👣 Could Your Foot Alignment Be Causing Your Lower Back Pain?

Lower back pain is something most of us experience at some point in life — but what if the problem isn’t actually in your back? At Hip to Sole Podiatry, we often find that the true root of back pain starts lower than you’d expect — in your feet. As a podiatrist, it is one of the most common pathologies I see in clinical practice.

Your foot alignment could be placing stress on your spine and causing those nagging aches and pains in your lower back. Let’s take a look at what the science says and how podiatry can help.

🦶 Why Your Feet Matter for Your Spine

Think of your body like a building. Your feet are the foundation, and if they’re not level or stable, the entire structure above — including your knees, hips, and lower back — can shift out of balance. Over time, this can cause wear, strain, and pain.

Common foot issues like overpronation (feet rolling in) or supination (feet rolling out) can affect how you walk, stand, and move. These little imbalances can create a ripple effect, leading to poor posture and lower back pain.

🔬 What Does the Research Say?

1. It’s More About How Your Feet Move

A large study called the Framingham Foot Study found that abnormal foot movement, especially overpronation, is linked to lower back pain — particularly in women (Dufour et al., 2013). Interestingly, it wasn’t just about having flat feet — it was the way the feet moved during walking that made the difference.

💡 At Hip to Sole Podiatry, we look beyond what your feet look like and focus on how they function.

2. A Small Leg Length Difference Can Cause a Big Problem

Even a small difference in leg length — something you may not even notice — can tilt your pelvis and spine, leading to back pain. One study using advanced 3D imaging found that leg length discrepancies can significantly affect posture and spinal alignment (D’Annunzio et al., 2021).

🧍 We routinely check for leg length differences at our clinic and can offer simple solutions, like shoe inserts, to correct it.

3. Orthotics Can Relieve More Than Just Foot Pain

Custom foot orthoses (insoles) are one of our most effective tools. Many people think of them as a fix for foot pain — but they can also help reduce strain on your lower back. A study found that people using orthotics often reported improved comfort, posture, and reduced back pain (Williams et al., 2013).

👟 At Hip to Sole, we custom-fit orthotics to support your unique foot shape and movement, helping your whole body feel more balanced.

🩺 How Can we Help?

If you’ve been battling back pain and haven’t found answers, don’t overlook your feet. Here’s how we approach it:

✔️ Biomechanical assessments to check how your feet and legs move✔️ Gait analysis to spot abnormal walking patterns✔️ Leg length evaluations✔️ Custom orthotics tailored to your needs✔️ Collaborative care with physios and other health professionals

🌟 Final Thoughts

Lower back pain is complex, but your foot alignment plays a bigger role than most people realise. As podiatrists, we’re trained to look at the whole picture — from the ground up.

If you're struggling with persistent back pain, visit us at Hip to Sole Podiatry. A biomechanical assessment is usually what is required to help treat foot and lower back issues.

References

Dufour, A. B., Riskowski, J. L., Hillstrom, H. J., & Hannan, M. T. (2013). Foot posture, foot function, and low back pain: The Framingham Foot Study. Rheumatology, 52(12), 2275–2282. https://doi.org/10.1093/rheumatology/ket293

D’Annunzio, G., Pellegrini, A., Russo, F., Vadalà, G., Papalia, R., & Denaro, V. (2021). Leg length discrepancy and nonspecific low back pain: 3-D stereophotogrammetry analysis. Frontiers in Bioengineering and Biotechnology, 9, 743132. https://doi.org/10.3389/fbioe.2021.743132

Williams, A. E., Hill, L. A., & Nester, C. J. (2013). Foot orthoses for the management of low back pain: A qualitative approach capturing patient perspectives. Journal of Foot and Ankle Research, 6(17). https://doi.org/10.1186/1757-1146-6-17