SENIOR LIVING: When pain doesn’t tell the whole story

Could stubbing your toe eventually contribute to back pain?  

It sounds a little far-fetched, but sometimes an injury, or stiffness in one joint, can change the way we move, creating problems elsewhere.  Our bodies don’t move as a collection of separate parts. When we walk, climb stairs, reach into a cupboard or get up from a chair, multiple joints and muscles work together. If one part of that system isn’t doing its usual job, another area often must compensate. 

Take that stubbed toe as an example. 

If you badly injure your big toe, you may change the way you walk for a while. You might shorten your stride, put more weight through the outside of your foot or shift weight onto the other leg.  That’s a very normal response. Your body is trying to protect the sore area. 

Usually, as the toe gets better, your normal walking pattern returns. But sometimes it doesn’t.  A small change at the foot can affect how the ankle, knee, hip and pelvis move. Over time, those altered movement patterns may contribute to discomfort somewhere farther up the chain, including the lower back. 

That doesn’t mean every stubbed toe is going to cause back pain. However, it does illustrate an important point: where you feel the pain isn’t always where the problem started. 

Osteoarthritis can create a similar situation. For example, someone with osteoarthritis in the hip may gradually lose some hip movement, particularly if the joint becomes stiff or painful. Without even realizing it, they may begin taking shorter steps, rotating differently through the pelvis or relying more heavily on the other leg. 

The lower back may then be asked to provide movement that would normally come from the hip. A person may arrive complaining primarily of back pain, while limited movement at an arthritic hip is one piece of the puzzle. 

I have my own example. I had an elbow injury when I was eight years old that required surgery and a cast. There was no rehabilitation after the cast came off, and I never completely regained normal movement in that arm. My body adapted. Over the years, my shoulder and neck learned to compensate for my elbow, but it left me with recurring shoulder and neck problems. 

It’s one of the reasons I tell people that “it doesn’t hurt anymore” isn’t always the same thing as “I’ve fully recovered.” Physiotherapy assessment and care can be particularly valuable to optimize recovery outcomes. A physiotherapist looks for restored comfort but also movement, strength, balance and confidence. 

That can mean identifying a lingering limp after an ankle injury, restoring strength after joint replacement, improving movement following a fracture, or helping someone with osteoarthritis find ways to keep the affected joint, and the rest of the body, moving as well as possible.  

Compensation itself isn’t bad. In fact, it’s one of the clever ways our bodies keep us moving when something hurts. The key is ensuring a temporary workaround doesn’t become your new normal. If a new ache seems to have appeared “out of nowhere,” it can be worth thinking beyond the body part that hurts and getting help to identify contributing factors. 

Laura Lundquist is a physiotherapist whose passion for healthy active aging prompted her to open Zoomers Physiotherapy and Health Solutions in Halifax. More information about Zoomers’ health care and fitness services can be found at www.zoomershealth.ca or by calling 902-453-1525. Located at 291 Horseshoe Lake Dr., Halifax.