As a Podiatrists interested in the complex mechanics of human movement, I see many clients each week who present with a number of difficult to manage, painful conditions.
One of the most difficult conditions that many of my clients have to live with is low back pain (LBP).
LBP is a highly prevalent problem with about 18% of the worldwide population experiencing this pain daily.
The financial burden (health care costs and productivity loss) of LBP is substantial.
Healthcare expenditure for low back pain in Australia alone was reported to be A$9.17 billion back in 2001.
A complex array of risk factors are known to contribute to the condition, such as increased age, female sex, low educational status, obesity, occupation, and certain psychosocial factors.
The relationship between back pain and the function of the feet has been debated for many years.
As a Podiatrist I often encounter clients coming to see me as a last option, people who are desperate to find some way of helping their LBP.
Also, for many people with LBP, simple things like taking care of your feet and nails become almost impossible when you can’t bend due to back pain!
One of the most effective and widely recommended treatments for LBP is walking.
This gentle form of exercise has long been known to help relieve the pain associated with back problems and encourage mobility and independence.
Walking, however, is a very difficult thing to do when you also have foot or leg pain.
In many situations, our main role as a Podiatrist in managing LBP is to keep our clients' feet and legs pain-free so they can continue their walking as part of the LBP management plan.
Often I meet clients who have been experiencing LBP for many years and upon investigation, we identify a limb length difference.
During stance and walking, a limb length difference will often be compensated for by a change in the level at the hips.
This hip change can then cause a curvature and stress on the lower spine structures that result in LBP.
Another issue I see at the level of the foot that affects LBP is subtalar joint pronation.
What the subtalar joint (the foot joint under the ankle) remains pronated or rolled in, this causes internal rotation of the leg to persist for too long during the gait cycle.
When we walk, a complex interaction of hip and leg rotations need to occur at the correct time to facilitate our ability to move.
When these rotations are ‘blocked’ by an abnormally rotated leg, the rotations required to move our body weight forward need to come from somewhere else and commonly, this can be from the joints in the lower spine.
Optimising the speed and timing of subtalar joint pronation by using appropriately designed foot orthoses can have significant benefits on LBP.
Muscle weakness in your hips and gluteal area (your bottom muscles) can also have a significant effect on the movement in the legs and feet.
If these muscles are weak or are not functioning in the correct sequence or at the right time, the legs and knees can rotate internally and restrict the external leg rotation required during normal gait.
Once again, the low back can then become more stressed as it tries to compensate for these leg changes.
Exercises to improve the strength in the hips, legs and feet are an important part of ensuring the best gait pattern to reduce LBP.
LBP can have a major impact on your ability to earn an income, be socially active and just enjoy your life in general.
The Podiatrists at Complete Podiatry are experts in human movement and we would love to see if we can help you manage your low back pain.
I'm so confident I can help you with your back pain that I'd love to chat with you personally; it's what I'm passionate about!
Just enter your details in the field below and a rough time that you'd like me to contact you & I'll be more than happy to explain how we can help you get the best results!
Yours in helping to build healthy lives from the feet up,
Complete Podiatry, Owner and Principal Podiatrist
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