We are bipedal mammals, the only ones that walk, consistently, with the back completely upright. This is no mean feat, moving and walking is achieved through a complex mechanical process. It is worth remembering what we are reminded of in the old children songs; “Dem Bones” – that the toe bone’s connected to the foot bone, the foot bone’s connected to the ankle bone etc. Those connections imply, quite correctly, a dependency on each other. In terms of proper body posture and deportment, proper alignment between the feet, knees, femur, pelvis and spine, known medically as the Kinetic Chain, is a crucial element in avoiding lower back pain.
Non-specific lower back pain is exactly that, non-specific, meaning that no organic reason for the pain and discomfort is usually found. However, the cause of dull, generalised aching in the lower back and feelings of weakness, particularly during standing, is commonly the result of over-pronation (turning inwards) of the feet which then impacts the whole Kinetic Chain. Research has shown that foot orthotics can help correct over pronation. A recent American study carried out amongst lower back pain sufferers showed that the majority had pronated feet and 68% experienced improvement after orthotic treatment.
Imagine a lady’s seamed stocking running down the back of the leg and over the Achilles tendon. Visualise the seam running straight under the heel and over the sole of the foot. Where foot position is correct the seam will end between the big toe and the second toe. Where pronation is occurring it will end on the inside of the big toe and this needs to be corrected to avoid the whole posture being misaligned.
The way a person stands is affected by the architecture of the feet. In cases where the arches are high or virtually non-existent (flat footed) then the feet may turn in. This causes a similar effect in the knees with the result that suffers become what is colloquially termed, knock-kneed (medically; Genu Valgus). Misalignment of the knees skews the way in which the femur locks into the pelvic girdle; a condition referred to medically as Coxa Vara. This can cause forward leaning and poor hip posture. The ultimate consequence of all of this is poor spinal alignment, which of course affects standing and the position of the feet, further exacerbating the situation and indicating that we have come full circle.
Walking upright, with the Kinetic Chain aligned carries no adverse effect for the spine and non-specific lower back pain should not occur. Where it does occur, excluding diagnoses of Sciatic which requires different treatment, people try a combination of different methods. Like the pain, these are often non-specific, therapies although they can also include things like acupuncture and heat treatment, both of which may provide some relief. Where the sufferer feels the treatment works for them, the routine is maintained. Where no positive effect is experienced the routine is discarded. There is now growing evidence that foot orthotics, by working on the alignment of the feet through manipulation, can correct over pronation and put the feet back in proper alignment. Often this is aided by the provision of special footwear insoles designed to compensate for problems with high or low arches. The insoles slot easily in and out of different shoes and trainers providing appropriate support.
If you suffer from non-specific lower back pain or know someone who does foot orthotics from The Foot and Leg Clinic could be the solution you are looking for and appropriate treatment could help alleviate the pain. The evidence strongly suggests that it is worth serious consideration.
