Foot and Low Back
Pain: How they are interconnected
Previous to me becoming a Podiatrist I had no idea how interconnected
low back pain is related to foot and ankle problems. As a Podiatrist I have
good relationships with spine and back physicians since their patients suffer
from foot and ankle problems and vica versa.
How is the back
related to the foot and ankle?
The anatomy and physiology of the foot and ankle isn’t
exclusive to the foot and ankle. As a Podiatrist when I do a foot exam I focus
on 4 different components. I focus on the vascular system, dermatological exam,
an orthopedic exam and a neurologic exam. These 4 components of an exam are not
exclusive to the foot and they need to be investigated further if there is a
deficit in one of them.
In relation to back problems, I will usually see a deficit
in the neurologic exam in the foot.
What exactly does
this mean?
Let’s say a patient has a pinched nerve or disc degeneration
in the L4-L5 Lumbar Spine, which is causing them symptoms of pain in their low
back. They will most likely have numbness, lack of sensation, weakness or
burning in different parts of the foot. Many times a patient with low back pain
will complain of pain that shoots from their back to their feet. It is the
podiatrist and neurologist job to figure out if the pain is exclusively from
the back or if there is a foot component as well.
Many times when I have this dilemma of where the pain is
coming from I will order a Nerve Conduction Test and an Electromyography Test
(EMG). These tests will be able to determine exactly where the problem is
arising from.
How do you treat foot
problems related to back problems?
When a patient presents with back and foot problems I am
honest with them and I let them know that I will try to cure their foot and
ankle problems but they may still have residual problems in their back. Many patients
can be helped with their foot problems by changing their shoe gear, wearing a
custom orthotics, ice, stretching and even anti-inflammatory medication.
Physical therapy is a great modality which can focus on the foot and ankle as
well as strengthen the core muscles to help alleviate back problems. In
addition, there are medications to help with nerve pain, such as Gabapentin
(Neurontin) and Lyrica (Pregabalin).
In conclusion, when a patient presents with symptoms in the foot
and the back I like to take a multi system approach. I like to engage the
patient, myself, their neurologist or back specialists and a physical therapy.
Many patients with these symptoms present feeling that there is no treatment to
help them, but with a little effort their pain can be reduced significantly.
For more information, please visit our website at www.footnj.com
