Where Does Your Foot Pain Come From?
This week's post is going to be a little different. I would like to tell you a little story about a patient who came back into my office last week. "Joe" returned to the office last week to discuss a recent recurrence of his lower back pain, and mentioned, casually, that he has been dealing with pain in his feet too. He then told me that they "aren't related at all." After glancing at him sideways, I recommended that it was probably best if I made that determination. "Joe" was a little taken aback, but gathered his thoughts and sheepishly asked me what I knew about feet. He thought that we only knew about backs... It was time to teach "Joe" a little about how the body functions as one big unit.
Bear in mind that I have been seeing "Joe" off and on, over several years, primarily for episodes of his lower back pain. I have met his wife, his children, and even a couple of his grandchildren. The simple exercise routine that he has been doing since we first met has been limiting the frequency and intensity of his episodes of lower back pain (which explains why I haven't seen him in years). Unbeknownst to me, in an effort to lose weight, he recently decided to start running, despite the fact that he has never run before in his life. You can probably guess where this is going... He began running about 4 months ago, and his "foot pain" began approximately 3 months ago... He spoke with his primary care doctor about it briefly, and was advised to "take Aleve and call back if it doesn't get better." While he was taking the Aleve, the pain was less intense, so he continued to run... Do you see the problem with that thinking??? The Aleve, in this case, decreased the pain intensity, but it certainly did not address the CAUSE of the foot pain. "Joe" continued to run, until the Aleve did not even help his foot pain anymore, and then came the lower back pain. Do you see why I told him to let me determine whether they were related or not?
After the conversation, we began to do our evaluation of his problems. As you can probably guess, the foot and the lower back were related. The primary issue was with the hip. Drastic changes in activity levels can cause significant problems to pop up in areas that have never been a problem before. “Joe” had difficulty with controlling his hip which either directly caused, or at the very least contributed to his foot AND lower back pain. To better explain this to “Joe” I asked him if he had ever needed to replace the tires on his car. He replied “Of course I have.” My next question was “Do you think that it happened because the tires were bad? Or do you think that the alignment caused them to wear out faster?” He thought about it for a minute and realized what I was getting at.
Time for the happy ending! After two weeks of treatment, “Joe” has changed his exercise routine to include more hip and ankle mobility drills, and a little tweak to his core stability routine, and has noticed that his lower back pain has cleared up almost completely, and his foot pain is 50% reduced already! It feels better now than it did when he was taking the Aleve…
To make a long story short…
Remember that pain in your foot may not be caused by the foot!
Dr. William "Chip" Bleam