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The Chain of Pain: How Joint Pain Can "Spread" Through the Body.

Updated: 3 days ago

See this? This is my ankle, or lack thereof, about 6 hours after a fire ant bite; if you can't tell I'm very allergic. It happens about twice a year, I'll be mowing the yard in my neighborhood which is infested with fire ants, and one will sneak up my shoe and get me. Following a bite like this, my ankle is typically swollen for about 5 days, the first 2 of which I can barely walk due to the pain of putting pressure on my foot.

The Ankle pain would naturally be expected, but the knee and low back pain that accompanied it by day 3 may come as a surprise to some. After a few days of hobbling around the house attempting to maintain some level of productivity, I started to have some achy pain on the side of my left knee and I'd feel dull low back pain when I was standing. This may sound unusual but this apparent spreading of joint pain is just an accelerated representation of a problem that happens to many of us during our lifetime.

To understand why joint pain could seemingly spread like this (in a way that is not pathological such as with septic arthritis), we must think of the body as an engineer would. The human skeleton in motion is a chain of rigid structure (bones) that hinge at their connections (joints) in various ways and the motion of these structures is controlled by contractile pistons (muscles).

If we think of the body as this complex chain of joints and pistons then it becomes easier to understand how problems in one part of the chain can "spread" and cause problems in other parts of the chain. In the original example, I talked about my ankle pain eventually causing me knee and back pain, which at first may seem odd. But when we consider that without the proper function of the foot and ankle, the "hinge" joint that is the knee is stressed with every step, and the "pistons" which are the muscles of the lower back are having to work overtime to hobble and limp while keeping the body upright then the problem becomes more apparent.

Unfortunately, not all examples of this "chain of pain" problem are so apparent. In my case, it was very obvious that my (c)ankle was a big problem. It was the size of a baseball, but there are many people who may have subtle underlying problems in their calf or knee or some other part of their chain that are causing pain elsewhere and they don't know it. Someone with a fallen arch or a stiff ankle could develop pain in their knee or back just as I did, but in their case, this subtle problem in the chain could develop over the course of months or years instead of the 3 days it took me thanks to my fire ant allergy. Problems along the chain also aren't just limited to the ankle. Hip pain can cause back pain, a mid-back problem can cause shoulder pain, there are many potential connections in the pain chain.

So what can we do with this knowledge that problems can have far-reaching effects on the muscles and joints of the body? In our office we use this knowledge to get better results for our patients, providing them more lasting relief or resolution of their muscle, nerve, or joint pain. Instead of focusing our treatment strictly on where a patient complains of pain, we check for problems in the body's support structure. It can be the difference between providing a few days of relief and correcting an underlying problem giving them a permanent solution.

People who suffer from muscle or joint pain, especially chronic pain, should take a look in the mirror. Problems in the body's chain can be subtle, but if you look closely you may be able to distinguish a foot that points outward, an arch that looks fallen compared to the other, or realize that your belt is resting on your hips at an angle. Other signs to look for include only feeling comfortable standing with your weight on one hip as compared to the other, or difficulty performing unilateral exercises such as a lunge or single-leg squat with one side of the body. Although these problems aren't typically something you can fix yourself, your chiropractor can help address them. Once your particular problem has been examined and diagnosed, treatment of these problems can include manipulation of restricted joints, loosening or strengthening of particular muscle groups, or even orthotic support.

We often take for granted how complex our bodies are and all the things that have to go right in order for us to perform the daily tasks and motions we do without even thinking. Different parts of the body have to work together in harmony in order for us to do these things and when this harmony is disrupted consequences arise, not always where the problem is, sometimes further down the chain.

Thanks for reading, If you're interested about this topic and you'd like to read more about how the body's structures are connected and how they interplay with one another you might enjoy the book "Anatomy Trains" by Thomas W. Myers.

If you'd like to see an example of this "chain of pain" problem, check out this video we put together:


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