For many if not most patients with lower back pain, finding a treatment or a combination of treatments that provide effective pain relief is a process of trial and error.

Most available treatments for low back pain do not always result in a favorable outcome for all patients, even when the condition is similar between patients. The same general rule holds true with the use of foot orthotics.

See Non-Surgical Treatments for Lower Back Pain

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.

See Foot Orthotics for Chronic Low Back Pain

Foot Orthotics and the Domino Effect

This process can be illustrated in the following manner. In a person with normal foot arches, if one draws an imaginary line down the tibia (shin bone) to the foot, that imaginary line should pass between the person’s big toe and second toe. However, if one draws the same imaginary line on a person with either flat or excessively high foot arches that cause the foot and ankle to pronate, or roll inward, that line would 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, a condition commonly known as knock-knees. This abnormal placement of the knees then shifts the angle where the thigh bone meets the pelvis, resulting in an unsteady hip posture that also destabilizes the 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.

See Posture to Straighten Your Back

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

Improving the Kinetic Chain

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 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 to the neck.


During the process of walking, if the feet are pronated, or rolled inwards, at each step, the rest of the kinetic chain is negatively affected.

Pronated feet cause the knees to come together into a knocked-knee stance, medically known as genu valgus. This also affects the angle of the hip, forcing the femur (thigh bone) to angle inward from the hip, which is medically known as coxa vara. The faulty angulation of the hips and knees then destabilizes the pelvis, which also affects overall posture and the spine.

Use of foot orthotics can theoretically correct the foot pronation which can destabilize the knees, pelvis, and low back.

Dr. Steven Yeomans is a chiropractor and partner at the Yeomans-Edinger Chiropractic Center. He is board certified by the Academy of Chiropractic Orthopedists and has over 40 years of experience using chiropractic manipulation and pain management techniques to treat patients with spine conditions.

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