Back Pain

About 80% of people are affected by back pain in this country at one time or another in their life. The prevalence of back pain occurs between the ages of about 35 and 60. It is approximated that around 4% of these people who develop back pain will continue to have chronic back pain. Patients with low back pain may have postural asymmetry, which can be described as the malalignment of one part of the body, and as a result the other part of the body will become malaligned trying to compensate for the originally unbalanced segment. Postural asymmetry may cause an excessive amount of tension and tightness in various muscle groups such as the hamstrings and back extensors. On the other hand, postural asymmetry will decrease the tension and cause weakness of the nonpostural muscles, such as the abdominals and glutei. One of the main causes of lower back pain is attributed to the positioning of the pelvis during gait (walking), and is often correlated with foot malalignment.

If our normal way of walking tends to be painful, our body will adjust itself to prevent pain in that specific area and shift the pressure and strain to another. Our bodies are like a chain, so for instance, if our big toe becomes painful due to arthritis, then we will stop bending the joint while we walk. This will cause additional stress to the ankle joint, which will then affect the knee, the hip, and then make its way to the lower back. As you see, everything is connected, just as the song states, “The leg bone’s connected to the thigh bone, and the thigh bone is connected to the knee bone,” and so on.

Causes of Back Pain

Back pain can be attributed to various foot deformities and problems. These include such problems as a limb length discrepancy, which is the actual shortening of one leg compared to the other and excessive foot pronation, which is “flat feet.” With limb length discrepancy one side of the body will take up more of the weight with walking, and with excessive pronation, there is a forward tilt of the pelvis (hip), which in turn causes the curvature of the spine to increase and strain the muscles and ligaments in the lower back.

Another cause of back pain could be that one foot is rolling in or out more significantly than the other during gait and this would also increase the curvature through the lower back and cause the pelvis to tilt towards one side. This can lead to scoliosis (curving of the spine), and places stress and strain on the associated muscles and ligaments of the back. As mentioned above, arthritis and other pains in our joints and feet can cause us to begin walking in a certain way to prevent that particular area from hurting, but in turn we start adding additional stress and strain to other areas. We begin to protect the joint in our big toe because of the arthritic pain we feel with walking, so we no longer bend it with walking, adding more stress and strain to the ankle joint, which will eventually find its way to the lower back.

Treatment of Back Pain

Various treatment options include following up with your podiatrist for a biomechanical assessment to determine if you may have some of the problems discussed such as limb length discrepancy or excessive pronation. Insoles can be used in attempt to control the abnormal motion of the foot and keep them balanced, resulting in stabilizing the pelvis and correct distribution of stress and strain to the spine. The use of heel lifts in the shoe can help correct the pelvic tilt and the correct arch supports can assist with flat feet (pronation).

If you have Back Pain and are experiencing and foot problem immediately consult your foot doctor.

This material is only provided as helpful information and you should always go to your medical doctor or podiatrist for a professional diagnosis.