Low back pain can have many causes, but one of the most overlooked factors might be right at your feet. 

As physical and occupational therapy providers, we don’t only examine your back, we also evaluate your footwear and your gait (the way you walk). For many first-time patients, this can be surprising. However, it’s essential to understand this truth: your shoes can indeed contribute to back pain.

The body operates as a connected system. Your feet, knees, hips, and spine are all linked. When you walk, 2 to 5 times your body weight travels through your spine. If your foot mechanics are off, that stress travels upward. Even subtle changes in how your foot rolls, absorbs shock, or pushes off can create abnormal forces that impact your knees, hips, and lower back.

Take a look at the soles of your shoes. If the outer part of the heel is worn out a little, it may be normal, but too much may be abnormal. If there is wear at the inner pair of balls of the foot, it’s a sure sign of abnormal pronation.

What Is Pronation? Pronation occurs when the foot rolls inward as you step on it. A certain amount of this is normal. But if it gets excessive while standing or pushing off when walking, abnormal forces can go up to the spine, causing back pain. Some heavily cushioned shoes can actually worsen this issue. Supportive walking or running shoes with multi-density soles are often better options, as they help control motion and improve alignment.

Flat feet, also known as excessive pronation, are a common cause of low back pain. Athletes, in particular, are especially vulnerable due to the repetitive stress placed on their bodies.

You may be overpronating if:

• You have calluses along the inside of your big toe.
• Your big toe angles inward toward the second toe.
•  Your arches noticeably flatten when standing.

When Changing Shoes Isn’t Enough

Sometimes, upgrading your footwear resolves the issue. It’s the simplest and most affordable fix. However, if pain persists, custom orthotics may be recommended. They are custom-made inserts worn inside the shoes that change the way the feet interact with the ground.

A Word of Caution:

High heels may look attractive, but they shift your center of gravity forward and increase stress on the spine. Wearing them occasionally is acceptable, but daily use can contribute to ongoing pain.

Additionally, if your shoes are old, compressed, or unevenly worn, it’s time to replace them. Worn-out footwear doesn’t provide adequate support and can actively contribute to pain.

So if your back hurts, check your shoes. Sometimes addressing the foundation is all it takes to eliminate the problem entirely.

Our goal is not just to treat symptoms; we aim to identify the true source of your pain. If you’re experiencing back pain, schedule an evaluation with us. A simple footwear or gait correction could make all the difference. Your pain relief is our victory.