Foot Pain, Scoliosis, and Pelvic Misalignment: A Holistic Approach

Frequent dislocation of foot bones + pelvic tilt + scoliosis + leg length discrepancy?

Hello, Doctor! I am 19 years old.
During the summer vacation two years ago, I wore slightly high sandals while going out.
Although I felt a prickling sensation, I thought it was due to a foreign object in my shoe, so I didn't pay much attention.
However, a few months later, I started experiencing severe pain, and my big toe could not bend normally (when I try to lift it, the big toe does not move and is very painful).
I visited an orthopedic department at a major hospital, and they diagnosed me with avascular necrosis (the X-ray showed irregularities in the bone, corresponding to the prickling sensation).
Initially, surgery was recommended, but my family took me to a massage therapist who said it was just tightness in the calf (near the upper bone, I’m not sure how to describe it, but it’s along the area below the knee).
After some stretching, I felt a bit more comfortable, but after a while, the pain returned (and there is noticeable swelling at the top of the big toe, which hurts when walking).
Additionally, my ankle or the top of my foot tends to dislocate about once a week...
even if I manage to pop it back in, just running a little, dancing, or even walking causes it to dislocate again...
making it impossible for me to exercise or walk with confidence (I wear an ankle brace).
Also, due to my field of study, I need to write frequently, which has led to persistent tendonitis in my right wrist (I have tried heat therapy and massage), but it recurs shortly after (I wear a wrist brace and take breaks while writing).
Furthermore, I have a leg length discrepancy (my left leg is about 1 cm shorter), and I have previously sprained my right ankle, though I’m not sure if that has any related effects.
Additionally, I have an S-shaped scoliosis (13 degrees to the left at the top and 20 degrees to the right at the bottom) and a pelvic tilt issue.
What should I do to improve my situation? Thank you, Doctor, for taking the time to respond!

Niming, 10~19 year old female. Ask Date: 2015/12/30

Dr. He Yujun reply Traditional Chinese Medicine

Frequent dislocation of bones can be attributed not only to poor posture but also to constitutional issues.
Qi deficiency can lead to weakness in muscles and ligaments, resulting in inadequate stabilization of bones, which may dislocate with minimal exertion.
Yin deficiency can reduce the secretion of synovial fluid in the fascia and joints, leading to increased wear and tear.
Leg length discrepancy is often caused by pelvic tilt, resulting in a three-dimensional positional deviation rather than true leg length differences.
Scoliosis can be more problematic; if the curvature is excessive, it may compress internal organs, and surgical correction might need to be considered.
Based on the symptoms you described, it is advisable to consult a professional physician for a personal examination.
The focus should be on internal medication to adjust the constitution, strengthen muscle and ligament integrity, reduce skeletal stress, and complement treatment with acupuncture and chiropractic care.

Reply Date: 2015/12/30

More Info

Your situation involves a complex interplay of foot pain, potential skeletal misalignments, and muscle tightness, which can significantly affect your overall mobility and quality of life. Given your age and the variety of symptoms you are experiencing, it is crucial to take a holistic approach to address these issues effectively.

Understanding Your Symptoms
1. Foot Pain and Toe Dysfunction: The pain in your big toe and the inability to flex it properly could be indicative of a condition known as avascular necrosis, where the blood supply to the bone is compromised, leading to bone death. This can result in deformities and pain, especially when pressure is applied, such as during walking or running. The swelling you mentioned could be due to inflammation or fluid accumulation in the joint.

2. Muscle Tightness: The tightness in your calf muscles, as noted by the massage therapist, could be contributing to your foot pain. Tight muscles can lead to altered biomechanics, which may exacerbate existing conditions or lead to new ones. Stretching and strengthening exercises can help alleviate this tightness and improve your overall function.

3. Skeletal Issues: The presence of scoliosis and pelvic misalignment can further complicate your situation. Scoliosis can lead to uneven weight distribution across your body, which may cause compensatory mechanisms in your legs and feet, leading to pain and discomfort. Additionally, having one leg shorter than the other can create an imbalance that affects your gait and posture.

4. Wrist Pain: The tendonitis in your wrist is likely related to repetitive strain from writing, especially if you are not taking adequate breaks or using ergonomic tools. This condition can be exacerbated by poor posture, which may also be influenced by your spinal alignment.

Recommendations for a Holistic Approach
1. Consult a Specialist: Given the complexity of your symptoms, it would be beneficial to consult with a multidisciplinary team, including an orthopedic specialist, a physical therapist, and possibly a chiropractor. They can provide a comprehensive assessment and develop a tailored treatment plan.

2. Physical Therapy: Engaging in physical therapy can be highly beneficial. A physical therapist can help you with specific exercises to strengthen your foot and ankle muscles, improve flexibility, and address any muscle imbalances. They can also provide guidance on proper footwear and orthotics, which may alleviate some of your foot pain.

3. Stretching and Strengthening: Incorporate a routine of stretching and strengthening exercises for both your lower extremities and your core. This can help improve your posture and reduce the strain on your spine and pelvis. Focus on calf stretches, toe flexor exercises, and core stabilization exercises.

4. Footwear and Orthotics: Proper footwear is crucial, especially given your foot issues. Look for shoes that provide adequate arch support and cushioning. Custom orthotics may also be beneficial, particularly to address the leg length discrepancy and provide additional support to your arches.

5. Pain Management: For your wrist pain, consider using ergonomic tools that reduce strain, such as a wrist rest while writing. Ice therapy can help reduce inflammation, and over-the-counter anti-inflammatory medications may provide relief. If the pain persists, further evaluation by a hand specialist may be warranted.

6. Regular Monitoring: Since you have a history of injuries and skeletal issues, regular check-ups with your healthcare providers are essential. They can monitor your progress and make necessary adjustments to your treatment plan.

7. Mind-Body Connection: Lastly, consider incorporating mindfulness practices such as yoga or meditation. These can help reduce stress, improve your body awareness, and promote relaxation, which may alleviate some of the tension in your muscles.

Conclusion
Your symptoms are interconnected, and addressing them requires a comprehensive approach that considers both physical and functional aspects of your body. By working with healthcare professionals and committing to a structured rehabilitation program, you can improve your symptoms and enhance your overall well-being. Remember, patience and consistency are key in managing complex musculoskeletal issues.

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