Pain from Ankle Injuries: Why Is My Lower Back Hurting?

A tear in the ankle joint can cause pain that radiates to the pelvis and lower back?

Hello Doctor: I was in a car accident on June 9 and went to the emergency room where I had an X-ray of my ankle, which showed no issues with the bones.
However, I have been experiencing severe pain in my knee, pelvis, lower back, and tailbone, making it impossible to sleep.
I went to a major hospital where they diagnosed me with a tear in the medial collateral ligament of my knee and ankle, but the bones were fine.
The attending physician advised me to limit movement for 4 weeks, wear a compression brace for my ankle and knee, and alternate hot and cold therapy.
I have been using crutches for mobility for about half a month.
Why am I experiencing constant severe pain in my pelvis, lower back, and tailbone every day, making it impossible to sleep? I have to take 3 to 4 prescription painkillers to manage the pain, and sometimes the pain relief for my pelvis, lower back, and tailbone is not effective.
Did I purchase the wrong compression brace for my ankle and knee, or is there another issue?

Kola, 30~39 year old female. Ask Date: 2022/06/20

Dr. Chen Bochen reply Orthopedics

Hello, there are many possible causes of pain after trauma, and it is not possible to diagnose based solely on description; a physical examination and imaging studies are also necessary.
However, since you have been experiencing severe pain for over ten days, it is advisable to be more vigilant.
I recommend that you return for an earlier follow-up appointment, where the physician can arrange for more detailed examinations of the painful area, such as a CT scan, MRI, or ultrasound of the affected region.
Wishing you a speedy recovery.

Reply Date: 2022/06/20

More Info

Understanding pain following an ankle injury, especially after a traumatic event like a car accident, can be complex. Your situation involves not only the ankle but also significant pain in the lower back, pelvis, and tailbone area. This multifaceted pain can arise from several interconnected factors.

Firstly, it's essential to recognize that pain is not always localized to the site of injury. The body often responds to trauma with a generalized pain response, which can be exacerbated by muscle tension, inflammation, and compensatory movements. After an ankle injury, you may unconsciously alter your gait or posture to avoid putting weight on the injured area. This compensatory behavior can lead to overuse or strain in other parts of the body, particularly the lower back and pelvis, resulting in pain.

In your case, the pain in your lower back, pelvis, and tailbone could be attributed to several factors:
1. Compensatory Mechanics: After your ankle injury, you might be favoring your injured leg, leading to altered biomechanics. This can place additional stress on your lower back and pelvis as they compensate for the lack of mobility and support from the injured ankle.

2. Muscle Imbalance and Tension: The pain you are experiencing could also be due to muscle imbalances. When certain muscles are overworked due to compensatory movements, they can become tight and painful. This tension can radiate to the lower back and pelvis, causing discomfort and pain.

3. Nerve Involvement: Sometimes, injuries can lead to nerve irritation or compression, which can manifest as pain in areas distant from the actual injury site. If the nerves that innervate the lower back and pelvis are affected, this could explain the pain you are experiencing.

4. Inflammation: Following an injury, inflammation can spread beyond the initial site of damage. If there is significant swelling or inflammation in the ankle or knee, it can contribute to systemic pain responses, affecting the lower back and pelvis.

5. Psychological Factors: Pain perception can also be influenced by psychological factors. Stress, anxiety, and fear of re-injury can amplify the sensation of pain. This is particularly relevant in cases of trauma, where the psychological impact can be significant.

Given that you are experiencing persistent pain that is affecting your sleep and daily activities, it is crucial to follow up with your healthcare provider. They may recommend further imaging studies, such as MRI or CT scans, to rule out any underlying issues that may not have been visible on the initial X-rays. Additionally, a thorough physical examination can help identify any specific areas of tenderness or dysfunction that may require targeted treatment.

In the meantime, consider the following management strategies:
- Physical Therapy: Engaging in a structured physical therapy program can help address muscle imbalances, improve mobility, and strengthen the surrounding muscles, which may alleviate some of the pain in your lower back and pelvis.

- Pain Management: Discuss with your doctor about adjusting your pain management plan. While it may be necessary to use pain medications, exploring non-pharmacological options such as heat therapy, cold therapy, and gentle stretching can also be beneficial.

- Activity Modification: While it is essential to rest the injured ankle, be mindful of how you move and engage in daily activities. Avoid positions that exacerbate your pain and focus on maintaining a neutral spine to reduce strain on your lower back.

- Ergonomic Adjustments: If your pain is affecting your ability to work or perform daily tasks, consider making ergonomic adjustments to your workspace or home environment to support better posture and reduce strain.

In conclusion, while your ankle injury is the primary concern, the pain in your lower back and pelvis is likely a result of compensatory mechanisms and muscle imbalances. A comprehensive approach involving medical evaluation, physical therapy, and pain management strategies will be essential in addressing your symptoms and facilitating recovery. Always consult with your healthcare provider before making any changes to your treatment plan.

Similar Q&A

Understanding Ankle Pain: Causes, Symptoms, and Treatment Options

Hello Doctor: I have been suffering from ankle pain for the past six months. When I squat down and then stand up suddenly, I experience severe pain in my ankle. Whenever I squat with my ankle in a flexed position or kneel on the ground (with my ankle flat), I feel pain when I get...

Dr. Xie Tianjie reply Orthopedics
A woman with bilateral ankle pain who has not experienced any injuries is advised to get an X-ray at the hospital and undergo blood tests. This will help rule out any issues with the ankle bones and surrounding ligaments, and also consider the possibility of gout or rheumatoid ar...

Understanding Ankle Pain: Causes, Diagnosis, and Treatment Options

I previously injured my ankle from dancing and playing basketball. Prolonged standing or walking causes significant pain. The doctor mentioned that overuse has led to joint wear, resembling that of someone in their 40s. Since I work in the kitchen during my military service, I ha...

Dr. Shi Guozheng reply Orthopedics
Ankle joint injuries typically affect the ligaments surrounding the joint, which are present on both the medial and lateral sides. The most commonly injured ligament is the anterior talofibular ligament, often damaged during activities such as basketball when the ankle is subject...

Old Injury or Sciatica? Understanding Your Leg Pain After Exercise

Hello doctor, my left foot used to get sprained often and I didn't rest properly. After graduating from high school, if I avoid intense exercise, my foot feels fine. However, after engaging in vigorous activities, I experience discomfort in my left ankle and left buttock whi...

Dr. Zheng Shunping reply Rehabilitation
In response to your question: If you experience discomfort in your left ankle and left buttock simultaneously after exercise, the possible cause could originate from the left buttock, or it may be due to separate conditions that require thorough examination to differentiate. Addi...

Understanding Ankle Pain After Injury: When to Seek Medical Advice

Hello doctor, I have a question I've been wanting to ask. I was playing basketball with my classmates at school, not in a formal way, just for fun. While trying to grab the ball, I accidentally fell and may have twisted my left ankle. At the time, I had some difficulty stand...

Dr. Xu Yongnan reply Rehabilitation
Please see a doctor for an examination.