Do I need a Physio?

[dougcalv]

I need an opinion.

I have arthritis in the big toe joint of my right foot. That is the only place in my body that I have arthritis.

I have been to a podiatrist who gave me orthodontics for my shoes. This helped with the pain in the toe joint.

I have also developed pain on the left side of my neck which I have been to a Chiropractor for. With not much success. I also have periodic tightness in my Gluteus Medius and Quadratus Lumborum on my left side. Recently I was treated for inflamtion to my peroneus brevi tendon at the insertion point on the fifth metatarsal.

I believe that all these other problems are related to my compensation for my toe problem.

I have been to a doctor for the bottom problem and the top problem.

Would a Physiotherapists be able to look at my problems as a connected whole and help me?

[dougcalv]

Is there anyone one here who has an opinion?

[Quickstart]

Hi Dougcalv,

Certainly if you sustain an injury or have a problem with a joint in your foot, it can create some other, compensatory, changes in the rest of your body, including in your back/gluteals and possibly in your neck.

A few questions:

a.) How do you know you have arthritis in that joint? Did you have an X-ray? Or is it just stiff and sore? How old are you?

b.) How much activity do you do? What are your main problems? The foot? The back? The neck? You mentioned that your QL and GMed were tight, how do you know and do they cause you pain or are they just tight?

c.) What are your goals out of going to physio? What exactly is the problem?

I honestly cannot say definitively that a physio is going to help you, just as you could not ask an oncologist if they are going to get rid of your cancer for you. But I can tell you that you're probably going to get a more definitive answer if you go in for a proper assessment. Really it all depends on what your problems are, which can only be done when we look at you as a whole and in person.

Asking a physio to try and diagnose a problem like this is much like asking a doctor to tell you what infection you have without being able to see the blood results. Bloody difficult! What I can tell you is that physios are trained to look at biomechanics, and the movement of the body parts in relation to the whole. Obviously I am biased, but I would be putting your money on a physio before a doctor or chiropractor.

[dougcalv]

Thanks Quickstart for your reply. I fully understand that I cannot be diagnosed without being seen. I have an appointment with Orthopaedic Surgeon specializing in Sports Medicine and Total Joint replacement this Monday. This is my way of trying to get to a PT and still have insurance pay.

I will answer the question below point by point.

Originally Posted by Quickstart

Hi Dougcalv,

Certainly if you sustain an injury or have a problem with a joint in your foot, it can create some other, compensatory, changes in the rest of your body, including in your back/gluteals and possibly in your neck.

A few questions:

a.) How do you know you have arthritis in that joint? Did you have an X-ray? Or is it just stiff and sore? How old are you? Xray showed narrowing and spurring of the joint. I am 48.

b.) How much activity do you do? What are your main problems? The foot? The back? The neck? You mentioned that your QL and GMed were tight, how do you know and do they cause you pain or are they just tight? I am fairly active. Do a golf specific workout 3/wk. Foot is main concern. QL and GMed get sore after a lot of walking. I work them with foam roller and tennis ball.

c.) What are your goals out of going to physio? What exactly is the problem?
To try and be able to live with the bad toe without compensations. And if surgery is the only solution then I want to know and either live with discomfort or have the surgery

What I can tell you is that physios are trained to look at biomechanics, and the movement of the body parts in relation to the whole.This is what I want. The Chiro could not fix the neck in isolation and the Podiatrist could not fix the foot in isolation.

Obviously I am biased, but I would be putting your money on a physio before a doctor or chiropractor.I totally agree

[Canuck Physio]

There are some specific physiotherapy modalities that can be used, however, certain nutritional compounds may also need to be considered in conjunction to this. Additionally, exercise in and of itself may be important. I am an avid proponent of physio-nutrition.

[alophysio]

I agree with the above - you should get a physio assessment.

The periodic muscle spasms are compensations for something else during your walking - the most obvious culprit as you say is the big toe however it may not be...for example why is your big toe the only joint with arthritis?? Perhaps there is something else causing you to put pressure on the big toe in a certain way that is causing the inflammation in the joint...

Find someone who can check your pelvis and thorax as it seems someone has looked at your feet and neck. My bet is that either your ribs or lumbopelvic region is dysfunctional... the trick is finding out which is the key driver of all the different dysfunctions you have - that is, when you address the key driving force, all the other dysfunctions improve.

Good luck!