But Doc I Don’t Understand How My Feet Have Anything To Do With My Back Pain?

Did you know the body works in a series of mechanical events? This is referred to as the kinetic chain. Or as the old nursery rhyme reminds us…”the ankle bone is connected to the knee bone, the knee bone is connected to the hip bone, the hip bone is connected to the back bone…” you get the idea.

Regional Interdependence

This is called Regional Interdependence. This refers to the concept that seemingly unrelated impairments (or parts of the body) in a remote anatomical region may contribute to or be associated with the individuals primary complaint. This almost answers your question. Your back pain may be coming from a problem in your feet or being complicated by a problem in your feet. Without a full analysis of the whole body you would only be potentially treating part of the problem. 

When we discuss how the treatment of the foot could help in the treatment of the back we are understanding a full examination has been performed and the issues are related. The treatment of poor biomechanics of the foot may include the use of a custom orthotic or insole. The foot is considered to be a movable area but needs to provide stability to the weight bearing joints above. Which makes the treatment of this area difficult. We need to treat for mobility and stability at the same time. Sounds somewhat contradicting. Stay with me and I’ll explain.

Back Pain

You have back pain, you came in for an examination and treatment, then here I go talking about your feet. During the initial examination each patient receives a full body posture and movement assessment in addition to the standard orthopedic and neurological testing. The posture evaluation and movement assessment allow me to see what you can do, what you can’t do or what your brain has forgotten to do. And over time with poor posture, improper movements or lack of training, your body will adapt and change. Muscles will get short or long, weak or strong inappropriately. Movements of changes change, get limited or excessive. 

All of this is leading to mechanical stress and eventually pain somewhere along the kinetic chain. The treatment of joint restrictions (improper ailment or movement) is movement therapy (adjustment, manipulations, mobilizations) and the treatment for soft tissue elasticity problems (too short, too long, too strong, too weak) is stretch, tighten, strengthen or relax. 

The Missing Link... Stability

But here is the missing link . . . what about stability. If the area is meant to move but function to provide stability, then you use the appropriate treatment to create normal movement. However, you may need to use additional treatment to enhance stability. What does that look like in the treatment arena:

Stability is only given after mobility is restored. This is an important rule in treatment and is followed in all top sports medicine treatment regimens. Mobility then stability. 

But wait we’re not done yet. Not to confuse anyone but the brain needs to be connected back to the body after an injury or poop mechanical patterns are developed and restored. This is called turning on the switch, turning on the neurological pathways that allow the continued correct mechanics and patterns of movements.

The Bottom Line

Taking a whole body approach in treatment is the best prevention. A wise professor once told me the number one indicator for a second injury in any area of the body is the first injury!


Have you experienced back pain due to foot issues? What did you do for treatment and rehabilitation? We'd like to hear from you! Feel free to leave any comments in the "Contact Us" page under the "Contact" page. 

Dr. Lori Nuzzi

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