In my 20 plus years as a foot doctor, I’ve been asked many times…

If custom orthotics can help relieve low back pain. My answer has always been a guarded yes.

While there aren’t many definitive studies that support this answer, many of my patients have anecdotally pointed out that since wearing custom orthotics, their back pain has been relieved.

Foot orthotics can theoretically help patients with back pain because they help realign how the feet articulate themselves on the ground, which in turn can affect the body’s entire overall posture and gait.

In a person with normal foot arches, if you drew an imaginary line down the tibia (shin bone) to the foot, this line will pass between the big toe and second toe. However, in a person with either flat or excessively high foot arches, the foot and ankle pronate (roll inward). This imaginary line will pass through the inside of the big toe instead.
In people with pronated feet and ankles, the bearing of body weight shifts to the outside of the foot, which can lead to painful bunions, among other problems.

Pronated feet and ankles can also cause the knees to turn inward in a knocked-knee stance, medically known as genu valgum. This abnormal placement of the knees then forces the femur (thigh bone) to angle inward from the hips, medically known as coxa vara.This faulty angulation of the hips and knees then destabilizes the pelvis, affecting the overall posture and spine. The result is a domino effect that starts at the feet, works its way up the leg and into the pelvis and spine.

Walking and standing with the feet, legs, hips, and spine constantly out of alignment can contribute to back pain.

The use of foot orthotics that realign the rear of the foot to prevent foot pronation may help stop this domino effect from occurring.

Foot orthotics can help manage low back pain by improving and stabilizing the position of the feet which, in turn, improves every aspect of a person’s gait. The medical term for this phenomenon is called the kinetic chain. The feet represent the base of the kinetic chain, and each subsequent joint above the feet can be considered a “link” in the chain – which goes all the way up the trunk of the body.

During the process of walking, if the feet are pronated at each step, the rest of the kinetic chain is negatively affected. Use of custom foot orthotics can theoretically correct foot pronation, which can help realign the ankles, knees and hips into an optimal position during walking and standing.

Written by Dr. J. Mari Adad, Podiatrist