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Your feet carry you from point A to point B. What is often forgotten is that the way you walk impacts other areas of your body, such as your legs, hips, and back. The entire human body is connected. Your foot structure, the length of your lower extremities, the tightness of your calf muscles, and the way you walk can all affect your back.
Why is this important? A whopping 70-80% percent of people experience low back pain at some point in their life. By gaining knowledge on how the foot affects the back, you can effectively take action to lower the strain on your back.
In this article, you’ll learn all the different ways your foot pain could be causing your back to hurt, and what you can do about it.
Let’s dive in…
1) Flatfeet Can Cause Back Pain
If your arch is collapsed, you have a flat foot structure. Your flat foot can be flexible or rigid. When someone has a flat foot, the body is unable to disperse the forces evenly across the feet when walking. This can cause additional strain to occur in your back.
With a severe flatfoot, comes instability. Your back will naturally take on the additional strain with every step. A study done by Y. Kosashvili done in 2008 examined 97,279 military recruits with mild, moderate, and severe flat feet. They found that the people who had moderate to severe flatfoot deformity had double the rate of low back pain (1). This suggests a correlation exists between the severity of flatfeet and back pain.
Solution
Not everyone needs orthotics. However, if you have a severe flatfoot structure and you notice that your back is often achy, you may want to look into getting orthotics.
Custom orthotics would be ideal, however, they can be costly if your insurance doesn’t cover them. If you are looking for over-the-counter insoles, you should get insoles based on your shoe size.
You should obtain an insole with a firm arch and a deep heel cup so that your heel doesn’t slide. I prefer the Powerstep Protech Insoles. These insoles are supportive and can be worn for 6-12 months. You should remove your shoe liner before placing these insoles in your shoes. They are meant to be worn in athletic shoes but can be worn in slip-on shoe gear as long as they fit.
In addition to wearing good insoles, you will want to make sure to obtain supportive athletic shoes. You can go to a local running shoe store, get your feet measured, and receive recommendations on shoe gear. Your shoes should be stiff on the bottom, and provide your arch with adequate support.
If you have a severe flat foot structure, you should avoid wearing flat shoes with no arch support, as this can make this condition worse.
Related article: Can Flatfeet Hinder Athletic Performance?
2) Overpronation Can Cause Back Pain
Pronation is when the foot collapses when walking. Some people’s feet pronate more than others. Some people experience overpronation in one foot more than the other. Your body pronates to disperse forces throughout the feet and reduce shock.
The problem with overpronation is that due to the instability it causes, your back could be affected.
S. Khamis in his study in Gait & Posture tested this theory in 35 patients. He had them stand on 10°, 15°, and 20° wedges to simulate hyper pronation. What he found was that pelvic alignment was affected in these patients. Standing on these wedges caused the participants to internally rotate their thighs and altered their pelvic positioning (2). This caused malalignment and strained their back.
This occurs because when your legs and thighs rotate inwards, your pelvis tips forward to compensate. This curvature in your back can cause pain over time.
Solution
The solution is to control overpronation. This can be done with orthotics and appropriate shoes.
As I stated earlier, Powerstep Protech orthotics work well to control flatfeet and pronation.
However, if you suffer from severe pronation, you may want to get the Powerstep Pinnacle Maxx Support. This orthotic has good arch support to help with pronation but also has an angled heel post on the bottom that can help with heel stability and overpronation.
3) Over-Supination Can Cause Back Pain
A high arched foot or an over-supinated foot can also create instability and cause back pain. Oftentimes, when people have a high arch, there’s a significant amount of strain occurring in the front part and the back part of the foot. Thus, a lot of the strain can then be transferred into the back.
Solution
Just like in people who suffer from overpronation, people who suffer from supination can benefit from orthotics as well. If your feet are over supinated, you are at higher risk of twisting your ankle or sustaining injuries on the outside of your foot due to excessive pressure on the outside of your feet.
Custom orthotics are ideal for over supinated feet. However, if you’re looking for over-the-counter insoles you can obtain Powerstep Pinnacle High Arch Orthotics. These can be placed directly into your shoes.
4) Limb Length Discrepancy Can Affect Your Back
Most people are born with one foot slightly bigger than the other, and one leg slightly longer than the other. If you suffer from a functional limb length discrepancy, your pelvis tilts creating a functional difference in leg length (3). This can cause back pain due to an imbalance of the pelvis.
Solution
If you suspect you have a limb length discrepancy, it’s best to see your foot doctor to have an exam done. Your doctor will measure your lower limbs and determine if there is a limb length discrepancy. If one limb is >1cm shorter than the other limb, your doctor may suggest a heel lift to wear on your shorter side.
Generally, a small ⅛” lift is used initially, as large adjustments can sometimes cause pain. Once you are used to wearing the ⅛” lift for a few weeks, you can slowly increase the lift. You can buy the Adjustable Orthopedic Heel Lift on Amazon. I like this adjustable lift because you can start with the smallest lift of ⅛” and then slowly increase to the needed ⅜” lift.
5) Shoe Gear Can Affect Your Back
Certain shoes like high heels can cause back pain to worsen. The height of the heel is important. If the height of the heel is excessively high, a curvature of the lower back can occur and can cause discomfort over time. High heels are generally less supportive. This can cause instability in the foot and ankle.
Solution
Wearing smaller wedge platform heels (instead of stiletto heels) can be beneficial to disperse forces throughout the feet. Of course, if you must wear high heels for an event, make sure that the amount of time wearing heels is limited. Especially if you suffer from chronic low back pain.
Read How Bad Shoes Can Cause Foot Pain here.
6) Injuries May Cause Strain on Your Back
Certain injuries, especially ankle sprains can cause significant instability. When you suffer from a severe ankle sprain that disrupts the ankle ligaments, this can impact your balance due to the weakening of the ligaments.
Your balance may never fully be the same after an ankle injury and you may compensate by walking differently. This can cause strain on your back.
Solution
If you suffer from chronic ankle sprains, you may want to speak to your foot doctor about obtaining an ankle brace. I prefer the Zenith Ankle Brace, Lace Up Adjustable Support as this brace provides stability in the ankles and can be worn regularly.
Although other elastic braces may be more comfortable, they may not be supportive enough for your ankle.
7) Equinus Can Affect Your Back
Equinus is when the upward bending of your ankle joint is limited. This can be caused by tight calf muscles and Achilles tendon. A bone growth in the ankle can also limit range of motion of the ankle joint. Most people are unaware that they have equinus, as it is very common.
The body naturally compensates for the equinus by changing the way you walk. Equinus can also cause changes to occur in your knees and lower back. Equinus can cause your lower spine to curve inwards. This is called “lordosis”. Over time, this can cause back pain.
Solution
Stretching exercises for tight calf muscles can be very beneficial. Stretches should be done 3 times daily for a total of 15 minutes at a time. You can check out how to perform stretching exercises properly in this supplemental post.
Conclusion
As you can see, there are many things related to the feet that can affect your back and cause it to ache. Finding solutions to foot pathology that can affect your back is important to reduce the strain on your back. The sooner you fix the issue, the better off you will be.
Do you suffer from back pain from your feet? What did you do to help reduce the pain? I would love to hear your thoughts!
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References
- Kosashvili Y, Fridman T, Backstein D, Safir O, Bar Ziv Y. The correlation between pes planus and anterior knee or intermittent low back pain. Foot Ankle Int. 2008 Sep;29(9):910-3.https://pubmed.ncbi.nlm.nih.gov/18778669/
- Khamis S, Yizhar Z. Effect of feet hyperpronation on pelvic alignment in a standing position. Gait Posture. 2007 Jan;25(1):127-34. doi: 10.1016/j.gaitpost.2006.02.005. Epub 2006 Apr 18. https://pubmed.ncbi.nlm.nih.gov/16621569/
- O’Leary CB, Cahill CR, Robinson AW, Barnes MJ, Hong J. A systematic review: the effects of podiatrical deviations on nonspecific chronic low back pain. J Back Musculoskelet Rehabil. 2013;26(2):117-23. https://pubmed.ncbi.nlm.nih.gov/23640312/
- Yoon KS, Park SD. The effects of ankle mobilization and active stretching on the difference of weight-bearing distribution, low back pain, and flexibility in pronated-foots subjects. J Exerc Rehabil. 2013 Apr;9(2):292-7. doi: 10.12965/jer.130013. Epub 2013 Apr 25.https://pubmed.ncbi.nlm.nih.gov/24278874/
- Barwick A, Smith J, Chuter V. The relationship between foot motion and lumbopelvic-hip function: a review of the literature. Foot (Edinb). 2012 Sep;22(3):224-31. doi: 10.1016/j.foot.2012.03.006. Epub 2012 Apr 12. https://pubmed.ncbi.nlm.nih.gov/22503311/
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