Custom made orthotics are the solution for many patients suffering lower-back pain resulting from uncorrected foot misalignments
Patients are sometimes prescribed custom made foot orthotics to help relieve pain in the foot, ankle, or lower leg. These shoe inserts are used to correct misalignments or structural dysfunction. They also enable patients to stand, walk, and run with more comfort and ease.
Research shows that custom orthotics can also sometimes serve another valuable purpose for patients experiencing chronic low-back pain.
The connection between the feet and low-back pain
When there is misalignment in the lower leg, structural issues in the ankle or foot, or some other type of dysfunction, this can affect the way a person stands or moves. Over time, continuously engaging in an unhealthy posture or gait in an effort to work around this issue can cause problems in the lower spine. The end result is low-back pain.
An example of this is when a person’s foot is pronated. When this occurs, a larger amount of the individual’s body weight is placed on the outer rim of the foot. Initially, this may cause issues in the ankles or knees. If left untreated, pain may continue upward until it is felt in the lower back.
Before suggesting that patients consider custom made foot orthotics to help reduce low-back pain that originate in the feet, diligent health care providers seek out research to gain trust that this treatment method actually works. In the past, this presented a few issues.
Orthotic/back pain studies
In March 2016, the National Library of Medicine published an article written by researchers from the New York Chiropractic College and the National University of Health Sciences. In this piece, it was noted that there weren’t enough high-quality randomized clinical trials (RCTs) to support the notion that foot orthotics do help relieve back pain.
This can be problematic if you’re a health care professional who strives to offer only evidence-laden treatment options. However, other researchers say that just because there are limited RCTs, it doesn’t negate the fact that many studies are finding the same thing – that orthotics can help ease pain in the lower back.
An example of this is an article published in the International Journal of Athletic Therapy and Training. In this piece, researchers from Old Dominion University in Norfolk, Va., conceded that, when engaging in a comprehensive and systematic search for higher-evidence studies, they only found one RCT and two prospective cohorts that met their criteria.
But they further noted that all of these studies did find that, after seven weeks of use, custom foot orthotics were able to reduce chronic low back pain. Thus, researchers concluded that moderate evidence exists to support using orthotics to ease this type of pain.
Combining chiropractic with custom made orthotics offers better results
Other pieces of more recent research have looked specifically at the impact of foot orthotics when combined with chiropractic care. For instance, in September 2017, the Archives of Physical Medicine and Rehabilitation published a study involving 225 adult participants with symptomatic lower back pain lasting at least three months.
A portion of the subjects received custom shoe orthotics. Others received orthotics combined with chiropractic manipulation, the use of ice or heat packs, and soft tissue massage. A third group received no care at all and served as a control.
After six weeks, all of the participants reported improvements in low-back pain. However, only the combination chiropractic plus orthotics group experienced “significant” improvements in function as well. This suggests that using a combination approach of chiropractic and orthotics offers patients greater benefits.
Custom orthotics versus OTC orthotics
When foot-related issues are the suspected cause of low-back pain, some patients may want to try over-the-counter (OTC) orthotics before being fitted for custom devices. These store-bought shoe inserts are often more appealing because they are less expensive and don’t require an additional doctor’s visit.
While OTC options may offer some low-back pain relief, devices fit to the individual’s foot have the potential to work better since they correct the person’s exact issue or dysfunction, and should support all three arches of the foot. Also, if the patient chooses the wrong insert, it could potentially make things worse. Pain could be increased versus decreased because the insert not only doesn’t fix the problem, but accentuates it instead. Custom made foot orthotics can help patients avoid these types of issues.