Shoe inserts, or foot orthotics, are sometimes used to treat lower back pain in people who have some type of foot dysfunction or imbalance. The prevailing medical theory is that foot or ankle problems can cause lower back misalignment, or imbalances, which over time can lead to lower back pain.
Custom-made foot orthotics are professionally made devices inserted into the shoe to correct an abnormal or irregular gait by realigning the ankle. Commonly prescribed to reduce certain types of foot and heel pain, these shoe inserts may also be prescribed to reduce lower back pain.
This article focuses on the use of shoe insoles to address lower back pain caused by certain foot dysfunctions.
Theory of Foot Orthotics for Lower Back Pain
Mechanical problems in the feet can negatively affect the way a patient walks or stands, which over time places strain on the lower back, causing pain.
Examples of common foot problems that can lead to an irregular posture and/or walking pattern include:
- Plantar fasciitis, which can lead to chronic heel pain and/or arch pain
- Nerve pain or numbness in the foot (such as neuromas and tarsal tunnel syndrome)
- Bunions and bunionettes (big-toe versus little-toe side, respectively)
- Excessive foot pronation (rolling in) or supination (rolling out)
In general, if a shoe insole can help the patient achieve a healthy posture and gait, this correction can allow the soft tissues in the lower back to heal, reducing pain. Theoretically, any problem with the foot or ankle resulting in a compromised posture or gait can lead to lower back pain, as well as possible pain in other weight-bearing joints, such as the hips, knees and ankles.
It is notable that many people can have one or more of these conditions without any accompanying back pain. However, when back pain is present in a patient with dysfunction in the foot or ankle, it may be possible to reduce the back pain by treating the foot or ankle dysfunction.
Because there are a limited number of nonsurgical treatment options for low back pain, foot orthotics are often a reasonable choice because they are both low-cost and have few negative side effects—the most common of which is tender feet. Foot tenderness also tends to disappear over time as patients gets used to the orthotics.
Foot orthotics are easy to use. Patients simply place them in their shoes and go about their regular daily business of standing and walking. The orthotics’ design in turn helps correct the wearers’ gait in a way that can alleviate their back pain.
Foot orthotics do help provide pain relief for a substantial number of low back pain patients. They also provide a safe, noninvasive, drug-free treatment approach for anyone seeking to reduce reliance on pain medications. Foot orthotics may be used alone or in conjunction with other non-surgical treatments for lower back pain.