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  • Writer's pictureDr. Ndidi Ufondu, DPM

How Can a Podiatrist Help with Low Back Pain?


Low back pain is a very common condition that affects millions of people. While low back pain can originate from the muscles, ligaments, joints, and discs in the lumbar spine, it can also be caused by problems in the feet. As podiatrists, we are experts in diagnosing and treating foot and ankle issues that can contribute to low back pain. In this comprehensive article, we will explore the connection between the feet and low back pain, and how podiatrists can help alleviate symptoms.

How Foot Problems Can Lead to Low Back Pain


The feet serve as the foundation of the body. If this foundation is unstable or unbalanced, it can throw off proper alignment and biomechanics up the kinetic chain. Abnormal pronation (inward rolling of the foot) is one of the biggest culprits of low back pain. Overpronation causes the ankle to collapse inward, resulting in improper alignment of the legs, pelvis, and spine. This leads to altered gait patterns and excess rotational and shear forces on the lumbar spine.

Other common foot issues that can contribute to low back pain include:

  • Plantar fasciitis - Inflammation of the plantar fascia ligament in the foot leading to heel and arch pain

  • Achilles tendonitis - Irritation and inflammation of the Achilles tendon causing pain and stiffness

  • Arthritis - Degenerative joint changes in the feet causing pain and stiffness

  • Bunions and hammertoes - Bony deformities that force the big toe or other toes out of alignment

  • Nerve pain (Morton's neuroma or Baxter's neuritis) - Pinched nerve in the ball of the foot

In addition, leg length discrepancies, where one leg is longer than the other, can originate in the feet. A longer leg often causes pelvic tilt and rotation as the body tries to compensate. Even small differences in leg length (5 mm) can generate low back symptoms.

How Podiatrists Diagnose the Foot's Role in Low Back Pain


Podiatrists are experts at evaluating the foot's role in low back pain. During the appointment, the podiatrist will perform a complete biomechanical exam of the feet, ankles, and legs. This includes:

  • Observation of standing, walking, range of motion

  • Palpation - Feeling for areas of tenderness

  • Neurological testing - Assessing sensations and reflexes

  • Muscle strength assessment

  • Examining foot arches and alignment

  • Gait analysis - Evaluating walking patterns

In addition, the podiatrist may order x-rays or advanced imaging studies to evaluate the structure and position of the feet and ankles. They can also perform computerized gait analysis to precisely pinpoint gait abnormalities. Leg length measurements are taken to identify any discrepancies. By thoroughly examining the feet and lower extremities, the podiatrist can find foot problems that may be transmitting forces up the body and causing low back pain. This allows them to provide specialized treatment targeted at the source of the pain.

Podiatric Treatments to Relieve Low Back Pain


If the podiatrist determines that foot dysfunction is contributing to low back pain, they can provide a variety of treatments to realign the feet, ankles, and legs to alleviate symptoms.


Common podiatric treatments include:

  • Orthotics: Custom-made shoe inserts, called orthotics, help control abnormal foot motion. They support the arches and improve alignment to prevent overpronation. By stabilizing the feet, orthotics can significantly reduce low back pain. Studies show orthotics reduce low back pain by an average of 54%.

  • Physical Therapy: Specific foot and ankle stretches and exercises can strengthen the muscles, improve range of motion, and correct faulty biomechanics. Your podiatrist may recommend physical therapy guided by a specialist in foot/ankle rehabilitation.

  • Padding and Strapping: Placed padding and strapping techniques can optimize foot and ankle alignment. These simple treatments can provide pain relief by correcting biomechanical faults.

  • Footwear Modifications: Your podiatrist may recommend wearing shoes with proper arch support, cushioning, stability, and motion control features. Proper footwear enhances comfort and minimizes strain on the back.

  • Anti-inflammatory Medications: Oral or topical anti-inflammatory medication may be prescribed to reduce inflammation from foot conditions like plantar fasciitis. Resolving inflammation alleviates associated back pain.

  • Orthotic Devices: Braces or splints can stabilize the foot and ankle. Devices like a CAM walker boot or ankle brace restrict abnormal motion and encourage proper positioning.

  • Injections: Corticosteroid injections into inflamed areas in the feet can relieve pain caused by plantar fasciitis, neuromas, tendonitis and arthritis. Less foot pain means less compensatory back pain.

  • Surgery: In severe cases, surgery may be warranted to correct major foot deformities or arthritis. Procedures like bunion and hammertoe surgery can eliminate pain and realign the feet.

By directly treating the foot problem, these podiatric treatments remove the source of the altered forces and movement patterns that lead to low back pain. Most patients experience significant back pain relief by correcting foot imbalances with podiatric care.


5 Key Benefits of Seeing a Podiatrist for Low Back Pain

Seeing a podiatrist for low back pain offers many advantages:

  1. Podiatrists specialize in foot disorders and biomechanics. They are uniquely trained to diagnose foot issues causing back pain.

  2. Podiatrists perform thorough biomechanical exams tailored to back pain. This allows them to pinpoint the foot problem.

  3. They offer customized podiatric treatments to realign the feet to alleviate back pain.

  4. Podiatric therapies like orthotics and physical therapy provide lasting relief by correcting underlying foot imbalances.

  5. Podiatrists take the whole body into account. They alleviate back pain by treating the feet rather than just the spine.

The Takeaway: Give Your Feet Some Love to Relieve Low Back Pain Low back pain can stem from various causes, including subtle foot problems that affect posture and movement patterns. As experts in foot function, podiatrists are specially trained to diagnose and treat foot conditions that contribute to back pain. Through detailed biomechanical exams and customized podiatric treatments, they can realign the feet to eliminate the source of the strain on your back. By properly supporting the feet, orthotics, therapy, and other podiatric therapies provide longer-lasting back pain relief. So the next time your low back is acting up, consider having your feet checked by a podiatrist. Giving your feet some extra love may be the solution to relieving your back pain.


FAQs

  • How common is back pain caused by foot problems? Studies show that in up to 60% of low back pain cases, abnormal foot mechanics play a role. Problems like overpronation are a frequent contributor to back symptoms.

  • When should I see a podiatrist for back pain? You should schedule an appointment with a podiatrist if you have persistent low back pain and notice signs of foot issues like overpronation, plantar fasciitis, or leg length discrepancy. A podiatrist can evaluate your feet and determine if they are causing or contributing to your back pain.

  • What conditions do podiatrists treat related to back pain? Podiatrists commonly treat overpronation, plantar fasciitis, bunions, hammertoes, arthritis, and leg length discrepancy which can all lead to back pain. Custom orthotics and physical therapy for the feet and ankles are typically prescribed.

  • How quickly does treating the feet alleviate back pain? Most patients experience some degree of back pain relief quite rapidly after starting podiatric treatments like orthotics. However, it can take up to 6 weeks to see the full effects as your body adjusts to the orthotics or physical therapy program. Significant long-term improvements are common when foot alignment is corrected.

  • Can surgery on the feet help relieve back pain? In severe cases, foot surgery to correct major deformities or arthritis may be necessary to properly realign the feet and alleviate associated back pain. Procedures like bunion, hammertoe, and joint fusion surgery are options if more conservative treatments are inadequate.



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