Foot Orthotics for Chronic Low Back Pain

At the time of this article, the medical research appears focused on the assessment of whether or not foot orthotics help alleviate low back pain and improve daily function and quality of life in general, rather than on a specific low back diagnosis.

Many studies covering use of foot orthotics in the treatment of low back pain use the term chronic, non-specific low back pain, sometimes abbreviated as CNS-LBP. This term typically means non-neurologically compromised low back pain—i.e., no nerve-root compression or subsequent focal muscle weakness, muscle atrophy, etc.

Chronic non-specific lower back pain

Chronic non-specific lower back pain generally includes lower back pain resulting from one of several possible conditions, including but not limited to:

• Degenerative disc disease
• Lower back muscle strain
• Disc derangement not pinching a specific nerve root
• Facet syndromes, such as lumbar osteoarthritis
• Sacroiliac joint syndromes, such as sacroiliac joint dysfunction
• Varying degrees of lumbar spinal stenosis (without nerve root impingement, radiating leg pain)
• Likely several more unspecified low back conditions

This definition does not include patients with a diagnosis of herniated disc with nerve root entrapment and active radiculopathy—also known as radiating leg pain or sciatica—as candidates for treatment with foot orthotics. Similarly, it would not be a treatment option for symptoms such as leg weakness, numbness, or foot drop.

Research on shoe inserts for lower 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.¹Ferrari R. Effect of customized foot orthotics in addition to usual care for the management of chronic low back pain following work-related low back injury. J Manipulative Physiol Ther.2013 Jul-Aug;36 (6):359-63. doi: 10.1016/j.jmpt.2013.06.002.

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.