Back pain treatments may have to start at the feet

Aug 19 2011
Parts of the lower body, in particular the ankles and feet, are gaining more attention among healthcare professionals who treat patients with chronic back pain symptoms.

This makes sense, since the feet are tasked with supporting the weight of the entire body, but they have often been overlooked both by patients and doctors baffled by the persistence of some forms of back pain despite trying a variety of treatments.

Chiropractor Mark Charrette, DC, recently wrote on the website of the journal Dynamic Chiropractic that given the role of feet and ankles in carrying the weight and absorbing repetitive forces, insufficient or inadequate support in the lower limbs can easily expose the spine to undue stresses, resulting in strains that may lead to low back pain.

This inadequate support may result in insufficient or excessive joint motion and has been associated with conditions such as plantar fascitis, bunions and dropped metatarsal heads.

Effective treatment for any of these conditions may involve a podiatrist, in addition to an orthopedist and a chiropractor, and may lead to substantial improvements in back pain symptoms and a better quality of life for patients.

Charrette reviewed several studies on the subject and concluded that the use of orthotics may provide significant relief by improving the biomechanics of weight-bearing joints. He cited experts who conducted earlier studies as saying that "the full rehabilitation of the patient with chronic back pain must include reeducation in the optimal use of the spine in walking."

Orthotics are corrective devices that are used to treat conditions such as bunions or hammer toe as they help realign bones and tendons implicated in these deformities. Medical advances have caused orthotics to become available in a variety of forms - from rigid ones that can be worn overnight to soft ones that can be used during the day and fit snugly into the shoe.

According to the Centers for Disease Control and Prevention, more than 65 percent of American adults experience low back at some point in their lives, and most of them are diagnosed with non-specific pain. Meanwhile, Professor David Magee, who specializes in physical therapy at the University of Alberta, estimates that 80 percent of adults suffer from foot problems.