Hidden causes of low back pain and sciatica – part 4: your feet

So far in this blog series we have seen that low back pain and sciatica can come from neck problems, ankle joints problems, and chest tightness. There are many more unusual and fascinating causes of low back pain I have seen over the years, however for this article I want to finish off by staying grounded (literally!) and as such we are finishing by discussing the feet again.

I also want to give you some tips on how better to look after your spine and there is a very good chance you have at least one of the problems in this 4 part series.

The fourth ‘hidden cause’ of low back pain and sciatica is foot overpronation.

An issue with the foot which can have knock on effects higher up the kinematic chain giving low back pain or sciatica is something called overpronation. This is where the arch of the foot becomes dropped – this can happen whilst standing or whilst moving. The first signs that this is happening is subtle as the arch will be normal but then drop slightly whilst you are walking or running. This would be called a functional dropped arch as it is happening with movement.

If present in the standing, or static position, this means that the problem has likely been there for a while and the foot arch has become dropped and stuck there (functional to structural dropped arch) either permanently, or until we do something to bring it back up again.

In both scenarios the dropping of the arch causes the foot to turn in slightly, which will in turn cause the femur (thigh bone) to turn in as well. This, over time can really pull on the muscles in the hip and the joints in the lower back and causes problems.

Test time!

Now previously we have had some nice little tests for you to replicate and see what is happening – but this time you can’t really replicate my clinical tests for this easily at home, you will just have to just use your eyes or imagination!

1. Have a little walk or just look at the shape of your feet.
2. Take note of whether your arches in the feet are looking like they are dropping downwards whilst you are walking (indication of a functional drop arch), or if you have been told you have ‘flat feet’ just from someone looking at you when you are still (indicating the functional- to structural dropped arch)

How does this cause low back pain or sciatica?

If you stand with your palms flat on your hip bones on the very side of your thighs about a hands distance below the belt line. Now twist your foot tilting it up towards the ceiling, and then all the way down so the arch points further towards the floor. Slowly roll the foot in and out between these two positions. Can you feel the hip bone moving? With excessive and repetitive movement this can cause pressure and force to build up and cause low back pain and sciatica through either muscular tension or repeated dysfunctional spinal movement patterns.

In clinic if we see this problem is causing a patient low back pain or sciatica, we can treat the joints of the foot, instruct on strengthening exercises, and test for correct insoles which offer support to the arch of the foot. Of course we do that after we treat their back and get them up and running again!

See you in clinic for your next adjustments!

Andrew Harlow – Derby Chiropractor