Orthotics...for back pain?

By Dr Sonya Hamilton, BSc MSc DC

Believe it or not, your feet can be a factor in the development of chronic low back pain. Your feet act as a very important foundation for your body, and can dictate how you adapt to stresses and changes in activity. Your feet strike the ground and propel you forwards, and faulty foot biomechanics can result in pain and dysfunction in other joints and structures in the body. If you think of your body as a kinetic chain from the ground up, your weight-bearing feet and ankles function as shock-absorbers for the whole body. If your feet are not working effectively at this job, the shock and stress makes its way up the biomechanical chain in your body. This concept often gets lost in translation, and people do not always understand the missing link between the feet and the back. 


The most common offending foot dysfunction leading to back pain and other issues is over-pronation, or the inward rolling/dropping of the arches. As the foot over-pronates, the feet become flat and therefore absorb less shock when you walk or run. The rest of your body is then forced to compensate for faulty foot mechanics; your pelvis may slightly drop, your knees may rotate, and you may develop a slight lean. Over time, this adaptation may lead to the development of pain in other areas of the body such as in the back, neck, knees, hips, Achilles tendon, and plantar fascia. In one study, it was found that women with flat feet are almost 50% more likely to develop low back pain.  

When faulty foot mechanics are a factor in low back pain, one way to approach is to consider supporting your foot as you walk or run. When I see patients with chronic back or hip pain that are not responding to treatment and exercise recommendations, I often look to the feet as a possible solution. Using foot orthotics to support your feet can help you with foot pain, and they can change the way your whole body moves and adapts.

Orthotics have been shown to be beneficial for low back pain in a number of studies on groups exposed to higher levels of foot stress (such as in runners, military recruits, and golfers). The idea behind using orthotics for back pain- as your feet are better supported, your body becomes more balanced as you stand and walk. Eliminating imbalances in your feet will cause a ripple effect up the biomechanical chain in your body. Studies show that people suffering from chronic or re-occurring low back pain tend to respond very well to custom orthotics within 6 weeks of wearing them. So if you have been suffering from low back pain which continues even after a course of conservative care/exercise, consider taking a look to your feet as another part of the puzzle.