Low back pain (LBP) is a common issue that affects millions of people globally, causing discomfort, limiting mobility, and decreasing quality of life. While the causes of LBP are diverse, recent research has highlighted the significant role that foot mobility plays in both the development and management of back pain. Foot posture and function directly influence the biomechanics of the entire body, and any misalignment or dysfunction in the feet can radiate upward, impacting the spine. This essay explores the relationship between foot mobility and low back pain, summarizing scientific evidence and explaining how Mancuso Clinic integrates this understanding into our holistic approach to patient care.

Foot Posture and Low Back Pain: Insights from the Framingham Foot Study

A landmark investigation into the relationship between foot posture and low back pain is the Framingham Foot Study, which examined over 1,900 participants. The study found a significant association between foot posture—particularly pronated foot function—and low back pain in women. Pronation, the inward rolling of the foot during movement, can lead to gait imbalances and musculoskeletal strain. These findings suggest that altered foot mechanics contribute to the development of low back pain, particularly in females.

At Mancuso Clinic, we recognize that addressing foot mobility is essential for maintaining body alignment and reducing compensatory strain on the lower back. When the foot posture is misaligned, it triggers a chain reaction of compensatory movements, causing stress on the knees, hips, and lumbar spine. This is why we prioritize evaluating foot posture in patients suffering from low back pain. By correcting foot posture through customized interventions, such as osteopathic manipulation or foot-strengthening exercises, we aim to prevent and alleviate back pain in a way that goes beyond mere symptom management.

The Role of Foot Orthoses in Managing Low Back Pain

A qualitative study explored the use of customized foot orthoses in patients with non-specific low back pain. The study found that orthoses were effective in managing back pain, with many patients reporting significant improvements in pain levels and mobility. The orthoses worked by correcting biomechanical imbalances, particularly in the foot, which alleviated the strain on the lumbar spine.

Flat Feet and Low Back Pain: Targeting the Root Cause

Flat feet (pes planus) are another common cause of low back pain, as demonstrated by a cross-sectional study that found a 65.9% prevalence of low back pain in individuals with flat feet. Flat feet disrupt the normal biomechanics of the legs and lower back, increasing the risk of both acute and chronic back pain. The absence of an arch in the foot reduces the body’s ability to absorb shock during movement, leading to increased pressure on the lumbar spine.

At Mancuso Clinic, we view foot mobility as an essential aspect of holistic care. In cases of flat feet, we incorporate a combination therapeutic exercises, and lifestyle recommendations to improve foot posture and function. This comprehensive strategy not only relieves back pain but also addresses the root cause, allowing patients to regain their mobility and quality of life.

Trunk and Foot Mobility: The Mancuso Clinic Holistic Approach

While much of the focus is on foot mobility, research on trunk mobility is equally important. The Back Performance Scale (BPS), which assesses mobility-related activities in individuals with back pain, includes tests for sagittal-plane mobility—a range of motion essential for functional movement. Foot posture and function influence sagittal-plane mobility, which directly impacts trunk mobility and overall body mechanics.

Why Foot Mobility Matters in Our Holistic Approach

At Mancuso Clinic, our philosophy centers on providing holistic, patient-focused care. We recognize that the body functions as an integrated system, meaning that imbalances in one area can lead to problems in another. For this reason, we pay close attention to foot mobility and posture when treating patients with low back pain. Scientific research consistently demonstrates the importance of foot posture in the development and management of low back pain, whether it be due to pronation, flat feet, or other biomechanical issues.

Our holistic approach involves more than just symptom management. We aim to identify the root causes of pain by thoroughly assessing the entire musculoskeletal system, including the feet, spine, and trunk. By addressing these interconnected areas, we can offer treatments that not only relieve pain but also enhance overall health and well-being. In addition to custom orthotics and mobility exercises, our care plans may include nutritional guidance, ergonomic advice, and stress-reducing techniques, reflecting our commitment to treating the whole person.

Conclusion

Foot mobility plays a crucial role in reducing and managing low back pain. Research demonstrates a clear link between foot posture—such as pronation or flat feet—and the development of back pain. At Mancuso Clinic, we integrate this knowledge into our holistic approach to patient care. By evaluating and addressing foot function as part of a broader strategy, we aim to provide effective, long-term solutions for low back pain. Our goal is to not only alleviate pain but also improve our patients' overall quality of life by promoting better body mechanics and holistic wellness.