Low Back Pain (LBP) is a very widely known problem all over the world, with an estimated prevalence of 18% of general populations. Treatment of low back pain is difficult since a clear diagnosis cannot be
determined in 85% of patients.
In addition to these well-known risk factors, structural abnormalities such as reduced lumbar lordosis and leg length discrepancy have long been suspected of playing a role in the tendency to low back pain by modifying the loads exerted on muscles and ligaments around the spine.
Foot posture and function have been linked to low back pain, with some researchers claiming that those
with low back pain are more likely to have planus (low-arched or pronated) feet.
Faulty foot postures leading to LBP are also caused by the kinematic interplay of the lower extremity
joints when walking.
The postulated correlation between foot position and lumbopelvic alignment when standing is the
mechanical rationale for suspecting such a correlation. There has long been speculation that there is a link
between poor foot posture and low back discomfort.
Symptoms:
Pronation: It is the movement of the foot from side to side during walking or running. It also happens when you stand for a longer duration.
Overpronation occurs when the foot slides inwards excessively toward the arch.
In contrast, supination occurs when the feet slide outward.
Flat feet: When standing, the whole sole is in contact with the floor.
Plantar Fasciitis is an inflammation of the thick band of tissue connecting the heel bone to the
toes.
When running, standing, or walking, changes in foot arches can affect the lumbar spine acceleration, affecting pelvic alignment and muscle activity of erector spinae and gluteal muscles.
The calcaneus everts while the talus adducts and plantar flexes as the foot pronates during the
early stance phases of walking.
The inferomedial translation of the talus causes an internal rotation of the tibia, which causes the
femur rotation inwards.
There is a strong fibrous connection supplied by the sacroiliac joint, this increases the internal rotation of the femur, resulting in an anterior pelvic tilt.
Wearing inappropriate shoes like heels or tight shoes or shoes that are worn out can lead to
changes in posture leading to LBP.
How is this Diagnosed?
Reduction or changes in the arches of the foot. Gait abnormalities, such as weight-bearing more on one side. Foot pronation while walking can lead to imbalance and cause Low Back Pain. Recent injuries, falls, traumas to foot and ankle joints.
What is the treatment?
Interventions that improve poor foot function may improve LBP prevention and treatment.
Some people may have a “postural-structural-biomechanical” mechanism underpinning their LBP,
in such cases, Physical Therapy could help in improving posture, imbalance, and strengthening of
the back may prove to be highly beneficial.
Foot exercises such as foot pointing inward or outward or stretches of the back would help in
loosening tight muscles and improve strength and stability.
Balance exercises are also proven to improve foot and back overall.
Physical Therapists at Allied Health Solutions can help you in assessing your foot postures and correct
them with the right kind of treatment and improve your quality of life to a great extent.
We can also customize an exercise program that would make strengthening fun and interesting to do every
day.
Reference:
Menz HB, Dufour AB, Riskowski JL, Hillstrom HJ, Hannan MT. Foot posture, foot function and low
back pain: the Framingham Foot Study. Rheumatology (Oxford). 2013 Dec;52(12):2275-82. doi:
10.1093/rheumatology/ket298. Epub 2013 Sep 17. PMID: 24049103; PMCID: PMC3828513.
https://pubmed.ncbi.nlm.nih.gov/24049103/