Lower Extremity Pain

What’s Really Going On?

Lower Extremity pain is an umbrella term for pain affecting the Hips, Upper Legs, Knees, Lower Legs, Ankle/Foot complex, and Toes. Generally, not all components are included in lower extremity pain, however there are commonly multiple areas in the kinetic chain of the lower extremity affected once one area is due to the intimate anatomic association between all listed structures.

Hip Pain is defined as pain localized to the hip joint and surrounding structures including the joint capsule, hip labrum, muscles, tendons and ligaments. Hip pain is the second most common lower extremity pain complaint treated at Evolve Chiropractic.

Upper Leg Pain is defined as pain localized to the musculature and fascia of the upper leg, most commonly affecting the quadriceps group and hamstring group.

Knee Pain is defined as pain localized to the knee joint, and can have more complex underlying causes due to the supporting menisci and ligaments both within and surrounding the knee joint. Knee pain is the most common lower extremity pain complaint treated at Evolve Chiropractic.

Lower Leg Pain is defined as pain in the musculature, and fascia of the lower leg, most commonly affecting the gastrocnemius and soleus muscles, which comprise the calf, and the tibialis muscles, which when irritated initiates ‘shin splints’.

Ankle and Foot Pain are defined as pain in the ankle joint, the tarsal bones of the foot, metatarsals of the foot and numerous surrounding muscles, tendons and ligaments connecting in the area.

Toe Pain is defined as pain in any of the toes, most commonly affecting the first toe and the first toe joint.

Some of the most common conditions causing lower extremity pain include joint misalignment, muscular tightness, tension and trigger points, sprains and strains, sport-specific traumas, overuse, repetitive motion trauma, fractures and dislocations, general stress, shin splints, tendonitis, plantar fasciitis, turf toe, gout, diabetes related pain, sciatica, restless leg syndrome, and “down-river” neurological symptoms from lumbar disc herniations.

How Does Evolve Chiropractic Treat Lower Extremity Pain?

While we believe no two conditions are the same, at Evolve Chiropractic we have a similar systematic approach to our treatment of conditions causing Lower Extremity pain. We utilize an innovative three phase treatment protocol beginning with our Relief phase, where we initiate immediate pain relief. Once the majority of patients’ pain complaints are reduced, we can graduate to the Recovery phase, where we build the foundation for lasting pain relief, and complete functional recovery. And finally, patients progress to our last phase of care is the Rehabilitation phase, where we stabilize and strengthen the supporting tissues to prevent reinjury.

The length of care in each phase, and treatment modalities received in each phase depend on patient presentation in the clinic, underlying condition/cause of pain, contraindications to care, and previous medical and chiropractic health histories. However, some of the typical treatment modalities we utilize in care for Lower Extremity pain include chiropractic manipulative therapy, manual muscular and fascial release therapy, trigger point therapy, voodoo flossing, intersegmental traction therapy, percussion therapy, cupping therapy, dry needling therapy, heat/ice therapy and CBD application.

What Is The Underlying Condition To My Pain?

There are many different causes for lower extremity pain - here are a few of the most common conditions causing these pain complaints.

HIP:
1. Hip Tendinitis and Bursitis - Inflammation of the tendons surrounding the hip, or the bursa, which is a fluid filled sac allowing proper motion of structures surrounding the hip. This generally presents as a chronic dull, achy pain that becomes a more intense sharp and burning pain with activity.
2. Trigger Points - Local areas of inflammation in the muscle bellies surrounding the hip. These can present as either local pain, or they can refer pain from the hip to low back or down the leg.
3. Sprains and Strains - Sprains affect the ligaments, and strains affect the musculature. Both of these are traumas to supporting structures of the hip. These are generally seen in active individuals and competitive athletes.
4. Hip Labrum Injury - The labrum of the hip provides stability to the joint, and can be injured with compression forces and rotational forces as well. This injury is typically seen in active individuals and competitive athletes who are either extensively running, tackling, or performing explosive rotational activities such as hitting, punching, throwing or swinging.
5. Degeneration and Arthritis - Degenerative joint changes happen to many of us as we age. While no one can fix the bony changes associated with degeneration, we can certainly provide palliative care to alleviate pain associated with degenerative and keep you engaged in all the activities you love.
6. Sciatica Pain - Sciatica has become an umbrella term for burning pain radiating down the leg from the low back or hip. This is due to a compression of the sciatic nerve, either by a lumbar disc herniation or because of the piriformis (piriformis syndrome) near your hip. Sciatica pain can be extremely debilitating for individuals experiencing it. Sciatica can easily be mistaken for restless leg syndrome, which is an overactivity of the nerves in your legs.

KNEE:
1. Iliotibial IT Band Syndrome - Tightness of the IT band, which is a connection of the gluteus and tensor fascia lata muscles to the tibia can cause a chronic dull, achy pain on the outside of the knee. This can occasionally be accompanied with a popping sensation during flexion of the knee.
2. Knee Tendinitis and Bursitis - Inflammation of the tendons surrounding the knee, or the bursa, which is a fluid filled sac allowing proper motion of structures surrounding the knee. This generally presents as a chronic dull, achy pain that becomes a more intense sharp and burning pain with activity.
3. Sprains and Strains - Sprains affect the ligaments, and strains affect the musculature. Both of these are traumas to supporting structures of the knee. These are generally seen in active individuals and competitive athletes.
4. Internal Knee Meniscus and Ligament Disruption - The meniscus and ligaments inside the knee joint both allow for smooth motion of the knee, while limiting unnecessary or unwanted motions of the knee. These structures can be injured with trauma or explosive movements, and while many opt to have surgical repair of these structures, individuals who are not competitive athletes may choose the more cost-effective route of conservative care to treat these conditions. Generally individuals who have an internal disruption of these structures know immediately, as they are accompanied by severe inflammation and swelling, instability of the knee, and severe pain.
5. Locking Syndrome - This is an issue with the popliteus muscle, behind your knee. Generally this presents as pain and clicking with full extension of the knee.
6. Degeneration and Arthritis - Degenerative joint changes happen to many of us as we age. While no one can fix the bony changes associated with degeneration, we can certainly provide palliative care to alleviate pain associated with degenerative and keep you engaged in all the activities you love.

ANKLE:
1. Sprains and Strains - Sprains affect the ligaments, and strains affect the musculature. Both of these are traumas to supporting structures of the ankle. These are generally seen in active individuals and competitive athletes.
2. Joint Misalignment - Joint pain can either be local pain or can refer down into the feet and toes. This misalignment is a signal sent to the brain interpreted as pain, and responds extremely well to chiropractic care.
3. Shin Splints - This is an umbrella term, referring to inflammation of the tibia due to overuse of the musculature surrounding the tibia. This most commonly affects active individuals and competitive athletes involved in running, jumping, dancing and skating.
4. Degeneration and Arthritis - Degenerative joint changes happen to many of us as we age. While no one can fix the bony changes associated with degeneration, we can certainly provide palliative care to alleviate pain associated with degenerative and keep you engaged in all the activities you love.

FOOT/TOES:
1. Plantar Fasciitis - Inflammation of the plantar fascia on the bottom of your foot. This can present as pain near the heel, extended forward to the underside of your big toe. The plantar fascia can become contracted, and cause severe, debilitating, chronic pain for individuals affected by this condition.
2. Joint Misalignment - The tarsal bones of the foot and metatarsal bones of the toes can become misaligned during strenuous activity, sending a signal to your brain which is interpreted as pain.
3. Fat Pad Syndrome - This is an inflammation of the fat pad underneath your heel, and is commonly mistaken for plantar fasciitis. This condition will present as pain with walking, or pressure on the bottom of your heel.
4. Turf Toe - Turf Toe is an extension injury to the big toe. This is generally seen in active individuals or competitive athletes who commonly have to plant, cut and quickly create lateral movement. This presents as severe pain at the big toe, worsening with pressure and any bending of the big toe.
5. Sprains and Strains - Sprains affect the ligaments, and strains affect the musculature. Both of these are traumas to supporting structures of the foot and toes. These are generally seen in active individuals and competitive athletes, however they are much less common than ankle sprains and strains.
6. Gout Pain - Gout Pain generally presents initially at the big toe, and is associated with a diet heavy in meats and wine or other alcohol. In some individuals, this diet creates a build up of uric acid in joints and presents as arthritis type pain. Evolve Chiropractic is dedicated to working with you, and your primary care physician and nutritionist to help provide palliative care with Gout pain.
7. Diabetes Pain - Diabetes, when poorly controlled, can cause severe pain and neuropathy starting in the feet and spreading through the extremities. There is an associated loss of sensation when left untreated, which can lead to further diabetes-related complications. Evolve Chiropractic is dedicated to working with you, and your primary care physician and nutritionist to help provide palliative care with Diabetes pain.

Do you think you’re suffering from one of these conditions? The good news is they respond quite well to the lower extremity treatment protocol at Evolve Chiropractic! Let us help alleviate your pain today.

Do You Have Research Backing Your Treatment Protocol For Lower Extremity Pain?

Evolve Chiropractic prides itself on being the gold-standard for evidence-based chiropractic care, and we are happy to provide all resources backing our treatment protocol upon request for individuals who would like to learn more in depth about our profound impact on lower extremity pain.

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