The body is an efficiently-connected system, from top to bottom, and any misalignment in one part of the body has an impact on the other parts. The feet for instance, are the bottom link in a ‘kinetic chain,’ and anything that negatively affects this link will be felt in other links. Women who wear heels, for instance, often suffer lower back pain in addition to pain to the feet, because the heels cause a forward leaning posture which places stress on the spine. High heels cause the pelvis to arch forward, causing sway back, which places extra stress on the lower back. The hyperextension of the muscles of the lower back or calves to compensate for the misalignment caused by wearing heels to keep the head straight, leads to chronic lower back pain.
Another foot-related cause of lower back pain is that suffered by joggers and runners. Shoes without adequate cushioning to mitigate the effect of shock waves from feet pounding against the ground traveling up the leg to the spine can cause stress to the lower back. If shoes don’t provide proper support to the feet, this can also lead to imbalances between the feet and legs, or improper posture, which can also result eventually in lower back pain.
Just how in general do shoes relate to back pain? When walking, there is a normal inward roll of the foot, called pronation, which is necessary to help the foot absorb the shock. Pronation, as a process, is the interval between the time the heel of the foot makes contact with the ground until the toe is lifted. Some people underpronate; that is, the foot doesn’t roll inward enough to adequately absorb shock; while others overpronate, or roll their feet inwards too much causing excessive internal rotation of the knee and lower leg, stressing the entire lower body.
While pronation is essential to absorb shock, even proper pronation will not absorb all of the shock from the foot striking the ground, and improper pronation absorbs even less. Improper footwear can only aggravate the situation, increasing the risk of developing chronic lower back pain in addition to problems with the legs, knees, and ankles.
Shoes need to be adequately cushioned to assist in absorption of shock from the feet hitting the ground, especially on hard surfaces or when walking great distances. For people who underpronate, cushioning is extremely important, but it is essential that shoes not have too much cushioning, which can reduce the shoe’s stability and make the situation worse.
Arch support works to prevent the feet from excessive rolling or overpronation, as does adequate heel support. To minimize lower back pain from improper footwear, there is need of an appropriate combination of cushioning and support based on the size and shape of the feet, and on the walking style.