As a sports chiropractor I see people with low back pain, who have been misdiagnosed daily. More often than not the cause of the back pain is misdiagnosed due to the fact that the symptoms and severity of lower back pain vary greatly. Another source of misdiagnosis is the fact that orthopedists, and MD’s focus their evaluation and diagnosis based purely on the area of the symptoms presentation. If you have a back pain, they only look at the back and completely fail to evaluate the cause of the back pain. At Chiro-Health, Inc, a San Francisco sports and chiropractic clinic we see patients who are young and active and have back pain. They have already been evaluated with x-rays, MRIs and those come negative for any deformity, degeneration, disc problems, and joint problems. So the question is why these patients still have back pain if there is nothing wrong with their backs? Shoe Inserts/ Orthotics for Low Back pain is often the answer.
The chiropractors at Chiro-Health, Inc go beyond evaluating the patient symptoms and try to find the cause of these symptoms. With low back pain we do that by evaluating the whole lower extremity kinetic chain which includes foot, ankle, knee, hip and lower back. In most cases where the patient complains of low back pain we find that the problem is in their feet. Hyper pronation or decrease in the arch of the feet will cause strain in the lower extremity and torque in the lower back. It will also decrease the shock absorption during walking, running, weight lifting, or other sports activities. These changes are functional and go unnoticed on MRI and x-rays.
Identifying the true cause of the problem will warrant completely different treatment. So instead of treating the low back pain, we need to treat the over pronation of the feet. Custom orthotics seem to be the answer in this case.
Research on shoe inserts/orthotics for low back pain
A 2013 study published in the Journal of Manipulative Physiological Therapy investigated the use of foot orthotics in a 62-subject group with chronic non-specific low back pain resulting from a work-related injury.1
This study split the 62 subjects into two groups that compared “usual care” versus usual care plus customized foot orthotics. The “usual care” consisted of a 6-week exercise therapy program and prescription analgesics. The study found that at the eighth week, the group receiving both usual care and foot orthotics reported greater improvement than the group receiving usual care alone.
While some of the finer points of whether foot orthotics provide a measurable benefit for specific low-back conditions remain unanswered by the current medical literature, there is considerable evidence that use of foot orthotics can benefit many patients experiencing low back pain as well as those suffering from a number of foot and ankle conditions.
In many patients the degree of overpronation is different from right to left foot. Over the counter orthotics will help with improving the arch support, and shock absorption, and you may feel better for a while, however it does not address the difference in the arches. So the dysfunction remains and the stress on the joints persists, but the symptoms are delayed. We always recommend that you seek the help of experienced chiropractor to get fitted with custom orthotics. Be cautious when using podiatrists for sports and functional orthotics. Most deal with foot related problems such as arthritis, bunions, ingrown nails, hammer toes, rather than with functional problems. The cast needs to be functional and be made in seated and standing position. Most patients will also need two different type of orthotics, one for their sports shoes and one pair for dress shoes.
For more information on back pain and orthotics go to Chiro-Health’s, Inc You tube channel. For questions or phone consultations you can e-mail Dr. Amelia Mazgaloff at , call Chiro-Health, Inc at (415) 546-1461 or visit http://www.chirohealthsf.com/services/.
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