A patient asked me today about referred pain travelling up their back from a corn on their foot. This is something that most people intuit; If you have a problem with your foot that affects your gait you will find that you may start to get pain in your low back or even higher in the neck.
This particular patient had a corn in his left foot and he felt that this was causing the referred pain in his back; the fact that he was avoiding walking on the edge of his left foot caused an abnormal pull on the muscles in his legs, affecting his pelvis and low back.
He asked me “ Is that how it goes, from the left foot to the right side of the low back?” I had to answer that I did not know. In fact no-one can know. The body is a very complex moving “machine”. There is a whole science build around complexity, analysing complex systems such as weather patterns or economics. In most cases if you make a small change in some part of the system you cannot predict the outcome. This brings to mind the well known butterfly effect where a butterfly flapping its wings in the Amazon rainforest can cause a storm somewhere else in the world. So a corn on the foot could cause a migraine (but it probably won’t!)
Basically things affect other things and we cannot exactly predict outcomes. However, what we can say is that if you alter your gait due to a problem in your foot, it is likely to have a knock on effect that moves up the body, putting pressure on tissues in different places. We can also say that the points of stress on tissues often swap sides of the body. So, a corn on the left foot might put excess stress on the right knee, the left side of the pelvis, the right side of the mid back and the left side of the neck…. Or you may find that the opposite happens; strain is put on the right side of the pelvis, the left side of the mid back and right side of the neck. Or some other strain pattern may emerge.
We can ascertain the pain/strain pathway by simple observation; where the strain and pain is experienced, where the muscles are tender and where you can see subtle bends and twists in the body.
A problem in one part of the body can reflect and cause referred pain in other parts via a number of different mechanisms. The chiropractor’s skill lies in diagnosing the root cause(es) of a problem, and working out what effects this has had on the body. When you know the cause and the effect the treatment is straightforward.