Most chronic low back pain is the result of some form of structural weakness or failure.2
If leg or foot asymmetries or misalignments exist, abnormal forces can interfere with spinal function and contribute to health concerns all along the kinetic chain—especially the generalized condition of “back pain.”3
Reduce back pain with orthotic support
The following conditions can have a major impact on lumbar spine function. In each case, orthotic supports can decrease external forces and contribute significantly to a cost-effective treatment outcome:
- Excessive pronation and/or arch collapse. Torque produces internal rotation stresses to the leg, hip, pelvis and low back.4 The result is recurring subluxations and eventual ligament instability affecting the sacroiliac and lumbar spine joints. These forces can be decreased significantly with the use of custom-made functional orthotics.
- Degenerative changes in the lumbar discs and facets. The external force of heel strike can aggravate and perpetuate low back pain. This force is easily reduced with the use of shock-absorbing shoe inserts or orthotics that contain viscoelastic compounds.5 The reduction in symptoms is often dramatic.
- Anatomical difference in leg length. This produces abnormal structural strains on the pelvis and low back, which can cause chronic pain and can result in specific degenerative changes.6-8 Lifts and orthotics have been shown to reduce these structural strains and bring about significant response.9
The Archives of Physical Medicine and Rehabilitation reports that Foot Levelers custom orthotics “significantly improved back pain and dysfunction.” Patients treated with custom orthotics and chiropractic had a 40.4 precent reduction in low back pain.
Use self-scanning technology to improve outcomes and income
Using technology in your practice not only helps with your assessment process, but also gives patients the “wow” factor. The 3D digital foot scanner has become integral to the in-take process in many practices, analyzing patients’ feet for structural imbalances which can cause imbalances throughout the body.
Digital foot scanners also send orders for custom orthotics instantaneously, for quicker turn around. Finally, the images on screen and detailed reports of findings are excellent educational tools.
Even if a particular patient decides not to invest in custom orthotics, the printed reports of findings they take home is professional and reminds them of their eye-opening chiropractic experience, generating discussion with family and friends.
3D imaging is the fastest, easiest, and most accurate way to capture images of your patients’ feet, but in a busy practice, some doctors wonder if they will have time. Now getting patients info custom orthotics is even easier with self-scanning technology, which empowers patients to scan themselves as they wait for their chiropractic appointment.
When patients scan themselves, orthotic usage increase
It also saves staff time. Doctors who have already integrated self-scanning technology into their practices have seen orthotic usage skyrocket, some by as much as 100 percent. Better outcomes for patients, better income for the practice.
Kristina (Kris) L. Petrocco-Napuli, DC, MS, is currently an associate professor at National University of Health Sciences-Florida. She is a graduate of New York Chiropractic College, and also received her master’s degree in instructional design development and evaluation from Syracuse University. She is frequently sought after as a national speaker and has a strong interest in clinical and educational research. Petrocco-Napuli can be contacted at drkrispn@icloud.com or on Twitter @drkrispn.
References
1 Cambron J, Dexheimer J, Duarte M, Freels S. Shoe orthotics for the treatment of chronic low back pain: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation 2017. dx.doi.org/10.101 /j.apmr.2017.03.0282 Fulton M. Lower back pain: new protocols for diagnosis and treatment. Rehab Management 1988; Nov/Dec:39-42.
3 Keane GP. Back pain complicated by an associated disability. In: White AH, Anderson R. eds. Conservative Care of Low Back Pain. Baltimore: Williams & Wilkins, 1991:307.
4 Hammer WI. Hyperpronation: causes and effects. Chiro Sports Med 1992; 6:97-101.
5 Light LH, et al. Skeletal transients on heel strike in normal walking with different footwear. J Biomechanics 1980; 13:477-480.
6 Giles LGF, Taylor JR. Low-back pain associated with leg length inequality. Spine 1981; 6:510-521.
7 Friberg O. Clinical symptoms and biomechanics of lumbar spine and hip joint in leg length inequality. Spine 1983; 8:643-651.
8 Giles LGF, Taylor JR. Lumbar spine structural changes associated with leg length inequality. Spine 1982; 7: 159-162.
9 Hoffman KS, Hoffman LL. Effects of adding sacral base leveling to osteopathic manipulative treatment of back pain: a pilot study. JAOA 1994; 94:217-226.
