Hip Pain

What does it have in common with diabetes? The vitamin D link.

Keywords; hip pain, osteoporosis, vitamin D, diabetes, metabolic syndrome, chiropractic help.


Several months back we mentioned in our newsletter, issue number 18, the importance of a walk in the sunshine to get your vitamin D levels up in order to prevent hip pain. The problem though is that the further from the equator you live, the less skin there is exposed to that sunshine in the winter months; what's more the sun has precious little power for about four months of the year if you live far from the equator.

A vitamin D deficiency is linked not only to osteoporosis and broken bones, hip pain, but new research also links it to diabetes and metabolic syndrome.

Two new studies have uncovered evidence that low levels of vitamin D could lead to poor blood sugar control among diabetics and increase the risk of developing metabolic syndrome among seniors.


Metabolic syndrome is a grouping of four health risks factors.

  • high blood pressure
  • abdominal obesity
  • abnormal cholesterol levels 
  • high blood sugar.

Diabetes

With new research indicating that both type one and two diabetes has increased dramatically amongst the young in the last decade, there is extreme concern about future health trends. Diabetes before entering into the reproductive phase has serious implications, and not only for musclo skeletal health.

Read more about this at our osteoporosis and diabetes link. Use the search function in the navigation bar.


These two new research studies are pertinent to our current interest in the hip pain and diabetes link.

Study 1: Johns Hopkins Medical School

Researchers reviewed over 100 type two diabetes patients who sought care at an endocrine outpatient facility. More than 90 percent of these patients, aged between 36 and 90 had either Vitamin D deficiency or insufficiency, despite the fact they had had consultations with their primary care practitioners before their consult with a specialist.

About 6 percent of the patients were taking a Vit D supplement at that specialist consult.

Those who had lower Vit D levels on blood tests were also more likely to have high average blood glucose readings.

This finding supports the role of vitamin D in the development of type two diabetes, said Dr Krug, in a statement from the endocrine society. Since primary care providers diagnose and treat most patients with type two diabetes, testing and vitamin D supplementation would improve the general health outcomes of this increasingly common disease.



Study 2: The Netherlands VU University Medical Centre

A second study involving nearly 1300 white Dutch men and women over the age of 65 found almost half were Vit D deficient, while nearly 40 percent had metabolic syndrome.

Since metabolic syndrome increases the risk of diabetes, heart disease and stroke, sufficient vitamin D in the body may be part of the management of diabetes and preventing these diseases.

Regardless of their sex, those patients with insufficient amounts of vitamin D in their bodies were more likely to have this combination of signs known as metabolic syndrome than those with adequate amounts of Vitamin D.

It is vital, added Eekhoff, to investigate the exact role that vitamin D plays in diabetes, and to find new ways to prevent this increasingly prevalent disease and the cardiovascular diseases associated with it.     


The best nutritional sources of Vitamin D are fatty fish like salmon, mackerel, herring; and cod liver oil supplements.

The heart foundation recommends eating fatty fish at least twice a week. The omega 3 in fatty fish helps keep your cholesterol levels in order, and Vitamin D is vital for a host of factors; not only for metabolic syndrome, but also in osteoporosis and the inevitable ensuing hip fracture and severe hip pain and disability.

A walk in the sun increases vitamin D levels, and strengthens the bones, doubly decreasing the risk of osteoporosis. It's the loss of independence more than the pain and cost of a pin or total hip replacement that so disrupts the lives of patients with osteoporosis.

Save yourself from hip pain, diabetes and heart disease with fatty fish. That could be a fish soup or, perhaps just a simple smoked salmon dip recipe.  

On a personal note I eat smoked mackerel, or pilchards, and less commonly salmon several times a week. They are rich in both omega 3 and vitamin D, and have a high quality protein.


The Right Bed

There's no perfect bed, but do consider Memory Foam Mattresses ...


Chiropractic Help for hip pain

It is goes without saying that the right bed is vital if you are suffering from hip pain. Or even if you have a perfect back. Skimp on your bed and you'll simply spend the money on your chiropractor, or worse a surgeon.

I recommend the Dutch option; two mattresses on one double bed.

If you are suffering from significant side of the hip pain, sometimes laying a series of pillows across the bed, with your hip squarely placed on the pillow may give some relief at night. This can be caused by a hip condition, per se, or a referral from a sacroiliac subluxation, or a femoral nerve lesion in the upper lumbar spine.

Chiropractic helps by reducing these subluxations, followed by a vigorous rehabitiation programme of the offending joints. 

Just yesterday an interesting anecdote from the trenches; an elderly lady was suffering from severe side of the hip pain. Unable to sleep she was miserable. Two hip replacements appeared in order, but the right sacroiliac joint was fixated like it had been dipped in concrete. Within ten minutes, using the Thompson drop protocol, she was a new woman. I've no doubt that next week when she consults me again for follow up, that it will be less than optimal. Rome wasn't built in a day, nor is stubborn hip pain resolved in a week. 


Here are some simple ways to increase the fatty fish in your diet.

My favourite, simply because of ease, is smoked mackerel and canned pilchards or sardines that have not had the fat extracted. Sometimes, in the mistaken belief that we should drastically reduce the fat in our diet, in order to lose weight, we might buy fish served in brine. That extracted fat is then processed into omega 3 capsules at ten times the price; eat full fat fish. 

It's not the solution ot obesity. Cutting out the essential fatty acids that coat our nerves, fill our brains and supply the neurotransmitters and hormones in our bodies makes absolutely no sense. Eat your fatty fish, and learn about the role of the glycemic index of carbohydrates in order to lose weight; it's processed carbs in the main that makes us fat. 

Fish soup is one very quick and easy way to provide variety to the fatty fish in your diet. A good fish soup is to die for. Try this recipe that I managed to squeeze out of a small Portuguese restaurant in Leeuwaarden in Holland.

This smoked salmon dip recipe you can rustle up in minutes. By spreading your biscuit with a protein and fat rich spread, it dramatically reduces the otherwise high glycemic index of many rolls, breads and biscuits.


Melanoma

Don't rely on the sunshine for all your vitamin D, remembering that excessive exposure to the sun causes potentially serious skin diseases. Always wear a hat in the summer months, but in those midwinter months, far from the equator, you might give the hat a miss if you have healthy skin.



Alcohol and hip pain

Alcohol causes one in twenty deaths according to the World Health Organisation. A third of those deaths are caused by the connection between booze and cardiovascular disease and diabetes.

Alcohol inhibits calcium absorption and because it affects the liver, the activation of vitamin D is reduced. Although it does not cause an insulin rush, alcohol does have a negative impact on the pancreas.

No question of it, alcohol in excess plays a very important role in brittle bone disease. Add to that more falls on the buttocks whilst inebriated, subluxating the sacroiliac joint and causing fractures in the pelvis, and you have a strong association between alcohol and hip pain.

Coupled with a poor diet, deficient in green leafy vegetables, fruit, and whole grains - a vitamin B deficiency - and you have a catastrophe.


Femoro Acetabular Impingement syndrome

A fairly common hip abnormality is one of the major causes of hip pain and arthritis. Because it reduces the flow of nutrients and oxygen to the cartilage lining the hip this stiffness is the main cause of cartilage degeneration until there is bone on bone. Hip pain. 

I'm convinced that if young people with this stiff hip condition were to exercise them daily, we'd have far less surgical procedures later in life. Femoro Acetabular Impingement Syndrome is a silent disease, like diabetes, in its early stages; it's rare detected until full blown. 

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Interesting challenges of the day

1. Mrs D, a 78 year old woman has very severe sacroiliac joint pain, and even more severe cramps in her right leg. There are two problems; she is on two diuretics but no slow K. Taking her temporarily off one diuretic and adjusting the SIJ brought 50 percent relief within four days. 

2. Mr S, a 48 year old man, has right low back pain, groin pain and a numb feeling in his lower leg when he sports. For six months he's been off football. He too has two problems; a very treatable lumbar facet syndrome and a very serious blocked artery in the groin; it's called intermittent claudication. Smokers beware.  

3. Mr S looks like the leaning tower of Pisa; he has a slipped disc at L5 making him lean towards the opposite side. It's called the postero lateral disc hernia; we'll fix it, but he has to stop for a week or two. Antalgias are serious so take them seriously. 

4. Mrs V too has  two conditions; a chronic low grade sciatica giving her an ache in the right leg, and a threatening Morton's neuroma. She's glad I'm back in Holland; chiropractic fixed it before, and we'll fix it again. 

5. Mrs W is one of the lucky ones, says her doctor. I agree. He says only 40% of patients with lumbar stenosis have a successful operation. We fixed a nasty slipped disc three years ago, but it came back two years later; the surgeon did a fine job but she has a weak ankle now giving her subtalar joint pain; it's routine stuff. 

6. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment of the new strain by my colleague has fixed the pain in the lower back, but there's some residual numbness in the lower leg; no soaring tomorrow alas.

7. This lady is a 86 year old woman with a 63 scoliosis. Chronic lower back has been her lot in life but she's well pleased with chiropractic and comes for chiropractic help once a month; some conditions you can never cure.

8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.

9. A 61 year old man with upper cervical pain yesterday; it's not severe but also not getting better of its own accord. He's afraid it may turn very acute as when I treated him three years ago. Since then it's been fine. 

10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.

13. Mrs B has had one of the nastiest of conditions; vertigo caused by a disturbance in the inner ear. Falling repeatedly and vomiting she consulted her doctor but medication didn't help. After two sessions of the Epley manoeuvres she was 50 percent better. After two weeks 75 percent improved. No longer vomiting all falling. She's not enjoying the Brandt Daroff home exercises.

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?


Interesting questions from visitors

CLS writes:

Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.


You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.

The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.