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Lower Back Pain – Are Your Shoes to Blame for Spinal Stenosis Symptoms?

shoes and back pain from spinal stenosis

Love your spine? Don't wear these shoes.

When lower back pain strikes it might be tempting to think that a disc herniation, spinal tumor or other such calamity has occurred. However, have you considered the idea that your shoes may be to blame for your spinal stenosis symptoms?

Anyone with a job that entails standing for long periods of time, or who regularly has to carry considerable weight at work or at home is particularly vulnerable to the effects of poor footwear. Read on to find out how shoes affect your spine and what makes for good footwear to avoid back problems like spinal stenosis.

How Shoes and Back Pain Are Connected

Anyone working in retail knows the agony of standing all day in a pair of ill-fitted shoes that pinch the toes, rub at the ankle and flatten the arches to cause plantar fasciitis. Connecting backache, and even neck ache to your shoes might not be quite so obvious, however, but the wrong kind of shoe can increase stress on the vertebrae, destabilize the spine and cause fatigue and wear in the muscles and ligaments supporting the spinal column. Over time the ligaments may thicken and bone spurs may grow in an attempt by the spine to restore stability when tottering daily on high heels. Poor footwear may also cause discs to bulge and herniate and spinal stenosis may arise, leading to back pain and radiating pain in the legs or even down the arms into the hands.

Shoe Choice and Spinal Stenosis

It’s not just excessively high heels that can cause back problems; totally flat shoes providing no arch support and the new fitness trend for shoes that separate out the toes can also trigger a cascade of problems in the spine. Some shoes can cause immediate back pain, trigger old injuries to begin hurting again or cause chronic symptoms over time by triggering degeneration of spinal tissues and collapse of the vertebral space or osteophyte growth in the foramina. Shoes affect the way we walk, the way we stand and how much stress is put on the spine as we go about our everyday activities.

Gait Analysis and Back Pain

A natural gait involves the heel touching the ground first as we step, with the foot’s arch then rolling inwards (referred to as ‘pronation’), then the ball of the foot and the toe make contact and these then provide the momentum to push off the ground again. Those wearing shoes that affect the gait may have either underpronation or overpronation, the former being where the arch of the foot does not roll far enough inward, causing excess shock to the spine, and the latter where the arches roll too far inward, causing the lower body to rotate inward. Both of these result in excess strain on the back and may contribute to spinal stenosis through degenerative changes over time.


Overpronation and Underpronation

Having a gait specialist analyze the way you walk can save you a whole lot of suffering with back pain later in life. Those who exhibit underpronation usually have inflexible, high arches and can require significant cushioning in their choice of footwear in order to absorb the shocks that their inflexible feet do not absorb. Wearing very flat and unsupportive shoes, such as ballet flats or moccasins can lead to severe strain on the feet and the spine in those that tend to overpronate, leading to painful plantar fasciitis and possible sciatica. These ‘flat-footed’ people may require orthotic support or orthopedic shoes to help restore stability to the gait and avoid twisting and back strain.

Flats and Spine Pain

Ballet flats are a particularly poor choice of footwear for anyone with back pain, knee problems or hip pain. They should not be worn regularly unless orthotic inserts are used to provide some arch support and cushioning. Custom-made orthotic inserts are ideal but over-the-counter heel pads and shoe inserts can also help for occasional use. Health insurance may cover some patients’ orthotic inserts, especially if the patient has existing back problems.

Flip-Flops and Back Pain

Just as ballet flats are terrible for the feet and the spine, so are flip-flops. These also expose the feet to the detritus of the street and are particularly risky for those with diabetes and other conditions that can cause poor healing of the extremities. The peculiar gait necessary to keep flip-flops on the feet causes problems with the back, knees, hips and the feet themselves and such footwear should be avoided for anything other than incidental use at the pool.

Minimalist Shoes and Barefoot ‘Orthotics’

Minimalist shoes have become popular with some runners and fitness fanatics but the purported benefits of these shoes have been oversold. Although the shoes claim to mimic natural barefoot mechanics they offer no support for the feet and those that separate the toes can adversely affect balance and gait, causing excess strain on the feet, lower limbs and the spine.

High Heels Hellish for the Spine

No round-up of shoes bad for the back is complete without mention of the dreaded stiletto. These narrow-heeled shoes are highly likely to cause a raft of health complications, including leg strain, hip strain, back pain and even conditions such as hammertoes and bunions. High heeled shoes put all the stress on a single point of the foot and every step shoots that stress right up the spine. The body has to work incredibly hard to absorb this stress and balance the body and this can lead to fatigue, wear and tear and premature degeneration of the discs, ligaments, muscles and bones in the spine. Anything over a two inch heel is advised against and even lower heels should only be worn very occasionally as these too can destabilize the spine.

Avoiding Lower Back Pain

Lower back pain has a variety of inherited causes, including congenital spinal stenosis, as well as environmental and lifestyle causes and idiopathic origins, many of which are difficult to avoid or impossible to ameliorate. Your choice of footwear offers a daily opportunity to do right by your spine so next time you have back ache after a long day standing at work consider whetheryour shoes are to blame for your lower back pain.

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  1. […] and make sure your shoes aren’t the real cause of your back pain after wandering around sightseeing all […]

  2. […] down. The buttocks appear to be stuck out when excessive lordosis is present and those wearing high heels can see this accentuated even further. […]

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