Sunday, July 21, 2024
FOOT HEALTH Footwear/Biomechanics

Foot Pain Causing Back Pain: 8 Ways Your Feet Could Be Causing Low Back Pain

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The impact of foot pain extends beyond discomfort in the foot. It can contribute to back pain, a condition afflicting 70-80% of individuals at some point. Foot issues range from overpronation and oversupination to unsuitable footwear and flat feet.

Limb length discrepancies, foot and ankle injuries, equinus, plantar fasciitis, and sciatica further complicate matters. The link between these foot problems and back pain is undeniable.

This article delves into how these factors intertwine and offers insights for pain relief.

1) Overpronation Can Cause Low Back Pain

Pronation refers to the natural inward roll of the foot during walking or running.  Overpronation is an excessive or overly pronounced inward roll. While pronation helps in dispersing forces and reducing shock, excessive pronation can lead to instability affecting the back.

In a study by S. Khamis published in Gait & Posture, 35 patients were made to stand on 10°, 15°, and 20° wedges to mimic hyperpronation. The results showed that this led to internal rotation of the thighs, altering pelvic alignment and causing back strain. 

The inward rotation of the legs causes the pelvis to tip forward. This can cause back pain over time. 

Controlling overpronation preventing pain in the lower back is crucial. This can be achieved using orthotics like the Powerstep Protech inserts.

For severe pronation, the Powerstep Pinnacle Maxx Support, which offers enhanced arch and heel stability, may be more suitable.

2) Over-Supination Can Cause Lower Back Pain

Supination refers to the outward roll of the foot during normal motion, and over-supination is its excessive occurrence, often seen in those with high arches. Over-supination can lead to instability and lower back discomfort due to the strain it places on both the front and rear parts of the foot, with this stress potentially transferring to the back.

For those experiencing supination, orthotics can be beneficial, as over-supination increases the risk of ankle twists and injuries on the foot’s outer side. Custom orthotics are recommended for those with pronounced supination.

Alternatively, over-the-counter options such as Powerstep Pinnacle High Arch Orthotics can be fitted directly into shoes for support.

shoe gear

3) Poor Footwear

Bad footwear, particularly those lacking proper support or with imbalanced designs, can be a contributor to back problems.

High heels, especially with excessive height, can induce a curvature in the lower back, leading to prolonged discomfort. Such shoes often offer limited support, resulting in foot and ankle instability and thus back pain.

Can Platform Shoes Cause Back Pain?

Platform shoes, while appearing supportive due to their uniform height, can also lead to back pain. The rigid sole doesn’t accommodate the foot’s natural flexing motion,  leading to a misaligned walking pattern and consequent back strain.

If high heels are a must for an occasion, it’s advised to limit their wear time, especially for those with a history of pain.

Read How Bad Shoes Can Cause Foot Pain here.

flatfeet

4) Flat Feet 

Flat feet, characterized by a collapsed arch, can be either flexible or rigid. Having flat feet impedes the body’s ability to distribute forces evenly across the feet when walking, potentially resulting in back strain.

A pronounced flatfoot condition brings about instability, with the back absorbing additional stress with each step. A 2008 study by Y. Kosashvili in Foot & Ankle International which analyzed 97,279 military recruits, revealed that those with moderate to severe flatfoot deformities experienced twice the rate of lower back pain, hinting at a link between flatfoot severity and back discomfort.

While not everyone with flat feet requires orthotics, those with significant arch collapse coupled with frequent back problems might benefit from them. While custom orthotics are ideal, they can be expensive without insurance coverage.

As an alternative, over-the-counter insoles tailored to shoe size can be useful. Insoles with a firm arch and deep heel cup, like the Powerstep Protech Insoles, are recommended for stability.

When incorporating these insoles, it’s advisable to remove the existing shoe liner, and while they are best suited for athletic shoes, fitting them in slip-ons is also feasible if they fit well.

Additionally, selecting supportive athletic shoes is essential. Local running shoe stores can offer measurement services and shoe recommendations. Ideally, shoes should have a sturdy base and sufficient arch support.

Avoiding completely flat shoes with no arch support is crucial for those with pronounced flatfoot structures.

In severe cases, foot surgery may be needed. 

Related article: Can Flatfeet Hinder Athletic Performance?

5) A Limb Length Discrepancy Can Cause Foot Problems, Leg Problems and Spinal Pain

Limb length discrepancy refers to a condition where one limb is shorter than the other. It’s not uncommon for individuals to have slight variations in limb lengths, with one foot or leg being marginally longer than its counterpart.

According to C.O’Leary in the Journal of Back and Musculoskeletal Rehabilitation, a functional limb length discrepancy can tilt the pelvis, leading to a perceived difference in leg lengths and potential spinal pain from pelvic imbalance.

For those suspecting a limb length discrepancy, consulting a medical foot doctor in their clinic (office) for an examination is recommended.

If the discrepancy exceeds 1cm, a heel lift might be suggested for the shorter side. Typically, a modest ⅛” lift is introduced first to avoid sudden adjustments that might be discomforting.

Over time, the lift can be gradually increased. Products like the Adjustable Orthopedic Heel Lift available on Amazon allow for such incremental adjustments, starting from ⅛” and potentially moving up to ⅜”.

ankle injury

6) Foot and Ankle Injuries

Foot and ankle injuries encompass damages to the bones, ligaments, or tendons in those areas. Specifically, severe ankle sprains that impair the ligaments can lead to pronounced instability, affecting balance due to weakened ligaments.

Post-injury, one’s gait might change to compensate for the imbalance, potentially placing strain on the back.

For those experiencing recurrent ankle sprains, consulting a foot doctor about using an ankle brace is advised. The Zenith Ankle Brace is a recommended choice for its stability features.

While some elastic braces might offer comfort, they often lack the requisite support for injured ankles.

equinus

7) Equinus and Plantar Fasciitis Can Affect the Back

Equinus is a condition characterized by limited upward flexion of the ankle, often due to tight calf muscles, the Achilles tendon, or bone growth in the ankle.

Plantar fasciitis involves inflammation of the thick tissue that runs across the bottom of the foot. Plantar fasciitis causes arch pain and heel pain.  

Equinus and plantar fasciitis can prompt the body to alter its walking pattern, potentially leading to changes in the knees and a curvature in the lower back known as “lordosis,” which over time can cause back pain.

To alleviate the effects of equinus and plantar fasciitis, stretching exercises targeting the calf muscles are recommended. This will prevent the back problem as well. Undertaking these stretches three times daily, for 15 minutes each session, can yield notable benefits

8) Sciatica

Sciatica, characterized by radiating nerve pain from the lower back down through the leg due to compression or irritation of the sciatic nerve. A problem with the sciatic nerve can be influenced by foot pain.

When the foot experiences discomfort, individuals often unconsciously modify their walking or standing posture to relieve it. These adjustments can result in an imbalanced distribution of the body’s weight, exerting undue strain on the lumbar spine.

Over time, this consistent stress can contribute to the onset of sciatica, underscoring the profound connection between foot pain and spinal nerve health.

To reduce the risk of foot pain leading to sciatica, it’s crucial to address the root cause promptly. Opt for supportive footwear that aligns with the foot’s natural arch and distributes weight evenly.

Regular foot exercises and stretches can maintain strength and flexibility, reducing strain.

Conclusion

In conclusion, the intricate relationship between one’s feet and lower back is undeniable. From the tip of the toe to the heel, foot pain can cascade upward, resulting in lower back issues. At a foot and ankle center, experts can determine the cause of foot related back pain that a patient may be experiencing. Every individual is advised to be proactive, and rather than waiting for symptoms to worsen, they should promptly dial the phone and schedule a physical or medical examination at the first sign of unease.

Armed with a comprehensive understanding of the interconnectedness of the feet and lower back joints, early intervention can pinpoint and address the root cause of discomfort. It’s crucial to remember that every journey starts with a step, so addressing foot issues in the office is essential before they escalate to lower back pain. 

Related article: Can Foot Pain Cause Leg Pain: 11 Common Problems and Solutions

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Vaishnavi Bawa
Dr. Vaishnavi Bawa is a Podiatrist who specializes in treating foot and ankle pathology. LifesLittleSteps mission is to educate the public about foot health in an easy-to-understand manner using evidence-based medicine.
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