to and from work, getting up to go to meetings or the office kitchen, or post school/work exercising. But with most Americans doing work and school from home, a lot of these small breaks have been erased. 

Inactivity

The pain from prolonged sitting is exacerbated by lack of physical activity, which is much more likely to be the daily experience of many since the onset of quarantine. “A lot of people have had their normal routines disrupted,”  says Dr. Siddiqi. “Now the body is having to accommodate a new normal.” 

The duration at which we sit at a computer for meetings, catching up with friends, and entertainment has gone up. Physical activity, along with access to gyms and workout spaces, has gone down. When routines are disrupted, it can be hard to summon the motivation to exercise at home. For people who live in cities, exercising outdoors is not risk free. These changes are resulting in people who never experienced back issues experiencing some pain. “Many of my patients have reported new aches and pains,” comments Saiah Yates, DPT, a physical therapist with Loch Raven VA Outpatient Clinic in Maryland. “The fear and very present risk of catching COVID-19 has limited people’s outdoor and social activities.”

Poor posture

Before the pandemic began, the average American used screens for about four hours a day. Now that number has shot up to six hours daily, according to a survey conducted by One Poll. Fifty seven percent of respondents say that has led to more “screenaches” than ever before.

Poor posture adds to this stress by overstretching the spinal ligaments and straining the spinal discs. Muscles spasm due to the increased pressure. When we sit, this portion of our body is already crunched together, and poor sitting posture magnifies this slouching and causes the strain. Low back pain from sitting for extended periods is typically associated with other symptoms of prolonged screen use, such as neck pain and shoulder pain.

How can I prevent lower back pain when sitting?

So, how do you solve these issues during the ongoing pandemic? You can’t simply start commuting again, or make your house any bigger. But there are simple steps you can take to decrease the negative impact of being glued to your desk all day (and night) long.

At-home ergonomics

Ergonomics is the study of what makes a work environment as comfortable, and therefore productive, as possible. Many companies and schools put significant attention into spacing equipment in a way that suits long-term sitting. This design is pretty different from most of our kitchen counters and bedroom setups.

Where you decide to hold your Zoom calls may be a good backdrop, but not the most ergonomic, says Dr. Siddiqi. While you may not have a lot of money to put toward ergonomic design, there are some small cues we can use to make the spaces of our homes suitable for working and supportive of our bodies:  

Eye cues	Close your eyes while sitting, with your head looking straight forward. When you open them, the center of your screen or whatever the main focus of your activity should be at eye level. If not, adjust your computer height using lap desks or a pile of thick books.
Elbow cues	If you place your hands on your desk, your elbows should make a 90-degree angle. If not, you should adjust your chair higher or lower as needed.
Arm cues	Sit in a way that allows your upper arms to be parallel with your spine. Shoulders should be relaxed. Forearms should rest comfortably parallel to the floor.
Lower back cues	Sit with your butt pressed against the back of your chair. Place a pillow between you and the back of your chair to allow your spine to sit with its natural curve. If your chair doesn’t have a back, try sitting against a wall, and place the pillow behind you to support the lumbar area.
Thigh cues	Adjust your seat level so your thighs rest parallel to the floor. Try placing your hands underneath your thigh where your leg meets the chair. If it can’t fit, you may need a footrest for your feet. If there’s too much space, your may need to move your chair height up.

If you’re already experiencing back pain while sitting, try breaking up your sitting into short intervals and changing your sitting position. Lying down is the position that has the least strain on your back. Alternate periods of sitting with standing or take breaks to lie down as possible. Standing allows for better weight distribution, which gives the lower back a much-needed break. 

“You can do things in the privacy of your own home that you may have otherwise been self-conscious to do,” Dr. Siddiqi says. Working and attending school from home offer a degree of flexibility, and that flexibility can be used to help restore back function.

How to treat lower back pain

Often the only symptom of lower back problems is the experienced pain. Lower back pain happens among all ages and demographics, and typically goes away on its own within two to four weeks when the cause is removed. Chronic low back pain may require physical therapy, over-the-counter or prescription pain medications, or possibly surgery.

RELATED: Lower back pain treatments

Regular stretching and exercise

Even the most comfy, ergonomically savvy chair can contribute to back pain if sat in for too long. Finding ways to be a little active each day is difficult, but essential to preventing and alleviating pain. Most medical providers recommend taking active breaks to stand up at least once every hour. 

“Schedule time for physical activity, even if that was not something you previously did,” Dr. Siddiqi says. “Get up, stretch, do something that gets the blood pumping a little bit, and then reset your position.” 

Movements that strengthen the core abdominal muscles are especially important, as our core supports the part of the body under strain while sitting. “Our core musculature may not be engaged during long-term sitting or laying, thereby decreasing the stability of the spine,” Dr. Yates notes. 

When deciding what kinds of movements to do, think of what your normal activity level is so that you meet your appropriate edge. “Find ways to compete with yourself; find different ways to measure and track your success,” Dr. Siddiqi says. For some, that may look like yoga, or stretching once a day. Here are some recommended stretches that give the lower back a little extra love:

• Knee to chest: Lie down on your back, with your lower back against the floor. Lift your legs up and hug your knees into your chest. Hold for 10-15 seconds and release.
• Reclined spinal twist: Lie down, with arms extending out in a “T” formation, knees bent, and feet on the ground. Let both knees fall to the right, and gaze to the left. Hold for 5-10 seconds, then reset. Repeat, shifting both knees to the left and gazing to the right.
• Cat-cow: Start on your hands and knees in a table-top position. As you breathe in, arch your back to move your stomach down and lift your head up. As you exhale, reverse this motion and cave your back in, letting your head fall down. Repeat 5-10 times.

Over-the-counter medications

Over-the-counter (OTC) anti-inflammatory medications, such as aspirin or ibuprofen (along with the use of hot/cold pads), can also be used for short-term pain relief when your back hurts. Turmeric has also been proven to have anti-inflammatory effects. These effects may help with alleviating back pain, though studies are not conclusive.

When to see a doctor for back pain

Seeking professional medical advice can be helpful for distinguishing whether or not structural damage, such as a ruptured disc or spinal stenosis, is causing the pain. Get medical attention if pain lasts longer than a few weeks, or is progressively getting worse. It’s important to pay attention to what changes make the pain better or worse, and if any other symptoms are present. “Often the timing of symptom onset can give clues as to what is causing the back pain,” describes Dr. Yates. 

Your primary care provider may refer you to a physiatrist or physical therapist to get a comprehensive care plan for addressing the cause of the back pain and help restore function. 

Whether your pain is a result of structural damage or quarantine-related adjustments, there are resources available to help alleviate it.

RELATED: Herniated disc treatments and medications

Related resources:

90,000 a detailed overview of all stages of treatment

Crown – this is the name of a denture in dentistry, which is placed on a tooth, on an implanted implant, or included in the construction of a dental bridge. With the help of dental crowns, severely damaged or lost teeth can be restored, the restoration of which must be done urgently and contact a dentist for this.

How will the installation of the crown take place, is it painful to put the crown on the tooth – we will answer all these questions in detail in our article.

When it is required to put a crown on a tooth: indications for restoration of teeth with a crown

The need to place a crown on a tooth may arise in the following situations:

• The tooth is severely decayed. If the natural crown of a tooth is damaged by more than 50% by caries, then it would be more correct to put a crown on the tooth, and not restore it with a filling. Large fillings do not withstand the chewing load well and can fall out or break, and together with the filling, a tooth can also break.If the root of the tooth is damaged, then it will have to be removed. By placing a crown on a decayed tooth, you get the opportunity to preserve it;

• The tooth is destroyed by trauma. If, when the tooth is injured, its roots were not affected, the tooth can be restored – it will be enough to put a crown on it;

• It is also possible to put a crown on a tooth for an aesthetic restoration: for example, if a tooth is chipped or its enamel has changed color, becoming gray or yellow, and this defect cannot be eliminated by classical bleaching.

Doctors recommend placing temporary crowns to preserve teeth for patients with periodontitis. In this case, the crowns prevent the teeth from loosening and falling out.

Do you need to put a crown on the tooth in your case, or is it possible to apply another restoration technique? The answer to this question can help you find the doctors of our dental clinic in Moscow – “Firadent” – to make an appointment with our specialists, you just need to dial the phone number of our dentistry!

Need to put a crown on the tooth: is it painful to carry out the treatment?

Statistics show that most people, knowing that they need to put a crown on their tooth, still postpone their treatment out of fear of visiting the dentist and pain, which supposedly cannot be avoided when prosthetic teeth. Is it really painful to put a crown on a tooth? Let’s deal with this issue together.

Is it painful to put a crown on a tooth or not? The most painful stage in the process of installing a crown on a tooth will be preparation, during which the teeth are treated for caries, depulped (if necessary), and also ground to the thickness of the future crown. All these procedures are not performed without anesthesia, as they can cause a person quite severe pain.

Before starting to treat and prepare a tooth to put a crown on it, the doctor will definitely perform an anesthetic procedure using a local anesthetic.The type and amount of the drug are selected individually, for each patient. The use of anesthesia makes the process of preparing the tooth for the installation of a crown painless.

If the patient literally experiences a panic fear of dentists – in our dental clinic “Firadent” he can be offered the service of dental treatment in a dream, under sedation. Sedation should not be confused with general anesthesia, it is a light medication sleep in which the patient will remain during treatment.Sedation allows you to relieve the patient not only of pain when preparing teeth for prosthetics, but also of psychological discomfort and stress! At the same time, after sedation, there are no negative side effects, which are not uncommon after general anesthesia.

You can read all the details on dental treatment in a dream in a separate article on our website, which is dedicated to sedation, or ask the doctors of our clinic – “Firadent”.

How to put a crown on a tooth: a detailed description of all stages of installing dental crowns

To put a crown on a tooth, you will have to visit a dental clinic several times, since dental prosthetics is carried out in several stages.Each of the stages of installing a crown on a tooth will be discussed in detail below.

Initial inspection and diagnostics

The decision that a crown should be placed on a tooth is made by an orthopedic dentist, after examining the patient’s oral cavity and teeth, as well as performing a number of diagnostic measures.

Based on the data obtained, the orthopedist will develop a treatment plan, which may include not only the installation procedure itself, but also a number of additional measures:

• Professional oral hygiene, which allows cleaning teeth from plaque and tartar;
• Extraction of badly decayed teeth that cannot be properly treated and restored with a filling;
• Treatment of caries and any other diseases of the teeth and gums diagnosed by examination;
• Tooth pulping, processing and filling of canals.

Note that depulpation of a tooth before placing a crown on it is not always carried out. The depulpation procedure involves the removal of the dental nerve, after which the tooth becomes more fragile and vulnerable to external factors. If the tooth has more than one root and it is in good condition, doctors prefer not to remove the dental nerve and place a crown on a living tooth.

When drawing up a treatment plan, the question of which crown will be placed on the tooth is also decided. Modern dental crowns are made from different materials and there is always an opportunity to choose the variant of the prosthesis that will most suit the patient in terms of aesthetics, price and durability.

The prepared treatment plan is coordinated with the patient and, after agreement, the treatment process begins. The first step will be to prepare the tooth for the installation of the crown.

Preparation for the installation of a dental crown

Preparation for the installation of a dental crown may include the following procedures:

1. Professional teeth cleaning.Removing tartar and plaque from the surfaces of the teeth will help to accurately select the color of the future crown, as well as identify primary caries and other diseases that are important to cure before placing the crown on the tooth.

2. Treatment of caries, pulpitis, periodontitis and gum disease. It is impossible to put a crown with sick teeth!

3. Treatment of the tooth on which the crown will be placed. During this process, the doctor will re-drill the tooth, remove all tissues affected by caries.If necessary, tooth pulping is carried out, as well as processing and filling of dental canals.

IMPORTANT: Root canal treatment must be of high quality! If during the treatment of the canals the doctor makes a mistake, removes not all the tissues affected by inflammation or incorrectly seals the canals, the tooth may begin to ache under the already placed crown and then it will have to be removed and treated again! In our dental clinic “Firadent” in Moscow, the treatment of tooth canals is carried out under a microscope with an optical device, which allows the doctor not to act at random, but to accurately see the length and inner space of the dental canals, and therefore to carry out the procedure with impeccable quality.

After filling the canals, the tooth is restored with a filling and the next stage in prosthetics begins – turning the tooth under the crown.

Turning a tooth under a crown

Before placing a crown on a tooth, the tooth must be ground to the thickness of the future prosthesis. This procedure is called “preparation” in professional dentistry. The enamel of the tooth is grinded with a drill and during processing the doctor will give the tooth the shape that will allow the crown to be firmly and tightly placed.

IMPORTANT: Grinding living teeth can be quite painful, so local anesthesia must be given prior to this procedure. If the tooth was depulpated before grinding, local anesthesia can not be used, the procedure will not cause pain.

When preparing teeth, a layer of tissue is removed from the tooth before placing the crown. The layer thickness will depend on how thick the crown will be. The minimum layer of tissue is removed from the teeth for cast crowns, a significant layer of tissue has to be removed from the tooth if it is decided to put ceramic or metal-ceramic crowns. On average, during the grinding process, about 2.5 mm of tissue is removed from each side of the tooth.

As a result of the preparation of the tooth, a stump base (stump) is obtained, on which the doctor will place a crown.

Manufacturing of crowns

Crowns are produced according to an impression taken from the prepared teeth. To obtain this impression, the orthodontist will use a special plastic mass. Based on the impression taken, the laboratory will first make a plaster model of the prosthesis, and then – a crown, which will be placed on the tooth.

Modern dental crowns are made from different materials: metal, ceramics, cermets and zirconium. The timing of the manufacture of the prosthesis will depend on which crown it will be decided to put on the tooth. The longest production of crowns is made of ceramics and cermets. So that a person does not have to walk without a tooth during the entire time of making crowns, a temporary plastic prosthesis is put on the tooth.

IMPORTANT: Temporary plastic crowns help to hide a defect in the dentition, a person will not have to be ashamed of missing a tooth and experience stress for this reason.Also, temporary dentures help to protect a sharpened and, accordingly, weakened tooth from the negative effects of environmental factors and bacteria.

Try-on, temporary and permanent crown cementation

Before placing a crown on a tooth, it must be tried on. For this, the patient is invited to the clinic. During the fitting, the accuracy of manufacturing the crown and the density of its fit on the stump base are assessed. If the fitting does not reveal any manufacturing inaccuracies, the patient does not feel discomfort and is satisfied with the aesthetics of the finished product – the crown is temporarily fixed on the tooth.

What is a temporary fix? This is a kind of “test drive” of the crown. With a temporarily placed crown, the patient will walk for a certain amount of time (usually up to 4 weeks). If during this time no defects and inaccuracies in the manufacture of crowns are revealed, the patient comes to the clinic and the crown is placed and fixed with permanent dental cement.

At this point, the process of installing the crown can be considered complete.

How to place a crown on an implant?

The crown can be placed not only on the tooth, but also on the implant.This allows you to restore lost teeth without turning healthy units in rows. Crowns on implants are durable, aesthetic, visually indistinguishable from natural teeth.

Before placing a crown on an implant, an artificial root implantation procedure is performed. As soon as the implant has taken root, an abutment is placed on it, and then a crown. It will be more expensive to put a crown on an implant than to carry out conventional prosthetics, but the price of the service is fully paid off by the impeccable aesthetics and long service life of both the implant and the crown.

Service life of crowns

Patients planning to get a crown are often interested in its useful life. The service life of the crown placed on the tooth will depend on a number of factors:

• Material and technology of crown manufacturing;
• Compliance by the patient with all the doctor’s recommendations for the care of the crown;
• Quality of preparation of teeth for prosthetics.

The last factor is of fundamental importance: if mistakes are made during the preparation and manufacturing of the crown, the crown will not last long, and unwanted complications may also arise, due to which the crown will have to be removed and placed on the tooth again.For these reasons, you need to very carefully choose the clinic in which you plan to treat and restore your teeth! Remember that the worst kind of savings is saving on your own health!

The crown should be placed in a well-equipped dental clinic, staffed by experienced orthopedic specialists and dental technicians. The clinic should use the most modern technologies for diagnostics, treatment and prosthetics of teeth, only such an approach to the choice of dentistry guarantees a high quality of treatment!

How much does it cost to put a crown on a tooth?

How much does it cost to put a crown on a tooth? It is difficult to give an unambiguous and precise answer to this question, because the cost of installing a crown may include various additional, but necessary procedures. For example, professional cleaning of teeth, treatment of caries or pulpitis, treatment and filling of canals.

The cost of installing a crown will be influenced by both the material and the technology of the prosthesis production. The most expensive options are ceramic and zirconium CAD / CAM crowns. But such crowns fully pay off their cost with high strength, reliability and aesthetics.

Also, the cost of installing a crown will depend on how exactly it will be placed – on the abutment tooth or on the implant.

The best way to find out how much it costs to put a crown on a tooth is to visit the orthopedic doctors of our dental clinic in Moscow – “Firadent”. Experienced specialists of our dentistry will conduct an examination and diagnostics and draw up a treatment plan, which will indicate the exact price of the service.

90,000 Recovery after rhinoplasty: how quickly sensitivity will return and whether it hurts

Table of Contents

Plastic surgery of the nose (rhinoplasty) is one of the most popular interventions. Its first results can be seen within 10-14 days, but the final effect is evaluated only after 6-12 months. This is due to the special properties of the recovery period. Consider both the rehabilitation process and the features of the operation itself, indications and contraindications to it.

Indications for rhinoplasty

Rhinoplasty can be performed for aesthetic and medical reasons. In some cases, the operation is prescribed when several factors are combined.

Aesthetic indications

Rhinoplasty can be performed with such disadvantages as:

• Large nostrils
• Pronounced hump
• Bulky tip
• Long length
• Various curvatures

All such defects impair the perception of appearance and disturb the proportions of the face.

Functional indications

The nose performs a number of important, from the point of view of life support, functions.These include:

• Respiratory
• Reflex
• Olfactory
• Speech
• Protective

The nose allows us to breathe normally, provides warming and purification of the incoming air, participates in the formation of speech and makes it possible to perceive odors. Congenital and acquired defects of both the bone-cartilaginous skeleton and the septum can reduce nasal breathing, interfere with smell and reduce other organ functions.At the same time, only pronounced breathing disorders are an absolute indication for plastic surgery.

Complex

Rhinoplasty can be performed with a combination of various aesthetic and functional indications. Reconstructive rhinoseptoplasty is usually performed. This operation makes it possible for:

• Expansion and strengthening of narrowed passages
• Baffle fixes
• Elimination of asymmetry of the nose, etc.

Preparation for plastic surgery of the nose

Preparation for surgery always begins with a consultation with a surgeon.The patient describes the changes that he would like to see after the end of the rehabilitation period. The surgeon conducts an examination and announces the options for correction, discusses with the patient the terms of rehabilitation and possible complications.

During the examination, the doctor:

Computer modeling is also carried out.It allows you to understand how your nose will look after recovery.

For a detailed assessment of the condition of all internal structures of the nose, CT (computed tomography) is performed. Such diagnostics is also necessary for competent planning of the course of the intervention.

If necessary, other examinations are carried out. The full list is voiced by the doctor.

Typically, patients:

• Undergoing X-ray and ECG
• Pass blood and urine tests
• Consult an otorhinolaryngologist

In some cases, it is also necessary to make an appointment with a maxillofacial surgeon.

Contraindications to surgery

Plastic surgery of the nose is not performed at:

• Diseases of the blood associated with impaired blood clotting
• Diabetes mellitus
• Pregnancy and lactation
• Acute stages of infectious and inflammatory diseases
• Oncological pathologies, etc.

The intervention is not performed on patients under 18 years of age. This is due to the fact that only at this age the formation of the osteochondral skeleton is completed.

The doctor will tell you about all the contraindications.

Postoperative period

After the intervention, the patient remains in the hospital for a day. In the early days, insignificant nasal discharge is possible. Also, edema develops immediately after the intervention. It extends to the area of ​​the nose and eyelids. The swelling usually subsides within a month. The applied plaster is removed 1.5-2 weeks after the operation.

The total rehabilitation period varies from 10 days to 3-4 weeks. The duration depends on both the scope of the intervention and the individual characteristics of the patient and the quality of postoperative care.

If the operation involved working only with soft tissues and cartilage, recovery is quite quick and takes up to 1.5 weeks. If during the intervention all structures were affected (not only cartilage and soft tissues, but also bone), then rehabilitation takes on average 2-3 weeks.

There are also some restrictions on the postoperative period:

• Eliminate physical activity for 6 weeks
• Refusal to engage in contact and traumatic sports for 3 months
• Wearing a special bandage for 1.5 weeks after surgery

Also, patients after surgery are prohibited from:

• Wear glasses for a month (including for correcting vision)
• Sleep on stomach or side
• Visit the bathhouse, pool and sauna
• Sunbathe
• Visit the solarium

The exact terms of the restrictions will be announced by the operating surgeon.He will also issue specific recommendations regarding nutrition, intake of liquids, medicines, vitamin complexes, etc.

As a rule, many patients return to their usual way of life within a few days after the operation.

In the recovery period, the following complications are also possible:

• Hematomas. They are formed both directly in the nose and under the eye sockets
• Swelling. They form in the area of ​​the nose and eyes, at first they can provoke difficulty in nasal breathing and impaired sense of smell
• Complete or partial numbness
• Pain in the nose. In some cases, discomfort is concentrated in a certain area, in others – over the entire area of ​​the face
• Slight increase in body temperature
• Callus formation, that looks like a slight hump or irregularity

All these complications are not dangerous, do not require repeated intervention and are eliminated on their own. Pain and discomfort can be reduced with special medications.

You should consult a doctor only with severe pain syndrome and an increase in body temperature above 38 degrees.Also, a doctor’s consultation is required for prolonged swelling and bruising.

Dangerous complications after plastic surgery of the nose include:

• Infection
• Necrosis of skin, bone or cartilage
• Seam divergence

They arise due to medical errors or violation of the recommendations of specialists in the postoperative period. That is why it is very important to follow all the rules of rehabilitation and go to proven medical institutions.

Important! The final result of the nose plasty is assessed one year after the operation.

Advantages of rhinoplasty at MEDSI in St. Petersburg

• Experience of plastic surgeons. Well-known doctors of international level work in our clinic. They perform all types of rhinoplasty and help patients get rid of many imperfections related to the appearance of the nose and its functionality
• Possibility of a comprehensive preoperative examination. It is carried out within one day. In this case, the patient undergoes diagnostics and consults with doctors
• Modern techniques. Thanks to them, it is possible to shorten the rehabilitation period and reduce the risk of complications. Recovery takes place as quickly as possible and without unpleasant consequences
• Modern operating rooms and wards. All rooms in the clinic are equipped with everything necessary for interventions and patient recovery. The intensive care unit has all the possibilities for round-the-clock monitoring of vital signs of the body.We also have an intensive care unit
• 24-hour postoperative care. In the wards, patients are offered three balanced meals a day, the constant attention of the medical staff is guaranteed

If you want to make an appointment for a consultation before plastic surgery of the nose, to find out the approximate cost of the intervention in St. Petersburg, call +7 (812) 336-33-33. Our experts will answer all your questions. In the near future you will get an appointment with the operating surgeon.At the consultation, the doctor will announce the exact cost of plastic surgery of the nose in St. Petersburg in our clinic.

Daria Lymar revealed the details of the plastics of the priests

Daria Lymar
Photo: “Instagram”

The star of the reality show Daria Lymar finally did what she had dreamed of for a long time. Dasha corrected a serious, in her opinion, lack of a figure. In order to become the owner of luxurious buttocks, the girl underwent a six-hour lipomodelling operation.And after anesthesia, I woke up as a completely happy person. Daria Lymar spoke about how she feels after the surgery in an exclusive interview with Dom2Life.ru.

“I am lying on my back, they put special pillows on me. It hurts me very much to even just take a mug, and sitting is generally hell, my head is immediately dizzy, ” Daria shared with Dom2Life.ru, barely recovering from anesthesia. – The first three days are the most difficult. But I have already reached the bathroom to look at myself.There is a mirror, I stood on tiptoe and looked. ”

How it all began: Dasha Lymar makes plastic buttocks

According to the ex-participant, she is quite happy with her new buttocks. The surgeons coped with their task perfectly and pleased the girl. Now her butt looks quite proportional to the size of the fifth breast.

After the operation, special pillows were placed under Dasha
Photo: Daria Lymar’s archive

“I like the result, but it is not yet final, because there is still edema,” Lymar continued in an interview with Dom2Life.ru. – Plus, the doctor did not allow me to make a too big ass, there may be complications. I corrected the shape and slightly enlarged it. ”

From now on, Daria Lymar considers her figure to be ideal, but until recently she suffered from complexes about a flat priests, and it is because of this, the brunette believes, that she could not build a relationship on the project.

“I understand that I am a beautiful girl. But when you pay attention to something, you get hung up on it, but I lived in the Seychelles, wore swimsuits and constantly had complexes.Men feel all your fears. And so I got someone like Joseph. He can only date notorious girls, because he asserts himself at their expense. We once had a pillow fight.

We stood in a line, and Malyshev then said to me: “Dash, has your ass ever seen a sport at all?” I was hurt. A year of training in the gym! Then I just locked myself in the toilet and cried, ”Dasha Lymar admitted in an interview with Dom2Life.ru.

Now the figure of Dasha Lymar has become even more beautiful than before
Photo: “Instagram”

Her friend Lena Khromina helped the girl to get ready for the operation.For which Daria is very grateful to her.

“She took my hand and said:“ Dash, let’s make you an ass. I’m telling you as a friend. ” If not for her words, I would still be thinking, and not the fact that I would have made up my mind.

Lena was the only person who told me what I needed, helped me get ready and sign up for the operation. All the others twirled their fingers at their temples. Nobody supported, they said that everything can be done in the hall. Not all!” – says Daria Lymar.

The ex-participant advises all girls who are complex due to external data, without hesitation, go and do operations.Correct what prevents them from living normally.

“I woke up queen today. I just adore myself, I’m gorgeous. Everything is perfect for me. I have a beautiful butt, no tummy and sides, but I have my own, real big chest, and my figure is an hourglass. I dreamed about it for many years and I am happy! ” – concluded Daria Lymar in an interview with Dom2Life.ru.

90,000 What if you are unable to stand and sit due to back pain? | Eternal Questions | Question-Answer

Answer Professor, Doctor of Medical Sciences, Physician-Kinesitherapist Sergei Bubnovsky :

– I always say that osteochondrosis is not a disease, but a punishment for the wrong attitude to your body.

This is a kind of rust of the spine and joints that builds up during life due to lack of movement. The fact is that the entire vascular system is located inside the muscles, which facilitate the transport of blood and lymph to their destinations (brain, heart, internal organs, intervertebral discs and joints). Muscles are pumps, without which blood circulation is impossible without full-fledged work. Non-working muscles weaken and atrophy over time, and with them the vessels and nerves passing through these muscles atrophy.The blood flow and nutrition of the joints are impaired.

When dying, the muscles ache. These pains make you run to the radiologist to take pictures of the bones. The doctor says: osteochondrosis or disc herniation, prescribes pain pills, a corset, rest – in a word, everything that continues to kill muscles. It turns out a vicious circle. To break it, you need to act. Muscles cannot be cured by rest – only by movement.

What if you cannot stand and sit because of back pain?

“Walking on all fours”

I.P. – kneeling, hands on the floor, start moving around the apartment on all fours according to the principle: right leg – left hand. In this case, there is no axial load on the spine, only arms and legs work.

You can move around by wearing gloves and knee pads (or wrapping an elastic bandage around your knees) for 5 to 20 minutes, at the same time removing children’s toys from under the bed and wiping the baseboards. Anything is better than lying, moaning and swallowing pills.

“Press on the back”

I.P. – lying on his back, legs bent at the knees, heels on the floor, hands clasped behind the head. As you exhale “ha-a”, try to simultaneously tear your shoulder blades off the floor and pull your bent knees to your stomach so that your elbows touch your knees. Draw in your stomach towards the spine.

This exercise allows you to gently stretch the muscles of the entire spine, especially in the lumbar region.

See also:

90,000 It was painful for the delegation of the Syrian government to sit at the same table with the armed opposition

Head of the delegation of the Syrian government Bashar Jaafari / Photo informburo.kz

The head of the delegation of the Syrian government, Bashar Jaafari, during the final press conference on the results of the Astana process, was asked what emotions he experienced when he first sat down at the same table with representatives of the armed opposition.

“It was very painful for us to sit in the same room with other Syrians who are associated with foreign programs and work for foreign forces. Some of them even committed terrorist acts, attacks,” he replied.

Despite this, according to Jaafari, it is not the first time that the government delegation of Syria has to sit at the same table with representatives of the armed Syrian opposition.

“We have already sat down twice during the consultations in Geneva.This is not the first time that we sit together at the same table. But we will do this in order to save our country and our people. We do this in accordance with a certain framework, in accordance with special programs, regulations and in accordance with certain meetings. We don’t do it blindly. We think that after we carefully consider these frameworks, whatever the cost to us, we will continue to do so. In order to stop the bloodshed and terror in our country and among our people, “Bashar Jaafari added.

Note that earlier it was stated that in Astana on January 23, for the first time, representatives of the Syrian government and the armed opposition sat down at the same negotiating table and looked into each other’s eyes.

How to tell if a dog has pain: main symptoms

When your best friend is feeling bad, you want to help him. If you are not feeling well, you can simply take the right medication, such as a heartburn pill or a cough lozenge, but figuring out how to help your dog when he is in pain is not easy.Here’s what you can do if she gets sick.

How to understand that a dog is sick and sick

Some breeds will let you know by their behavior that something is wrong with them, they will whine, bark or generally behave anxiously. However, most dogs endure pain stoically without showing that they are suffering. They may be completely unable to let you know when they feel bad. Fortunately, there are signs that tell you that your dog is not feeling well.Subtle signs that your dog is in pain:

• Change in behavior: loss of strength or, conversely, inability to sit still.
• The dog looks socially withdrawn.
• Change in breathing (labored or rapid, and more shallow than usual).
• Loss of appetite and consumption of less water.
• Constant licking of certain places on the body.
• Increased heart rate.
• Bites, growls, or whines when trying to pick her up.
• Changes in mobility (abruptly refuses to climb stairs).

Keep in mind that only you, the one who knows your dog best, will be able to see the signs of a puppy feeling unwell.

Consult Veterinarian

First of all, if you notice any of these signs, make an appointment with your veterinarian.He will be able to identify the cause of the discomfort. Sometimes the injuries are obvious, such as a wound or broken bone, while other causes may not be as noticeable. Most often, the dog experiences pain for the following reasons:

• Arthritis.
• Bone cancer.
• Kidney stones.
• Ear infections.
• Pancreatitis or gastritis.
• Dislocation of the patella.
• Periodontitis.

How to relieve pain

The most common pain relievers your veterinarian can recommend for your pet is non-steroidal anti-inflammatory drugs (or NSAIDs), which act like ibuprofen or aspirin.Some experts recommend these medications to reduce pain, swelling, stiffness, and any other joint discomfort your pet may be experiencing. Some NSAIDs formulated specifically for dogs include carprofen, deracoxib, firocoxib, and meloxicam. However, many commonly used NSAIDs that are approved for human use can be toxic to your dog, so don’t give your pet your pain relievers – consult a specialist first.The Food and Drug Administration (FDA) offers an easy way to remember the signs of worrying NSAID side effects:

• Decreased appetite.
• Redness or flaking of the skin.
• Behavior change.
• Tarry stools, diarrhea or vomiting.

If you notice any of these signs, stop giving the dog immediately and contact your veterinarian.

Get rid of pain once and for all

Although pain relievers can be a temporary solution, the ultimate goal should be to get the dog out of pain completely. You can achieve this by changing your diet. The pain your dog is experiencing can be alleviated by changing his diet. According to Dr. Donna Solomon of the Huffington Post, foods rich in omega-3s can help relieve pain by relieving joint inflammation.

You can also help ease the pain of your pet by slightly adjusting its weight.Pain from pancreatitis and dislocated patella may worsen if the dog is overweight. To lose weight, try a nutritional formula designed to maintain a healthy weight, such as Hill’s Science Plan Adult Perfect Weight.

Physiotherapy can also be tried. It will help your dog recover from injury or arthritis. Ask your veterinarian about physical therapy options.

What not to do

If your dog is in pain, it may be tempting to give him something from your first aid kit.Do not hurry. Although NSAIDs approved for dogs are similar to conventional over-the-counter medications you can buy for yourself, they can be very dangerous for your dog. This is because the dosages dogs need can be very different from your dosages, or the drug can be metabolized differently. Just one tablet can aggravate your pet’s health problems and even lead to death.

Never give pain reliever to your pet without first consulting your veterinarian.A doctor who is well aware of your dog’s health problems will be able to recommend the right medication and dosage.

Nobody knows your dog better than you. If you think there is something wrong with him, trust your intuition and remember that the signs that your dog is in pain may not be obvious. Consulting your veterinarian is always a safe bet.

Kara Murphy

Kara Murphy is a freelance journalist and pet owner based in Erie, Pennsylvania.She has a goldendoodle named Maddy.

90,000 Coxarthrosis (osteoarthritis of the hip joint) – treatment of coxarthrosis in the Clinical Hospital on Yauza

11/01/2021

The article was checked by traumatologist – orthopedist Baleskov E.A. , is for general informational purposes only and does not replace specialist advice.
For recommendations on diagnosis and treatment, a doctor’s consultation is required.

Orthopedic traumatologists at the Yauza Clinical Hospital successfully treat coxarthrosis (osteoarthritis of the hip joint), including surgery – they carry out all types of hip arthroplasty, restoring the patient’s mobility and quality of life.

• Coxarthrosis (after arthrosis of the knee joint) occupies the 2nd place in terms of frequency among joint diseases.
• Loads from 1.5 to 6 times the weight of a person affect the hip joint during walking and running.
• At 1-2 st. coxarthrosis, conservative treatment is possible, for 3-4 tbsp. – surgery is indicated (usually hip replacement)

Make an appointment

How does osteoarthritis deformans of the hip joint arise?

The hip (h / b) joint is the most powerful in the body, bearing the main load in human movement. It allows for greater mobility while maintaining stability under the pressure of the entire body weight.Such pressure is a serious test for the articular cartilage, bone articulation – the acetabulum of the ilium and the articular head of the femur, which over the years leads to microdamage and degenerative-dystrophic changes in the joint.

Certain diseases also play a role. Sometimes, for various reasons, the joint fluid changes its properties and no longer protects the cartilage well enough from friction. It becomes thinner, damaged and no longer protects the bones of the joint, which leads to their deformation.Pain appears.

This is how coxarthrosis develops. This is a severe progressive degenerative-dystrophic disease of the TB joints, often leading to disability and disability.

Causes of DOA of the hip joint

The causes and factors contributing to the onset of coxarthrosis can be:

• Injuries and prolonged excessive loads on the hip joint (fractures, dislocations, fragmentation of the joint, as well as chronic persistent microtrauma in athletes, dancers).
• Congenital malformations of the hip joint, dysplasia (up to 90% of cases), chondropathy.
• Postponed inflammatory process (autoimmune – rheumatoid arthritis and other systemic diseases, infectious – tuberculosis, etc.)
• Metabolic Disorders
• Aseptic osteonecrosis

Most experts associate the development of coxarthrosis with a violation of blood microcirculation in the joint area, caused by various reasons – sedentary work, low mobility, endocrine diseases, etc.The situation is aggravated by excess weight and curvature of the spine, which create additional stress on the joints.

Without proper treatment, coxarthrosis leads to disability. The unbearable pain that appears at stage 4 of the development of the disease is poorly controlled even with strong anesthetic drugs. Don’t let the disease change your life for the worse. Make an appointment with your doctor to get adequate treatment and stop joint damage.

Degrees of coxarthrosis and symptoms of the disease

The symptoms of coxarthrosis usually appear in people over 40 years of age.Among them:

• Joint pain, often radiating to the groin, knee
• Gait disorder
• Limitation of range of motion in the joint
• Muscle atrophy on the affected side
• In severe cases – disability

The severity of symptoms depends on the severity of changes in the joint.

With coxarthrosis 1 degree , patients feel intermittent minor pain in the joint area that occurs at the beginning of physical activity, quickly passing after a short rest.The process of climbing and descending stairs is disrupted. The patient is able to work. The range of motion in the joint is preserved in full.

On X-rays, the minimum narrowing of the joint space is determined, minor bone outgrowths are possible. The head and neck of the femur are not changed.

Coxartose 2 degree . In the second stage, the pain intensifies, occurs with a slight load on the joint (when getting out of bed, standing, walking for a short time), is given to the leg (thigh, knee).The patient limps noticeably. The range of motion in the joint is markedly limited, the ability to work is impaired.

Radiographically, the narrowing of the joint space is determined by about 1/3, the head of the femur has an uneven contour, the neck of the femur is thickened.

With 3 degree coxarthrosis the joint hurts, both during movement and at rest, sometimes preventing the patient from falling asleep. Mobility is severely limited. The patient needs support while walking. In fact, he becomes disabled.

On the radiograph, the joint space is strongly narrowed, the joint is deformed – the head of the femur is irregular in shape with an uneven contour, the neck is wide and short.

In the early stages, it is easy to miss the progression of the disease. Symptoms are mild and often taken without seriousness. To check the condition of the joints and not miss the onset of the disease, make an appointment with a doctor and have an examination at a convenient time for you.

Diagnosis of the disease

A detailed survey and clinical examination by a traumatologist-orthopedist helps to identify the first signs of coxarthrosis.

The basis of diagnostics is radiography (computed tomography) of the joint. Already at the first degree of coxarthrosis, a slight narrowing of the joint space and the growth of bone tissue are determined. In the future, deforming osteoarthritis of the hip joint is manifested by deformation of the femoral head, thickening of its neck, the appearance of osteophytes (bone spines), and the narrowing of the joint space becomes more pronounced.

Magnetic resonance imaging (MRI) of the joint reveals changes not only in bone structures, but also in cartilage tissue, ligaments, and synovium.

Laboratory studies make it possible to exclude the presence of an inflammatory process in the body, to reveal signs of metabolic disorders.

If necessary, a diagnostic puncture of the joint is performed, followed by a study of the synovial fluid

Treatment of coxarthrosis

Conservative therapy

In the initial stages, conservative treatment of osteoarthritis of the hip joint can be effective, individually selected depending on the specific situation: the severity of the process, age, the presence of other diseases.

To relieve pain at any stage of the DOA of the hip joint, non-steroidal anti-inflammatory drugs are prescribed. Unfortunately, they have side irritating effects on the gastrointestinal tract, and their effectiveness diminishes over time.

Muscle relaxants can be used to relieve muscle tension and improve blood circulation in the joint area.

The restoration of cartilage tissue is facilitated by the use of chondroprotectors.

Apparatus traction, physiotherapy exercises, physiotherapy treatment, manual therapy, post-isometric relaxation (the patient strains and relaxes certain muscles, and the doctor stretches them during relaxation), osteopathy have a good effect.

Early diagnosis of the disease allows you to stop the development of coxarthrosis without resorting to surgery. If you are concerned about discomfort in the joints (even minor), urgently make an appointment with a specialist.This will allow you to detect the problem in a timely manner and select the most gentle treatment method.

To make an appointment with a doctor

Surgical treatment

Endoprosthetics of TB joint

With the ineffectiveness of conservative therapy, surgical treatment of osteoarthritis of the hip joint is indicated.

At the Clinical Hospital on Yauza, the most common and effective operation for severe coxarthrosis is carried out today – hip arthroplasty (its replacement with a modern prosthesis from the world’s best manufacturers DePuy, Zimmer, Smith & Nephew, Biomet).

Other methods of surgical treatment of coxarthrosis (DOA of the hip joint):

Arthroplasty – restoration of altered bone and cartilaginous structures

Osteotomy – The bones that form the joint are dissected and re-aligned in an anatomically more correct position. This operation sometimes helps to maintain the joint and its mobility.

Arthrodesis – rigid (motionless) fixation of bones in the joint area with metal braces and screws.It allows you to keep the leg as a support, but makes it motionless in the joint.

Rehabilitation after surgery

By the end of the first day after surgery, the patient begins to perform isometric exercises (tension and relaxation of certain muscle groups).

After 7-10 days, the patient can sit, get up, walk with crutches, both on a flat floor and on stairs.

It takes about six months to fully recover, during which it is imperative to engage in physiotherapy exercises.

Further, a complete restoration of physical activity and work capacity of the patient usually occurs.

Literature:

1. Koryak V.A., Sorokovikov V.A., Svistunov V.V., Sharova T.V. Epidemiology of coxarthrosis [Electronic resource] // Siberian medical journal (Irkutsk). 2013.
   https://cyberleninka.ru/article/n/epidemiologiya-koksartroza.

3. Juhakoski R.