Got Foot-Related Back Pain?

Well, you're not alone.  Up to 80% of the developed world suffers from low back pain at some point.  It's the most common pain complaint as well as the most common musculoskeletal reason for an emergency room visit.  A Google search for "low back pain" generates 123,000,000 hits (try it, it's fun!).  And it's not a new phenomenon - there are reports of back pain dating back to 1500 BCE, and Hippocrates and Galen themselves discussed treatments.  Now for some good news - a recent article in Rheumatology, based on the Framingham Foot Study, found that among women, there was a correlation between flat feet and back pain.  So what does all this mean?

Generally feet can be divided into three main types.  The pronated foot is the so-called flat foot, a supinated foot manifests as a high arch, and a neutral foot is somewhere in between.  How bad is a pronated foot?  That is a matter of some debate among doctors, patients, and the shoe manufacturers.  The short story is that pronation is a problem if it's a problem - meaning the foot is painful.  Does it lead to back pain?  Before this study, that was debatable. Now, we have a definitive link between flat feet and back pain in women, although curiously not in men (sorry ladies).  And presumably, if flat feet are linked to back pain, then orthotics may relieve that back pain.  In fact, we know from a study in the Archives of Physical Medicine and Rehabilitation published in 2005, that patients with one leg longer than the other (up to 96% of the population) and back pain, experience relief just from the use of corrective orthotics in the absence of any other treatment.  My patients are well aware of this as they limp into my NYC podiatry office with foot, leg and back pain and dance out with new custom orthotics, and, dare I say, a new outlook on life.

So can custom orthotics solve the global economic crisis, end war, and bring peace and harmony to the universe?  Cure back pain, cancer, impotence and the common cold (not necessarily in that order)?  Well, probably not.  But they can make your feet, and probably your back, feel a whole lot better, and that, my NYC podiatry fans, is a step in the right direction.

See you in the office.

Ernest Isaacson

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