LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Hip Pain

Tylenol for Your Pain; Surprising Finding on How Well it Works

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Tylenol for back pain
Radosław Brzozo / Dollar Photo Club

Society would never consider going without over the counter pain meds. Doesn’t matter what’s it’s for; headaches, knee pain, shoulder pain, back pain.   We don’t seem to care where the pain is; that magical little pill hones in with radar precision to zap the pain and give you relief.

Or at least this is what the advertising messages would have you believe.

For starters, there is no magical honing; all drugs reach all areas of the body.  This is one of the reasons why so many side effects occur in organ systems that have nothing to do with the reason for taking a drug in the first place.

Personally, I haven’t taken any over the counter or prescriptive medications for at least 20 years (it may have been longer—I just can’t actually remember…) despite my share of martial arts injuries over the years.  But I certainly have my share of patients who take them on a regular basis.  We’ve become somewhat immune to the idea that every drug has a risk / benefit ratio.  There is not a drug out there that does not have side effects; since every single drug interferes with the way your body functions to some degree or another this is inevitable.

Paracetamol, the active ingredient found in Tylenol and generic acetaminophen, has a long list of side effects.  Just some of these include:

But, as mentioned, sometimes the side effects are worth the risk (although anyone on the liver or kidney transplant waiting lists may disagree…) so long as there are benefits.

But what if what you’ve been taking your Tylenol for really doesn’t work?  I can tell you that it certainly seems like many of my patients who are in pain and take many of the OTC pain medications aren’t jumping up and down for joy over how well they work (because, after all, they are in a chiropractor’s office looking for additional pain relief.

At the most, they seem to help “take the edge off” or help for a few hours at the most.  This particular study seems to agree with what I’ve experienced in my office.  In it, researchers looked across 13 different clinical trials looking at the use of paracetamol for back pain, knee or hip arthritis pain.  In the review, the researchers looked for the quality of the studies to see what the outcomes were.  Here’s what they found:

  • High quality results from the studies found that paracetamol is ineffective for reducing pain intensity and disability or improving quality of life in the short term in people with low back pain.
  • High quality results from the studies found that paracetamol used for hip or knee osteoarthritis for that any short-term improvement on pain and disability was not clinically important.
  • High quality results showed that those taking paracetamol were nearly four times more likely to have abnormal liver function tests.

When it comes to research, there are no absolutes and no single study can determine whether something works or not. To make it a little more complicated, there are good quality and bad quality studies.  But when you have multiple high quality studies pointing to the same outcome, you can be far more confident that the results from that study may apply to you.

That’s what we have here.  Could you be one of the few for whom Tylenol is going to work for back, knee or hip pain?  Possibly.  But it should not be your first choice given that there is a long list of side effects associated with the use of Tylenol and this review strongly suggests that it is not going to work.

Of course, being somewhat biased towards chiropractic care for these conditions, I would strongly suggest that chiropractic care should be your first choice for treatment of these conditions.

Hip Pain Not Related to Structural Damage – (03-08-01)

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Hip Pain Not Related to Structural Damage

Any good chiropractor could come to this conclusion without all the money spent on a study. So many times I hear patients coming in saying “My doctor told me I have arthritis.” Guess what?? If you’re over the age of 25, you’ve got arthritis. We can not always rely on X-rays for a diagnosis.

Hip Pain Causes–It May Not Be What (or Where) You Think

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Nothing slows you down like pain in hips. But sometimes hip pain causes may not be coming from the hip and it takes an experienced physician to tease out answers.

First, though, this is one of those blog posts that I need to make full disclosure up front.  I’m going to be biased.  There.  Now we can move on…

As a practicing chiropractor, patients come into our office with all types of complaints.  Only rarely do they present with textbook-like cases that are as clear cut as putting together an IKEA desk (ok…so maybe a little easier than following that little guy scratching his head…).

The point is, the value in chiropractic treatment is that we understand the pain that our patients experience.  We understand that just because it hurts HERE does not mean that HERE is where the problem is.  This knowledge comes from years of study in school (chiropractors get FAR more education on the musculoskeletal system than any other physician out there) and is honed with years of clinical practice.

This is why the patient who has been getting epidurals for a year to treat her “sciatic” pain was better in 2 visits with a heel lift and some work on the hip in our office.

This is why the patient who was told they have a disc problem (because it was found on an MRI that shouldn’t have been ordered in the first place) really just had joint dysfunction in his back that was better in 2 chiropractic treatments.

It is why a long term patient who’s MRI of the shoulder led her to 2 surgical recommendations, but I explained that what she really needed was a quick steroid injection to control the inflammation caused by a vaccination.

This is why chiropactors shine at treating musculoskeletal pain.  And sometimes, our diagnosis is not really ironed out on the first visit.  I usually tell patients that, if they REALLY want to know what is causing his or her pain, I recommend autopsy.

It is common for a patient to present to our office with low back, hip and leg pain.  Believe it or not, far too commonly a diagnosis can’t be made with clear cut certainty.  An MRI can be a very bad idea here (and what do we order?  A lumbar MRI?  A hip MRI?  Xrays?).  The answer?  Diagnosis made by clinical response to treatment.

I think it’s a hip, so I treat the hip for a visit or two.  Disc problem?  We start a protocol of Flexion Distraction.  Sacroiliac joint dysfunction?  Soft tissue work, stretching and chiropractic manipulation.  If the patient gets better, I was right.  If the patient doesn’t get better, time to move to the next likely diagnosis.

That’s why they call it “practice.”

But what about that 5 minute consultation with the orthopedic or neurosurgeon (after waiting in the waiting room for 2 hours past your appointment time)?  If it takes me, a seasoned chiropractor who thinks he’s pretty good, several visits to pin down more exactly what is going on with a patient, how can it possibly be done in 5 minutes?

It can’t.  And maybe this is why surgical outcomes are so unpredictable.  I can’t tell you how many times I’ve had a patient undergo some type of surgery for something that clearly was not causing the pain.

So why all this rambling?

Of course it has to do with this particular study looking at arthritis in the upper lumbar spine and hip pain.  Researchers looked at the presence of self reported hip pain and the presence of arthritis in the upper lumbar spine in over 2800 patients aged 55+.  Here’s what they found:

  1. Those with disc space narrowing at L1/L2 (the top part of the lumbar spine) had double the likelihood of hip pain in the last month for men.
  2. For women, the increased risk was 70%.
  3. For reported chronic hip pain in men, the likelihood of having disc space narrowing at L1/L2 jump to 2.5 times more likely.
  4. Disk space narrowing at the lower levels (L3/L4/L5/S1) was not associated with hip pain.

What does this mean?

It means that if you have hip pain, you need to see a provider who understands the way the body works (hint, hint, wink, wink).  If not, you may get that hip replaced when it wasn’t the problem.

But heck–hip replacement surgery these days is a cake walk, right…?